| 何淑凤,孙敏雅,肖建平.双胎妊娠 358例中不同受孕方式围产结局比较分析[J].安徽医药,2022,26(3):531-535. |
| 双胎妊娠 358例中不同受孕方式围产结局比较分析 |
| Comparative analysis of perinatal outcomes in 358 cases of twin pregnancy with different conception methods |
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| DOI：10.3969/j.issn.1009-6469.2022.03.026 |
| 中文关键词: 妊娠，双胎 妊娠结局 胚胎移植 自然受孕 单绒毛膜双羊膜囊双胎( MCDA) 双绒毛膜双羊膜囊双胎(DCDA) |
| 英文关键词: Pregnancy, twin Pregnancy outcomes Embryo transfer Natural conception Monochorionic diamniontic twin(MCDA) Dichorionic diamnionic twin (DCDA) |
| 基金项目:无锡市科技发展资金( WX18IIAN028) |
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| 中文摘要: |
| 目的比较分析不同受孕方式在双胎妊娠中围产结局。方法回顾性分析南京医科大学附属无锡妇幼保健院 2017年 1月至 2019年 8月通过胚胎移植受孕双胎 204例作为胚胎移植组，并将 154例自然受孕双胎作为自然受孕组，比较其围产结局。结果两组在年龄、孕次、产科高危评分、分娩方式、产后出血量、新生儿平均体质量、总体质量、悬浮少白红细胞及血浆输血人数比较中差异有统计学意义( P<0.05)。双绒毛膜双羊膜囊双胎及单绒毛膜双羊膜囊双胎中，孕妇年龄、高危评分、新生儿总体质量、受孕方式、产后出血、早产及输血人数及产后出血量的比较中，均差异有统计学意义( P<0.05)。在胚胎移植组中，胎妊娠行剖宫产手术需采取其他辅助措施、甚至子宫切除较自然受孕组双胎多(P<0.05)。两组分娩孕周及有无宫腔操作史比双较中，差异无统计学意义( P>0.05)。平衡孕周后发现，胚胎移植双胎在 35~36+6周［(5 041.26±588.77)g比( 4 847.46±595.94)g］及 37~38+6周［(5 442.7±475.91)g比( 5 264.38±498.75)g］中分娩新生儿体质量均较自然受孕双胎体质量偏大(P<0.05)。两组产科合并症如妊娠期糖尿病、妊娠肝内胆汁淤积症、胎盘粘连比较差异有统计学意义( P<0.05)。两组未足月胎膜早破的发生率差异无统计学意义( P>0.05)。结论胚胎移植双胎较自然受孕双胎妊娠并发症增加，主要表现在妊娠期糖尿病、妊娠肝内胆汁淤积症、胎盘粘连、产后出血及剖宫产手术时需要多种辅助手段降低产后出血等方面，孕期应加强管理。 |
| 英文摘要: |
| Objective Comparative analysis of perinatal outcomes of different conception methods in twin pregnancy.Methods A retrospective analysis of 204 cases of twins conceived by embryo transfer from January 2017 to August 2019 in the Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University was used as the embryo transfer group, and 154 cases of naturallyconceived twins were selected as the natural conception group, and their perinatal outcomes were compared.Results There were significant differences between the two groups in age, time of pregnancy, obstetric high-risk score, mode of delivery, postpartum hemorrhage, average newborn body weight, overall weight, number of suspended leukocyte-reduced red blood cells and plasma transfusion (P <0.05). The differences in maternal age, high-risk score, overall neonatal quality, method of conception, postpartum hemorrhage, number of preterm births and blood transfusions, and postpartum hemorrhage volume in dichorionic diamniotic twins and monochorionic di?amniotic twins were all different. In the embryo transfer group, cesarean section for twin pregnancy required other auxiliary measures,and even hysterectomy was more common than in the natural conception group (P < 0.05). There was no significant difference in gestational age of delivery or history of uterine cavity operation between the two groups (P < 0.05). After balancing the gestational weeks, itwas found that the weights of newborns delivered by embryo transfer twins were larger than those of twins delivered by natural conception at 35-36+6 weeks [(5 041.26±588.77) g to (4 847.46±595.94) g] and 37-38+6 weeks [(5 442.7±475.91) g to (5 264.38±498.75) g] (P < 0.05). There were significant differences in obstetric complications, such as gestational diabetes mellitus, intrahepatic cholestasisof pregnancy and placental adhesions, between the two groups (P < 0.05). There was no significant difference in the incidence of premature rupture of membranes between the two groups (P > 0.05).Conclusions Embryo transfer twin pregnancy has more complicationsthan natural conception twin pregnancy, mainly in gestational diabetes mellitus, intrahepatic cholestasis of pregnancy, placental adhesion, postpartum hemorrhage, and the need for multiple auxiliary means to reduce postpartum hemorrhage during cesarean operation. |
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