双胎妊娠胎儿发育及适宜分娩孕周临床研究.docVIP

双胎妊娠胎儿发育及适宜分娩孕周临床研究 　　【摘要】 目的 探讨双胎妊娠的胎儿发育规律及适宜分娩孕周。方法 回顾性分析宜宾市翠屏区妇幼保健院1997年11月至2007年3月收治的166例双胎妊娠的胎儿超声测量结果、妊娠期限等。结果 双胎妊娠自孕28周以后发育平均双顶径值较单胎小2．42 mm(t=6．43,P 　　【关键词】 妊娠；双胎；分娩；胎儿发育 　　 　　Clinical stady of the fetal development and the best gestational weeks for delivery in twin pregnancy CHEN Anzhen.Department of Obstetrics and Gynecology, Cuiping Maternal and Child Health Central in Yibin City,Sichuan 644000,China? 　　【Abstract】 Objective To investigate the patterns of the fetal development and the best gestational weeks for delivery in twin pregnancy. Methods We retrospectively analyzed the gestational weeks and fetal developments measured by ultrasound in 166 triplet pregnancies in my hospital from November 1997 to March 2007. Results The speed of the fetal development slowed down at the beginning of the 28th gestational week. The mean biparietal diameter was 2.42 mm shorter and the mean femoral length was 3.l mm shorter than those in singleton pregnancy. The birth weight of newborns was lower than that in singleton infanis. The average delivery gestational week was significantly shorter than that of singleton ones. Conclusion The patterns of the fetal development of the twin pregnancy are different from those of singleton pregnancies. Compared to singleton pregnancies, the fetus of the triplet pregnancies is obviously lightweight, and the deliveries are brought forward.? 　　【Key words】 Pregnancy； Twin pregnancy; Delivery; Fetal development 　　 　　随着促排卵药物的应用和辅助生殖技术的开展，多胎妊娠的发生率明显上升[1]。多胎妊娠无论是孕产妇并发症还是围生儿死亡率均明显高于单胎妊娠，其中胎儿发育监测、适宜分娩时机的选择、新生儿的治疗等一直是围生医学关注的问题。多胎妊娠中以双胎妊娠占绝大多数。本研究通过超声观察胎儿生长发育情况并对新生儿出生体质量、分娩孕周进行分析，探讨双胎妊娠的胎儿发育规律以及适宜分娩孕周，以降低孕产妇并发症及围生儿死亡率。 　　? 　　1 对象与方法? 　　1．1 研究对象 1997年11月至2007年3月本院收治双胎妊娠孕妇166例，孕妇年龄22~36岁。其中115例因不??症治疗后妊娠，51例为自然妊娠。从妊娠20周开始每2~4周对胎儿宫内发育情况进行监测直至分娩。? 　　1．2 方法? 　　1．2．1 超声测量内容 多胎妊娠胎儿宫内所处位置有限，胎儿测量难度较大，故选择较易测量的双顶径（biparietal diameter, BPD）、股骨长（femoral length, FL）两项指标。将测量结果及其出生体质量与单胎胎儿发育曲线进行比较。新生儿体质量单胎标准值以“1986-1987年我国15城市不同胎龄新生儿出生体质量”为标准[1]。超声不