摘要
目的:探究双胎妊娠不同分娩孕周的孕妇分娩方式、产后出血、新生儿不良结局发生情况。方法:收集2018年12月-2021年12月本院产科和苏州市立医院产科收治的双胎妊娠孕妇105例临床资料,回顾性分析分娩方式、胎儿大小、早产、晚期流产、胎儿体重、新生儿窒息发生率,统计不同分娩孕周(≥37周32例、孕34~36周52例、孕28~33周21例)新生儿窒息率及产妇产后出血情况。结果:自然分娩与剖宫产产妇产后出血发生率在分娩孕周≥37周(0、10%)、34~36周(28.6%、8.9%)、28~33周(0、6.3%)均无差异(P>0.05);34~36周剖宫产组与自然分娩组第2胎新生儿窒息率(4.4%、14.3%)有差异,孕34~36周分娩的新生儿体质量自然分娩组低于剖宫产组(均P<0.05);孕≥37周、孕28~33周自然分娩组及剖宫产组新生儿窒息率及出生体质量无差异(P>0.05)。结论:对于双胎妊娠产妇临床应尽量将孕期适当延长至孕36~37周,并放宽剖宫产指征,以减少阴道试产过程中可能发生的意外风险。
Objective: To study the situations of postpartum hemorrhage and the neonatal outcomes of twin pregnant women with pregnancy termination in different gestational weeks by different delivery model. Methods: The clinical data of 105 pregnant women with twin pregnancy from December 2018 to December 2021 were collected. The delivery model, the gestational weeks of newborns, the premature delivery rate, and the abortion rate during the third trimester of pregnancy, the fetal weight, and the incidence of neonatal asphyxia of these women were analyzed retrospectively. The incidence of neonatal asphyxia and the situation of postpartum hemorrhage of the women after cesarean section(in group A) or vaginal delivery(in group B) were analyzed, which included 32 cases with delivery during ≥37 gestational weeks, 52 cases with delivery during 34-36 gestational weeks, and 21 cases with delivery during 28-33 gestational weeks. Results: There was no significant difference in the incidence of postpartum hemorrhage of the women delivered during ≥37 gestational weeks(0 vs. 10%), during 34-36 gestational weeks(28.6% vs. 8.9%), and during 28 to 33 gestational weeks(0 vs. 6.3%) between the two groups(P>0.05). When delivery during 34-36 gestational weeks, the asphyxia rate(4.4%) of the second neonate of the women in group A was significantly different from that(14.3%) of the women in group B, and the body weight of neonates in group B was significantly lower than that in group A(all P<0.05). When delivery during ≥37 and 28-33 gestational weeks, there were no significant differences in neonatal asphyxia rate and the neonatal birth weight between the two groups(P>0.05). Conclusion: The pregnant women with twin pregnancies should be prolonged their pregnancy to 36-37 gestational weeks as far as possible, and the indications of cesarean section should not be severely limited for decreasing the risk of accidents that may occur in the process of vaginal trial delivery.
作者
杜娟
魏翠
汪云
DU Juan;WEI Cui;WANG Yun(The Frist People's Hospital of Suqian,Jiangsu Province,223800;Suzhou Municipal Hospital of Jiangsu Province)
出处
《中国计划生育学杂志》
2022年第8期1897-1900,共4页
Chinese Journal of Family Planning
关键词
双胎妊娠
不同分娩孕周
剖宫产
阴道分娩
产后出血
新生儿结局
Twin pregnancies
Different delivery gestational weeks
Delivery mode
Postpartum hemorrhage
Neonatal outcomes
