8例多胎妊娠延迟间隔分娩的母婴结局分析

Maternal and Neonatal Outcomes of Delayed-Interval Delivery in Multiple Pregnancy

目的：探讨多胎妊娠延迟间隔分娩的围生期管理及母婴结局。方法：对我院2007-2012年收治的8例延迟间隔分娩的患者进行回顾性分析,统计其分娩间隔时间、分娩孕周、产科处理及母婴结局。结果：8例均为初产妇,三胎妊娠3例,双胎妊娠5例。延迟间隔分娩第1胎分娩平均孕周为21＋2周,最后一胎延迟间隔分娩平均时限为17.27天（3小时至60天）,分娩平均孕周为23＋2周,胎儿平均体重为593.33 g。共获3例活婴：延迟间隔分娩时间分别为42天、60天和1天,分娩孕周26＋1周、33＋4周和30＋5周,胎儿出生体重865 g、1600 g和1430 g。所有患者均使用抗生素、宫缩抑制剂治疗,未行宫颈环扎术。发生宫内感染4例、胎盘早剥1例、胎膜早破3例、产时宫缩乏力2例及产后出血1例。结论：当多胎妊娠20周后娩出一个胎儿,使用抗生素加宫缩抑制剂治疗,延迟间隔分娩可为其余胎儿（胚胎）延长孕周,提供生存机会,从而有效改善新生儿的存活、降低死亡率。

Objective： To investigate management of delayed-interval delivery in multiple pregnancy and maternal and neonatal outcomes. Methods： A retrospective analysis of 8 delayed-interval delivery patients in the Third affiliated hospital of Guangzhou Medical University from 2007 to 2012： analyze the interval delivery,gestational age,clinical treatments,maternal and neonatal outcomes. Results： 8 patients were primipara,triplet pregnancy 3 cases,twin pregnancies 5 cases; the average gestational age births before delay-interval delivery was 21＋2weeks,the average delayed-interval period is 17. 27d（ range 3 h-60 d）. The average gestational age of delayed-interval delivery is 23＋2weeks,average fetal weight is 593. 33 g. Live birth 3 cases： their delayed-interval delivery period is respectively 42、60 and 1 days,at 26＋1,33＋4and 30＋5weeks gestation,fetal weight is 865,1600 and 1430 g. All patients were using antibiotics,tocolytic treatment,no cervical cerclage. Intrauterine infection occurred in 4 cases,placental abruption 1 cases,premature rupture of membranes 3 cases,uterine inertia intrapartum 2 cases and postpartum hemorrhage 1 case. Conclusions： When one fetus was born at more than 20 weeks in multiple pregnancy,contractions inhibitor treatment with antibiotics,delay-interval delivery can be extended by gestational age for the rest of the fetus（ es）,thus neonatal survival could be effectively improved and reduce mortality.