Lazzarin Natalia, Vaquero Elena, Exacoustos Caterina, Bertonotti Elena, Romanini Maria Elisabetta, Arduini Domenico
Department of Obstetrics and Gynecology, Ospedale Fatebenefratelli Isola Tiberina, University of Rome Tor Vergata, Lungotevere degli Angullara 12, Rome. Italy.
Fertil Steril. 2009 Jul;92(1):296-300. doi: 10.1016/j.fertnstert.2008.05.045. Epub 2008 Aug 9.
To determine the effect of different therapeutic approaches on uterine artery blood flow in women with recurrent miscarriage (RM) and impaired uterine perfusion.
Prospective, randomized study.
Department of Obstetrics and Gynecology, University of Rome "Tor Vergata," Italy.
PATIENT(S): Sixty women with unexplained RM and impaired uterine perfusion.
INTERVENTION(S): Patients were randomly assigned to three different therapeutic regimens: 20 patients received a daily dose of 100 mg of aspirin (LDA); 20 patients were treated with omega-3 fatty acids (Omega(3)), 4 g daily; and 20 patients received LDA plus Omega(3).
MAIN OUTCOME MEASURE(S): Doppler measurement of uterine artery pulsatility index (PI) was performed, in the midluteal phase of the cycle, before and after 2 months of therapy.
RESULT(S): All therapeutic regimens induced an improvement in uterine perfusion with a significant reduction of uterine artery PI values. LDA alone or in combination with Omega(3) was found to achieve the highest improvement of uterine blood flow. Omega-3 supplementation was less effective, as reflected by the lower PI values.
CONCLUSION(S): LDA and Omega(3) are effective in improving uterine artery blood flow velocity in women with RM due to abnormal uterine perfusion. Further studies are needed to determine whether the improvement of uterine perfusion may lead to a better pregnancy outcome.
确定不同治疗方法对复发性流产(RM)且子宫灌注受损女性子宫动脉血流的影响。
前瞻性随机研究。
意大利罗马“托尔韦尔加塔”大学妇产科。
60例原因不明的RM且子宫灌注受损的女性。
患者被随机分配至三种不同治疗方案:20例患者每日服用100毫克阿司匹林(LDA);20例患者接受ω-3脂肪酸(Omega(3))治疗,每日4克;20例患者接受LDA加Omega(3)治疗。
在月经周期的黄体中期,治疗前及治疗2个月后,采用多普勒测量子宫动脉搏动指数(PI)。
所有治疗方案均使子宫灌注得到改善,子宫动脉PI值显著降低。单独使用LDA或与Omega(3)联合使用时,子宫血流改善最为显著。补充Omega-3的效果较差,PI值较低即反映了这一点。
LDA和Omega(3)可有效改善因子宫灌注异常导致RM的女性的子宫动脉血流速度。需要进一步研究以确定子宫灌注的改善是否会带来更好的妊娠结局。