Tong Stephen, Kaur Anupinder, Walker Susan P, Bryant Valerie, Onwude Joseph L, Permezel Michael
University Department of Obstetrics and Gynaecology, Mercy Hospital for Women, Victoria, Australia.
Obstet Gynecol. 2008 Mar;111(3):710-4. doi: 10.1097/AOG.0b013e318163747c.
To estimate the risk of miscarriage among asymptomatic women after a prenatal visit between 6 and 11 weeks of gestation where proof of fetal viability of a singleton was obtained by office ultrasonography at the same visit.
This was a prospective cohort study performed over 2 years (March 2004-2006) at an antenatal clinic at a large tertiary hospital in Victoria, Australia. Those recruited were 697 asymptomatic women who attended their first antenatal visit between 6 (+2 days) and 11(+6 days) weeks of gestation, where evidence of fetal cardiac activity of a singleton was obtained by office ultrasonography. The main outcome measure was rates of miscarriage, stratified by gestation at presentation.
One case was lost to follow-up. The risk of miscarriage among the entire cohort was 11 of 696 (1.6%). The risk fell rapidly with advancing gestation; 9.4% at 6 (completed) weeks of gestation, 4.2% at 7 weeks, 1.5% at 8 weeks, 0.5% at 9 weeks and 0.7% at 10 weeks (chi(2); test for trend P=.001). Most who miscarried received their ultrasound diagnoses many weeks after their visit; five (45%) were diagnosed in the second trimester, and all but one received their ultrasound diagnoses after 10 weeks of gestation.
For women without symptoms, the risk of miscarriage after attending a first antenatal visit between 6 and 11 weeks is low (1.6% or less), especially if they present at 8 weeks of gestation and beyond. Our data could be used to reassure such women that the probability of progressing to later than 20 weeks of gestation is very good.
评估妊娠6至11周进行产前检查且通过门诊超声检查确认单胎胎儿存活的无症状女性的流产风险。
这是一项前瞻性队列研究，于2004年3月至2006年在澳大利亚维多利亚州一家大型三级医院的产前诊所进行了两年。招募的对象为697名无症状女性，她们在妊娠6（+2天）至11（+6天）周期间进行了首次产前检查，且通过门诊超声检查获得了单胎胎儿心脏活动的证据。主要结局指标为流产率，按就诊时的孕周分层。
1例失访。整个队列中的流产风险为696例中有11例（1.6%）。随着孕周增加，风险迅速下降；妊娠6（整）周时为9.4%，7周时为4.2%，8周时为1.5%，9周时为0.5%，10周时为0.7%（卡方检验；趋势检验P = 0.001）。大多数流产者在就诊数周后才得到超声诊断；5例（45%）在孕中期被诊断，除1例之外，所有病例均在妊娠10周后得到超声诊断。
对于无症状女性，在妊娠6至11周进行首次产前检查后的流产风险较低（1.6%或更低），尤其是在妊娠8周及以后就诊者。我们的数据可用于让此类女性放心，妊娠进展至20周以后的可能性非常大。
