Lynch L, Berkowitz R L, Weiss G, Goldsmith L T, Lapinski R, Wein R
Department of Obstetrics, Gynecology and Reproductive Science, Mount Sinai Medical Center, New York, New York, USA.
Obstet Gynecol. 1995 May;85(5 Pt 1):756-9. doi: 10.1016/0029-7844(95)00010-o.
To determine the effect of multifetal pregnancy reduction on circulating relaxin levels.
Patients with multifetal pregnancies had relaxin levels determined on the day of multifetal pregnancy reduction, after the procedure, and late in pregnancy.
Forty-eight women (26 presenting with three fetuses and 22 with four or more) were studied. All pregnancies followed some form of ovulation induction. All pregnancies (except for one, which was reduced to a singleton) were reduced to twins. Pre-procedure, post-procedure and late-pregnancy relaxin levels were significantly higher in the in vitro fertilization (IVF)-gamete intrafallopian transfer (GIFT) group compared with the human menopausal gonadotropin (hMG)-alone group (P < .05). The initial number of fetuses had no significant effect on relaxin levels. Although post-procedure relaxin levels were significantly lower than pre-procedure levels (P = .002), relaxin levels continued to decrease throughout pregnancy, as evidenced by even lower levels later on (P = .0001).
Serum relaxin levels were significantly higher in the IVF-GIFT group than in the hMG-alone group, which probably reflects more aggressive ovulation induction in the former. Because relaxin levels continued to decrease throughout pregnancy, the difference observed between pre- and post-procedure levels are not considered to be due to the procedure itself.
确定多胎妊娠减胎术对循环中松弛素水平的影响。
对多胎妊娠患者在多胎妊娠减胎术当天、术后及妊娠晚期测定松弛素水平。
共研究了48名女性（26例怀有三胞胎，22例怀有四胞胎或更多）。所有妊娠均采用某种形式的促排卵方法。所有妊娠（除1例减为单胎妊娠外）均减为双胎妊娠。与单纯使用人绝经期促性腺激素（hMG）组相比，体外受精（IVF）-配子输卵管内移植（GIFT）组术前、术后及妊娠晚期的松弛素水平显著更高（P <.05）。初始胎儿数量对松弛素水平无显著影响。尽管术后松弛素水平显著低于术前水平（P =.002），但整个孕期松弛素水平持续下降，后期水平更低即证明了这一点（P =.0001）。
IVF-GIFT组的血清松弛素水平显著高于单纯hMG组，这可能反映了前者更积极的促排卵情况。由于整个孕期松弛素水平持续下降，术前和术后水平的差异并非被认为是由手术本身所致。
