INCIDENCE OF EARLY LOSS OF PREGNANCY
INCIDENCE OF EARLY LOSS OF PREGNANCY
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DOI：
10.1056/nejm198807283190401
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发表时间：
1988-07-28
影响因子：
158.5
通讯作者：
NISULA, BC
中科院分区：
文献类型：
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作者：
WILCOX, AJ;WEINBERG, CR;NISULA, BC
我们通过收集221名试图怀孕的健康妇女的每日尿液样本来研究早期流产的风险。人类绒毛膜促性腺激素（hCG）尿浓度在707个月经周期中使用免疫放射测定法进行测量，该方法能够检测到hCG水平低至0.01 ng / ml，在黄体生成素存在时，hCG的特异性几乎为100%。我们的早孕标准。hCG连续三天高于0.025纳克/毫升。在我们将研究组的hCG水平与28名通过输卵管结扎进行绝育的妇女的hCG水平进行比较后确定。我们发现198例妊娠在接近预期着床时间时hCG水平升高。其中，22%的人在临床检测出怀孕前就结束了妊娠。早期研究中使用的hCG敏感性较低的检测方法无法检测到大多数早期妊娠损失。包括临床认可的自然流产在内，植入后的总流产率为31%。在40名未被发现的早孕流产妇女中，大多数人的生育能力正常，因为95%的妇女在两年内都有正常的生育能力。
We studied the risk of early loss of pregnancy by collecting daily urine specimens from 221 healthy women who were attempting to conceive. Urinary concentrations of human chorionic gonadotropin (hCG) were measured for a total of 707 menstrual cycles with use of an immunoradiometric assay that is able to detect hCG levels as low as 0.01 ng per milliliter, with virtually 100 percent specificity for hCG in the presence of luteinizing hormone. Our criterion for early pregnancy .sbd. an hCG level above 0.025 ng per milliliter on three consecutive days .sbd. was determined after we compared the hCG levels in the study group with the levels in a comparable group of 28 women who had undergone sterilization by tubal ligation. We identified 198 pregnancies by increase in the hCG level near the expected time of implantation. Of these, 22 percent ended before pregnancy was detected clinically. Most of these early pregnancy losses would not have been detectable by the less sensitive assays for hCG used in earlier studies. The total rate of pregnancy loss after implantation, including clinically recognized spontaneous abortions, was 31 percent. Most of the 40 women with unrecognized early pregnancy losses had normal fertility, since 95 percent within two years.