63例双胎妊娠预后的临床分析

A clinical analysis of outcomes of 63 cases of twin pregnancy

目的了解双胎妊娠并发症及妊娠结局。方法对2002—2007年5年中63例双胎妊娠和同期5037例单胎妊娠的妊娠结局进行回顾性对比分析。结果双胎妊娠占1．24％，双胎妊娠中早产、胎膜早破、妊娠期高血压疾病、贫血和产后出血妊娠并发症高于单胎妊娠，经比较有显著性差异（X2分别为296．11、10．67、52．26、100．17、47．29，均P〈0．01）；双胎围产儿病死率中低出生体重儿、足月小样儿、新生儿窒息、早期新生儿死亡、病理性黄疸、出生缺陷发生率均高于单胎围产儿（X2分别为372．01、110．34、10．92、20．49、21．94、13．01，均P〈0．01）。双胎围产儿死亡率为55．56‰，与单胎13．70‰比较有显著性差异（Y2=14．85，P〈0．01）。结论加强双胎围产期监测和管理，对降低母体并发症及双胎围产儿病死率有重要意义。

Objective To investigate complications and outcomes of twin pregnancy. Methods The pregnancy outcomes of 63 cases of twin pregnancy during 5 years from 2002 to 2007 were compared with those of 5 037 cases of singleton pregnancy in the same period. Results Twin pregnancy accounted for 1.24% of total pregnancy in the period. The incidence rates of preterm labor, premature rupture of fetal membranes, hypertensive disorder complicating pregnancy, anemia and postpartum hemorrhage of women with twin pregnancy were significantly higher than those women with singleton pregnancy and there were significant differences （X2 = 296. 11, 10.67, 52.26, 100.17 and 47.29 respectively, all P 〈 0.01 ）. The incidence rates of low birth weight, small for date infant, neonatal asphyxia and early neonatal mortality, pathologic jaundice and birth defects among pregnant women with twin pregnancy were significantly high than those among pregnant women with monocyesis （ singleton pregnancy） and there were significant differences （X2 = 372.01, 110. 34, 10.92, 20.49, 21.94, 13.01 respectively, all P 〈 0.01 ）. The mortality rate of twin perineonates was 55.56‰, and that of single perineonates was 13.70‰ and there was a significant difference （ X2 = 14.85, P 〈 0.01 ）. Conclusion It is of important significance to intensify monitoring and supervision to twin pregnancy for reducing maternal complications and case fatality rate of twin perineonates.