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自然双胎妊娠及体外受精后双胎妊娠孕中期和孕晚期的并发症发生率。

Complication rates in the second and third trimester of spontaneous twin pregnancies and twin pregnancies after in vitro fertilization.

作者信息

Florjanski Jerzy, Zimmer Mariusz, Borowiec Zofia, Pomorski Michal, Filipowski Henryk

机构信息

Department of Gynecology Obstetrics and Neonatology, Wroclaw Medical University, Poland.

出版信息

Neuro Endocrinol Lett. 2010;31(3):384-9.

Abstract

BACKGROUND

Most authors agree that the twin pregnancies have a higher risk of complications compared to singleton pregnancies. However, there is no unanimity as to whether the risk of complications in twin pregnancies resulting from in vitro fertilization is higher than in twin pregnancies resulting from spontaneous conception.

OBJECTIVE

The aim of this study was to estimate the frequency rates of complications in the second and third trimester of dichorionic-diamniotic twin pregnancies resulting from IVF (group I) compared to dichorionic-diamniotic and monochorionic-diamniotic twin pregnancies resulting from spontaneous conception (group II and III).

RESULTS

The rate of cesarean section and cervical cerclage was significantly higher in the group I. Polyhydramnios occurred less frequently in group I than in group III. The discordant growth of fetuses occurred significantly more frequently in the group I. The frequency of other complications did not differ in the studied groups. The Apgar score was similar in the group I and II but significantly lower in the group III compared to the group I.

CONCLUSIONS

  1. The frequency of complications in twin pregnancies after IVF is similar to those in the twin pregnancies conceived spontaneously. 2) In the twin pregnancies after IVF it is necessary to expect only a higher frequency of caesarean sections, cervical incompetence and a discordant growth of the twins when comparing with twin pregnancies conceived spontaneously. 3) In the twin pregnancies after IVF the intrauterine fetal demise and polyhydramnios occurred less frequently than in monochorionic-diamniotic pregnancies after spontaneous conception.
摘要

背景

大多数作者认为,与单胎妊娠相比,双胎妊娠的并发症风险更高。然而,对于体外受精导致的双胎妊娠并发症风险是否高于自然受孕导致的双胎妊娠,尚无一致意见。

目的

本研究的目的是评估体外受精导致的双绒毛膜双羊膜囊双胎妊娠(第一组)与自然受孕导致的双绒毛膜双羊膜囊和单绒毛膜双羊膜囊双胎妊娠(第二组和第三组)在妊娠中期和晚期并发症的发生率。

结果

第一组剖宫产和宫颈环扎率显著更高。第一组羊水过多的发生率低于第三组。第一组胎儿生长不一致的发生率显著更高。其他并发症的发生率在研究组之间没有差异。第一组和第二组的阿氏评分相似,但第三组与第一组相比显著更低。

结论

1)体外受精后双胎妊娠的并发症发生率与自然受孕的双胎妊娠相似。2)与自然受孕的双胎妊娠相比,体外受精后的双胎妊娠仅需预期更高的剖宫产率、宫颈机能不全和双胎生长不一致的发生率。3)体外受精后的双胎妊娠中,胎儿宫内死亡和羊水过多的发生率低于自然受孕后的单绒毛膜双羊膜囊妊娠。

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