Pandya P P, Snijders R J, Psara N, Hilbert L, Nicolaides K H
Harris Birthright Research Centre for Fetal Medicine, King's College Hospital Medical School, London, UK.
Ultrasound Obstet Gynecol. 1996 Mar;7(3):170-3. doi: 10.1046/j.1469-0705.1996.07030170.x.
In an ultrasound screening study at 10-13 weeks of gestation involving 17,870 women, the prevalence of early pregnancy failure was 2.8% (501 cases), including 313 (62.5%) missed abortions and 188 (37.5%) anembryonic pregnancies. Lower gestation and higher maternal age were associated with a higher prevalence (chi 2 = 143.5; p < 0.001 and chi 2 = 53.3; p < 0.0001, respectively). The prevalence was higher in women with a history of vaginal bleeding (chi 2 = 141.5; p < 0.0001), but there was no significant association with previous pregnancy losses (chi 2 = 2.8), parity (chi 2 = 0.6) or cigarette smoking (chi 2 = 0.0). Recent evidence suggests that the most effective method of screening for chromosomal abnormalities is measurement of fetal nuchal translucency thickness at 10-13 weeks, and therefore ultrasound examination at this gestation is likely to become universally available. As shown in this study, an additional advantage of such a scan is the diagnosis of early pregnancy failure, which will be found in about 3% of patients examined. Elective evacuation of retained products of conception is likely to be more cost effective and potentially safer than emergency surgery in a patient presenting during miscarriage.
在一项针对17870名妊娠10 - 13周女性的超声筛查研究中，早期妊娠失败的发生率为2.8%（501例），其中稽留流产313例（62.5%），空孕囊妊娠188例（37.5%）。妊娠周数较低和母亲年龄较大与较高的发生率相关（分别为χ² = 143.5；p < 0.001和χ² = 53.3；p < 0.0001）。有阴道出血史的女性发生率较高（χ² = 141.5；p < 0.0001），但与既往妊娠丢失（χ² = 2.8）、产次（χ² = 0.6）或吸烟（χ² = 0.0）无显著关联。最近的证据表明，筛查染色体异常最有效的方法是在10 - 13周测量胎儿颈部透明带厚度，因此在此孕周进行超声检查可能会普及。如本研究所示，这种扫描的另一个优点是能够诊断早期妊娠失败，在接受检查的患者中约3%会发现这种情况。对于流产期间就诊的患者，选择性清宫清除残留妊娠物可能比急诊手术更具成本效益且潜在更安全。
