Detection and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy

Objective:To investigate the changes and significance of reproductive hormones, prethrombotic state markers and coagulation related factors in threatened abortion in early pregnancy.Methods:Review the clinical data of threatened abortion in early pregnancy (include continuing pregnancy and miscarriages) and healthy pregnant women in the early pregnancy in our hospital, and the levels of reproductive hormones, prethrombotic state markers and coagulation related factors were compared between the three groups.Results: The results of single factor variance showed that the levels ofβ-HCG, progesterone, E2, PC, PLG, D-D, TAT, F1+2 and PAI-1 level were all statistically significant. Compared with the control group, the average levels ofβ-HCG, progesterone, E2 and PLG in the pregnancy maintenance group and the interrupted pregnancy group were significantly decreased, and the level of the interrupted pregnancy group was significantly lower than that of the pregnancy maintenance group. The levels of PC, D-D, TAT, F1+2 and PAI-1 in the pregnancy maintenance group and the interrupted pregnancy group were significantly higher than those in the control group, and the level of the interrupted pregnancy group was significantly higher than that of the pregnancy maintenance group. There was no significant difference in the level of AT III between the groups.Conclusion: There are significant abnormal levels of reproductive hormones, prethrombotic state markers and coagulation related factors in patients with threatened abortion in early pregnancy, the detection of its index level is of great value in predicting threatened abortion in the early stage.

Application of the painless technique for visual induced abortion in early pregnancy clinic female

Objective: This project is to analyze and evaluate the efYect of the painless technique in the visual induced abortion. Methods: 300 pregnant women who needed induced abortion and had no contraindication were selected as the research objects. Under the condition of the informed consent of the pregnant women, they were divided into two groups according to the different methods of the induced abortion. 150 cases in the observation group were treated with the painless technique for visual abortion, and 150 cases in the control group were treated with the painless technique for the blind curettage. Relevant surgical indicators and complications were compared between the two groups. Results: The operation time, the vaginal bleeding time, the induced abortion syndrome, the uterine aspiration incompleteness, and the postoperative infection in the observation group were significantly lower than those in the control group. The difference between the two groups was significant (P 0.05), with the statistical significance. The incidence of complications in the observation group (8.33%) was significantly lower than that in the control group (37.50%). The difference between the two groups was significant (P 0.05), with the statistical significance. Conclusion: The visual induced abortion with the painless technique is of great value in the outpatient induced abortion, and it is worth adopting and applying.

Clinical Observation on Termination of Early Pregnancy of 213 Cases after Caesarian Section with Repeated Use of Mifepristone and Misoprostol

Objective To investigate the efficacy and safety in women after caesarian section for termination of early pregnancies by treatment, or repeated treatment with mifepristone and misoprostol. Subjects and Methods A total of 213 pregnant women with amenorrhea of 34~69 d after caesarian section who asked for medical abortion were recruited, including 63 cases undergoing their second medical abortion. A total amount of mifeprisstone of 150 mg given in separate doses (25 mg×4 and 50 mg at the first time) was administered orally within 3 d, followed by misoprostol of 0.6 mg orally in the morning of d 3. Results The complete abortion rate was 92.5%, incomplete abortion was 4.7% and failure was 2.8%. Conclusion The sequential use of mifepristone and misoprostol could be successfully and repeatedly used for induced abortion in those women with a caesarian section history. Its efficacy was similar to that for ordinary population. Its safety and effectiveness were satisfactory.

Clinical Observation of Disposal Uterine Cavity Observation and Suction Surgery System on Terminating Pregnancy in Very Early Pregnancy

Objective: To compare the clinical effects of uterine cavity observation and suction surgery system with ultrasound guided induced abortion in very early pregnancy induced abortion surgery. Method: Select 80 patients who requested termination of pregnancy due to early pregnancy from August 2022 to April 2023, and analyze the data. 40 patients who underwent ultrasound-guided induced abortion to terminate pregnancy were included in the control group, and 40 patients who underwent uterine cavity observation surgery to terminate pregnancy were included in the observation group. Compare the surgical time, number of times the straw enters the uterine cavity, incidence of complications, and menstrual recovery time between the two groups. Results: There was no statistically significant difference in the surgical time between the observation group and the control group, but the number of times negative pressure straws entered the uterine cavity and the incidence of surgical complications in the observation group were significantly lower than those in the control group (P Conclusion: Applying the uterine cavity observation and suction surgical system to terminate pregnancy in very early pregnancy has the advantages of minimal damage to the uterus and low incidence of surgical complications, greatly protecting the patient’s fertility.

