双胎之一胎儿宫内死亡15例临床分析

Clinical analysis of 15 intrauterine death of one twins

目的 探讨双胎妊娠一胎儿死亡的原因 ,对存活儿的处理及分娩方式。方法 回顾性分析 1997年 1月～ 2 0 0 0年 12月我院收治的 15例双胎之一胎儿宫内死亡的临床资料。结果 双胎之一胎儿死亡的主要原因 :双胎输血综合征 4例 ,帆状胎盘 4例 ,胎盘早剥 1例 ,原因不明 6例。阴道顺娩 12例 ,引产 2例 ,剖宫产 1例。确诊胎儿死亡到分娩间隔时间平均5 5天。结论 孕中晚期发现双胎之一胎儿死亡 ,随无凝血机制变化 ,为减少存活儿围产期病死率及患病率 ,根据成熟胎儿情况 ,适时终止妊娠 ,期待治疗时间不宜过长。分娩方式 :如无产科指征 。

Objective:To explore the cause of intrauterine fetal death of one twine and its management on the other survivor as well as the way of parturauterine.Methods:Retrospective analysis of 15 cases of intrauterine fetal death of one twins between January 1997 and December 2000.Results:The main cause of fetal death of one twins were:twins-twins transfusion of syndrome (4 cases),velamentous insertion of umbilical cord (4 cases),abruptio placentae (1 cases)and unknown cause (6 cases).Vaginal delivery (12 cases),induces labor (2 cases),cesarean section (1 cases).The auerage time interval between the confirned death and other living born was 5.5 day.Conclusion:Although there is no change of blood coagulation,if the intrauterine death of one twins at the second or last trimester,according to the mature degree of the fetus the termination of pregnancy must be considered in order to reduce the perinatal mortality or morbidity of the live fetus,but the time of therapy of expectanoy no long.The way of parturition:If no obstetrical indication,vaginal delivery is safe for the mother and fetus.