Department of Obstetrics & Gynecology, Iran University of Medical Sciences, Tehran, Iran.
Early Hum Dev. 2010 Mar;86(3):193-6. doi: 10.1016/j.earlhumdev.2010.02.005. Epub 2010 Mar 15.
To evaluate the pregnancy outcome in pregnancies with threatened abortion (miscarriage).
A prospective cohort study was performed on 1000 pregnant women. 500 women (case group), had a history of vaginal bleeding during the first half of pregnancy and the other 500 women (control group), did not have this history. Both groups of women were monitored from 20 weeks of pregnancy up to delivery.
The women of the 2 groups did not have any significant differences according to age, parity or body mass index (BMI). Spontaneous preterm delivery [126 cases (25.2%) vs. 47 cases (9.4%), P=0.001, adj RR=1.4, CI 95%=1.2-1.5], PROM [51 cases (10.2%) vs. 24 cases (4.8%), P=0.02, adj RR=2.1, CI95%=1.2-2.3], placental abruption [20 cases (4%) vs. 7 cases (1.4%) P=0.01, adj RR=1.1, CI 95%=1.01-1.2], were more in the case group. There were no differences between the 2 groups with regard to Preeclampsia, small for gestational age (SGA), and cesarean deliveries. Neonatal weight (in term pregnancies) in the case group was lower than in the control group (3046.4+/-560.8 g vs. 3317.6+/-432 g, P=0.001). There was a significant relationship between the number of bleeding episodes, spontaneous preterm delivery and placental abruption and there was also a significant relationship between the amount of bleeding and placental abruption.
Threatened abortion increases the rate of spontaneous preterm delivery, PROM and placental abruption, and decreases the neonatal weight. Therefore threatened abortion indicates a high risk pregnancy and, as such, demands more serious prenatal care.
评估有先兆流产(流产)史的妊娠的妊娠结局。
对 1000 名孕妇进行前瞻性队列研究。500 名孕妇(病例组)在妊娠前半段有阴道出血史,另外 500 名孕妇(对照组)没有这种病史。两组孕妇均从妊娠 20 周监测至分娩。
两组孕妇的年龄、产次或体重指数(BMI)均无显著差异。自发性早产[126 例(25.2%)与 47 例(9.4%),P=0.001,调整 RR=1.4,95%CI=1.2-1.5]、胎膜早破[51 例(10.2%)与 24 例(4.8%),P=0.02,调整 RR=2.1,95%CI=1.2-2.3]、胎盘早剥[20 例(4%)与 7 例(1.4%),P=0.01,调整 RR=1.1,95%CI=1.01-1.2]在病例组中更为常见。两组间子痫前期、小于胎龄儿(SGA)和剖宫产分娩无差异。病例组新生儿体重(足月妊娠)低于对照组(3046.4+/-560.8 g 与 3317.6+/-432 g,P=0.001)。出血次数、自发性早产和胎盘早剥与出血次数呈显著相关,出血量与胎盘早剥也呈显著相关。
先兆流产增加自发性早产、胎膜早破和胎盘早剥的发生率,降低新生儿体重。因此,先兆流产提示高危妊娠,需要更加认真的产前护理。