Elliott J P, Radin T G
Phoenix Perinatal Associates, Arizona.
Obstet Gynecol. 1992 Sep;80(3 Pt 1):421-4.
Quadruplets are occurring more frequently as assisted-reproduction techniques improve fertility in couples previously unable to conceive. Ten quadruplet pregnancies cared for in one perinatal practice over 5 years had excellent outcome. The mean gestational age at delivery was 32.5 weeks, compared with approximately 30 weeks in the literature. There were no perinatal deaths and no long-term morbidity. Our patients were compared with a series of 57 consecutive patients with quadruplet pregnancies monitored by a home monitoring system. Parity of 1 or more appeared to improve outcome. Pregnancy-induced hypertension occurred in nine of our pregnancies and necessitated delivery in seven instances. Fetal distress was responsible for two deliveries and uncontrollable preterm labor for only one. Key points in our management protocol include prophylactic use of low-dose aspirin, home contraction monitoring, use of terbutaline pump tocolysis, and bed rest at home starting at 16 weeks.
随着辅助生殖技术提高了以往无法受孕的夫妇的生育能力，四胞胎的发生率越来越高。在一项围产期实践中，5年内照料的10例四胞胎妊娠结局良好。分娩时的平均孕周为32.5周，而文献报道约为30周。没有围产期死亡和长期发病情况。将我们的患者与通过家庭监测系统监测的57例连续四胞胎妊娠患者进行了比较。有一次或多次分娩史似乎能改善结局。我们的9例妊娠发生了妊娠高血压，7例需要分娩。胎儿窘迫导致2例分娩，仅1例因不可控制的早产分娩。我们管理方案的关键点包括预防性使用低剂量阿司匹林、家庭宫缩监测、使用特布他林泵进行宫缩抑制以及从16周开始在家卧床休息。
