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胎儿减少与期望管理在二三胎三胞胎的结果

Xinlu Meng¹, Jiaqi Huang¹, Pengbo Yuan¹

¹Department of Obstetrics and Gynecology, Peking University Third Hospital, Beijing, China.

Prenatal diagnosis

|September 6, 2023

概括

对二三双胞胎的胎儿减小可以减少早产,但不能改善存活率. 减少到单身提供更好的结果,而不是减少到双胞胎.

科学领域:

孕产妇和胎儿医学孕产妇和胎儿医学
周围生理学周围生理学
生殖医学生殖医学

背景情况:

双三胞胎 (DCTA) 三胞胎由于早产和不良结果的高风险而存在独特的管理挑战.
胎儿减少 (FR) 是一种通过减少胎儿数量来改善DCTA三胞胎的妊娠结果的策略.

研究的目的:

为了比较DCTA三胞胎的怀孕结果,预期管理与那些经历胎儿减少到单胞胎或二二双胞胎的双胞胎相比.

主要方法:

追溯研究108个DCTA三胎妊娠,在11-14周怀孕时有三个活胎儿.
三组结果的比较:预期管理 (EM),双胞胎FR和单身FR.

主要成果:

与EM (33.1周) 相比,FR后单子 (38.6周) 和双胞胎 (37.0周) 的中位妊娠年龄在出生时显著更高.
在FR组中,早产率 (在37周和34周之前) 比EM组要低得多.
新生儿出生体重在FR组中较高;然而,流产,存活率,孕产妇和新生儿并发症率在各组之间是可比的.

结论:

与预期管理相比,DCTA三胞胎的胎儿减少可以降低早产的风险,而不会赋予生存优势.
减少单生子似乎比减少双双胞胎产生更有利的结果.

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