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目的探讨发育不同一性双胎妊娠的并发症特点及双胎发育不同一性发生的相关因素。方法以双胎胎儿体重差>20%为发育不同一性双胎妊娠诊断标准,回顾性分析96例发育不同一性双胎(观察组)和349例发育一致双胎(对照组)的临床资料,比较两组在妊娠并发症、合并症、分娩情况和围产儿预后等方面的差异。结果(1)观察组晚期流产、羊水过多、双胎输血综合征和胎盘早剥的发生率分别为13.5%(13/96)、22.9%(22/96)、9.4%(9/96)和5.2%(5/96),明显高于对照组的4.3%(15/349)、10.0%(35/349)、1.4%(5/349)和1.1%(4/349),两组比较,差异有统计学意义(P<0.05)。(2)观察组围产儿死亡和胎儿畸形的发生率分别为22.9%(44/192)和5.2%(10/192),明显高于对照组的4.4%(31/698)和1.3%(9/698),两组比较,差异有统计学意义(P<0.01)。(3)观察组胎儿体重轻者较体重重者的围产儿死亡率高,分别为30.2%(29/96)和15.6%(15/96),两组比较,差异有统计学意义(P<0.05);体重差分别为≤20%、20%～30%和≥30%时,围产儿死亡率分别为4.4%、11.0%和41.9%;胎儿畸形发生率分别为1.3%、5.1%和5.4%,3者间分别比较,差异有统计学意义(P<0.05)。结论发育不同一性双胎妊娠主要的并发症为晚期流产、羊水过多、双胎输血综合征、胎盘早剥、围产儿死亡和胎儿畸形。双胎中体重轻者围产儿死亡率高,且随体重差别增大围产儿死亡和胎儿畸形发生率升高。
Objective To explore the characteristics of complications of twins with different development and related factors of different development of twins. Methods The diagnostic criteria of twins pregnancy with different twins birth weight> 20% were retrospectively analyzed. The clinical data of 96 twins with developmental uniforms (observation group) and 349 identical twins (control group) were retrospectively analyzed The differences between the two groups in pregnancy complications, complications, childbirth and perinatal outcomes were compared. Results (1) The incidences of late miscarriage, polyhydramnios, twin transfusion syndrome and placental abruption in the observation group were 13.5% (13/96), 22.9% (22/96) and 9.4% (9/96) And 5.2% (5/96) respectively, which were significantly higher than those in the control group (4.3%, 10.0%, 1.4% and 1.1%, respectively) , The difference was statistically significant (P <0.05). (2) The incidences of perinatal deaths and fetal malformations in the observation group were 22.9% (44/192) and 5.2% (10/192) respectively, significantly higher than those in the control group (4.4%, 31/698 and 1.3%, respectively) / 698), the difference between the two groups was statistically significant (P <0.01). (3) The perinatal mortality of the observation group with lighter weight was higher than those with the heavier weight (30.2% (29/96) and 15.6% (15/96), respectively). There was significant difference between the two groups (P < 0.05). The rates of perinatal mortality were 4.4%, 11.0% and 41.9% respectively when the differences in body weight were ≤20%, 20% ~ 30% and ≥30% respectively. The fetal malformation rates were 1.3%, 5.1% and 5.4% %, Respectively, the three were compared, the difference was statistically significant (P <0.05). Conclusions The main complications of twins with different developmental status are late miscarriage, polyhydramnios, twin transfusion syndrome, placental abruption, perinatal death and fetal malformation. In twin twins, there was a high rate of perinatal mortality in light weight and increased perinatal mortality and fetal malformations with differences in body weight.