Se1ective multifetal pregnancy reduction in second trimester.

doi:10.7504/fk2015060107

Abstract

Abstract:

Abstract:Selective multifetal pregnancy reduction in second trimester aims to improve pregnancy outcomes by reducing the numbers of fetus or abnormal fetus. Intracardiac injection of KCl usually managed from 11 to 24 weeks is proven relatively safe，but this method is not suitable for monochorioic twin pregnancies. Its successful pregnancy rate is close to spontaneous pregnancy twins. Multifetal reduction of monochorioic twin pregnancies is managed with vascular occlusion technique from 15 to 27 weeks，and radiofrequency ablation is more widely used in China.Pregnancy outcomes are related to surgical indications，surgical times，surgical procedures and performers' experience. Assessment of chorionicity，early diagnosis of fetal abnormalities and identification of twin pregnancy complications should be done by ultrasonography before pregnancy reduction.

Key words: multifetal pregnancy, second trimester of pregnancy, selective multifetal pregnancy reduction, pregnancy outcomes

摘要：

中孕期妊娠选择性减胎术主要目的是减少多胎妊娠胎儿数、减灭异常胎儿,改善多胎妊娠结局。在排除单绒毛膜双胎的情况下，药物减胎比较成熟和安全，一般在妊娠 11～24 周实施，妊娠成功率接近自然双胎。对于单绒毛膜双胎采用血管闭塞的技术进行选择性减胎，国内多采用射频消融，一般选择在15～27周。手术适应证、手术时机、手术方法以及术者的熟练程度与妊娠结局有关。减胎术前应行超声检查判断绒毛膜性、诊断早期胎儿异常和识别双胎特殊并发症。

关键词: 多胎妊娠, 妊娠中期, 选择性减胎, 妊娠结局

CLC Number:

R714.23

*LI Hong-yan，LI Shan-ling，WANG Xie-tong，LIU Cai-xia.. Se1ective multifetal pregnancy reduction in second trimester.[J]. Acta Metallurgica Sinica, DOI: 10.7504/fk2015060107.

李红燕1，李善玲1，王谢桐1，2，刘彩霞3. 多胎妊娠中孕期选择性减胎术[J]. 中国实用妇科与产科杂志, DOI: 10.7504/fk2015060107.

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（2015-04-15 收稿）

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