Zhou Jianjun, Wu Min, Wang Bin, Hou Xiaoni, Wang Junxia, Chen Hua, Zhang Ningyuan, Hu Yali, Sun Haixiang
a Reproductive Medicine Center, Department of Obstetrics and Gynecology, Drum Tower Hospital Affiliated to Nanjing University Medical College , Nanjing , Jiangsu , PR China.
J Matern Fetal Neonatal Med. 2017 Feb;30(4):406-410. doi: 10.1080/14767058.2016.1174682. Epub 2016 Apr 28.
The aim of this retrospective cohort study was to assess the effect of subchorionic hematoma (SCH) on pregnancy outcomes in IVF/ICSI patients.
We retrospectively analyzed 1097 pregnancies achieved by in vitro fertilization and embryo transfer (IVF-ET) or frozen-thawed embryo transfers (FETs) between January 2013 and June 2013 at the IVF center of Nanjing Drum Tower Hospital. The prevalence of SCH was 12.1% in this group (133/1097). We compared the pregnancy outcomes between the SCH group and non-SCH group, while the risk factors for SCH were also evaluated.
There was no significant difference between SCH group and non-SCH group with regard to patients' age, spouse's age, endometrial thickness, miscarriage rate (5.6% versus 6.2%, p > 0.05), second trimester fetus loss rate (5.6% versus 7.7%, p > 0.05) or live birth rate (89.5% versus 86.1%, p > 0.05). While the birth weight in singleton pregnancy in SCH group was significant lower (3207.8 ± 595.7 g versus 3349.2 ± 59.7 g, p = 0.03). SCH was more common in fresh embryo transfer patients than that in FET patients (16.6% versus 5.1%, p < 0.01), fresh embryo transfer was a high risk for SCH with OR 3.67, 95% CI: 2.28-5.90.
We concluded that SCH was associated with lower birth weight in singleton pregnancy, but SCH did not increase pregnancy loss rate in IVF/ICSI patients, and fresh embryo transfer may contribute to SCH onset.
本回顾性队列研究旨在评估绒毛膜下血肿(SCH)对体外受精/卵胞浆内单精子注射(IVF/ICSI)患者妊娠结局的影响。
我们回顾性分析了2013年1月至2013年6月在南京鼓楼医院体外受精中心通过体外受精和胚胎移植(IVF-ET)或冻融胚胎移植(FET)实现的1097例妊娠。该组中SCH的患病率为12.1%(133/1097)。我们比较了SCH组和非SCH组的妊娠结局,同时还评估了SCH的危险因素。
SCH组和非SCH组在患者年龄、配偶年龄、子宫内膜厚度、流产率(5.6%对6.2%,p>0.05)、孕中期胎儿丢失率(5.6%对7.7%,p>0.05)或活产率(89.5%对86.1%,p>0.05)方面无显著差异。而SCH组单胎妊娠的出生体重显著较低(3207.8±595.7g对3349.2±59.7g,p = 0.03)。SCH在新鲜胚胎移植患者中比在FET患者中更常见(16.6%对5.1%,p<0.01),新鲜胚胎移植是SCH的高风险因素,比值比为3.67,95%可信区间:2.28-5.90。
我们得出结论,SCH与单胎妊娠出生体重较低有关,但SCH不会增加IVF/ICSI患者的妊娠丢失率,新鲜胚胎移植可能导致SCH的发生。