双胎妊娠胎盘早剥母儿妊娠结局及相关因素分析

Pregnancy outcomes and related factors in tw in pregnancy with placental abruption

目的回顾性分析双胎妊娠相关资料,探讨双胎妊娠胎盘早剥的母儿妊娠结局及相关影响因素,提高对双胎妊娠胎盘早剥的认识和处理能力.方法以2015年6月至2018年5月福建省妇幼保健院双胎妊娠孕妇为研究对象,选取胎盘早剥(病例组)30例,同期非胎盘早剥(对照组)60例,分析两组妊娠结局的差异和可能的相关因素.结果研究期间双胎胎盘早剥的发生率为2.26%(30/1325).病例组发生胎儿窘迫的概率显著高于对照组(P<0.05);高龄孕妇、单绒毛膜双胎、产前贫血是双胎发生胎盘早剥的危险因素(P<0.05);单绒毛膜双胎和产前贫血是独立危险因素[OR=4.809,95%CI:(1.366,16.935);OR=2.930,95%CI:(1.048,8.193)].结论胎盘早剥增加了双胎胎儿窘迫的发生,双胎妊娠胎盘早剥与高龄孕妇、单绒毛膜、产前贫血等因素相关.

Objective To retrospectively analyze the maternal and neonatal outcomes and possible associated factors of placental abruption in twin pregnancies so as to improve the awareness and ability to deal with placental abruption in twin pregnancies.Methods Ninety cases of twin pregnant women delivered in Fujian Maternity and Child Health Hospital, Gynecology and Pediatrics Clinical Medical College of Fujian Medical University from June 2015 to May 2018 were involved, among which, 30 cases of placental abruption were chosen as case group and 60 cases of non-placental abruption as control group.The differences in pregnancy outcomes between the two groups and the possible related factors were analyzed.Results The incidence rate of twin placental abruption was 2.26%(30/1 325) during the study period.The incidence of fetal distress in case group was significantly higher than that in control group(P<0.05).Single factor analysis showed that advanced maternal age, monochorionic twin and prenatal anemia were the risk factors of placental abruption(P<0.05).Multiple logistic regression analysis showed that monochorionic twin and prenatal anemia were independent risk factors [OR=4.809, 95%CI:(1.366,16.935) and OR=2.930, 95%CI:(1.048,8.193)].Conclusion Placental abruption increased the incidence of twin fetal distress when compared with non-twin pregnancies.Placental abruption was associated with advanced maternal age, monochorionic membranes and prenatal anemia.