Systematic Study Of The Etiology Of Recurrent Spontaneous Abortion

Objective:To investigate the incidence of recurrent spontaneous abortion(RSA)in women of childbearing age in urban community,to survey the etiology of RSA patients in outpatient clinics,to study the correlation of various etiology of RSA and its correlation with clinical outcome.Object of study:Kunming,Yunnan Province,grass-roots family planning service site to the jurisdiction of the community resident population book subject,according to the principle of random,sampling,take the Kunming City,Yunnan Province Guandu District Shang 6 community 3 to 4 million resident population,excluding men and Under the age of 18,50 years of age women,the remaining population in the past three years had pregnant women married as a major research object.Identify the spouse,parents,and children of the woman being investigated as secondary investigators.Commissioned investigators to use the household survey,telephone verification and other methods to collect records of the community from January,2014 to July,2016 between all the pregnancy situation of childbearing age(18 to 49 years old)women's pregnancy The number of times and the corresponding outcome of each pregnancy and detailed clinical examination results,calculate the incidence of RSA in women of childbearing age in urban community.At the same time,collect RSA patients at the outpatient clinic,the same age as the normal fertility history couple as a control.register the detailed information and related inspection results of the study subjects,followed by retrospective statistical analysis and prospective interventions and observations.Under the conditions of informed consent,On the study of the couple do the detection of peripheral blood chromosome,corpus luteum test,erythrocyte folic acid concentration,vitamin D concentration,common genital tract infection and toxoplasmosis,rubella virus,cytomegalovirus,herpes simplex virus(TORCH),and after the ultrasound examination and early pregnancy hormone determination of embryos to stop the development of the villi tissue embryonic chromosome examination.Abortion embryos of the sample selection criteria:early pregnancy unexplained abortion,habitual abortion early pregnancy in patients with early pregnancy,IVF after the early pregnancy to stop the development of early pregnancy B-ultrasound no fetal heart rate of the empty sacral villi tissue.Methods:The CHR karyotype of peripheral blood lymphocytes in both the case group and the control group was detected by routine G-band analysis.The number of chromosomes in miscarriages/embryos was detected by flow cytometry(FCM).(Including inhibin A)and erythrocyte folic acid in follicular phase were detected by automatic micrograph chemiluminescence immunoassay.Serum TORCH antibody and 25-hydroxyvitamin D were measured by chemiluminescence immuneOassay.Chlamy-dia trachomatis(CT)and Ureaplasma urealyticum(UU)were detected by PCR fluoro-scopy.statistical analysis:The difference between the two groups was compared with the t test.The count data were compared using the x2 test.The difference of the P value was less than 0.05.The difference was significant and statistically significant.P<0.01 indicates that the difference is very significant.Comparison of case groups and the control group of various possible causes are different,compare the various causes of patients with RSA and whether there is a correlation.Results:RSA patients in Kunming,Yunnan Province Guandu District community population accounted for the number of women of childbearing age was 48/836=5.74%.The average age of women is 29.7±5.0 years old.The man is 31.9± 5.5 years old.In the outpatient clinic of the outpatient lab,315 couples(630 persons)had 31 pairs of chromosomal abnormalities.There were 145 positive TOUCR antibodies,301 of the reproductive tract Ct,30 pairs of UU infection,60 pairs of low folic acid,20 pairs of VD,Corpus lutea function of 23 people;There were 36 pairs of chromosomal abnormalities in 105 couples(210 persons)who had had normal children and had no RSA history.There were 36 pairs of positive TOUCR antibodies,67 pairs of reproductive tracts,67 pairs of UU infection,19 pairs of low folic acid,Yes,the corpus luteum function is less than 9 people.Conclusion:RSA patients in Yunnan Kunming urban and rural communities accounted for the number of women of childbearing age 5.74%;In the study of hospital outpatients,resulting in various causes of RSA is a genetic abnormalities,positive infection,endocrine abnormalities,folic acid deficiency,VD deficiency.Among them,there were significant differences in genetic factors,TORCH antibody factors were significantly different,other factors on the RSA patients the difference was not significant.In the impact of the number of abortion,the infection factors were very significant differences,statistically significant.