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目的 探讨行新鲜周期IVF-ET治疗后获得妊娠的患者发生宫腔积血(SCH)的危险因素。方法 回顾性分析2020年6月1日至2021年6月1日于青岛市妇女儿童医院生殖中心接受新鲜周期IVF-ET治疗后确诊早孕的402例患者的临床资料，根据B超影像学表现分为积血组(n=170)和对照组(n=232),比较两组患者的一般资料，并采用单因素和多因素分析探讨SCH发生的影响因素。结果 两组患者的一般资料无显著性差异(P>0.05)。对各不同因素进行分层分析发现，不同年龄、不孕年限、体质量指数(BMI)各组间SCH发生率无显著性差异(P>0.05);不同不孕类型、凝血功能、女方染色体、男方染色体状态各组间SCH发生率有显著性差异(P<0.05)。多因素分析结果显示，继发性不孕女性SCH患病率显著高于原发性不孕女性(P=0.021,OR=1.794);合并免疫功能异常女性SCH患病率显著高于免疫功能正常女性(P<0.001,OR=7.210);凝血功能异常女性SCH患病率显著高于凝血功能正常女性(P<0.001,OR=4.255);女方染色体呈现多态性或异常核型者SCH的患病率显著高于染色体正常女性(P=0.021,OR=2.045);而无论男方染色体正常与否，女方SCH患病率无显著性差异(P>0.05)。结论 继发性不孕、凝血功能异常、免疫功能及女方染色体异常是SCH发生的独立危险因素。临床工作中，对于继发性不孕、IVF-ET移植前检查发现免疫功能异常、凝血功能异常及女方染色体异常的女性在助孕治疗获得妊娠后应警惕SCH的发生。
Abstract：Objective:To investigating the risk factors of subchorionic hematoma(SCH) among patients treated with IVF-ET.Methods:The data of 402 patients who received fresh IVF-ET treatment and diagnosed with first-trimester pregnancies in the reproductive center of Qingdao Women and Children's Hospital from June 1st 2020 to June 1st 2021 were retrospectively analyzed. The patients were divided into SCH group(n=170) and control group(n=232) according to B-ultrasound imaging findings. The general data of the two groups were compared, and the influencing factors of intrauterine hematoma were analyzed by univariate and multivariate analysis.Results:There was no significant difference in general data between the two groups(P>0.05). Stratified analysis of different factors showed that there was no significant difference in the incidence of SCH among different age, infertility years and body mass index(BMI)(P>0.05). There were significant differences in the incidence of SCH among different infertility types, coagulation function, female and male chromosome(P<0.05). Multivariate analysis showed that the prevalence of SCH in secondary infertile women was significantly higher than that in primary infertile women(P=0.021,OR=1.794). The prevalence of SCH in women with abnormal immune function was significantly higher than that in women with normal immune function(P<0.001,OR=7.210). The prevalence of SCH in women with abnormal coagulation function was significantly higher than that in women with normal coagulation function(P<0.001,OR=4.255). The prevalence of SCH in women with chromosome polymorphism or abnormal karyotype was significantly higher than that in women with normal chromosome(P=0.021,OR=2.045). There was no significant difference in the prevalence of SCH in women regardless of whether the men were chromosomally normal or not(P>0.05).Conclusions:Secondary infertility, abnormal coagulation function, immune function and female chromosome abnormality are independent risk factors for SCH. In clinical practice, for women with secondary infertility, abnormal immune function, abnormal coagulation function and abnormal chromosome found in pre-transplantation examination of IVF-ET,they should be alert to the occurrence of SCH after pregnancy obtained.
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基本信息:
中图分类号:R714.8
引用信息:
[1]赵明子,郝翠芳,杜鑫,等.体外受精-胚胎移植妊娠后宫腔积血的多因素分析[J].生殖医学杂志,2022,31(05):625-631.
2022-05-15
2022-05-15