双双胞胎的晚期选择性终止:比较第二和第三季度末期的手术.
Tal Weissbach1, Inbal Tal2, Noam Regev2
1Institute of Obstetrical and Gynecological Imaging, Department of Obstetrics and Gynecology, Sheba Medical Center, Tel-Hashomer, Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel..
Reproductive biomedicine online
|May 25, 2024
概括
在第二季度末期选择性终止双胞胎提供了比第三季度更好的产周结果. 宫长度较短和双胞胎减少增加了选择性终止后早产风险.
科学领域:
- 孕产妇和胎儿的医学
- 周围生理学 周围生理学
- 双胞胎怀孕管理 双胞胎怀孕管理
背景情况:
- 选择性终止在多胎妊娠中进行,以改善结果.
- 选择性终止的时间可能会影响围产期结果和风险.
- 双双胞胎对选择性终止程序提出了独特的考虑.
研究的目的:
- 为了比较二生双胞胎选择性终止的围产期结果,该选择性终止在第二季度晚期和第三季度进行.
- 为了确定与晚期选择性终止后早产相关的风险因素.
主要方法:
- 对81例经过选择性终止 (2009-2021) 的二双胞胎怀孕进行了回顾性队列研究.
- 在第二季度末 (20.2-24.2周) 和第三季度 (≥28.2周) 之间对结局的比较.
- 单变量和多变量分析以确定与术后早产相关的因素.
主要成果:
- 末期的第二季度终止与更高的出生体重百分比和更低的宫内生长限制 (IUGR) 和剖腹产率有关.
- 在两组之间,早产率相似 (46.2%对63.6%).
- 呈现双胞胎的缩小 (OR 8.7) 和子宫长度≤35mm (OR 3.8) 是早产的独立风险因素.
结论:
- 在二双胞胎中,第二个三个月的选择性终止与与第三个三个月相比,改善了围产期结果.
- 宫长度≤35毫米和呈现双胞胎的缩小是术后早产的重要风险因素.
- 研究结果表明,早期干预对双胞胎怀孕的选择性终止有潜在的益处.
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