双胎妊娠44例妊娠结局临床分析

目的：探讨改善双胎妊娠的产妇和围产儿的预后。方法回顾分析该院2001年1月-2013年10月病案资料，包括双胎妊娠孕妇基本资料、妊娠并发症、新生儿并发症及新生儿结局，数据经统计学处理。结果双胎妊娠女性年龄相对较大，有较高的平均身高和较重平均体重。虽然没有孕产妇死亡，但妊娠并发症均显着较高，其中早产发生率（36.3%），妊娠期高血压疾病（9.1%），胎膜早破（27.2%），贫血（29.5%），产后出血（15.9%），产前出血（6.8%），妊娠糖尿病（11.3%），羊水过多（4.5%），大多数患者有一个以上并发症。只有8%的患者没有任何并发症。剖宫产与阴道分娩相比没有显著减少或增加围产儿结局。产科医生及时有效的判断行紧急剖宫产可有效降低新生儿死亡率及严重并发症的发病率。结论双胎妊娠具有较高的妊娠并发症和新生儿并发症，剖宫产与阴道分娩相比没有显著减少或增加围产儿结局。

Clinical Analysis of Maternal and Perinatal Outcome of 44 Patients with Twin Pregnancy

Objective To explore the measures of improving the maternal and perinatal outcome of twin pregnancy by analyzing the treatment and outcome of 44 puerperants with twin pregnancy retrospectively. Methods The clinical data during January, 2001 to October, 2013 in our hospital, including the basic data of puerperants with twin pregnancy, pregnancy complications, neonatal complications and neonatal outcome, were analyzed retrospectively and treated statistically. Results The results showed that the women with twin pregnancy were relatively older, had a higher average height and a heavier body weight. Although there was no maternal mortality, pregnancy complications were remarkably higher, pregnancy complicated by preterm labor（36.3%）, hypertensive disorders in pregnancy （9.1%）, premature rupture of membrane（27.2%）, anaemia（29.5%）, postpartum hemorrhage （15.9%）, antepar-tum hemorrhage（6.8%）, gestational diabetes（11.3%）, polyhydramnios（4.5%）. Most of the patients had more than one complication. Only 8% patients did not have any complications. Cesarean delivery did not significantly decrease or increase the risk of fetal or neonatal death or serious neonatal morbidity, as compared with vaginal delivery. Timely and effective judgment of the obstetricians for emergency cesarean section can effectively reduce the neonatal mortality and rate of severe complications. Conclusion There are high rates of maternal and neonatal complications in twin pregnancy. Cesarean delivery does not significantly decrease or in-crease the risk of perinatal death or serious perinatal morbidity, as compared with vaginal delivery.