Objective To investigate the influencing factors of pregnancy outcome in patients with subchorionic hematoma(SCH)and recurrent spontaneous abortion(RSA)combined with SCH,so as to formulate corresponding treatment strategies and improve pregnancy outcome.Methods A total of 204 patients with subchorionic hematoma admitted to the Fourth Hospital of Shijiazhuang and the Second Affiliated Hospital of Hebei Medical University from June 2019 to June 2021 were retrospectively analyzed.The high-risk factors of adverse pregnancy outcomes were analyzed by analyzing the patient's age,BMI,gestational age when SCH was diagnosed,whether accompanied by vaginal bleeding,pregnancy history,coagulation indicators(platelet aggregation rate AA,platelet aggregation rate ADP,D-dimer,homocysteine),and recurrent miscarriage history.Results A total of204 SCH patients were included in the study.After controlling confounding factors,vaginal bleeding(OR=3.443,95％CI 1.613-7.351,P=0.001),the history of recurrent miscarriage(OR=2.392,95％CI 1.136-5.035,P=0.022),platelet aggregation rate(ADP)(OR=1202,95％CI 1.118-1292,P＜0.001)were found that they were the risk factors for adverse pregnancy outcomes,and the number of gestational ages at diagnosis of hematoma(OR=0.963,95％CI 0.938-0.989,P=0.006)and previous live births(OR=0.125,95％CI 0.047-0.330,P＜0.001)were the protective fac-tors.After controlling confounding factors,platelet aggregation rate(ADP)(OR=1.171,95％CI 1.043-1.316,P=0.008)and D-dimer(OR=1.011,95％CI 1.002-1.020,P=0.020)were found to be risk factors for adverse pregnancy outcomes in 92 SCH patients with RSA,and the number of previous live births(OR=0.154,95％CI 0.061-0.392,P＜0.001)was a protective factor for adverse pregnancy outcomes.Conclusion Abnormal coagulation(hypercoagulability)is a risk factor for adverse pregnancy outcomes in patients with subchorionic hematoma or subchorionic hematoma combined with recurrent spontane-ous abortion.Patients with subchorionic hematoma complicated with recurrent abortion should pay more attention to moni-toring coagulation indexes(D-dimer,etc.)during pregnancy,and those with hypercoagulable state should be given corre-sponding anticoagulation therapy to improve pregnancy outcome.
维普
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