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目的:探析不同类型单绒毛膜双羊膜囊(MCDA)双胎妊娠选择性宫内生长受限(s IUGR)胎儿的妊娠结局及预后情况。方法:选取我院2010年6月至2015年6月收治的MCDA并发s IUGR孕妇40例(80胎)作为观察组,同时根据脐动脉血流频谱分型将其细分为Ⅰ型组(20例)、Ⅱ型组(12例)和Ⅲ型组(8例)。另选取同期无合并症的MCDA孕妇40例(80胎)作为对照组。对比2组及3种类型s IUGR之间胎儿的分娩孕周、出生体质量、双胎出生体质量差、宫内病死率、新生儿病死率及半年存活率等情况。结果:观察组孕妇宫内两胎病死率、两胎儿出生体质量差均明显高于对照组(P<0.05或P<0.01);观察组胎儿分娩孕周明显早于对照组,大、小胎儿的出生体质量明显低于对照组(P<0.01);观察组中Ⅱ型组新生儿病死率显著高于Ⅰ型组,分娩孕周明显早于Ⅰ型组,且小胎儿出生体质量最低,明显低于Ⅰ型组(P<0.05)。观察组和对照组间新生儿病死率、半年双胎存活率无显著性差异(P>0.05)。结论:不同类型MCDA合并s IUGR胎儿的妊娠结局和预后均不同,其中Ⅱ型预后差,胎儿宫内病死率高,因此临床需密切监测孕期胎儿情况,及时警惕各种异常。
Objective: To investigate the pregnancy outcome and prognosis of fetuses with different intrauterine growth restriction (sIUGR) in different types of single chorionic amniocentesis (MCDA). Methods: Forty pregnant women (80 fetuses) with MCDA and sUUGR admitted to our hospital from June 2010 to June 2015 were selected as the observation group. At the same time, they were subdivided into type Ⅰ group (20 Cases), type Ⅱ group (12 cases) and type Ⅲ group (8 cases). In addition, 40 pregnant women (80 fetuses) with MCDA without complications were selected as the control group. The gestational age, birth weight, birth weight difference, intrauterine mortality, neonatal mortality and six-month survival rate were compared between two groups and three types of IUGR. Results: The intrauterine mortality of two fetuses in the observation group was significantly higher than that in the control group (P <0.05 or P <0.01). The gestational weeks in the observation group were significantly earlier than those in the control group, large and small fetuses (P <0.01). The morbidity of newborn infants in type Ⅱ group in observation group was significantly higher than that in type Ⅰ group. The gestational weeks of delivery was earlier than that of type Ⅰ group, and the birth weight of the small fetus was the lowest, Significantly lower than the type Ⅰ group (P <0.05). There was no significant difference in neonatal mortality and six-month twin survival between observation group and control group (P> 0.05). Conclusions: The pregnancy outcome and prognosis of fetuses with different types of MCDA combined with IUGR are different. Among them, type Ⅱ has a poor prognosis and high intrauterine mortality. Therefore, it is necessary to closely monitor fetal status in pregnancy and be alert to various abnormalities in time.