پديد آورندگان :
فرجي، رويا دانشگاه علوم پزشكي گيلان - مركز تحقيقات بهداشت باروري - گروه جراحي زنان و زايمان , اصغرنيا، مريم دانشگاه علوم پزشكي گيلان - مركز تحقيقات بهداشت باروري - گروه جراحي زنان و زايمان , ظهيري، زيبا دانشگاه علوم پزشكي گيلان - مركز تحقيقات بهداشت باروري - گروه جراحي زنان و زايمان , دليل حيرتي، فاطمه
چكيده فارسي :
ﺯﻣﻴﻨﻪ ﻭ ﻫﺪﻑ: ﺑﺎﺭﺩﺍﺭﻱ ﺩﻭﻗﻠﻮﻳﻲ ﺍﺯ ﺣﺎﻟﺖ ﻫﺎﻱ ﭘﺮﺧﻄﺮ ﺑﺎﺭﺩﺍﺭﻱ ﺍﺳﺖ ﻛﻪ ﻫﻤﺮﺍﻩ ﺑﺎ ﺍﻓﺰﺍﻳﺶ ﭼﻬﺎﺭ ﺑﺮﺍﺑﺮ ﻣﻴﺰﺍﻥ ﻣﺮﮒ ﻭ ﻣﻴﺮ ﺟﻨﻴﻦ ﻭ ﺍﻓﺰﺍﻳﺶ ﺷﺶ ﺑﺮﺍﺑﺮ ﻣﺮﮒ ﻭ ﻣﻴﺮ ﻧﻮﺯﺍﺩﻱ ﻣﻲ ﺑﺎﺷﺪ. ﭘﮋﻭﻫﺶ ﺣﺎﺿﺮ ﺑﺮﺍﻱ ﺗﻌﻴﻴﻦ ﻓﺮﺍﻭﺍﻧﻲ ﺣﺎﻣﻠﮕﻲ ﺩﻭﻗﻠﻮﻳﻲ ﻭ ﻋﻮﺍﺭﺽ ﻫﻤﺮﺍﻩ ﺑﺎ ﺁﻥ ﺩﺭ ﺑﻴﻤﺎﺭﺳﺘﺎﻥ ﺍﻟﺰﻫﺮﺍ)ﺱ( ﺭﺷﺖ ﺩﺭ ﻃﻲ ﭘﻨﺞ ﺳﺎﻝ ﺻﻮﺭﺕ ﮔﺮﻓﺘﻪ
ﺍﺳﺖ.
ﻣﻮﺍﺩ ﻭ ﺭﻭﺵ ﻫﺎ: ﺍﻳﻦ ﻣﻄﺎﻟﻌﻪ ﺗﻮﺻﻴﻔﻲ ـ ﻣﻘﻄﻌﻲ ﺩﺭ ﻣﺮﻛﺰ ﺁﻣﻮﺯﺷﻲ ﺩﺭﻣﺎﻧﻲ ﺍﻟﺰﻫﺮﺍ)ﺱ( ﺭﺷﺖ ﺑﺼﻮﺭﺕ ﺳﺮﺷﻤﺎﺭﻱ ﺍﻧﺠﺎﻡ ﮔﺮﻓﺖ. ﺍﺑﺰﺍﺭ ﺟﻤﻊ ﺁﻭﺭﻱ ﺍﻃﻼﻋﺎﺕ ﭘﺮﺳﺸﻨﺎﻣﻪ ﺑﻮﺩﻩ ﺍﺳﺖ ﻛﻪ ﺑﺎ ﺍﺳﺘﻔﺎﺩﻩ ﺍﺯ ﺍﻃﻼﻋﺎﺕ ﻣﻮﺟﻮﺩ ﺩﺭ ﭘﺮﻭﻧﺪﻩ ﻫﺎ ﺗﻜﻤﻴﻞ ﮔﺮﺩﻳﺪﻩ ﺍﺳﺖ. ﺍﻃﻼﻋﺎﺕ ﺷﺎﻣﻞ ﺳﻦ ﻣﺎﺩﺭ، ﺳﻦ ﺣﺎﻣﻠﮕﻲ، ﺗﻌﺪﺍﺩ ﺯﺍﻳﻤﺎﻥ ﻫﺎ، ﻧﻮﻉ ﺣﺎﻣﻠﮕﻲ ﺍﺯ ﻧﻈﺮ ﺗﻌﺪﺍﺩ ﻗﻞ ﻫﺎ(، ﻧﻮﻉ ﺯﺍﻳﻤﺎﻥ، ﺟﻨﺲ ﻧﻮﺯﺍﺩ، ﻭﺯﻥ ﻧﻮﺯﺍﺩ، ﻧﺎﻫﻤﺴﺎﻧﻲ ﻭﺯﻥ ﺩﻭﻗﻠﻮﻫﺎ، ﭘﺮﻩ ﺍﻛﻼﻣﭙﺴﻲ، ﺩﻳﺎﺑﺖ ﺣﺎﻣﻠﮕﻲ، ﻧﺎﻫﻨﺠﺎﺭﻱ ﺟﻨﻴﻨﻲ ﺑﻮﺩ. ﭘﺲ ﺍﺯ ﺟﻤﻊ ﺁﻭﺭﻱ
ﺩﺍﺩﻩ ﻫﺎ، ﺍﻃﻼﻋﺎﺕ ﺗﻮﺳﻂ ﻧﺮﻡ ﺍﻓﺰﺍﺭ ﺁﻣﺎﺭﻱ SPSS ﻣﻮﺭﺩ ﺗﺠﺰﻳﻪ ﻭ ﺗﺤﻠﻴﻞ ﻗﺮﺍﺭ ﮔﺮﻓﺘﻨﺪ.
ﻳﺎﻓﺘﻪ ﻫﺎ: ﻓﺮﺍﻭﺍﻧﻲ ﺩﻭﻗﻠﻮﻳﻲ ﺩﺭ ﻣﻄﺎﻟﻌﻪ ﻣﺎ 1/7 ﺍﺯ ﻛﻞ ﺣﺎﻣﻠﮕﻲ ﻫﺎ ﺑﻮﺩ. ﻛﻪ 53/5 ﺍﺯ ﺍﻳﻦ ﺯﻧﺎﻥ ﭼﻨﺪﺯﺍ ﺑﻮﺩﻧﺪ. ﺑﻴﺸﺘﺮﻳﻦ ﻓﺮﺍﻭﺍﻧﻲ ﺣﺎﻣﻠﮕﻲ ﺩﻭﻗﻠﻮﻳﻲ ﺩﺭ ﻣﺤﺪﻭﺩﻩ ﺳﻨﻲ 20 -30 ﺳﺎﻝ ﺑﻮﺩﻩ ﺍﺳﺖ32/1 ﺑﺮﻭﺯ ﺯﺍﻳﻤﺎﻥ ﺯﻭﺩﺗﺮ ﺍﺯ ﻣﻮﻋﺪ ﺩﺭ ﺣﺎﻣﻠﮕﻲ ﺩﻭﻗﻠﻮﻳﻲ 60/4 ﺑﻮﺩﻩ ﻭ ﻓﺮﺍﻭﺍﻧﻲ ﺣﺎﻣﻠﮕﻲ ﻃﻮﻝ ﻛﺸﻴﺪﻩ 0/6 ﺑﻮﺩﻩ ﺍﺳﺖ. ﺍﺧﺘﻼﻑ ﻭﺯﻥ ﺑﻴﺶ ﺍﺯ 25 ﺑﻴﻦ ﺩﻭﻗﻠﻮﻫﺎ 13/2 ﺑﻮﺩﻩ ﺍﺳﺖ. ﺑﻄﻮﺭ ﻛﻠﻲ ﺑﺮﻭﺯ ﻧﺎﻫﻨﺠﺎﺭﻱ ﺟﻨﻴﻨﻲ ﺩﺭ ﺣﺎﻣﻠﮕﻲ ﺩﻭﻗﻠﻮﻳﻲ 1/6%، ﺩﻳﺎﺑﺖ ﺣﺎﻣﻠﮕﻲ 2/3%، ﭘﺮﻩ ﺍﻛﻼﻣﭙﺴﻲ 8/8 ﺑﻮﺩﻩ ﺍﺳﺖ ﻭ ﻫﻤﭽﻨﻴﻦ 65/8 ﺍﺯ ﺯﻧﺎﻥ ﺑﺎ ﺣﺎﻣﻠﮕﻲ ﺩﻭﻗﻠﻮﻳﻲ ﺯﺍﻳﻤﺎﻥ ﺳﺰﺍﺭﻳﻦ ﺩﺍﺷﺘﻪ ﺍﻧﺪ. 47/9 ﺍﺯ ﻧﻮﺯﺍﺩﺍﻥ ﺩﻭﻗﻠﻮ ﭘﺴﺮ ﺑﻮﺩﻩ ﻭ ﺍﻛﺜﺮ ﻧﻮﺯﺍﺩﺍﻥ66/8 ﺍﺯ ﺁﻧﻬﺎ ﻭﺯﻥ ﻛﻤﺘﺮ ﺍﺯ 2500 ﮔﺮﻡ
ﺩﺍﺷﺘﻨﺪ.
