生殖医学杂志2017，Vol.26Issue(10)：1035-1040,6.DOI:10.3969/j.issn.1004-3845.2017.10.015
选择性减胎可以明显改善多胎妊娠的临床妊娠结局
Multifetal pregnancy reduction improves clinical pregnancy outcome of multiple pregnancies
摘要
Abstract
Objective:To study the effectiveness and necessity of multifetal pregnancy reduction(MFPR).Methods:The data of 2 923 pregnancy patients undergone IVF-ET between April 2008 and April 2016 were retrospectively analyzed,and their pregnancy status,delivery and neonatal health etc.were followed up.At same time,130 patients undergone multifetal pregnancy reduction(MFPR)were followed up to collect the information including spontaneous abortion in 4 weeks after surgery,late abortion and premature birth etc.The multiple pregnancies patients who underwent MFPR were received the assisted reproductive technology(ART)or used ovulation induction drugs.Results:(1)The clinical pregnancy rate was 51.52 ％,the twins rate 26.03 ％,and the rate of triplets or more than three pregnancies 1.23 ％ in IVF-ET group.The rates of late abortion and premature birth in twins group were significantly higher than in singleton group(P＜0.001).(2)85.71％ patients with four pregnancies were caused by using ovulation induction drugs alone.The average gestation time was 60.55 days(49-126 days)at MFPR.Abortion rate was 3.10％,and 100％ occurred within one week after the surgery.Late abortion rate was 7.41％ and premature birth rate was 1.85％.(3)The incidence of low birth weight after MFPR was significantly lower than that of twin pregnancy without MFPR in IVF group(P＜ 0.001).Premature birth rate in twin pregnancy after MFPR was significantly lower than that of twin pregnancy without MFPR in IVF group(P＜0.001).The premature birth rate in the patients with triplet pregnancy who underwent MFPR to reduce the multiple to twin pregnancy or single pregnancy was significantly lower than that of twin pregnancy without MFPR in IVF group(P＜0.05).Conclusions..The adverse pregnancy outcome is increased in twins group.The main reason of ≥ four pregnancies is usage of ovulation induction drugs alone.MFPR can reduce the rate of preterm birth and low birth weight of multiple pregnancies and improve the clinical outcome of multiple pregnancies due to assisted reproductive technology and ovulation induction.MFPR as a remedial measure is effective and also very necessary.关键词
多胎妊娠/体外受精-胚胎移植/选择性减胎术/妊娠结局Key words
Multiple pregnancy/IVF-ET/Multifetal pregnancy reduction/Pregnancy outcome引用本文复制引用
孟庆霞,吴惠华,李建芬,陈冰,邹琴燕,李红..选择性减胎可以明显改善多胎妊娠的临床妊娠结局[J].生殖医学杂志,2017,26(10):1035-1040,6.基金项目
江苏省苏州市卫生局项目(lczx201411) （lczx201411）
江苏省苏州市临床医学中心项目(szzx201505) （szzx201505）
