Department of Obstetrics and Gynecology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; the Department of Biostatistics & Informatics, Colorado School of Public Health, and the Center for Innovative Design & Analysis (CIDA), Aurora, Colorado; and the Department of Obstetrics and Gynecology, University of California Davis School of Medicine, University of California, Davis, Sacramento, California.
Obstet Gynecol. 2022 Jun 1;139(6):1149-1151. doi: 10.1097/AOG.0000000000004792. Epub 2022 May 2.
Early pregnancy loss can be treated medically with mifepristone followed by misoprostol, with ultrasonographic confirmation of pregnancy expulsion. Alternative strategies that ascertain treatment success remotely are needed. We compared percent decline in human chorionic gonadotropin (hCG) level with treatment success or failure between patients who received mifepristone pretreatment followed by misoprostol or misoprostol alone for early pregnancy loss between 5 and 12 weeks of gestation to determine a threshold decline that might predict success. Early pregnancy loss treatment success was associated with a greater percent hCG level decline compared with treatment failure, but no threshold was able to predict success. Additional research is needed to understand hCG trends after medical management of early pregnancy loss to develop reliable protocols for remote follow-up.
早期妊娠丢失可以用米非司酮联合米索前列醇进行药物治疗，并通过超声确认妊娠排出。需要寻找其他能够远程确认治疗成功的策略。我们比较了 5 至 12 孕周早期妊娠丢失患者，在接受米非司酮预处理后加用米索前列醇或单独使用米索前列醇治疗，人绒毛膜促性腺激素（hCG）水平下降的百分比与治疗成功或失败的关系，以确定可能预测成功的阈值下降。与治疗失败相比，早期妊娠丢失治疗成功与 hCG 水平下降的百分比更大相关，但没有阈值能够预测成功。需要进一步研究以了解药物治疗早期妊娠丢失后 hCG 的变化趋势，从而制定可靠的远程随访方案。
