多胎妊娠的现状分析.docVIP

多胎妊娠的现状分析 【摘要】目的探讨目前多胎妊娠的发生率及影响妊娠结局的相关因素。方法选择2000年1月～2005年12月在我院分娩的340例多胎妊娠，对其临床资料进行统计学分析。结果多胎妊娠的母婴并发症多，胎龄小于34周的早产儿窒息率、围产期死亡率高，胎龄大于34周者，剖宫产组新生儿的窒息率、围产期死亡率显著低于阴道分娩组（P0.01）。结论应严格掌握促排卵药物及辅助生育技术的应用指征，注意孕期保健，减少并发症，尽量延长孕周至34周以上。剖宫产指征可适当放宽。 【关键词】 多胎妊娠 分娩方式 新生儿结局 Analysis of the present multiple pregnancy situations HUANG Ling, SU Qin, XU Xiu-fang(Taian Central Hospital,Taian 271000, China) Abstract: Objective: To study the incidence of multiple pregnancy and the related factors affecting the outcome of pregnancy. Methods: 340 cases of multiple pregnancy in the authors hospital from Jaunary,2000 to December,2005 were selected and analyzed statistically. Results: Multiple pregnancy had more compilcations of expectant mother and infant, as well as increased incidence of neonatal asphyxia and perinatal mortality of preterm infants whose gestational age were less than 34 weeks. Among neonatals whose gestational age were over 34 weeks, the incidence of neonatal asphyxia and perinatal mortaliy in cesarean section was significantly lower than that in vaginal delivery (P0.01). Conclusion: Application indications of promoting ovulation drugs and assisted reproductive techniques should be mastered strictly, attention should also be paid to health care of pregnant period in order to reduce complications and prolong pregnant weeks to surpass as many as 34 weeks or more.The indications of ceasarean section should be relaxed suitably. Key words: multiple pregnancy; delivery route; neonatal outcome 多胎妊娠属高危妊娠，它的并发症发生率高，出现时间早，围生儿的畸形率、病死率均高于单胎妊娠。近年来，由于促排卵药物及辅助生育技术的应用，其发生率有逐渐上升趋势。本文对近5年在我院分娩的340例多胎妊娠做一回顾性分析，现报道如下。 1 资料与方法 1. 1 一般资料 2000年1月至2005年12月我院分娩总数26712例，双胎妊娠332例，发生率1.23%，产妇年龄23～36岁，平均27.2±3.2岁，孕周29～40周，平均36+1±2.48周，初产妇188例，经产妇134例，其主要并发症：早产149例（44.88%）,产后出血124例(37.35%),子痫前期（13.55%），胎膜早破43例（12.95%）。三胎妊娠8例，发生率1：3339，产妇年龄27～36岁，平均30岁，初产妇6例，经产妇2例，孕周29～37周，平均34+1±2.53周，并发症：早产7例（87.5%）,产后出血5例（62.5%）,子痫前期3例（37.5%）,胎膜早破2例（25%）。 1.2 研究方法 调查分析近5年多胎妊娠的发生率及相关因素，并分组比较分娩方式、孕周对新生儿结局的影响。 1.3