Time of implantation of the conceptus and loss of pregnancy
Time of implantation of the conceptus and loss of pregnancy
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DOI：
10.1056/nejm199906103402304
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发表时间：
1999-06-10
影响因子：
158.5
通讯作者：
Wenberg, CR
中科院分区：
文献类型：
--
作者：
Wilcox, AJ;Baird, DD;Wenberg, CR
背景植入的概念是一个关键步骤，在怀孕，但鲜为人知的植入时间或植入的时间和妊娠outcome of pregnancy.Methods之间的关系，我们收集了每天的尿液样本长达6个月的221名妇女试图怀孕后停止使用避孕药。排卵的基础上确定的尿雌激素代谢产物的比例，孕酮代谢产物的变化迅速与黄体化的卵泡，植入的时间是由绒毛膜促性腺激素在母体urina.Results的外观定义有199概念，其中95%（189），我们有足够的数据进行分析。在这189例妊娠中，有141例（75%）在末次月经后至少持续了6周，其余48例（25%）妊娠以早期流产告终。妊娠6周以上者，绒毛膜促性腺激素首次出现在排卵后6 ~ 12天; 118名妇女（84%）在第8、9或10天着床，早期妊娠丢失的风险随着着床的推迟而增加。102例第9天着床的孕鼠中，13%的孕鼠早期流产（P < 0.001）。第10天着床的比例为26%，第11天着床的比例为52%，第11天后着床的比例为82%。（N Engl J Med 1999;340：1796-9，）（C）1999，马萨诸塞州医学会。
Background Implantation of the conceptus is a key step in pregnancy, but little is known about the time of implantation or the relation between the time of implantation and the outcome of pregnancy.Methods We collected daily urine samples for up to six months from 221 women attempting to conceive after ceasing to use contraception. Ovulation was identified on the basis of the ratio of urinary estrogen metabolites to progesterone metabolites, which changes rapidly with luteinization of the ovarian follicle, The time of implantation was defined by the appearance of chorionic gonadotropin in maternal urine.Results There were 199 conceptions, for 95 percent of which (189) we had sufficient data for analysis. Of these 189 pregnancies, 141 (75 percent) lasted at least six weeks past the last menstrual period, and the remaining 48 pregnancies (25 percent) ended in early loss. Among the pregnancies that lasted 6 weeks or more, the first appearance of chorionic gonadotropin occurred 6 to 12 days after ovulation; 118 women (84 percent) had implantation on day 8, 9, or 10, The risk of early pregnancy loss increased with later implantation (P < 0.001), Among the 102 conceptuses that implanted by the ninth day, 13 percent ended in early loss. This proportion rose to 26 percent with implantation on day 10, to 52 percent on day 11, and to 82 percent after day 11.Conclusions In most successful human pregnancies, the conceptus implants 8 to 10 days after ovulation, The risk of early pregnancy loss increases with later implantation. (N Engl J Med 1999;340:1796-9,) (C) 1999, Massachusetts Medical Society.