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目的:评估双胎妊娠早期两胎儿不同一性发育的妊娠结局。方法:回顾性研究在216对双胎妊娠中共有19例(不同一组),41例为对照组。用方差分析和Fisher’sexacttest比较两组胎儿生长受限(IUGR)发生率、新生儿不同一性发生率和早产发生率情况。结果:不同一组IUGR发生率、新生儿不同一性发育发生率以及早产发生率分别为57.2%,35.7%,78.6%,显著高于对照组24.4%,7.5%和30%(P值分别为0.03,0.02和0.01),不同一组先天畸形的发病率高于对照组,当双胎不同一性比率(A-B/A)>25%时,有显著性差异(P=0.039)。所有发现的畸形均为易于识别的严重畸形。结论:双胎不同一性发育可发生于妊娠早期。双胎不同一性程度>25%时,胎儿畸形率增高且为易识别的显著畸形。早期不同一性发育双胎的IUGR发生率、新生儿不同一性发生率和早产发生率均增高。
OBJECTIVES: To assess the outcome of pregnancy with two different fetuses in the first trimester of pregnancy. METHODS: A retrospective study of 216 pairs of twin pregnancies in a total of 19 cases (a different group), 41 cases as a control group. ANOVA and Fisher’sexacttest were used to compare the incidence of fetal growth restriction (IUGR), neonatal non-homogeneity and preterm delivery. Results: The incidence of IUGR, the rate of newborn birth and the rate of preterm birth were 57.2%, 35.7% and 78.6%, respectively, which were significantly higher than those in control group (24.4%, 7.5% and 30%, respectively 0.03,0.02 and 0.01). The incidence of congenital malformations in different groups was higher than that in control group. There was a significant difference (P = 0.039) when the twins’ different sex ratio (AB / A)> 25%. All the deformities were found to be easily identified as severe deformities. Conclusion: The development of twins may occur in the first trimester of pregnancy. Twins of different degrees of homogeneity> 25%, fetal malformations increased and easy to identify significant deformity. The incidence of IUGR, neonatal nonspecificity and preterm birth were significantly higher in the early twins with different sexual development.