生殖医学杂志2026，Vol.35Issue(1)：37-41,5.DOI:10.3969/j.issn.1004-3845.2026.01.006
54例IVF-ET后双绒毛膜三胎妊娠减胎术后临床结局分析
Analysis of clinical outcomes of 54 cases of fetal selective reduction in dichorionic triplet pregnancies after in vitro fertilization and embryo transfer
摘要
Abstract
Objectives:To retrospectively analyze the clinical outcomes of dichorionic triplet pregnancy after different fetal reduction strategies. Methods:The clinical data of 54 cases of dichorionic triplet pregnancy in the No.924 Hospital of PLA Joint Logistic Support Force from March 2018 to May 2024 were recruited.Patients were grouped according to the different fetal reduction strategies:reduction of one fetus from a monochorionic diamniotic pair(DCDA group,n=41),reduction of the entire monochorionic diamniotic pair(SP group,n=10),and reduction of a singleton from a separate placenta(MCDA group,n=3).The DCDA group was further divided into two subgroups based on ultrasound findings one week post-procedure:singleton survival(DCDA-1 group,n=28)and survival of both remaining fetuses(DCDA-2 group,n=13).The impact of the number of retained fetuses and chorionicity on pregnancy outcomes was analyzed. Results:One week after reduction,68.29％of patients in the DCDA group naturally reduced to a single surviving fetus(DCDA-1).The rates of miscarriage,preterm birth,and low birth weight were significantly higher in the DCDA-2 group compared to the DCDA-1 group(P＜0.05).The twin survival groups(DCDA-2 and MCDA groups)had significantly higher rates of miscarriage,preterm birth,and low birthweight than those of the singleton survival groups(DCDA-1 and SP groups,P＜0.001).The monochorionic twin group(MCDA group)exhibited significantly higher rates of preterm birth and miscarriage compared to the dichorionic twin group(DCDA-2 group,P＜0.001). Conclusions:Among the different fetal reduction strategies for dichorionic triamniotic triplet pregnancies,retaining a singleton results in superior pregnancy outcomes compared to retaining twins.Furthermore,dichorionic twin pregnancies have better outcomes than monochorionic twin pregnancies.Reducing the monochorionic diamniotic pair may be the preferred clinical strategy.关键词
多胎妊娠/双绒毛膜三胎妊娠/多胎妊娠减胎/辅助生殖/妊娠结局Key words
Multiple pregnancy/Dichorionic triplet pregnancy/Fetal reduction in multiple pregnancies/Assisted reproduction/Pregnancy outcome分类
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李为玉,朱保平,安欣裕,周欣..54例IVF-ET后双绒毛膜三胎妊娠减胎术后临床结局分析[J].生殖医学杂志,2026,35(1):37-41,5.基金项目
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-C20221053) （Z-C20221053）
