Author/Editor		Reljič, Milan
Title		Dejavniki ogrožanja za neželen izid nosečnosti pri grozečem splavu v prvem trimesečju
Translated title		Risk factors for an adverse pregnancy outcome in threatened abortion in the first trimester
Type		članek
Source		Zdrav Vestn
Vol. and No.		Letnik 69, št. 3
Publication year		2000
Volume		str. 161-5
Language		slo
Abstract		Background. We tried to establish whether certain sonographic signs and anamnestic data of women with threatening abortion can be used to identify an increased risk of spontaneous abortion, premature delivery and low birth weight of infants (adverse pregnancy outcome), which are these factors and what risk they actually represent. Methods. In 296 women with threatening abortion up to the 13th week of viable pregnancy, sonographic investigation was used to measure the crown-to-rump length (CRL) and to discover subchorionic hematomas. Data regarding age, previous and present pregnancy outcome, uterine malformations (UMF), surgery for UMF and infertility treatment were collected. By logistic regression, the connection between the observed factors and the adverse pregnancy outcome was verified. Results. The smaller the CRL with regard to amenorrhea, the higher the risk of spontaneous abortion in the first trimester, in CRL < 10th centile the odds ratio (OR) =11.1(95% confidence intervals (CI) = 2.9-43.3). Previous premature deliveries (OR = 8.4, CI =1.3-56.3) and unoperated UMF(OR =10.3, CI =1.5-70.1) were associated with the increased risk of spontaneous abortion in the second trimester. The risk of premature delivery was higher in unoperated UMF (OR = 5.5, CI =1.1-26.8), previous premature deliveries (OR = 8.1, CI =1.7-38.5) and in age >30 years (OR = 4.3, CI =1.7-11.0). An increased risk of low birth weight of infants born on the EDD was only found in CRL < 50th centile (OR = 3.3, CI =1.1-9.9). Infertility treatment, UMF following operative treatment and the presence of subchorionic hematoma were not connected with an increased risk of adverse pregnancy outcome. Conclusions. On the basis of CRL measurement, assessment of UMF, age and previous premature deliveries, pregnant women who run an increased risk of adverse pregnancy.
Summary		Izhodišča. Ugotavljali smo, ali lahko na osnovi nekaterih ultrazvočnih znakov in anamnestičnih podatkov pri nosečnicah z grozečim splavom odkrivamo povečano nevarnost za spontani splav, prezgodnji porod in nizko porodno težo otrok (neželen izid nosečnosti); kateri so ti dejavniki in kakšno ogroženost predstavljajo. Metode. Pri 296 nosečnicah z grozečim splavom do 13. tedna vitalne nosečnosti smo z ultrazvokom merili razdaljo teme - trtica (RTT) in ugotavljali subhorialne hematome. Zbrali smo podatke o starosti, izidu prejšnjih in sedanje nosečnosti, razvojnih nepravilnostih maternice (RNM), operacijah zaradi RNM in zdravljenju neplodnosti. Z logistično regresijo smo ugotavljali povezanost dejavnikov z neželenim izidom nosečnosti. Rezultati. Manjša kot je bila RTTglede na amenorejo, večja je bila nevarnost za spontani splav v prvem trimesečju, pri RTT < 10. centilom je bilo razmerje obetov (RO) = 11,1(95% interval zaupanja (IZJ = 2,9-43,3). Prejšnji prezgodnji porod (RO = 8,4, IZ = 1,3-56,3) in neoperirana RNM (RO = 10,3, IZ = 1,5-70,1), sta bila povezana s povečano nevarnostjo za spontani splav v drugem trimesečju. Nevarnost za prezgodnji porod je bila višja pri neoperiranih RNM (RO = 5,5, IZ = 1,1-26,8), prejšnjem prezgodnjem porodu (RO = 8,1, IZ = 1, 7-38,5) in starosti > 30 let (RO = 4,3, IZ = 1,7-11,0). Povečana nevarnost za nizko porodno težo otrok smo ugotovili le pri RTT<50. centilom (RO =3,3, IZ=1,1-9,9). Zdravljenje neplodnosti, RNM po operativnem zdravljenju in prisotnost subhorialnega hematoma niso bili povezani s povečano nevarnostjo za neželen izid nosečnosti. Zaključki. Z merjenjem RTT, ugotavljanjem RNM, starosti in prejšnjih prezgodnjih porodov lahko odkrivamo nosečnice s povečano nevarnostjo za neželen izid nosečnosti.
Descriptors		ABORTION, THREATENED PREGNANCY TRIMESTER, FIRST PREGNANCY OUTCOME PREGNANCY RISK FACTORS ABORTION, HABITUAL INFANT, LOW BIRTH WEIGHT CROWN-RUMP LENGTH UTERUS AGE FACTORS