多胎妊娠减胎术的临床研究

目的:随着辅助生殖技术的广泛应用,多胎妊娠的发生率显著增高,不良妊娠结局的发生率也随之增高。近20余年来,多胎妊娠减胎术(MFPR)成为改善多胎妊娠结局的一种补救措施。然而由于多胎妊娠的复杂性、绒毛膜性的不同、初始胎儿数目不同,特别是二胎政策下高龄高危孕妇增加,对于减胎的方案、减胎的时机、减胎后的妊娠管理,目前尚无规范及指南,且在某些方面仍存在争议。因此笔者将围绕多胎妊娠绒毛膜性、初始胎儿数目不同对减胎时机及减胎方案等进行阐述。

Progress on clinical research of multifetal pregnancy reduction

Objective:The number of multiple gestations and adverse pregnancy outcomes have substantially increase,which primarily relate to a more wide use of assisted reproduction techniques.In the latest twenty years,multifetal pregnancy reduction has become a remedial measure to lessen maternal morbidity and fetal mortality by reducing the number of fetuses.However,due to the complexity of multiple pregnancies,the difference of chorionicity,the initial number of fetuses,especially the rise of high risk pregnant women after two-child policy,there are some disputes in the appropriate technique,the ideal timing of multifetal pregnancy reduction,and further pregnant management to perform selective termination.The purpose of this study was to review the method and timing of multifetal pregnancy reduction according to chorionicity and the initial number of fetuses.