辅助生殖技术双胎与自然妊娠双胎妊娠结局比较

Clinical outcome comparison between twin pregnancy after in virto fertilization and embryo transfer and intracytoplasmic sperm injection and spontaneous twin pregnancy

目的探讨自然受孕与辅助生殖技术(ART)双胎妊娠母婴临床结局。方法收集666例辅助生殖技术(试管组)与自然妊娠(自然组)双胎妊娠的孕产妇和新生儿资料,分别比较孕产妇一般情况和妊娠并发症、剖宫产手术指征和围产儿临床妊娠结局。结果试管组初产妇比例、剖宫产、双绒毛膜双羊膜囊双胎比例、妊娠期糖尿病的发病率和产后出血量均高于自然组孕妇,差异有统计学意义(P<0.05);除瘢痕子宫外,2组剖宫产手术指征差异无统计学意义(P>0.05);2组新生儿并发症发生率差异无统计学意义(P>0.05)。结论加强辅助生殖技术受孕双胎妊娠的产前监护和管理,合理选择终止妊娠方式。

Objective To compare the clinical outcome of twin pregnancy after in virto fertilization and embryo transfer(IVF-ET)and intracytoplasmic sperm injection(ISCI)with that of spontaneous twin pregnancy.Methods Retrospective analysis of the clinical data of 666 twin pregnancies of IVF-ET/ISCI and spontaneous twin pregnancy including pregnancy complications,surgical indications of cesarean section,birth defects and perinatal outcomes was conducted.Results IVF-ET/ISCI group had advanced mean maternal age and a greater proportion of primipare and cesarean section and dichorionic twin pregnancy when compared with spontaneous twin pregnancy group(P<0.05).The incidence of gestational diabetes mellitus and postpartum hesmorrhage was significantly higher in IVF-ET/ISCI group(P<0.05).There was no difference in the incidence of surgical indications of cesarean section of these two groups except scarred uterus(P>0.05)and there was no difference regarding to the incidence of neonatal defects,asphyxia neonatorum,congenital heart disease,hyperbilirubinemia,ecrotizing enterocolitis,intracranial hemorrhage,retinopathy and septicemia of these two groups(P>0.05).Conclusions Antenatal care and management of twin pregnancy after IVF-ET/ISCI should be strengthened and a reasonable delivery method should be chosen.