Effect on Clinical Outcomes by Different Selective Fetal Reduction in Monochorionic Diamniotic Twin Pregnancy
- VernacularTitle:不同减胎方式对单绒毛膜双羊膜囊双胎临床结局的影响
- Author:
Yan-chun LIANG
1
;
Yu-jing DAI
2
;
Unleng CHOI
2
;
Han-qiu ZENG
2
;
Qian-yi CHENG
2
;
Xing-huan CHEN
2
;
Cai-xia ZHU
1
;
Gang NIU
1
Author Information
1. Department of Obstetrics and Gynecology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510058, China
2. Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou 510080, China
- Publication Type:Journal Article
- Keywords:
monochorionic diamniotic twin pregnancy;
pregnancy reduction;
bipolar umbilical cord coagulation;
radiofrequency ablation;
pregnancy outcome;
neonatal outcome
- From:
Journal of Sun Yat-sen University(Medical Sciences)
2020;41(6):902-909
- CountryChina
- Language:Chinese
-
Abstract:
【Objective】 To compare clinical outcomes between bipolar umbilical cord coagulation(BCC) and radiofrequency ablation(RFA) after selective fetal reduction in monochorionic diamniotic twin pregnancy. 【Methods】 We retrospectively analyzed all cases of monochorionic diamniotic twin pregnancies who received selective fetal reduction in The First Affiliated Hospital of Sun Yat-sen University from 2009 to 2019. Patient underwent regular antenatal care during the whole pregnancy and finally delivered in our hospital. The impact of basic conditions of the patients, different methods of reduction, gestational weeks of delivery and other factors on the final pregnancy outcomes and neonatal outcomes were studied. The data were analyzed by SPSS20.0. 【Results】 The frequency of tightening feeling of the lower abdomen of RFA group and BCC group after surgery were 65.0% and 61.5%, respectively(P > 0.05). The symptom was relieved after symptomatic treatment. In addition, time of surgery and the hospitalization days were not statistically different between the two groups. The median gestational age at delivery of the RFA group was 366/7(264/7 ~ 406/7) weeks, which was later than 324/7 (290/7~374/7) weeks of the BCC group, without statistical significance(P > 0.05). The proportion of patients who delivered before 370/7 weeks in the BCC group was higher than that in the RFA group(100% vs. 62.5%, P = 0.024). In the neonatal outcomes, the rate of low birth weight infants in the BCC group was greater than that in the RFA group(92.31% vs. 52.5%, P = 0.025), but the differences in the rate of very low birth weight infants and the rate of small for gestational age infant were not statistically significant(both P values are greater than 0.05). The rate of neonatal transfer pediatrics or intensive care unit in the BCC group was greater than that of the RFA group(84.62% vs. 30%, P = 0.001). In a multivariate analysis of the effects on neonatal outcomes, multivariate logistic regression was used to analyze the association between different indicators and the incidence of low birth weight infants. The results showed that gestational weeks < 270/7 weeks was a risk factor for low birth weight infant(OR = 2.091, 95% CI, 0.312 to 14.162, P = 0.032) . 【Conclusions】 The effects of RFA and BCC on the pregnancy outcome and neonatal outcome are different. We should consider various factors when we choose individualized method of pregnancy reduction.
