Johnson M R, Abbas A, Nicolaides K H
Academic Department of Obstetrics and Gynaecology, Chelsea and Westminster Hospital, London, UK.
J Endocrinol. 1994 Nov;143(2):309-12. doi: 10.1677/joe.0.1430309.
The aim of the study was to investigate the circulating levels of human chorionic gonadotrophin (hCG), oestradiol (OE2) and progesterone in multifetal pregnancies before and after embryo reduction. The levels of hCG, OE2 and progesterone were measured in plasma samples obtained from two groups of pregnant women: (i) singleton (n = 17), twin (n = 15) and triplet (n = 5) pregnancies achieved following superovulation; and (ii) multifetal pregnancies (three to ten embryos) undergoing fetal reduction to twin pregnancies (n = 31). The median value for each analyte at each gestational age in twin pregnancies was defined and used to derive multiples of the median (MoMs) for each analyte in samples obtained from multifetal pregnancies before and after reduction. The levels of hCG, OE2 and progesterone were significantly associated with the number of fetuses. Prior to reduction, the median MoMs for hCG, OE2 and progesterone were 1.54, 0.99 and 1.11 respectively. After reduction to twins the median MoMs decreased to 0.84 for hCG, 0.37 for progesterone and 0.51 for OE2. These data suggest that (i) the circulating levels of hCG, OE2 and progesterone increase with conceptus number; (ii) placental tissue does not remain active following fetal reduction; and (iii) the rate of steroid metabolism is increased in multiple pregnancy and remains elevated following fetal reduction.
本研究的目的是调查多胎妊娠减胎前后人绒毛膜促性腺激素（hCG）、雌二醇（OE2）和孕酮的循环水平。在从两组孕妇采集的血浆样本中测量hCG、OE2和孕酮的水平：（i）超排卵后获得的单胎妊娠（n = 17）、双胎妊娠（n = 15）和三胎妊娠（n = 5）；（ii）接受减胎术以减为双胎妊娠的多胎妊娠（三至十个胚胎，n = 31）。定义双胎妊娠各孕周每种分析物的中位数，并用于得出减胎前后多胎妊娠样本中每种分析物的中位数倍数（MoM）。hCG、OE2和孕酮的水平与胎儿数量显著相关。减胎前，hCG、OE2和孕酮的中位数MoM分别为1.54、0.99和1.11。减为双胎后，hCG的中位数MoM降至0.84，孕酮降至0.37，OE2降至0.51。这些数据表明：（i）hCG、OE2和孕酮的循环水平随胎儿数量增加；（ii）减胎后胎盘组织不再活跃；（iii）多胎妊娠中类固醇代谢率增加，减胎后仍保持升高。
