van Gruting Isabelle M A, Müller Moira A, van Groningen Krijn, Exalto Niek
Department of Obstetrics and Gynaecology, Spaarne Gasthuis, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands.
Department of Clinical Pathology, Spaarne Gasthuis, Spaarnepoort 1, 2134 TM, Hoofddorp, The Netherlands.
Placenta. 2017 May;53:16-22. doi: 10.1016/j.placenta.2017.02.022. Epub 2017 Feb 27.
Reduced chorionic villous vascularization is associated with first trimester miscarriage and second trimester fetal loss. Differences in villous vascularization have been observed in combination with complications in the third trimester of pregnancy. The aim of this study was to investigate whether abnormal morphology and reduced chorionic villous vascularization in first trimester miscarriages are associated with an increased risk on adverse outcome and/or pregnancy complications in subsequent pregnancy. Secondly, to assess the influence of these parameters on the length of the interpregnancy interval and infertility.
In a retrospective cohort study 134 consecutive women who underwent dilatation and curettage for a miscarriage were included. The degree of chorionic villous vascularization in miscarriage tissue was determined by a pathologist. Ultrasound details of these miscarriages and clinical data on the subsequent pregnancy of these women were obtained.
Neither reduced vascularization nor early embryonic arrest in first trimester miscarriages are associated with an increased risk of a subsequent miscarriage or adverse obstetric and perinatal outcome of subsequent pregnancy. Abnormal morphology of the first trimester miscarriage did not influence the time to subsequent pregnancy. A shorter mean interpregnancy interval between miscarriages was observed after miscarriages with reduced chorionic villous vascularization (5.5 vs. 10.7 months; p = 0.051), showing a trend towards an association.
Chorionic villous vascularization and morphology have no influence on subsequent pregnancy outcome. Therefore it remains unknown what aspects of miscarriage are causing the increased risk on subsequent miscarriage and complications in the third trimester of the subsequent pregnancy.
绒毛膜绒毛血管化减少与孕早期流产和孕中期胎儿丢失有关。在妊娠晚期并发症中观察到绒毛血管化存在差异。本研究的目的是调查孕早期流产中绒毛形态异常和绒毛膜绒毛血管化减少是否与后续妊娠不良结局和/或妊娠并发症风险增加有关。其次，评估这些参数对妊娠间隔长度和不孕的影响。
在一项回顾性队列研究中，纳入了134名连续因流产接受刮宫术的女性。由病理学家确定流产组织中绒毛膜绒毛血管化程度。获取这些流产的超声详细信息以及这些女性后续妊娠的临床数据。
孕早期流产中血管化减少或早期胚胎停育均与后续流产风险增加或后续妊娠不良产科和围产期结局无关。孕早期流产的异常形态不影响后续妊娠时间。绒毛膜绒毛血管化减少的流产后，流产之间的平均妊娠间隔较短（5.5个月对10.7个月；p = 0.051），显示出一种关联趋势。
绒毛膜绒毛血管化和形态对后续妊娠结局没有影响。因此，流产的哪些方面会导致后续妊娠晚期流产和并发症风险增加仍不清楚。
