A Relationship Between Karyotype Analysis Of Villus Chromosome And TCM Syndrome And Other Factors Related In Spontaneous Abortion

Objective To explore the necessity and importance to determine karyotype of villus chromosome from women with early spontaneous abortion,and the TCM syndrome distribution of spontaneous abortion.To evaluate the clinical significances of ultrasound findings and the variation of human chorionic gonadotrophin(HCG)in the matetnal blood with triploidy in early pregnancy.Methods This was a prospective study including 200 patients with early spontaneous abortion and 105 with artificial abortion in our institution.The karyotype of villus chromosome were analyzed,all cases were confirmed from the same period.From May 2014 to April 2015,200 patients with early pregancy loss were evaluated by regular ultrasound and human chorionic gonadotrophin(HCG)and TCM syndrome during pregnancy and karyotyping was performed on chorionic villus after curettage.Results Of the 200 samples from early spontaneous abortion,114 cases(57%)were abnormal karyotype.While 22、16 trisomy are primary form of phenotype.Of the 105 samples from early artificial abortion,6 cases displayed chromosome abnormality(5.7%).Chromosomal abnormality rate was different in two groups.We observed that 57 cases out of 200 are spleen-kidney deficiency type(28.5%),105 cases are kidney deficiency type(52.5%),13 cases are qi and blood asthenia type(6.5%),25 cases are blood-heat type(12.5%),indicating that a large proportion deficiency are kidney deficiency in the all syndromes.The proportion of karyotype anomaly in each syndrome is 57 cases(50%)、32 cases(28%)、15 cases(13.2%)、10 cases(8.8%),there were no statistic differences in between normal and abnormal chromosome.The most frequent chromosomal anomalies in miscarriage with presence of cardiac activity were(45,X),triploidy and trisomy 16.While trisomy 16 was most frequent in miscarriage with absence of cardiac activity.Frequencies for triploidy in miscarriage with presence of cardiac activity were signifantly higher than that of absence of cardiac activity(19.8%vs 3%),(P<0.05).The embryonic pole was larger in viable autosomal trisomies,(45,X),triploidy group than that of other chromosomal anomaly(5.0±5.1mm)and normal karyotype(6.4±7.7mm).On the contrary,the amount of human chorionic gonadotrophin(HCG)with triploidy is less than any other chromosomal karyotype.Conclusion Anomaly of villus chromosome is the most important factor of early spontaneous abortion.In clinic,it will benefit to patients with early spontaneous abortion by examining the embryonic chromosome to judge the reasons of abortion.The existence of low amount of human chorionic gonadotrophin(HCG)with precocious fetal heart and obviously higher embryonic pole alerts the clinician for the possibility of underlying fetal chromosomal abnormalities.