双胎妊娠分娩方式与妊娠结局临床研究分析.docVIP

双胎妊娠分娩方式与妊娠结局临床研究分析 　　【摘要】 目的：探讨双胎妊娠不同分娩方式及临床结局关系。方法：回顾性分析2016年1-12月本院收治的双胎妊娠孕妇459例的临床资料，比较不同分娩方式下孕妇的一般资料、妊娠并发症和妊娠结局。结果：双胎妊娠选择剖宫产比率明显高于阴道分娩，臀/头位剖宫产比率最高；阴道分娩组孕妇的年龄、孕周及初产妇例数均显著低于剖宫产组（P0.05）；新生儿体重较大者选择剖宫产的比率高于阴道分娩（P0.05），阴道分娩组第2胎生后的Apgar评分≤7分者明显高于剖宫产组（P0.05）。结论：双胎妊娠的孕妇在选择分娩方式时要综合考虑各项因素，改善妊娠结局及新生儿预后。 　　【?P键词】 双胎妊娠； 剖宫产； 阴道分娩 　　【Abstract】 Objective：To investigate the relationship between different delivery modes and clinical outcomes in twin pregnancy.Method：The clinical data of 459 twin pregnancy in our hospital from January to December 2016 were analyzed retrospectively，the general data，pregnancy complications and pregnancy outcomes of pregnant women under different delivery modes were compared.Result：The rate of cesarean section in twin pregnancy was significantly higher than that of vaginal delivery，and the rate of cesarean section was the highest in buttocks/head position.The age，gestational weeks and number of primiparous women of vaginal delivery group were significantly lower than those of cesarean section group（P0.05）.Apgar score after first birth of two groups were compared，the difference was not statistically significant（P0.05），Apgar score≤7 after second birth of vaginal delivery group was significantly higher than that of cesarean section group（P0.05）Conclusion：Twice pregnant women in the choice of mode of delivery should take into account the various factors，and to improve the outcome of pregnancy and neonatal prognosis. 　　【Key words】 Twin pregnancy； Cesarean section； Vaginal delivery 　　First-author’s address：Fujian Provincial Maternal and Child Health Hospital，Fuzhou 350000，China 　　doi：10.3969/j.issn.1674-4985.2017.34.015 　　近年来由于促排卵药物的大量使用，以及新的辅助生殖技术的不断更新及在临床工作中的大量使用，双胎妊娠的发生率越来越高[1]。但是，据研究其新生儿的窒息率以及病死率均较高，高于单胎妊娠5～7倍[2]。此外，双胎妊娠并发症的发生率明显高于单胎，并发症亦是双胎妊娠的风险所在[3]。双胎妊娠是高危妊娠。因此对于双胎妊娠患者，为了最大程度保障孕妇和新生儿的健康，根据自身情况最终选择何种分娩方式分娩具有重大的临床意义。本文收集2016年1-12月来本院就诊的双胎妊娠孕妇459例的临床资料、分娩方式临床结局进行分析，探讨孕妇最应采用的分娩方式。现报道如下。 　　1 资料与方法 　　1.1 一般资料 回顾性分析2016年1-12月本院收治的双胎妊娠孕妇459例的临床资