中国实用妇科与产科杂志2017，Vol.33Issue(6)：590-594,5.DOI:10.19538/j.fk2017060110
双胎妊娠孕期规范化诊疗和管理对围产儿预后影响研究
Effect of standardized diagnosis and management during pregnancy on the outcome of twin pregnancies
摘要
Abstract
Objective To compare the accuracy of diagnosis and the prognosis of twin pregnancies before and after the standardized diagnosis and management of twin pregnancies is implemented.Methods A total of 444 cases who had delivery in the Obstetrics and Gynecology Hospital of Fudan University from 1 January 2010 to 31 December 2015 were enrolled,whose chorionicity was defined by visual examination or placental pathology after birth.By the date of implementing the standardized diagnosis and management of twin pregnancies from 1 June 2013,cases were divided into two groups,and we compared the accuracy of chorionic diagnosis,pregnancy and perinatal outcome.Results (1) There was no significant difference in age,height and weight between the two groups (P ＞ 0.05).(2)After the implementation,the proportion of diagnosis of chorionicity by ultrasonography increased significantly (91.7％ vs.70.2％,P ＜ 0.01).The proportion of chorionicity that was diagnosed by the number of gestational sacs increased significantly after the implementation (71.7％ vs.60.0％,P＜0.01).Two cases were misdiagonosed before the implementation and no case was misdiagonosed after the implementation;however,there was no significant difference in the accuracy of diagnosis of chorionicity between two groups (P ＞ 0.05).(3)The delivery week of elective cesarean section was significantly later after implementation than before the implementation (37.17± 0.45weeks vs.36.93±0.51 weeks,P ＜ 0.01),so was the delivery week of elective cesarean section in dichorionic twin gestations (37.32-±0.32 weeks vs.37.03±0.46 weeks,P ＜0.01).(4)There was no significant difference in neonatal birth weight between the two groups (P＞ 0.05).The proportion of maternal-with-infant after implementation was higher than that before the implementation (58.3％ vs.54.1％,P ＜ 0.05).The proportion of newborns admitted to the NICU,transferred after born or giving up rescue was lower than that before the implementation (37.4％ vs.37.7％,4.3％ vs.7.3％,0 vs.0.9％,P ＜ 0.05).Conclusion The standardized diagnosis and management of twin pregnancies is conducive to improving perinatal outcome.关键词
双胎妊娠/诊疗规范/绒毛膜性/围产儿预后Key words
twin pregnancy/standardized diagnosis and management/chorionicity/perinatal prognosis分类
医药卫生引用本文复制引用
齐嫣婷,周琼洁,沈婕,程海东,刘彩霞,李笑天,熊钰..双胎妊娠孕期规范化诊疗和管理对围产儿预后影响研究[J].中国实用妇科与产科杂志,2017,33(6):590-594,5.基金项目
国家卫计委公益性行业科研专项项目(201402006) （201402006）
中国双胎和胎儿结构异常协作组 （）
