摘要
目的总结分析超声引导下早/中孕期多胎妊娠减胎术(MFPR)的临床经验及手术对妊娠结局的影响。方法经辅助生殖技术(ART)受孕的12例多胎妊娠患者行阴道或腹部B超引导下减胎术。结果早孕期行多胎妊娠选择性减胎术8例,手术方式为B超引导下经阴道负压吸胚术,手术孕周为(7.13±0.35)周,共减灭9个胚胎,消减每个胚胎时间平均为(4.00±1.51)min,7例已分娩,其中4例早产,共14个新生儿,分娩孕周(36.43±2.64)周,出生体重为(2.05±0.46)kg。1例孕5月余时合并羊水过多流产。中孕期多胎妊娠减胎术4例,手术方式为B超引导下经腹部穿刺胎心区注射氯化钾,手术孕周为(12.75±0.96)周,共减灭5个胎儿,消减每个胎儿时间平均为(13.63±4.92)min,3例已分娩,其中1例早产,共6个新生儿,分娩孕周(37.67±1.53)周,出生体重为(2.45±0.37)kg,1例现孕6月余继续妊娠中,产检无异常。孕早期减胎与孕中期减胎两组相比,消减每个胚胎/胎儿时间(P=0.027)、穿刺次数(P=0.038)之间差异有统计学意义,而分娩孕周(P=0.478)和出生体重(P=0.079)之间差异无统计学意义。均无新生儿死亡。结论孕早期阴道B超引导和孕中期腹部B超引导下减胎术均为改善多胎妊娠结局的有效方法,但孕早期经阴道减胎更加简便、省时省力,并发症少,在感情及伦理方面,可能更易为患者所接受。
To summarize the experience of multifetal pregnancy reduction （MFPR） and its＇ effect on the outcome of pregnancy. Methods Twelve cases of multiple pregnancies resulting from assisted repro- ductive technique received aspiration of embryo tissues by the transvaginal ultrasound guided technique or ultra sonographically guided transadominal intracardiac injection of high concentrate potassium chloride （KCI） solution. Results Eight cases in first triemster received aspiration of embryo tissues by the transvaginal uhrasoundguided technique. The mean （±SD） gestational age at reduction was （7.13±0.35） weeks,and nine embryos were reducted at all. And the mean （±SD） time of the procedure was （4.00±1.51 ） minutes per sac. Seven patients de livered 14 infants and four of them were premature delivery. The mean （±SD） gestational age at delivery was （36.43±2.64） weeks, and the mean （±SD） birth weight （2.05±0.46） kg. The outcome of the other one with polyhydramnios was miscarriage when the gestational age was five months. Four cases in second triemster received uhrasonographically guided transadominal intracardiac injection of high concentrate potassium chloride （KCl） solution. The mean （±SD） gestational age at reduction was （12.75±0.96） weeks and five fetals were reducted at all. And the mean （±SD） time of the procedure was （13.63±4.92） minutes per sac. Three patients delivered 6 infants and one of them were premature delivery. The mean （±SD） gestational age at delivery was （37.67± 1.53） weeks, and the mean （±SD ） birth weight （2.45±0.37）kg. Another one patient continued pregnancy. The fetus growth and development have been normal so far. The mean rimeof the procedure per sac （P=0.027） and the number of the puncture （P=0.038） of the first triemster group were significantly different from those of the second triemster group. And the mean gestational age at delivery （P=0.478） and the mean birth weight （P=0.079） were not different between two groups, And no neonatal death occurred in the two groups. Conclusion Transvaginal
出处
《微创医学》
2007年第5期381-384,共4页
Journal of Minimally Invasive Medicine
基金
广西科学研究与技术开发计划项目基金资助(No0236027)
关键词
多胎妊娠减胎
胚胎组织抽吸
B超
辅助生殖技术
Multifetal pregnancies reduction
Aspiration of embryo tissues
Transvaginal ultrasound
Assisted reproductive technique
