van Doorn H C, van Wezel-Meijler G, van Geijn H P, Dekker G A
Department of Obstetrics and Gynecology, Free University, Amsterdam, The Netherlands.
Acta Obstet Gynecol Scand. 1999 Sep;78(8):710-5.
Evaluation of the success of delayed interval delivery in multiple pregnancies.
Retrospective analyses of all multiple pregnancies with the birth of one child at a gestational age of 16-31 weeks (n=80). Three groups were defined: group I, unsuccessful attempt to temporize delivery, group II, interval between the first child and the other child or children 3 hours or more, with delivery of the remaining children before 28 weeks and group III, prolongation of pregnancy beyond 28 weeks.
In 15 multiple pregnancies (ten sets of twins, five sets of triplets), the aim was to postpone the delivery of the second (and third) child. The mean gestational age at admittance was 25 weeks. Delay of the delivery of the second child was achieved in ten cases, five in group II and five in group III. In groups II and III, the mean interval of delivery was 12 days; the gestational age at the delivery of the remaining children in these ten patients was 27 5/7 weeks. No relation could be found between the reason for admittance and the interval in delivery between the first and the other children. The only severe maternal complication was blood loss exceeding 2 liters. In the neonatal outcome of first and second children (with a gestational age of 28 weeks or more) no striking differences were observed.
Delayed delivery in multiple pregnancies after the birth of the first child is only successful in a minority of patients and should be considered prior to the birth of the first child.
评估多胎妊娠延迟间隔分娩的成功率。
对所有在孕16 - 31周分娩一个孩子的多胎妊娠进行回顾性分析(n = 80)。定义了三组:第一组,尝试延迟分娩未成功;第二组,第一个孩子与其他孩子之间的间隔为3小时或更长时间,其余孩子在28周前分娩;第三组,妊娠延长至28周以上。
在15例多胎妊娠(10对双胞胎,5组三胞胎)中,目标是推迟第二个(及第三个)孩子的分娩。入院时的平均孕周为25周。10例实现了第二个孩子分娩的延迟,其中5例在第二组,5例在第三组。在第二组和第三组中,平均分娩间隔为12天;这10例患者中其余孩子分娩时的孕周为27又5/7周。入院原因与第一个孩子和其他孩子之间的分娩间隔之间未发现关联。唯一严重的母体并发症是失血超过2升。在第一个和第二个孩子(孕周28周或以上)的新生儿结局方面未观察到显著差异。
多胎妊娠中第一个孩子出生后延迟分娩仅在少数患者中成功,应在第一个孩子出生前予以考虑。