不同绒毛膜性质双胎妊娠母儿结局分析(1)
[摘要] 目的 分析不同絨毛膜性双胎妊娠的母儿结局，探讨绒毛膜性质对母婴儿结局的影响。 方法 收集2011年1月～2015年12月首都医科大学附属北京同仁医院双胎妊娠559例临床资料，根据超声及产后病理检查胎盘胎膜的方法，将其分为单绒双羊双胎组(单绒双胎组，198例)及双绒双羊双胎组(双绒双胎组，361例)，比较两组孕产妇并发症及胎儿结局，分析不同绒毛膜性与母儿结局的关系。 结果 妊娠期高血压疾病、妊娠期糖尿病、羊水过多、胎膜早破、胎盘早剥、严重产后出血发生率分别为24.7%、16.7%、14.6%、18.2%、4.6%、4.0%，双绒双胎组为21.6%、15.5%、13.6%、17.5%、3.9%、4.7%，仅早产发生率两组比较差异有统计学意义(P < 0.05)；单绒双胎组其胎儿丢失，复杂性双胎，新生儿窒息及围生儿死亡发生率(分别为17.7%、54.6%、13.1%、4.6%)明显高于双绒双胎组(分别为4.4%、21.3%、4.4%、2.8%)，差异均有统计学意义(P < 0.05)。 结论 不同绒毛膜性的双胎妊娠其孕产妇并发症无明显差异，单绒双胎妊娠其胎儿不良结局发生率明显高于双绒双胎妊娠，孕早期超声确定双胎妊娠绒毛膜性至关重要，孕期应加强监护及合理干预，改善母儿结局。
[关键词] 双胎妊娠；绒毛膜性；妊娠期并发症；围生儿预后
[中图分类号] R456 [文献标识码] A [文章编号] 1673-7210(2017)06(c)-0106-03
[Abstract] Objective To analyze maternal and neonatal outcomes of different chorionic twins， in order to investigate the effect of chorionic villi on the complications of pregnant women. Methods The clinical data of 559 twin pregnancy women in Beijing Tongren Hospital from January 2011 to December 2015 were collected， according to the results of chorionic nature by ultrasound in early trimester and pathologic checking the placenta and membrane after delivery， they were divided into two groups： monochorionic diamniotic twin pregnancy group (monochorionic twin group， 198 cases) and diachorionic diamniotic twin pregnancy group (diachorionic twin group， 361 cases)， the pregnancy complications of pregnant women and outcomes of fetal-neonate of two groups were compared. Results The incidence of complications during pregnancy such as gestational hypertension，gestational diabetes， polyhydramnios， premature rupture of membranes and placenta abrupture and sevene postpartum hemorrhage of monochorionic twin group was 24.7%， 16.7%， 14.6%， 18.2%， 4.6%， 4.0% respectively， those of the diachorionic twin group was 21.6%， 15.5%， 13.6%， 17.5%， 3.9%，4.7% respectively， there was a statistically significant only in the incidence of preterm of two groups (P < 0.05). The fetal loss， complicated twin， asphyxia rate of neonatal and mortality rate of the monochorionic twin group (17.7%， 54.6%， 13.1%， 4.6% respectively) were significantly higher than those of the diachorionic twin group (4.4%， 21.3%， 4.4%， 2.8% respectively)， the difference were statistically significant (P < 0.05). Conclusion Chorionic properties of pregnancy complications in two groups have no difference， but monochorionic twin pregnancies has a higher risk， it should be accurately determine about the chorionic nature in the first trimester， setting up monitoring and intervention measures during pregnancy to improve the outcomes of fetal-newborn., 百拇医药(李婷 冯碧波 翟建军)
[关键词] 双胎妊娠；绒毛膜性；妊娠期并发症；围生儿预后
[中图分类号] R456 [文献标识码] A [文章编号] 1673-7210(2017)06(c)-0106-03
[Abstract] Objective To analyze maternal and neonatal outcomes of different chorionic twins， in order to investigate the effect of chorionic villi on the complications of pregnant women. Methods The clinical data of 559 twin pregnancy women in Beijing Tongren Hospital from January 2011 to December 2015 were collected， according to the results of chorionic nature by ultrasound in early trimester and pathologic checking the placenta and membrane after delivery， they were divided into two groups： monochorionic diamniotic twin pregnancy group (monochorionic twin group， 198 cases) and diachorionic diamniotic twin pregnancy group (diachorionic twin group， 361 cases)， the pregnancy complications of pregnant women and outcomes of fetal-neonate of two groups were compared. Results The incidence of complications during pregnancy such as gestational hypertension，gestational diabetes， polyhydramnios， premature rupture of membranes and placenta abrupture and sevene postpartum hemorrhage of monochorionic twin group was 24.7%， 16.7%， 14.6%， 18.2%， 4.6%， 4.0% respectively， those of the diachorionic twin group was 21.6%， 15.5%， 13.6%， 17.5%， 3.9%，4.7% respectively， there was a statistically significant only in the incidence of preterm of two groups (P < 0.05). The fetal loss， complicated twin， asphyxia rate of neonatal and mortality rate of the monochorionic twin group (17.7%， 54.6%， 13.1%， 4.6% respectively) were significantly higher than those of the diachorionic twin group (4.4%， 21.3%， 4.4%， 2.8% respectively)， the difference were statistically significant (P < 0.05). Conclusion Chorionic properties of pregnancy complications in two groups have no difference， but monochorionic twin pregnancies has a higher risk， it should be accurately determine about the chorionic nature in the first trimester， setting up monitoring and intervention measures during pregnancy to improve the outcomes of fetal-newborn., 百拇医药(李婷 冯碧波 翟建军)