先兆流产合并绒毛膜下血肿妊娠结局的相关性研究.docVIP

先兆流产合并绒毛膜下血肿妊娠结局的相关性研究 【摘要】目的：通过对先兆流产合并绒毛膜下血肿的患者回顾性研究，从而探讨影响绒毛膜下血肿生成的相关因素及先兆流产合并绒毛膜下血肿对妊娠结局的影响。方法：选取2006年1月～2009年12月因早孕先兆流产在我院住院保胎治疗的患者，将单纯先兆流产者设为对照组，将先兆流产合并绒毛膜下血肿者设为研究组，根据超声下提示血肿的大小将研究组分为轻度及重度两组。 结果：3组间患者年龄无差异( P0.05);随着患者宫腔积血量的加重，其辅助生殖受孕率升高、住院天数及其阴道出血时间相应延长，差异有显著性(P0.05);对照组与轻度组保胎成功率无差异(P0.05)，重度积血组的保胎成功率较前两组低，差异有显著性(P 0.05);随着宫腔积血的加重，其女婴的出生率升高，3组间差异有显著性(P0.05);重度组新生儿的平均体重较对照组及轻度组低，差异有显著性(P0.05)。结论： 辅助生殖技术是影响绒毛膜下血肿生成的因素，大量的绒毛膜下血肿可影响先兆流产的妊娠结局。在临床工作中，对于先兆流产的患者应尽早发现其绒毛膜下血肿情况，及时给予止血等保胎治疗，阻止血肿的进一步加重。 【关键词】 先兆流产;绒毛膜下血肿;妊娠结局;胎儿性别 [ABSTRACT] Objective：To explore the effect of threatened abortion complicated with subchorionic hematoma on pregnant outcomes. Methods： A total of 338 women with threatened abortion in the first trimester， who were admitted from January 2006 to December 2009， were divided into two groups： the observed group with subchorionic hematoma and the control group. And the patients in observed group were further divided into the mild group and the severe group according to the size of the hematoma detected by ultrasound scanning. Results： No statistical difference was found in age among the three group (P0.05). Compared with the control group， the observed group had significantly higher rates of assistant conception， longer time of hospitalization and vaginal bleeding (P0.05). There was no significant difference in success rate of abortion prevention between the control group and the mild group (P0.05)， but the severe group had the lowest rate， the highest birth rate of female infants and the lowest median birth weight (P0.05). Conclusions： Assistant reproductive technology has effect on the development of subchorionic hematoma which is adversely associated with the outcome of threatened abortion. And subchorionic hematoma should be detected and treated as early as possible. [KEY WORDS] Threatened abortion; Subchorionic hematoma; Outcome of pregnancy; Gender of fetus 先兆流产是妊娠早期常见的病理临床表现，以阴道出血、腹痛为主要症状，大约占妊娠的15%～20%[1]。近年随着超声技术的不断发展， 对有阴道出血症状的先兆流产妇女， 进行常规B