Implementation and Follow-Up of Medical Abortion in Catalonia (2010-2014)

In 2011 a protocol for medical abortions (MA) up to 49 days of pregnancy was approved by the Ministry of Health of Catalonia’s autonomous government and it was progressively introduced through the public network of the Sexual and Reproductive Health Units (SRHU). In 2014, a new protocol extended to 63 days of pregnancy was set up. Data come from the official abortion registry held by the Ministry of Health, which collects statistical data from all abortions performed in Catalonia. Since 2011, the number and rate of abortions in Catalonia have decreased while the number of health centers providing abortions has increased, especially the SRHU. The proportion of MA abortions went from 0.4% (2010) to 36.9% (2014), while the percentage of early abortions (up to 7 weeks) surged by 14.7%. SRHU reported 73.4% of all MA and hospitals performed 18.7% of the total, while outpatient centers accounted for the remaining 7.9%. Compared to surgical abortions, women having had MA have higher levels of education and lower rates of unemployment. Furthermore, they have more living offspring and fewer previous terminations as well as more frequent attendance to a public family planning center.

A prospective randomized, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy

A prospective randomized, placebo-controlled trial comparing mifepristone and vaginal misoprostol to vaginal misoprostol alone for elective termination of early pregnancy. Author: Dr Roopa Malik, Assistant Professor, Obstetrics and gynaecology department Pt BDS PGIMS Rohtak BACKGROUND: Vaginal misoprostol has been shown to be an effective single agent for medical agent for medical abortion. This randomized, placebo controlled trial compared a regimen of mefipristone and misoprostol with misoprostol alone for termination of early pregnancy. METHODS: 200 women with gestation <56 days were randomized by a random number table to receive either 200 mg mifepristone orally or placebo followed 48 h later by 800 ug vaginal misoprostol. Abortion success was defined as complete abortion without the use of surgical aspiration. RESULTS: Successful medical abortions occurred in 96 out of 100 subjects (96%) after mifepristone followed by vaginal misoprostol. In all, 79 out of 100 subjects (79%) successfully aborted after placebo and vaginal misoprostol. The higher success rate of complete abortion with mifepristone and misoprostol regimen was statistically significant compared with the placebo and misoprostol regimen (p < 0.05). CONCLUSION: A regimen of mifepristone and misoprostol was significantly more effective for termination of pregnancies <56 days than misoprostol alone. The misoprostol alone regimen for termination of early pregnancy is not a very good method for medical abortion but 79% efficacy obtained with vaginal misoprostol alone may clinically acceptable when mifepristone is not available.

Efficacy of Single Dose of Mifepristone Combined with Two Doses of Misoprostol in Early Medical Abortions

Objective To study the efficacy of single dose of mifepristone and two doses of misoprostol in women undergoing early medical abortion （EMA） up to 9 weeks of gestation. Methods An audit was performed on a retrospective data analysis of 162 women who underwent an early medical abortion in Southampton U.K. Relevant data on completeness of abortion and other details were analyzed. Results Majority of the women （67%） aged 20-30 years old, 22% were between 30 and 40 years old and 1% were above 40 years old when they came for abortion. About 94.5% women had complete abortion following the use of single dose mifepristone combined with two doses of misoprostol, 4.9% had an incomplete abortion and 0.6% had failure of the procedure. These figures had significantly improved over the results of similar audit in 2005 with single dose of misoprostol to women below 7 weeks of pregnancy. The results in this audit were 82.1% complete abortion, 7.2% incomplete abortion and O. 7% failed procedure. Conclusion Mifepristone in combination with two doses of misoprostol appears to be more effective in all cases of early medical abortion when compared with single dose of misoprostol for termination below 49 d （7 weeks） and two doses of misoprostol between 49 d and 63 d （7-9 weeks） of pregnancy.

