Porreco R P, Sabin E D, Heyborne K D, Lindsay L G
Rocky Mountain Perinatal Associates, P.C. Columbia-HealthONE Perinatal Services, Denver, CO, USA.
Am J Obstet Gynecol. 1998 Jan;178(1 Pt 1):20-3. doi: 10.1016/s0002-9378(98)70620-9.
Our goal was to review a single subspecialty practice experience with a uniform approach to delayed-interval delivery.
A 66-month retrospective review of our maternal-fetal medicine practice database was completed. Fifty-nine sets of twins or triplets delivered at < 30 weeks' gestation were identified. No cases of twins or triplets who came to our care, either in consultation or as primary providers, were excluded.
Forty-three patients were excluded as candidates for delayed-interval delivery because of monochorionicity, abruptio placentae, severe preeclampsia, and the need for hysterotomy. Sixteen pregnancies were identified as candidates for delayed-interval delivery, and we actually attempted to delay delivery in 9 of them. The details of the interval deliveries are summarized; there was a mean latency interval of 34 days with a range of 3 to 76 days. Pregnancies in which delayed-interval deliveries wer attempted were significantly less mature at the time of presentation than those managed by delivery of all infants initially. Perinatal mortality was significantly lower in the retained fetuses.
This retrospective consecutive case review from a single maternal-fetal practice documents that selected multichorionic pregnancies may benefit from delayed-interval delivery. Modest intervals between siblings during critical gestational ages can improve newborn survival and decrease neonatal morbidity.
我们的目标是回顾单一亚专业实践中采用统一方法进行延迟间隔分娩的经验。
对我们母胎医学实践数据库进行了为期66个月的回顾性研究。确定了59例孕30周前分娩的双胞胎或三胞胎。无论是作为会诊还是主要提供者来我们这里就诊的双胞胎或三胞胎病例均未被排除。
43例患者因单绒毛膜性、胎盘早剥、重度子痫前期以及需要行子宫切开术而被排除在延迟间隔分娩候选者之外。16例妊娠被确定为延迟间隔分娩候选者，其中9例我们实际尝试延迟分娩。总结了间隔分娩的详细情况；平均延迟间隔为34天，范围为3至76天。尝试延迟间隔分娩的妊娠在就诊时的成熟度明显低于最初所有婴儿均分娩的情况。留存胎儿的围产儿死亡率显著更低。
这项来自单一母胎医学实践的回顾性连续病例研究证明，选定的多绒毛膜妊娠可能从延迟间隔分娩中获益。关键孕周期间兄弟姐妹之间适度的间隔时间可提高新生儿存活率并降低新生儿发病率。
