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目的探讨影响双胎之一胎死宫内妊娠结局的相关因素。方法对2006年1月-2014年1月在该院住院分娩的24例双胎之一胎死宫内的病例进行回顾性分析。结果双胎之一胎死宫内的发生率为5.7%,单绒毛膜性(MC)双胎9例,双绒毛膜性(DC)双胎15例。一胎胎死宫内发生在早期5例,中期10例,晚期9例。期待治疗中,孕27周放弃治疗引产1例,孕29~34周终止妊娠8例,34~37周终止妊娠6例,>37周终止妊娠9例。双绒毛膜性、孕早期发生一胎胎死宫内、孕34周后终止妊娠的围生儿病死率均低于单绒毛膜性、孕中、晚期发生一胎胎死宫内、小于孕34周终止妊娠的患者;双胎之一胎死宫内对母亲的凝血功能、妊娠期高血压疾病及感染风险无明显影响。结论在双胎之一胎死宫内的孕妇中,绒毛膜性、死胎发生的时间、终止妊娠的时间是影响妊娠结局的重要因素,在孕早期B超了解绒毛膜性质,及早发现一胎胎死宫内的时间,加强孕期母儿监测,尽可能延长孕周,有利于改善围产儿结局。
Objective To investigate the related factors that affect the outcome of pregnancy in the unborn child. Methods A retrospective analysis was performed on the intrauterine fetal death in 24 twins, which were hospitalized in our hospital from January 2006 to January 2014. Results The incidence of intrauterine death in one of the twins was 5.7%. There were 9 cases of monochorionic (MC) twins and 15 cases of double chorionic ducts (DC). One fetus died of intrauterine death in the early five cases, mid-term in 10 cases, late in 9 cases. Looking forward to treatment, 27 weeks pregnant give up treatment of induced labor in 1 case, 29 to 34 weeks pregnant termination of pregnancy in 8 cases, 34 to 37 weeks termination of pregnancy in 6 cases,> 37 weeks of termination of pregnancy in 9 cases. Double chorionic sex, the first trimester of pregnancy occurred within a dead fetus, 34 weeks after the pregnancy termination of pregnancy, perinatal mortality were lower than the single chorionic sex, pregnancy, late fetal death in a fetus, less than 34 Weeks of patients with termination of pregnancy; twins, one of the fetal death of the mother’s blood clotting function, pregnancy-induced hypertension and infection risk no significant effect. Conclusions The number of chorionicity, the time of stillbirth and the time of termination of pregnancy are important factors affecting the outcome of pregnancy in one of the twin fetuses. In the first trimester of pregnancy, the quality of chorionic villi is known and the early detection of one fetus Dead time within the mother and child to strengthen monitoring during pregnancy, as long as possible to extend gestational age, help to improve perinatal outcome.