初孕药物流产对再孕影响分析

目的 探讨初孕药物流产对再次怀孕的影响.方法 采用前瞻性调查方法对126例有药物流产史的初孕妇女及260例有人工流产史初孕妇女进行比较,随访足月分娩结局.结果 因胎盘引起的并发症,药物流产组明显低于人工流产组(P<0.01);产后出血发生率,药物流产组也明显低于人工流产组(P<0.01).结论 初孕妇女药物流产后再次怀孕分娩因胎盘引起的并发症比人工流产后再次怀孕分娩者少,且有较大的安全性.     

初孕妇女药物流产与负压吸宫流产对再妊娠影响的对比观察

探讨初孕妇女人工流产对再妊娠的影响。采用前瞻性调查方法对126例有药物流产史及260例有负压吸宫流产史的初孕妇女进行比较,随访其妊娠分娩结局。结果表明:因胎盘引起的并发症,药物流产组明显低于负压吸宫流产组(P<0.01);产后出血发生率,药物流产组亦明显低于负压吸宫流产组(P<0.05)。提示:初孕妇女药物流产后再次妊娠分娩时因胎盘引起的并发症低于负压吸宫流产者,有较大的安全性。     

初孕不同流产方式对再次妊娠母婴结局影响的研究

目的探讨药物流产或人工流产（刮宫术）对再次妊娠及母婴的影响。方法将初孕有一次药物流产史的健康孕妇120例分为A1组,初孕〉1次药物流产史的健康孕妇70例分为A2组,初孕有一次人工流产（刮宫术）史的健康孕妇120例分为B1组,初孕〉1次人工流产（刮宫术）史的健康孕妇60例分为B2组,孕前无流产史的健康孕妇随机选择120例分为对照组C,分析3组孕妇病例随访资料。结果除先兆流产外,药物流产组与对照组再次妊娠的孕期,围生期及新生儿情况差异均无统计学意义（P〉0.05）,与人工流产组相比,药物流产组与对照组胎盘粘连、胎盘残留、胎盘植入和产后出血发生率均较低（P〈0.05）。一次以上人工流产组胎盘植入,胎盘粘连和早产发生率明显高于1次人流组（P〈0.05）,而药流组妊娠并发症的发生率与药流次数无明显关联。结论药物流产对再次妊娠母婴的影响小于人工流产,相对更安全,为中止非意愿妊娠首选,但仍可能引起某些并发症,人工流产后再次妊娠并发症发生率与人工流产次数有关,因此仍要大力普及避孕知识,提倡安全妊娠和分娩。     

初孕药物流产对再次妊娠的影响

目的：探讨药物流产对再次妊娠的影响。方法：采用回顾性调查方法，对268例有药物流产史的初孕妇女，623例有人工流产史及329例无流产史的初孕妇女进行对照分析。结果；药物流产组胎盘粘连和产后出血的发生率低于人工流产组（P＜0．05），胎盘粘连、产后出血、先兆流产和早产的发生率高于无流产组（P＜0．05）。结论：药物流产是比人工流产安全的避孕失败补救措施。但药物流产后再次妊娠并发症增加。     

人工流产和药物流产对再次妊娠发生孕产期并发症的影响探析

目的:分析人工流产和药物流产对再次妊娠发生孕产期并发症的影响.方法:选择2010年1月-2015年12月期间我院收治的250例流产孕妇作为研究对象,根据流产史方式不同随机将患者分为人工流产组(114例)和药物流产组(136例),另外选择我院无流产史孕妇120例作为对照组,观察对比三组孕妇孕产期并发症发生情况.结果:人工流产组和药物流产组孕期前置胎盘、先兆流产及产期胎盘粘连、胎盘残留、产后出血发生率明显高于对照组(p<0.05);人工流产组孕期前置胎盘、先兆流产及产期胎盘粘连、胎盘残留、产后出血发生率明显高于药物流产组(p<0.05).结论:早期妊娠采用药物流产安全性更高,会减少再次妊娠孕产期的并发症发生情况.     

