Clinical Analysis Of 258 Patients With Twin Pregnancies

Obgective:To review the general records for twin pregnancies,and investigate their general clinical features,study the factors which influence the pregnancy outcomes,and explore the measures of improving the results in twin gestations.Methods:The clinical data of 258 cases of twin pregnancies delivered in the Military General Hospital of BeiJing from Jun.1st.2009 to Dec.31 st.2014 were collected and retrospective analyzed,The clinical document included maternal data(age,maternal,conception),pregnancy complications(preterm birth,anemia during pregnancy,hypertensive disorders complicating gestational,postpartum hemorrhage,specific to pregnancy complications,et al.),delivery time,delivery mode,and the babies' ordinary circumstances like birth weight,neonatal outcome and other clinical data,comparing the difference between the related indicators.Results:1.The incidence of pregnancy of complication of twin pregnancy from high to low in turn for preterm birth(78.68%),pregnancy with anemia(20.16%),premature rupture of membranes(19.38%),postpartum hemorrhage(17.44%),gestational diabetes(16.28%),hypertensive disorders complicating gestational(13.95%),selective fetal growth restriction and(or)twins grow inconsistent(12.40%),pregancy with abnormal thyroid function(7.75%),placenta previa(4.65%),abnormal amniotic fluid(4.26%),placenta or abnormal umbilical cord attached(4.26%),placental abruption(0.78%),umbilical cord prolapse(0.39%).2.The reasons of preterm birth in twin pregnancy were preterm labor(6.90%),premature rupture of membranes(22.66%)and iatrogenic preterm birth(70.44%),34 weeks later of iatrogenic preterm proportion(87.41%)was obviously higher than 34 weeks ago the preterm group(12.59%).3.Newborn's complications of different levels of premature birth and partus matures group were low birth weight infant(the incidence of each group were 100.00%?48.2%?12.07%?4.00%?1.33%),neonatal respiratory distress syndrome(the incidence of each group were 100.00%?30.77%?8.62%?2.00%?2.22%),high bilirubin blood disease(the incidence of each group were75.00%?41.03%?20.69%?21.67%?5.56%),neonatal hypoxic ischemia encephalopathy(the incidence of each group were 100.00%?82.05%?39.66%?8.67%?1.11%),neonatal asphyxia(the incidence of each group were 100.00%?58.97%?24.14%?8.67%?4.44%),compare each complications rates were visible significant difference(P<0.001).4.The incidence of hypertensive disorders complicating gestational,preterm birth and low birth weight infant in pregnant women with anemia group were significantly higher than pregnant women without anemia group(P < 0.001),the incidence of postpartum hemorrhages and neonatal birth weight had no difference between two groups.5.Twin pregnancy has a high rate of cesarean section,in which the social factor is the main cause of the high rate of cesarean section,the incidence of postpartum hemorrhages in two delivery ways has no difference(P>0.05),and neonatal asphyxia rate of vaginal delivery group was obviously higher than cesarean delivery group(P<0.001).6.Specific to pregnancy complications(selective fetal growth restriction,twin to twin transfusion syndrome,single intrauterine fetal death,single fetal malformation)can increase the perinatal adverse outcomes.Conclusion:1.Twin pregnancy complicated with multiple complications and its incidence rate is high,premature birth,pregnancy with anemia,premature rupture of membrane,postpartum hemorrhage,gestational diabetes,hypertensive disorders complicating gestational were major complications,premature birth is the main cause of neonatal morbidity,active prevention and treatment of premature birth to improving the quality and the long-term prognosis of neonatal survival is of great significance.2.Pregnancies with anemia increase the incidence of hypertensive disorders complicating gestational,preterm birth and low birth weight infant,we should pay attention to prevention and treatment of anemia.3.How to choose the delivery mode of twin pregnancy was according to maternal-fetal situation,we should encourage the suitable women choose vaginal delivery,improve the twin midwifery technology and reduce the high rate of cesarean section.4.Specific to pregnancy complications can increase the perinatal adverse outcomes.