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根据计划分娩方式的第二胎儿脐带动脉血气与围产结局。

Umbilical arterial blood gas and perinatal outcome in the second twin according to the planned mode of delivery.

机构信息

Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Korea.

出版信息

Int J Med Sci. 2011;8(8):643-8. doi: 10.7150/ijms.8.643. Epub 2011 Oct 15.

Abstract

PURPOSE

To compare umbilical arterial gas parameters in the second twin of twin pregnancies according to the mode of delivery.

METHODS

We retrospectively analyzed the medical records of twin deliveries after 34 weeks of gestation for 3 years. Excluding the cases which underwent emergency cesarean delivery during trial of labor, a total of 79 twin gestations had umbilical arterial blood gas values available and were and divided into cesarean delivery group (N=40) and vaginal delivery group (N=39). The mean differences of umbilical arterial blood parameters and the Apgar score between the first and second twin in each pregnancy were compared according the mode of delivery.

RESULTS

The differences of umbilical arterial gas parameters between twin siblings showed no significant difference according to the mode of delivery. With regard to the 1 minute and 5 minute Apgar scores, the differences between twin siblings are significantly increased in vaginal delivery group compared to cesarean delivery group (p=0.048, and p=0.038, respectively). In comparing the 28 cases delivered vaginally with an inter-twin delivery interval < 10 minutes and 40 cases delivered by cesarean section, no significant differences were observed in the umbilical arterial gas parameters and Apgar scores.

CONCLUSION

The inter-twin umbilical arterial blood gas parameters according to the mode of delivery showed no difference. For twin deliveries, it is relatively safe to plan for a vaginal delivery, but an effort should be made to reduce the inter-twin delivery interval time.

摘要

目的

比较根据分娩方式的不同,双胎妊娠第二胎儿的脐动脉血气参数。

方法

我们对 3 年来 34 周以上分娩的双胎妊娠的病历进行了回顾性分析。排除试产期间行急症剖宫产的病例,共有 79 例双胎妊娠有脐动脉血气值,分为剖宫产组(N=40)和阴道分娩组(N=39)。根据分娩方式比较每组妊娠中第一和第二胎儿脐动脉血参数和 Apgar 评分的平均值差异。

结果

根据分娩方式,双胎胎儿脐动脉气体参数的差异无统计学意义。在 1 分钟和 5 分钟 Apgar 评分方面,与剖宫产组相比,阴道分娩组双胎间的差异明显增加(p=0.048 和 p=0.038)。在比较间隔时间<10 分钟的 28 例阴道分娩和 40 例剖宫产的病例中,脐动脉血气参数和 Apgar 评分无显著差异。

结论

根据分娩方式,双胎间脐动脉血气参数无差异。对于双胎分娩,计划阴道分娩相对安全,但应努力减少双胎分娩间隔时间。

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本文引用的文献

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A comparison of the neonatal morbidity of second twins to that of a low-risk population.
Eur J Obstet Gynecol Reprod Biol. 2003 Jun 10;108(2):157-63. doi: 10.1016/s0301-2115(02)00435-9.

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