稽留流产的病因分析

Analysis of the causes of missed abortion

目的探讨稽留流产的病因分析情况。方法选取我院2017年2月～2018年3月收治的418例稽留流产患者作为稽留流产组,选取同期正常妊娠500例孕妇作为对照组。观察两组沙眼衣原体(Chlamydiatrachomatis,Ct)、解脲支原体(M.urealyticum,UU)感染结果,5种病原体[弓形虫(TOX)、风疹病毒(RV)、巨细胞病毒(CMV)、单纯疱疹病毒(HSV)、TORCH-IgM、TORCH-IgG]检测结果、血清孕酮(serum progesterone,SP)、妊娠相关血浆蛋白A(pregnancy-associated plasma protein-A,PAPP-A)含量和不同孕龄PAPP-A含量情况。结果稽留流产组Ct、UU、Ct+UU感染率、总感染率高于对照组(P<0.05),稽留流产组TORCH-IgM和TORCH-IgG检测阳性率高于对照组(P<0.05),稽留流产组SP和PAPP-A含量均低于对照组(P<0.05),稽留流产组≤9、10、11、12、13周,≥14周PAPP-A含量均低于对照组(P<0.05),两组随孕龄增加PAPP-A含量逐渐升高,差异均有统计学意义(P<0.05)。结论感染是引起稽留流产的重要病因,及早诊断,对患者有重要的意义。

Objective To investigate the etiology of missed abortion. Methods A total of 418 patients with missed abortion admitted to our hospital from February 2017 to March 2018 were selected as the missed abortion group. Another of 500 normal pregnancy women was categorized into control group. The infection of chlamydiatrachomatis(Ct),M. urealyticum(UU), detection of five pathogens including Toxoplasma Gondii(TOX), Rubella virus(RV), Cytomegalovirus(CMV), Herpes simplex virus(HSV), TORCH-IgM, and TORCH-IgG, serum progesterone(SP), content of pregnancyassociated plasma protein-A(PAPP-A) and PAPP-A content in different gestational weeks were observed in the two groups. Results Infection rates of Ct, UU, and Ct+UU as well as total infection rate in the missed abortion group were all higher than those in the control group(P<0.05). The positive rates of TORCH-IgM and TORCH-IgG in the missed abortion group were higher than those in the control group(P<0.05). The SP and PAPP-A levels in the missed abortion group were both lower than those in the control group(P<0.05). The PAPP-A content ≤9, 10, 11, 12, 13 weeks, ≥14 weeks in the missed abortion group was lower than those in the control group(P<0.05). The PAPP-A content increased gradually following the increase of gestational age in both the control group and missed abortion group with statistical significance(P<0.05). Conclusion Infection is an important cause for missed abortion. Early diagnosis is of great significance to patients.