早孕期血清hCG、P及E_(2)水平变化与不同妊娠结局之间的关系

Relationships between changes of serum hCG,P,and E2 levels in early pregnancy and different pregnancy outcomes

目的探讨早孕期血清人绒毛膜促性腺激素(hCG)、孕酮(P)、雌二醇(E_(2))水平对妊娠结局的预测价值。方法选取2019年1月至2020年9月在广州医科大学附属第二医院妇科及产科门诊随诊的早期妊娠妇女286例(年龄18~43岁),根据妊娠结局分为正常妊娠组(147例)、继续妊娠组(69例)和稽留流产组(70例),比较各组之间相同孕周的血清hCG、P、E_(2)水平。结果稽留流产组在妊娠6~9周的血清hCG水平均低于正常妊娠组(均P<0.05);稽留流产组在妊娠5~8周的血清P、E_(2)水平均低于正常妊娠组(均P<0.05)。继续妊娠组妊娠4~8周血清hCG水平,妊娠5~8周的血清P水平,妊娠4、6、7、8周的血清E_(2)水平与正常妊娠组比较差异均无统计学意义(均P>0.05)。结论动态观察血清hCG、P及E_(2)水平有助于早期识别不良妊娠结局,及时干预可减少妊娠丢失。

Objective To investigate the predictive values of serum human chorionic gonadotropin(hCG),progesterone(P),and estradiol(E_(2))levels in early pregnancy for pregnancy outcomes.Methods A total of 286 early pregnant women aged 18-43 who were followed up in the Departments of Gynecology and Obstetrics of The Second Affiliated Hospital of Guangzhou Medical University from January 2019 to September 2020 were selected and were divided into a normal pregnancy group(147 cases),an ongoing pregnancy group(69 cases),and a missed abortion group(70 cases)according to the pregnancy outcomes.Serum levels of hCG,P,and E_(2) at the same gestational week were compared between all groups.Results The serum hCG levels of the missed abortion group at 6-9 weeks of gestation were lower than those of the normal pregnancy group(all P<0.05);the serum P and E_(2) levels of the missed abortion group at 5-8 weeks of gestation were lower than those of the normal pregnancy group(all P<0.05).There were no statistically significant differences in serum hCG levels at 4 to 8 weeks of gestation,serum P levels at 5 to 8 weeks of gestation,and serum E_(2) levels at 4,6,7,and 8 weeks of gestation between the ongoing pregnancy group and the normal pregnancy group(all P>0.05).Conclusion Dynamic observation on serum hCG,P,and E_(2) levels is helpful to identify early adverse pregnancy outcomes,and timely intervention can reduce pregnancy loss.