Medication Rules of Traditional Chinese Medicine for Treating Threatened Abortion in the Early Stage of Pregnancy with Subchorionic Haematoma Based on Data Mining

Objective:Using data mining technology to explore the rules of traditional Chinese medicine(TCM)in the treatment of threatened abortion in the early stage of pregnancy with sub-chorionic haematoma(SCH).Methods:Literature of TCM in the treatment of threatened abortion in the early stage of pregnancy with SCH were retrieved from CNKI,VIP,WANFANG and Pubmed,EMBASE.The literature information database was established to be used for descriptive analysis,association rule analysis and cluster analysis of relevant data.Results:A total of 100 literatures were included,involving 114 Chinese herbs.The efficacy of Chinese herbs were mainly tonic drugs,hemostatic drugs,heat-clearing drugs,dissolving blood stasis and hemostatic drugs.The medicinal properties were mostly mild and warm,and the taste of the drug was mainly sweet,bitter and pungent.The liver meridian,spleen meridian and kidney meridian were frequently used.The commonly used drug pair combination was"Xu duan(Radix dipsaci,续断)-Tusizi(Semen Cuscutae,菟丝子)",and the core combination was"Tusizi-Xu duan-Ejiao(Donkeyhide gelatin,阿胶)-Baizhu(Atractylodes macrocephala,白术)-Dangshen(Codonopsis pilosula,党参)".Commonly used drugs for removing blood stasis and hemostasis were with Sanqi(Panax notoginseng,三七),Puhuang(cattail pollen,蒲黄),and Qiancao(Radix Rubiae,茜草).Conclusion:Data mining traditional Chinese medicine for the treatment of threatened abortion in the early stage of pregnancy with SCH clinically commonly used drug efficacy,taste,meridian,commonly used drug pairs,core combination and commonly used blood stasis hemostatic drugs,has important reference significance for the treatment of threatened abortion in the early stage of pregnancy combined with SCH.

Small RNA sequencing revealed aberrant piRNA expression profiles in deciduas of recurrent spontaneous abortion patients

Piwi-interacting RNAs(piRNAs)is a novel class of non-coding RNAs.However,changes in piRNA expression profiles in recurrent spontaneous abortion(RSA)have not yet been investigated.The aim of this study was to identify differentially expressed piRNAs in deciduas of RSA patients.Decidua tissues were collected by curettage from recruited RSA patients and normal early pregnant(NEP)women with their informed consent.Small RNA sequencing was used to evaluate the differences in piRNA expression profiles between RSA and NEP.The present results demonstrated that the counts of total piRNA reads in RSA samples were increased compared with those in NEP samples(0.21%vs.0.11%).Differential expression analysis identified 29 upregulated piRNAs and 18 downregulated piRNAs in RSA samples.RT-qPCR further confirmed that the expression levels of uniq-109625,uniq-89328,uniq-50651 and uniq-4569 were decreased in 8 RSA tissues,compared with 13 NEP tissues.Otherwise,pi-22628 and uniq-173406 were increased in 8 RSA tissues.Based on GO term and KEGG pathway analysis,we speculate that these piRNAs regulate RSA by targeting extracellular matrix component pathway,cell adhesion pathway and focal adhesion pathway.PiRNAs may be involved in RSA pathogenesis by target genes function on adhesion and extracellular matrix component.

Clinical Study on the Termination of 388 High-risk Early Pregnancies with Mifepristone and Misoprostol

To inverstgate the safety, effectiveness and acceptability Of conbination Of mifepristone and misoproslol for termination of high-risk pregnancy (amenorrhea≤ 70 days ).Three hundred and eighty-eight high-risk pregnant women, complicated with scarreduterus, or reproductive tract malformation, or uterus fibromyoma, or histories of recentabortion or repeated abortions, or pregnancy during lactation, and having duration of gestation ranging from 34 to 69 days, were administered orally 150 mg mifepristone (50 mgat the first time, and then 25 mg q 12 h × 4), and 600 μg misoprostol on the third day.The complete abortion rate ωas 92. 3%, while the incomplete abortion rate was 6. 2%, ongoing and pregnancy rate was 1. 5%. It was shown that combination of mifepristone andmisoprostol was effective in inducing abortion Of those high-risk pregnancies. Theregimen's effectiveness for high-risk population was similar to that for general population. Its safety, effectiveness and acceptability were satifactory. In addition, the softenedand dilated cervix made it easier and less painful to make vacuum aspiration in case offailure of the abortion.

