双胎妊娠一胎死亡后期待治疗15例分析

Conservative approach to twins pregnancy with intrauterine single fetal demise:15 cases analysis

目的探讨双胎妊娠一胎宫内死亡的原因、临床处理及预后。方法回顾性研究分析1998年1月-2009年12月安徽医科大学第一附属医院双胎妊娠一胎死亡的病例共12例。结果双胎一胎宫内死亡的发生率为3.3%,期待治疗时间最长为66d,最短为数小时,平均保胎时间为10.1 d,分娩平均孕周为34 w。无一例出现明显凝血功能障碍,无一例出现明显凝血功能障碍,先兆子痫和胎膜早破发生率最高,分别为33.3%和26.7%。结论双胎妊娠一胎死亡后可采取期待治疗,在严密监测存活胎儿宫内安危,积极处理母体合并症或并发症的条件下,尽量延长存活胎儿在宫内生长的时间,提高存活胎儿的生存质量。

Aim To study the cause,clinical treatment,and prognosis of twin pregnancy with one fetal intrauterine death.Methods 15 selected cases of twin pregnancy with intrauterine single fetal demise were reviewed in the First Affiliated Hospital of Anhui Medical University from January 1998 to December 2009.Results The rate of twin pregnancy with one fetal intrauterine death is 3.3%.The conservative approach lasted from several hours to 66 days（average 10.1 days）,without any case complicated with coagulopathy.The mean gestation week on labor was 34 weeks.The most common complications were the preeclampsia and premature rupture of membranes.Conclusions Conservative approach is an appropriate therapy to multiple pregnancies with one of intrauterine fetal death.