Research On Effects Of Treatments With Early Recurrent Spontaneous Abortion

Objective:To find out the possible high risk causes of early recurrent spontaneous abortion.Analysis of the treatment outcomes of patients with early recurrent spontaneous abortion.To investigate the effects of triple therapy with aspirin,prednisone and combined vitamin(including 0.8mg folic acid)in patients with unexplained early recurrent spontaneous abortion.Methods:From January 2013 to March 2017,this research was applied with patients from Peking Union Medical College Hospital Gynecologic clinic,who were seeking treatments for two or more spontaneous abortion.The patients were examined for various blood,urine and swabs,and the results were recorded.The first part:symptomatic treatment was applied with patients whose test results were abnormal.As the same time,triple therapy with aspirin 100 mg/d,prednisone 5 mg/d,Vitamin Complex Tablets(0.8mg folic acid contained)1 pill/day was prescript for at least three months.After 3 months of contraception and treatments,with abnormal test results turned to normal,the dose of aspirin was changed to 75 mg/d,with the dose of prednisone and Vitamin Complex Tablets unchanged.Then patients could begin to prepare pregnant.It is necessary to take orders until the end of the first trimester.The second part:the patients with unexplained recurrent early spontaneous abortion taking triple therapy with aspirin 100 mg/d,prednisone 5 mg/d,Vitamin Complex Tablets(0.8mg folic acid contained)1 pill/day were administered as treatment group.The patients with unexplained recurrent early spontaneous abortion taking folic acid 0.4 mg/d were administered as control group.After three months of contraception and treatments,in the treatment group,the dose of aspirin was changed to 75 mg/d,with the dose of prednisone and Vitamin Complex Tablets unchanged.Meanwhile;in the control group,the dose of folic acid was unchanged.Then patients in both groups could begin to prepare pregnant.It is necessary to take orders until the end of the first trimester.The outcome was set as follows:in the end of first trimester,ultrasound examination was used to reveal fetal heart,and nuchal translucency<0.25cm,consistent with gestational age and fetal early malformation was ruled out.T test and chi square test were used to analyze and compare the statistical significance of the differences between the two groups,and the data were corrected by Logistic method to observe the effect of treatments.Results:372 patients with early recurrent spontaneous abortion were included in this study.During the follow-up period,10 subjects were missed,and the rest 362 cases were followed up.There was 191 cases with one or more abnormality in endocrine index,coagulation index,immune index,nutritional index,infection index or chromosome index,accounting for 52.76%.There was 171 cases with normal results in all examinations,accounting for 47.24%.There are 298 abnormal results in 191 cases,of which 64 endocrine abnormal results,41 coagulation abnormal results,43 immune abnormal results,34 nutrition abnormal results,109 infection abnormal results,7 chromosome abnormal results.Symptomatic treatment was applied with patients whose test results were abnormal except chromosomal abnormalities until all results returned to normal in monthly follow-up.The success rates were 96.49%,84.85%,93.94%,100%,93.41%,83.3%respectly in endocrine index,blood coagulation index,immune index,nutrition index,infection index and chromosome index in the end of first trimester.There was 171 cases of early unexplained recurrent spontaneous abortion totally.95 of 106 cases were pregnant and the success rate of treatment was 86.32%(82/95)in treatment group.In the control group,60 of 65 cases were pregnant and the success rate of treatment was 53.33%(32/60).The difference between the two groups was statistically significant(P<0.05).Conclusion:For patients with early recurrent abortion,it is possible to find the cause and treat the disease as much as possible.In patients with early recurrent abortion,symptomatic treatment combined with triple therapy can achieve promising success rate of treatment.Aspirin,prednisone and compound vitamin(0.8mg folic acid contained)triple therapy in the treatment of unexplained recurrent spontaneous abortion can significantly improve the success rate,and reduce the early abortion rate.