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早期将双绒毛膜三胎妊娠减胎为双绒毛膜双胎或单胎妊娠:一项回顾性研究。

Early fetal reduction of dichorionic triplets to dichorionic twin or singleton pregnancies: a retrospective study.

作者信息

Lin Haiyan, Wen Ya, Li Yu, Chen Xiaoli, Yang Dongzi, Zhang Qingxue

机构信息

Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.

Department of Gynecology and Obstetrics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Guangzhou, China.

出版信息

Reprod Biomed Online. 2016 May;32(5):490-5. doi: 10.1016/j.rbmo.2016.02.011. Epub 2016 Mar 2.

Abstract

A retrospective study conducted in an academic reproductive medicine centre evaluated the feasibility and safety of early fetal reduction in dichorionic triplets to dichorionic twin or singleton pregnancies. Thirty-three dichorionic triplets that underwent early transvaginal fetal reduction mechanically between 2002 and 2013 were included, of which 21 patients underwent fetal reduction to dichorionic twins (Group A) and 12 patients underwent fetal reduction to a singleton pregnancy (Group B). A further 84 patients with trichorionic triplets reduced to twins were included as the control group (Group C). The main outcome measures were live birth and preterm labour rates. Both early and late spontaneous abortion rates, were similar in group A compared with groups B and C. Gestational age at delivery was significantly lower in group C versus group A (P = 0.02). The preterm labour rate in group A, which was comparable with that in group C, was greater than in group B, but not significantly. Neonatal birth weight, low birth weight rate and neonatal body height were similar among groups. Small for gestational age rates were comparable. Live birth rates were similar among the groups. Early transvaginal fetal reduction for dichorionic triplets to dichorionic twins may be feasible and safe.

摘要

在一家学术性生殖医学中心进行的一项回顾性研究,评估了将双绒毛膜三胎妊娠减为双绒毛膜双胎或单胎妊娠的早期减胎术的可行性和安全性。纳入了2002年至2013年间接受早期经阴道机械性减胎术的33例双绒毛膜三胎妊娠患者,其中21例患者减为双绒毛膜双胎(A组),12例患者减为单胎妊娠(B组)。另外84例将三绒毛膜三胎妊娠减为双胎的患者作为对照组(C组)。主要观察指标为活产率和早产率。A组的早期和晚期自然流产率与B组和C组相似。C组的分娩孕周显著低于A组(P = 0.02)。A组的早产率与C组相当,高于B组,但差异无统计学意义。各组间新生儿出生体重、低出生体重率和新生儿身高相似。小于胎龄儿发生率相当。各组的活产率相似。将双绒毛膜三胎妊娠经阴道早期减为双绒毛膜双胎可能是可行且安全的。

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