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頁籤選單縮合
題名 | Characteristics and Birth Outcomes of Pregnant Women Treated with Corticosteroid after Fetal Reduction=使用類固醇之減胎婦女特徵與懷孕結果 |
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作者 | 潘恆新; 黃莉文; 謝碧純; 林禹宏; 黃建榮; 張杰仁; | 書刊名 | 輔仁醫學期刊 |
卷期 | 2:1 2004.03[民93.03] |
頁次 | 頁57-62 |
分類號 | 417.42 |
關鍵詞 | 類固醇治療; 多胞減胎; 腦性麻痺; 雙胞胎; Multifetal pregnancy reduction; Corticosteroid therapy; Cerebral palsy; Twin pregnancy; |
語文 | 英文(English) |
中文摘要 | 腦性麻痺往往使嬰幼兒發展遲緩,若能早期發現、早期療育,可減緩期臨床表徵,避免帶給家庭及社會極大的負擔。相較於單胞胎,經多胚胎減胎之雙胞胎常有明顯的運動神經發育遲緩,特別易有腦性麻痺。在1997年,Pharoah等學者提出〝Vanishing Twin Syndrome〞,特別強調,由於此現象,極有可能是腦性麻痺的原因之一。其次,對於安胎的孕婦施行類固醇以利胎兒的肺部成熟行之有年,近幾年來,此種治療有陸續有人指出,對嬰兒神經的發育不良之影響。本次研究主要以前瞻性的調查,在多胚胎減胎的雙胞胎中使用類固醇的族群,其出聲預後之追蹤成果。方法:本次研究主要比較經多胚胎減胎的雙胞胎中,母親因早期宮縮而施打類固醇與無早期宮縮的對照族群,調查其出生之雙胞胎嬰兒,在腦性麻痺、先天性異常、平均出生體重、母親年紀、減胎時的週數是否有明顯的差異,樣本由新光醫院自西元1992年至2000年,共有94位由四胞胎減成雙胞胎的孕婦,其中使用類固醇的孕婦有38位為實驗組,另外56位為對照組。以SPSS10.0中文版套裝軟體進行統計:包括平均值、標準差、t檢定。結果:此94位孕婦,其所出生的雙胞胎皆存活並大於兩歲,生產方式皆為剖腹產,平均出生週數是實驗組32.4±2.7週,對照組為36.0±2.9週。平均胎兒出生體重實驗組2099±555公克,對照組2405±519公克。在腦性麻痺而方面,僅實驗組有一位,其於皆在正常之神經方面範圍。在比較此兩組資料,只有平均出生體重與生產週數有明顯差異,其餘皆無明顯差異。結論:嚴格限制胚胎的植入數,並且在經減胎後的雙胞胎孕婦方面,儘量延長新生兒的出生周數是必要的措施。 |
英文摘要 | Background and Purpose: Compared with singleton births, twin pregnancies are at increased risk of significant child morbidity, particularly cerebral palsy, after high-order fetal reduction. This is termed the vanishing-twin syndrome, and is an important etiology of cerebral palsy. Antenatal corticosteroid dexamethasone, however, increases the risk for detrimental long-term neurodevelopmental effects. Thus, in this study we assess the effect of CCT on neurological disability and congenital abnormality in twins over 2 years of age after fetal reduction. Methods: The CCT (38 sets of twins) and control (56 sets) mean birth weight, maternal age, and mean gestational age at delivery and at fetal reduction using records from Shin-Kong Memorial Hospital for the period 1992~2000. Results: There were 94 quadruplet-reduced sets of twins in our study. All of these twins were alive and aged over 2 years at the time of this writing. The gestational age at the time of delivery was 32.4±2.7 weeks for the CCT group vs. 36±2.9 weeks for the controls, with mean birth weights of 2099±555 vs. 2405±519g, respectively (p<0.01). All 94 sets of twins were delivered by cesarean section, with only 1 case of cerebral palsy in the CCT group, while the others had developed normally by the age of 2 years. Only mean birth weight and gestational age at delivery showed significant differences in comparisons of the 2 groups of twins. Conclusion: Limiting the number of embryo transfers is essential for preventing adverse effects of the vanishing-twin syndrome. When reduction has been performed, a prolonged gestational age at delivery is mandatory for twin babies. |
本系統之摘要資訊系依該期刊論文摘要之資訊為主。