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目的研究多胎妊娠早期选择性减胎术的可行性、安全性及对妊娠的影响。方法2002年1月~2005年12月在我院生殖中心行体外受精-胚胎移植受孕的16例多胎妊娠(A组)孕早期在阴道B超引导下穿刺,采用氯化钾心腔内注射或单纯胚芽穿刺抽吸法行减胎术,并与同期进行体外受精-胚胎移植受孕的64例双胎妊娠(B组)相比较。结果16例减胎术均一次成功。其中3例流产,13例患者已分娩(其中早产5例),24个新生儿平均孕周(37.2±1.4)周,出生体重(2660.0±417.5)g,均健康无畸形。B组64例患者中4例孕早期流产,3例孕晚期流产,57例(其中早产24例)分娩109个新生儿,其中2个重度窒息死亡,2个先天畸形,平均孕周(37.0±2.0)周,出生体重(2603.3±459.7)g。两组的流产率、活产率、早产率、平均孕周、平均出生体重等均无明显差别。结论在B超引导下,多胎妊娠早期减胎术是安全、有效治疗多胎妊娠的方法。
Objective To study the feasibility, safety and effect of selective pregnancy reduction on multiple pregnancy in early pregnancy. Methods From January 2002 to December 2005, 16 cases of multiple pregnancy (group A) underwent in vitro fertilization - embryo transfer in our hospital reproductive center were punctured with vaginal B - A simple embryo aspiration method was used for ablation and compared with 64 identical twin pregnancies (group B) who underwent in vitro fertilization-embryo transfer in the same period. Results 16 cases of abortion surgery were successful. Among them, 3 were aborted, 13 were delivered (5 were premature), 24 were average gestational weeks (37.2 ± 1.4) weeks, and birth weight was 2660.0 ± 417.5 g, all of whom were healthy and without deformity. Four of 64 patients in group B were miscarried in the first trimester, three were aborted in the third trimester of pregnancy, and 57 (including 24 preterm births) delivered 109 newborns. Two of them died of severe asphyxia and two of them were congenital malformations with an average gestational age of 37.0 ± 2.0) weeks, birth weight (2603.3 ± 459.7) g. There was no significant difference in abortion rate, live birth rate, premature birth rate, average gestational age, and average birth weight in both groups. Conclusion Under the guidance of B-ultrasound, early pregnancy reduction of multiple pregnancies is a safe and effective treatment for multiple pregnancy.