黄体酮治疗早孕期先兆流产合并绒毛膜下血肿的临床研究

Clinical Observation of Progesterone in Treatment of Threatened Abortion Combined with Sub-chorionic Haematoma during Early Pregnancy

目的观察黄体酮治疗早孕期先兆流产合并绒毛膜下血肿的妊娠结局。方法选择2013年1—12月收治的早孕期先兆流产孕妇126例,采用黄体酮保胎的70例为观察组,采用维生素E保胎的56例为对照组。将观察组中有腹痛症状的42例设为A组,无腹痛症状的28例设为B组。采用B超监测并记录观察组绒毛膜下血肿的大小并分度。比较妊娠结局及疗效。结果观察组和对照组流产、早产、死胎、足月分娩、胚胎畸形、胎盘粘连发生率差异均有统计学意义(P<0.05)。A、B两组胎儿结局、妊娠情况差异无统计学意义(P>0.05);重度血肿与轻度血肿的流产、死胎、胚胎发育异常、产后合并出血、胎盘植入发生率及妊娠终止时间差异具有统计学意义(P<0.05)。结论早孕期发现绒毛膜下血肿的先兆流产孕妇,中度和轻度血肿采用黄体酮治疗效果良好。

Objective To observe the pregnancy outcome of Progesterone in treatment of threatened abortion combined with sub-chorionic hematoma during the early pregnancy. Methods A total of 126 pregnant women with threatened abortion during early pregnancy from January to December 2013 were divided into the observation group using Progesterone（ n = 70） and the control group using vitamin E（ n = 56）. The observation group was divided into subgroup with abdominal pain（ n = 42） and subgroup B without abdominal pain（ n = 28）. The sizes and grades of sub-chorionic hematoma in the observe group were monitored and recorded using B ultrasound,and pregnancy outcomes and curative effects in both the groups were compared. Results The differences in incidence rates of abortion,premature birth,stillbirth,term delivery,fetal malformation and placental adherence between observation and control groups were statistically significant（ P〈0. 05）. In group A and B,the differences in fetal outcome and pregnancy condition were not statistically significant（ P〉0. 05）,and the differences in incidence rates of abortion,stillbirth,abnormal development of placenta,postpartum hemorrhage and placenta implantation,and time of pregnancy termination between cases of severe hematoma and mild hematoma were statistically significant（ P〈0. 05）. Conclusion Progesterone in treatment of threatened abortion combined with sub-chorionic hematoma during the early pregnancy can achieve satisfactory results in pregnant women with moderate and mild hematoma.