Wang Jing, Li Lisha, Zhou Jing, Pan Xinyao, Qi Qing, Sun Hongmei, Liu Ming, Wang Ling
Yueyang Hospital of Integrated Traditional Chinese and Western Medicine Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai, China.
Laboratory for Reproductive Immunology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai, China.
Glob Health Med. 2024 Dec 31;6(6):427-432. doi: 10.35772/ghm.2024.01056.
Recurrent spontaneous abortion (RSA), defined as two or more clinically confirmed pregnancies that end before 20-24 weeks of gestation, encompasses both embryonic and fetal losses and is a significant clinical challenge. The aim of this study was to compare the efficacy of allylestrenol (AT) and progesterone in improving pregnancy outcomes in RSA. From June 2021 to June 2024, 480 participants were randomly assigned to an AT, Progesterone, or Control group. Key outcomes included early pregnancy rates, ongoing pregnancies with fetal heart activity, live birth rates after 24 weeks, and pregnancy loss before 24 weeks. Results indicated significantly higher pregnancy rates at 6-8 weeks in both the Allylestrenol (71.8%) and Progesterone groups (76.2%) compared to the Control group (57.5%). At 12 weeks, ongoing pregnancies with fetal heart activity were higher in the Allylestrenol (65%) and Progesterone groups (64%) versus the Control group (52.5%). Both treatment groups had higher live birth rates (60% and 60.6%) compared to the Control group (45%). Pregnancy loss before 24 weeks was lower in both treatment groups (31.8% and 33.1%) compared to the Control group (38.7%). No significant adverse reactions were observed, indicating good safety profiles for both treatments. These findings suggest that both treatments effectively improve pregnancy outcomes in cases of RSA with satisfactory safety, supporting their potential clinical use. However, further research is needed to explore their long-term effects and broader applicability in clinical settings.
复发性自然流产(RSA)定义为两次或更多次经临床确认的妊娠在妊娠20 - 24周前结束,涵盖胚胎和胎儿丢失,是一项重大的临床挑战。本研究的目的是比较烯丙雌醇(AT)和孕酮在改善RSA妊娠结局方面的疗效。2021年6月至2024年6月,480名参与者被随机分配到AT组、孕酮组或对照组。主要结局包括早期妊娠率、有胎心活动的持续妊娠、24周后的活产率以及24周前的妊娠丢失。结果表明,烯丙雌醇组(71.8%)和孕酮组(76.2%)在6 - 8周时的妊娠率显著高于对照组(57.5%)。在12周时,烯丙雌醇组(65%)和孕酮组(64%)有胎心活动的持续妊娠率高于对照组(52.5%)。两个治疗组的活产率均高于对照组(分别为60%和60.6%,对照组为45%)。两个治疗组在24周前的妊娠丢失率均低于对照组(分别为31.8%和33.1%,对照组为38.7%)。未观察到明显的不良反应,表明两种治疗方法的安全性良好。这些发现表明,两种治疗方法均能有效改善RSA患者的妊娠结局,安全性良好,支持它们在临床上的潜在应用。然而,需要进一步研究以探索它们的长期影响以及在临床环境中的更广泛适用性。