体外受精-胚胎移植后妊娠早期阴道流血对妊娠结局的影响

摘要

目的 探讨体外受精-胚胎移植(IVF-ET)后妊娠早期阴道流血的发生率及其对妊娠结局的影响.方法 回顾性分析行IVF-ET或胚胎解冻-移植(F-ET)获得临床妊娠 823例患者的临床资料,分析早期阴道流血与患者年龄、不孕年限、体质量指数(BMI)、孕酮及人绒毛膜促性腺激素水平、不孕类型、流产、妊娠期并发症、早产及剖宫产率的相关性.结果 ①妊娠早期阴道流血发生率为23. 69％,多元回归分析结果显示妊娠早期阴道流血与妊娠期并发症的发生明显相关,差异有统计学意义(OR=2.90,95％ CI: 1. 85～ 4. 57,P<0.05),与流产、早产及剖宫产率无明显相关;②患者孕前BMI是影响剖宫产的独立危险因素(OR=1.09,95％ CI:1.02～1. 17,P<0.05). 结论 IVF/F-ET后妊娠早期阴道流血对妊娠结局如流产、早产率无明显影响,但与妊娠期并发症的发生密切相关.%Objective To explore the correlations of vaginal bleeding in early pregnancy with the pregnancy outcomes after in vitro fertilization-embryo transfer (IVF-ET). Methods The clinical data of 823 pregnancy women received IVF-ET or frozen-thawed embryo transfer (F-ET), and the correlations of vaginal bleeding in early pregnancy with females' age, duration of infertility, body mass index(BMI), levels of progesterone and human chorionic gonadotropin, the rates of miscarriage, pregnancy complications, premature delivery and cesarean section were analyzed by multivariate logistic regression. Results Among 823 pregnant women, 23. 69％ women experienced vaginal bleeding in early pregnancy. There were positive correlations between vaginal bleeding in the early pregnancy and the rate of pregnancy complications (OR =2. 90, 95％ CI: 1. 85～4. 57,P＜ 0. 05 ), as well as the BMI and the rate of cesarean section(OR =1. 09, 95％ CI: 1. 02～1. 17, P＜0. 05). While no significant correlations of vaginal bleeding in the early pregnancy with the rates of miscarriage, premature delivery and cesarean section were found. Conclusion Vaginal bleeding in early pregnancy after IVF/F-ET is significantly associated with the occurrence of pregnancy complications, but not with the occurrences of miscarriage and premature deliver.