A Simple Procedure for Termination of Pregnancy in the Late First Trimester with Mifeprostone and Misoprostol

Purpose: To assess the efficacy of medical methods for termination of pregnancy at 9 - 12 weeks of gestation. Methods: Between December 2008 and December 2010, the 116 consecutive women received 200 mg oral mifepristone and after 24 - 36 hours they applied 800 μg vaginal misoprostol to medically terminate pregnancy. If the products of conception did not pass, three further doses of 400 μg misoprostol were given vaginally at three hours intervals to medically terminate pregnancy. Results: Of the 116 patients undergoing the procedure 104 (90%) aborted completely. Half of the patients aborted within 6 hours. After medical termination, five per cent of the women were treated because of infection, and five per cent needed a revisit to hospital because of excessive bleeding. Two women received a blood transfusion. Previous live births or previous inducted abortion is presented in the study results. Conclusions: Medical abortion at 9 - 12 weeks’ gestation is a safe alternative to surgery.

补肾固胎方联合黄体酮注射液治疗肾虚型早期先兆流产疗效及对妊娠激素水平和Th1/Th2细胞因子的影响

目的 观察补肾固胎方联合黄体酮注射液治疗肾虚型早期先兆流产疗效及对妊娠激素水平和Th1/Th2细胞因子的影响。方法 采用随机数字表法将符合入选标准的120例肾虚型早期先兆流产患者分为观察组和对照组。对照组予黄体酮注射液治疗,观察组同联合补肾固胎方治疗。连续治疗2周后,比较两组中医证候积分(妊娠期阴道流血、小腹坠胀或疼痛、腰酸痛、膝关节酸软)、妊娠激素水平[雌二醇(Estradiol, E_(2))、人绒毛膜促性腺激素(Human chorionic gonadotropin, β-HCG)、孕酮(Progesterone, P)]、Th1/Th2细胞因子[白细胞介素2(interleukin-2,IL-2)、白细胞介素4(interleukin-4,IL-4)、γ干扰素(Interferon-γ,INF-γ)]改善情况,统计两组治疗总有效率、妊娠结局及不良反应发生率。结果 两组治疗后妊娠期阴道流血、小腹坠胀或疼痛、腰酸痛、膝关节酸软积分,IL-2、INF-γ水平均低于治疗前(P<0.05),且观察组治疗后以上中医证候积分和IL-2、INF-γ水平均低于对照组(P<0.05);两组治疗后IL-4水平均高于治疗前(P<0.05),且观察组治疗后IL-4水平高于对照组(P<0.05);观察组总有效率为(91.7%,55/60),高于对照组(75.0%,45/60)(P<0.05);观察组足月分娩率为(85.0%,51/60),高于对照组(56.7%,34/60)(P<0.05);观察组不良反应发生率为3.3%,低于对照组(25.0%)(P<0.05)。结论 补肾固胎方联合黄体酮注射液能够有效调节肾虚型早期先兆流产患者妊娠激素水平和Th1/Th2细胞因子水平,纠正免疫功能紊乱,降低患者流产率,提高足月妊娠率,改善妊娠结局。

