超声引导下孕中期选择性多胎妊娠减胎术23例分析

Ultrasound-guided selective multifetal pregnancy reduction in second trimester： 23 cases report

目的 探讨超声引导下孕中期选择性多胎妊娠减胎术的临床应用价值。方法 超声引导下对23例孕中期多胎妊娠进行选择性减胎术，其中多胎妊娠中异常胎儿减胎7例，要求减少胎儿数目16例。结果 对23例孕妇施行减胎术共26例次，一次减胎成功率96．2％（25／26），再次减胎矫正后成功率100％。共手术减灭胎儿25个（2例四胎妊娠同时减去2个胎儿）。23例全部分娩。其中〉36周分娩者12例，32-36周7例，28-32周2例，〈28周2例（流产）。在23例分娩的孕妇中20例获存活健康新生儿32名，妊娠成功率86．96％。结论 超声引导下孕中期选择性多胎妊娠减胎术是一种方法简单、定位准确、安全可靠、有效的微创操作技术，为多胎妊娠的管理提供了一个新的方法。

Objective To investigate the clinical application value of ultrasound-guided selective multifetal pregnancy reduction in second trimester. Methods Trans-abdominal selective pregnancy reduction in 23 multiple pregnancies were performed under ultrasound. Seven cases were performed for abnormal fetuses,and 16 cases for reducing fetal number. Results Twenty-six times of trans-abdominal selective pregnancy reduction in 23 multiple pregnancies were performed under ultrasound. The one action successful rate was 96.2% （25/26） ,the corrective successful rate for the second action was 100%. Twentyfive fetuses were reduced in total （two cases of quadruplet pregnancies reduced to twin pregnancies in one time）. All cases had delivered： 12 delivered after 36 weeks, seven delivered between 32 and 36 weeks, two delivered between 28 and 32 weeks and two aborted. All of the 32 newborns were normal. The successful pregnancy rate was 86.96%. Conclusions Ultrasound-guided selective multifetal pregnancy reduction in second trimester is an easy, safe, effective micro-invasive technique. It has provided a new method in treatment of multifetal pregnancy.