体外受精-胚胎移植术后81例多胎妊娠自然减胎临床分析

目的探讨体外受精-胚胎移植（IVF-ET）术后多胎妊娠的自然减胎率和妊娠结局。方法对2002年6月至2008年9月在我院生殖中心实施IVF-ET术后97例多胎妊娠者进行全妊娠期的追踪随访。结果 97例多胎妊娠者实施选择性减胎术17例,81例（含减胎术前自然减胎1例）多胎妊娠中发生自然减胎24例,自然减胎率为29.6%（24/81）,其中三胎为55.6%（5/9）,双胎为25.4%（18/71）,四胎妊娠1例减胎术前发生自然减胎;自然减胎发生在妊娠前9周为58.3%;自然减胎后单胎分娩孕周和新生儿体重与同期单胎妊娠无显著性差异（P〉0.05）,但显著高于同期双胎妊娠（P〈0.05）。结论多胎妊娠自然减胎后可延长妊娠时间,增加保留胎儿的体重;孕9周后行选择性减胎术可减少选择性减胎术的实施。

Clinical analysis of 81 cases with spontaneous reduction of multiple pregnancies after the treatment in vitro fertilization-embryo transfer

Objective To analyze the incidence of spontaneous reduction in multiple pregnancies and the outcomes of the surviving fetuses after the treatment in vitro fertilization-embryo transfer（IVF-ET）.Methods 97 multiple pregnancies conceived by IVF-ET in our hospital from June,2002 to September,2008 were prospectively analyzed.Results 17 cases out of 97 multiple pregnancies were performed selective reduction,and 24 cases out of 81 multiple pregnancies occurred spontaneous reduction（29.6%,24/81）,25.4%（18/71） in twin and 55.6%（5/9） in triplet and one case in quadruplet respectively.Among which 58.3% cases occurred before 10th week of gestation respectively.Pregnancy duration and birth weight in remaining singleton fetus after spontaneous reduction were similar to that of singleton pregnancy（P〉0.05）,and were significantly longer than that of twin gestation（P〈0.05）.Conclusion Spontaneous reduction of multiple pregnancies was associated with prolonged gestation and higher birth weight for the remaining fetus.Performing selective reduction after 9th week of gestation might reduce the performance of selective reduction and its complication.