丁金玉,鄢金柱,雷 艳

双胎妊娠延迟间隔分娩，在第一个胎儿娩出后，可能不需要分娩剩余的胎儿，这些胎儿可能仍然存在在子宫内，这一决定旨在让剩余的胎儿达到完全的胎儿发育，从而改善新生儿发病率和死亡率。我们报告一例在本科协助下的双胎妊娠延期分娩的病例。探究双胎妊娠，延迟第二胎分娩的处理方法，包括其结果、可能的风险和益处，更好的指导临床工作，特将该患者的诊疗经过报道如下。

妊娠，多胎；延迟分娩；肝内胆汁淤积症

[1] 师媛,赵淑华,杨红.双胎妊娠第二胎儿延迟分娩的临床分析[J].中华妇产科杂志,2020,55(07):479-483. [2] Carson J.Twins born with an interval of forty-four days.Br Med J 1880;1:242. [3] Palmara V,Lo Re C,Priola V,Sturlese E,Villari D,et al.(2011).Delayed delivery of a twin pregnancy and uterine atony:morphological and clinical evidence.Twin Res Hum Genet 14:198-200. [4] 中华医学会围产医学分会胎儿医学学组,中华医学会妇产科学分会产科学组.中华医学会妇产科学分会产科学组双胎妊娠临床处理指南(2020 年更新)[J].中国产前诊断杂志:电子版,2021,13(1)51-63. [5] Arabin B,Eyck J.Delayed-interval delivery in twin and triplet pregnancies:17 years of experience in 1 perinatal center.Am J Obstet Gynecol.2009;200:154.e1-8. [6] Doger E,Cakiroglu Y,Ceylan Y,et a1.Obstetric and neonatal outcomes of delayed interval delivery in cerclage and non-cerclage cases：an analysis of 20 multiple pregnancies[J]．J Obstet Gynaecol Res,2014,40(7):1853—1861． [7] ROMAN A S,FISHMAN S,FOX N,et a1.Maternal and neonatal outcomes after Delayed-Interval delivery of multifetal pregnancies[J].Am J Perinatol,2011,28(2):91-95. [8] Jayaram PM，Mohan MK，Farid I，et al.Antenatal magnesium sulfate for fetal neuroprotection:a critical appraisal and systematic review of clinical practice guidelines[J].J Perinat Med,2019,47(3):262-269. [9] Romero R,Conde‐Agudelo A,El-Refaie W,et al.Vaginal progesterone decreases preterm birth and neonatal morbidity and mortality in women with a twin gestation and a short cervix:an updated meta-analysis of individual patient data.Ultrasound in Obstetrics&Gynecology.2017;49(3):303-314.

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