胆管性对三胎妊娠中母亲和新生儿结局的影响
Maya Levy-Coles1, Offer Erez2, Yuval Mizrakli3
1Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben Gurion University of the Negev, Beer Sheva, Israel.
概括
与三胎妊娠相比,二胎三胎妊娠的早产和新生儿死亡率更高. 在三胎妊娠中,早产史独立增加了早产的风险.
科学领域:
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 新生儿科学 新生儿科学
- 生殖医学 生殖医学
背景情况:
- 三胞胎怀孕面临着母亲,胎儿和新生儿并发症的高风险,特别是早产.
- 胆管性会影响怀孕结果,原因是共享的血液循环和胎盘血管解剖,影响诸如双胞胎对双胞胎输血综合征和生长限制等风险.
研究的目的:
- 为了研究胆管性对三胎妊娠中母亲,胎儿和新生儿结局的影响.
- 确定二或三三胎妊娠对怀孕和新生儿并发症的具体影响.
主要方法:
- 基于人口的回顾性队列研究.
- 分析了125例三胎怀孕在一家第三级医院产生的情况.
- 在二和三妊娠之间对母亲,胎儿和新生儿的结果进行比较.
主要成果:
- 迪科里奥孕期在分娩时的妊娠年龄中位数较低 (31 vs. 33 周),早期 (<32 周) 和极端 (<28 周) 过早分娩的比例较高 (56% vs. 34%; 33.3% vs. 8%).
- 新生儿死亡率在二胆子妊娠中明显高于三胆子妊娠 (22%与7%相比).
- 过去的早产被确定为三胎妊娠中早产的独立风险因素 (adj. OR 5.91) 的情况.
结论:
- 与二三胎妊娠相比,二三胎妊娠与早期和极端早产率的增加以及较高的新生儿死亡率有关.
- 过早分娩的病史是三胎妊娠中早期过早分娩的重要独立风险因素.
- 胆管性显著影响早产时间和三胎妊娠中新生儿存活率.
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