双胎妊娠适宜的分娩时机与分娩方式

发布时间：2018-04-15 10:40

本文选题：双胎妊娠 + 分娩方式　；参考：《中国实用妇科与产科杂志》2015年07期

【摘要】：双胎妊娠的分娩仍是产科最具挑战性的事件。双胎妊娠的分娩时机与分娩方式应根据孕周、当地的医疗条件(产科条件是否为区域性医疗中心、新生儿重症监护病房救治水平等)及母胎的具体情况(绒毛膜性,有无并发症或合并症、复杂双胎等,甚至患者经济情况)等综合考虑,制定适宜的个体化分娩方案。对于无并发症及合并症的双绒毛膜双羊膜囊双胎,38~39+6周分娩较适宜;对于无并发症及合并症的单绒毛膜双羊膜囊双胎,适宜的分娩时机为37~38周;复杂性双胎(如单羊膜囊双胎、双胎输血综合征、选择性胎儿生长受限、贫血-红细胞增多序列征、单绒毛膜双胎减胎术或宫内治疗后),需结合孕妇及胎儿的具体情况制定个体化的分娩方案,分娩时机为32~36周。双胎择期剖宫产指征包括单羊膜囊双胎、连体双胎(除外早中孕者)、第一胎非头位、具有单胎的剖宫产指征者,除此之外,均可考虑阴道分娩。
[Abstract]:The delivery of twin pregnancies remains the most challenging event in obstetrics.The delivery time and delivery mode of twin pregnancy should be based on the gestational age, local medical conditions (whether the obstetric condition is regional medical center, neonatal intensive care unit treatment level, etc.) and the specific conditions of the mother's fetus (chorionic villi, etc.)Whether there are complications or complications, complex twins, or even the patient's financial situation, etc., are considered to make appropriate individualized delivery plan.For the twin chorionic double amniotic sac twins with no complications and complications, the best delivery time is 3 738 weeks for the single chorionic double amniotic sac twins without complications and complications, and for complex twins (such as single amniotic bursa twins, the optimal delivery time is 3 738 weeks), for the single chorionic double amniotic sac twins without complications and complications, the optimal delivery time is 3 738 weeks.Twin transfusion syndrome, selective fetal growth restriction, anemia and polycythemia, single chorionic twins reduction or intrauterine treatment should be combined with the specific conditions of pregnant women and foetus to formulate individualized delivery plan.The delivery time was 32 ~ 36 weeks.The indications of elective cesarean section include single amniotic sac twins and conjoined twins (except for early and middle pregnancy, the first child is not cephalic, and the single child is the indication of cesarean section), in addition, vaginal delivery can be considered.
【作者单位】：重庆医科大学附属第一医院妇产科重庆市胎儿医学中心;
【分类号】：R714.23

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