Analysis On Diagnosis And Treatment Of Early Recurrent Spontaneous Abortion

Objective: Discuss the aetiology of early recurrent spontaneous abortion(ERSA) to improve the clinic diagnosis and treatment. Try to find out if there is relationship between vaginal infection and ERSA. Reduce ERSA by using propriate test and theropy. And test peripheral blood CD4~+CD25~+ regulative T cells of ERSA to find out if it is related to maternal-fetal immune.Methods:1. Find the etiology of ERSA by rewiewing the 136 ERSA patients in our Genecology clinic with retrospective analysis. 2. The control group is consist of 140 patients for preconception examination. 3. Find the results after treatment in Uu and CT positive patients by using oral antibiotic and sepatate uterus by using hysteroscopic metroplasty 4. Test the CD4~+CD25~+ regulatory T cells and cytotxic T lymophocyte antigen-4 expressed in T lymophocyte in both the patients with 21 unexplained spontaneous abortion and 5 earrly pregancy women, to find if there are relations between them.Results: 1. The consistent of etiology in ERSA was unexplained patients(36.03%), infectious patients (31.62%), anatomic abnormity(14.71%). 2. The infection rate of Ureaplasma urealyicum and Chlamydia trachomatis was higher in observation group than in control group respectively. 3. By the end of 3 therapeutic courses, the infection become negative in 91.43% patients. After the treatment, the rate of pregancy is 61.90% and the rate of abortion is 23.81%. 4. Sepatate uterus treated with hysteroscopic metroplasty, after operation, 64.29%(9/14) have pregnancy, 21.43%(3/14) get spontaneous abortion. 5. Compare with the group of unexplained spontaneous abortion, normal pregnancy women has generally upward trend in the expression of Treg cells, but from the 26 database only, we can not get the conclusion that the expression of cytotoxic T lymophocyte-4 expression in T lymophocytes concerned with spontaneous abortion.Conclusion:1. The incidence of Uu and CT infections was higher in the patients with spontaneous abortions, it suggests the infection of urogenital pathogen have relationship with early recurrent spontaneous abortion. 2. It is common to see the Uu and CT infection in clinic, that we should pay attention to cure it to improve the pregnant outcome. 3. On the basis of eliminating the influence of other related factors, it is effetive using the hysteroscopic metroplasty patients with sepatate uterus in ERSA. 4. 35% ERSA patients have not been figured out their etiology, we found that study the ratio of CD4~+CD25~+Treg expression in T lamphocyte may has future clinial value.