子宫内膜厚度与母婴围产结局关系

Analysis the relationship between the thickness of endometrial and perinatal and neonatal outcomes

目的回顾性分析陆军军医大学附属第一医院生殖医学中心1139例妊娠女性移植前子宫内膜厚度[注射人绒毛膜促性腺激素(hCG)当天或进行黄体酮转化当天]与胚胎移植术后母婴围产结局的关系。方法收集整理2011年1月至2014年7月该中心采用助孕技术成功妊娠并顺利生产的妊娠女性1139例,根据注射hCG当天或进行黄体酮转化当天的子宫内膜厚度分为4组,A组(<8 mm,150例)、B组(8~<10 mm,489例)、C组(10~<14 mm,452例)和D组(≥14 mm,48例);根据助孕妊娠女性是否合并有子宫病变分为合并子宫病变组和未合并子宫病变组。结果1139例妊娠女性中共有239例合并有子宫病变,两组间子宫内膜厚度比较,差异无统计学意义(P>0.05),两组间母婴围产期并发症发生率比较,差异无统计学意义(P>0.05);A至D组妊娠女性合并有子宫病变的概率分别是22.0%、18.2%、22.3%和33.3%,D组明显高于B组(P<0.05);A、B两组发生胎膜早破(PROM)、子痫、产后出血以及母亲入ICU的概率较C、D两组高(P<0.05)。结论子宫内膜厚度较薄者(<10 mm),其母婴围产期并发症可能较高;注射hCG或黄体酮转化当天子宫内膜厚度可作为预测母婴围产结局的指标。

Objective Retrospective analysis the relationship between the thickness of endometrial before transfer(the day of using hCG or progesterone)and perinatal and neonatal outcomes in pregnancies of 1139 cases of reproductive medicine center of First Affiliated Hospital of Army Military Medical University.Methods Data from the 1139 cases January 2011 to July 2014 in reproductive medicine center were collected.Four groups were divided based on the thickness of endometrial on the day of hCG injection or progesterone conversion in froze embryo transfer cycle,which were A group(<8 mm),B group(8-<10 mm),C group(10-<14 mm)and D group(≥14 mm),and the cases were 150,489,452 and 48 respectively.Two groups were divided based on whether patients with uterine lesions,which were patients with uterine lesions group and patients without uterine lesions group.Results A total of 239 pregnant women with uterine lesions were included in 1139 pregnant women.There was no significant difference in the thickness of the endometrium between the two groups(P>0.05),no difference in the incidence of perinatal and newborn complications as well as(P>0.05).The percentage of uterine lesions were 22.0%,18.4%,22.3%and 33.3%from A to D respectively,and obvious difference was found between the B and D(P<0.05).The rate of premature rupture of membranes(PROM),eclampsia,postpartum hemorrhage and maternal into ICU in group A and B were higher than group C and D(P<0.05).Conclusion It is shown that more perinatal complications of mother and infant may found in the patients with thinner endometrial thickness(<10 mm).The thickness of endometrial on the day of hCG injection or progesterone conversion maybe a“bio-marker”in prediction the perinatal and newborn outcomes.