史宏顾玮刘春敏孟瑜蔡彦卿.双胎妊娠一胎宫内死亡18 例临床分析[J].现代生物医学进展英文版,2012,12(11):2095-2098. |
双胎妊娠一胎宫内死亡18 例临床分析 |
18 cases of Twin Pregnancy Complicated by Single Intrauterine Fetal Death |
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DOI: |
中文关键词: 双胎妊娠 一胎死亡 期待疗法 |
英文关键词: Twin pregnancy Intrauterine fetal death Expectant therapy |
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中文摘要: |
目的:探讨双胎妊娠中一胎宫内死亡的原因、对母亲和存活胎儿的影响及临床处理方法。方法:对2001 年1 月至2011 年10
月分娩的双胎妊娠之一胎宫内死亡的18 例产妇临床资料进行回顾性分析。结果:双胎妊娠一胎宫内死胎的发生率占双胎的
1.08%,其中单绒毛膜双羊膜囊双胎(monochorionic-diamniotic twin, MCDA)11 例( 61.11%),双绒毛膜双羊膜囊双胎(dichorionicdiamniotic
twin, DCDA)7 例( 38.89%)。胎儿死因:胎盘脐带因素3 例(16.67%) , 胎儿畸形1 例(5.56%),妊娠并发症3 例(16.67%),
双胎输血综合征(twin-twin transfusion syndrome, TTTs)3 例(16.67%),宫内感染3 例( 16.67%),不明原因5 例( 27.78%)。另一胎选
择剖宫产者13 例, 阴道分娩3 例。双胎一胎死亡后对母体的凝血功能影响不大(P>0.05)。结论:单绒毛膜双胎较双绒毛膜双胎母
儿结局存在差别;双胎一胎宫内死亡对母体及存活儿有一定影响。对于孕周小,胎儿尚不成熟的病例,可严密监测存活胎儿宫内
情况,行期待治疗延长孕龄至足月再分娩。 |
英文摘要: |
Objective: To investigate the cause and factors of the mother and fetus survival in single intrauterine fetal death complicated
by twin pregnancy and clinical treatments. Methods: To collect 18 cases of twin pregnancy complicated by single intrauterine fetal
death in our hospital from January 2001 to October 2011 and their clinical data were retrospectively analyzed. Results: Single intrauterine
fetal death accounted for 1.08% in twin pregnancy, in which 11 cases (61.11%) were monochorionic-diamniotic twin (MCDA), and 7
cases dichorionic-diamniotic twin (DCDA) (38.89%). The cause of fetal death: 3 cases of Placental umbilical cord factor (16.67%), 1
case of fetal malformation (5.56%), 3 cases pregnancy complications (16.67%), 3 cases twin-twin transfusion syndrome (TTTs) (16.67
%), 3 cases intrauterine infection (16.67%), and unknown causes in 5 cases (27.78%). Cesarean section was the delivery mode in 15 cases,
and 3 cases vaginal delivery. Little effect was on mother's coagulation in twin pregnancy after single intrauterine fetal death (P> 0.05).
Conclusions: There were differences in the maternal and fetal outcome between DCDA and MCDA. A lot of impact on the mother and
survival fetus occurred after single intrauterine fetal death in twin pregnancy. Expectant therapy was an effective choice for twin pregnancy
complicated by single intrauterine death before delivery because the small gestational age and immature fetus. |
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