反复自然流产患者主动免疫治疗对母婴预后的影响

The influence to the prongnosis of maternal and infant in patients with recurrent spontaneous abortion after active immunotherapy

目的评价反复自然流产患者主动免疫治疗对母婴预后的安全性。方法采用回顾性分析的方法,对既往有反复自然流产史,经主动免疫治疗后妊娠分娩的114例患者,与同期正常妊娠分娩的114例患者,进行母婴预后的对比分析。结果研究组孕产妇妊高征发生率为8.77%(10/114)均为轻度,产后出血发生率为4.39%(5/114),平均出血量为320.56±37.64m l,明显高于对照组的309.6±29.87m l,剖宫产率为39.47%(45/114)。与对照组相比妊高征和胎儿生长受限的发生率近似,差异无显著性(P>0.05);而产后出血量和剖宫产率高于对照组,差异有显著性(P<0.05)。研究组新生儿1例患先天性巨结肠。与对照组相比,在出生体重、出生后1分钟Apger评分、新生儿病率以及出生缺陷等方面相似,差异没有显著性(P>0.05)。结论采用主动免疫治疗的方法,对反复自然流产的母婴无明显副作用,预后是安全的、良好的,但应注意产后出血的预防及适当放宽剖宫产指征,此方法可以在临床推广使用。

Objective： To evaluate the security of the prognosis of maternal and infant in patients of RSA after aetive immunotherapy . Methods A retrospective study was conducted to analyse the prognosis of maternal and infant between 114 cases diagnosedas RSA after active immunotherapy and 114 cases of the normal pregnancies . Results： The incidence of hypertensive disorder complicating prenancy , in patients with RSA was 8. 77% （10/114） , all of which were light The rate of postpartum hemorrhage was 4. 39% （5/ 114） , and the average blood loss was 320. 56 ± 37.64ml , which was signficautly higher than that in normal pregnancy group （ 309. 60 ±29. 87ml） . The incidence of cesarean section delivery was 39.47% （45/114） . Compared to normal pregnancies , the incidence of hypertensive disorder complicating pregnancy and fetal growth restriction are the same to these in normal pregnancy （ P 〉 0. 05） . while the amount of postpartum hemorrhage and the rate of cesarean section delivery were significantly higher than these in normal cases （ P 〈 0. 05）. One baby in the study group wasdiagnosedas congenital megaeolon. The weight of infant, Apger score in 1 minute , pefiental morbidity and birth defect were similar to these in normal pregnancy （ P 〉0. 05）. Conclusion： Active immunotherapy is a simple , safe and effective treatment to patients with RSA , and there is no obvious adverse effect to matermal and infant Hower, we must take precautions against postpartum hemorrhage and we should border the requinements of cesanean section delivery. Active immunotherapy is appliable to clinical practice.