Prenatal Diagnosis And Intrauterinr Intervention Of Multiple Pregnancy

Objective:To explore the related factors and risks of antenatal diagnosis between multiple pregnancy and single pregnancy,and the difference of pregnancy outcome,as well as the risk and pregnancy outcome of multiple pregnancy reduction,so as to provide reference for antenatal diagnosis and fetal reduction of multiple pregnancy.Methods:This study retrospectively analyzed 194 cases of multiple pregnancy diagnosed in our hospital from January 2016 to December 2018 and 200 cases of single pregnancy diagnosed before birth at random.The clinical data of 40 cases with multiple pregnancy reduction were followed up and the pregnancy outcomes were analyzed.The clinical data,indication,risk and complications of prenatal diagnosis and pregnancy outcome were compared between the two groups,and the general data,indication,risk and outcome of pregnancy and complications were analyzed in 40 cases of multiple pregnancy.Results:?A total of 194 cases were found in the multiple pregnancy group,including 25 cases of abnormal karyotype,12 cases of thalassemia genotypic abnormality,6.19%of thalassemia and 12.9%of chromosome abnormality.19 cases of chromosome abnormalities and 5 cases of thalassemia genotypic abnormalities were detected in 200 cases of single fetus group.The abnormal detection rate was 11.5%(26/200).?There was no significant difference in age and method of sampling between single fetus group and multiple fetus group(P>0.05).There were significant differences in gestational age,number of pregnancy,mode of conception and indication of antenatal diagnosis between the two groups(P<0.05).?The most common indication of antenatal diagnosis of multiple fetuses was advanced age(49.0%,95/194),followed by abnormal ultrasound structure(36.1%,70/194),parental thalassemia gene carrying(19.1%,37/194),Serological screening was abnormal(17.0%,33/194).Abnormal serological screening(32.5%,65/200)was the main indication of antenatal diagnosis in single fetal group.There was significant difference between the two groups(P<0.05).?There was no significant difference in live delivery rate between the two groups in clinical outcome,but there was significant difference in abortion rate,term delivery rate,premature delivery rate and cesarean section rate between the two groups(P<0.05).?Most of the multiple fetuses during fetal reduction were iatrogenic multifetuses(87.5%,35/40),of which twins were the main(60.0%,24/40).Fetal factors were performed in 18 cases and maternal factors in 22 cases.?A total of 2 miscarriages were performed in 40 cases after selective fetal reduction.The postoperative abortion rate was 5.0%(2/40),and the premature delivery rate ?34 weeks was 15.0%(6/40).Conclution:The antenatal diagnosis indication of multiple pregnancy is different from that of single pregnancy.The main antenatal diagnosis indication of multiple pregnancy is old age,and the abnormal serological screening is the main indication of antenatal diagnosis of multiple pregnancy.Most of the twins in multiple pregnancies were double velvet double sheep,followed by single velvet double sheep.Most of them were naturally conceived,and most of them were assisted reproductive assisted pregnancy.The antenatal diagnosis of multiple pregnancies can effectively detect abnormal fetuses,and multiple fetal reduction can effectively improve the outcome of pregnancy.It is safe and feasible to strictly grasp the surgical indication and skilled operation.