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目的探讨复杂性双胎的分类、发生率和预后等。方法回顾性分析2000年1月至2009年12月分娩的617例双胎妊娠中出现双胎之一死胎、双胎之一胎儿畸形、双胎发育不一致等复杂情况,并追踪其预后。结果双胎妊娠中复杂性双胎112例,其中双胎之一死胎28例,双胎发育不一致59例,双胎输血综合征5例,32例双胎胎儿畸形中双胎均胎儿畸形7例,双胎之一胎儿畸形25例(胎儿畸形漏诊5例),其中反向动脉灌注序列征5例,短肢畸形、尿道下裂、神经管畸形各3例,足内翻、并指、肾脏畸形各2例,唇裂、先天性心脏病、单脐动脉、阴茎短小各1例。结论复杂性双胎早产率、各种并发症的发生比例较高,研究组新生儿窒息的发生率明显高于对照组,不仅异常胎儿本身的预后不良,而且由于一胎异常并发羊水过多、前置胎盘、晚期流产、早产等也影响另一胎预后。
Objective To investigate the classification, incidence and prognosis of complicated twins. Methods A retrospective analysis of 617 twin pregnancies between January 2000 and December 2009 in which twins died had one of the twins, one of the twins had fetal malformations, the twins had inconsistent development, and the prognosis was followed up. Results Twins were complicated with twins in 112 cases, of which 28 were stillborn twins, 59 were twins misdiagnosed, 5 were twin-twin syndromes and 7 were twins in 32 cases of twins , One of the twins had fetal malformation in 25 cases (5 cases of misdiagnosis of fetal malformation), including 5 cases of reverse arterial perfusion sequence, 3 cases of short limb deformity, hypospadias and neural tube defects, 2 cases of deformity, cleft lip, congenital heart disease, single umbilical artery, short penis in 1 case. Conclusions The rate of twin premature birth complicated by various complication rates is high. The incidence of neonatal asphyxia in the study group is significantly higher than that in the control group. Not only the abnormal fetus itself has a poor prognosis, Placenta previa, abortion, premature delivery, etc. also affect the prognosis of the other child.