初孕药物流产对再次妊娠的影响

目的 探讨药物流产对再次妊娠的影响。方法 采用回顾性调查方法,对 268例有药物流产史的初孕妇女,623例有人工流产史及329例无流产史的初孕妇女进行对照分析。结果 药物流产组胎盘粘连和产后出血的发生率低于人工流产组(P<0.05),胎盘粘连、产后出血、先兆流产和早产的发生率高于无流产组(P<0.05)。结论 药物流产是比人工流产安全的避孕失败补救措施。但药物流产后再次妊娠并发症增加。     

不同流产方式和次数对再次妊娠分娩的影响

目的:探讨不同流产方式和次数对再次妊娠分娩的影响。方法:回顾性分析2009年7月~2013年7月入住武汉市第五医院的100例孕妇的临床资料,其中50例孕妇有人工流产史,50例孕妇有药物流产史。比较两组孕妇再次妊娠结局及并发症的发生情况。结果:人工流产史组妊娠期高血压疾病、早产、剖宫产、新生儿低血糖、胎儿窒息及胎儿畸形发生率(26.00%、18.00%、30.00%、24.00%、26.00%及44.00%)均显著高于药物流产史组(12.00%、8.00%、12.00%、10.00%、8.00%及16.00%);两组流产≥2次孕妇胎盘异常及产后出血发生率明显高于流产1次的孕妇(P<0.05)。结论:有人工流产史以及流产次数≥2次对再次妊娠结局及分娩有十分重要的影响,应积极做好避孕工作并尽量减少计划外妊娠。     

初孕妇女药物流产对再妊娠的影响

目的:探讨初孕妇女药物流产对再妊娠的影响。方法:采用回顾性调查方法对200例有药物流产史的初孕妇女及200例无流产史的初孕妇进行比较,随访妊娠分娩结局。结果:两组妊娠病理发生情况(孕早期先兆流产率,妊娠高血压综合征、过期妊娠、胎膜早破、前置胎盘),两组胎儿情况(胎儿体重、畸形率、Apgar评分)比较无明显差异。结论:初孕妇女药物流产后对再次妊娠的影响不显著。     

633例未产妇药物与人工流产后再次妊娠安全性对比分析

<正> 近年来,流产作为避孕失败后补救措施,无论是药物流产及人工流产,因其安全、简便已广泛用于临床。但未产妇人工流产后再次妊娠分娩时并发症高于无人工流产者。药物流产因不是机械干扰官腔,是否对再次妊娠有影响。本研究采用前瞻性对比方法对633例未产妇药物人工流产后再次妊娠进行了系统观察,并进行对比分析,现报道如下。     

人工流产类型对再次妊娠产妇妊娠期并发症及母儿结局的影响

目的 观察人工流产类型对再次妊娠产妇妊娠期并发症及母儿结局的影响。方法 选取2016年10月至2022年10月于南京大学医学院附属苏州医院分娩的有人工流产史的初产妇580例,将药物流产史产妇纳入药物流产组(n=300),手术流产史产妇纳入手术流产组(n=280),另外选取同期无流产史的初产妇280例作为对照组。比较3组产妇妊娠期并发症发生情况、产妇分娩结局及新生儿评分。结果 药物流产组与手术流产组的先兆流产率高于对照组,手术流产组的胎盘前置、胎膜早破、产后出血、胎盘粘连及胎盘残留发生率高于药物流产组与对照组(P<0.05),同时药物流产组妊娠期并发症总发生率低于手术流产组(P<0.05)。3组产妇分娩结局中的剖宫产以及死胎率之间的差异无统计学意义(P>0.05),药物流产组与手术流产组产妇早产比例高于对照组(P<0.05)。3组新生儿的体重、身高及1 min Apgar评分之间的差异无统计学意义(P>0.05),药物流产组与手术流产组5 min Apgar评分低于对照组(P<0.05),药物流产组与手术流产组之间的差异无统计学意义(P>0.05...     

