The Effect Of Different Chorionic Nature And Gestational Management On Outcomes Of Gemellary Pregnancy

Objective: To analyze the cases of gemellary pregnancy,assess different chorionic nature and diagnosis time on gemellary pregerency in order to emphasize the importance of standard gestational management on gemellary pregnancy.Methods: This study was a retrospective case control study and 174 cases of terminal gemellary pregnancy from January 2015 to December 2015 in Lianyungang Maternity and Child Health Hospital were enrolled and all enrolled cases conformed to inclusion criteria.According to chorionic nature and diagnosis time,cases were grouped.The general conditions,the pregnancy complications of pregnant women and outcomes of fetal-neonate of two groups were compared.Results: No significant difference between antenatl diagnosis and no diagnosis group was found in age,gestational age and the number of labors.Moreover,no significant difference was observed in the incidence of complications during pregnancy such as gestational diabetes mellitus(GDM),acute fatty liver of pregnancy(AFLP),abnomal amniotic fluid,premature rupture of membrane(PROM),placenta previa and abnormal umbilical cord insertion,postpartm hemorrhage(PPH)and perinatal morbidity between two groups.However,the incidence of hypertensive disorders of pregnancy(HDP)and anemia during pregnancy between two groups was significantly different.As to comparison between monochorionic(MC)group and diachorionic(DC),no significant difference of age and the number of labors was found.Additionally,the incidence of HDP,GDM,AFLP,PROM,abnomal amniotic fluid,placental abnormality,abnormal umbilical cord insertion,PPH and anemia during pregnancy was not significantly different.Nontheless,significant difference was found in gestational age,preterm birth,twin-twin transfusion syndrome(TTTS),selective intrauterine gowth retardation(s IUGR),neonate birth weight,neonatal asphyxia and stillbirth between these two groups.Conclusion: The diagnosis of chorionic nature before 14 weeks of gestation was of great importance on evaluation of gemellary pregnancy,prognosis and management of pregnancy.By diagnosis of chorionic nature,personalized monitoring of pregnancy and standard pregancny management could be made in order to reduce the incidence of complications during pregnancy and poor perinatal prognosis.