Margaliot Kalifa Tal, Lang Ben Nun Eyal, Sela Hen Y, Khatib Fayez, Grisaru-Granovsky Sorina, Rottenstreich Misgav
Department of Obstetrics & Gynecology, Shaare Zedek Medical Center, Hebrew University School of Medicine, Jerusalem 91031, Israel.
Department of Nursing, Jerusalem College of Technology, Jerusalem 93721, Israel.
J Clin Med. 2022 May 13;11(10):2767. doi: 10.3390/jcm11102767.
Objective: To evaluate the maternal and neonatal outcomes of pregnancies conceived ≤6 months after first trimester (<14 weeks) dilation and curettage (D&C). Methods: A retrospective computerized database study of women who conceived ≤6 months following a missed abortion and delivered in a single tertiary medical center between 2016 and 2021. The maternal and neonatal outcomes of women who had D&C were compared to those of women who had non-medical or spontaneous miscarriages. The primary outcome of this study was the rate of preterm birth (<37 weeks). Secondary outcomes were adverse maternal and neonatal outcomes. Univariate analysis was followed by multiple logistic regression models; adjusted odds ratios (aORs) and 95% confidence intervals (CIs) were calculated. Results: During the study period, 1773 women met the inclusion criteria; of those, 1087 (61.3%) women gave birth following D&C. We found no differences between the study groups in any maternal or neonatal parameter examined including preterm birth (PTB), miscarriage to pregnancy interval, fertility treatments, hypertension disorders of pregnancy, placental complications, mode of delivery and neonatal birth weights. This was confirmed on a multivariate analysis as well [aOR 1.74 (0.89−3.40), p = 0.11] for preterm birth. Conclusion: Watchful waiting or the medical treatment of a first trimester missed abortion present no more risks than D&C to pregnancies conceived within six months of the index miscarriage. Further studies in other settings to strengthen these findings are needed.
评估孕早期（<14周）刮宫术（D&C）后≤6个月内受孕的孕产妇及新生儿结局。方法：对2016年至2021年期间在单一三级医疗中心因稽留流产后≤6个月内受孕并分娩的女性进行回顾性计算机数据库研究。将接受刮宫术的女性的孕产妇及新生儿结局与非医疗性或自然流产的女性进行比较。本研究的主要结局是早产率（<37周）。次要结局是孕产妇和新生儿不良结局。先进行单因素分析，然后建立多因素逻辑回归模型；计算调整后的优势比（aORs）和95%置信区间（CIs）。结果：在研究期间，1773名女性符合纳入标准；其中，1087名（61.3%）女性在刮宫术后分娩。我们发现，在检查的任何孕产妇或新生儿参数方面，包括早产（PTB）、流产与再次妊娠间隔、生育治疗、妊娠高血压疾病、胎盘并发症、分娩方式和新生儿出生体重，研究组之间均无差异。多因素分析也证实了这一点[早产的aOR为1.74（0.89−3.40），p = 0.11]。结论：对于在稽留流产后6个月内受孕的妊娠，观察等待或对孕早期稽留流产进行药物治疗所带来的风险并不比刮宫术更多。需要在其他环境中进行进一步研究以强化这些发现。
