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目的探讨双胎妊娠并发子痫前期的早期预测指标及临床特征。方法选取44例双胎妊娠并发子痫前期孕妇作为病例组,62例正常双胎妊娠妇女作为对照组,两组孕妇均于孕12~13周在本院留取了血液标本,检测两组血液标本中妊娠相关蛋白A(PAPP-A)、抑制素A、人绒毛膜促性腺激素(h CG)、激活素A 4项指标,并对比两组妊娠妇女的一般资料、妊娠并发症及分娩结局。结果病例组患者的PAPP-A、抑制素A、h CG、激活素A在孕12~13周均显著高于对照组,差异有统计学意义(P<0.05);病例组患者的年龄、流产史、经产妇比例与对照组差异无统计学意义(P>0.05);病例组的孕前BMI、分娩前BMI均显著高于对照组,差异有统计学意义(P<0.05);病例组的低蛋白血症发生率显著高于对照组,剖宫产率、早产率、产后出血率均显著高于对照组,终止妊娠孕周显著的早于对照组,差异均有统计学意义(P<0.05)。结论双胎妊娠子痫前期妇女在孕早期PAPP-A、抑制素A、h CG、激活素A水平即可能发生显著的变化,妊娠期并发症、不良分娩结局发生率增加。
Objective To investigate the early prediction index and clinical features of preeclampsia in twin pregnancy. Methods Totally 44 pregnant women with twin pregnancy complicated with preeclampsia were selected as case group and 62 normal pregnant women with twin pregnancy as control group. Blood samples were collected from 12 to 13 weeks of gestation in both groups, Four specimens of pregnancy-related protein A (PAPP-A), inhibin A, hCG, and activin A were compared. General data of pregnant women, pregnancy complications and delivery outcomes . Results The PAPP-A, inhibin A, h CG and activin-A levels in patients of 12 to 13 weeks of pregnancy were significantly higher than those of the control group (P <0.05). The age of patients, abortion (P> 0.05). The BMI before pregnancy and the BMI before delivery in the case group were significantly higher than those in the control group (P <0.05). The cases of low Cesarean section rate, premature delivery rate and postpartum hemorrhage rate were significantly higher than those in the control group. The gestational age at termination of pregnancy was significantly earlier than that in the control group, with significant differences (P <0.05 ). Conclusions The levels of PAPP-A, inhibin A, hCG, and activin-A in preeclampsia women with twin pregnancies may change significantly in the first trimester of pregnancy. The incidence of complications during pregnancy and the incidence of adverse childbirth may increase.