Plank K, Mikulaj V, Stencl J, Drobná H, Klesken P
Department of Obstetrics and Gynecology, Dérer's Hospital, Bratislava, Slovak Republic.
J Perinat Med. 1993;21(4):309-13. doi: 10.1515/jpme.1993.21.4.309.
Early prenatal diagnosis, intensive prenatal care, bed rest, cerclage, and preventive in-patient management are discussed. The authors present the management and outcome of 83 twin pregnancies in a 5-year retrospective study. The frequency of twin pregnancy wa 1.08%, the mean gestational age at the time of delivery was 37.5 weeks. Mean birth weight of the first fetus was 2453 grams, second 2406 grams. The incidence of preterm deliveries was 31.3% and perinatal mortality of twins came up to 54.2%. The early prenatal diagnosis of a twin pregnancy is the most important step in prenatal management. The centralization of prenatal care in the out-patient department designated for "high risk pregnancies" is recommended. Ultrasound scanning is recommended as a screening examination. Bed rest before the 25th gestational week is recommended on an individual basis though it is recommended in all cases after the 25th gestational week. Cerclage was indicated in 28.9% cases with unfavourable cervical findings. The mean gestational age of 38 weeks and the birth weight of 2659 grams found in the group who had in-patient management should be compared with 35.8 weeks and 2120.0 grams in the group managed on an out-patient basis. Perinatal mortality before 32nd week--300/1000, between 33-37th week--62.5/1000, and after 37th week--8.7/1000. The authors recommend in-patient management before the 32nd week of pregnancy in twins.
讨论了早期产前诊断、强化产前护理、卧床休息、宫颈环扎术和预防性住院管理。作者在一项为期5年的回顾性研究中介绍了83例双胎妊娠的管理及结局。双胎妊娠的发生率为1.08%，分娩时的平均孕周为37.5周。第一个胎儿的平均出生体重为2453克，第二个为2406克。早产发生率为31.3%，双胎围产儿死亡率高达54.2%。双胎妊娠的早期产前诊断是产前管理中最重要的一步。建议将产前护理集中在指定的“高危妊娠”门诊。推荐超声扫描作为筛查检查。尽管建议妊娠25周后所有病例都卧床休息，但妊娠25周前建议根据个体情况卧床休息。28.9%宫颈检查结果不利的病例需要进行宫颈环扎术。应将住院管理组的平均孕周38周和出生体重2659克与门诊管理组的35.8周和2120.0克进行比较。32周前的围产儿死亡率为300/1000，33 - 37周之间为62.5/1000，37周后为8.7/1000。作者建议双胎妊娠在孕32周前进行住院管理。
