妊娠早期绒毛膜下血肿对妊娠结局的影响

The influence of subchorionic hematoma on pregnancy outcomes

目的:分析妊娠早期绒毛膜下血肿(subchorionic hematoma,SCH)与妊娠结局的相关影响。方法:收集2014年1月至2015年12月在首都医科大学附属北京妇产医院进行产前检查并住院生产的孕妇1 055例,筛除10周前发生流产的病例23例。分组如下:Ⅰ组无SCH及孕10周后阴道出血;Ⅱ组无SCH伴出血;Ⅲ组有SCH、无出血;Ⅳ组有SCH及出血。采用SPSS19.0的统计学方法进行分析研究。结果:1 032例中SCH占172例(16.67%);Ⅰ组618例;Ⅱ组242例;Ⅲ组87例;Ⅳ组85例。发生流早产的比例是Ⅰ组15.70%、Ⅱ组30.17%、Ⅲ组18.39%、Ⅳ组28.24%。与第Ⅳ组比较存在显著差异的有Ⅰ、Ⅲ组(P<0.05),与Ⅱ组比较无显著性差异(P>0.05)。关于流早产,有出血组(Ⅱ+Ⅳ)与无出血组(Ⅰ+Ⅲ)之间存在显著性差异(P<0.05);SCH组(Ⅲ+Ⅳ)与非SCH组(Ⅰ+Ⅱ)之间无显著性差异(P>0.05)。结论:妊娠早期单纯绒毛膜下血肿与后期发生流、早产关系不大;当孕妇出现阴道出血后,会增加流早产的发生率。

Objective： To analyze the impact of early pregnancy subchorionic hematoma on the pregnancy outcome. Methods： We collected 1 055 cases of pregnant women from January 2014 to December 2015 in the Beijing Maternity Hospital Affiliated the Capital Medical University who had prenatal care and hospitalization production, screening out 23 cases of miscarriage 10 weeks ago. Grouped as follows： group Ⅰ without SCH and vaginal bleeding after 10-week pregnant; group Ⅱ without SCH but with bleeding; group Ⅲ with SCH, no bleeding; group Ⅳ has both SCH and bleeding. Data were analyzed with SPSS13.0 statistical manner. Results： Among 1 032 cases, SCH accounted for 172 cases（16.67%）; group Ⅰ, 618 cases; group Ⅱ, 242 cases; group Ⅲ, 87 cases; group Ⅳ, 85 cases. The proportion of flow, preterm birth is respectively group Ⅰ 15.70%, group Ⅱ 30.17%, group Ⅲ 18.39%, group Ⅳ 28.24%. Compare with group Ⅳ, group Ⅰ and Ⅲ have significant differences（P〈0.05）, but no statistically significant differences between group Ⅱ（P〉0.05）. About flow and premature birth, there was significant difference（P〈0.05） between bleeding（Ⅱ＋Ⅳ） and non-bleeding group（Ⅰ＋Ⅲ）; group SCH（Ⅲ＋Ⅳ） and group non-SCH（Ⅰ＋Ⅱ） showed no significant difference（P〉0.05）. Conclusion： Early pregnancy SCH has little relationship with flow and premature birth, but when vaginal bleeding occurs in pregnant women, it will increase the rate of flow and premature birth.