试议胎儿双胎妊娠中第一胎儿与第二胎儿新生儿结局及分娩方式

论文导读：ectionandvaginaldeliverywereanalyzed.ResultsTherewasnosignificantdifferenceinweightoffirstfetusandsecondfetus（P>0.05）.Therateofneonatalasphyxiaandamnioticfluidcontaminationofsecondfetusbothwerehigherthanthatoffirstfetus，buttherewasnosignificantdifferen
[摘要] 目的 探讨双胎妊娠新生儿结局及更好的分娩方式。 方法 回顾性分析56例双胎妊娠中第一胎儿与第二胎儿的新生儿体重、新生儿窒息率、羊水污染率；分析剖宫产分娩与分娩新生儿窒息率。 结果 第一胎儿与第二胎儿的体重比较，两组差异无统计学意义（P > 0.05）。第一胎儿与第二胎儿新生儿窒息率与羊水污染率比较，第二胎儿新生儿窒息率及羊水污染率均大于第一胎儿窒息率，但差异无统计学意义（P > 0.05）。剖宫产组新生儿窒息率明显低于及分娩组（P < 0.05）。 结论 第二胎儿较第一胎儿易发生新生儿窒息，对于第一胎儿为头位、第二胎儿为臀位者选择分娩应慎重，若接产医生没有内倒转或臀位牵引的经验，以剖宫产为宜；对于中等大小的胎儿，两胎均为头位，特别是经产妇时，可选择分娩，其它情况宜选择剖宫产术。
[关键词] 双胎妊娠；第一胎儿；第二胎儿；新生儿窒息；剖宫产；分娩方式
[] B[文章编号] 1674—4721（2012）09（c）—018摘自：本科毕业论文致谢www.7ctime.com
2—02
Study on the neonatal outcome and delivery ways of first fetus and second fetus in twin pregnancy.
WENXuehua
The Third Hospital of Nanchang City in Jiangxi Province， Nanchang 30009， China
[Abstract] Objective To study the neonatal outcome and the better delivery ways in twin pregnancy. Methods Neonatal weight， the rate of neonatal asphyxia， the rate of amniotic fluid contamination of first fetus and second fetus in 56 twin pregnancy were retrospective analyzed； the neonatal asphyxia rate of cesarean section and vaginal delivery were analyzed. Results There was no significant difference in weight of first fetus and second fetus （P > 0.05）. The rate of neonatal asphyxia and amniotic fluid contamination of second fetus both were higher than that of first fetus， but there was no significant difference between the two （P > 0.05）. The rate of neonatal asphyxia of cesarean section was much lower than that of vaginal delivery （P < 0.05）. Conclusion Neonatal asphyxia of second fetus is tend to occur easier than first fetus， when first fetus is in the position of head presentation， second of breech presentation， vaginal delivery should be chosen carefully， if the doctor he no experience of internal version and breech extraction， cesarean section is more appropriate. For moderately sized fetus and two foetuses both are head presentation， especially to multipara， vaginal delivery should be chosen， else the cesarean section is more appropriate.
[Key words] Twin pregnancy； First fetus； Second fetus； Neonatal asphyxia； Cesarean section； Delivery way
一次妊娠同时有2个胎儿时称双胎妊娠。其早产发生率及围生儿死亡率高，属高危妊娠范围，临床上应予以重视[1—2]。本文通过回顾分析本院56例双胎妊娠第一胎儿与第二胎儿的新生儿结局来探讨双胎妊娠中更好的分娩方法。现报道如下：
1 资料与方法

1.1 一般资料

选择2003年1月～2008年9月住院分娩的双胎妊娠共56例，孕产妇年龄20～40岁，平均28岁，经产妇28例，初产妇28例。孕周为31+3～41+2周，其中，未足月分娩16例，足月分娩40例，早产发生率为28.5%。剖宫产分娩43例，分娩13例。

1.2 方法

对56例双胎妊娠的第一胎儿与第二胎儿的新生儿体重、新生儿窒息率与羊水污染率进行比较；对剖宫产分娩与分娩的新生儿窒息率进行比较。

1.3 统计学方法

所有数据资料均采用SPSS 16.0统计学软件进行处理，计量资料采用t检验，计数资料采用χ2检验，以P < 0.05为差异有统计学意义。源于：如何写论文www.7ctime.com