METHODS: Patients with DCTA triplet pregnancies who underwent elective foetal reduction between January 2012 and June 2020 were recruited. A total of 67 eligible patients with DCTA triplet pregnancies were divided into two groups: a DCTA-to-dichorionic diamniotic (DCDA) twin group (n = 38) and a DCTA-to-monochorionic diamniotic (MCDA) twin group (n = 29); the basic clinical data of the two groups were collected for comparison.
RESULTS: Compared with the DCDA-to-MCDA twin group, the DCTA-to-DCDA twin group had lower rates of complete miscarriage (7.89% versus 31.03%, p = 0.014), early complete miscarriage (5.26% versus 24.14%, p = 0.034), late preterm birth (25.71% versus 65.00%, p = 0.009) and very low birth weight (0 versus 11.11%, p = 0.025). In addition, the DCTA-to-DCDA twin group had higher rates of full-term delivery (65.71% versus 25.00%, p = 0.005), survival (92.11% versus 68.97%, p = 0.023), and taking the babies home (92.11% versus 68.97%, p = 0.023) than did the DCTA-to-MCDA twin group. In terms of neonatal outcomes, a significantly greater gestational age (38.06 ± 2.39 versus 36.28 ± 2.30, p = 0.009), average birth weight (3020.77 ± 497.33 versus 2401.39 ± 570.48, p < 0.001), weight of twins (2746.47 ± 339.64 versus 2251.56 ± 391.26, p < 0.001), weight of the larger neonate (2832.94 ± 320.58 versus 2376.25 ± 349.95, p < 0.001) and weight of the smaller neonate (2660.00 ± 345.34 versus 2126.88 ± 400.93, p < 0.001) was observed in the DCTA-to-DCDA twin group compared to the DCTA-to-MCDA twin group.
CONCLUSIONS: The DCTA-to-DCDA twin group had better pregnancy and neonatal outcomes than the DCTA-to-MCDA twin group. This reduction approach may be beneficial for patients with dichorionic triamniotic triplet pregnancies who have a strong desire to have DCDA twins.
方法:招募在2012年1月至2020年6月期间接受选择性胎儿复位术的DCTA三胎妊娠患者。将67例符合条件的DCTA三胎妊娠患者分为两组:DCTA-二胎双胎(DCDA)双胎组(n=38)和DCTA-单胎双胎(MCDA)双胎组(n=29);收集两组的基本临床资料进行比较。
结果:与DCDA至MCDA双胞胎组相比,DCTA至DCDA双胞胎组的完全流产率较低(7.89%对31.03%,p=0.014),早期完全流产(5.26%对24.14%,p=0.034),晚期早产(25.71%对65.00%,p=0.009)和非常低的出生体重(0对11.11%,p=0.025)。此外,DCTA至DCDA双胞胎组的足月分娩率更高(65.71%对25.00%,p=0.005),生存率(92.11%对68.97%,p=0.023),并将婴儿带回家(92.11%对68.97%,p=0.023)比DCTA至MCDA双胞胎组。就新生儿结局而言,孕龄明显更大(38.06±2.39vs36.28±2.30,p=0.009),平均出生体重(3020.77±497.33对2401.39±570.48,p<0.001),双胞胎的体重(2746.47±339.64对2251.56±391.26,p<0.001),与DCTA至MCDA双胞胎组相比,观察到较大新生儿的体重(2832.94±320.58对2376.25±349.95,p<0.001)和较小新生儿的体重(2660.00±345.34对2126.88±400.93,p<0.001)。
结论:DCTA-DCDA双胎组的妊娠和新生儿结局优于DCTA-MCDA双胎组。这种减少方法对于强烈希望拥有DCDA双胞胎的双胎羊膜三胎妊娠患者可能是有益的。