高位多胎妊娠中的经腹减胎术--尼泊尔先驱队列回顾性研究

Sharma Paudel, Prajwal Dahal, P. Pant, Nilam Subedi
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引用次数: 0

摘要

分享尼泊尔经腹多胎妊娠减胎术(MFPR)的初步经验。 一家私立医院在 3 年内为 108 名患者实施了该手术。在超声引导下,通过经腹途径向心脏内注射 0.2 至 3.0 毫升 15% w/v(2 mEq/mL)氯化钾(KCl)。 在妊娠第七至第十五周共进行了108例减胎手术,其中最多的44例(40.7%)是在妊娠第九至第十周进行的。共有 123 个胎儿被减胎。在 108 例多胎妊娠中,96 例(88.8%)是体外受精(IVF)。85名孕妇(78.7%)从三胞胎减胎为双胎。有 5 例需要第二次减胎。有 3 例需要进行两次减胎(在同一次妊娠中)。在 3 例二绒毛膜三羊膜三胞胎妊娠中,第二个胎儿意外夭折。 在妊娠第七周至第十二周期间进行超声引导下经腹减胎术是安全有效的。
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Transabdominal fetal reduction in higher order multiple pregnancies – A pioneer cohort retrospective study in Nepal
To share initial experience of transabdominal multifetal pregnancy reduction (MFPR) in Nepal. The procedure was performed in 108 patients in a private hospital over a period of 3 years. Under ultrasound guidance, intracardiac injection of 0.2 to 3.0 ml of 15% w/v (2 mEq/mL) potassium chloride (KCl) was administered via transabdominal route. A total of 108 fetal reduction procedures were carried out at the seventh to fifteenth weeks of gestation, a maximum of 44 (40.7%) of which were done at the ninth to tenth weeks of gestation. A total of 123 fetuses were reduced. Out of total 108 multifetal pregnancies, 96 (88.8%) were due to In Vitro fertilization (IVF). 85 pregnancies (78.7%) underwent reduction from triplet to twin. The second-time reduction was needed in 5 cases. Two attempts (in the same sitting) were required in 3 cases. Inadvertent demise of the second fetus was noted in 3 cases of dichorionic triamniotic triplet pregnancy. Ultrasound-guided transabdominal fetal reduction performed between the seventh and twelfth weeks of gestation is safe and effective.
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