胚胎宫内生长受限42例临床分析

目的:探讨孕早期胚胎宫内生长受限存在的临床依据及其发病相关因素和临床意义。方法:对42例孕早期月经龄与胚胎生长发育不相符病例的临床资料进行回顾性分析(研究组),与同期随机抽取的1956例正常孕妇作对照(对照组),对年龄、婚龄、不孕不育病史、不良孕史、宫内操作史、盆腔感染性疾病史,孕中、晚期并发症发生情况、分娩期情况及新生儿情况进行分析。产后随访1年,记录新生儿及婴儿生长发育、智力发育情况。结果:孕早期胚胎宫内生长受限发病的相关危险因素两组比较,差异有统计学意义,年龄(P<0.05)、婚龄(P<0.05)、不孕不育病史(P<0.01)、不良孕史(P<0.01)、宫内操作史(P<0.01)、盆腔感染性疾病史(P<0.01)、前置胎盘(P<0.01)、胎盘异常(P<0.01)、胎盘粘连及植入(P<0.01)、产后出血(P<0.05)。结论:孕早期存在胚胎宫内生长受限,其发病相关因素有遗传、免疫因素;盆腔感染性疾病史;受精卵滋养层发育迟缓等。

Clinical analysis on 42 fetuses with intrauterine growth restriction

Objective:To explore the clinical basis of intrauterine growth restriction in the first trimester pregnancy,related pathogenic factors and clinical significance.Methods:The clinical data of 42 cases of first trimester pregnancy whose menstrual age did not coincide with growth and development of fetus were analyzed retrospectively(study group),and 1 956 normal pregnant women at the same time were selected randomly(control group).Ages,married ages,histories of infertility,adverse pregnancy,intrauterine operation and medical histories of pelvic inflammatory diseases,incidences of complications in the second and third trimester pregnancy,conditions during delivery and neonatal conditions in the two groups were compared.Follow-up was conducted for one year after birth,growth and development,intelligence development of neonates and infants were recorded.Results:There was significant difference in related risk factors of intrauterine growth restriction between the two groups:age(P<0.05),married age(P<0.05),history of infertility,history of adverse pregnancy(P<0.01),history of intrauterine operation(P<0.01),medical history of pelvic inflammatory diseases(P<0.01),placenta previa(P<0.01),placenta abnormity(P<0.01),placental adherence and implantation(P<0.01),postpartum hemorrhage(P<0.05).Conclusion:Intrauterine growth restriction exists in the first trimester pregnancy,the related factors includes genetic and immune factors,medical history of pelvic inflammatory diseases and developmental retardation of trophic layer in zygote.