摘要
目的:探讨多胎妊娠延迟分娩的临床处理及母胎近远期结局。方法:回顾性分析2010年1月至2018年9月四川大学华西第二医院发生的多胎妊娠延迟分娩15例的临床资料。结果:15例中1例单绒毛膜双羊膜囊双胎,1例双绒毛膜三羊膜囊三胎,1例三绒毛膜三羊膜囊三胎,余均为双绒毛膜双羊膜囊双胎。第一胎儿平均分娩孕周为28周。延迟分娩平均间隔时间为5.2天,延迟胎儿平均分娩孕周为29周,延迟胎儿平均出生体质量1294.6 g。延迟胎儿共17个,死胎、死产3个,活产儿14个,存活新生儿8个。15例共32个胎儿活产23个,存活12个,存活儿平均分娩孕周31+5周,出生体质量为1672 g,存活儿中1例发生脑白质软化,余预后良好。15例中发生宫内感染2例,母体败血症1例,胎盘胎膜残留4例,胎盘早剥2例,母体肺水肿1例,母体上消化道出血1例。结论:当多胎妊娠第一胎儿流产或早产后,密切监测母胎状况下,严格掌握指征,实施延迟分娩,可延长未娩出胎儿孕周,改善延迟胎儿围生结局。
Objective:To investigate the clinical management and the recent and long-term perinatal outcome of the delayed-interval delivery in multiple pregnancies.Methods:15 cases of delayed delivery in multiple pregnancies in West China Second University Hospital between January 2010 and september 2018 were retrospectively analyzed.Results:There were one case of monochorionic diamniotic twin,one case of dichorionic triamniotic triplet,one case of trichorionic triamniotic triplet,and thirteen cases of dichorionic diamniotic twins.The mean gestational age at first delivery was 28 weeks.The mean duration of delay was 5.2 days and the mean gestational age at second delivery was 29 weeks.The average birth weight of second fetuses was 1294.6 g.Among 17 delayed fetuses,stillbirth occurred in 3 cases and 8 cases survived in the 14 born alive neonates.There were 32 fetuses in the 15 cases,among them,12 neonates survived with delivery age at 31+5 weeks in the 32 born alive neonates,and their birth weight was 1672 g.Except for 1 born alive neonate suffered from leukomalacia,the others are in good health during following up.Maternal complications were clinical chorioamnionitis(2 cases),maternal sepsis(1 case),remains of pregnancy products(4 cases),placental abruption(2 cases),maternal pulmonary edema(1 case),and maternal upper gastrointestinal bleeding(1 case).Conclusions:Delayed-interval delivery is an optional and useful procedure for the management of the first fetus abortion or preterm delivery in multiple pregnancy.It can prolong gestational age of unborn fetuses and improve the perinatal outcome of the second or third infant.
作者
邓春艳
胡青
王晓东
廖华
余海燕
DENG Chunyan;HU Qing;WANG Xiaodong(Department of Obstetrics and Gynecology,West China Second University Hospital,Key Laboratory of Birth Defects and Related Diseases of Women and Children Sichuan University Ministry of Education,Chengdu Sichuan 610041,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2019年第9期689-693,共5页
Journal of Practical Obstetrics and Gynecology
基金
四川省科技厅重点研发项目(编号:2018FZ0041)
四川省学术和技术带头人培养支持经费项目(编号:川人社办发[2017]919-25)
关键词
多胎妊娠
延迟分娩
围生结局
Multiple pregnancy
Delayed-interval delivery
Perinatal outcome