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单中心多胎妊娠减胎术的结局:202例完成病例报告

The outcome of the multifetal pregnancy reduction procedures in a single centre: A report of 202 completed cases.

作者信息

Cihangir Yılanlıoglu Necip, Semiz Altug, Arisoy Resul, Kahraman Semra, Arslan Gürkan Ali

机构信息

Sisli Memorial Hospital, Department of Obsteric and Gynecology, Istanbul, Turkey.

Sisli Memorial Hospital, Department of Obsteric and Gynecology, Istanbul, Turkey.

出版信息

Eur J Obstet Gynecol Reprod Biol. 2018 Nov;230:22-27. doi: 10.1016/j.ejogrb.2018.09.008. Epub 2018 Sep 11.

Abstract

OBJECTIVE

To review the results of fetal reduction procedures in our institution, evaluate its effects on the pregnancy outcome in terms of miscarriage, preterm delivery, taking home healthy babies and discuss the factors that may have contributed to the outcome.

STUDY DESIGN

This is a retrospective study performed at the Fetal Medicine Unit of the Sisli Memorial Hospital in Istanbul after ART therapies in our unit from 2000 to 2011.

RESULTS

The sample comprised 151 triplets, 35 quadruplets, 11 quintuplets, 3 twins, 1 sextuplet and 1 septuplet. The average maternal age was 30 ± 4.4 and the average week of interventions was 11.7 ± 1.3 weeks. In 40 cases two or more needle insertions were necessary. The two-week post-procedure loss rate, defined as 'the procedure related loss rate', was 0.7%; however, for the whole sample, the losses were 6.9% when they occured before 24 completed weeks and was defined as 'the total loss rate'. 184 of the remaining 188 cases had at least one baby to take home (91.1% of 202 patients). The average birth week for those healthy babies discharged home was 35.5 ± 2.4. The rate of early preterm birth before gestational weeks of 32 was 9%. The mean birthweight of this "take-home" group was 2302 ± 525 g.

CONCLUSION

Fetal reduction in multifetal pregnancy is associated with low miscarriage rate and preterm delivery rates. Fetal reduction in multifetal pregnancy should be considered for better pregnancy outcomes and the results of this study can be used in prenatal counseling.

摘要

目的

回顾我院多胎妊娠减胎术的结果,从流产、早产、健康婴儿出院情况等方面评估其对妊娠结局的影响,并探讨可能影响结局的因素。

研究设计

这是一项回顾性研究,于2000年至2011年在伊斯坦布尔西什利纪念医院胎儿医学科对接受辅助生殖技术治疗后的患者进行。

结果

样本包括151例三胎妊娠、35例四胎妊娠、11例五胎妊娠、3例双胎妊娠、1例六胎妊娠和1例七胎妊娠。产妇平均年龄为30±4.4岁,平均干预孕周为11.7±1.3周。40例患者需要进行两次或更多次穿刺。术后两周的损失率(定义为“与手术相关的损失率”)为0.7%;然而,对于整个样本,在孕24周前发生的损失率为6.9%,定义为“总损失率”。其余188例中的184例至少有一个婴儿出院(占202例患者的91.1%)。这些健康婴儿出院时的平均孕周为35.5±2.4周。孕32周前的早期早产率为9%。这个“出院”组的平均出生体重为2302±525克。

结论

多胎妊娠减胎术与低流产率和早产率相关。为获得更好的妊娠结局,应考虑对多胎妊娠进行减胎术,本研究结果可用于产前咨询。

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