Guo X Y, Yuan P B, Wei Y, Zhao Y Y
Department of Obstetrics and Gynecology, Peking University Third Hospital, National Clinical Research Center for Obstetric and Gynecologic Diseases, National Center for Healthcare Quality Management in Obstetrics, Beijing 100191, China.
Zhonghua Fu Chan Ke Za Zhi. 2024 Jan 25;59(1):41-48. doi: 10.3760/cma.j.cn112141-20231008-00135.
To investigate the clinical characteristics of induced labor in twin pregnancy and the related factors of induced labor failure. The clinical data of twin pregnant women who underwent induced labor in Peking University Third Hospital from January 2016 to December 2022 were retrospectively analyzed. According to whether they had labor or not after induction, pregnant women were divided into the success group (pregnant women who had labor after induction, 72 cases) and the failure group (pregnant women who did not have labor after induction, 30 cases). Logistic regression was used to analyze the related factors of induction failure in twin pregnant women. The parity and cervical Bishop score in the failure group were significantly lower than those in the success group, while the proportion of dichorionic diamniotic twins, assisted reproductive technology pregnancy and cervical Bishop score <6, postpartum hospital stay and total hospital stay in the failure group were significantly higher than those in the success group (all <0.05). The proportion of induced labor by artificial rupture of membranes ± oxytocin intravenous infusion in the success group was 72.2% (52/72), which was significantly higher than that in the failure group (46.7%, 14/30; =0.030). There were no significant differences between the two groups in the gestational age at delivery, the incidence of severe postpartum hemorrhage and blood transfusion, the amount of postpartum hemorrhage, the neonatal weight of two fetuses, the incidence of neonatal asphyxia, and the proportion of neonates admitted to the neonatal intensive care unit (all >0.05). There were no severe perineal laceration and hysterectomy in all pregnant women. Multivariate logistic regression analysis showed that primipara (=3.064, 95%: 1.112-8.443; =0.030) and cervical Bishop score <6 (=5.208, 95%: 2.008-13.508; =0.001) were the independent risk factors for induction failure in twin pregnancy. Elective induction of labor in twin pregnancy is safe and feasible. It is helpful to improve the success rate of induction of labor by strictly grasping the timing and indications of termination of pregnancy, choosing the appropriate method of induction according to the condition of the cervix, and actively promoting cervical ripening
探讨双胎妊娠引产的临床特点及引产失败的相关因素。回顾性分析2016年1月至2022年12月在北京大学第三医院行引产的双胎孕妇的临床资料。根据引产术后是否分娩,将孕妇分为成功组(引产术后分娩的孕妇,72例)和失败组(引产术后未分娩的孕妇,30例)。采用Logistic回归分析双胎孕妇引产失败的相关因素。失败组的产次和宫颈Bishop评分显著低于成功组,而双绒毛膜双羊膜囊双胎的比例、辅助生殖技术妊娠及宫颈Bishop评分<6、产后住院时间和总住院时间在失败组显著高于成功组(均<0.05)。成功组人工破膜±缩宫素静脉滴注引产的比例为72.2%(52/72),显著高于失败组(46.7%,14/30;=0.030)。两组在分娩孕周、严重产后出血及输血发生率、产后出血量、两个胎儿的出生体重、新生儿窒息发生率及入住新生儿重症监护病房的新生儿比例方面均无显著差异(均>0.05)。所有孕妇均无严重会阴裂伤及子宫切除术。多因素Logistic回归分析显示,初产妇(=3.064,95%:1.112 - 8.443;=0.030)和宫颈Bishop评分<6(=5.208,95%:2.008 - 13.508;=0.001)是双胎妊娠引产失败的独立危险因素。双胎妊娠选择性引产安全可行。严格掌握终止妊娠的时机和指征,根据宫颈情况选择合适的引产方法,积极促宫颈成熟,有助于提高引产成功率