双胎妊娠孕妇在剖宫产术中一胎保留胎膜囊的临床研究

Clinical research on the preservation of membrane sac for first newborn of pregnant women with twin pregnancy during cesarean section

目的探讨双胎妊娠一胎保留胎膜囊的剖宫产术对孕妇及新生儿的影响。方法选取新余市妇幼保健院2018年6月至2020年12月收治的双胎妊娠欲行剖宫产术的孕妇50例,采用随机数字表法分为研究组(25例)和对照组(25例),研究组剖宫产术中前一新生儿常规方式娩出,另一新生儿保留胎膜囊,使子宫切口周围无胎盘,胎儿及羊水随羊膜囊自宫腔完整娩出;对照组按传统方法分别破膜,吸尽羊水,依次取出胎儿,比较两组术中及术后24 h子宫出血和产妇及新生儿不良反应发生情况。结果两组产妇第二胎儿娩出时间比较,差异无统计学意义(P>0.05);研究组术中、术后24 h子宫出血量均少于对照组,差异有统计学意义(P<0.05)。研究组第二个新生儿并发症总发生率均低于对照组,差异具有统计学意义(P<0.05)。结论采用双胎妊娠一胎保留胎膜囊的剖宫产术可以减少术中及术后24 h出血量,同时可以降低第二个新生儿临床并发症发生率。

Objective To investigate the effect of cesarean section with preserving membrane sac for first newborn in twin pregnancy on pregnant women and newborns.Methods A total of 50 cases of pregnant women who underwent cesarean section for twin pregnancy admitted to Xinyu Maternal and Child Health Hospital from June 2018 to December 2020 were selected as the research subjects.According to the random number table,they were divided into a study group(25 cases)and a control group(25 cases).In the study group,the first newborn was delivered by the conventional method during the cesarean section.And the other newborn was preserved with the membranous sac.It was observed that there was no placenta around the uterine incision.The newborn and amniotic fluid were completely delivered from the uterine cavity along with the amniotic sac.The control group was delivered by traditional methods.The membranes were broken,the amniotic fluid was sucked,and the newborns were taken out in sequence.Intraoperative and 24 hour postoperative uterine bleeding,and the incidence of maternal and neonatal adverse reactions were compared in the two groups.Results There was no statistically significant difference in the delivery time of the second newborn between the two groups(P>0.05).The intraoperative and 24 h uterine bleeding in the study group were fewer than those of the control group,and the differences were statistically significant(P<0.05).The total incidence of complications in the second newborn in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion The cesarean section with preserving membrane sac for first newborn in twin pregnancy can reduce the intraoperative and 24 h blood loss,and reduce the clinical complications of the second newborn.