不同分娩方式对双胎妊娠分娩结局的影响分析

Influence analysis on pregnancy outcome of twin pregnancy affected by different delivery modes

目的探讨不同分娩方式对双胎妊娠结局的影响。方法回顾性收集154例双胎妊娠资料，依据分娩方式不同，将其分为阴道产组（58例）和剖宫产组（96例），比较两组的孕周、新生儿体重、产后出血、Apgar评分、围产儿并发症发生率等。结果剖宫产组的孕周、新生儿体重、第2胎儿Apgar评分均明显大于或高于阴道产组（P〈0．05）；剖宫产组的新生儿窒息、围生儿死亡等并发症发生率均明显低于阴道产组（P〈0．05）。结论双胎妊娠进行剖宫产，可明显降低新生儿窒息率、围生儿病死率等，但可能导致早产、发育不全、新生儿窒息等，应适当控制剖宫产率；双胎妊娠分娩方式的选择，需综合考虑剖宫产指征、孕周、胎儿体重、胎位、妊娠并发症等情况。

ObjectiveTo explore the influence of different delivery modes affecting twin pregnancy. Methods We retro- spectively collected clinical data of 154 cases of twin pregnancy, and according to different delivery modes, these cases were di- vided into vaginal delivery group （58 cases） and uterine-incision delivery group （96 cases）. These indexes such as gestational weeks, newborn weight, postpartum hemorrhage, Apgar score and complication incidence rates of perinatal fetus were compared between the two groups. Results Gestational weeks, newborn weight and Apgar score of the second fetus in the uterine-incision delivery group were much larger or higher than those of the vaginal delivery group （ P〈0.05 ）. The complication incidence rates of neonatal asphyxia and perinatal mortality in the uterine-incision delivery group were much lower than those of the vaginal deliv- ery group （ P〈0.05 ）. Conclusion Twin pregnancy women being carried out uterine-incision delivery, could obviously decrease the rate of neonatal asphyxia and rate of perinatal mortality, but it also could lead to premature delivery, hypoplasia and neonatal asphyxia, so we should properly control the rate of uterine-incision delivery. In the case of the choice of delivery modes of twin pregnancy, we should comprehensively consider cesarean section indication, gestational weeks, body weight of fetus, fetal posi- tion and pregnancy complications.