Zhang Fan, Chi Lin, Diao Yan-Hua
Reproductive Center, Hulunbeier People's Hospital Hailar, Hulunbuir 021000, Inner Mongolia, China.
Am J Transl Res. 2024 Nov 15;16(11):6946-6954. doi: 10.62347/FLYC9199. eCollection 2024.
To evaluate the efficacy of low-molecular-weight heparin (LMWH) in pregnant women with recurrent spontaneous abortion (RSA) and to investigate the correlation with changes in the gestational sac and embryo development, and miscarriage prevention as outcomes.
A retrospective analysis was conducted on 100 pregnant women with RSA treated at Hulunbeier People's Hospital between January 2022 and January 2023. Among them, 52 patients received LMWH therapy (observation group), while 48 received routine treatment (control group). Serum levels of human chorionic gonadotropin (hCG), progesterone (P), estradiol (E2), and coagulation markers (D-dimer [D-D], plasminogen activator inhibitor 1 [PAI-1], and fibrinogen), as well as gestational sac diameter (GSD), embryo length (EL), and uterine artery blood flow resistance, were assessed before and after treatment. Pregnancy outcome and adverse reaction rate were recorded and compared. Patients were categorized into successful and unsuccessful groups based on miscarriage prevention outcomes, and differences in GSD and EL were analyzed. Logistic regression was performed to identify factors influencing miscarriage prevention.
Baseline hCG, P, E2, D-D, PAI-1, fibrinogen, GSD, EL, and uterine artery blood flow resistance were comparable between groups (all P>0.05). After treatment, these measuremnts improved significantly, with greater changes in the observation group (all P<0.05). The term pregnancy rate was significantly higher in the observation group than in the control group (P<0.05), while adverse reaction rates were similar (P>0.05). The successful group exhibited significantly greater GSD and EL compared to the unsuccessful group (P<0.05). Logistic regression identified age, number of miscarriages, and LMWH use as independent factors influencing miscarriage prevention outcome (P<0.05).
LMWH therapy significantly improves hormone levels, coagulation status, GSD, and EL in pregnant women with RSA, enhancing miscarriage prevention outcomes with minimal adverse reactions, making it a safe and effective treatment option for clinical practice.
评估低分子肝素（LMWH）对复发性自然流产（RSA）孕妇的疗效，并探讨其与妊娠囊及胚胎发育变化的相关性以及预防流产的效果。
对2022年1月至2023年1月在呼伦贝尔市人民医院治疗的100例RSA孕妇进行回顾性分析。其中，52例患者接受LMWH治疗（观察组），48例接受常规治疗（对照组）。治疗前后评估血清人绒毛膜促性腺激素（hCG）、孕酮（P）、雌二醇（E2）水平及凝血指标（D - 二聚体[D - D]、纤溶酶原激活物抑制剂1[PAI - 1]和纤维蛋白原），以及妊娠囊直径（GSD）、胚胎长度（EL）和子宫动脉血流阻力。记录并比较妊娠结局及不良反应发生率。根据预防流产效果将患者分为成功组和失败组，分析GSD和EL的差异。进行Logistic回归分析以确定影响预防流产的因素。
两组间基线hCG、P、E2、D - D、PAI - 1、纤维蛋白原、GSD、EL及子宫动脉血流阻力比较，差异均无统计学意义（均P>0.05）。治疗后，上述指标均显著改善，观察组变化更明显（均P<0.05）。观察组足月妊娠率显著高于对照组（P<0.05），而不良反应发生率相似（P>0.05）。成功组的GSD和EL显著大于失败组（P<0.05）。Logistic回归分析确定年龄、流产次数及LMWH使用为影响预防流产结局的独立因素（P<0.05）。
LMWH治疗可显著改善RSA孕妇的激素水平、凝血状态、GSD及EL，提高预防流产效果且不良反应轻微，是临床安全有效的治疗选择。
