Pregnancy outcome following cerclage. 2. Multiple pregnancy

In a retrospective study pregnancy and labour after cerclage had been studied in comparison to 160 patients with singleton pregnancies and a matched pair control group of multiple pregnancies without operative cervix closure. Cervical incompetence in multiple pregnancy observed more frequently than in singleton ones is not correlated to obstetric history, but has a bad prognosis because of necessity of tocolysis during pregnancy, marked shortening of duration of pregnancy, lowering of length and weight of newborns. An increase in frequency of amniotic infections had to be calculated following cerclage in multiple pregnancies, too. Our results especially in multiple pregnancies are not so optimistic. This statement is valid also for the indication to its prophylactic use.     

Multiple pregnancy

Multiple pregnancy is of continuing clinical interest and concern. The recent widespread use of ovulation induction techniques has increased the incidence of twins and higher multiple pregnancy well beyond traditional experience, leading to frequent ethical and clinical dilemmas. Although the perinatal mortality for multiple pregnancy exceeds that for singleton pregnancy, aggressive team management minimizes losses. In experienced hands, close clinical attention to the course of the pregnancy, combined with serial ultrasonic and biophysical studies and supportive psychological counselling, produces good results.     

Multiple abortion

The Center of Social Gynecology at Marseille studied voluntary termination of pregnancy, based on material obtained in questioning 1000 cases. An attempt was made to set up some guidelines based on psychosociological research, going beyond the medical and deontological aspects. The demand for multiple abortions was of special attention, in which they are considered not a recurrent phenomenon, but a delinquent one. The concept of abortion as an inescapable phenomenon is considered, evoking the need of new sociological approaches to this "fruit of progress." Definite links are seen between the abortion psychology and the multiple phenomenon. A sociogenesis of abortion is considered, in which the notion of security is thought to play a role, related to one's "social contract" and socioeconomic conditions. Elements for the solution to this problem are thought to lie with the latter.     

Multiple pregnancies

Twin and multiple pregnancies carry an increased risk compared to singleton pregnancies and a challenge in obstetrical management. Multiple births are a worldwide issue, especially due to the increased incidence in several countries in the last few years. Prenatal care and obstetrical management call for specific solutions due to specific risks in such pregnancies. The present papers try to give both an overview and to offer a deeper insight into selected problems of obstetrical care for multiple pregnancies.     

多胎妊娠的原因及流行病学调查

在人类 ,一般一次妊娠仅有一个胎儿 ,多胎是人类妊娠中一种特殊现象 ,当一次妊娠怀有两个或两个以上胎儿称为多胎妊娠。人类的多胎妊娠中以双胎多见 ,三胎少见、四胎和四胎以上罕见。多胎妊娠的早产率、难产率、合并妊娠高血压综合征、产后出血及围生儿死亡率均明显高于单胎妊娠。因此 ,它一直是产科临床研究的重点课题之一 ,本文重点讨论多胎妊娠的发生率及影响发生率的有关因素。1　发生率2 0世纪 70年代以前 ,多胎妊娠的发生率相对稳定。Ｈｅｌｌｉｎ曾根据大量资料计算出多胎妊娠发生率为 1∶89ｎ -1,ｎ代表一次妊娠的胎儿数 ,这仅是自…