双胎妊娠不同绒毛膜性母儿妊娠结局差异

Differences in Pregnancy Outcomes of Twins with Different Chorionic Pregnancies

目的 分析双胎妊娠不同绒毛膜性母儿妊娠结局的差异。方法 纳入2021年1月-2022年12月于武汉市妇幼保健院分娩的257例双胎孕妇,根据不同绒毛膜性将其分为双绒毛膜组与单绒毛膜组,回顾分析这些孕妇一般情况、分娩结局及新生儿并发症发病率,比较不同绒毛膜性母儿妊娠结局的差异。结果 单绒毛膜组孕妇早产发生率高于双绒毛膜组(58.4%vs43.3%),差异有统计学意义(P <0.05);单绒毛膜组与双绒毛膜组之间产后出血(3.9%vs8.9%)、剖宫产率(88.3%vs 92.8%)差异无统计学意义(P> 0.05);单绒毛膜组新生儿低体重(72.1%vs 47.5%)、新生儿肺炎(36.4%vs 20.0%)、新生儿高胆红素血症(33.8%vs 22.8%)、新生儿呼吸衰竭(15.6%vs 7.5%)发生率高于双绒毛膜组,差异具有统计学意义(P <0.05);两组新生儿呼吸窘迫综合征(8.4%vs 5.8%)、缺血缺氧性心肌损害(17.5%vs 11.7%)发病率差异均无统计学意义(P> 0.05)。结论 单绒毛膜组孕妇早产率、新生儿低体重儿、新生儿肺炎、新生儿高胆红素血症及新生儿呼吸衰竭发生率更高,临床应更加重视。

Objective To analyze the difference in pregnancy outcomes of twins with different chorionic pregnancies.Methods We analyzed 257 pregnant women with twins who gave birth in Wuhan Maternal and Child Healthcare Hospital from January 2021 to December 2022 and divided them into two groups according to their chorionic characteristics:the double chorionic group and the single chorionic group.The general conditions,delivery outcomes,and neonatal complications of these pregnant women were analyzed retrospectively,and the differences in pregnancy outcomes of different chorionic mothers and children were compared.Results The incidence of preterm delivery in the monochorionic group was higher than in the double-chorionic group(58.4%vs.43.3%).The difference was statistically significant(P<0.05).There was no significant difference in postpartum hemorrhage(3.9%vs.8.9%)and cesarean section rate(88.3%vs.92.8%)between the monochorionic group and the dichorionic group(P>0.05).The incidence of neonatal low body weight(72.1%vs.47.5%),neonatal pneumonia(36.4%vs.20.0%),neonatal hyperbilirubinemia(33.8%vs.22.8%),and neonatal respiratory failure(15.6%vs.7.5%)in the monochorionic group was higher than that in the dichorionic group.The difference was statistically significant(P<0.05).There was no significant difference in the incidence of neonatal respiratory distress syndrome(8.4%vs.5.8%)and ischemic hypoxic myocardial damage(17.5%vs.11.7%)between the two groups(P>0.05).Conclusion The incidence of preterm birth,low birth weight,neonatal pneumonia,neonatal hyperbilirubinemia,and neonatal respiratory failure are higher in the monochorionic group,which should be paid more attention to clinically.