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目的:探讨体外受精-胚胎移植术后三胎妊娠减胎前后的妊娠结局。方法:回顾性分析2011年10月至2013年12月广州医科大学附属第三医院收治的辅助生殖受孕病例31例;比较三胎妊娠、减胎后的双胎妊娠、单胎妊娠的流产率、孕期并发症发生率及新生儿围产期结局。结果:三胎妊娠、经减胎后的双胎妊娠、单胎妊娠在孕产次、胎儿疾病、胎膜早破、重度子痫前期、妊娠期糖尿病、产后出血等方面比较差异无统计学意义(P>0.05),在新生儿出生孕周、出生体重、早产率、新生儿转NICU率、新生儿RDS方面比较,差异有统计学意义,减胎后的双胎、单胎分娩孕周延长[三胎、双胎、单胎妊娠分娩孕周分别为(37.3±1.9)、(35.2±0.9)、(32.6±2.3)周]、早产率下降(100%、100%、33.3%)、新生儿出生体重增加[(1 707±360.4)g、(2 066.1±307.5)g、(2 712.5±514.1)g]、新生儿并发症少(P<0.05)。结论:多胎妊娠减胎术治疗降低了早产风险及新生儿低出生体重发生率,改善了母胎结局,但减胎后的早中孕期流产率较高。
Objective: To investigate the outcome of pregnancy before and after trimester pregnancy after in vitro fertilization and embryo transfer. Methods: A retrospective analysis of 31 cases of assisted reproductive pregnancy admitted to the Third Affiliated Hospital of Guangzhou Medical University from October 2011 to December 2013 was carried out. The three-fetus pregnancy, twin pregnancy after pregnancy loss, miscarriage rate of single pregnancy, The incidence of complications during pregnancy and neonatal perinatal outcome. Results: There was no significant difference in three-pregnancy, twins pregnancy after twins reduction, singleton pregnancy in terms of maternity time, fetal disease, premature rupture of membranes, severe preeclampsia, gestational diabetes and postpartum hemorrhage (P> 0.05). There was significant difference between the gestational age at birth, birth weight, premature birth rate, neonatal NICU rate and newborn RDS (37.3 ± 1.9, (35.2 ± 0.9), (32.6 ± 2.3) weeks) in prenatal and postnatal pregnancies, respectively. Preterm birth rates decreased 100%, 100% and 33.3% The birth weight gain was (1 707 ± 360.4) g, (2 066.1 ± 307.5) g, (2 712.5 ± 514.1) g, with less neonatal complications (P <0.05). CONCLUSIONS: Multiple pregnancy reduction reduces the risk of preterm delivery and neonatal low birth weight, improves maternal fetal outcomes, and abortions have a higher rate of miscarriage in early and middle pregnancy.