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投稿时间：2024-01-02 网络发布日期：2024-09-20
投稿时间：2024-01-02 网络发布日期：2024-09-20
中文摘要: 目的 探讨影响双胎妊娠分娩方式的因素。方法 回顾性分析2006年6月至2019年10月于南京医科大学第一附属医院产科分娩的2 085例双胎妊娠产妇临床资料，根据分娩方式的不同分为剖宫产组1 376例和生理产组709例。通过分析双胎妊娠孕妇的危险因素与分娩方式的关系，总结影响双胎妊娠分娩方式的相关因素。结果 相较于生理产组，剖宫产组中产妇的平均年龄较高，初产妇比例明显增加（P＜0.01），自然受孕的孕妇比例差异明显（P＜0.01），且有子宫手术史的孕妇均选择剖宫产终止妊娠；剖宫产组双绒毛膜双羊膜囊（DCDA）比例低于生理产组（P＜0.01）。妊娠合并症及并发症方面，剖宫产组子痫前期率显著升高；同时发现，剖宫产组早产发生率高于生理产组，差异有统计学意义（P＜0.05）。剖宫产组中产后出血率高于生理产组，第一胎和第二胎的低体重儿比例明显高于生理产组；但剖宫产组中第二胎新生儿重度窒息率、死胎率低于生理产组，差异有统计学意义（P＜0.05）。剖宫产组和生理产组第一胎发生窒息及死亡的概率差异无统计学意义（P＞0.05）。结论 年龄、子宫手术史、子痫前期等是双胎妊娠分娩方式的重要影响因素。
Abstract:Objective To explore the factors affecting the mode of delivery in twin pregnancies. Methods Clinical data of 2 085 pregnant women with twin pregnancy who were delivered in the First Affiliated Hospital of Nanjing Medical University from June 2006 to October 2019 were retrospectively analyzed. According to different delivery modes, 1 376 cases were divided into cesarean section group and 709 cases were divided into natural delivery group. The general prenatal conditions, pregnancy complications and pregnancy outcomes of the two groups were analyzed. Results Compared with the natural delivery group, the average age of pregnant women in the cesarean section group was higher, the proportion of primipara was significantly increased (P＜0.01), and the proportion of pregnant women who conceived naturally was significantly different (P＜0.01). All pregnant women with a history of uterine surgery chose cesarean section to terminate pregnancy. The rate of dichorionic?diamniotic (DCDA) twins in the cesarean section group was lower than that in the natural delivery group (P＜0.01). In terms of pregnancy complications and complications, the rate of preeclampsia in the cesarean section group was significantly higher; at the same time, it was found that the incidence rate of preterm birth in the cesarean section group was also significantly higher than that in the natural delivery group, with a statistically significant difference (P<0.05). The rate of postpartum hemorrhage in the cesarean section group was higher than that in the natural delivery group, and the proportion of low birth weight infants in the first and second fetuses was significantly higher than that in the natural delivery group. However, the severe asphyxia rate and stillbirth rate of the second newborn in the cesarean section group were lower than those in the natural birth group, and the differences were statistically significant (P＜0.05). There was no statistically significant difference in the probability of first fetal asphyxia and death between the two groups (P＞0.05). Conclusion Age, history of uterine surgery, and preeclampsia are important factors affecting the mode of delivery in twin pregnancies.
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基金项目:国家自然科学基金项目（82001578）；江苏省科学技术协会-江苏省科协青年科技人才托举工程（JSTJ-2023-WJ020）；江苏省妇幼健康青年人才项目（FRC202151）
附件
| 作者 | 单位 |
| 黄婷 | 1. 南京医科大学第一附属医院产科，江苏 南京 210029 |
| 许叶涛 | 1. 南京医科大学第一附属医院产科，江苏 南京 210029 |
| 蒋玲玲 | 2. 南通市第一人民医院产科，江苏 南通 226001 |
| 孙丽洲 | 1. 南京医科大学第一附属医院产科，江苏 南京 210029 |
| 潘义 | 1. 南京医科大学第一附属医院产科，江苏 南京 210029 |
引用文本：
黄婷,许叶涛,蒋玲玲,等.双胎妊娠分娩方式的影响因素分析[J].中国临床研究,2024,37(9):1408-1411,1427.
黄婷,许叶涛,蒋玲玲,等.双胎妊娠分娩方式的影响因素分析[J].中国临床研究,2024,37(9):1408-1411,1427.