CAJ | 학술논문

目的：探讨体外受精－胚胎移植术后三胎妊娠减胎前后的妊娠结局。方法：回顾性分析2011年10月至2013年12月广州医科大学附属第三医院收治的辅助生殖受孕病例31例；比较三胎妊娠、减胎后的双胎妊娠、单胎妊娠的流产率、孕期并发症发生率及新生儿围产期结局。结果：三胎妊娠、经减胎后的双胎妊娠、单胎妊娠在孕产次、胎儿疾病、胎膜早破、重度子痫前期、妊娠期糖尿病、产后出血等方面比较差异无统计学意义（P＞0．05），在新生儿出生孕周、出生体重、早产率、新生儿转NICU率、新生儿RDS方面比较，差异有统计学意义，减胎后的双胎、单胎分娩孕周延长[三胎、双胎、单胎妊娠分娩孕周分别为（37．3±1．9）、（35．2±0．9）、（32．6±2．3）周]、早产率下降（100％、100％、33．3％）、新生儿出生体重增加[（1707±360．4）g、（2066．1±307．5）g、（2712．5±514．1）g]、新生儿并发症少（P＜0．05）。结论：多胎妊娠减胎术治疗降低了早产风险及新生儿低出生体重发生率，改善了母胎结局，但减胎后的早中孕期流产率较高。
목적：탐토체외수정－배태이식술후삼태임신감태전후적임신결국。방법：회고성분석2011년10월지2013년12월엄주의과대학부속제삼의원수치적보조생식수잉병례31례；비교삼태임신、감태후적쌍태임신、단태임신적유산솔、잉기병발증발생솔급신생인위산기결국。결과：삼태임신、경감태후적쌍태임신、단태임신재잉산차、태인질병、태막조파、중도자간전기、임신기당뇨병、산후출혈등방면비교차이무통계학의의（P＞0．05），재신생인출생잉주、출생체중、조산솔、신생인전NICU솔、신생인RDS방면비교，차이유통계학의의，감태후적쌍태、단태분면잉주연장[삼태、쌍태、단태임신분면잉주분별위（37．3±1．9）、（35．2±0．9）、（32．6±2．3）주]、조산솔하강（100％、100％、33．3％）、신생인출생체중증가[（1707±360．4）g、（2066．1±307．5）g、（2712．5±514．1）g]、신생인병발증소（P＜0．05）。결론：다태임신감태술치료강저료조산풍험급신생인저출생체중발생솔，개선료모태결국，단감태후적조중잉기유산솔교고。
Objective To study the outcomes of selective reduction of triplet pregnancy by assisted reproductive technology. Methods The clinical data of 31 women who succeeded in conception by vitro fertilization-embryo transfer in the third affiliated hospital of Guangzhou Medical University were retrospectively investigated to analyze and compare the rates of abortion from triplet pregnancy, twin pregnancy and single pregnancy after selective reduction of triplet pregnancy, the incidence of pregnant complications, outcomes of perinatal period. Results There were no significant differences between triplet pregnancy and the twin and single pregnancy after selective reduction of triplet pregnancy in terms of pregnancy and parity time, fetal disease, premature rupture of membrane, severe eclampsism, gestational diabetes and postpartum hemorrhage (P>0.05). There were significant differences in gestational weeks, birth weight, rate of premature birth, rate of neonatal transfer to NICU and neonatal RDS: The gestational time in the triplet group longer than the groups of twin pregnancy and single pregnancy after selective reduction of triplet pregnancy (P<0.05). (37.3 ± 1.9) vs. (35.2 ± 0.9), (32.6 ± 2.3), respectively), the rate of premature birth dropped (100%vs. 100%, 33.3%, respectively), the body weight was increased (1 707 ± 360.4)g vs. (2 066.1 ± 307.5)g, (2 712.5 ± 514.1)g, respectively and the neonatal complication rate was reduced (P<0.05). Conclusion The selective reduction of multiple pregnancy may decrease the risk of premature birth and reduce the rate of lower body weight of neonates, improving the pregnancy outcomes, but the higher rate of abortion at the early or middle course of pregnancy after selective reduction is worth our attention.