复发性流产患者发生先兆流产合并绒毛膜下血肿的临床分析

目的探讨复发性自然流产患者发生早期先兆流产合并绒毛膜下血肿的临床特征、治疗方法及效果。方法将2010年1月至2013年7月就诊的复发性自然流产孕妇早期妊娠期间,出现先兆流产症状且合并绒毛膜下血肿的48例患者作为研究组。选择同期复发性自然流产孕妇早期妊娠期间,仅有先兆流产症状的50例患者作为对照组。记录两组患者入院时血清β-HCG、P、E2,施以相同治疗方案后,观察两组患者症状缓解所需时间、症状基本消失所需时间,并追踪两组患者是否继续妊娠至13周末。结果研究组有73%的患者继续妊娠至13周末,对照组有90%的患者继续妊娠至13周末,差异有统计学意义(P0.05)。两组患者症状缓解时间、症状消失时间比较差异有统计学意义(P0.05),两组患者血清β-HCG、P、E2比较差异无统计学意义(P0.05)。结论 HCG、黄体酮、间苯三酚、止血三联等药物的使用,可缓解复发性自然流产患者早期妊娠期间出现的先兆流产症状。但存在绒毛膜下血肿的患者再次流产的风险较高,预后较差。

The clinical analysis of 48 cases of recurrent spontaneous abortion patients in early pregnancy with threatened abortion and subchorionic hematoma

Objective To explore the clinical features of recurrent spontaneous abortion patients in early pregnancy with threatened abortion and subchorionic hematoma, treatment methods and the effects of treatment. Methods From 2010 to 2013,48 cases of recurrent spontaneous abortion patients in early pregnancy with threatened abortion and subchorionic hematoma were recruited as study group and 50 cases of recurrent spontaneous abortion patients in early pregnancy with threatened abortion were recruited as control group. The serum levels of β-HCG,P and E2 of patients were recorded. Two groups of patients were treated with the same medicine. The symptom remission time and the symptoms disappeared time were observed. And the patients were followed up to 12 weeks. Results 73% patients in the study group the pregnancy continued to 13 weeks, while 90% patients in control group the pregnancy continued to 13 weeks, the difference has statistical significance （P〈0.05）. The remission time and disappear time of symptoms were different in the two groups （P〈 0.05）. The serum levels of β-HCG, P and E2 in two groups were compared, and there was no statistically significant difference between the two groups （P〉0.05）. Conclusions The use of HCG,progesterone,phloroglucinol,aminomethylbenzoie acid, etamsylate, and vitamin C can reduce threatened abortion symptoms of recurrence spontaneous abortion patients during early pregnancy.The risk of miscarriage in recurrence spontaneous abortion patients with subchorionic hematoma is high. Treatment and sufficient communication are very important to this kind of patients.