ﻧﺘﻴﺠﻪ ﮔﻴـﺮﻱ: ﻋﻮﺍﺭﺿﻲ ﻛﻪ ﺣﺎﻣﻠﮕﻲ ﻫﺎﻱ ﭼﻨﺪﻗﻠﻮ ﺭﺍ ﺗﺤﺖ ﺗﺎﺛﻴﺮ ﻗﺮﺍﺭ ﻣﻲ ﺩﻫﺪ ﺩﺍﺭﺍﻱ ﺍﻫﻤﻴﺖ ﻛﻠﻴﻨﻴﻜﻲ ﻭﻳﮋﻩ ﺍﻱ ﻣﻲ ﺑﺎﺷﻨﺪ. ﺑﺎ ﺗﺸﺨﻴﺺ ﺍﻳﻦ ﻋﻮﺍﺭﺽ ﻭ ﻣﺮﺍﻗﺒﺖ ﻫﺎي ﭘﺮﻱ ﻧﺎﺗﺎﻝ ﻣﻨﺎﺳﺐ ﻭ ﻣﻬﺎﺭﺕ ﺗﻴﻢ ﺯﺍﻳﻤﺎﻧﻲ ﻣﻲ ﺗﻮﺍﻥ ﺍﺯ ﺑﺮﻭﺯ ﻋﻮﺍﺭﺽ ﺣﺎﻣﻠﮕﻲ ﭼﻨﺪﻗﻠﻮﻳﻲ ﻛﺎﺳﺖ.
چكيده لاتين :
Introduction & Objective: Twin pregnancy is a high risk pregnancy that leads to four fold increase in
fetus mortality rate and six fold increase in neonatal mortality rate.
This study, done at Alzahra hospital in Rasht, was undertaken to assess the relative frequency and some
associated complications of twin pregnancies in a period of five years.
Materials & Methods: This is a descriptive cross sectional study in Rasht’s Alzahra hospital. The data
which were gathered from patient’s records, included age, gestational age, parity, type of pregnancy, route of
delivery, gender of neonate, weight of neonate, discordances between twins weights, preeclampsia , GDM,
fetal anomaly after collection of data. These were analyzed with SPSS software.
Results: The frequency of twins was 1.7% and 53.5% of the females were multipara. The highest
frequency of twin pregnancies were in females between 20 to 30 years old (32.1%). Preterm delivery in twin’s
pregnancy was 60.4% and prevalence of post term was 0.6%. Weight difference above 25% between twins
was 13.2%. The prevalence of fetal anomaly, GDM and preeclampsia were 1.6%, 2.3% and 8.8%
respectively. 65.8% of ladies with twin pregnancy underwent cesarean section. 47.9% of neonates were male
and the weight of 66.87% was under 2500gr.
Conclusions: The complications that affect twin pregnancies have special clinical importance. With
diagnosis of those complications, appropriate prenatal care, and the experience of delivery team in providing
favorable condition for mother and her fetuses it is possible to prevent complications