妊娠期心理压力与流产关系研究

目的：了解妊娠期心理压力与流产的关系,探索妊娠期心理压力源,为做好孕妇的心理保健工作提供依据。方法：随机抽取就诊的早期自然流产患者及正常早孕妇女534名,进行现场问卷调查。结果：流产组的压力水平（24.01±5.84）明显高于正常早孕妇女（20.95±6.74,P〈0.01）,在怀孕症状、子代健康、父母角色认同、家庭关系、社会关系、工作等六个方面因素引发的心理压力水平均高于正常早孕妇女（P〈0.05）,妊娠期心理压力是流产的危险因素（β=0.02,〈0.05）,其中孕期症状引发心理压力影响最为显著（β=1.12,P〈0.01）,同时流产可能增加妊娠期心理压力（=β3.81,P〈0.01）。结论：宁波市流产孕妇心理压力高于正常早孕妇女,流产可能增加孕妇妊娠期心理压力,妊娠期高心理压力水平是引起流产危险因素,妊娠期主要心理压力来自妊娠期临床症状和担心子代健康。     

Risks of repeated miscarriage

There is a lack of well-designed epidemiological studies of possible risk factors for repeated miscarriage. In this Swedish population-based case-control study, we investigated the association between sociodemographic and anthropometric factors, obstetric history and life-style factors, with respect to the risks of first-trimester repeated miscarriage. Information on maternal characteristics was collected through in-person interviews. Plasma blood samples were analysed for cotinine and folate concentrations. Adjusted odds ratios (OR) with 95% confidence interval [CI] were used to estimate the relative risk of repeated miscarriage. The risks of repeated miscarriage were increased for women aged > or = 35 years (adjusted OR 2.9 [95% CI 1.4, 5.8]), as well as for women aged < or = 24 years (OR 2.8 [95% CI 1.1, 6.8]). Women with a history of at least one preceding miscarriage prior to the two index pregnancies, women reporting prolonged time to conceive, and women with a history of myoma, faced a more than fourfold increased risk of repeated miscarriage. Smokers were at an increased risk of repeated miscarriage (OR 2.1 [95% CI 1.1, 4.1]). Among non-smoking women with high caffeine intake, there was an increased risk of repeated miscarriage, whereas there was no such association among smokers. Low plasma folate levels were not associated with increased risks.     

The effect of caffeine consumption and nausea on the risk of miscarriage

Evidence for a harmful effect of caffeine intake on risk of miscarriage (spontaneous abortion) is inconsistent and nausea during pregnancy has been claimed to explain any association seen. The objective of this analysis was to determine whether caffeine consumption both before and during pregnancy influenced the risk of miscarriage in a group of pregnant women in the UK. We examined the association with maternal caffeine intake in a case-control study of 474 nulliparous women. Participants were recruited during the years 1987-89 from the Royal Berkshire Hospital in Reading and from a large group practice situated within the hospital's catchment area. Cases were 160 women with a clinically diagnosed miscarriage and controls were 314 pregnant women attending for antenatal care. Information on coffee/tea/cola consumption and potential confounders was collected by interview and caffeine content was assigned to individual drinks according to published data on caffeine content of beverages. Compared with a maternal caffeine intake of < 151 mg/day, we found evidence that caffeine consumption > 300 mg/day doubled the risk of miscarriage. Adjusted odds ratios were 1.94 [95% CI 1.04, 3.63] for 301-500 mg/day and 2.18 [95% CI 1.08, 4.40] for > 500 mg/day. This effect could not be explained by nausea in pregnancy. Nausea appeared to be strongly independently associated with a reduced risk of miscarriage (test for trend P < 0.0001). There was no evidence that prepregnancy caffeine consumption affected the risk. Our results indicate that high caffeine consumption during pregnancy (>300 mg/day), in particular coffee consumption, is an independent risk factor for increased risk and nausea is an independent protective factor for a lower risk of miscarriage.     

Determinants of depressive symptoms in the early weeks after miscarriage.

