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目的采用阴道B超引导,对促排卵治疗后妊娠早期多胎妊娠者实施选择性胚胎减灭术(MFPR),分析其对妊娠结局的影响,并对其安全性进行评估。方法收集2004年1月-2014年1月于该院行促排卵治疗受孕的多胎妊娠者共24例,在妊娠7~11周时行阴道B超引导下选择性MFPR。统计其术后早产发生情况及低体重儿出生情况,并与同期50例未经胚胎减灭的双胎妊娠者进行比较。结果实施选择性MFPR后,1例出现流产(4胎减至2胎者),占4.17%;其余23例均已分娩,共41例婴儿。多胎减至双胎与双胎未减胎者平均年龄、分娩情况和新生儿体质量比较差异均无统计学意义(t=0.853,P=0.39;χ2=0.30,P=0.63;t=1.117,P=0.35)。双胎减为单胎者其早产发生情况少于另外2组,而足月产发生情况多于另外2组,新生儿出生体质量也高于另外2组,差异均有统计学意义(χ2=4.68,P=0.03;t=2.71,P=0.007)。结论 B超引导下对促排卵治疗后妊娠早期多胎妊娠者实施选择性MFPR将多胎减为双胎或单胎可以减少多胎妊娠的并发症,改善妊娠结局,提高人口素质,该方法安全可行。
Objective To investigate the effect of selective embryo ablation (MFPR) on pregnant women with multiple pregnancy in early gestation after ovulation induction by vaginal B-ultrasound and analyze its effect on pregnancy outcome and assess its safety. Methods A total of 24 pregnant women with multiple pregnancies who underwent ovulation treatment in our hospital from January 2004 to January 2014 were collected and underwent vaginal ultrasound guided selective MFPR at 7-11 weeks of gestation. The incidence of postoperative preterm birth and the birth of low birth weight children were calculated and compared with 50 pregnant women without twofold pregnancy. Results After the selective MFPR, one case of miscarriage (4 fetuses reduced to 2 fetuses), accounting for 4.17%; the remaining 23 cases have been delivered, a total of 41 infants. There was no significant difference between the multiple births and the twins and the twins without any reduction of fetal birth (t = 0.853, P = 0.39; χ2 = 0.30, P = 0.63; t = 1.117, P = 0.35). Twins were reduced to single births were less premature birth than the other two groups, while the full-term occurrence of more than the other two groups, newborn birth weight is also higher than the other two groups, the differences were statistically significant (χ2 = 4.68, P = 0.03; t = 2.71, P = 0.007). Conclusion Under the guidance of B-ultrasound, the selective MFPR of multiple pregnancies during early pregnancy after pregnancy-induced ovulation can reduce the number of multiple births to twin or single births, reduce the complications of multiple pregnancy, improve the pregnancy outcomes and improve the population quality. This method is safe and feasible.