中华实用儿科临床杂志
中華實用兒科臨床雜誌
중화실용인과림상잡지
Journal of Applied Clinical Pediatrics
2014年
14期
1074-1078
,共5页
辅助生殖%体外受精-胚胎移植%促排卵%双胎%并发症
輔助生殖%體外受精-胚胎移植%促排卵%雙胎%併髮癥
보조생식%체외수정-배태이식%촉배란%쌍태%병발증
Assisted reproductive techniques%In vitro fertilization-embryo transfer%Ovulation induction%Twin pregnancy%Complication
目的 探讨采用不同受孕方式妊娠双胎妊娠期及新生儿期常见临床并发症情况.方法 对102例体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)妊娠双胎(IVF-ET组)、16例单纯促排卵妊娠双胎(单纯促排卵组)及96例自然受孕妊娠双胎(自然受孕组)孕母孕期病史、分娩情况及新生儿期并发症情况进行回顾性分析,比较组间差异.结果 1.IVF-ET组产妇年龄[(32.51±4.03)岁比(31.25 ±3.38)岁比(30.20±4.13)岁,F=8.061,P＜0.05]、足月儿娩出率(21.5％比0比10.4％,x2=7.566,P＜ 0.05)明显高于单纯促排卵组及自然受孕组,单纯促排卵组新生儿出生体质量明显低于IVF-ET组及自然受孕组[(1 918.1±516.4)g比(2 228.3±454.2)g比(2 164.4±442.5)g,F=3.293,P＜0.05],晚期早产儿娩出率(87.5％比51.0％比64.6％,x2 =9.322,P＜0.05)及双胎发育不一致发生率(50.0％比21.6％比18.8％,x2=7.781,P＜0.05)则明显高于IVF-ET及自然受孕组,而自然受孕组单卵双胎率明显高于IVF-ET组及单纯促排卵组(52.1％比5.9％比0,x2=58.016,P＜0.05).2.单纯促排卵组妊娠高血压病发生率明显高于IVF-ET组及白然受孕组(50.0％比17.6％比22.9％,x2=8.344,P＜0.05),而单纯促排卵组及自然受孕组妊娠期糖尿病发生率明显高于IVF-ET组(12.5％比14.6％比3.9％,x2=6.838,P＜0.05).3.自然受孕组新生儿双胎输血综合征发生率明显高于IVF-ET组及单纯促排卵组(6.3％比0比0,x2=7.588,P＜0.05),单纯促排卵组新生儿呼吸暂停发病率明显高于IVF-ET组及自然受孕组(43.8％比15.7％比24.0％,x2=7.081,P＜0.05).单纯促排卵组新生儿窒息、新生儿湿肺、新生儿低血糖症、颅内出血及重症感染等多项新生儿常见并发症的发生率高于IVF-ET组及自然受孕组,但差异均无统计学意义.结论 采用IVF-ET技术受孕双胎母婴围生期并发症与自然受孕双胎相似,但采用单纯促排卵技术妊娠双胎发生部分母婴围生期并发症概率高于IVF-ET技术及自然受孕,应重视及加强对单纯促排卵技术妊娠双胎母婴围生期的保健及新生儿救治,避免出现严重并发症.
目的 探討採用不同受孕方式妊娠雙胎妊娠期及新生兒期常見臨床併髮癥情況.方法 對102例體外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)妊娠雙胎(IVF-ET組)、16例單純促排卵妊娠雙胎(單純促排卵組)及96例自然受孕妊娠雙胎(自然受孕組)孕母孕期病史、分娩情況及新生兒期併髮癥情況進行迴顧性分析,比較組間差異.結果 1.IVF-ET組產婦年齡[(32.51±4.03)歲比(31.25 ±3.38)歲比(30.20±4.13)歲,F=8.061,P＜0.05]、足月兒娩齣率(21.5％比0比10.4％,x2=7.566,P＜ 0.05)明顯高于單純促排卵組及自然受孕組,單純促排卵組新生兒齣生體質量明顯低于IVF-ET組及自然受孕組[(1 918.1±516.4)g比(2 228.3±454.2)g比(2 164.4±442.5)g,F=3.293,P＜0.05],晚期早產兒娩齣率(87.5％比51.0％比64.6％,x2 =9.322,P＜0.05)及雙胎髮育不一緻髮生率(50.0％比21.6％比18.8％,x2=7.781,P＜0.05)則明顯高于IVF-ET及自然受孕組,而自然受孕組單卵雙胎率明顯高于IVF-ET組及單純促排卵組(52.1％比5.9％比0,x2=58.016,P＜0.05).2.單純促排卵組妊娠高血壓病髮生率明顯高于IVF-ET組及白然受孕組(50.0％比17.6％比22.9％,x2=8.344,P＜0.05),而單純促排卵組及自然受孕組妊娠期糖尿病髮生率明顯高于IVF-ET組(12.5％比14.6％比3.9％,x2=6.838,P＜0.05).3.自然受孕組新生兒雙胎輸血綜閤徵髮生率明顯高于IVF-ET組及單純促排卵組(6.3％比0比0,x2=7.588,P＜0.05),單純促排卵組新生兒呼吸暫停髮病率明顯高于IVF-ET組及自然受孕組(43.8％比15.7％比24.0％,x2=7.081,P＜0.05).單純促排卵組新生兒窒息、新生兒濕肺、新生兒低血糖癥、顱內齣血及重癥感染等多項新生兒常見併髮癥的髮生率高于IVF-ET組及自然受孕組,但差異均無統計學意義.結論 採用IVF-ET技術受孕雙胎母嬰圍生期併髮癥與自然受孕雙胎相似,但採用單純促排卵技術妊娠雙胎髮生部分母嬰圍生期併髮癥概率高于IVF-ET技術及自然受孕,應重視及加彊對單純促排卵技術妊娠雙胎母嬰圍生期的保健及新生兒救治,避免齣現嚴重併髮癥.
