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体外受精妊娠并发严重卵巢过度刺激综合征时的自然早产风险:一项病例对照研究。

Risk of spontaneous preterm labor in pregnancies achieved by in vitro fertilization and complicated with severe form of ovarian hyperstimulation syndrome: A case control study.

作者信息

Dobrosavljevic Aleksandar, Rakic Snezana, Mihajlovic Sladjana

机构信息

Dr. Aleksandar Dobrosavljevic, Obstetrician and Gynecologist, The Obstetrics and Gynecology Clinic Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia.

Dr. Snezana Rakic, Professor of Obstetrics and Gynaecology, The Obstetrics and Gynecology Clinic Narodni Front, Kraljice Natalije 62, 11000 Belgrade, Serbia. University of Belgrade School of Medicine, Dr Subotica 8, Serbia.

出版信息

Pak J Med Sci. 2019 Jul-Aug;35(4):923-928. doi: 10.12669/pjms.35.4.145.

Abstract

OBJECTIVES

The purpose of this study was to examine the potential impact of severe Ovarian hyper stimulation syndrome (OHSS) on the risk of preterm birth. Severe ovarian hyperstimulation syndrome is a serious complication in the methods of in vitro fertilization. The pathophysiology of this process is not clear enough and the treatment is symptomatic. Human chorionic gonadotropin (h-CG) is the most important known cause of this condition. Findings of other authors often do not match when it comes to complications that may occur in pregnancy.

METHODS

In the Gynecology and Obstetrics Clinic "Narodni Front" a case control study was conducted on 50 female patients with severe forms of OHSS in the period from January 2008 to March 2015. A control group was created based on age and it involved 59 patients with pregnancy achieved with IVF/ICSI during the same period, but in which OHSS did not occur.

RESULTS

Patients with the pregnancy complicated by OHSS, had a considerably higher rate of preterm labor, whether this was labor before gestation week 37 (56.0% vs. 30.5%) or before gestation week 34 (34.0% vs. 6.8%); significantly lower weight of newborns, as in the newborns with low body weight <2500g (45.6% vs. 25.0%) and specially in the newborn with very low body weight <1500 grams (19.1% vs. 3.8%), as well as preterm premature rupture of membranes (PPROM), (11.76% vs. 1.59%).

CONCLUSIONS

Pregnancy achieved by the IVF/ICSI method in which severe form of OHSS has been developed could have an increased risk of preterm birth.

摘要

目的

本研究旨在探讨重度卵巢过度刺激综合征(OHSS)对早产风险的潜在影响。重度卵巢过度刺激综合征是体外受精方法中的一种严重并发症。该过程的病理生理学尚不够明确,治疗以对症治疗为主。人绒毛膜促性腺激素(h-CG)是已知导致这种情况的最重要原因。在妊娠可能发生的并发症方面,其他作者的研究结果往往不一致。

方法

在“国民阵线”妇产科诊所,于2008年1月至2015年3月期间对50例重度OHSS女性患者进行了病例对照研究。根据年龄设立了一个对照组,该组包括同期通过体外受精/卵胞浆内单精子注射(IVF/ICSI)成功妊娠但未发生OHSS的59例患者。

结果

并发OHSS的妊娠患者,早产发生率显著更高,无论是妊娠37周前分娩(56.0%对30.5%)还是妊娠34周前分娩(34.0%对6.8%);新生儿体重显著更低,如低体重儿<2500g(45.6%对25.0%),尤其是极低体重儿<1500克(19.1%对3.8%),以及胎膜早破(PPROM)(11.76%对1.59%)。

结论

通过IVF/ICSI方法实现妊娠且发生重度OHSS时,早产风险可能增加。

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