目的　多胎妊娠在近年来呈上升趋势 ,将我院多胎妊娠临床处理的经验进行总结 ,探讨提高围产质量。方法　取自1992～ 2 0 0 3年在上海第二医科大学附属新华医院产科住院分娩的三胎及三胎以上妊娠 7例 ,对所有的资料进行回顾性分析。结果　在妊娠早中期 ,对所有孕妇均进行门诊随访 ,全部孕妇均有中、重度贫血及低蛋白血症 ,2 /3的孕妇在孕 3 2～ 3 6周出现先兆早产症状 ,因产科并发症入院后 ,对之进行纠治。除 1例四胎妊娠在孕 3 3周分娩外 ,其他均在孕 3 5～ 3 7周终止妊娠 ,2 2个新生儿出生时评分均佳 ,体重均在同龄单胎新生儿出生曲线的第 3百分位以上 (其中约 1/2的新生儿达到或超过同孕龄单胎新生儿第 10百分位以上 )。结论　在处理多胎妊娠时 ,应 :⑴早诊断 ,高危门诊随访。⑵充分休息、积极纠正贫血 ,加强营养 ,尤其在孕晚期要注意蛋白的补充。⑶应用B超测定宫颈长度等无创性手段筛查早产风险孕妇 ,密切监护 ,有先兆早产者合理使用宫缩抑制剂。⑷在孕 3 6周左右 ,在应用促胎肺成熟药物后 ,适时计划分娩 ,注意做好对产时母儿并发症的预防和抢救工作。只要做好多胎孕妇产前的监测和注意对孕期并发症的防治 ,三胎和三胎以上妊娠仍能和单胎妊娠一样有良好的结局 Objective The number of multiple pregnancies in recent years showed an upward trend, the clinical experience of multiple gestation in our hospital to summarize, to explore to improve perinatal quality. Methods From 1993 to 2003, 7 cases of third trimester and third trimester pregnancy in obstetrics of Xinhua Hospital, Shanghai Second Medical University were retrospectively analyzed. Results All pregnant women were followed up during the first trimester of pregnancy. All pregnant women had moderate and severe anemia and hypoproteinemia. Two thirds of pregnant women had symptoms of threatened and premature birth during 32 to 36 weeks of pregnancy. Obstetric complications Admission, the correction. Except one case of four-child pregnancy delivered at 33 weeks of pregnancy, all other pregnancies were terminated at 35 to 37 weeks’ gestation. The scores of 2 2 newborns were all good at birth, 3 percentiles or more (of which about 1/2 of newborns meet or exceed the 10th percentile of singleton fetuses at the gestational age). Conclusion In the treatment of multiple pregnancy, should: ⑴ early diagnosis, high-risk clinic follow-up. ⑵ adequate rest, and actively correct anemia, strengthen nutrition, especially in late pregnancy should pay attention to protein supplementation. ⑶ application of B-measurement of cervical length and other noninvasive means of screening for risk of preterm birth in pregnant women, close monitoring, premature births have a reasonable use of tocolytic agents. ⑷ in pregnancy about 36 weeks after the application of fetal lung mature drugs, timely planning of childbirth, pay attention to the production of maternal and child complications prevention and rescue work. As long as prenatal monitoring of multiple pregnant women and pay attention to the prevention and treatment of complications during pregnancy, third and third trimester or more pregnancy can still have the same outcome as single pregnancy