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在双胞胎怀孕中成功的阴道分娩的因素:为期十年的单中心回顾性研究
Hiroki Ito1, Takashi Shibata2, Toshio Shimokawa3
1Department of Obstetrics and Gynecology, Takatsuki General Hospital, Takatsuki, Japan.
BMC pregnancy and childbirth
|December 8, 2025
概括
成功的阴道双胞胎分娩更有可能发生在29岁或更年轻的多胞胎妇女和初胞胎妇女中. 这些发现有助于确定阴道分娩的候选人,可能减少双胞胎怀孕的剖腹产.
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
- 围产期结局的结果
背景情况:
- 双胞胎怀孕的阴道分娩在特定条件下可能是安全的,但模式选择仍在争论中.
- 确定成功的阴道双胞胎分娩的预测因素对于减少不必要的剖腹产至关重要.
研究的目的:
- 在双胞胎怀孕中确定与成功的阴道分娩相关的因素.
- 为了为临床决策提供有关双胞胎分娩方式的信息.
主要方法:
- 对370例双胞胎怀孕 (不包括单子双胞胎) 的回顾性分析,在怀孕32周后分娩.
- 提供第一个双胞胎头部表现的阴道分娩,估计胎儿体重≥1500g,并且没有其他剖腹产指示.
- 多变量后勤回归和分类和回归树 (CART) 分析用于识别预测因素.
主要成果:
- 在133次阴道分娩尝试中,有115次 (86.5%) 成功.
- 多变量分析确定多对 (aOR 15.29) 和较年轻的母亲年龄 (aOR 0.84/年) 是成功的预测因素.
- 卡特分析强调平价是主要的歧视因素;对于 primiparas,孕产妇年龄≤29岁是一个关键的切断值.
结论:
- 年龄在29岁以下的多夫妇妇女和初夫妇妇女有很高的成功的阴道双胞胎分娩的可能性.
- 这些发现可以指导产科医生咨询患者,并选择双胞胎怀孕的分娩方式.
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