OBJECTIVES. We tested whether and under what conditions miscarriage increases depressive symptoms in the early weeks following loss. METHODS. We interviewed 232 women within 4 weeks of miscarriage and 283 pregnant women and 318 community women who had not recently been pregnant. Depressive symptoms were measured with the Center for Epidemiologic Studies Depression (CES-D) Scale. RESULTS. Among women who had miscarried, the proportion who were highly symptomatic on the CES-D was 3.4 times that of pregnant women and 4.3 times that of community women. Among childless women, the proportion of women who had miscarried who were highly symptomatic was 5.7 times that of pregnant women and 11.0 times that of community women. Women who had miscarried were equally depressed regardless of length of gestation; among pregnant women, depressive symptoms declined with length of gestation. Among women who had miscarried, symptom levels did not vary with attitude toward the pregnancy; among pregnant women, depressive symptoms were elevated in those with unwanted pregnancies. Prior reproductive loss and advanced maternal age (35+ years) were not associated with symptom levels in any cohort. CONCLUSIONS. Depressive symptoms are markedly increased in the early weeks following miscarriage. This effect is substantially modified by number of living children, length of gestation at loss, and attitude toward pregnancy.     

Circulating chemokine levels and miscarriage

Evidence suggests that chemokines, proteins involved in regulation of inflammation and immune response, may have a regulatory function in pregnancy. The authors hypothesized that circulating levels of chemokines are associated with increased risk of miscarriage. Serum samples were obtained from women in the Collaborative Perinatal Project cohort who had had a miscarriage (n=439) and controls (n=373) matched by gestational age at sample collection. Concentrations of interleukin 8, epithelial cell-derived neutrophil-activating peptide (ENA)-78, macrophage inhibitory protein (MIP)-1alpha, MIP-1beta, monocyte chemotactic protein 1, and RANTES (regulated upon activation, normal T-cell-expressed, and secreted) were determined by multiplex assays, and values were standardized using the standard deviation among controls. Conditional logistic regression was used to model the relation between chemokine levels and risk of miscarriage. In multivariable analysis using all available data, the authors did not observe significant associations between any of the evaluated chemokines and miscarriage risk. In analyses using subsets of the study population based on the collection-outcome interval, elevated ENA-78 levels were associated with increased risk of miscarriage as the collection-outcome interval increased; the adjusted odds ratio was 1.25 (95% confidence interval: 1.04, 1.49) for samples collected more than 35 days prior to pregnancy outcome. The observation regarding ENA-78, which has roles in regulation of angiogenesis and leukocyte recruitment, suggests a possible role for this chemokine as an early indicator of miscarriage risk.     

Aspirin use and miscarriage risk

BACKGROUND: Recent research has found nonsteroidal antiinflammatory drugs, including aspirin, to increase the risk of miscarriage. The objective of the present study was to evaluate the association between aspirin use and miscarriage. METHODS: We conducted a case-control study using data from the Collaborative Perinatal Project. This prospective cohort study recruited approximately 54,000 pregnant women at 12 sites in the United States from 1959 to 1965. Women who had miscarriages (n = 542) were matched by clinic and time in pregnancy when they came under observation to 2587 women who had live births. Participants were interviewed at each prenatal visit. Data on aspirin use were collected prospectively by in-person interviews and medical record review. Aspirin use among controls was considered only for the duration of pregnancy when the matched cases remained pregnant. The outcome of interest was miscarriage, defined as spontaneous pregnancy loss at less than 140 days from the last menstrual period. RESULTS: Twenty-nine percent of cases and 34% of controls used aspirin during pregnancy. Aspirin use was not associated with an increased risk of miscarriage. Adjusted odds ratios ranged from 0.64 to 0.92 (95% confidence intervals = 0.48-1.38) for individual lunar months and combinations of lunar months. CONCLUSIONS: Use of aspirin during pregnancy is not associated with an increased risk of miscarriage.     

