非复杂性双胎妊娠妇女分娩时机对其母婴结局的影响

Effect of timing for delivery of twins from uncomplicated twin pregnancy on outcomes in terms of the well being of mother and neonate

目的探讨非复杂性双胎妊娠妇女分娩时机对其母婴结局的影响。方法回顾2014年1月—2016年6月313例非复杂性双胎妊娠孕妇的临床资料,统计单绒毛膜双羊膜囊双胎(monochorionic diarnniotictwin pregnancy,MCDA)、双绒毛膜双羊膜囊双胎(dichorionic diamniotic twin pregnancy,DCDA)例数;分析两组患者的分娩时间对新生儿及产妇的不良结局的影响。结果 DCDA组产妇以辅助受孕为主,MCDA组患者以自然受孕为主;两组受孕方式差异有统计学意义(P<0.05),其他一般资料比较差异无统计学意义(P>0.05)。DCDA组的分娩时间较MCDA晚,新生儿不良情况发生率低于MCDA组,差异均有统计学意义(P<0.05);两组产妇妊娠合并症发生率比较差异无统计学意义(P>0.05)。DCDA孕妇36周以后、MCDA孕妇37周以后分娩可降低新生儿不良反应的发生。结论分娩时间是非复杂性双胎的新生儿不良结局的重要因素,临床上应加以重视。

Objective To evaluate the effect of timing for delivery of twins from non-complex twin pregnancy on the maternal and neonatal outcomes.Method The clinical data of 313 cases of non-complex twin pregnancy collected from January 2014 to June 2016 were firstly reviewed.Cases of monochorionic diamnionic twin（MCDA） and cases of double chorionic diamnionic twin（DCDA） were then documented.The effect of the timing for delivery on the maternal and neonatal outcomes of the two groups was then analyzed and evaluated.Findings The pregnant women in the DCDA group were mainly of assisted conception,while the patients in the MCDA group were mainly of natural conception（P〈0.001）.No statistical difference was found between the two groups in the other general data（P〈0.05）.The delivery time of the DCDA group was later than that of the MCDA group.The rate of incidence of mal-neonatal condition was lower than that of the MCDA group（P〈0.05）.No statistically significant difference was found between the two groups in the rate of incidence of pregnancy complications（P〈0.05）.Delivery time for the DCDA group set at a time after 36 weeks of pregnancy and that for the MCDA group after 37 weeks of pregnancy reduced the incidence of neonatal adverse reactions.Conclusion Delivery time is an important factor leading to adverse outcomes of non complex twins and should therefore be scientifically scheduled.