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11例双胎妊娠中孕期选择性减胎治疗临床分析
Clinical analysis of 11 cases of selective pregnancy reduction in twin pregnancy
【摘要】 目的评估双胎妊娠在中孕期进行选择性减胎治疗的安全性、有效性以及对妊娠结局的影响。方法回顾性分析2018年12月至2019年12月长沙市妇幼保健院在孕中期出现复杂性双胎严重并发症或其中一个胎儿发现结构或染色体异常而进行选择性减胎治疗的11例孕妇的临床资料。分析手术效果、术后并发症、分娩结局、新生儿出生情况及目前情况。结果 11例孕妇减胎手术均获得成功。其中4例足月分娩,5例早产, 1例持续妊娠中,1例术后发生死胎;9例已分娩孕妇(剖宫产3例,阴道分娩6例)平均分娩孕周为(33.60±6.79)周;新生儿平均出生体重(2 268.75±892.80)g,新生儿平均出生身长(44.50±6.30)cm;9例新生儿娩出均未见畸形,电话随访该9例存活儿均在儿科定期检查,目前身高、体重、智力及行为发育等各项生长发育指标均正常。结论选择性减胎手术可以治疗复杂性双胎的严重并发症,也可防止先天性缺陷胎儿出生,减少妊娠并发症,改善妊娠结局,提高出生人口素质,该手术安全、有效。
【Abstract】 Objective To evaluate the safety, effectiveness, and impact on pregnancy outcomes of selective reduction of twin pregnancy in the second trimester.Methods Retrospective analyzed the clinical data of 11 pregnant women who underwent selective fetal reduction in the complicated complications of twins or the discovery of structural or chromosomal abnormalities in one of the fetuses during the second trimester of Changsha Maternal and Child Health Hospital from December 2018 to December 2019. Surgical effects, postoperative complications, delivery outcomes, neonatal births and current conditions were analyzed.Results 11 pregnant women had successful fetal reduction surgery. Among them, 4 cases were delivered at term, 5 cases were born prematurely, 1 case continued pregnancy, 1 case stillbirth occurred after operation; 9 cases of delivered pregnant women(3 cases of cesarean section, 6 cases of vaginal delivery), the average gestational week of delivery was(33.60±6.79) weeks; the average birth weight of newborns was(2 268.75±892.80) g, the average birth length of newborns was(44.50±6.30) cm; 9 newborns were delivered without deformities, telephone follow-up the 9 surviving children were regularly in pediatrics examination showed that all growth and development indicators such as height, weight, intelligence and behavior development are normal.Conclusion Selective fetal reduction surgery can treat severe complications of complex twins, prevent birth of congenitally defective fetuses, reduce pregnancy complications, improve pregnancy outcomes, and improve the quality of the birth population. The operation is safe and effective.
【Key words】 pregnancy; second trimester; complex twin; selective reduction;
- 【文献出处】 中国计划生育和妇产科 ,Chinese Journal of Family Planning & Gynecotokology , 编辑部邮箱 ,2020年09期
- 【分类号】R719
- 【下载频次】145