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[复发性流产患者诊断性前瞻性算法的应用]

[Use of a diagnostic prospective algorithm for patients with recurrent miscarriage].

作者信息

Bustos López H H, Barrón Vallejo J, García Malváez B, Kably Ambe A, Cáceres Zelaya H

机构信息

Instituto Nacional de Perinatología, México, D.F.

出版信息

Ginecol Obstet Mex. 1995 Feb;63:96-101.

PMID:7698682
Abstract

The application of a diagnostic algorithm to couples with recurrent pregnancy loss, was evaluated in this descriptive, prospective, clinical trial, at Infertility Clinic and Assisted Reproduction Unit, Instituto Nacional de Perinatología (INPer), México City. Fifty couples with primary or secondary recurrent pregnancy loss, were studied. A study protocol was applied to evaluate the following factors of miscarriage: anatomic, endocrine, infectious, genetic and immunologic. The frequency of altered factors was determined in the couples including in this trial. There were no cases of diabetes mellitus or impaired glucose tolerance in the studied group. The most common abnormal findings were: luteal phase defects; genital infections (Chlamydia trachomatis, Mycoplasma hominis, Ureaplasma urealyticum) and; an elevated frequency of chromosomal abnormalities. In addition, in 16% of the couples there was not an identified cause of their problem. The applied algorithm find the etiology of the recurrent pregnancy loss in the 84% of the couples studies. The method included new technologies (detection of anti-immunity, allo-immunity and infectious diseases), however, need corrections to increase its diagnostic and prognosis accuracy.

摘要

在墨西哥城国家围产医学研究所(INPer)的不孕不育诊所和辅助生殖科,通过这项描述性、前瞻性临床试验,对一种诊断算法在复发性流产夫妇中的应用进行了评估。研究了50对原发性或继发性复发性流产的夫妇。应用一项研究方案来评估以下流产因素:解剖学、内分泌、感染、遗传和免疫因素。确定了纳入该试验的夫妇中各因素异常的发生率。研究组中无糖尿病或糖耐量受损病例。最常见的异常发现为:黄体期缺陷;生殖器感染(沙眼衣原体、人型支原体、解脲脲原体);以及染色体异常频率升高。此外,16%的夫妇未发现其问题的病因。所应用的算法在84%的研究夫妇中找到了复发性流产的病因。该方法包括新技术(抗免疫、同种免疫和传染病检测),然而,需要进行修正以提高其诊断和预后准确性。

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