双胎妊娠在不同孕周分娩方式选择与结局的临床分析

发布时间：2018-12-17 03:11

【摘要】：目的探讨不同孕周双胎妊娠病例的分娩方式与妊娠结局的关系。方法选择2014年8月至2015年12月在该院分娩的孕周分别为28~33~(+6)周,34~36~(+6)周及37~39周(分为A、B、C 3组)的270例双胎妊娠孕妇及其分娩的新生儿作为研究对象。回顾性分析在不同孕周,分娩方式与产妇分娩并发症、胎位、新生儿体质量、新生儿窒息率的关系,同时记录了绒毛膜性与分娩孕周的关系。结果 3组孕周中,不同分娩方式的产后出血发生率比较差异无统计学意义(P0.05)。B组阴道分娩组第2胎新生儿窒息2例,剖宫产组第2胎新生儿窒息1例,差异有统计学意义(P0.05);B组中剖宫产组新生儿体质量显著高于阴道分娩组(P0.05)。50%单绒毛膜双羊膜囊及51%双绒毛膜双羊膜囊双胎于34~36+6周剖宫产终止妊娠。结论暂无确切证据证明在某一孕周剖宫产对于妊娠结局优于阴道分娩,但随孕周及胎儿体质量的增加,应放宽剖宫产指征,以避免阴道试产过程可能发生的风险。
[Abstract]:Objective to explore the relationship between delivery mode and pregnancy outcome in twin pregnancy cases with different gestational weeks. Methods from August 2014 to December 2015, 270 pregnant women with twin pregnancy and their newborns were divided into three groups: 2830 ~ (6) weeks, 3436 ~ (6) weeks and 37 ~ 39 weeks, respectively, from August 2014 to December 2015. The relationship between parturient complications, gestational position, neonate body mass and neonatal asphyxia rate in different gestational weeks was analyzed retrospectively. The relationship between chorionic villi and gestational age was also recorded. Results there was no significant difference in the incidence of postpartum hemorrhage among the three groups during gestational weeks (P0.05). There were 2 cases of neonatal asphyxia in the vaginal delivery group and 1 case in the cesarean section group. The difference was statistically significant (P0.05). The body mass of newborns in group B was significantly higher than that in vaginal delivery group (P0.05). 50% single chorionic double amniotic sac and 51% double chorionic double amniotic sac twins were terminated by cesarean section at 3436 weeks. Conclusion there is no definite evidence that cesarean section in a certain gestational week is superior to vaginal delivery in pregnancy outcome, but with the increase of gestational week and fetal body mass, the indications of cesarean section should be relaxed to avoid the possible risk of vaginal trial labor.
【作者单位】：重庆市妇幼保健院产科;
【基金】：重庆市卫生计生委2016年医学科研计划项目(2016MSXM091)
【分类号】：R714.23

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