58例多胎妊娠孕妇减胎术后妊娠结局分析及护理*

doi:10.3969/j.issn.1006-9143.2021.02.012

天津护理 ›› 2021, Vol. 29 ›› Issue (2): 172-175.DOI: 10.3969/j.issn.1006-9143.2021.02.012

58例多胎妊娠孕妇减胎术后妊娠结局分析及护理*

赵晓敏, 张蕾, 李雯, 李姗姗, 申永梅, 常颖

天津市中心妇产科医院天津市人类发育与生殖调控重点实验室,天津 300100

收稿日期:2020-12-20 修回日期:2020-07-09 发布日期:2021-09-28
通讯作者: 常颖,E-mail：changying4470@sina.com
作者简介:赵晓敏,女,主治医师,硕士
基金资助:
*天津市科技计划项目（18ZXDBSY00230）

Analysis of outcome for 58 cases of multifetal pregnancy reduction

ZHAO Xiaomin, ZHANG Lei, LI Wen, LI Shanshan, SHEN Yongmei, CHANG Ying

Tianjin Central Hospital of Obstetrics and Gynecology, Tianjin 300100

Received:2020-12-20 Revised:2020-07-09 Published:2021-09-28

摘要/Abstract

摘要： 目的: 分析多胎妊娠减胎术后的妊娠结局并总结护理的要点。方法: 回顾性分析2016年1月至2018年12月行减胎术的58例多胎妊娠孕妇临床资料,术前对其进行心理护理、术后进行饮食及活动指导,分析减胎术后的妊娠结局。结果: 所有多胎妊娠均减至单胎或双胎,孕早期减胎与孕中期减胎比较,在术后2周内流产率、活产胎儿分娩孕周方面差异无统计学意义（P>0.05）,孕中期减胎较孕早期减胎新生儿出生体质量更重,差异有统计学意义（P<0.05）;心内注射氯化钾（KCl）减胎和射频消融（RFA）减胎两种手术方法比较,在术后2周内流产率、分娩孕周、围生儿存活率方面差异无统计学意义（P>0.05）。结论: 减胎术可在孕早中期进行,KCl减胎及RAF减胎均可改善多胎妊娠的妊娠结局。术前心理护理及术后饮食、活动指导,对妊娠结局有益。

关键词: 多胎妊娠, 射频消融减胎术, 氯化钾减胎术, 护理, 妊娠结局

Abstract: Objective: To analyze the pregnancy outcome after reduction in multiple pregnancy and discuss the importance of nursing. Methods: Retrospective analysis was made on clinical data of 58 multiple pregnancy women who underwent fetal reduction from January 2016 to December 2018, including preoperative psychological care, postoperative diet and activity guidance, and pregnancy outcome. Results: All cases were reduced to single or twin. For reduction in first trimester vs in second trimester, the miscarriage within 2 weeks after surgery and the mean gestational age at delivery, had no significant difference(P>0.05), but the neonatal birth weights in second trimester were greater than in first trimester (P<0.05); For fetal reduction by potassium chloride(KCl) vs by radiofrequency ablation（RAF）, the miscarriage within 2 weeks after surgery, gestational age and the survival rate were no statistically significant differences(P>0.05). Conclusion: Multiple pregnancy reduction can be performed in the first and second trimester, both KCl and RAF reductions can improve pregnancy outcomes. Preoperative psychological care and postoperative diet and activity guidance are beneficial to pregnancy outcome.

Key words: Multiple pregnancy, Radiofrequency ablation reduction, Potassium chloride reduction, Nursing, Pregnancy outcomes

中图分类号:

R473.71

赵晓敏, 张蕾, 李雯, 李姗姗, 申永梅, 常颖. 58例多胎妊娠孕妇减胎术后妊娠结局分析及护理*[J]. 天津护理, 2021, 29(2): 172-175.

ZHAO Xiaomin, ZHANG Lei, LI Wen, LI Shanshan, SHEN Yongmei, CHANG Ying. Analysis of outcome for 58 cases of multifetal pregnancy reduction[J]. Tianjin Journal of Nursing, 2021, 29(2): 172-175.

参考文献

[1] Blondel B, Kaminski M.Trends in the occurrence, determinants, and consequences of multiple births[J]. Semin Perinatol, 2002, 26(4): 239-249.
[2] Murray SR, Norman JE.Multiple pregnancies following assisted reproductive technologies-A happy consequence or double trouble?[J]. Semin Fetal Neonatal Med, 2014, 19(4): 222-227.
[3] Moh W, Graham JM Jr, Wadhawan I, et al.Extrinsic Factors Influencing Fetal Deformations and Intrauterine Growth Restriction[J]. J Pregnancy, 2012, 2012: 1-11.
[4] Lewi L, Van Schoubroeck D, Gratacós E, et al.Monochorionic diamniotic twins: Complications and management options[J]. Curr Opin Obstet Gynecol, 2003, 15(2):177-194.
[5] Huber A, Hecher K.How we can diagnose and manage twin-twin transfusion syndrome?[J]. Best Pract Res Clin Obstet Gynaecol, 2004, 18(4): 543-556.
[6] G1inianaia SV, Obeysekera MA, Sturgiss S, et al. Stillbirth and neonatal mortality in monocloriollic and dichorionictwins: a pulation-based study[J]. Hum Reprod, 2011, 26(9): 2549-2557.
[7] Berghella V, Kaufmann M.Natural history of twin-twin transfusion syndrome[J].J Reprod Med, 2001, 46(5): 480-484.
[8] 鞠辉, 李红燕, 王谢桐. 多胎妊娠孕中期选择性减胎术后不良妊娠结局危险因素分析[J]. 中国实用妇科与产科杂志, 2016,32(8): 779-783.
[9] Hobel CJ, Goldstein A, Barrett ES.Psychosocial stress and pregnancy outcome[J]. Clin Obstet Gynecol, 2008, 51(2):333-348.
[10] Grote NK, Bridge JA, Gavin AR, et al.A meta-analysis of depression during pregnancy and the risk of preterm birth, low birth weight, and intrauterine growth restriction[J]. Arch Gen Psychiatry, 2010, 67(10):1012-1024.
[11] Moore TR, Gale S, Benirschke K.Perinatal outcome of forty-nine pregnancies complicated by acardiac twinning[J]. Am J Obstet Gynecol,1990,163(3):907-912.
[12] 孟艳蕾,周飞京.55例妊娠中期选择性减胎术后的妊娠结局与护理体会[J].中西医结合护理(中英文),2019,5(6):130-133.
[13] 王燕芸. 多胎妊娠减胎术手术并发症及妊娠结局相关因素研究[D].济南:山东大学,2018.
[14] El Marroun H, Jaddoe VW, Hudziak JJ,et al.Maternal use of selective serotonin reuptake inhibitors, fetal growth, and risk of adverse birth outcomes[J]. Arch Gen Psychiatry,2012,69(7):706-714.

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58例多胎妊娠孕妇减胎术后妊娠结局分析及护理*

Analysis of outcome for 58 cases of multifetal pregnancy reduction

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