多胎妊娠减胎术的临床结局分析
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摘要
目的探讨辅助生殖技术在多胎妊娠减胎术中的临床应用效果。方法回顾性分析2013年1月1日—2017年11月30日对通过辅助生育技术助孕而发生多胎妊娠的80例患者,行经阴道B超引导下的选择性减胎术,观察减胎术后患者的妊娠结局。结果 80例多胎妊娠患者均一次性减胎成功,其中1例四胎减至单胎,1例四胎减至三胎,2例四胎减至双胎,三胎减至双胎32例,三胎减至单胎26例,双胎减至单胎18例。其中流产共13例,早期流产7例,晚期流产6例,流产率为16.25%,早期流产率为8.75%,晚期流产率为7.50%,早产共19例,早产发生率为28.36%,其中单胎早产为4例,早产发生率为8.89%,双胎早产15例,早产发生率为68.18%。共分娩新生儿89个,其中男孩60个,女孩29个。结论孕早期经阴道B超引导行选择性减胎术,其方法简单,安全有效,使多胎妊娠有一个良好结局。
Objective To investigate the clinical effect of assisted reproductive technique for multiple pregnancy reduction. Methods From January 1, 2013 to November 30, 2017, 80 patients with multiple pregnancyinduced by assisted fertility technique were treated with selective fetal reduction under the guidance of transvaginal ultrasound, and the pregnancy outcome of the patients after fetal reduction was observed. Results 80 cases of multiple pregnancy were successfully aborted at one time. Among them, 1 case had four births reduced to single, 1 case had four births reduced to triplets, 2 cases had four births reduced to twins, 32 cases had three births reduced to twins, 26 cases had triplets reduced to single births, and 18 cases had twins reduced to single births. Among them, there were 13 cases of abortion, 7 cases of early abortion, 6 cases of late abortion, the abortion rate was 16.25%, the early abortion rate was 8.75%, the late abortion rate was 7.50%, the premature birth rate was 19, and the premature birth rate was 28.36%. Among them, there were 4 cases of single premature birth, 8.89% of premature birth, 15 cases of twin premature birth and 68.18% of premature birth. A total of 89 newborns were delivered, including 60 boys and 29 girls. Conclusion Selective fetal reduction guided by transvaginal B-mode ultrasound in early pregnancy is a simple, safe and effective method, which can lead to a good outcome of multiple pregnancy.
Objective To investigate the clinical effect of assisted reproductive technique for multiple pregnancy reduction. Methods From January 1, 2013 to November 30, 2017, 80 patients with multiple pregnancyinduced by assisted fertility technique were treated with selective fetal reduction under the guidance of transvaginal ultrasound, and the pregnancy outcome of the patients after fetal reduction was observed. Results 80 cases of multiple pregnancy were successfully aborted at one time. Among them, 1 case had four births reduced to single, 1 case had four births reduced to triplets, 2 cases had four births reduced to twins, 32 cases had three births reduced to twins, 26 cases had triplets reduced to single births, and 18 cases had twins reduced to single births. Among them, there were 13 cases of abortion, 7 cases of early abortion, 6 cases of late abortion, the abortion rate was 16.25%, the early abortion rate was 8.75%, the late abortion rate was 7.50%, the premature birth rate was 19, and the premature birth rate was 28.36%. Among them, there were 4 cases of single premature birth, 8.89% of premature birth, 15 cases of twin premature birth and 68.18% of premature birth. A total of 89 newborns were delivered, including 60 boys and 29 girls. Conclusion Selective fetal reduction guided by transvaginal B-mode ultrasound in early pregnancy is a simple, safe and effective method, which can lead to a good outcome of multiple pregnancy.
引文
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[7]庄广伦.现代辅助生育技术[M].北京:人民卫生出版社,2005:416-417.
[8]马淳,师娟子,李明昭,等.辅助生殖技术助孕后的多胎妊娠早孕期减胎91例分析[J].生殖与避孕,2016,36(9):774-777.
[9]Spittle A,Orton J,Anderson P,et al.Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants[J].Cocharane Database Syst Rev,2015,24(11):CD005495.
[10]何春,付士强,罗函渝,等.早期综合干预对早产低体重儿体格发育和智力发展的影响分析[J].中国妇幼保健,2016,31(5):976-978.
[11]刘凤华,杨业洲,张松英,等.辅助生殖技术并发症诊断及处理共识[J].生殖与避孕,2015,35(7):431-439.
[12]徐冰,路遥,何亚琼,等.多胎减胎后单胎分娩与单胎妊娠分娩比较分析[J].中华生殖与避孕杂志,2017,37(6):485-488.
[2]白云,马艳萍.多胎妊娠减胎术发展现状[J].中华生殖与避孕杂志,2017,37(3):245-149.
[3]胡琳莉,黄国宁,孙海翔,等.多胎妊娠减胎术操作规范(2016)[J].生殖医学杂志,2016,25(3):193-198.
[4]李艳梅,马晓玲,张学红,等.辅助生殖技术中多胎妊娠减胎术后妊娠结局的比较[J].生殖医学杂志,2017,26(9):874-879.
[5]孟庆霞,吴惠华,李建芬,等.选择性减胎术可以明显改善多胎妊娠的临床妊娠结局[J].生殖医学杂志,2017,26(10):1035-1040.
[6]Dodd JM,Dowswell T,Crowther CA.Reduction of the number of fetuses for women with a multiple pregnancy[J].Cochrane Database Syst Rev,2015,4(11):CD003932.
[7]庄广伦.现代辅助生育技术[M].北京:人民卫生出版社,2005:416-417.
[8]马淳,师娟子,李明昭,等.辅助生殖技术助孕后的多胎妊娠早孕期减胎91例分析[J].生殖与避孕,2016,36(9):774-777.
[9]Spittle A,Orton J,Anderson P,et al.Early developmental intervention programmes provided post hospital discharge to prevent motor and cognitive impairment in preterm infants[J].Cocharane Database Syst Rev,2015,24(11):CD005495.
[10]何春,付士强,罗函渝,等.早期综合干预对早产低体重儿体格发育和智力发展的影响分析[J].中国妇幼保健,2016,31(5):976-978.
[11]刘凤华,杨业洲,张松英,等.辅助生殖技术并发症诊断及处理共识[J].生殖与避孕,2015,35(7):431-439.
[12]徐冰,路遥,何亚琼,等.多胎减胎后单胎分娩与单胎妊娠分娩比较分析[J].中华生殖与避孕杂志,2017,37(6):485-488.