在三胎妊娠中需要胎儿减小吗? 单一的三级中心体验体验
Sukran Dogru1, Huriye Ezveci1, Fikriye Karanfil Yaman1
1Department of Obstetrics and Gynecology, Division of Perinatology, Necmettin Erbakan University Medical School of Meram, Konya, Turkey.
Fetal and pediatric pathology
|December 4, 2024
概括
三胎妊娠的预期管理 (TCTA) 是一个合理的选择,旨在实现三个活产,显示出低流产和高存活率. 从三胞胎的胎儿减少到双胞胎 (DCDA) 导致34周前的分娩显著减少.
科学领域:
- 周围生理学 周围生理学
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 生殖医学 生殖医学
背景情况:
- 多胎妊娠,特别是三胞胎妊娠,具有显著的围产期风险.
- 胎儿减小 (FR) 是高阶多胎妊娠 (HOMP) 的常见干预措施.
- 对三胎妊娠的不同管理策略的结果进行比较至关重要.
研究的目的:
- 评估和比较预期管理的三胎怀孕与经受胎儿缩小治疗的三胎怀孕的周产期结果.
- 为了评估二 - 三 (DCDA) 双胞胎的结果,由胎儿减少三 - 三 (TCTA) 三胞胎的结果.
- 将从HOMP减少的TCTA三胞胎的结果与预期的TCTA管理进行比较.
主要方法:
- 在8年内对69例多胎妊娠进行了回顾性分析.
- 分类为三组:期待TCTA三胞胎,TCTA三胞胎减少从HOMP,和DCDA双胞胎减少从TCTA三胞胎.
- 流产率,32周和34周之前的出生率,胎儿体重和死产率的比较.
主要成果:
- 在不同组中,流产率 (p=0.190) 或32周前出生率 (p=0.158) 没有显著差异.
- 在TCTA组的DCDA双胞胎中,34周前的出生率显著降低 (p=0.001).
- 来自TCTA组的DCDA双胞胎的胎儿体重高于预期的TCTA,但类似于三胞胎减少的HOMP.
结论:
- 预期管理TCTA怀孕是一个合理的选择,当目标是三个活产,由于流产率低,幸存率高.
- 从TCTA怀孕中减少胎儿到DCDA双胞胎与34周前早产的风险更高有关.
- 可能需要进一步的研究来优化复杂的多胎妊娠的管理策略.
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