Siddiqi T A, Caligaris J T, Miodovnik M, Holroyde J C, Mimouni F
Department of Obstetrics and Gynecology, University of Cincinnati Medical Center, OH 45267.
Am J Perinatol. 1988 Jan;5(1):1-4. doi: 10.1055/s-2007-999640.
The incidence of spontaneous abortion once embryonic development has reached the stage of sonographically demonstrable cardiac activity has not been precisely determined in a large population. This retrospective study was designed to determine the risk of pregnancy loss after first trimester sonographic confirmation of fetal cardiac activity. A total of 840 patients were referred for ultrasound examination to the Perinatal Center, University of Cincinnati, between January 1, 1979 and December 31, 1985 who fulfilled the criteria of singleton pregnancy with sonographically visible fetal cardiac activity and crown-rump length consistent with gestational age less than or equal to 12 weeks. Patients were grouped into two categories based on the absence (control) or presence of vaginal bleeding (bleeding) prior to or at the time of the ultrasound examination. The abortion rates for the two groups were 5.2 and 16.4%, respectively (P less than 0.001). The relative risk of abortion in patients with vaginal bleeding was nearly four-fold greater than the control population. In the control group there was a significantly greater incidence of pregnancy loss in the greater than or equal to 34 years age group compared to less than 34 years age patients (4.4 versus 11.1%, P less than 0.05). Although there was no significant effect of race on abortion rates, low socioeconomic status almost doubled the relative risk of miscarriage. We conclude that the presence of visible fetal cardiac activity in the first trimester predicts a decreased risk for spontaneous abortion compared to generally reported rates. The significant risk factors for increased chance of abortion are vaginal bleeding, advanced maternal age, and low socioeconomic status.
在一大群人中，一旦胚胎发育到超声可显示心脏活动的阶段，自然流产的发生率尚未得到精确测定。这项回顾性研究旨在确定孕早期超声确认胎儿心脏活动后妊娠丢失的风险。1979年1月1日至1985年12月31日期间，共有840名患者被转诊至辛辛那提大学围产期中心进行超声检查，这些患者符合单胎妊娠标准，超声可见胎儿心脏活动，且头臀长度与胎龄一致，小于或等于12周。根据超声检查前或检查时是否有阴道出血（出血组）或无阴道出血（对照组），将患者分为两类。两组的流产率分别为5.2%和16.4%（P<0.001）。有阴道出血的患者流产的相对风险几乎是对照组人群的四倍。在对照组中，年龄大于或等于34岁的患者与年龄小于34岁的患者相比，妊娠丢失的发生率显著更高（4.4%对11.1%，P<0.05）。虽然种族对流产率没有显著影响，但社会经济地位较低几乎使流产的相对风险增加一倍。我们得出结论，与一般报道的发生率相比，孕早期可见胎儿心脏活动预示着自然流产风险降低。流产几率增加的显著风险因素是阴道出血、孕妇年龄较大和社会经济地位较低。
