复杂性双胎妊娠对母体、胎儿或新生儿并发症的影响

Effect of complicated twin pregnancy on maternal,fetal and neonatal complications

目的探讨复杂性双胎妊娠对母体、胎儿或新生儿并发症的影响。方法回顾性分析2000-01至2014-12终止妊娠的双胎妊娠319例,其中57例复杂性双胎作为复杂组,262例非复杂性双胎作为非复杂组,比较两组母体、胎儿或新生儿并发症的差别。结果 (1)复杂组的分娩孕周(35.0周)早于非复杂组(36.0周),羊水过多或羊水过少的发生率(12.3%)明显高于非复杂组(1.5%),差异均有统计学意义(P<0.05);两组孕产妇的年龄、孕次、受孕方式、胎儿性别等一般情况,妊娠期高血压、妊娠期糖尿病、前置胎盘或胎盘早剥、胎膜早破、产后出血、产后贫血、妊娠期肝内胆汁淤积症等并发症均无统计学差异(P>0.05)。(2)复杂组胎儿丢失率(18.4%)、早产或流产率(87.7%)、新生儿颅脑损伤发生率(12.3%)、新生儿窒息率(8.8%)等并发症的发生率均高于非复杂组,新生儿出生体重(2113±574)g明显低于非复杂组(2332±471)g,复杂组新生儿住院率(32.5%)明显高于非复杂组(20.4%),差异均有统计学意义(P<0.05)。结论复杂性双胎对孕产妇的并发症无明显影响;对胎儿或新生儿的影响明显,不仅异常胎儿本身预后不良,而且一胎儿异常也影响另一胎儿的预后。

Objective investigate the effect of complicated twin pregnancy on maternal,fetal and neonatal complications.Methods 319 cases of twin pregnancies were retrospectively studied in this hospital from January 2000 to December 2014. The complicated twin pregnancies（ n = 57） were taken as the complicated group,and the non-complicated twin pregnancies（ n = 262） during the same period as the non-complicated group,and the complications between the two groups were compared. Results（ 1） Delivery gestational weeks of the complicated group（ 35. 0 weeks） was less than that of the non-complicated group（ 36. 0weeks）,and the incidence of polyhydramnios or oligohydramnios of the complicated group（ 12. 3%） was higher than that of the non-complicated group（ 1. 5%）. Boththe differences were statistically significant（ P〈0. 05）. The maternal age,pregnancy,fertilization way,fetal sex,gestational period hypertension,pregnancy diabetes,placenta previa or abruption,premature rupture of membranes,postpartum hemorrhage,postpartum anemia,pregnancy intrahepatic cholestasis and other complications had no significant differences（ P〈0. 05）.（ 2） The fetal loss rate（ 18. 4%）,preterm birth or abortion rate（ 87. 7%）,neonatal brain injury rate（ 12. 3%）,neonatal asphyxia rate（ 8. 8%） and the incidence of other complications of the complicated group were higher than the non-complicated group. The birth weight of the complicated group（ 2113 ± 574） g was significantly less than the non-complicated group（ 2332 ± 471） g,neonatal hospitalization rate of the complicated group（ 32. 5%） was higher than the non-complicated group（ 20. 4%）. All the differences were statistically significant（ P〈0. 05）. Conclusions Complicated twinpregnancy has no significant effect on the maternal complications. It has a worse outcome for the fetus or neonate,not only the abnormal fetal prognosis is bad,but also the prognosis of the other is affected by the abnormal fetus.