摘要
目的:探讨单绒毛膜双羊膜囊双胎选择性胎儿生长受限(sFGR)的临床特征与围产结局。方法:产前检查并分娩单绒毛膜双羊膜囊双胎妊娠孕妇365例,其中单绒毛膜双羊膜囊双胎sFGR 65例为研究组,随机选择同期分娩无sFGR单绒毛膜双羊膜囊双胎70例为对照组,对两组孕妇的基本资料、胎儿超声检查结果及围产儿结局进行分析与比较。结果:研究组分娩孕周小于对照组,差异有统计学意义(P<0.01);研究组大、小新生儿出生体质量低于对照组,双胎间出生体质量的差异高于对照组,差异均有统计学意义(P<0.01);研究组脐动脉血流异常、早产率、双胎之一胎死宫内及围产儿死亡的发生率明显高于对照组,差异有统计学意义(P<0.01);研究组1胎羊水过少及重度新生儿窒息的发生率高于对照组,差异有统计学意义(P<0.05);研究组轻度新生儿窒息及两胎胎死宫内的发生率高于对照组,但差异无统计学意义(P>0.05);单绒毛膜双羊膜囊双胎sFGR围产儿死亡组的羊水过少发生率和脐动脉血流频谱Ⅱ型胎儿的比率均显著高于围产儿存活组,差异有统计学意义(P<0.01);围产儿死亡组的脐动脉血流频谱Ⅰ型或Ⅲ型胎儿的比率低于围产儿存活组,差异有统计学意义(P<0.01)。结论:单绒毛膜双羊膜囊双胎并发sFGR的不良围产结局发生率增加,围产儿死亡率明显升高,脐动脉血流多普勒监测异常可提示不良的围产结局,应严密加强产前监护。
Objective： To explore the clinical characteristics and perinatal outcome of monoehorionic diamnotic twin pregnancies combined with selective intrauterine growth restriction （sFGR） . Methods： A total of 365 pregnant women with monochorionic diamnotic twin pregnancies receiving prenatal examination in the hospital were selected, and 65 pregnant women of them were found with sFGR （ study group ） ; 70 pregnant women with monoehorionic diamnotic twin pregnancies and without sFGR were selected as control group; the basic data, fetal ultrasonographic results and perinatal results in the two groups were compared. Results： The gestational week at delivery in study group was statistically significantly lower than that in control group （ P 〈 0. 01 ） . Neonatal birth weight in study group was statistically significantly lower than that in control group, and the difference of neonatal birth weight between the twins in study group was statistically significantly higher than that in control group （P 〈 O. 01 ） . The incidence rates of umbilical artery flow abnormality, preterm delivery, one fetal death and perinatal mortality in study group were statistically significantly higher than those in control group （P 〈 0. 01 ） . The incidence rates of one fetal oligohydramnios and severe neonatal asphyxia in study group were statistically significantly higher than those in control group （ P 〈 O. 05 ） . The incidence rates of mild neonatal asphyxia and two fetal death in study group were higher than those in control group, but there was no statistically significant difference （ P 〉 0.05 ） . In study group, the incidence rate of fetal oligohydramnios and the ratio of fetal with umbilical artery flow Doppler type II in perinatal death subgroup were statistically significantly higher than those in perinatal survival group （ P 〈0. 01 ） , the ratios of fetal with umbilical artery flow Doppler type [ or type m in perinatal death subgroup were statistically significantly lower than those in perinatal survival group （ P 〈 0. 01 ） . Conclusion ： The incidence rate of poor perinatal outcome and perinatal mortality of monochorionic diamnotic twin pregnancies combined with sFGR increase significantly. Umbilical artery flow Doppler abnormalities may in- dicate worse perinatal outcome, prenatal monitoring should be enhanced.
出处
《中国妇幼保健》
CAS
北大核心
2014年第13期2030-2032,共3页
Maternal and Child Health Care of China
关键词
单绒毛膜双羊膜囊双胎
选择性胎儿生长受限
围产儿
结局
Momochorionic diamnotic twins
Selective intrauterine growth restriction
Perinatal infant
Outcome
