改善双胎妊娠母婴结局及减少并发症的方法

Clinical analysis of 258 patients with twin pregnancies

目的寻求改善双胎妊娠母婴结局及减少双胎妊娠并发症的方法。方法回顾性分析258例双胎妊娠孕产妇及其围生儿的临床资料,比较早产儿并发症、不同分娩方式及双胎特有并发症对母婴结局的影响。结果 (1)分娩孕周不同,新生儿并发症(主要有极低出生体重儿、呼吸窘迫综合征、高胆红素血症、缺血缺氧性脑病、新生儿窒息)发生率不同,差异有统计学意义(P<0.01)。(2)双胎妊娠剖宫产率93.57%,社会因素居于剖宫产原因的首位(22.75%);两种分娩方式产后出血发生率比较无统计学差异,自然分娩组新生儿窒息率(46.67%)明显高于剖宫产分娩组(10.20%),差异有统计学意义(P<0.001)。结论早产是造成双胎新生儿发病的主要原因,积极防治早产对提高新生儿的生存质量及远期预后具有重要意义。鼓励双胎孕妇阴道分娩,降低社会因素的剖宫产率。双胎妊娠特有并发症会增高胎儿不良结局的发生率。

Objective To review the clinical features of twin pregnancies,exploring the measures of improving the results of twin gestations. Methods The clinical data of 258 cases of twin pregnancies were collected and retrospectively analyzed; the neonatal complications,mode of delivery,and twins unique complications were compared. Results Different levels of newborn＇s complications in premature birth group and in different gestational age were low birth weight infant,neonatal respiratory distress syndrome,high bilirubin blood disease,neonatal hypoxic ischemia encephalopathy,neonatal asphyxia,each complication rate with very significant difference（ P〈 0. 001）. Cesarean section rate in twin pregnancy was 93. 57%,social factor was the main cause of cesarean section（ 22. 75%）,the incidence of postpartum hemorrhage in two delivery ways had no significantly difference（ P〉 0. 05）,neonatal asphyxia rate in vaginal delivery group（ 46. 67%） was significantly higher than in cesarean delivery group（ 10. 20%,P〈 0. 001）.Conclusions Premature birth is the major cause of neonatal twins morbidity. Prevention and treatment of premature birth is important to improve the quality of life and long-term prognosis of newborns. The suitable women are encouraged to choose vaginal delivery,reducing the cesarean section rates due to social factors.