早期妊娠伴低血清孕酮者的孕激素治疗研究

Research on the progestogen therapy in the early pregnancy patients with low-value of serum progesterone

目的探讨早期妊娠伴血清孕酮(P)值为47.7 nmol/L^79.5 nmol/L,β-HCG正常增长,B超确定宫内活胎且无症状者孕激素治疗的必要性。方法对43例在本院门诊就诊并住院分娩者进行回顾性分析,根据其是否要求给予孕激素治疗的主观意愿分为2组,要求给予孕激素23例为治疗组,要求观察不给药20例为观察组,分析各组的妊娠结局。结果观察组与治疗组孕妇年龄、孕次、产次、妊娠时间、孕酮水平、先兆流产和难免流产的发生率、产前出血、早产、妊娠期高血压疾病及新生儿畸形发生率比较,差异均无统计学意义(P>0.05)。结论早期妊娠伴低血清孕酮值(47.7 nmol/L^79.5 nmol/L)者不予孕激素治疗并不影响妊娠结局,有必要寻找更有效的监测方法避免这类人群的过度治疗和治疗不足。

Objective To investigate the normal increase of β- HCG when the serum progesterone（ P） value was within47. 7 nmol/L- 79. 5 nmol/L,ultrasound diagnosis of intrauterine growth,and the necessity of progesterone treatment on patients without symptom. Methods 43 cases of patients who come for clinic and childbirth in our hospital were retrospectively analyzed. According to whether or not the subjective will accept progesterone treatment,all cases were divided into 2 groups,which were the progesterone therapy group with 23 patients receiving progesterone therapy and the control group with 20 patients without drug given. Then the pregnancy outcome was analyzed. Results The differences of age,gravidity,parity,gestational age,P valume,the incidence rates of threatened abortion and inevitable abortion,antepartum bleeding,premature delivery,hypertensive disorders in pregnancy,and the incidence rate of neonatal malformation between the two groups were not statistically significant（ P〈0. 05）. Conclusion Patients in the early pregnancy with serum progesterone valume among 47. 7 nmol/L-79. 5 nmol/L without progestogen therapy may not affect pregnancy outcomes. It is necessary to search for more effective monitoring methods to avoid over treatment and under- treatment on these people.