Objective To analysis the chromosomal karyotype of chorionic villus in early pregnancy loss with or without fetal pole .Methods A retrospective analysis was conducted from January 2012 to June 2016 in Nanfang Hospital of Southern Medical University .A total of 431 patients, who underwent dilation and curettage ( D&C) and cytogenetic tests for early pregnancy losses , were recruited .Embryonic and anembryonic pregnancy loss were diagnosed based on the presence or absence of an embryonic pole during transvaginal sonography , all cases derived from natural conception or in vitro fertilization and intracytoplasmic sperm injection ( IVF/ICSI ) .The composition of chromosomal in two groups were analyzed , as well as patient characteristics .Results Of the 431 samples from early spontaneous abortion , 255 cases (59.2%) were with abnormal karyotype .The frequency of aneuploidy in embryonic group was significantly higher than that in anembryonic group (65.8%versus 47.1%, P=0.000), especially in women under 35 years old.All monosomy X and ninety percent viable autosomal trisomy ( trisomy 13, 18 and 21) were observed in embryonic group , while trisomy (16 and 22) were mostly observed in anembryonic group .Advanced maternal age increased the risk of aneuploidy , but there was no significant difference between ART pregnancy and aneuploidy after adjustment .There was no statistically sig-nificant difference in abortus sex ratio .Conclusion Chromosomal anomaly is closely correlated to embryonic pregnancy , thouhg may not be the major reason of anembryonic pregnancy .Compared with natural conception , ART doesn′t increase the rate of chorionic villus chromosome abnormality in spontaneous abortion during the first trimester .%目的 分析在早期稽留流产中有胎芽和无胎芽两种绒毛染色体的差异性.方法 回顾性收集因早期流产行清宫术+胚胎绒毛染色体检查的患者431例,根据B超情况分为胎芽组和空囊组,有自然妊娠(NC)和IVF/ICSI妊娠(ART)两种不同来源.比较两组一般情况和染色体核型的组成差异.结果 431例样本中检出异常核型255例(59.2%),胎芽组染色体异常率显著高于空囊组(65.8%vs 47.1%,P=0.000),35岁以下更为明显;所有45,X和90%可存活三体(13、18、21-三体)存在胎芽组,空囊组最常见的异常核型为16、22-三体;年龄是非整倍体的危险因素,校正年龄后ART不增加非整倍体的发生风险,各组间流产物性别比差异无统计学意义.结论 绒毛染色体异常和有胎芽流产密切相关,但可能不是无胎芽的主要原因,ART妊娠并不增加孕早期自然流产胚胎染色体异常的发生率.
展开▼
