Intrauterine Clinical Analysis Of Twin Pregnancy And One Fetal Death

Objective:Since the mid-1980 s,due to the improvement of infertility treatment technology,the rapid development of ovulation induction therapy and assisted reproductive technology,the incidence of twin pregnancy has increased significantly.In obstetric complications,intrauterine death of twin pregnancy and one child is extremely rare.In anticipation of a good pregnancy outcome,we retrospectively analyzed the clinical diagnosis,treatment and prognosis of 53 twin pregnancies and one-feet death cases in our hospital,and discussed their clinical features and pregnancy management strategies.Provide reference basis for clinical practice work.Methods:A total of 53 intrauterine cases of twin pregnancy and one child death in the Second Hospital of Jilin University were selected from January 2015 to December 2020,and medical records were collected and retrospectively analyzed.The clinical diagnosis,treatment methods,management strategies,and maternal and child prognosis of the cases were statistically analyzed.Results:(1)General situation: The incidence of s IUFD in twin pregnancies is6.2%.The causes of intrauterine death of one child in twin pregnancy include fetal factors such as umbilical cord abnormalities(15.1%),congenital malformations(7.5%),twin transfusion syndrome(3.8%)and placental factors(3.8%);maternal factors There were 6 cases of hypertension in pregnancy,1 case of acute fatty liver of pregnancy,4cases of gestational diabetes,4 cases of hypothyroidism,3 cases of uterine fibroids,2 cases of anemia,and 1 case of viral hepatitis B example.In twin pregnancy s IUFD,the age,gestational week of delivery,and method of conception in the double-chorionic group were significantly different from those in the monochorionic group(P<0.05);the gestational age and delivery method of the double-chorionic group were similar to those in the monochorionic group.There was no statistically significant difference between the membrane groups(P>0.05).(2)Treatment and prognosis: 5 of the 53 cases gave up treatment and chose to induce labor,13 cases were delivered by cesarean section immediately after s IUFD was diagnosed with twin pregnancy,and the remaining 35 cases chose expectant treatment to extend the gestational week.Compared with the monochorionic group,the expected treatment time and the birth weight of newborns were statistically significant(P<0.05).There was no significant difference between the 1-minute Apgar score and 5-minute Apgar score of the double chorionic group and the single chorionic group(P>0.05).(3)Pregnancy outcome of twin pregnancy s IUFD: Among 53 cases,5 cases(9.4%)gave up abortion and chose to induce labor;3 cases(5.7%)gave up treatment after birth due to premature;1 case died one day after birth(1.9%).%);1 case(1.9%)gave up treatment 2 days after birth;1case(1.9%)gave up treatment 10 days after birth.The incidence of low birth weight infants(46.7%,75.0%)and premature infants(56.7%,80.0%)in the twin pregnancy s IUFD double chorionic group was significantly lower than that of the monochorionic group,and the difference was statistically significant(P<0.05)).There was no significant difference in the incidence of neonatal asphyxia,perinatal death and neonatal transfer between the two groups(P>0.05).(4)Comparison of pregnancy outcomes of twin pregnancy s IUFD occurring in different trimesters: twin pregnancy s IUFD occurred in the second trimester and third trimester of the newborn outcome,premature birth rate,neonatal transfer rate,birth weight and gestational week of delivery There was no statistically significant difference between the two groups(P>0.05).Conclusion:This paper retrospectively analyzed 53 cases of intrauterine death of twin pregnancy and one child who were hospitalized in the Second Hospital of Jilin University in the past five years,analyzed their clinical diagnosis and treatment,pregnancy management strategies,and related factors related to maternal and child prognosis.In intrauterine cases of fetal pregnancy,the stillbirth may be caused by fetal factors or maternal complications.Intrauterine deaths of twins with twins have a better prognosis than that of twins with twins.