不同绒毛膜性质双胎产妇母婴结局分析

Analysis of maternal and infant outcomes of twin pregnancy with different chorionic properties

目的探讨不同绒毛膜性质双胎产妇的母婴结局。方法选择2017年1月至2020年1月于灵宝市妇幼保健院常规产检并分娩的207例双胎妊娠,判定绒毛膜性,并依据结果分为DC双胎组与MC双胎组。采集两组的孕产期临床资料,对比两组孕产妇并发症与胎儿结局,对不同绒毛膜性质与母婴结局的关系进行分析。结果两组孕产妇年龄、孕次比较,差异均无统计学意义(P> 0.05);DC双胎组医源性妊娠率高于MC双胎组,差异有统计学意义(P <0.05)。MC双胎组GDM、HDP、胎膜早破、羊水过多、胎盘早剥发生率略高于DC双胎组,PPH发生率略低于DC双胎组,差异均无统计学意义(P> 0.05)。MC双胎组早产发生率高于DC双胎组,差异有统计学意义(P <0.05)。MC双胎组复杂性双胎、孕早中期胎儿丢失、新生儿窒息及围产儿死亡发生率均较DC双胎组高,差异有统计学意义(P <0.05)。结论不同绒毛膜性的双胎妊娠不会明显增加孕产妇并发症风险,但MC双胎妊娠的胎儿不良结局发生风险明显高于DC双胎妊娠,临床应在孕早期行超声检查明确绒毛膜性,并尽早实施监护和干预,以达到改善母婴结局的目的。

Objective To explore the maternal and infant outcomes of twin pregnancy with different chorionic properties.Methods From January 2017 to January 2020, 207 cases of twin pregnancy who had routine obstetrics and delivery in our hospital were selected to determine chorionic property, and were divided into DC twin group and MC twin group according to the results. The clinical data of the two groups during pregnancy and delivery were collected, the maternal complications and fetal outcomes between two groups were compared, and the relationship between different chorionic properties and maternal and infant outcomes was analyzed. Results There were no statistically significant differences between two groups in maternal age and pregnancy times(P > 0.05). The iatrogenic pregnancy rate in the DC twin group was higher than that in the MC twin group, and the difference was statistically significant(P < 0.05). The incidence of GDM, HDP, premature rupture of membranes, polyhydramnios, and placental abruption were slightly higher in the MC twins group than in the DC twins group, and the incidence of PPH was slightly lower than in the DC twins group, and there was no statistically significant difference(P > 0.05). The incidence of premature delivery in the MC twin group was higher than that in the DC twin group,and the difference was statistically significant(P < 0.05). The incidence rates of complicated twins, fetal loss in the first and second trimester, neonatal asphyxia and perinatal death in the MC twins group were higher than those in the DC twins group(P < 0.05).Conclusions Twin pregnancy of different chorionic nature will not significantly increase the risk of maternal complications, but the risk of adverse fetal outcomes in MC twin pregnancy is significantly higher than that of DC twin pregnancy. Ultrasound examination should be performed in the early pregnancy to confirm chorionic, and implement monitoring and intervention should be carried out as soon as possible to achieve the goal of improving maternal and child outcomes.