21例三胎以上妊娠临床分析

Clinical Analysis of 21 Cases of Multiple Pregnancy

目的三胎妊娠近年来呈上升趋势,三胎妊娠在孕期及分娩期更容易发生各种并发症,危及母儿安全。总结我院三胎妊娠临床治疗经验,旨在提高围产期处理质量。方法对我院产科2003～2010住院分娩三胎以上妊娠21例临床资料进行回顾分析。结果 20例三胎妊娠分娩时孕周28+6～36+4周,平均32+5周围生儿死亡率40.63%。结论治疗三胎妊娠及以上应该:(1)早诊断,高危门诊随诊,及早发现及时治疗各种并发症;(2)充分休息、积极纠正贫血、加强营养,尤其在孕晚期要注意蛋白质补充;(3)应用B超监测胎儿的发育及孕母宫颈管的长度,预防胎儿宫内生长受限及早产,有FGR及先兆早产及时治疗;(4)孕34周后根据母儿情况计划终止妊娠,并做好产时母儿并发症的预防和抢救工作。

Objective Multiple pregnancy has increased in recent years. During pregnancy and delivery, mutiple pregnancy has more complications than singleton pregnancy, which endangers mother and fetus. In order to elevate the quality of perinatal management, the experiences of triplet pregnancy in our hospital has been summarized. Methods The clinical data of 21 cases of multiple pregnancy in our department from 2003 to 2010 were analyzed retrospectively. Results The gestational age of the 21 triplet pregnancies at delivery was 28^＋6 36^＋4 wsk, with the menn gestational age of 32^＋5 wks. The perinatal mortality was 40.63%. Conclusion The key points for managing the multiple pregnancy were as follows： （1） Good prenatal care should be given to all pregnant women, incluing early diagnosis, fllow-up of high risk out-patient clinic, early discovery and treatment of various complication in time. （2） Pregnant women should be in good rest, anemia must be correct, and the adequate nutrition was suplied, especially in third trimester. （3） Using ultrasound to determine the cervix length, fetal development and evaluate the risk ofpreterm delivery. When the preterm delivery signs were shown, the inhibiting drugs should be used cauiously and rationally. （4） After 34 gestation weeks, selective cesarean section was preferred to deliver the babies according to pregnancy women and fetus, and at the same time various kinds of preventive and rescue measures for complications should be got well ready.