3种不同方法用于终止早孕的临床观察

目的 :探讨子宫内膜微型导管法、传统负压吸宫术及药物流产 (药流 )等 3种不同方法用于终止早孕的临床应用价值。方法 :对 150例孕 42～ 49d的早孕妇女分别采用子宫内膜微型导管法、传统负压吸宫术及药物流产等 3种不同方法终止妊娠 ,观察完全流产率、术中疼痛、出血量、术后阴道流血时间等。结果 :完全流产率 ,微管组与药流组比较 ,有显著性差异 (P<0 .0 5) ,与常规人流组比较无显著性差异 (P>0 .0 5) ;微管组的无痛率较常规人流组、药流组明显增高 (P<0 .0 0 5) ;出血量及术后阴道流血时间相比 ,微管组较常规人流组、药流组明显减少 (P<0 .0 0 5)。结论 :子宫内膜微型套管法终止早孕具有手术简单、病人痛苦小、术后恢复快等优点 ,值得进一步推广和应用     

Managing miscarriage: the management of the emotional sequelae of miscarriage in training practices in the West of Scotland

Miscarriage is a very common event which is rarely a medical emergency, and which, from a biomedical perspective, may justifiably be viewed as a 'normal' complication of early pregnancy. From the mother's point of view however, the loss of a wanted pregnancy may be viewed quite differently. A number of studies have identified significant levels of dissatisfaction with the medical care which women have received at the time of a miscarriage. This paper describes a survey of the management of miscarriage by general practitioner trainees and trainers in the West of Scotland and on the basis of responses to a series of MEQ-type questions, indicates GPs views on the importance of counselling, sympathetic listening and good information in this area. The translation of these attitudes and beliefs into practice is, of course, a different issue, and one which may be affected by the task-oriented approach of the new contract.     

Role of Chlamydia trachomatis in miscarriage

To determine the role of Chlamydia trachomatis in miscarriage, we prospectively collected serum, cervicovaginal swab specimens, and placental samples from 386 women with and without miscarriage. Prevalence of immunoglobulin G against C. trachomatis was higher in the miscarriage group than in the control group (15.2% vs. 7.3%; p = 0.018). Association between C. trachomatis-positive serologic results and miscarriage remained significant after adjustment for age, origin, education, and number of sex partners (odds ratio 2.3, 95% confidence interval 1.1-4.9). C. trachomatis DNA was more frequently amplified from products of conception or placenta from women who had a miscarriage (4%) than from controls (0.7%; p = 0.026). Immunohistochemical analysis confirmed C. trachomatis in placenta from 5 of 7 patients with positive PCR results, whereas results of immunohistochemical analysis were negative in placenta samples from all 8 negative controls tested. Associations between miscarriage and serologic/molecular evidence of C. trachomatis infection support its role in miscarriage.     

Pre-pregnancy predictors linked to miscarriage among Aboriginal and Torres Strait Islander women in North Queensland

Objective : Identify preventable pre‐pregnancy risk factors that may affect the prevalence of miscarriage among a cohort of Australian Indigenous women. Methods: Data from 1,009 Indigenous women of childbearing age who participated in a 1999–2000 health screening program in far‐north Queensland were linked to Queensland hospitalisation data. Women who attended hospital after their health check (censor date: March 2008) for a pregnancy‐related condition were identified. Characteristics associated with becoming pregnant and subsequent miscarriage were analysed using generalised linear models. Results: After adjusting for age and ethnicity, women who became pregnant were more likely to be smokers and to have low red cell folate at baseline. The risk of miscarriage increased with age. Women who reported risky drinking or had elevated gamma‐glutamyl transferase were also at higher risk. After further adjustment for risky drinking, the presence of chlamydia or gonorrhoea before pregnancy was associated with miscarriage. The presence of both infections at baseline compared with women who had no infection, again after further adjustment for risky drinking, was strongly associated with miscarriage; these women had more than a four‐fold increase in risk (PR: 4.57 [2.21–9.46]). Elevated body mass index, high blood pressure and smoking were not statistically significantly associated with risk of miscarriage. Conclusions and implications: A high prevalence of pre‐pregnancy sexually transmitted infections and high rates of risky drinking are associated with miscarriage among young Indigenous women in rural and remote communities in north Queensland.