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[不育婚姻的治疗成功率及产科结局分析]

[Analysis of therapeutic success and of obstetrical results in sterile marriages].

作者信息

Schmidt-Elmendorff H, Jordan I

出版信息

Fortschr Med. 1977 Mar 3;95(9):557-63.

PMID:844782
Abstract

In the course of sterility therapy 375 pregnancies were observed in 296 patients. 63 women conceived twice or more. At the first visite the mean age of the patients was 25,8 years, the mean duration of sterility 2,7 years. A primary sterility was observed in 207 and a secondary sterility in 98 cases. The main therapeutic procedure was the induction of ovulation with FSH/LH releasing preparations (Clomiphen, Cyclofenil, Epimestrol) (40,3%), followed by the substitution therapy with human gonadotrophins (22,7%). 78 pregnancies ended by spontaneous and 4 by artificially induced abortion. The abortion rate in this study was 20,8 %, exceeding considerably the normal abortion rate. The rate of extrauterine pregnancies was also increased, being 2,4%. There was no significant difference in the abortion rate of pregnancies with or without induction of ovulation. The age at the time of conception and the duration of therapy had no significant influence on the rate of abortions. In 293 pregnancies the duration of gestation exceeded the 28th week. However, 33,1% of these pregnancies had complications that required hospitalisation. Almost 50% of the complications consisted of threatened abortion. The mean duration of gestation was reduced by 5 days, caused by a relatively high frequency of early births (16,9%). The mode of delivery of our patients was in 68,8% spontaneous delivery, in 16,2% caesarian section, in 15,0% forceps or vacuum extractions. This corresponds to the general mode of delivery of our hospital. Only after gonadotrophin therapy a higher caesarian section rate of 26,8% was noted. Out of the 310 live born children, 9,2% had a weight below 2500 g, owing to a multiple pregnancy rate of 4,1%. 4% of the children showed the signs of dystrophia. The perinatal mortality amounted to 5,1%. However, when the gonadotrophin induced multiple pregnancies are excluded, the rate is 2,7%. Only 2 cases of malformations were observed.

摘要

在不育症治疗过程中,观察到296例患者中有375次妊娠。63名妇女怀孕两次或更多次。首次就诊时,患者的平均年龄为25.8岁,平均不育时间为2.7年。原发性不育207例,继发性不育98例。主要治疗方法是使用促卵泡生成素/促黄体生成素释放制剂(克罗米芬、环芬尼、表美雌醇)诱导排卵(40.3%),其次是用人促性腺激素替代治疗(22.7%)。78例妊娠以自然流产告终,4例为人工流产。本研究中的流产率为20.8%,大大超过正常流产率。宫外孕率也有所上升,为2.4%。有或没有诱导排卵的妊娠流产率没有显著差异。受孕时的年龄和治疗时间对流产率没有显著影响。293例妊娠的妊娠期超过了第28周。然而,这些妊娠中有33.1%出现了需要住院治疗的并发症。几乎50%的并发症为先兆流产。由于早产发生率相对较高(16.9%),平均妊娠期缩短了5天。我们患者的分娩方式为自然分娩占68.8%,剖宫产占16.2%,产钳或真空吸引占15.0%。这与我们医院的一般分娩方式相符。仅在促性腺激素治疗后,剖宫产率较高,为26.8%。在310名活产婴儿中,9.2%的婴儿体重低于2500克,原因是多胎妊娠率为4.1%。4%的儿童有营养不良迹象。围产期死亡率为5.1%。然而,排除促性腺激素诱导的多胎妊娠后,该率为2.7%。仅观察到2例畸形病例。

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