Zhang H X, Yang R, Yang S, Pan N N, Wang L L, Li R
Reproductive Medical Center, Peking University Third Hospital, Beijing 100191, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2022 Oct 18;54(5):943-947. doi: 10.19723/j.issn.1671-167X.2022.05.022.
To evaluate the feasibility and effectiveness of fetal reduction by transabdominal intracranial KCl injection for multifetal pregnancies in the early second trimester.
The data of 363 patients who underwent transabdominal fetal reduction in the Reproductive Medical Center of Peking University Third Hospital from January 2006 to December 2019 were analyzed retrospectively. According to the location of fetal reduction, they were divided into two groups: Intracranial injection group (=196) and intrathoracic injection group (=167). The process of fetal reduction and pregnancy outcome of the two groups were compared.
There was no significant difference between the two groups in the average age and the proportion of type of infertility before assisted reproductive technology, conception method, indication for fetal reduction, starting number of fetuses, reduced number of fetuses, and finishing number of fetuses (>0.05). There was no significant difference between the two groups in the proportion of the number of puncture ≥ 2 times (12.1% . 8.6%, =0.249) and the incidence of replacing puncture site (10.7% . 6.4%, =0.161). The next day after fetal reduction, color Doppler ultrasound was rechecked. In the intracranial injection group and intrathoracic injection group, the incidence of fetal heartbeat recovery [3.6% (8/224) . 1.1% (2/187), =0.188], the volumes of KCl used [(2.6±1.0) mL . (2.8±1.1) mL, =0.079], and the abortion rate within 4 weeks after fetal reduction (1.0% . 0.6%, =0.654) were of no significant difference. In addition, there was no significant difference in the total abortion rate after fetal reduction, premature delivery rate, cesarean section rate, delivery gestational week and neonatal birth weight between the two groups (>0.05).
Intracranial KCl injection can be an effective alternative to intrathoracic KCl injection for multifetal pregancy reduction.
评估孕中期经腹颅内注射氯化钾减胎术在多胎妊娠中的可行性及有效性。
回顾性分析2006年1月至2019年12月在北京大学第三医院生殖医学中心接受经腹减胎术的363例患者的资料。根据减胎部位将其分为两组：颅内注射组（n = 196）和胸腔内注射组（n = 167）。比较两组减胎过程及妊娠结局。
两组患者的平均年龄、辅助生殖技术前不孕类型比例、受孕方式、减胎指征、起始胎儿数、减胎胎儿数及剩余胎儿数比较，差异均无统计学意义（>0.05）。两组穿刺≥2次的比例（12.1%对8.6%，P = 0.249）及更换穿刺部位的发生率（10.7%对6.4%，P = 0.161）比较，差异均无统计学意义。减胎术后次日复查彩色多普勒超声，颅内注射组与胸腔内注射组胎儿心跳恢复率[3.6%（8/224）对1.1%（2/187），P = 0.188]、氯化钾用量[（2.6±1.0）mL对（2.8±1.1）mL，P = 0.079]及减胎术后4周内流产率（1.0%对0.6%，P = 0.654）比较，差异均无统计学意义。此外，两组减胎术后总流产率、早产率、剖宫产率、分娩孕周及新生儿出生体重比较，差异均无统计学意义（>0.05）。
对于多胎妊娠减胎术，颅内注射氯化钾可作为胸腔内注射氯化钾的有效替代方法。
