双胎妊娠绒毛膜性质对妊娠并发症及围产儿结局的影响

Effects of Chorionic Property of Twin Pregnancy on Pregnancy Complications and Perinatal Outcomes

目的:对比分析单绒毛膜双胎(MCT)和双绒毛膜双胎(DCT)对妊娠并发症及围产儿结局的影响。方法:选取2017年1月-2019年2月在本院产科接受产前检查,经超声检查并确认为双胎妊娠的98例孕妇为研究对象,按照双胎妊娠绒毛膜性质的不同,将其分为单绒毛膜双胎组(MCT组,46例)和双绒毛膜双胎组(DCT组,52例)。比较两组产妇妊娠期并发症及围产儿结局。结果:DCT组妊娠期肝内胆汁淤积症(ICP)、早产(PB)的发生率均低于MCT组,差异均有统计学意义(P<0.05)。两组胎膜早破(PROM)、妊娠期高血压、产后出血(PPH)、前置胎盘(PP)、胎盘早剥(PA)发生率比较,差异均无统计学意义(P>0.05)。DCT组双胎输血综合征(TTTS)、新生儿窒息(NA)、低出生体重儿(LBWI)、胎儿生长受限(FGR)、双胎生长不一致(DT)发生率均低于MCT组,差异均有统计学意义(P<0.05);两组胎儿窘迫(FD)、双胎之一胎死宫内(sIUFD)发生率比较,差异均无统计学意义(P>0.05)。结论:在孕早期对双胎妊娠绒毛膜性状进行判断,不仅有利于积极预防妊娠并发症的发生,同时还能促进围生儿预后状况明显改善。

Objective:To compare and analyze the effects of monochorionic twins(MCT) and dichorionic twins(DCT) on pregnancy complications and perinatal outcomes.Method:A total of 98 pregnant women who received prenatal examinations in our obstetrics department from January 2017 to February 2019 and were confirmed to have twin pregnancies by ultrasound were selected as the study subjects,according to the different chorionic properties of twin pregnancy,they were divided into single chorionic twin group (MCT group,46 cases) and double chorionic twin group (DCT group,52 cases).Pregnancy complications and perinatal outcomes were compared between the two groups.Result:The incidence of intrahepatic cholestasis of pregnancy (ICP) and preterm birth (PB) in the DCT group were lower than those in the MCT group,the differences were statistically significant (P<0.05).The incidence of premature rupture of membrane (PROM),gestational hypertension,postpartum hemorrhage (PPH),placenta previa (PP),placental abruptio (PA) between the two groups were compared,the differences were not statistically significant (P>0.05).The incidences of twin to twin transfusion syndrome (TTTS),neonatal asphyxia (NA),low birth weight infants (LBWI),fetal growth restriction (FGR),and discordance twin (DT) in the DCT group were lower than those in the MCT group,the differences were statistically significant (P<0.05);there were no significant differences in the incidence of fetal distress (FD) and single intrauterine fetal death (sIUFD) between the two groups (P>0.05).Conclusion:To judge the chorionic characteristics of twin pregnancy in the early stage of pregnancy is not only beneficial to prevent pregnancy complications,but also to improve the prognosis of perinatal babies.