Hogge W Allen, Byrnes Abigail L, Lanasa Mark C, Surti Urvashi
Department of Genetics, Magee-Womens Hospital, University of Pittsburgh, PA 15213, USA.
Am J Obstet Gynecol. 2003 Aug;189(2):397-400; discussion 400-2. doi: 10.1067/s0002-9378(03)00700-2.
The objective of this study was to assess the clinical use of routinely karyotyping spontaneous abortion material.
We retrospectively reviewed the records of the Pittsburgh Cytogenetics Laboratory from January 1, 1998, to December 31, 2001, for all tissues from spontaneous losses at 20 weeks' gestation or less for which complete medical records were available.
There were 517 submitted samples of which 28 (5.4%) failed to grow in culture. Overall, 55.8% of samples were abnormal; 52.3% of normal results were male. In samples from pregnancies at 13 weeks or less the rate of abnormality was 69.1%. When analyzed by maternal age, the rate of abnormality for first-trimester losses was 57.2% in women younger than 35 years, and 82.3% in those 35 years or older. There was no difference in the rate of abnormality when comparing first loss with two or more losses, first pregnancy with two or more pregnancies, or the presence or absence of at least one live birth.
Chromosome abnormalities are the cause for pregnancy loss in 50% to 80% of cases, depending on maternal age and gestational age at time of the loss. Karyotyping of spontaneous losses in the first trimester beginning with the patient's second loss provides clinically important etiologic information and decreases the number of evaluations necessary for recurrent pregnancy loss.
本研究的目的是评估对自然流产组织进行常规核型分析的临床应用价值。
我们回顾性分析了匹兹堡细胞遗传学实验室1998年1月1日至2001年12月31日期间所有妊娠20周及以内自然流产组织的记录，这些记录均有完整的医疗档案。
共提交了517份样本，其中28份（5.4%）在培养过程中未生长。总体而言，55.8%的样本存在异常；正常结果中52.3%为男性。在妊娠13周及以内的样本中，异常率为69.1%。按母亲年龄分析，孕早期流产的异常率在35岁以下女性中为57.2%，在35岁及以上女性中为82.3%。首次流产与两次或更多次流产、首次妊娠与两次或更多次妊娠，或有无至少一次活产相比，异常率无差异。
染色体异常是50%至80%自然流产病例的病因，这取决于母亲年龄和流产时的孕周。从患者第二次流产开始，对孕早期自然流产组织进行核型分析可提供重要的临床病因信息，并减少复发性流产所需的评估次数。
