人工流产次数、胎儿游离DNA与剖宫产后再次妊娠孕妇胎盘植入风险的关联性研究  

Correlation of number of induced abortions and fetal circulating cell free DNA with the risk of placenta accreta in pregnant women with previous cesarean section

作　　者：侯瑞杰[1] 王慧玲[1] 赵淑珍[2] 郝尚辉 王世进[1] Hou Rujie;Wang Huiling;Zhao Shuzhen;Hao Shanghui;Wang Shijin(Department of Gynecology,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China;Department of Obstetrics,the First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,China)

机构地区：[1]新乡医学院第一附属医院妇科,卫辉453100 [2]新乡医学院第一附属医院产科,卫辉453100

出　　处：《中国实用医刊》2024年第13期14-17,共4页Chinese Journal of Practical Medicine

摘　　要：目的:研究人工流产次数、胎儿游离DNA(ccf DNA)与剖宫产后再次妊娠孕妇胎盘植入风险之间的关系。方法:回顾性抽取2018年2月至2023年4月新乡医学院第一附属医院收治的189例剖宫产后再次妊娠合并胎盘植入妇女中睾丸特性蛋白Y(TSPY)为阳性的98例妇女作为观察组,另抽取同期88例剖宫产后再次妊娠未合并胎盘植入者作为对照组,两组均怀男胎(仅用于研究,未告知孕妇胎儿性别)。采用实时聚合酶链式反应法检测两组孕妇血浆TSPY水平。比较观察组与对照组,以及观察组不同胎盘植入深度患者、不同植入面积患者的既往人工流产次数及孕妇血浆TSPY-1水平。结果:观察组孕次及人工流产次数均多于对照组(P均<0.05),两组产次及剖宫产次数比较,差异未见统计学意义(P>0.05)。观察组孕妇血浆TSPY-1水平高于对照组(P<0.05)。粘连型、植入型及穿透型胎盘植入者人工流产次数及血浆TSPY-1水平比较,差异均有统计学意义(P均<0.05),其中植入型患者人工流产次数及血浆TSYP-1水平均高于粘连型,穿透型患者人工流产次数及血浆TSPY-1水平均高于粘连型与植入型(P均<0.05)。胎盘全部植入者人工流产次数及血浆TSPY-1水平均高于部分植入者(P<0.05)。结论:血浆ccf DNA水平及人工流产次数与既往剖宫产史孕妇再次妊娠胎盘植入具有一定的关联性。Objective:To investigate the correlation of number of induced abortions and fetal circulating cell free DNA(ccf DNA)with the risk of placenta accreta in pregnant women with previous cesarean section.Methods:Among 189 pregnant women with placenta accreta who had a history of cesarean section,98 women with positive testis-specific protein Y-encoded(TSPY)admitted to the the First Affiliated Hospital of Xinxiang Medical University from February 2018 to April 2023 were retrospectively selected as the observation group;the other 88 pregnant women without placenta accreta who had a history of cesarean section during the same period were selected as the control group.All pregnancy women conceived male fetuses.This information was detected for research purposes only,and pregnant women were not informed of fetal gender.Level of plasma TSPY of the two groups were detected by real-time polymerase chain reaction.The number of previous induced abortions and plasma TSPY-1 level were compared between the observation group and the control group,between patients with different depths of placenta accreta,and between patients with different areas of placenta accreta.Results:The number of pregnancy and induced abortion in the observation group were more than those in the control group(all P<0.05),but there was no significant difference in the number of delivery and cesarean section between the two groups(P>0.05).The level of plasma TSPY-1 in the observation group was higher than that in the control group(P<0.05).There are statistically significant differences in the number of induced abortions and plasma TSPY-1 level among patients with adhesion type,implantable type and penetration type placenta accreta(all P<0.05).The number of induced abortions and plasma TSPY level in patients with implantable type were higher than those in patients with adhesion type,while the number of induced abortions and plasma TSPY level in patients with penetration type were higher than those in patient with adhesion and implantable types,with statistical

关 键 词：人工流产 胎儿游离DNA 剖宫产 胎盘植入 

分 类 号：R714.2[医药卫生—妇产科学]