Yaman Tunç Senem, Ağaçayak Elif, Yaman Görük Neval, İçen Mehmet Sait, Fındık Fatih Mehmet, Evsen Mehmet Sıddık, Turgut Abdulkadir, Başaranoğlu Serdar, Yıldızbakan Ahmet, Gül Talip
Dicle University Faculty of Medicine, Department of Obstetrics and Gynecology, Diyarbakır, Turkey.
Memorial Hospitals, Clinic of Obstetrics and Gynecology, Diyarbakır, Turkey.
Turk J Obstet Gynecol. 2015 Dec;12(4):226-229. doi: 10.4274/tjod.35493. Epub 2015 Dec 15.
To evaluate the maternal and fetal demographic features and clinical aspects of twin pregnancies with single intrauterine demise.
This retrospective study was conducted in Dicle University Faculty of Medicine, Department of Gynecology and Obstetrics between January 2008 and December 2013. There were a total of 594 twin deliveries in our hospital between the given dates. Twenty-nine of these cases were referred to our hospital by another health center because of a preliminary diagnosis of single intrauterine demise. Maternal age, parity, chorionicity, week of fetal death, gestational week at delivery, mode of delivery, birth weight, Activity, pulse, grimace, appearance, respiration scores, maternal fibrinogen levels at delivery and during pregnancy, stay in the neonatal intensive care unit, and obstetric complications were explored in these 29 cases of single intrauterine demise.
The mean age of the 29 patients who were provided antenatal follow-up and delivery services in our hospital was 29.9±6.5 years. Thirteen (44.8%) of the patients were monochorionic, whereas 16 (55.2%) were dichorionic. Intrauterine fetal death occurred in the first trimester in 6 pateints and in the second or third trimester in 23. In addition, 20 (69%) patients underwent cesarean section, whereas 9 (31%) had spontaneous vaginal delivery. Lastly, none of the patients had a maternal coagulation disorder.
Twin pregnancies with single intrauterine death can lead to various complications for both the surviving fetus and the mother. Close maternal and fetal monitoring, and proper care and management can minimize complications.
评估单绒毛膜双胎妊娠合并一胎宫内死亡的母胎人口统计学特征及临床情况。
本回顾性研究于2008年1月至2013年12月在狄克莱大学医学院妇产科进行。在给定日期期间,我院共有594例双胎分娩。其中29例因初步诊断为单绒毛膜双胎妊娠合并一胎宫内死亡而由另一健康中心转诊至我院。对这29例单绒毛膜双胎妊娠合并一胎宫内死亡病例的产妇年龄、产次、绒毛膜性、胎儿死亡孕周、分娩孕周、分娩方式、出生体重、活动、脉搏、皱眉、外貌、呼吸评分、分娩时及孕期产妇纤维蛋白原水平、新生儿重症监护病房住院时间及产科并发症进行了探讨。
在我院接受产前随访及分娩服务的29例患者的平均年龄为29.9±6.5岁。其中13例(44.8%)为单绒毛膜双胎,16例(55.2%)为双绒毛膜双胎。6例患者在孕早期发生宫内胎儿死亡,23例在孕中期或孕晚期发生。此外,20例(69%)患者接受了剖宫产,9例(31%)经阴道自然分娩。最后,所有患者均无产妇凝血功能障碍。
单绒毛膜双胎妊娠合并一胎宫内死亡可导致存活胎儿及母亲出现各种并发症。密切的母胎监测及恰当的护理和管理可使并发症降至最低。