单体与双胞胎妊娠经历剖腹产时的孕产妇发病率
Mia Heiligenstein1, Nathan Fox1
1Department of Obstetrics, Gynecology, and Reproductive Science, Mount Sinai School of Medicine at Mount Sinai West, Maternal Fetal Medicine Associates, PLLC, New York.
American journal of perinatology
|May 6, 2025
概括
在双胞胎怀孕中,剖腹产与单双妊娠相比,没有增加主要孕产妇发病率的风险. 然而,经历剖腹产的双胞胎怀孕经历了更高的估计失血和输血率.
科学领域:
- 产科和妇科 产科和妇科
- 孕产妇和胎儿医学 孕产妇和胎儿医学
- 外科手术的结果
背景情况:
- 双胞胎怀孕正在增加,剖腹产的高率.
- 在经过剖腹产分娩的双胞胎妊娠中,母亲的发病风险需要进一步澄清.
- 对双胞胎和单胎怀孕进行剖腹产时的孕产妇发病率进行比较至关重要.
研究的目的:
- 为了确定经历剖腹产的双胞胎怀孕与单独怀孕相比,是否有更高的孕产妇发病风险.
- 分析经过剖腹产的双胞胎和单胎怀孕中母亲的结果.
- 确定双胞胎怀孕中剖腹产产生的特定风险.
主要方法:
- 对经过剖腹产 (2005-2023) 的单子和双胞胎怀孕的回顾性队列研究.
- 包括标准排除了特定的胎盘和子宫疾病.
- 产妇发病率被评估为一个复合结果,并进行了子组分析.
主要成果:
- 在单子 (0.8%) 和双胞胎 (1.4%) 怀孕中,经过初次剖腹产的孕妇之间,在综合孕妇发病率结局上没有显著差异 (p=0.172).
- 双胞胎怀孕的估计失血率 (EBL) 和输血率显著增加 (4.7%对1.8%,p<0.001).
- 这些发现在初级,劳动,非劳动和重复剖腹产分组中是一致的.
结论:
- 双胞胎怀孕的剖腹产与单独怀孕相比没有增加主要的孕产妇死亡率.
- 经过剖腹产的双胞胎怀孕妇女的血流明显增加,需要更多的输血.
- 虽然主要并发症是相似的,但对于经历剖腹产的双胞胎怀孕,仔细管理流血是必不可少的.
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