Goto S, Hasegawa I, Higashino M, Kazama Y, Yamada K, Takakuwa K
Department of Obstetrics and Gynaecology, Niigata University School of Medicine, Japan.
Hum Reprod. 1993 Apr;8(4):627-30. doi: 10.1093/oxfordjournals.humrep.a138108.
To examine whether recurrent spontaneous abortion (RSA) can be distinguished from repeated sporadic spontaneous abortion, the clinical course of 38 cases with three or more consecutive and unexplained first trimester RSAs were retrospectively investigated in this study. For comparison with controls, the clinical course was examined of 38 fertile females, who had had sporadic abortions. In 19 (50%) RSAs and 6 (16%) controls, fetal cardiac activity was demonstrated by ultrasound during the course of pregnancy. The rate of detection of live fetus during pregnancy or at 8 weeks +/- 7 days gestation, was significantly greater in the RSA group compared to the control. The rate of vaginal bleeding before spontaneous abortion was significantly less in the RSA group than in the control group. There was no difference between the two groups in age or gestational age at spontaneous abortion. The patients with RSA were all examined for antiphospholipid antibodies in their sera and these were detected in eight of them. However, there was no difference in the rate of positive fetal cardiac activity between the RSA patients who tested positive or negative for antibody. These results reveal that the clinical course of RSA is very different from the course of sporadic abortion. Although sporadic abortion is a common complication of pregnancy, RSA is not a random repeated abortion, but rather a separate disease from sporadic abortion in normal fertile females.
为了研究复发性自然流产（RSA）是否可与反复散发性自然流产相区分，本研究回顾性调查了38例连续发生三次或三次以上且原因不明的孕早期RSA患者的临床过程。为与对照组进行比较，研究了38例有散发性流产史的可育女性的临床过程。在19例（50%）RSA患者和6例（16%）对照组中，孕期超声检查显示有胎心活动。与对照组相比，RSA组在孕期或妊娠8周±7天时检测到活胎的比例显著更高。RSA组自然流产前阴道出血的比例显著低于对照组。两组在自然流产时的年龄或孕周方面无差异。对RSA患者均检测了血清中的抗磷脂抗体，其中8例检测到该抗体。然而，抗体检测呈阳性或阴性的RSA患者中，胎心活动阳性率并无差异。这些结果表明，RSA的临床过程与散发性流产的过程非常不同。虽然散发性流产是妊娠的常见并发症，但RSA并非随机反复流产，而是正常可育女性中与散发性流产不同的一种独立疾病。
