Gilstrap L C, Brown C E
Division of Maternal-Fetal Medicine, University of Texas Health Science Center, Dallas.
Clin Perinatol. 1988 Mar;15(1):71-7.
It is well established that mothers with twin gestations are at a significant risk of giving birth to a premature infant and, compared to singletons, the perinatal mortality and morbidity are significantly increased. Unfortunately, it is clear that little progress has been made over the past two decades in either the prevention or the treatment of premature labor in twins. The clinician is left with more questions than answers. This latter aspect needs to be recognized by the legal profession. Obviously, more studies regarding the possible beneficial effect of either bedrest or prophylactic beta-sympathomimetics are needed before meaningful recommendations can be made on a universal basis. It is also obvious that more potent tocolytic agents are needed to actually treat premature labor once it occurs. Taking all of these facts into consideration, the authors would recommend the protocol outlined in Table 3 for the general management of twins with regard to premature labor.
众所周知，怀有双胞胎的母亲生下早产儿的风险很大，与单胎妊娠相比，围产期死亡率和发病率显著增加。不幸的是，很明显在过去二十年里，双胞胎早产的预防或治疗方面几乎没有取得进展。临床医生面临的问题比答案更多。法律界需要认识到这后一个方面。显然，在能够普遍做出有意义的建议之前，需要进行更多关于卧床休息或预防性使用β-拟交感神经药可能产生的有益效果的研究。同样明显的是，一旦发生早产，需要更有效的宫缩抑制剂来实际治疗。考虑到所有这些事实，作者建议采用表3中概述的方案来对双胞胎早产进行总体管理。
