Morikawa Mamoru, Yamada Hideto, Kato Emi H, Shimada Shigeki, Yamada Takashi, Minakami Hisanori
Department of Obstetrics and Gynecology, Hokkaido University Graduate School of Medicine, Kita-ku N15 W7, Sapporo 060-8638, Japan.
Hum Reprod. 2004 Nov;19(11):2644-7. doi: 10.1093/humrep/deh451. Epub 2004 Aug 6.
The aim of this study was to assess pregnancy loss patterns in women with repeated miscarriage (RM), according to fetal chromosome karyotypes and aetiologies of RM.
In this cohort study, 168 fetal chromosome karyotypes of miscarriages were investigated. The pregnancy loss patterns were compared between 75 miscarriages from RM women who had a history of two or more consecutive miscarriages and 93 miscarriages from control women whose previous pregnancies ended in live births without a history of RM. By serial ultrasonography, embryo loss (EL) was defined as miscarriage before fetal heat movement was identified and fetal loss (FL) as miscarriage after fetal heat movement was identified. The EL rate was calculated as EL/(EL+FL).
The EL rate (66.7%) in miscarriages with normal karyotypes among RM women (n=42) was higher (P<0.05) than that (45.7%) in controls (n=46), while the EL rate (30.3%) in miscarriages with abnormal karyotypes among RM women (n=33) did not differ from that (25.5%) in the controls (n=47). The EL rate (71.4%) in miscarriages with normal karyotypes among unexplained RM women (n=21) was much higher (P<0.05) than that in the controls.
By evaluating fetal karyotypes, we demonstrated for the first time that EL was predominant in miscarriages with normal karyotype among RM women.
本研究旨在根据胎儿染色体核型及复发性流产(RM)的病因,评估RM女性的妊娠丢失模式。
在这项队列研究中,对168例流产胎儿的染色体核型进行了调查。比较了75例有两次或更多次连续流产史的RM女性的流产情况与93例既往妊娠以活产结束且无RM病史的对照女性的流产情况。通过连续超声检查,胚胎丢失(EL)定义为在识别到胎儿心跳之前发生的流产,胎儿丢失(FL)定义为在识别到胎儿心跳之后发生的流产。EL率计算为EL/(EL+FL)。
RM女性中核型正常流产的EL率(66.7%,n=42)高于对照组(45.7%,n=46)(P<0.05),而RM女性中核型异常流产的EL率(30.3%,n=33)与对照组(25.5%,n=47)无差异。不明原因RM女性中核型正常流产的EL率(71.4%,n=21)显著高于对照组(P<0.05)。
通过评估胎儿核型,我们首次证明在RM女性中,核型正常的流产以EL为主。