原因不明性复发性流产综合治疗后妊娠结局的研究

目的探讨原因不明性复发性流产患者给予孕激素治疗、主动免疫治疗及被动免疫治疗等综合治疗后的妊娠结局。方法回顾性分析102例原因不明性复发性流产病例,其中综合治疗组(观察组)52例,孕激素治疗组(对照组)50例。综合治疗组孕前及孕早期给予丈夫淋巴细胞免疫治疗,孕早期给予孕激素及免疫球蛋白治疗;孕激素治疗组孕早期仅给予孕激素。追踪两组患者的妊娠结局。结果给予综合治疗患者妊娠成功率达96.2%(50/52),单纯补充孕激素的患者妊娠成功率为40.0%(20/50),两者差异有统计学意义(χ2=6.37,P=0.012)。观察组妊娠期糖尿病的发生率为16.0%(8/50),对照组为25.0%(5/20),差异无统计学意义(P=0.518)。观察组分娩后新生儿Apgar评分7分的发生率为98.0%(49/50),对照组为95.0%(19/20),差异无统计学意义(P=0.915)。新生儿男女比例观察组为1.27∶1,对照组为1.22∶1,差异无统计学意义(P=0.857)。结论给予孕激素、主动免疫治疗及被动免疫治疗等综合治疗方法对于URSA患者是安全、有效的。

Pregnancy outcome of comprehensive treatment of unexplained recurrent spontaneous abortion

Objective To investigate pregnancy outcome of the patients with the unexplained recurrent spontaneous abortion（URSA） who were treated with progesterone, active immunotherapy and passive immunotherapy. Methods 102 patients with unexplained recurrent spontaneous abortion were retrospectively analyzed. 52 patients received comprehensive treatment were treated with husband lymphocyte before and during early pregnancy, and with progesterone and immunoglobulin treatment during early pregnancy. 50 patients received progesterone treatment were treated with progesterone during early pregnancy.Pregnancy outcomes of two groups of patients were compared. Results The success rates of comprehensive treatment and progesterone treatment were 96.2% and 40.0%, respectively, showing a significant difference（P 0.05）. The incidence of gestational diabetes mellitus in the comprehensive treatment group was 16.0%, and was 25.0% of the control group, without significant difference（P=0.518）. The incidence of neonatal Apgar score 7 of the observation group was 98.0% and was 95.0%of the control group, without significant difference（P=0.915）. Neonatal sex ratios of the comprehensive treatment group and control group were 1.27∶1 and 1.22∶1, respectively, showing no significant differences（P=0.857）. Conclusion Given progesterone, active immunotherapy and passive immunotherapy is safe and effective for patients with URSA.