Karyotype Analysis Of Chorionic Villus From Women With Early Spontaneous Abortion And The Predictive Role Of Inhibin A In Women With Threatened Abortion

1. Culture and karyotype analysis in early spontaneous abortion villusObjective: To investigate the methods of chromosome preparation and karyotype analysis of chorionic villus from women with early spontaneous abortion.Methods: 40 cases of chorionic villi were obtained by dilatation and curettage. Chromosome prepared by methods of direct harvest and long-term culture, karyotypes analyzed cytogenetically.Results: Successful cytogenetic evaluation was performed in 36 of the 40 cases. The successful culture rate of direct harvest method was 42.8%, while the long-term method was 93.9% (P=0.005). Chromosomal abnormalities were found in 15 of 36 cases (41.7%), including 10 cases of autosomal trisomies (27.8%), 3 cases of triploidy (8.3%) and 2 cases of monoploidy (5.6%). There were no significant differences between ages, gravidities and parities among women with normal and abnormal chromosome. Neither were women with no prior spontaneous abortions and RM. The chromosome abnormality rate in spontaneous abortion between 6~9w was 44.4% while that between 10~15w was 33.3% (P>0.05).All abnormalities except two cases of triploidy 21 and one case of monoploidy X were found during 6~9w.Conclusions: The data indicates that long-term culture of villus cell is a better method of chromosome preparation. Chromosomal abnormalities of embryo might be an important cause of spontaneous abortion. The earlier aborted, the higher rate of abnormalities, and the more lethal abnormalities, the earlier aborted. It's necessary to analyze karyotypes in early spontaneous abortion villus to guide the next pregnancy and prevent the use of empiric treatment modalities.2. The application of maternal serum inhibin A levels in prediction of pregnancy outcome in women with threatened abortionObjective: To determine the value of measurement of serum inhibin A in prediction of pregnancy outcome in patients with threatened abortion.Methods: Blood samples were collected from women with sporadic missed abortion (n=18), and threatened abortion of a viable pregnancy on ultrasound scan (n=27), and controls (n=40) that would deliver of a healthy baby. All samples were at 6~13 weeks gestation and analyzed for inhibin A using a two-site enzyme-linked immunosorbent assay (ELISA).Results: 27 cases of threatened abortion were allocated to another two groups according to the pregnancy outcome: ongoing pregnancy group consists of 17 patients (62.9%) whose pregnancy continued beyond 28 weeks;And inevitable abortion group consists of 10 patients (37.1%) who spontaneously aborted. There were no significant differences between ages, gravidities and parities among women of four groups. The concentration of inhibin A increased steadily along with weeks gestation in early pregnancy, reaching a peak at 10~11 weeks, then declined somewhat by 12~13 weeks. The inhibin A concentrations of both inevitable abortion group and missed abortion group were significantly lower than control group and ongoing pregnancy group (all P<0.01), while there were no significant differences between the two former groups (P>0.05) as same as the two latter groups (P=0.066). When the level of maternal serum inhibin A was less than 0.3MoM, 90% women with inevitable abortion were screened and it had a better sensitivity (90%) and specificity (94.1%).Conclusions: This study shows that low serum levels of inhibin A at early pregnancy may be used to predict the adverse outcomes in patients with threatened abortion. When the level of maternal serum inhibin A was less than 0.3MoM, it had a better sensitivity and specificity.