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目的分析早期选择性减胎术对妊娠并发症和新生儿的影响,评价其安全性。方法收集本中心2000年1月至2003年2月经体外受精胚胎移植(IVF ET)和卵胞浆内单精子注射(ICSI)受孕的三胎妊娠减灭为双胎妊娠35例(A组)及同期双胎妊娠166例(B组)。比较两组妊娠期并发症、剖宫产率、围产期死亡率、新生儿畸形率、平均出生体重及孕周。结果两组自然流产率、妊娠高血压综合征发生率、分娩率、剖宫产率、早产率、围产期死亡率、畸形率、平均出生孕周差异均无显著性;胎膜早破率和先兆早产率A组分别为30%、7.7%,B组分别为13%、56%,两组比较差异有显著性(P<0.05);平均出生体重A组(2410.8±570.0)g,明显低于B组(2560.9±530.6)g(P<0.05)。结论三胎妊娠早期选择性减胎术后胎膜早破和先兆早产率明显升高,胎儿存在低出生体重可能性。因此,预防多胎妊娠,限制胚胎移植数目,仍然是辅助生育技术实施过程中不可忽视的问题。
Objective To analyze the effect of early selective abortion on pregnancy complications and newborns and evaluate its safety. Methods A total of 35 pregnant women with twin pregnancy (group A) undergoing triple pregnancy with IVF ET and ICSI were enrolled in this study from January 2000 to February 2003 166 cases of twin pregnancy in the same period (group B). Pregnancy complications, cesarean section rate, perinatal mortality rate, neonatal malformation rate, average birth weight and gestational age were compared between the two groups. Results The incidence of spontaneous abortion, pregnancy-induced hypertension syndrome, delivery rate, cesarean section rate, preterm birth rate, perinatal mortality rate, deformity rate and average gestational age were not significantly different between the two groups. The rate of premature rupture of membranes (P <0.05). The average birth weight in group A (2410.8 ± 570.0) g was significantly higher than that in group A (30%, 7.7%, respectively) and group B was 13% and 56% Lower than that in group B (2560.9 ± 530.6) g (P <0.05). Conclusions The rate of premature rupture of membranes and premature rupture of membranes is obviously increased after selective pregnancy reduction in the third trimester of pregnancy. The fetus has the possibility of low birth weight. Therefore, preventing multiple pregnancy and limiting the number of embryo transfer are still issues that can not be neglected in the implementation of assisted reproductive technology.