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目的探讨双胎孕期规范化管理对改善妊娠结局的作用。方法选取2013年6月至2014年5月在首都医科大学附属北京妇产医院产检并分娩的孕妇,早孕期超声明确为双胎妊娠,随机选取92例为实验组,11~14周间超声明确绒毛膜性确定双胎类型,按不同方式进行规范监测。随机选取同期建档的双胎妊娠病例94例为对照组,进行常规产检,分别记录每组病例妊娠经过及母儿结局。采用SPSS 18.0统计学软件分析两组间妊娠结局差异。结果两组间孕妇年龄、体重指数、双胎类型均无明显差异。实验组胎儿生长受限发生率为31.53%,较对照组47.87%有所改善(P=0.023),早产发生率由原来47.87%下降至33.70%,低出生体重儿的发生率从41.48%降至30.43%,新生儿窒息发生率由5.85%降至1.63%,差异均有统计学意义(P=0.049,P=0.026,P=0.032)。结论通过双胎妊娠孕期规范化管理,加强监测频次及检测内容,并规范化终止妊娠时机,可减少早产、低出生体重儿、新生儿窒息等发生,对改善双胎妊娠母儿结局起到促进作用。
Objective To explore the effect of standardized management of twin pregnancy on the improvement of pregnancy outcome. Methods From June 2013 to May 2014, pregnant women at the Beijing Maternity Hospital Affiliated to Capital Medical University were enrolled in this study. During the first trimester of pregnancy, the pregnancy was confirmed as twin pregnancy. Ninety-two cases were randomly selected as the experimental group. Chorionic determination of twin types, according to different ways to regulate the monitoring. Ninety-four cases of twin pregnancies were simultaneously selected as the control group, and routine pregnancy tests were conducted to record the gestational and maternal outcomes of each group. SPSS 18.0 statistical software was used to analyze differences in pregnancy outcomes between the two groups. Results There was no significant difference in maternal age, body mass index and twins between the two groups. The incidence of fetal growth restriction in the experimental group was 31.53%, which was 47.87% better than that in the control group (P = 0.023), the incidence of preterm birth decreased from 47.87% to 33.70%, and the incidence of low birth weight children dropped from 41.48% to 30.43%, the incidence of neonatal asphyxia decreased from 5.85% to 1.63%, the difference was statistically significant (P = 0.049, P = 0.026, P = 0.032). Conclusions Through the standardized management of twin pregnancy during pregnancy, to strengthen the frequency of monitoring and testing content, and to normalize the timing of termination of pregnancy can reduce the incidence of premature birth, low birth weight infants, neonatal asphyxia and so on, to improve the outcome of maternal and fetal twin pregnancy play a catalytic role.