Carp H, Toder V, Aviram A, Daniely M, Mashiach S, Barkai G
Department of Obstetrics and Gynecology, Sheba Medical Center, Tel Hashomer, Israel.
Fertil Steril. 2001 Apr;75(4):678-82. doi: 10.1016/s0015-0282(00)01801-x.
To assess the chromosomal aberrations in the abortus in recurrent miscarriage and the live birth rate after a euploid or aneuploid miscarriage.
Retrospective analysis.
Tertiary referral unit in university hospital.
PATIENT(S): One hundred sixty-seven patients with 3 to 16 miscarriages before 20 weeks.
INTERVENTION(S): Material collected at curettage from 167 abortuses was analyzed by standard G-banding techniques.
MAIN OUTCOME MEASURE(S): The incidence of aberrations and the outcome of the subsequent pregnancy were assessed according to the embryonic karyotype.
RESULT(S): In this study 125 specimens were successfully karyotyped. Of these, 29% (36 of 125) had chromosome aberrations; 94% of the aberrations were aneuploidy, and 6% were structural. The most prevalent anomalies were chromosome 16, 18, and 21 trisomies, triploidy, and monosomy X. After an aneuploid miscarriage, there was a 68% subsequent live birth rate (13 of 19) compared to the 41% (16 of 39) rate after a euploid abortion.
CONCLUSION(S): The low (29%) incidence of aberrations indicates that alternative mechanisms may be responsible for the majority of recurrent miscarriages. These figures provide a basis for assessing the efficacy of therapy for recurrent miscarriage. If further studies confirm that patients with karyotypically abnormal fetuses have a good prognosis, an informed decision can be made as to whether further investigations and treatment should be undertaken.
评估复发性流产患者流产儿的染色体畸变情况以及整倍体或非整倍体流产后的活产率。
回顾性分析。
大学医院的三级转诊单位。
167例在20周前有3至16次流产的患者。
采用标准G显带技术分析167例流产儿刮宫时收集的材料。
根据胚胎核型评估畸变发生率及后续妊娠结局。
本研究中125份标本成功进行了核型分析。其中，29%（125例中的36例）存在染色体畸变；94%的畸变是非整倍体，6%是结构畸变。最常见的异常是16、18和21号染色体三体、三倍体和X单体。非整倍体流产后，后续活产率为68%（19例中的13例），而整倍体流产后的活产率为41%（39例中的16例）。
畸变发生率较低（29%）表明，大多数复发性流产可能由其他机制引起。这些数据为评估复发性流产的治疗效果提供了依据。如果进一步研究证实核型异常胎儿的患者预后良好，就可以就是否应进行进一步检查和治疗做出明智的决定。
