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澳大利亚一家三级医疗中心管理的54例三胎妊娠的母婴结局

Maternal and neonatal outcomes in 54 triplet pregnancies managed in an Australian tertiary centre.

作者信息

Barkehall-Thomas Andrea, Woodward Louise, Wallace Euan M

机构信息

Centre for Women's Health Research, Monash University, Clayton, Victoria, Australia.

出版信息

Aust N Z J Obstet Gynaecol. 2004 Jun;44(3):222-7. doi: 10.1111/j.1479-828X.2004.00214.x.

Abstract

BACKGROUND

To provide current data on maternal and neonatal outcomes in triplet pregnancies in an Australian population.

METHODS

Retrospective case note review of all triplet pregnancies managed within a single Australian tertiary centre.

RESULTS

Fifty-four sets of triplets were managed from January 1996 to October 2002. A total of 59% resulted from the use of assisted reproductive technologies. The median gestation at delivery was 32.5 weeks (range: 21-36 weeks); 14% delivered prior to 28 weeks and 43% delivered before 32 weeks. Preterm labour and preterm rupture of membranes were the most common antenatal complications occurring in 57 and 22% of pregnancies, respectively. A total of 93% of pregnancies were delivered by Caesarean section and 37% of mothers experienced at least one post-partum complication. A total of 96% of neonates were liveborn, with a median birthweight of 1644 g (range: 165-2888 g). The two most common neonatal complications were jaundice and hypoglycaemia in 52 and 43% of liveborn neonates, respectively. A total of 28% of neonates were below the 10th centile for gestational age and sex. A total of 8% of neonates demonstrated congenital anomalies. The perinatal mortality at a gestational age of 20-24 weeks was 100%, 22% at 25-28 weeks and zero for those babies born at 29 weeks or beyond.

CONCLUSION

Assisted reproductive technologies contribute significantly to the incidence of triplet pregnancies. Gestational age at delivery and perinatal mortality is comparable to published international data. Triplets born in a tertiary centre beyond 28 weeks gestation have a very favourable prognosis in the newborn period.

摘要

背景

提供澳大利亚人群中三胎妊娠的孕产妇和新生儿结局的当前数据。

方法

对澳大利亚一家三级中心管理的所有三胎妊娠进行回顾性病例记录审查。

结果

1996年1月至2002年10月期间管理了54组三胞胎。其中59%是使用辅助生殖技术受孕的。分娩时的中位孕周为32.5周(范围:21 - 36周);14%在28周前分娩,43%在32周前分娩。早产和胎膜早破是最常见的产前并发症,分别发生在57%和22%的妊娠中。93%的妊娠通过剖宫产分娩,37%的母亲至少经历了一种产后并发症。96%的新生儿为活产,中位出生体重为1644克(范围:165 - 2888克)。最常见的两种新生儿并发症是黄疸和低血糖,分别发生在52%和43%的活产新生儿中。28%的新生儿低于同孕周和性别的第10百分位数。8%的新生儿有先天性异常。孕20 - 24周的围产儿死亡率为100%,25 - 28周为22%,29周及以后出生的婴儿围产儿死亡率为零。

结论

辅助生殖技术对三胎妊娠的发生率有显著影响。分娩孕周和围产儿死亡率与已发表的国际数据相当。在三级中心出生的孕28周以上的三胞胎在新生儿期预后非常好。

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