多胎妊娠孕中期选择性减胎术后不良妊娠结局危险因素分析

发布时间：2018-05-15 02:17

本文选题：多胎妊娠 + 妊娠结局　；参考：《中国实用妇科与产科杂志》2016年08期

【摘要】：目的探讨多胎妊娠孕中期选择性减胎术后发生不良妊娠结局的危险因素。方法收集2004年5月至2015年9月在山东大学附属省立医院产科住院的经腹多胎妊娠减胎术后发生流产、早产的孕妇68例,并按照每年1∶2的比例随机抽取减胎术后妊娠结局良好的孕妇共136例为对照组;分别从年龄、体重、妊娠方式、早孕期阴道流血情况、减胎术前白细胞计数、总产次、减胎前胎儿数、减胎指征、减胎次数、减胎时孕周、被减胎儿数、保留胎儿数、减胎时有无穿过胎盘、穿刺次数、减胎前有无阴道炎、术后抗生素的使用天数方面收集两组孕妇减胎时的临床资料,进行统计学分析。经腹多胎妊娠减胎术采用目标胎儿心内或颅内氯化钾注射法。结果 (1)初步分析年龄、减胎前胎儿数、保留胎儿数、术中有无穿过胎盘、穿刺次数是减胎后妊娠结局的影响因素(P0.05),其他因素对减胎后妊娠结局无明显影响(P0.05)。(2)Logistic多因素回归分析显示术中有无穿过胎盘是独立影响因素(β=-1.143,P0.005)。结论减胎时穿刺针通过胎盘是经腹减胎术不良妊娠结局的独立危险因素,手术中穿刺位点尽量避开胎盘可能会改善妊娠结局。
[Abstract]:Objective to investigate the risk factors of adverse pregnancy outcome after selective pregnancy reduction in multiple pregnancy. Methods 68 cases of preterm pregnancy were collected from May 2004 to September 2015 in the obstetric department of Shandong University, a provincial hospital affiliated to the provincial hospital of Shandong University. A total of 136 pregnant women with good pregnancy were used as the control group. The clinical data of two groups of pregnant women with vaginitis and postoperative antibiotic use were collected, and the clinical data of pregnancy reduction were collected and analyzed statistically. The method of target fetal heart or intracerebral potassium chloride injection was used. Results (1) the initial analysis of age, the number of prefetuses before fetal reduction, the number of fetus retained, the number of transplacenta during the operation, and the number of punctures were reduced. Factors (P0.05), other factors have no significant influence on the outcome of pregnancy after pregnancy (P0.05). (2) multiple regression analysis of Logistic shows whether there is an independent influence factor (beta =-1.143, P0.005) during the operation (beta =-1.143, P0.005). Conclusion the puncture needle through the fetal disc is an independent risk factor for the adverse pregnancy outcome of the abdominal abortion. Avoiding the placenta at the puncture site may improve the outcome of pregnancy.

【作者单位】：山东大学附属省立医院妇产科;山东省妇幼保健院;国家卫计委生育调控技术重点实验室;
【基金】：泰山学者工程专项经费资助
【分类号】：R714.23

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