稽留流产的原因分析以及早期诊断

Thereason analysis and early diagnosis of missed abortion

目的:通过统计学方法探讨Ct、Uu、TORCH感染与稽留流产的相关性以及妊娠相关血浆蛋白-A(PAPP-A)、孕激素(Progesterone,P)水平在稽留流产早期诊断中的价值。方法:选取2014年7月到12月宝鸡市妇幼保健院稽留流产病例107人以及门诊同期正常妊娠病例150人,通过免疫法和培养法对孕妇宫颈分泌物进行感染(Ct、Uu和TORCH)检测,统计感染所占稽留流产病例的比例从而确定感染与稽留流产的相关性;同时通过用酶联免疫吸附法检测稽留流产患者和同期门诊正常妊娠病例血清孕酮和妊娠相关蛋白含量。结果:稽留流产患者Ct或/和Uu的感染率为56%,正常妊娠孕妇感染率为6.6%;稽留流产患者的TORCH感染率为17.8%,正常妊娠孕妇感染率为5.3%;稽留流产患者血清P和PAPP-A含量分别为(23.37±5.89)nmol/L和(59.58±8.32)U/L;而对应正常妊娠病例的含量分别为(75.47±17.63)nmol/L和(168.07±2.57)U/L。结论:感染和稽留流产有很高的相关性,是造成稽留流产病因之一;早期检测P和PAPP-A含量有利于稽留流产的早期诊断。

Objectives： To investigate the relevance between Ct, Uu and TORCH infections and missed a- bortion by statistical methods and the value of the concentration of pregnancy - associated plasma protein - A （ PAPP - A） and progesterone （ Progesterone, P） in the early diagnosis of missed abortion. Methods： 107 cases of missed abortion diagnosed in Baoji City Maternal and Child Health Hospital from July to December 2014; meanwhile, 150 normal pregnant women in the same period were selected as control group. The infection of Ct, Uu and TORCH was detected by immunoassay and culture of cervical secretions from pregnant women; then, it took advantage of statisti- cal method to determine the relevance between Ct Uu and TORCH infections and missed abortion. The concentration of serum progesterone and pregnancy - associated protein was determined by enzyme linked immunosorbent assay （ELISA）. Results： Infection rate of Ct and/or Uu in missed abortion pregnancies was 56% ; however the corre- sponding rate in normal pregnant women was 6.6% ; the TORCH infection rate in missed abortion pregnant women was 36.5% and that in normal pregnant women was 6% ; PAPP - A and P concentrations in abortion pregnancies were 23.37 ＋ 5.89n tool / L and 59.58 ＋ 8.32 U / L, and in the Corresponding normal pregnancies were 75.47 ＋ 17.63 n mol/L and 168.07 ＋ 2.57 U/L respectively. Conclusions： Infection, one of the causes of missed a- bortion, is highly correlated with missed abortion; and detection of P and PAPP - A contents in early pregnancy is conducive for the diagnosis of missed abortion.