阿胶珠结合黄体酮用于妊娠早期气血亏虚证先兆流产患者的临床效果

目的 分析妊娠早期气血亏虚证先兆流产患者应用阿胶珠结合黄体酮治疗的效果。方法 选取2022年7月至2023年12月江西省妇幼保健院收治的72例妊娠早期先兆流产患者为研究对象,均符合中医气血亏虚证诊断标准,采用随机数字表法将其分为对照组(36例)观察组(36例)。对照组采用单一黄体酮治疗,观察组采用阿胶珠结合黄体酮治疗,比较两组患者中医证候积分、激素水平、保胎成功率及不良反应发生率。结果 治疗前两组患者的中医证候积分、激素水平比较,差异无统计学意义(P>0.05),治疗后观察组中医证候积分低于对照组,观察组血清雌二醇(E_(2))水平、人绒毛膜促性腺激素(HCG)水平、保胎成功率高于对照组,差异有统计学意义(P<0.05);治疗后,两组患者孕酮激素(P)水平比较,差异无统计学意义(P>0.05);观察组不良反应总发生率低于对照组,差异有统计学意义(P<0.05)。结论 阿胶珠结合黄体酮治疗妊娠早期气血亏虚证先兆流产患者效果确切,能够快速改善症状,提高血清雌二醇和绒毛膜促性腺激素水平,提高保胎成功率的同时减少不良反应发生。

子宫腔超声指标预测药物流产治疗早期稽留流产的效果

目的:探讨子宫腔超声指标预测早期稽留流产药物治疗效果的价值。方法:收集自2018年1月-2023年12月本院早期稽留流产患者药物治疗后24h子宫内膜厚度、宫腔不均质回声团大小、宫腔内多普勒血流等子宫腔超声指标,根据治疗结局分为完全流产组和不完全流产组,分析预测药物治疗不全的超声指标。结果:药物治疗完全流产组和不完全流产组的体重指数、既往妊娠丢失病史、人工流产次数、子宫内膜厚度,宫腔不均质回声团的平均直径的差异有统计学意义(t=-4.880,χ^(2)=22.587,χ^(2)=21.018,t=-5.081,t=-4.890;P<0.001),两组的子宫多普勒血流情况的差异也有统计学意义(χ^(2)=8.501,P<0.05)。多因素logistic回归分析显示,子宫内膜厚度是药物流产不全的独立危险因素(OR=1.194,95%CI 1.116~1.278)。超声子宫内膜厚度预测药物流不全的最佳临界值为19.1mm,敏感度为60.5%,特异度为95.0%。结论:药物治疗后24h内经阴道超声子宫内膜厚度与药物流产不全有关,可作为早期稽留流产药物治疗效果的参考指标。

安胎汤联合西药治疗早期先兆流产临床研究

目的:观察安胎汤联合西药治疗早期先兆流产的临床疗效。方法:采用随机数字表法将164例早期先兆流产患者分为对照组、试验组各82例。对照组予以黄体酮注射液、地屈孕酮治疗,试验组在对照组基础上加用安胎汤治疗,2组均治疗2周。比较2组治疗前后基础体温、激素水平、中医证候积分,评估2组临床疗效及妊娠结局。结果:治疗后,试验组总有效率84.15%,高于对照组70.73%(P<0.05)。治疗后,2组血清孕酮(P)、雌二醇(E_(2))、β-人绒毛膜促性腺激素(β-HCG)及基础体温水平较治疗前升高(P<0.05),中医证候积分降低(P<0.05);试验组治疗后P、E_(2)、β-HCG及基础体温水平高于对照组(P<0.05),中医证候积分低于对照组(P<0.05)。试验组流产率低于对照组(P<0.05),足月产率高于对照组(P<0.05)。2组早产率比较,差异无统计学意义(P>0.05)。结论:安胎汤联合西药治疗早期先兆流产疗效确切,能够调节患者激素水平,改善妊娠结局,提高保胎效果。

