摘要
目的:探讨双胎妊娠结局及不同分娩时机与分娩方式对新生儿窒息的影响。方法:回顾性分析本院462例双胎妊娠孕妇晚期流产及分娩结局资料,以1分钟Apgar评分≤7分为标准诊断新生儿窒息,对比分析不同孕周的晚期流产率,及在不同分娩孕周采用不同分娩方式的新生儿窒息率。结果:(1)双胎妊娠孕妇孕28周前流产42例,主要集中于孕26～27^(+6)周(18例)。(2)孕28周后分娩的活产新生儿共834例,其剖宫产新生儿窒息率(2. 16%)低于阴道分娩(12. 77%)(P<0. 05),其中孕28～29^(+6)、孕32～33^(+6)周剖宫产与阴道分娩的新生儿窒息率差异有统计学意义(P<0. 05)。新生儿窒息率在孕36～37^(+6)周(0. 44%)明显低于其他孕周(P<0. 05)。(3)大胎儿和小胎儿的剖宫产新生儿窒息率均低于阴道分娩(P<0. 05),剖宫产中大胎儿新生儿窒息率低于小胎儿(P<0. 05)。剖宫产中大胎儿在孕34～35^(+6)周的新生儿窒息率(0)明显低于其他孕周(P<0. 05),剖宫产中小胎儿在孕36～37^(+6)周的新生儿窒息率(0)明显低于其他孕周(P<0. 05)。结论:双胎妊娠应加强孕期监护,防止晚期流产的发生。双胎妊娠无明显并发症时可尽量延长孕周至36～37^(+6)周,但不宜过迟,采取剖宫产方式可降低新生儿窒息率的发生。
Objective：To investigate delivery outcome and the effect of pregnant week and delivery mode on neonate asphyxia in twin pregnancy. Methods：A retrospective analysis of 462 cases of twin pregnancy in the Wu- han Maternal and Child Health Hospital was conducted,with a 1-minute Apgar score ≤7 diagnosed neonatal asphyxia,the gestational abortion rate and the neonatal asphyxia rate in different delivery weeks and modes were comparatively analyzed. Results：①Twin-pregnancy women had miscarriage in 42 cases before 28 weeks＇ gestation, mainly at 26 - 27 ＋6 weeks.②Neonatal asphyxia rate of cesarean section （2. 16% ） was lower than vaginal delivery（ 12.77% ）（ P 〈0.05）. The significant difference were attached in neonatal asphyxia rate between cesar- ean section and the vaginal delivery at 28 - 29 ＋6 weeks of pregnancy, as well as 32 - 33 ＋6 weeks （ P 〈 0. 05）. Neonatal asphyxia rate was significantly lower in 36 -37,6 weeks（0.44% ） than that in other gestational weeks （P 〈0. 05）.③The rates of neonatal asphyxia in cesarean section was lower than that in vaginal delivery,whether in large or small fetuses（P〈 0.05）. In cesarean section, the neonatal asphyxia rate of large fetuses was lower than that of small fetuses（ P 〈 0.05）. The lowest neonatal asphyxia rate of large fetus in cesarean section （0%） was occurred at 34 to 35^ ＋6 weeks of pregnancy,while the small fetus occurred at 36 -37^ ＋6 weeks（ P 〈0.05）. Conclusions：It is necessary to strengthen the pregnancy monitoring to minimize the incidence of late abortions. The gestational age could be prolonged to 36 -37 ^＋6 weeks if there is no complications in twin pregnancy. The cesarean section could reduce the incidence of neonatal asphyxia.
作者
余曼
张莹
申斌
YU Man;ZHANG Ying;SHEN Bin(Huazhong University of Science and Technology Tongji Medical College Affiliated Wuhan Children＇s Hospital,Wuhan Maternal and Child Health HospitaI,Wuhan Hubei 430016,China)
出处
《实用妇产科杂志》
CAS
CSCD
北大核心
2018年第11期844-847,共4页
Journal of Practical Obstetrics and Gynecology
关键词
双胎妊娠
分娩时机
分娩方式
新生儿窒息
Twin pregnancy
Gestational age
Delivery route
Neonatal asphyxia
