双胎妊娠286例的分娩方式与妊娠结局关系探讨

The Investigation of the Relationship between the Mode of Delivery and Pregnancy Outcome in 286 Cases

目的分析并评价双胎妊娠分娩方式与妊娠结局的关系。方法将汉川市第一人民医院2007年12月至2012年12月收治的286例双胎妊娠产妇根据分娩方式不同分为阴道产组(147例)与剖宫产组(139例),并对产妇的孕周、产后出血量、新生儿体质量、Apgar评分以及新生儿窒息率进行分析。结果不同分娩方式的产后出血率方面比较差异无统计学意义(P>0.05);新生儿体质量<2500 g者的阴道产组显著高于剖宫产组(P<0.05);剖宫产组新生儿体质量在2500 g以上以及≥37孕周者显著高于阴道产组(P<0.05)。阴道产组与剖宫产组第二胎新生儿窒息率比较,差异有统计学意义(P>0.05),且阴道产组第二胎儿Apgar评分>7分的窒息率显著低于第一胎儿(χ2=5.117,P<0.05),Apgar评分≤7分的窒息率明显著高于第一胎儿(χ2=4.312,P<0.05)。结论剖宫产新生儿窒息发生率与其出生顺序无关,双胎妊娠产妇选择合适的分娩方式能够降低新生儿窒息率。

Objective To analyze and evaluate the relationship between the mode of delivery and pregnancy outcome in twin pregnancy.Methods In the First People＇s Hospital of Hanchuan City from December 2007 to December 2012,286 cases of twin pregnancy women were divided into groups vaginal delivery group（147 cases） and Cesarean section group（139 cases）,and the maternal gestational weeks,postpartum bleeding,neonatal birth weight,Apgar score and neonatal asphyxia rate of the two groups were analyzed.Results postpartum hemorrhage rate difference of different modes of delivery was not statistically significant（P 0.05）;newborn weight 2500 g of the virginal delivery group were significantly higher than Cesarean section group（P 0.05）;newborn children weighing more than 2500 g with ≥37 weeks of gestation of Cesarean section group were significantly higher than vaginal birth group,the difference was significant（both P 0.05）.Differnce of second fetal asphyxia rate between the two groups was statistically significant（P 0.05）,and the second fetal asphyxia rate of Apgar score 7 point in the vaginal delivery group was significantly lower than the first fetus（χ2 = 5.117,P 0.05）,asphyxia rate of Apgar score ≤7 was significantly higher than the first fetus（χ2 = 4.312,P 0.05）.Conclusion Rate of neonatal asphyxia of Cesarean section is independent from the birth order,and choosing the appropriate mode of delivery for twin pregnancy can reduce the rate of neonatal asphyxia.