血清miRNA-146、LPS、ROS在早期妊娠胚胎丢失患者中的水平及临床意义

目的探讨血清微小RNA(miRNA)-146、脂多糖(LPS)和活性氧(ROS)在早期妊娠胚胎丢失(EPEL)患者中的水平及临床意义。方法选取2021年3月至2023年3月广东省东莞市妇幼保健院收治的100例EPEL患者作为研究组,另外选取同期在广东省东莞市妇幼保健院就诊的100例正常妊娠女性作为对照组,检测并比较研究组和对照组血清指标水平。培养HTR-8/SVneo细胞,按照不同转染方式分成miRNA-146抑制剂组、miRNA-146模拟物组及NC组。比较miRNA-146抑制剂组、miRNA-146模拟物组Toll样受体4(TLR4)蛋白和核因子-κB(NF-κB)蛋白水平,比较NC组、miRNA-146模拟物组和miRNA-146抑制剂组miRNA-146水平及HTR-8/SVneo细胞的凋亡率,比较不同水平LPS处理的HTR-8/SVneo细胞生长活力。采用Pearson相关分析EPEL患者miRNA-146水平与ROS、LPS、白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α、TLR4蛋白和NF-κB蛋白水平的相关性。结果研究组LPS、ROS、IL-6和TNF-α水平高于对照组,且雌二醇、孕酮、miRNA-146水平低于对照组,差异均有统计学意义(P<0.05)。miRNA-146模拟物组miRNA-146水平高于miRNA-146抑制剂组和NC组,差异均有统计学意义(P<0.05)。miRNA-146模拟物组TLR4蛋白、NF-κB蛋白水平低于miRNA-146抑制剂组,差异均有统计学意义(P<0.05)。不同水平LPS(8、12、16、20μg/mL)处理的HTR-8/SVneo细胞生长活力低于20μg/mL LPS+miRNA-146模拟物处理的HTR-8/SVneo细胞生长活力,差异均有统计学意义(P<0.05)。miRNA-146抑制剂组HTR-8/SVneo细胞的凋亡率高于NC组和miRNA-146模拟物组,且NC组高于miRNA-146模拟物组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,EPEL患者miRNA-146水平与ROS、LPS、IL-6、TNF-α、TLR4蛋白和NF-κB蛋白水平呈负相关(r=-0.737、-0.614、-0.712、-0.729、-0.739、-0.708,P<0.05)。结论EPEL患者血清中miRNA-146水平明显下降,并与LPS、ROS、IL-6、TNF-α的水平呈负相关,可能是EPEL发生的影响因素之一,有望为临床预测孕妇发生EPEL提供新思路。

阴道菌群失调与早孕流产风险的关系

目的 探讨阴道菌群失调与早孕流产风险的关系。方法 选取2021年5月至2022年3月在陕西中医药大学第二附属医院妇科就诊的147名孕妇为研究对象,其中病例组为早孕流产(妊娠12周内确诊)患者(n=64),对照组为健康足月分娩者(n=83)。采用基于16S rRNA基因测序,对病例组与对照组研究对象妊娠早期的阴道菌群组成进行比较及分析。结果 病例组与对照组在年龄、体质量指数、吸烟者人数、妊娠情况、既往流产、胎龄、阴道pH值的分布比较差异均无统计学意义(P>0.05)。在总样本队列中鉴定出244种细菌。样本分为5个主要类型,其中菌落状态类型(CST)Ⅰ的特征是卷曲乳酸杆菌占优势,CSTⅡ的特征是加氏乳酸杆菌占优势,CSTⅢ的特征是内乳酸杆菌占优势,CSTⅤ的特征是詹氏乳酸杆菌占优势,而CSTⅣ的特征是乳酸杆菌属的丰度较低。在CSTⅣ型群落中观察到了最高的α多样性和丰度。与对照组相比,病例组的阴道菌群组成中乳酸杆菌属消耗的比例显著增加[25.0%(16/64)vs. 6.0%(5/83),χ^(2)=10.626,P<0.01]。病例组中CSTⅣ型为主阴道菌群组成的比例明显增加[29.7%(19/64)vs. 12.0%(10/83),χ^(2)=7.100,P<0.01]。病例组的逆辛普森指数(2.81±1.20 vs. 1.41±0.48)和丰度(28.06±15.08 vs. 17.13±6.83)均明显高于对照组(t值分别为4.641、3.523,P<0.05)。当从病例组中排除报告阴道出血评分>1的孕妇时,这种相关性仍然存在。与稽留流产相比,不完全/完全流产的阴道菌群组成中乳酸杆菌属消耗的比例显著增加[19.2%(10/52)vs. 75.0%(9/12),χ^(2)=14.527,P<0.01]。不完全/完全流产中CSTⅣ型为主阴道菌群组成的比例显著增加[23.1%(12/52)vs. 75.0%(9/12),χ^(2)=11.923,P<0.01]。结论 高度多样性的阴道菌群群落和乳酸杆菌减少是早孕流产的危险因素。

