绒毛膜下血肿相关因素及妊娠结局研究

Study on the related factors of subchorionic hematoma and the pregnancy outcome

目的：回顾性研究先兆流产患者的临床资料,探讨绒毛膜下血肿（SCH）的相关因素及其对妊娠结局的影响。方法：选取2008年1月～2012年12月因先兆流产在郑州大学第五附属医院住院行保胎治疗的患者为研究对象,合并SCH的65例患者为研究组,不伴有SCH的264例患者为对照组。通过电话随访及抽调病历的方式统计患者妊娠相关资料,分析SCH发生与患者年龄、孕周、辅助生殖结局、治疗结局及妊娠结局的关系。结果：SCH的发生率为18.1%,SCH的发生与患者的年龄及是否接受辅助生殖无关（P〉0.05）。SCH患者与其他原因所致先兆流产妇女的自然流产率、早产率、剖宫产率、产后出血发生率、胎盘粘连及胎盘植入的发生率、新生儿体重及新生儿Apgar评分比较差异无统计学意义（P〉0.05）。结论：先兆流产合并SCH患者的预后较好,孕妇早孕期间应常规进行B超检查,及早发现SCH并及时治疗,从而得到较好的治疗效果。

Objective： To retrospectively research the clinical data of patients with threatened abortion,explore the related factors of subchorionic hematoma（ SCH） and its impact on pregnancy outcome. Methods： The hospitalized patients undergoing tocolysis treatment because of threatened abortion in the hospital from January 2008 to December 2012 were selected as study objects,65 patients combined with SCH were included into study group,while 264 patients without SCH were included into control group. Pregnancy related statistical data were collected from medical records and by telephone follow- up,then the relationship between SCH and age,gestational weeks,assisted reproduction outcome,pregnancy outcome was analyzed. Results： The incidence rate of SCH was 18. 1%,the occurrence of SCH was not correlated with age and undergoing assisted reproduction or not（ P〈0. 05）. There was no statistically significant difference in the incidence rates of spontaneous abortion,premature delivery,cesarean section,postpartum hemorrhage,placental adhesion and placenta implantation,neonatal weight,neonatal Apgar score between SCH patients and the women with threatened abortion induced by other causes（ P〈0. 05）.Conclusion： The prognosis of patients with threatened abortion combined with SCH is good,pregnant women during the first trimester of pregnancy should be checked by B ultrasound conventionally in order to detect SCH in time and treat it as soon as possible,so a better therapeutic effect can be obtained.