文章摘要
张 燕,董 娟,蔡令波,马 龙,千日成,刘嘉茵.IVF/ICSI-ET术后双胎妊娠的临床结局及预防对策[J].南京医科大学学报,2015,(9):1297~1301
IVF/ICSI-ET术后双胎妊娠的临床结局及预防对策
Analysis and preventive strategies on twins pregnancy outcome after IVF/ICSI-ET
投稿时间:2015-01-19  
DOI:10.7655/NYDXBNS20150925
中文关键词: 体外受精/卵细胞浆单精子注射-胚胎移植  辅助生殖技术  双胎  多胎减胎术
英文关键词: in vitro fertilization/intracytoplasmic sperm injection-embryo transferred  assisted reproductive technology  twins  mutifetal pregnancy reduction
基金项目:江苏省妇幼保健重点学科(FXK201221);国家临床重点专科妇科;江苏省高校优势学科资助项目(PAPD)
作者单位
张 燕 南京医科大学第一附属医院临床生殖科,江苏 南京 210029 
董 娟 南京医科大学第一附属医院临床生殖科,江苏 南京 210029 
蔡令波 南京医科大学第一附属医院临床生殖科,江苏 南京 210029 
马 龙 南京医科大学第一附属医院临床生殖科,江苏 南京 210029 
千日成 南京医科大学第一附属医院临床生殖科,江苏 南京 210029 
刘嘉茵 南京医科大学第一附属医院临床生殖科,江苏 南京 210029 
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中文摘要:
      目的:分析体外受精 (in vitro fertilization,IVF)/卵细胞浆单精子注射-胚胎移植 (intracytoplasmic sperm injection-embryo transfer,ICSI-ET)术后双胎妊娠的临床生殖结局,探讨降低辅助生殖技术中多胎率的有效治疗措施。方法:回顾性分析IVF/ICSI-ET术后获得双胎妊娠的425例孕妇的妊娠并发症?分娩方式和围产期结局。结果:①行IVF/ICSI-ET 4 603个治疗周期,双胎率23.35%,流产率9.18%,妊娠并发症发生率13.41%,出生缺陷发生率1.60%;②活胎双胎组孕周[(29.66 ± 3.64周) vs. (30.69 ± 3.47周)]? 出生体重[(2.64 ± 0.45)kg vs. (3.12 ± 0.64)kg]低于活胎单胎组,剖宫产率(97.68% vs. 77.38%)?早产率(41.06% vs. 16.67%)?低体重儿发生率(42.05% vs. 19.05%)高于活胎单胎组,两组间比较差异有统计学意义;③多胎减胎组和自然减胎组比未减胎组获得良好的生殖结局,孕周[(38.00 ± 2.03)周?(37.89 ± 2.46)周 vs. (36.43 ± 1.77)周)]和出生体重[(3.05 ± 0.65)kg?(3.15 ± 0.63)kg vs. (2.64 ± 0.45)kg]?早产率(13.64%?15.71% vs 37.24%)等方面比较,差异均有统计学意义。结论:在辅助生殖技术中,双胎较单胎妊娠发生早产?低出生体重不良风险高,需重视其围生期保健和产前检查。临床早期预测并进行减胎等补救性手段是安全有效的干预措施。
英文摘要:
      Objective:To analyze twin clinical reproduction outcome after in vitro fertilization (IVF)/intracytoplasmic sperm injection(ICSI)-embryo transfer(ET), the effective measure was explored in order to reduced ART multiple pregnancy rate. Methods:The data of 425 infertile couples were restrospectively analyzed,including pregnancy rate,pregnancy complications,delivery way and perinatal outcomes. Results:①There were IVF/ICSI-ET 4 603 cycles,the twin pregnancy rate was 23.35%,the abortion rate was 9.18%,the pregnancy complications occurrence rate was 13.41%,and the birth defects rate was 1.60%.②Between the two live born infant group and one live born infant group,there were statistically significant differences in fetal age[(29.66 ± 3.64) vs. (30.69 ± 3.47)week],birth weight[(2.64 ±0.45) vs. (3.12 ± 0.64)kg], cesarean delivery rate (97.68% vs. 77.38%),premature delivery rate (41.06% vs. 16.67%),low-weight baby occurrence rate(42.05% vs. 19.05)%. ③ Comparison of clinical data in mutifetal pregnancy reduction group and spontaneous reduction group with no reduction group,there were statistically significant differences in the fetal age[(38.00 ± 2.03),(37.89 ± 2.46) vs. (36.43 ± 1.77)week],birth weight [(3.05 ± 0.65),(3.15 ± 0.63) vs. (2.64 ± 0.45)kg] and premature delivery rate(13.64%,15.71% vs 37.24%). Conclusion:Compared the ART clinical reproduction outcome of twin with single live born infant,there were higher hazard in premature and lower birth weight. Women with ART pregnancies should get more perinatal care and antenatal examination. Clinical attention should be paid to diagnosis earlier,and multiple pregnancy reduction termination in time is very important for improving the perinatal outcomes.
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