Abstract
The objective. We aimed to study obstetric and perinatal outcomes in multiple pregnancies, depending on the type of choriality. Materials and methods. We used a retrospective analysis of the birth histories. 174 women with spontaneously occurring multiple pregnancies were involved in the study. There were 50 women with monochorionic placentation and 120 women with a dichorionic type of placentation. We analyzed the course of pregnancy, parturition and perinatal outcomes in these patients. The data were processed using parametric and nonparametric statistics. Results. Mean age of women was comparable and amounted to 28.5 ± 5.4 in women with monochorionic pregnancy and 29.4 ± 5.1 with dichorionic pregnancy. Both groups were comparable in social status, place of residence and parity. The risk of placental disorders (OR 2.9; 95% CI 1.4-5.7), fetal growth retardation (OR 2.4; 95% CI 1.1-5.4), gestational diabetes (Or 4,24; 95% CI 1.5-11.7), premature birth (OR 2.3; 95% CI 1.3-3.9), premature delivery at 34-36 weeks (OR 2.7; 95% CI 1.4-5.3), operative parturitions (OR 3.54; 95% CI 1.4-8.4), discordance of fetuses (OR 3.2; 95% CI 1.5-7.1) were higher in monochorionic multiple pregnancy. Prematurity (ОR 4.6; 95% CI 2.8-7.4) and low weight by gestational age (ОR 2.0; 95% CI 1,1-3.5) were the leading diagnosis in newborns who were born from monochorionic pregnancy. Conclusions. It is necessary to continue researches on this problem and develop guidelines for the management of women with monochorionic and dichorionic forms of placentation.
Highlights
High perinatal mortality and infant morbidity are more frequently observed in multiple pregnancy
We aimed to study obstetric and perinatal outcomes in multiple pregnancies, depending on the type of choriality
The risk of placental disorders, fetal growth retardation, gestational diabetes, premature birth, premature delivery at 34–36 weeks, operative parturitions, discordance of fetuses were higher in monochorionic multiple pregnancy
Summary
ФГБОУ ВО «Читинская государственная медицинская академия» Минздрава России Цель исследования: изучить акушерские и перинатальные исходы при многоплодной беременности в зависимости от типа хориальности. Проведён ретроспективный анализ медицинской документации 174 женщин со спонтанно наступившей многоплодной беременностью двойней, родоразрешенных в Забайкальском краевом перинатальном центре Чита) с 2015 по 2017 гг., из которых 50 женщин с монохориальным и 120 женщин – с дихориальным типами плацентации. Родов и перинатальные исходы у данных пациенток. Средний возраст женщин с монохориальной беременностью был сопоставим с возрастом матерей с дихориальной двойней и составил 28,5 ± 5,4 и 29,4 ± 5,1 года соответственно. Тип хориальности при многоплодии определяет развитие осложнений беременности и перинатальные исходы. Необходима разработка алгоритмов ведения беременности и родов у женщин с различным типом хориальности при двойнях. Ключевые слова: монохориальная и дихориальная двойня, осложнения беременности, перинатальные исходы.
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