体外受精胚胎移植助孕后双胎妊娠临床结果分析

Clinical analysis on twin pregnancy outcome after in vitro fertilization and embryo transfer

目的探讨试管婴儿双胎与自然妊娠双胎的妊娠、分娩的风险及新生儿结局。方法比较分析61例试管婴儿双胎与77例自然妊娠双胎母亲的一般情况、妊娠并发症、剖宫产情况及围产儿结局。结果试管婴儿组产妇平均年龄为(30.72±4.10)岁,与自然受孕组相比,差异有统计学意义(P<0.05)。试管婴儿组高龄初产产妇比例高于自然受孕组,试管婴儿组的产次显著低于自然受孕组,差异有统计学意义(P<0.05)。两组产检完成率、孕次及瘢痕子宫的差异无统计学意义(P>0.05)。试管婴儿组单绒毛膜性双胎发生率显著低于自然受孕组,差异有统计学意义(P<0.05),其他产科并发症差异无统计学意义(P>0.05)。试管婴儿组孕妇的剖宫产率高于自然受孕组,差异有统计学意义(P<0.05)。两组产后出血量、产后出血、输血率及子宫切除率差异无统计学意义(P>0.05)。试管婴儿组婴儿平均孕龄、活胎比例、低体质量儿与极低体质量比例、新生儿窒息率及胎儿性别方面与自然受孕组相比,差异无统计学意义(P>0.05)。结论与自然妊娠双胎相比,试管婴儿双胎妊娠并不增加孕妇的孕期及分娩的风险,且新生儿的出生结局亦无明显差异。

Objective To evaluate the pregnancy course and neonatal outcomes from the women,which got twin pregnant as a result of in vitro fertilization and embryo transfer( IVF- ET) procedures and natural conception. Methods Retrospective analysis was conducted in 61 cases of IVF twins and 77 cases of natural pregnancy,in terms of the mother of twins in general,pregnancy complications situation and perinatal outcomes. Results The average age of mothers in IVF group was( 30. 72 ± 4. 10) years,which was greater than natural conception group,and there was higher proportion of elderly primiparous pregnant in IVF group than in natural conception group( P < 0. 05). Parity was significantly lower in IVF group than in natural conception group( P < 0. 05). Prenatal care completion rate and whether the uterine scar pregnancies showed no statistical significance in two groups( P > 0. 05). Monochorionic twins was significantly lower in IVF group than in natural conception group( P < 0. 05),and there were no statistically significant difference in other obstetric complications( P > 0. 05). Cesarean section rate in IVF group was higher than in natural conception group( P < 0. 05),while postpartum hemorrhage,whether postpartum hemorrhage,transfusion rate and hysterectomy rate showed no significant difference in two groups( P > 0. 05). Mean gestational age,rate of live births,proportions of low birth weight and very low birth weight children,neonatal asphyxia and fetal gender aspects were not statistically different in two groups( P > 0. 05). Conclusion Compared with natural pregnancy twins,IVF twin pregnancy does not increase the risk of pregnancy and delivery and has no significant effect on the neonatal birth outcomes.