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预测早期妊娠丢失的生化标志物:综述。

Biochemical markers for prediction of the first half pregnancy losses: a review.

机构信息

Department of obstetrics and gynecology, West Kazakhstan Marat Ospanov Medical University Aktobe Kazakhstan Department of obstetrics and gynecology, West Kazakhstan Marat Ospanov Medical University, Aktobe, Kazakhstan.

Department of obstetrics and gynecology Asfendiyarov Kazakh National Medical University Almaty Kazakhstan Department of obstetrics and gynecology, Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan.

出版信息

Rev Bras Ginecol Obstet. 2024 Sep 6;46. doi: 10.61622/rbgo/2024rbgo72. eCollection 2024.

Abstract

OBJECTIVE

26% of all pregnancies end in miscarriage, and up to 10% of clinically diagnosed pregnancies, and recurrent pregnancy loss is 5% among couples of childbearing ages. Although there are several known causes of pregnancy loss in the first half, including recurrent pregnancy loss, including parental chromosomal abnormalities, uterine malformations, endocrinological disorders, and immunological abnormalities, about half of the cases of pregnancy loss in its first half remain unexplained.

METHODS

The review includes observational controlled studies (case-control or cohort, longitudinal studies, reviews, meta-analyses), which include the study of biochemical factors for predicting pregnancy losses in the first half, in singlet pregnancy. The Newcastle-Ottawa Scale (NOS) was used to assess the research quality.

RESULTS

Finally, 27 studies were included in the review, which has 134904 examined patients. The results of the review include estimates of β-human chorionic gonadotropin, progesterone, pregnancy-associated protein - A, angiogenic vascular factors, estradiol, α-fetoprotein, homocysteine and CA-125 as a predictors or markers of the first half pregnancy losses.

CONCLUSION

It may be concluded that to date, research data indicate the unavailability of any reliable biochemical marker for predicting pregnancy losses in its first half and require either a combination of them or comparison with clinical evidence. A fairly new model shall be considered for the assessment of α-fetoprotein in vaginal blood, which may have great prospects in predicting spontaneous miscarriages.

摘要

目的

所有妊娠中有 26%以流产告终,在临床诊断的妊娠中,多达 10%,而复发性流产在育龄夫妇中占 5%。尽管有许多已知的原因导致前半段妊娠丢失,包括复发性流产,包括父母染色体异常、子宫畸形、内分泌紊乱和免疫异常,但前半段妊娠丢失的大约一半病例仍无法解释。

方法

综述包括观察性对照研究(病例对照或队列、纵向研究、综述、荟萃分析),其中包括研究生化因素对半胎妊娠丢失的预测作用。纽卡斯尔-渥太华量表(NOS)用于评估研究质量。

结果

最后,综述纳入了 27 项研究,共纳入了 134904 名检查患者。综述结果包括β-人绒毛膜促性腺激素、孕酮、妊娠相关蛋白-A、血管生成因子、雌二醇、甲胎蛋白、同型半胱氨酸和 CA-125 作为前半段妊娠丢失的预测因子或标志物的估计值。

结论

可以得出结论,迄今为止,研究数据表明,目前尚无任何可靠的生化标志物可用于预测前半段妊娠丢失,需要将它们组合使用或与临床证据进行比较。应考虑评估阴道血中甲胎蛋白的新模型,该模型在预测自然流产方面可能具有广阔前景。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3b51/11460427/afe1218ffd89/1806-9339-rbgo-46-e-rbgo72-gf01.jpg

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