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2005年至2016年在一家大型转诊产科中心对三胎妊娠中双绒毛膜与单绒毛膜情况的评估。

Evaluation of Trichorionic versus Dichorionic Triplet Gestations from 2005 to 2016 in a Large, Referral Maternity Center.

作者信息

Peress Danielle A, Peaceman Alan M, Yee Lynn M

机构信息

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania.

Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Northwestern University Feinberg School of Medicine, Chicago, Illinois.

出版信息

Am J Perinatol. 2017 May;34(6):599-605. doi: 10.1055/s-0037-1600129. Epub 2017 Mar 6.

Abstract

To evaluate trends in the proportions and outcomes of dichorionic-triamniotic (DT) compared with trichorionic-triamniotic (TT) triplet gestations.  This is a retrospective cohort of all triplet gestations identified by first trimester ultrasound at an academic center between 2005 and 2016. Primary outcomes were the change in proportion of DT versus TT triplets over time and the number of fetuses at delivery. Secondary outcomes included differences in mode of conception and maternal/perinatal outcomes by chorionicity.  Of 258 identified triplet pregnancies, 65.5% ( = 169) were TT. The proportion of DT versus TT triplets increased from 2005 to 2016 ( < 0.001). Women with DT triplets were more likely to deliver a singleton (41.4 vs. 11.2%,  < 0.001). Mode of conception was known for 248 women, of whom 93.5% ( = 232) conceived through infertility treatment. Types of infertility treatment differed by chorionicity ( < 0.001), with DT triplets more likely to conceive through in vitro fertilization (88.3 vs. 60.7%). Women with DT delivered earlier than TT triplets (31.0 ± 5.0 vs. 33.1 ± 3.5 weeks;  = 0.03).  The proportion of DT triplet gestations increased significantly over time. Women with DT triplets delivered on average 2 weeks earlier than TT triplets. Women with DT triplets were more likely to reduce to a singleton gestation.

摘要

评估双绒毛膜三羊膜囊(DT)与三绒毛膜三羊膜囊(TT)三胎妊娠的比例及结局趋势。这是一项回顾性队列研究,纳入了2005年至2016年间在一所学术中心通过孕早期超声检查确诊的所有三胎妊娠病例。主要结局指标为DT与TT三胎妊娠比例随时间的变化以及分娩时存活胎儿数量。次要结局指标包括受孕方式以及不同绒毛膜性的孕产妇/围产儿结局差异。在258例确诊的三胎妊娠中,65.5%(n = 169)为TT。2005年至2016年期间,DT与TT三胎妊娠的比例有所增加(P < 0.001)。DT三胎妊娠的女性更有可能分娩单胎(41.4%对11.2%,P < 0.001)。已知248名女性的受孕方式,其中93.5%(n = 232)通过不孕治疗受孕。不孕治疗类型因绒毛膜性而异(P < 0.001),DT三胎妊娠更有可能通过体外受精受孕(88.3%对60.7%)。DT三胎妊娠的女性比TT三胎妊娠的女性分娩时间更早(31.0 ± 5.0周对33.1 ± 3.5周;P = 0.03)。随着时间推移,DT三胎妊娠的比例显著增加。DT三胎妊娠的女性平均分娩时间比TT三胎妊娠的女性早2周。DT三胎妊娠的女性更有可能减为单胎妊娠。

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