【摘要】 目的:探讨妊娠中期经腹选择性减胎术的方法及妊娠结局。方法:选择1999年12月～2010年6月在郑州大学第一附属医院妊娠中期因多胎或1胎畸形行减胎术的患者35例,分析中期减胎方法、减胎手术并发症、平均分娩孕周、新生儿出生体重等,并比较减胎后保留单胎或双胎新生儿出生体重和分娩孕周。结果:35例妊娠中期减胎患者均无术后出血、羊水溢漏、术后早期流产、凝血障碍;术后晚期流产3例(占8.57%),平均分娩孕周为(34.62±4.05)周,新生儿平均出生体重为(2.31±0.64)kg。妊娠中期减灭1胎和减灭2胎患者术后并发症无明显差异。保留单胎组平均分娩孕周(36.44±2.83)周,新生儿平均出生体重为(2.63±0.57)kg;保留双胎组平均分娩孕周(34.13±2.77)周,新生儿平均出生体重为(1.96±0.53)kg,两组患者相比,平均分娩孕周和新生儿出生体重均有统计学差异。结论:妊娠中期减胎术可作为避免多胎妊娠、异常胎儿出生的安全、简便、有效方法;保留单胎者妊娠结局优于保留双胎者。更多还原

【Abstract】 Objective:To explore the method and pregnancy outcome of transabdominal selective fetal reduction during the second trimester of pregnancy. Methods:35 patients receiving fetal reduction because of multiple birth or one fetus with fetal deformity were selected from the hospital from December 1999 to June 2010;the method and complications of fetal reduction,average gestational weeks,neonatal birth weight were analyzed;the neonatal birth weights and gestational weeks of retained single fetus or retained twin fetuses after fetal reduction were compared. Results:All the patients had no postoperative bleeding,fluid leakage,postoperative early abortion and coagulation disorder;postoperative late abortion occurred in 3 patients,accounting for 8.57%,the average gestational weeks were(34.62±4.05) weeks,the average neonatal birth weight was(2.31±0.64) kg.There was no significant difference in postoperative complications between fetal reduction group of retained one fetus and fetal reduction group of retained two fetuses.In retained single fetus group,the average gestational weeks were(36.44±2.83) weeks,the average neonatal birth weight was(2.63±0.57) kg;in retained twin fetuses group,the average gestational weeks were(34.13±2.77) weeks,the average neonatal birth weight was(1.96±0.53) kg,there was significant difference in the average gestational weeks and average neonatal birth weight between the two groups. Conclusion:Fetal reduction during the second trimester of pregnancy can be used as a safe,simple and effective method to avoid multiple pregnancy and the birth of abnormal fetuses;the pregnancy outcome of retained single fetus group is superior to that of retained twin fetuses group.更多还原