中药联合硫酸镁拉贝洛尔妊娠高血压合并肾损伤150.docVIP

2016-12-16 郭 2017-01-04 董 2017-1-10 主任加工 不同类型MCDA双胎并发sIUGR的妊娠结局 曾琳芮 （成都市第七人民医院 妇产科，四川 成都 610041） 【摘要】目的：探析不同类型单绒毛膜双羊膜囊（MCDA）双胎妊娠选择性宫内生长受限（sIUGR）胎儿的妊娠结局及预后情况。方法：选取我院2012015年6月收治的MCDA并发sIUGR孕妇40例（80胎）作为观察组，同时根据脐动脉血流频谱分型将其细分为Ⅰ型（20例）、Ⅱ型（12例8例）。另选取同期无合并症的MCDA孕妇40例（80胎）作为对照组。对比2组及3种类型sIUGR之间胎儿的分娩孕周、出生体质量、双胎出生体质量差、宫内病死率、新生儿病死率及半年存活率等情况。结果：观察组孕妇宫内两胎病死率、两胎儿出生体质量差均明显高于对照组（P＜0.05或P＜0.01）；观察组胎儿分娩孕周明显早于对照组，大、小胎儿的出生体质量明显低于对照组（P＜0.01）；观察组中Ⅱ型新生儿病死率显著高于Ⅰ型组，分娩孕周明显早于Ⅰ型组，且小胎儿出生体质量最低，明显低于Ⅰ型组（P＜0.05）。观察组和对照组间新生儿病死率、半年双胎存活率无显著性差异（P＞0.05）。结论：不同类型MCDA合并sIUGR胎儿的妊娠结局和预后均不同，其中Ⅱ型预后差，胎儿宫内病死率高，因此临床需密切监测孕期胎儿情况，及时警惕各种异常。 【关键词； 【中图分类号】R714.23【文献标识码】A DOI:10.11851/j.issn.1673-1557.2017.01.0 Pregnancy outcome and prognosis of different types of monochorionic diamniotic twins with selective intrauterine growth restriction ZENG Linrui (Department of Obstetrics and Gynecology, Chengdu Seventh People’s Hospital, Chengdu 610041,China) 【Abstract】 Objective： To evaluate the pregnancy outcome and prognosis of different types of monochorionic diamniotic(MCDA) twins with selective intrauterine growth restriction(sIUGR). Methods： 40 cases of pregnant women with MCDA twins(80 fetuses) with sIUGR in our hospital from June 2010 to June 2015 were selected as observation group, which was divided into type Ⅰ(20 cases), type Ⅱ(12 cases) and type Ⅲ(8 cases) according to the classification of umbilical artery blood flow spectrum. In addition, 40 normal MCDA cases(80 fetuses) were selected as control group. The gestational week at delivery, birth weight, birth weight difference of twins, rate of intrauterine fetal death, neonatal death and survival rate within 6 months were compared between the two groups, and among the three types of sIUGR as well. Results： Both the rate of intrauterine fetal death and birth weight difference of twins in the observation group were significantly higher than those in the control group(P＜0.05 or P＜0.01). The gestational week at delivery in the observation group was significantly earlier