Crawford J S
Br J Obstet Gynaecol. 1975 Dec;82(12):929-35. doi: 10.1111/j.1471-0528.1975.tb00601.x.
A series of 102 patients with a multiple pregnancy (including three sets of triplets) delivered vaginally is presented. An epidural block was provided for 55 of these patients, and comparisons were made between these patients and those who did not have an epidural block. There was a higher incidence of low Apgar-minus-colour (A-C) scores at one minute among the second twins of at least 36 weeks gestation in the epidural series, but no other remarkable contrasts in the (A-C) scores of the respective group of infants. In the non-epidural series two second twins of at least 36 weeks gestational age apparently suffered severe cerebral trauma. Of the 91 liveborn infants in the non-epidural series, five died (two with intracranial haemorrhage, three with hyaline membrane disease); of the 112 liveborn infants in the epidural series, two died (both with hyaline membrane disease). The incidence of instrumental delivery of infants presenting by the vertex, and of breech extraction, was markedly higher in the epidural series. The mean interval between full dilatation of the cervix and delivery of the first twin was greater in the epidural series, but the mean interval between delivery of the first and second infant was smaller in the epidural series. It is concluded that the provision of an epidural block for labour and delivery to patients with a multiple pregnancy is beneficial to the infants.
本文报告了102例多胎妊娠（包括3组三胞胎）经阴道分娩的病例。其中55例患者接受了硬膜外阻滞，并将这些患者与未接受硬膜外阻滞的患者进行了比较。在硬膜外阻滞组中，至少孕36周的第二对双胞胎在出生1分钟时低阿氏评分-肤色（A-C）评分的发生率较高，但各婴儿组的（A-C）评分无其他显著差异。在非硬膜外阻滞组中，至少孕36周的2例第二对双胞胎明显遭受了严重的脑损伤。在非硬膜外阻滞组的91例活产婴儿中，5例死亡（2例颅内出血，3例透明膜病）；在硬膜外阻滞组的112例活产婴儿中，2例死亡（均为透明膜病）。硬膜外阻滞组头先露婴儿器械助产和臀牵引的发生率明显较高。硬膜外阻滞组宫颈完全扩张至第一对双胞胎分娩的平均间隔时间较长，但第一和第二个婴儿分娩的平均间隔时间在硬膜外阻滞组较短。结论是，为多胎妊娠患者分娩时提供硬膜外阻滞对婴儿有益。
