| Background and ObjectiveIn early pregnancy,progesterone prepares for the implantation of fertilized eggs by stimulating the growth of glands in the uterine mucosa and promoting intimal thickening.Progesterone not only reduces uterine smooth muscle excitability and its sensitivity to oxytocin.In addition,progesterone can also maintain the resting state of the uterus by regulating the immune response of the mother,which is conducive to the normal development of the embryo or fetus in the uterus.Serum?-HCG levels in early pregnancy are directly proportional to the number of syncytiotrophoblasts,and low?-HCG levels mean syncytiotrophoblastic dysplasia.Low levels of serum?-HCG in early pregnancy may be associated with adverse pregnancy outcomes.There are many studies on the effects of progesterone and?-HCG levels in early pregnancy on early pregnancy outcomes at home and abroad,but there are few studies on the effects of progesterone levels and?-HCG doubling in early pregnancy on pregnancy outcomes in the third trimester and throughout pregnancy.This study explored the effects of progesterone levels and?-HCG doubling in pregnancy on pregnancy outcomes,providing a reference for clinical treatment.Materials and Methods1 Study subjects and groupsA total of 867 pregnant women from the first check-up(5-7 weeks)from the Third Affiliated Hospital of Zhengzhou University from November 2016 to May2018 were randomly selected and collected.The relevant data were collected.Statistical analysis was performed using retrospective analysis.Group 1:According to progesterone levels:progesterone progesterone<15 ng/ml group(Low progesterone group),15 ng/ml?progesterone<25ng/ml group(Mesoprogesterone group),progesterone?25ng/ml group(High progesterone group);Group 2:According to the?-HCG doubling after every 3 days(monitoring 3 times),the?-HCG doubling good group(at least one doubling is good);the?-HCG doubling bad group(both doubling poor).(1)Inclusion criteria:All patients had a history of menopause and urinary HCG positive;the first birth examination(5-7 weeks);all patients with non-recurrent abortion;all were naturally conceived;those who continued to be pregnant were all traced to childbirth.(2)Exclusion conditions:1history of hypertensive disorder and premature birth in pregnancy;2 history of cesarean section surgery;3 history of malignant tumors in pregnancy;4 uterine malformations and severe internal surgery complications and complications;5cytomegalovirus,toxoplasma gondii,rubella virus,herpes simplex virus(TORCH)infection.2 Research method2.1 Determination of blood progesterone and?-HCG:All patients received about5 ml of peripheral venous blood at the first check-up.The samples were centrifuged,serum was separated,and serum?-HCG and progesterone levels were measured by serum analyzer.After the test was completed for 3 days,the patient's venous blood was taken again and tested in the same manner.The test was performed according to the detection procedure provided by the kit,and was measured by radioimmunoassay for 3 times,that is,at the first check,after 3days,after6 days.2.2 Clinical pregnancy diagnostic criteria:using the GE E8 Logiq E9 color Doppler ultrasound diagnostic instrument,the probe frequency is 3.5-5.0MHZ.In the intrauterine pregnancy,the gestational sac can be seen at the last menstrual period of5 weeks,and the original cardiac pulsation can be seen at 6 weeks.After 7 weeks of pregnancy,the embryo can be judged according to the presence or absence of cardiac pulsation.Refer to the eighth edition of the textbook"Gynecology and Obstetrics"edited by Xie Xing and others from the People's Medical Publishing House.3 Experimental methodStatistical analysis was performed using SPSS22.0 statistical software.The percentages were used for statistical description of qualitative data and compared by?~2 test or corrected?~2 test.The difference was statistically based on the two-sided test;the rank-sum test was used for qualitative data that did not meet the chi-square test.P<0.05 difference was statistically significant.ResultsPregnancy outcomes were divided into early benign pregnancy outcomes and early adverse pregnancy outcomes.Early benign pregnancy outcomes include intrauterine continued pregnancy;early adverse pregnancy outcomes include abortion,ectopic pregnancy.Early benign pregnancy outcomes were grouped into progesterone levels and?-HCG doubling to study premature delivery,and fetal growth restriction,hypertensive disorders of pregnancy,premature rupture of membranes.1 Comparison of different progesterone levels and?-HCG doubling early pregnancy outcomes(1)Low progesterone group(progesterone<15ng/ml group),123 cases,39 cases of intrauterine pregnancy,58 cases of abortion,26 cases of ectopic pregnancy,84cases of adverse pregnancy outcomes(abortion and ectopic pregnancy),the incidence rate reached 68.29%,significantly higher than Mesoprogesterone group(15ng/ml?progesterone<25ng/ml group)38.29%and High progesterone group(progesterone?25ng/ml group)18.56%,the difference between the groups was statistically significant(P<0.05).(2)Serum progesterone levels within the stratification:the incidence of adverse pregnancy outcomes(abortion and ectopic pregnancy)in the early pregnancy of the?-HCG doubling group was 90.91%,73.24%,50.60%,significantly higher than the?-HCG doubling group(42.10%,19.78%,7.97%),the difference was statistically significant(P<0.05);the intrauterine continued pregnancy in the?-HCG doubling group was 6 cases,38 cases,41 cases,the incidence rate was 9.09%,26.76,respectively.%,49.40%,significantly less than the?-HCG doubling good group(33cases of 57.90%,215 cases of 80.22%,231 cases of 92.03%),the difference was statistically significant(P<0.05).2 Comparison of different progesterone levels and?-HCG doubling in the middle and late pregnancy outcomes564 cases of intrauterine pregnancy continued in this study(1)Among the 564 cases of intrauterine pregnancy,Low progesterone group premature delivery,fetal growth restriction,hypertensive disorder of pregnancy,premature rupture of membranes,cesarean section,low birth weight infants,5-minute Apgar score?7 points,respectively,the incidence rate reached 58.97%,25.64%,25.64%,17.95%,30.77%,23.08%,20.51%,significantly higher than Mesoprogesterone group(37.55%,11.07%,13.44%,7.51%,12.25%,10.67%,9.09%).High progesterone group(25.74%,5.15%,6.99%,3.31%,4.78%,5.51%,4.41%),the difference was statistically significant(P<0.05).(2)In Progesterone level stratification,premature birth,fetal growth restriction,hypertensive disorder of pregnancy,premature rupture of membranes,cesarean section,low birth weight infants,5-minute Apgar score?7 points The difference was statistically significant(P<0.05).Conclusions1 The lower the progesterone level in early pregnancy,the worse the?-HCG doubling,the higher the risk of adverse pregnancy outcomes2 Low Low serum progesterone and?-HCG dysfunction in early pregnancy,preterm birth in the second trimester,fetal growth restriction,hypertensive disorder of pregnancy,increased risk of premature rupture of membranes,cesarean section rate and low birth weight infants,newborns the yield rate have also increased accordingly. |
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