목적 탐토채용불동수잉방식임신쌍태임신기급신생인기상견림상병발증정황.방법 대102례체외수정-배태이식(in vitro fertilization-embryo transfer,IVF-ET)임신쌍태(IVF-ET조)、16례단순촉배란임신쌍태(단순촉배란조)급96례자연수잉임신쌍태(자연수잉조)잉모잉기병사、분면정황급신생인기병발증정황진행회고성분석,비교조간차이.결과 1.IVF-ET조산부년령[(32.51±4.03)세비(31.25 ±3.38)세비(30.20±4.13)세,F=8.061,P＜0.05]、족월인면출솔(21.5％비0비10.4％,x2=7.566,P＜ 0.05)명현고우단순촉배란조급자연수잉조,단순촉배란조신생인출생체질량명현저우IVF-ET조급자연수잉조[(1 918.1±516.4)g비(2 228.3±454.2)g비(2 164.4±442.5)g,F=3.293,P＜0.05],만기조산인면출솔(87.5％비51.0％비64.6％,x2 =9.322,P＜0.05)급쌍태발육불일치발생솔(50.0％비21.6％비18.8％,x2=7.781,P＜0.05)칙명현고우IVF-ET급자연수잉조,이자연수잉조단란쌍태솔명현고우IVF-ET조급단순촉배란조(52.1％비5.9％비0,x2=58.016,P＜0.05).2.단순촉배란조임신고혈압병발생솔명현고우IVF-ET조급백연수잉조(50.0％비17.6％비22.9％,x2=8.344,P＜0.05),이단순촉배란조급자연수잉조임신기당뇨병발생솔명현고우IVF-ET조(12.5％비14.6％비3.9％,x2=6.838,P＜0.05).3.자연수잉조신생인쌍태수혈종합정발생솔명현고우IVF-ET조급단순촉배란조(6.3％비0비0,x2=7.588,P＜0.05),단순촉배란조신생인호흡잠정발병솔명현고우IVF-ET조급자연수잉조(43.8％비15.7％비24.0％,x2=7.081,P＜0.05).단순촉배란조신생인질식、신생인습폐、신생인저혈당증、로내출혈급중증감염등다항신생인상견병발증적발생솔고우IVF-ET조급자연수잉조,단차이균무통계학의의.결론 채용IVF-ET기술수잉쌍태모영위생기병발증여자연수잉쌍태상사,단채용단순촉배란기술임신쌍태발생부분모영위생기병발증개솔고우IVF-ET기술급자연수잉,응중시급가강대단순촉배란기술임신쌍태모영위생기적보건급신생인구치,피면출현엄중병발증.
Objective To explore the differences in maternal and neonatal complications of twin pregnancies in different modes of conception.Methods Retrospective analysis was performed to compare the differences in mother's gestation history,childbirth and neonatal complications among 102 cases of in vitro fertilization-embryo transfer(IVFET) pregnancy twins,16 cases of simple ovulation induction(OI) pregnancy twins and 96 cases of spontaneous conception(SC) pregnancy twins.Results 1.The maternal age[(32.51 ±4.03) years vs (31.25 ±3.38) years vs (30.20 ± 4.13) years,F =8.061,P ＜ 0.05] and birthrate of full-term infants (21.5 ％ vs 0 vs 10.4％,x2 =7.566,P ＜ 0.05) of IVF-ET group were significantly higher than that of OI group and SC group.The body weight at birth of OI group was significantly lower than that of IVF-ET group and SC group [(1 918.1 ±516.4) g vs (2 228.3 ±4542) g vs (2 164.4 ±442.5) g,F =3.293,P ＜0.05].The birthrate of late preterm infant(87.5％ vs 51.0％ vs 64.6％,x2 =9.322,P ＜ 0.05) and the incidence of twin discordance (50.0％ vs 21.6％ vs 18.8％,x2 =7.781,P ＜ 0.05) of OI group were significantly higher than that of IVF-ET group and SC group,while the incidence of monozygotic twins of SC group was significantly higher than that of IVF-ET group and OI group(52.1％ vs 5.9％ vs 0,x2 =58.016,P ＜ 0.05).2.The incidence of pregnancy induced hypertension of OI group was significantly higher than those of IVF-ET group and SC group(50.0％ vs 17.6％ vs 22.9％,x2 =8.344,P ＜ 0.05).The incidence of gestational diabetes mellitus of OI group and spontaneous group was significantly higher than that of IVF-ET group(12.5％ vs 14.6％ vs 3.9％,x2 =6.838,P ＜0.05).3.The incidence of twin transfusion syndrome of SC group was significantly higher than that of the other groups(6.3％ vs 0 vs 0,x2 =7.588,P ＜0.05),but the incidence of apnea of prematurity of OI group was significantly higher than that of IVF-ET group and SC group(43.8％ vs 15.7％ vs 24.0％,x2 =7.081,P ＜0.05).The incidence of asphyxia,transient tachypnea of the newborn,hypoglycemia,intracranial hemorrhage and septicemia of OI group were higher than that of IVF-ET group and SC group,but there was no significantly difference among 3 groups.Conclusions IVF-ET conceived twin pregnancies are not at greater risk for pregnancy complications and adverse perinatal outcome than SC twin pregnancies.But the incidence of some adverse maternal and neonatal complications of simple OI twin pregnancies is higher than that of IVF-ET group and SC group.More attention should be paid to the perinatal health care of OI conception twins,which is important to avoid serious complications.
