Lotfy Ahmed Mohamed, Taha Wael Soliman, Abdelmoaty Muhamed Ahmed
Department of Obstetrics and Gynecology, Senbillawen General Hospital, Egyptian Ministry of Health and Population, Egypt.
Department of Obstetrics and Gynecology, Faculty of Medicine, Al-Azhar University, Egypt Email:
Qatar Med J. 2024 Feb 21;2024(1):9. doi: 10.5339/qmj.2024.9. eCollection 2024.
Pregnancy loss occurring before 20 weeks gestation is referred to as miscarriage. Various clinical presentations of miscarriage include threatened, inevitable, incomplete, complete, septic, and missed miscarriage. Early-stage threatened miscarriage may manifest with symptoms such as abdominal discomfort and vaginal bleeding. Threatened miscarriage is clinically defined as the manifestation of positive fetal heart sounds in pregnancies occurring before the 20th week of gestation, concomitant with vaginal bleeding and a closed cervix.
The primary aim of this study was to evaluate the association between serum C-reactive protein (CRP) levels and fetal ultrasound findings in the prediction of threatened miscarriage during the first trimester of pregnancy.
In this prospective case-control study, a total of 100 pregnant women at 7-13 weeks of gestation were enrolled. All participants initially presented with a singleton embryo displaying cardiac activity on ultrasound. The study cohort was divided into two groups: Group 1 consisted of 50 women with uncomplicated pregnancies, while Group 2 comprised 50 women experiencing symptoms indicative of threatened miscarriage.
Notably, within Group 2, patients who eventually experienced miscarriage exhibited significantly elevated serum high-sensitivity CRP levels in comparison to those who maintained their pregnancies.
Threatened miscarriage cases demonstrated a substantial increase in serum high-sensitivity CRP levels compared to the control group. Furthermore, CRP levels exhibited a correlation with the risk of miscarriage, suggesting their potential utility in conjunction with ultrasound parameters for prognosticating threatened miscarriage during the first trimester.
妊娠20周前发生的妊娠丢失称为流产。流产的各种临床表现包括先兆流产、难免流产、不全流产、完全流产、感染性流产和稽留流产。早期先兆流产可能表现为腹部不适和阴道出血等症状。先兆流产在临床上定义为妊娠20周前出现胎儿心音阳性，伴有阴道出血且宫颈闭合。
本研究的主要目的是评估血清C反应蛋白（CRP）水平与胎儿超声检查结果在预测妊娠早期先兆流产中的相关性。
在这项前瞻性病例对照研究中，共纳入了100名妊娠7-13周的孕妇。所有参与者最初超声检查均显示单胎胚胎有心脏活动。研究队列分为两组：第1组由50名妊娠无并发症的妇女组成，第2组由50名有先兆流产症状的妇女组成。
值得注意的是，在第2组中，最终流产的患者与维持妊娠的患者相比，血清高敏CRP水平显著升高。
与对照组相比，先兆流产病例的血清高敏CRP水平大幅升高。此外，CRP水平与流产风险相关，提示其与超声参数结合在预测妊娠早期先兆流产预后方面可能具有实用价值。
