刘莉++吴丽莉

[摘要] 目的 探讨双胎妊娠绒毛膜性质对孕妇妊娠期并发症及围生儿预后的影响。 方法 选取2009年1月～2014年1月延安市妇幼保健院产科收治的双胎妊娠产妇102例，根据绒毛膜性质将其分为单绒毛膜组（57例）和双绒毛膜组（45例），比较两组母体妊娠并发症及围生儿预后情况。 结果 单绒毛膜组围生儿的新生儿窒息率及围生儿病死率（25.44%、9.65%）均显著高于双绒毛膜组（7.78%、2.22），差异均有统计学意义（P < 0.05）。单绒毛膜组妊娠高血压疾病、妊娠糖尿病、羊水过多、胎膜早破等妊娠期并发症的发生率（35.09%、19.30%、21.05%、24.56%）均明显高于双绒毛膜组（6.67%、4.99%、4.15%、5.79%），差异均有统计学意义（P < 0.05或P < 0.01）。 结论 在双胎妊娠早期对绒毛膜性质进行诊断，有利于临床工作人员对双胎妊娠并发症和围生儿预后进行有效及时的预防。

[关键词] 双胎妊娠绒毛膜性质；妊娠期并发症；围生儿预后

[中图分类号] R714.2 [文献标识码] A [文章编号] 1673-7210（2015）05（b）-0071-03

Effect of the twin pregnancy chorionic properties on the pregnancy complications of pregnant women and prognosis of neonate

LIU Li WU Lili

Department of Obstetrics and Gynecology， Maternity and Child Health Care of Yan'an City， Shaanxi Province， Yan'an 716000， China

[Abstract] Objective To explore effect of the twin pregnancy chorionic properties on the pregnancy complications of pregnant women and prognosis of neonate. Methods 102 cases of gemellary pregnancy from January 2012 to January 2014 in Department of Obstetrics， Maternity and Child Health Care of Yan'an City were selected， they were divided into single chorion group （57 cases） and double chorion group （45 cases） according to the nature of chorionic. The pregnancy complications of pregnant women and prognosis of neonate of two groups were compared. Results The asphyxia rate of neonatal and mortality rate of perinatal infant of the single chorionic group （25.44%， 9.65%） were significantly higher than those of the double chorion group （7.78%， 2.22%）， the differences were statistically significant （P < 0.05）； the incidence of complications during pregnancy such as gestational hypertension， gestational diabetes， hydramnios， premature rupture of membranes of the single chorionic group （35.09%， 19.30%， 21.05%， 24.56%） were significantly higher than those of the double chorion group （6.67%， 4.44%， 6.67%， 6.67%）， the differences were statistically significant （P < 0.05 or P < 0.01）. Conclusion The early diagnosis of chorionic properties of twin pregnancy is helpful for clinical staff to prevent pregnancy complications of pregnant women and prognosis of neonate effectively and timely.

[Key words] Twin pregnancy chorionic properties； Pregnancy complications； Prognosis of neonate

双胎妊娠是指在一次妊娠同时有两个胎儿的情况，近些年由于受到人为有意或无意诱发排卵药物应用率显著提高等原因的影响，双胎妊娠率在我国显著提高。诊断绒毛膜性质需要根据分娩后胎盘病理检查确定。如两个胎盘完全分离，胎儿间隔膜为4层膜组成，则为双绒毛膜双羊膜囊（DCDA）双胎；如胎盘融合为一个，而且胎儿间隔膜由两层膜组成，则为单绒毛膜双羊膜囊（MCDA）双胎；如胎儿间无间隔膜，则为单绒毛膜单羊膜囊（MCMA）双胎。在孕早期可以用阴道B超做出产前诊断[1-2]，本研究对陕西省延安市妇幼保健院（以下简称“我院”）产科收治的102例双胎妊娠孕妇进行观察，现将观察情况总结报道如下：

1 资料与方法

1.1 一般资料

选择2012年1月～2014年1月我院收治的双胎妊娠孕妇102例，经B超检查和胎盘胎膜的病理检查分为单绒毛膜组（57例）和双绒毛膜组（45例），其中单绒毛膜组年龄19～45岁，平均（22.32±0.91）岁，经产妇27例，初产妇30例；……