【摘要】：目的探討體外受精-胚胎移植(IVF-ET)助孕單胎分娩者中,孕早期多胎妊娠自然減胎及手術(shù)減胎對圍產(chǎn)期母兒結(jié)局的影響。方法回顧性分析3 376例行IVF助孕治療,新鮮或冷凍胚胎移植后單胎分娩者的臨床資料,根據(jù)孕早期宮內(nèi)孕囊數(shù)分組:A組(多胎妊娠,455例),其中A1組(手術(shù)減胎,34例),A2組(自然減胎,421例);B組(單胎妊娠,2 921例);分年齡進行組間臨床基本資料,出生低體質(zhì)量兒率、新生兒畸形率、妊娠期并發(fā)癥等圍產(chǎn)期母嬰結(jié)局的比較。結(jié)果 (1)35歲的患者中,A組比B組不孕時間短、移植胚胎數(shù)多和優(yōu)質(zhì)胚胎數(shù)多;(2)囊胚移植比例、冷凍胚胎移植比例A、B組間均無統(tǒng)計學(xué)差異;(3)A1組和A2組出生低體質(zhì)量兒率、出生極低體質(zhì)量兒率、胎兒畸形率均顯著高于B組(P0.05),但A1、A2組間無統(tǒng)計學(xué)差異(P0.05),A2組早產(chǎn)率明顯增加,與B組有統(tǒng)計學(xué)差異(P0.01)。結(jié)論多胎妊娠即使減胎后單胎分娩,其新生兒低體質(zhì)量及畸形風(fēng)險仍高于單胎妊娠分娩者,35歲、不孕時間短者,建議選擇性單優(yōu)質(zhì)胚胎移植,以降低多胎妊娠。
[Abstract]:Objective to investigate the effect of spontaneous reduction of early multiple pregnancy and surgical reduction on perinatal outcome in patients with single pregnancy assisted by in vitro fertilization and embryo transfer (IVF-ET). Methods the clinical data of 3 376 patients undergoing IVF assisted pregnancy therapy and single pregnancy after fresh or frozen embryo transfer were retrospectively analyzed. According to the number of intrauterine pregnancy sacs in the first trimester of pregnancy, group A was divided into two groups: group A (multiple pregnancy, 455 cases), including A1 group (34 cases). Group A2 (421 cases); In group B (single pregnancy, 2921 cases), the perinatal outcome of perinatal period, such as basic clinical data, low birth weight infant rate, neonatal malformation rate, pregnancy complications and so on, were compared with each other. Results (1) in 35 years old patients, the time of infertility in group A was shorter than that in group B, the number of embryos transferred and the number of high-quality embryos were more, (2) the ratio of blastocyst transfer and frozen embryo transfer was not significantly different between group A and group B; (3) the rate of low birth weight, very low birth weight and fetal malformation in group A1 and group A2 were significantly higher than those in group B (P0.05), but there was no significant difference between group A _ 1 and A _ 2 (P0.05), and the rate of premature delivery in group A _ 2 was significantly higher than that in group B (P0.05). There was statistical difference between group B and group B (P0.01). Conclusion the low body mass and the risk of malformation of multiple pregnancy after single child delivery are still higher than those of single pregnancy, 35 years old and short time of infertility. It is suggested that selective single high quality embryo transfer should be used to reduce multiple pregnancy.
【作者單位】： 上海交通大學(xué)醫(yī)學(xué)院附屬仁濟醫(yī)院生殖醫(yī)學(xué)中心 上海市輔助生殖與優(yōu)生重點實驗室;
【基金】：國家自然科學(xué)基金面上項目(81571499),國家自然科學(xué)基金(81300547) 上海市教育委員會高峰高原學(xué)科建設(shè)計劃(20161413) 國家973子課題(2014CB943300) 衛(wèi)生計生委公益項目子課題(201402004) 上海市輔助生殖與優(yōu)生重點實驗室(17DZ2271100)~~
【分類號】：R714.8

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