双胎妊娠合并未足月胎膜早破对新生儿早期结局的影响

Influence of twin pregnancy with preterm premature rupture of membranes on neonatal outcomes

目的调查双胎妊娠未足月胎膜早破对新生儿结局的影响。方法回顾性分析2010年1月至2018年12月复旦大学附属妇产科医院分娩的1299对胎龄28^(+0)~36^(+6)周双胎儿的临床资料,分析未足月胎膜早破对新生儿结局的影响。结果胎龄28^(+0)~36^(+6)周双胎胎膜早破发生率为24.2%。胎膜早破组阴道分娩率高于对照组,差异有统计学意义(P<0.05)。胎膜早破组胎龄及出生体质量低于对照组,差异有统计学意义(P均<0.05)。围生儿结局中,胎膜早破组新生儿呼吸窘迫综合征、喂养不耐受、新生儿感染的发生率高于对照组,差异有统计学意义(P均<0.05)。结论双胎未足月胎膜早破发生率较高,其新生儿发生呼吸窘迫综合征、新生儿喂养不耐受、新生儿感染的风险增加,临床诊疗需警惕这些问题。

Objective To investigate the effect of preterm premature rupture of membranes(PPROM)on neonatal outcomes in twin pregnancy.Methods Clinical data of 1299 pairs of fetuses with gestational age of 28^(+0)-36^(+6) weeks delivered in Obstetrics&Gynecology Hospital of Fudan University from January 2010 to December 2018 were retrospectively analyzed to determine the effect of PPROM on neonatal outcomes.Results The incidence of PPROM in twins at 28^(+0)-36^(+6) weeks of gestational age was 24.2%.The vaginal delivery rate of PPROM group was higher than that of control group,and the difference was statistically significant(P<0.05).The gestational age and birth weight of PPROM group were lower than those of the control group,and the differences were statistically significant(P all<0.05).In the perinatal outcome,the incidence of neonatal respiratory distress syndrome,feeding intolerance and neonatal infection in PPROM group was higher than that in the control group,and the difference was statistically significant(P all<0.05).Conclusion The incidence of premature rupture of membranes in preterm twins is high,and the risk of respiratory distress syndrome,neonatal feeding intolerance and neonatal infection is increased.Therefore,it is necessary to be vigilant in clinical care.