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目的探讨影响双胎之一胎死宫内母儿预后的相关因素。方法对在我院分娩的13例双胎之一胎死宫内的临床资料进行回顾性分析。结果双胎之一胎死宫内的发生率占双胎的4.17%。单卵双胎6例,双卵双胎7例,胎儿死因中双胎输血综合征(TTTS)4例。母儿结局:晚期流产2例,早产6例,足月产5例。围生儿中小于胎龄儿2例,死亡2例。孕产妇均未发生弥散性血管内凝血(DIC)。一胎于妊娠12～34周死亡者或单卵双胎者,其存活胎婴儿病率增加。TTTS导致的一胎死宫内者,另一胎婴儿丢失率显著增加。孕34周前终止妊娠者围生儿死亡率显著增加。结论双胎之一胎死宫内后对母体的凝血功能影响不大。胎婴儿不良结局可能与双胎类型、胎死宫内的原因、一胎死宫内的时间及终止妊娠的孕周有关。
Objective To explore the related factors that influence the prognosis of the fetus and the fetus within one fetus. Methods Retrospective analysis was performed on the clinical data of one of the 13 twins in our hospital. Results One of the twins, the incidence of intrauterine fetal death accounted for 4.17% of twins. Six cases of monozygotic twins, seven pairs of twins and four cases of twin fetal transfusion syndrome (TTTS). Maternal and child outcomes: 2 cases of late abortion, premature 6 cases, full-term 5 cases. 2 cases of perinatal infants less than gestational age, 2 cases of death. No maternal disseminated intravascular coagulation (DIC). A child born in 12 to 34 weeks of pregnancy or monozygotic twins, the survival rate of infant fetus increased. TTTS caused a death of the womb, the loss of another child was significantly increased. Perinatal mortality was significantly increased in those who terminated their pregnancies 34 weeks prior to pregnancy. Conclusion One of the twins had little effect on the coagulation function of the mother after fetal death. Poor outcome of fetal infants may be related to the type of twins, the cause of fetal death, the time of a dead fetus, and gestational age at the termination of pregnancy.