1789例多胎妊娠减胎术患者的国际协作经验：风险与结局趋于平稳
International, collaborative experience of 1789 patients having multifetal pregnancy reduction: a plateauing of risks and outcomes.
作者信息
Evans M I, Dommergues M, Wapner R J, Goldberg J D, Lynch L, Zador I E, Carpenter R J, Timor-Tritsch I, Brambati B, Nicolaides K H, Dumez Y, Monteagudo A, Johnson M P, Golbus M S, Tului L, Polak S M, Berkowitz R L
机构信息
Department of Obstetrics and Gynecology, Wayne State University/Hutzel Hospital, Detroit, MI 48201, USA.
出版信息
J Soc Gynecol Investig. 1996 Jan-Feb;3(1):23-6. doi: 10.1016/1071-5576(95)00037-2.
OBJECTIVE
To develop the most up-to-date, complete data base of multifetal pregnancy reduction (MFPR) from cases, and to provide the best counseling for couples with multifetal pregnancies.
METHODS
From nine centers in five countries, 1789 completed MFPR cases were collected and outcomes evaluated. Pregnancy losses were defined as through 24 weeks and deliveries categorized in groups of 25-28, 29-32, 33-36, and 37 or more weeks.
RESULTS
Overall, the pregnancy loss rate was 11.7% but varied from a low of 7.6% for triplets to twins and increased with each additional starting number to 22.9% for sextuplets or higher. Early premature deliveries (25-28 weeks) were 4.5% and varied with starting number. Loss rates by finishing number were highest for triplets and lowest for twins, but gestational age at delivery was highest for singletons.
CONCLUSIONS
Multifetal pregnancy reduction has been shown to be a safe and effective method to improve outcome in multifetal pregnancies. Outcomes are worse with higher-order gestations and support the need for continued vigilance of fertility therapy.
目的
建立最新、完整的多胎妊娠减胎术（MFPR）病例数据库，并为多胎妊娠夫妇提供最佳咨询服务。
方法
从五个国家的九个中心收集了1789例完成多胎妊娠减胎术的病例，并对结果进行评估。妊娠丢失定义为至24周，分娩分为25 - 28周、29 - 32周、33 - 36周以及37周及以上几组。
结果
总体而言，妊娠丢失率为11.7%，但从三胎妊娠的7.6%（双胞胎）的低水平开始，随着起始胎儿数量增加，六胎及以上妊娠的丢失率增至22.9%。早期早产（25 - 28周）发生率为4.5%，且因起始胎儿数量而异。按分娩时胎儿数量计算的丢失率，三胎妊娠最高，双胞胎最低，但单胎分娩时的孕周最大。
结论
多胎妊娠减胎术已被证明是改善多胎妊娠结局的一种安全有效的方法。高阶妊娠的结局较差，这支持了对生育治疗持续保持警惕的必要性。
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