不明原因复发性流产患者生化妊娠史与妊娠结局关系的研究

Study on the Relationship between Biochemical Pregnancy History and Pregnancy Outcome in URSA Patients

目的探讨不明原因复发性流产(URSA)患者的生化妊娠史与妊娠结局的关系。方法选取URSA患者192例,根据既往生化妊娠次数,分为无生化妊娠组(A组)66例,1次生化妊娠组(B组)65例,≥2次生化妊娠组(C组)61例。分析并比较3组患者的临床特征及妊娠结局。结果 C组与A组及B组比较,既往自然流产次数(P<0.05)、既往体外受精和胚胎移植自然流产率(P<0.012 5)均显著增高,其自然流产率及自然流产伴正常染色体核型(SANK)率也均显著增高(P<0.012 5)。A组与B组比较,活产率、自然流产率及SANK率差别均无统计学意义(P>0.012 5)。结论≥2次生化妊娠的患者既往复发性流产更为严重,保胎治疗后其活产率较低、自然流产和SANK风险较高。

Objective To investigate the relationship between biochemical pregnancy history and pregnancy outcome in patients with unexplained recurrent spontaneous abortion. Methods Information of 192 cases with URSA in our hospital were collected. According to the number of previous biochemical pregnancy,they were divided into non biochemical pregnancy group（group A,66 cases）,one biochemical pregnancy group（group B,65 cases）,and two or more biochemical pregnancy group（group C,61 cases）. The clinical characteristics and the subsequent pregnancy outcome of the three groups were analyzed.Results Compared with group A and group B,the number of spontaneous abortion（P〈0.05）and the rate of in vitro fertilization and embryo transfer spontaneous abortion（P〈0.012 5）in group C were significantly higher. The live-birth was significantly lower in group C than that in group A or in group B（P〈0.012 5）. The spontaneous abortion rate and the rate of spontaneous abortion with normal karyotype（SANK）in group C were significantly higher than that in group A or in group B（P〈0.012 5）.Between group A and group B,the live-birth rate,spontaneous abortion rate,and the rate of spontaneous abortion with normal karyotype were not significantly different（P〉0.012 5）. Conclusion Patients with two or more biochemical pregnancyhad more serious previous recurrent abortion. They had lower livebirth rate,higher spontaneous abortion rate,and higher rate of spontaneous abortion with normal karyotype after preventing miscarriage treatment.