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双胎妊娠第二胎延迟分娩4例临床分析

     

摘要

Objective:To investigate the clinical feature, treatments and outcome delayed interval delivery of twins. Methods:Retrospective analysis of clinical features of 4 cases of delayed interval deliveries of twins occurred in Beijing Obstetrics and Gynecology Hospital and Central Hospital of Shandong Shengli Oilfield during 2007 -2010. Results:For the 4 cases of delayed interval deliveries, the gestational age of delivery of the first twin varied from 26 weeks to 31 weeks and the average gestation age was 28 weeks; birth weight varied from 140 g to 980 g and the average weight was 670 g. The pregnancy outcome were one dead fetus, one stillbirth and two dead infants. After delivery of the first twin, antibiotics, tocolytic and promotion of fetus lung maturity were adapted. One patient had cervical cerclage. 3 patients had cervical secretion culturewhich were negative,while one patient had Enterococcus faecalis infection. Meanwhile the blood test and C-reac-tion protein were normal in three patients, abnormal in one patient. The gestational age of delivery of the second twin varied from 27 weeks to 37 weeks and the average was 31 weeks; birth weight varied from 1020 g to 2980 g and the average weight was 1795 g and all babies survived. The interval of the first and second twin delivery varied from 7 days to 43 days and the average was 24 days. Conclusions:Delayed Interval delivery is a quite specific scenario, and proper treatment may increase the survival rate of the second twin newborn.%目的:探讨双胎妊娠第二胎延迟分娩的临床情况、处理及妊娠结局.方法:回顾性分析2007~2010年间首都医科大学附属北京妇产医院及山东胜利油田中心医院发生的双胎妊娠第二胎延迟分娩共4例患者的临床资料.结果:4例双胎妊娠延迟分娩患者第一胎分娩孕周26~31周,平均28周;分娩体重140 ~980 g,平均670 g;1例死胎,1例死产,2例新生儿死亡.第一胎分娩后,予抗感染、保胎、促胎肺成熟等治疗,1例行官颈环扎术.保胎期间宫颈分泌物培养3例阴性;1例发现粪肠球菌,其WBC(10.09×109 ~ 17.13×109/L)、C反应蛋白(4.32 ~47.7mg/L)监测升高;其余3例正常.第二胎分娩孕周为27 ~ 37周,平均31周;出生体重1020 ~2980 g,平均1795 g,皆存活.分娩间隔时间为7~43天,平均24天.结论:双胎妊娠第二胎延迟分娩是双胎妊娠的一种特殊并发症,处理得当可明显提高第二胎新生儿的存活率.

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