彩色多普勒超声检测孕早期先兆流产患者子宫动脉血流参数对预后的预测价值

目的分析孕早期先兆流产(TA)患者子宫动脉血流参数对预后的预测价值。方法纳入82例孕早期TA患者为研究组,同期健康妊娠人群102例为对照组,两组均采用彩色多普勒超声检测子宫动脉血流参数,比较不同分组孕妇的血流参数,分析S/D、RI、PI单独与联合检测预测孕早期TA患者预后的效能。结果对照组、保胎成功组、保胎失败组的S/D、RI、PI水平呈升高趋势(P<0.05)。ROC曲线显示,S/D、RI、PI联合检测对孕早期TA预后的预测价值最高(AUC为0.923,P<0.01)。结论孕早期TA患者的子宫动脉血流参数S/D、RI、PI均较高,联合检测子宫动脉血流参数对预后具有较高的预测价值。

补肾健脾方对早期先兆流产患者阴道微生态及免疫功能的影响

目的:观察地屈孕酮联合补肾健脾方对早期先兆流产患者性激素水平、阴道微生态、免疫功能、妊娠结局等指标的影响。方法:将130例肾虚型早期先兆流产患者随机分成观察组、对照组,每组65例。对照组予地屈孕酮口服,观察组在对照组治疗的基础上加用补肾健脾方颗粒,两组疗程均为2周。观察并比较两组患者治疗前后中医证候积分变化情况、血清性激素水平、阴道微生态变化情况、阴道肿瘤坏死因子α(TNF-α)、白细胞介素4(IL-4)水平以及妊娠结局。疗程结束后比较两组患者临床疗效,随访统计两组患者妊娠结局。结果:治疗后两组患者中医证候积分、TNF-α水平均较治疗前降低,且观察组低于对照组,差异有统计学意义(均P<0.01)。治疗后两组患者血清人绒毛膜促性腺激素(β-HCG)、雌二醇(E2)、孕酮(P)、IL-4水平均高于治疗前,且观察组高于对照组,差异有统计学意义(均P<0.01)。治疗后观察组正常阴道微生态的患者多于对照组,细菌性阴道炎(BV)、滴虫性阴道炎(TV)、外阴阴道假丝酵母菌病(VVC)清洁度异常者少于对照组,阴道pH值较观察组下降。观察组临床总有效率为93.4%高于对照组的75.0%,差异有统计学意义(P<0.05)。结论:地屈孕酮联合补肾健脾方能明显缓解早期先兆流产患者临床症状,具有良好的保胎效果,其机制与改善性激素水平、阴道微生态以及免疫状态有关。

CNV结合STR分型技术检测孕早期流产组织潜在葡萄胎效果及风险因素分析

目的:评估基因组拷贝数变异测序(CNV-seq)结合短串联重复序列(STR)多态性分析技术在检测孕早期(≤9周)流产物组织中潜在葡萄胎病例的应用效果.方法:收集2021年1月-2022年12月行孕早期流产组织CNV-seq结合STR多态性检测病例114例,其中部分新鲜绒毛组织进行CNV-seq结合STR多态性检测,部分组织行病理学检测.比较两种检测方法结果,并分析潜在葡萄胎病例的临床特征和影响因素.结果:CNV-seq结合STR多态性检测共检出染色体异常病例28例,阳性率为24.6%,其中单亲二倍体(UPD)8例,占阳性病例28.6%;病理学检出葡萄胎病例12例,阳性率为10.5%,其中完全性葡萄胎(CHM)10例,占阳性病例的83.3%.两种检测方法的结果一致率为89.5%,Kappa值为0.75,两种方法具较好一致性.潜在葡萄胎病例与非葡萄胎病例在年龄、孕次、流产次、β-hCG水平、超声表现等方面有差异,其中年龄、β-hCG水平和超声表现是潜在葡萄胎危险因素(均P<0.05).结论:CNV-seq结合STR多态性分析技术能有效检测孕早期流产物组织中潜在葡萄胎病例,有助于指导临床治疗和避免再次流产.