体外受精-胚胎移植中多胎减胎后双胎妊娠结局的分析

Pregnancy Outcome Analysis of Twins Pregnancies and Twins Pregnancies of Multifetal Reduction in IVF-ET

目的:探讨IVF-ET中多胎妊娠减胎术对双胎妊娠结局的影响。方法:回顾性地分析IVF-ET治疗后直接双胎妊娠124例(A组)和IVF多胎妊娠减为双胎妊娠43例(B组),比较二组孕期流产率、早产率、胎儿出生体重、胎儿畸形率、新生儿死亡率、胎盘粘连和产后出血等。结果:早期流产率A组8.1%,B组25.6%;晚期流产率A组16.9%,B组9.3%;总流产率A组25%,B组34.9%;A、B组间流产率有显著差异(P<0.01)。A、B组平均孕周(36.6±2.2周vs36.0±2.9周)、第一胎胎儿出生体重(2678.0±510.3gvs2542.5±454.8g)和第二胎胎儿出生体重(2393.4±496.8gvs2297.5±501.0g)间无统计学差异;A、B组间在母体并发症发生率、胎儿畸形率、新生儿死亡率之间也无统计学差异(P>0.05)。结论:IVF-ET中多胎减为双胎妊娠与IVF-ET中直接双胎妊娠相比,早期流产率明显增加。

Objective： To evaluate the efficacy and safety of the pregnancy outcome between twin pregnancies and twins of Multifetal reduction. Methods： A retrospective study was carried out to measure miscarriage rate, uterine-incision delivery rate, premature delivery rate, neonatal mortality rate, malformation rate and mean gestational age in the patients of twin pregnancy （n=124, group A） and multifetal pregnancy reduced to obtain twins （n=43, group B） undergoing IVF. Results： There was no significant difference in the pregnant complications, premature delivery rate, malformation rate, neonatal mortality rate and mean gestational age between groups A and B, while more significant in early abortion rate. Conclusion： Selective reduction increased early abortion rate.