中国实用妇科与产科杂志2025，Vol.41Issue(2)：161-166,6.DOI:10.19538/j.fk2025020107
双胎妊娠早产的早期预测与临床处理
Early prediction and clinical management of preterm birth in twin pregnancies
摘要
Abstract
Preterm birth is the most common complication in twin pregnancies.Monochorionic twins,history of previous preterm birth,history of cervical surgery and advanced maternal age have been shown to be correlated with a higher risk of preterm birth in twin pregnancies.Transvaginal cervical length measurement during the second trimester is the best predictor for spontaneous preterm birth in twin pregnancies.For asymptomatic twin pregnancies with short cervix,fetal fibronectin(FFN)and amniotic fluid sludge screening may have additional predictive value.Clinical management of the risk of preterm birth in twins.requires a detailed assessment of medical history and personalized management,including regular prenatal check-ups and ultrasound monitoring of cervical length and fetal conditions.Monochorionic diamniotic twins should be closely monitored for complications such as twin-to-twin transfusion syndrome(TTTS)and selective intrauterine growth restriction(sIUGR).Vaginal progesterone may be beneficial in preventing preterm birth in twin pregnancies with cervical length ≤25mm,but its efficacy needs further validation by high-quality randomized controlled trials.Routine use of cervical cerclage is not recommended for twin pregnancies,although emergency cerclage may be beneficial when the cervix is extremely short and accompanied by dilation.Clinical decisions should take specific conditions of patients and the latest research developments into account.关键词
双胎妊娠/早产/子宫颈长度/子宫颈环扎/孕酮Key words
twin pregnancy/preterm birth/cervical length/cervical cerclage/progesterone分类
临床医学引用本文复制引用
胡晓雨,邹刚..双胎妊娠早产的早期预测与临床处理[J].中国实用妇科与产科杂志,2025,41(2):161-166,6.基金项目
国家重点研发计划(2023YFC2705900 （）
2022YFC2704700) （）
