【摘要】 目的　探讨双胎妊娠中一个胎儿宫内死亡的原因及对存活胎儿的影响和处理。方法　回顾性分析1989～ 1998年我院收治的 2 7例双胎之一胎儿宫内死亡的原因及处理。结果　 8例孕周大于 34周双胎者在确诊一个胎儿死亡后 ,活胎即行剖宫产。 5例从确诊一个胎儿死亡至存活胎儿分娩时间平均相隔 8周。双胎之一胎儿死亡主要原因 :脐带因素 5例、胎儿畸形 3例、帆状胎盘 4例、原因不明 15例。结论　孕早中期双胎之一胎儿死亡后存活的胎儿预后良好 ;胎龄较大的胎儿死亡后 ,可增加存活胎儿的围产期病死率和患病率 ,尤其是单卵双胎 ;应加强对存活胎儿的监护以决定分娩时机和方式 ;对孕 34周以后发现的双胎之一胎儿宫内死亡者应考虑终止妊娠。更多还原

【Abstract】 Objective To explore the causes of death of one of twins and its effects on the other survivor as well as management.Methods The cause and management of 27 intrauterine death of one of twins from 1989 to 1998 were retrospectively analyzed.Results Cesarean section was carried out immediately in 8 cases after confirming the death of one of the twins with gestational age older than 34 weeks.And in 5 cases,the average time interval between the confirmed death and the other living born was 8 weeks.The main causes of the death of one fetus in twin pregnancy were cord elements(5 cases),fetal deformity(3 cases),velamentous insertion(4 cases)and unknown etiology(15 cases).Conclusion Prognosis of the live fetus was pretty well when the other died at the first or second trimester,while a greater perinatal mortality or morbidity of the live fetus was observed with the other died at older fetal-age,especially in monozygotic twins.It is proposed that monitoring must be reinforced for the survivor to decide the time and manner of delivery.Termination of pregnancy must be considered when one of twins is found intrauterine death after 34 gestation weeks.更多还原