低分子肝素在人类辅助生殖技术获得妊娠后发生复发性流产患者中的临床研究

Clinical Study of Low Molecular Weight Heparin in Patients with Recurrent Abortion after Pregnancy by Human Assisted Reproductive Technology

目的研究探讨低分子肝素在人类辅助生殖技术获得妊娠后发生复发性流产患者中的应用效果。方法选取2017年2月-2017年8月经辅助生殖技术治疗获得妊娠后出现复发性流产的68例患者为研究对象,并按着治疗方式不同将她们分为研究组和对照组各34例,研究组采用低分子肝素联合宫腔内人工授精,对照组采用单一宫腔内人工授精地屈孕酮治疗。并对两组患者孕前与孕后的D二聚体等指标及获得妊娠后发生复发性流产的情况进行比较。结果两组患者的D二聚体和血小板等指标在孕前与孕后比较有统计学意义(P<0.05);研究组在孕4周的D二聚体和血小板等指标对对照组比较有统计学意义(P<0.05)。同时研究组患者的妊娠成功率高与对照组,再次流产率低于对照组,两组比较差异有统计学意义(P<0.05)。结论低分子肝素可有效改善采用辅助生育技术患者的孕前及孕后D二聚体等指标,提高凝血机制,使复发性流产的发生率明显降低,减少不良妊娠结局的发生。

Objective To study the effect of low molecular weight heparin(LMWH) in the treatment of recurrent abortion after pregnancy with human assisted reproductive technology(ART). Methods 68 cases of recurrent abortion after pregnancy were treated by assisted reproductive technology in our hospital from February 2017 to August 2017. According to different treatment methods, they were divided into study group and control group, 34 cases in each group. The study group was treated with low molecular weight heparin combined with intrauterine insemination, while the control group was treated with single method. Intrauterine insemination with didrogesterone. The D dimer and other indicators before and after pregnancy and the occurrence of recurrent abortion after pregnancy were compared between the two groups. Results There were significant differences in D dimer and platelet between the two groups before and after pregnancy(P<0.05), and there were significant differences in D dimer and platelet between the study group and the control group at 4 weeks of gestation(P<0.05). At the same time, the pregnancy success rate of the study group was higher than that of the control group, and the rate of re-abortion was lower than that of the control group. There was a significant difference between the two groups(P<0.05). Conclusions Low molecular weight heparin can effectively improve D dimer before and after pregnancy in patients with assisted reproductive technology, improve coagulation mechanism, reduce the incidence of recurrent abortion and reduce adverse pregnancy outcomes.