复发性自然流产后的妊娠结局

来源 :世界核心医学期刊文摘(妇产科学分册) | 被引量 : 0次 | 上传用户:newbitcom
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The purpose of the present study was to examine the association between sponta neous consecutive recurrent abortions and pregnancy complications such as hypert ensive disorders, abruptio placenta, intrauterine growth restriction and cesarea n section (CS) in the subsequent pregnancy. A population-based study comparing all singleton pregnancies in women with and without two or more consecutive recu rrent abortions was conducted. Deliveries occurred during the years 1988-2002. Stratified analysis, using a multiple logistic regression model was performed to control for confounders. During the study period 154,294 singleton deliveries o ccurred, with 4.9%in patients with history of recurrent consecutive abortions. Using a multivariate analysis, with backward elimination, the following complica tions were significantly associated with recurrent abortions advanced maternal a ge, cervical incompetence, previous CS, diabetes mellitus, hypertensive disorder s, placenta previa and abruptio placenta, mal-presentations and PROM. A higher rate of CS was found among patients with previous spontaneous consecutive recurr ent abortions (15.9%versus 10.9%; OR = 1.6; 95%CI, 1.5-1.7; P <0.001). Anoth er multivariate analysis was performed, with CS as the outcome variable, control ling for confounders such as placenta previa, abruptio placenta, diabetes mellit us, hypertensive disorders, previous CS, mal-presenta-tions, fertility treatme nts and PROM. A history of recurrent abortion was found as an independent risk f actor for CS (OR = 1.2; 95%CI, 1.1-1.3; P < 0.001). About 58 cases of inherite d thrombophilia were found between the years 2000-2002. These cases were signif icantly more common in the recurrent abortion as compared to the comparison grou p (1.2%versus 0.1%; OR = 11.1; 95%CI, 6.5-18.9; P < 0.001). A significant as sociation exists between consecutive recurrent abortions and pregnancy complicat ions such as placental abruption, hypertensive disorders and CS. This associatio n persists after controlling for variables considered to coexist with recurrent abortions. Careful surveillance is required in pregnancies following recurrent abortions, for early detection of possible com plications. The purpose of the present study was to examine the association between sponta neous consecutive recurrent abortions and pregnancy complications such as hypertensive disorders, abruptio placenta, intrauterine growth restriction and cesarea n section (CS) in the subsequent pregnancy. A population-based study comparing comparing all singleton pregnancies in women with and without two or more consecutive recurent abortions been conducted. Deliveries occurred during the years 1988-2002. Stratified analysis, using a multiple logistic regression model was performed to control for confounders. During the study period 154,294 singleton deliveries Using a multivariate analysis, with subsequent elimination, the following complica tions were significantly associated with recurrent abortions advanced maternal a ge, cervical incompetence, previous CS, diabetes mellitus, hypertensive disorder s, placenta previa and abruptio place nta, mal-presentations and PROM. A higher rate of CS was found among patients with previous spontaneous consecutive recurr ent abortions (15.9% versus 10.9%; OR = 1.6; 95% CI, 1.5-1.7; P <0.001) multivariate analysis was performed with CS as the outcome variable, control ling for confounders such as placenta previa, abruptio placenta, diabetes mellit us, hypertensive disorders, previous CS, mal-presenta-tions, fertility treatments and PROM. A history of recurrent Abortion was found as an independent risk f actor for CS (OR = 1.2; 95% CI, 1.1-1.3; P <0.001). About 58 cases of inherite d thrombophilia were found between the years 2000-2002. These cases were signif icantly more common in the recurrent abortion as compared to the comparison grou p (1.2% vs. 0.1%; OR = 11.1; 95% CI, 6.5-18.9; P <0.001) Such as placental abruption, hypertensive disorders and CS. This association persists after controlling for variables considered to coexist with recurrent abortions. Careful surveillance is required in pregnancies following recurrent abortions, for early detection of possible com plications.
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