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目的：探讨双胎妊娠之一胎死宫内的原因及终止妊娠的时间和方式。方法回顾性研究分析2004年1月至2014年1月广西医科大学第一附属医院产科双胎妊娠之一胎死宫内的病例共20例。结果双胎一胎宫内死亡的发生率为3.3%。死胎原因主要为脐带及血管异常、双胎输血综合征、胎儿畸形、严重的妊娠并发症。期待治疗期间孕妇无1例发生凝血功能障碍，终止妊娠方式以剖宫产为主。结论双胎妊娠一胎死亡后可采取期待治疗，在严密监测存活胎儿宫内安危，积极处理母体合并症或并发症的条件下，尽量延长存活胎儿在宫内生长的时间，提高存活胎儿的生存质量。“,”Objective To study the cause, the proper time of termination of pregnancy and the method of delivery of twin pregnancy with one fetal intrauterine death.Methods 20 cases of twin pregnancy with one fetal intrauterine death from February 2004 to February 2014 in the first affiliated hospital of guangxi medical university were analyzed.Results The incidence of twins one foetus intrauterine death was 3.3%. Were mainly for the umbilical cord and vascular abnormalities, twins transfusion syndrome, severe fetal abnormalities, pregnancy complications.Expect treatment during pregnant women without coagulation dysfunction, and one way of termination is given priority to with cesarean delivery.clusions Conservative approach is an appropriate therapy tomultiple pregnancieswith one of intrauterine fetal death.