Radwanska E, Maclin V, Rana N, Henig I, Rawlins R, Dmowski W P
Department of Obstetrics and Gynecology, Rush Medical College, Chicago, Illinois.
Int J Fertil. 1988 May-Jun;33(3):162-7.
Progesterone (P) and human chorionic gonadotropin (beta-hCG) levels were measured randomly or serially in 141 single clinical intrauterine pregnancies resulting from treatment of infertility. Seventy (group I) were conceived during spontaneous cycles, 36 (group II) with clomiphene citrate, and 35 (group III) with menotropins (hMG). Each group was subdivided into subgroup A (normal pregnancies) and B (pregnancies ending in abortion). Thirteen percent of patients in group I aborted, 19% in group II, and 31% in group III (P less than .05). The overall mean (+/- SD) P level in group IA was 25.8 +/- 10.3 ng/mL and in group IB, 16.6 +/- 9.9 ng/mL (significantly lower, P less than .001); in group IIA the mean P level was 37.8 +/- 21.9 ng/mL and in group IIB, 22.9 +/- 17.9 ng/mL, again significantly lower (P less than .01). In subgroups IB and IIB, 11 of 16 patients showed early abnormal beta-hCG patterns; these findings suggest defective embryonic development and/or deficient corpus luteum function as the cause of abortion. There was no significant difference between mean P in group IIIA (71.1 +/- 43.7 ng/mL) and IIIB (75.7 +/- 55.9 ng/mL). In group IIIB, the mean "peak" P level of 101.1 +/- 73.6 ng/mL was followed by a mean "nadir" of 35.4 +/- 24.8 ng/mL at 6-9 weeks. In group IIIB, 7 of 11 patients showed normal beta-hCG patterns. Three patients with precipitous P decline aborted karyotypically normal fetuses in spite of normally rising beta-hCG levels and the presence of fetal cardiac activity.(ABSTRACT TRUNCATED AT 250 WORDS)
对141例因不孕症治疗而获得的单胎临床宫内妊娠患者，随机或连续测量其孕酮（P）和人绒毛膜促性腺激素（β-hCG）水平。其中70例（I组）为自然周期受孕，36例（II组）为克罗米芬促排卵受孕，35例（III组）为人绝经期促性腺激素（hMG）促排卵受孕。每组又分为A亚组（正常妊娠）和B亚组（妊娠结局为流产）。I组患者的流产率为13%，II组为19%，III组为31%（P<0.05）。IA亚组的P平均水平（±标准差）为25.8±10.3 ng/mL，IB亚组为16.6±9.9 ng/mL（显著降低，P<0.001）；IIA亚组的P平均水平为37.8±21.9 ng/mL，IIB亚组为22.9±17.9 ng/mL，同样显著降低（P<0.01）。在IB和IIB亚组中，16例患者中有11例出现早期β-hCG异常；这些发现提示胚胎发育缺陷和/或黄体功能不足是流产的原因。IIIA亚组（71.1±43.7 ng/mL）和IIIB亚组（75.7±55.9 ng/mL）的P平均水平无显著差异。在IIIB亚组中，P平均“峰值”水平为101.1±73.6 ng/mL，随后在6 - 9周时平均“谷值”为35.4±24.8 ng/mL。在IIIB亚组中，11例患者中有7例β-hCG模式正常。3例P急剧下降的患者尽管β-hCG水平正常上升且存在胎儿心脏活动，但流产的胎儿染色体核型正常。（摘要截短于250字）
