目的:探讨双胎妊娠绒毛膜性对孕妇妊娠期并发症及围生儿预后的影响及意义.方法:对我院定期随诊并分娩的472例双胎临床资料进行回顾性分析,根据绒毛膜性分为单绒毛膜双羊膜囊组(MCDA组)和双绒毛膜双羊膜囊组(DCDA组),对两组孕妇的分娩孕周、并发症以及围生儿预后等进行比较分析.结果:两组孕产妇妊娠并发症的发生率比较,差异无统计学意义(P＞0.05).MCDA组低出生体重儿、极低出生体重儿、新生儿窒息及围生儿死亡的发生率均明显高于DCDA组,其差异有统计学意义(P＜0.05),MCDA组中双胎输血综合征发生率为7.32％.结论:绒毛膜性对孕妇妊娠并发症的发生无明显影响,而双胎孕妇于孕早期行B超检查诊断单绒毛膜或双绒毛膜对预测围生儿预后具有重要意义.尽早确定双胎类型,加强对单绒毛膜双胎的监护及干预,是改善胎儿和新生儿预后的关键.%Objective:To investigate the clinical diagnostic significance of chorion properties. Methods: Retrospective analysis of the clinical data including gestational weeks, complications and perinatal outcomes of 472 twin pregnancies was done in Shanghai Changning Maternity and Infant Health Hospital. All the cases were divided into monochorionic diamnionic(MCDA) group and dichorionic diamnionic( DCDA ) group. Results: There was no statistically significant differences in complications between two groups (P>0.05). The incidences of low birth weight infant,extreme low birth weight infant, neonatal asphyxia and perinatal mortality in MCDA group were significantly higher than those in DCDA group (P < 0.05). The incidence of twin-twin transfusion syndrome(TTTS) in MCDA group was 7. 32%. Conclusions:Chorion properties make no difference in twin pregnancy complications. Differentiation between monochorionic and dichorionic twin pregnancy in first trimester of pregnancy by ultrasonography is very important in forecasting the perinatal prognosis. It is crutial to improve fetal and neonatal outcomes by making early diagnosis,strengthening the prenatal care and intervention.
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