| Background and Objective of Research:The first test tube baby in the world was born successfully in 1987 and the assisted reproductive technology(ART)has been developing so rapidly in recent 30 years that the incidence of twin pregnancy has been improved significantly.It was reported that the incidence of twin pregnancy has increased from 0.189% to 0.333%in America during 30 years,from 10.1‰ in 1985 to 15.5‰ in 2012 in Britain,and from 1.63 % 20 years ago to 3.18 % in our country.With the development of economy and the implementation of two-child policy,more and more women of childbearing age or over childbearing age need assisted reproductive technology to be pregnant,which accounts for the higher the incidence of twin pregnancy.Therefore,it becomes more and more important to research and handle the project about the complications of twin pregnancy.The thesis,by means and with the help of a retrospective analysis of pregnant women and perinatal infants who were hospitalized in the First Bethune Hospital of Jilin University between January,2014 and December,2017,is expected to conclude some experience in aspects of perinatal care,prevention and treatment of complication,and prognosis of perinatal infants and to reduce the impacts of complications of twin pregnancy on both pregnant women and infants.Research Materials and Methods:In this retrospective analysis,the pregnant women,who were hospitalized in the First Bethune Hospital of Jilin University between January,2014 and December,2017,were divided into Group A(double fetus group)and Group B(single fetus group).The former includes 842 cases,the latter,12215 cases.The thesis also analyzed live-born infants in that period in the First Bethune Hospital of Jilin University,the age,birth history,the method of ingravidation,the nature of the infants' chorion,the occurrence and types of complications,termination of pregnancyweek and mode of delivery,neonatal birth weight,apgar scores and the cases of neonate's transferring to NICU.In the retrospective analysis,those who left the hospital after successful tocolysis and who miscarried and induced labor because of personal reasons,were excluded.Data statistics and analysis are performed by SPSS22.0,enumeration data,by chi-square test,measurement data,by t test.If P<0.05 in chi-square test and t test,the result is of statistical significance.Results:1.From January,2014 to December,2017,there were 13057 cases of parturients in our hospital,including 842 cases of twin pregnancies,accounting for 6.45% of all parturients in the same period,530 cases of ART pregnant women,62.95% of the twin pregnancy.And during those four years,the percentage of ART twins in twin pregnancy in the same year had been increasing(3.23%?3.91%?4.18%?4.64%).And there were 12215 cases of monocyesis,accounting for 93.55% of all parturients in the same period.Among the cases of monocyesis,there were 860 cases of ART pregnant women,accounting for 7.04% of monocyesis.Similarly,during those four years,the percentage of ART nonocyesis in all monocyesis had been increasing year by year(5.21%?5.82%?6.83%?7.91%).The percentage of advanced maternal age in ART group is higher than that in nature conceived group(P < 0.05).The improvement of the incidence of twin pregnancy is related to the popularization of assisted reproductive technology.2.There were 735 cases of complications among twin pregnancies,accounting for 79.57%.And there were 4084 cases of complications among monocyesis,accounting for 67.46 %.Among twin pregnancies,the morbidity of premature rupture of fetal membranes,hypertensive disorder complicating pregnancy,postpartum hemorrhage,placental abruption,hydramnion,oligohydramnios,intrahepatic cholestasis of pregnancy,premature birth and dead fetus in uterus is higher than that among monocyesis(P < 0.05).Among twin pregnancies,the morbidity of premature birth is the highest.There were 303 cases of premature birthbabies,accounting for 36.0 % in twin pregnancies.Among monocyesis,it is the morbidity of hypertensive disorder complicating pregnancy that is the highest.There were 1890 cases,accounting for 15.5% in monocyesis.3.In Group A(double fetus group),the morbidity of premature rupture of fetal membranes,gestational diabetes mellitus,postpartum hemorrhage,uterine inertia and premature birth in Group ART is higher than that in Group of natural labor(P<0.05).In Group B(single fetus group),the morbidity of premature rupture of fetal membranes,hypertensive disorder complicating pregnancy,placental abruption,anemia and premature birth in Group ART is higher than that in Group of natural labor(P < 0.05).Among all ART patients,the morbidity of gestational diabetes mellitus,postpartum hemorrhage,premature birth,fetal anomaly,ICP and anemia in Group A(double fetus group)is higher than that in Group B(single fetus group)(P<0.05).4.The premature birth,because of premature rupture of fetal membranes,accounts for 49.8% of that in twins pregnancies.And the rate of premature rupture of fetal membranes between 32 and 34 gestational weeks is higher than that of premature twins' birth among other gestational weeks.5.The rate of cesarean section of twin pregnancies,81.9%,is higher than that of monocyesis,67.5%.The result is of statistical significance(P<0.05).The rate of cesarean section of ART twin pregnancies is higher than that of ART monocyesis and the result is of statistical significance(P<0.05).6.The rate of neonatal asphyxia and transferring into NICU is higher than that of Group of natural labor(P<0.05).7.The morbidity of twin-twin transfusion syndrome,twin's death in uterus,inconformity of twins' growth,twin's fetal anomaly,that are peculiar to twins pregnancies,and that of perinatal infant's undesirable ending has increased.Conclusions:1.With the development of assisted reproductive technology,the incidence of twin pregnancy has been improved significantly and the rate of advanced maternal age in ART twins pregnant is a little bit higher.2.The types of complications of twins pregnancies are more than that of monocyesis.And the morbidity of complications of twins pregnancies is higher than that of monocyesis.Among all complications of twins pregnancies,the morbidity of premature birth is the highest,which is mainly caused by premature rupture of fetal membranes,especially happens between 32 and 34 gestational weeks.It is the effective means of improving the prognosis of twins neonate to prevent and cure the premature birth because of premature rupture of fetal membranes.3.The rate of twins perinatal infant,low-birth-weight infants and the occupancy rate of Division of Neonatology in Group ART is higher than that in Group of natural labor(P<0.05).4.The rate of cesarean section of Group ART is higher than that of Group of natural labor.And the rate of cesarean section of twin pregnancies has increased significantly(P<0.05).5.The morbidity of perinatal infant's undesirable ending,caused by he complications of twins pregnancies has increased. |
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