海南医科大学学报

目的:探讨双胎妊娠临床特点及并发症的发生情况。方法:回顾性分析105例双胎妊娠和5 364例单胎妊娠孕妇的临床资料,分析并比较单胎和双胎妊娠新生儿及孕妇的临床情况和并发症发生情况,并采用宫颈长度预测双胎妊娠自发早产率。结果:5 469例孕妇中,单胎妊娠5 364例(98.08%),双胎妊娠105例(1.92%),双胎妊娠剖宫产率(78.1%)、低体重儿出生率(42.9%)、围产死亡率(10.5%)及新生儿死亡率(2.9%)均明显高于单胎妊娠(分别为30.1%、4.0%、3.9%、0.2%)(P均<0.05),双胎妊娠早产率(42.9%)、产后出血率(22.9%)、妊娠高血压综合征发生率(21.9%)、胎膜早破(20.9%)、妊娠合并贫血(18.1%)亦明显高于单胎妊娠(分别为4.6%、1.9%、9.2%、10.1%、8.1%)(P均<0.05)。38例双胎孕妇22~24周宫颈长度为(3.48±0.64)cm,孕34周前自发早产率为13.2%,宫颈长度预测双胎自发早产敏感性、特异性、阳性预测值和阴性预测值分别为80.0%、93.9%、66.7%和97.0%。结论:双胎妊娠早产率高,并发症多,对母体影响较大;孕22~24周宫颈长度可以作为预测双胎妊娠自发早产的重要方法之一。

Objective: To explore clinic feature and complication of twin pregnancy.Methods: Retrospectively analyzed clinic datas of 105 cases with twin pregnancy and 5 364 cases with single pregnancy,compared status of newborns and gravidas between twin pregnancy group and single pregnancy group.Measured cervical length to predict the incidence of spontaneous premature delivery.Results: 5 364 out of 5 469 pregnant women had single pregnancy(98.08%),while 105 had twin pregnancy(1.92%).Cesarean section rate(78.1%),birth rate of low birth weight infant(42.9%),perinatal mortality rate(10.5%),newborn mortality(2.9%) in twin pregnancy group were significantly higher than single pregnancy(30.1%,4.0%,3.9%,0.2% respectively)(P<0.05),and premature birth rate(42.9%),rate of postpartum hemorrhage(22.9%),pregnancy-induced hypertensive syndrome(21.9%),premature rupture of membranes(20.9%),anaemia during pregnancy(18.1%) in twin pregnancy were significantly higher than single pregnancy(4.6%,1.9%,9.2%,10.1%,8.1% respectively)(P<0.05).Cervical length of 38 twin pregnant women with 22-24 weeks was(3.48±0.64) cm,spontaneous premature birth rate at 34 pregnant weeks was 13.2%.Sensitivity,specificity,positive predictive value and negative predictive value of cervical length measurement were 80%,93.9%,66.7% and 97% respectively.Conclusion: Twin pregnancy has high premature delivery,several complications,and great effect on mothers.Measurement of cervical length at 22-24 pregnancy weeks is important method for predicting spontaneous premature delivery.