妊娠中期超声异常与晚期流产或早产的关系

Relationship between ultrasound abnormalities in middle pregnancy and abortion or premature delivery in late pregnancy

目的探讨妊娠中期经超声诊断的绒毛膜下血肿、胎盘低置状态和宫颈管分离对妊娠结局的影响。方法回顾性分析2014年1月~2016年12月我院妇产科收治的因妊娠中期先兆流产住院保胎的150例患者的临床资料。结果单因素分析显示,中孕期绒毛膜下血肿和阴道出血患者晚期流产(早产)发生率高(P<0.05),多因素分析显示中孕期绒毛膜下血肿(OR=2.430,95%CI为1.019~5.794,P<0.05)和阴道出血(OR=3.974,95%CI为1.493~10.578,P<0.01)均为晚期流产或早产的独立影响因素。结论中孕期绒毛膜下血肿增加了晚期流产(早产)的风险,而胎盘低置状态和宫颈管分离与晚期流产(早产)无关。

Objective To investigate the effect of chorionic hematoma,low status of placenta and cervical carial separa- tion in the second trimester of pregnancy diagnosed byI ultrasound on pregnancy outcomes.Methods The clinical data of 150 cases of puerperas who were hospitalized for treatment of threatened abortion in mid-pregnancy in department of obstetrics and gynecology of our hospital from January 2014 to December 2016 were retrospectively analyzed.Results Single-factor analysis showed that puerperas with chorionic hematoma and vaginal bleeding in the second trimester had higher incidence of abortion （premature birth） in the late pregnancy （P〈0.05）; according to the multivariate analysis, subchorionic hematoma （OR=2.430,95%CI 1.019-5.794,P〈0.05） and vaginal bleeding （0R=3.974,95%CI 1.493-10.578, P〈0.01） in the second trimester were independent risk factors of late abortion or premature delivery.Conclusion Chori- onic hematoma in middle pregnancy increases the risk of miscarriage （premature birth） in the late pregnancy,whereas low placental status and separation of the cervical canal are independent of late miscarriage （premature delivery）.