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复发性流产病例讨论 PowerPoint PPT Presentation


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复发性流产病例讨论. 江门市计划生育服务中心 陈建明 2012 年 12 月 2 日. 复发性流产的定义和分类 自然流产:是指在孕 28 周之前、胎儿体重不足 1000g 的妊娠物自然丢失。 复发性流产( RSA , 旧称习惯性流产):自然流产连续发生 3 次或 3 次以上。 国内认为连续 2 次或 2 次以上的自然流产( 包括IVF后自然流产 )即为复发性流产。. 复发性流产各种病因及所占比例. 3%-6%. 遗传因素. 解剖因素. 12%-15 %. 复发性流产 病因分布. 内分泌因素. 10%-20%. 感染因素. 5%-10%. 免疫因素.

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复发性流产病例讨论

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3668839

2012122


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281000g

RSA33

22IVF)


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3%-6%

12%-15 %

10%-20%

5%-10%

>60%


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1/32/3


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1

  • 32365

  • 123-8/45-90--G3P0R3, 76

  • 35-8B1


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  • 13

  • LH 17.30IU FSH6.11IU (LH/FSH2.83)

  • E2 63.5ng/mlPRL279IU

  • P 0.83ng T0.87ng

  • 5


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  • 158cm65kgBMI=26

  • BMIkg/m2 65(1.581.58) 26

  • 232530

  • 354018.5


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  • B76

  • 5-7mm12-

  • 14

  • ACA2-GP-Ab

  • 6


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  • 32

  • 76

  • LH 10.50IU FSH4.2IU (LH/FSH2.5)

  • E2 42.5ng/mlPRL320IU

  • P 0.67ng T0.92ng


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  • D-130g/LPTAPTT

  • 46XX46XY

  • 10

  • BV


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  • 1

  • 2

  • 3

  • 4


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  • 3

  • 1

  • 2


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  • LH/FSH23


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  • 1

  • 2/

  • 3

    29mm12/

    10ml


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32

PCOS


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  • 2011PCOS

  • 2011712011121

  • 1PCOS 2


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  • PCO

  • 2PCOS PCOS


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  • 3


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  • 1

  • 2

  • 3


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  • 1-2130.25-0.5 tid

  • 242


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  • 1CC5-950mg50mg/d20;

  • 2HMG1075IU18mmHCG10000IU

  • 31-212-142-3HCG2000IU3-5


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  • 335

  • -HCG460IU850IU

  • P25ng/ml

  • ACA2-GP-Ab

  • D-140g

  • NKB12%


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  • 1VitE

  • 240mg/dHCG 2000-5000IU/d

  • 35000-10000IU/d


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  • HCG


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  • 2-GP-1APA2-GP-12-GP-1APA

  • APAAPAHCGAPSAPS


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  • -HCGBHCG 2000IU20mgHCG10mgbid0.1bid0.1bid)12

  • -HCGPB


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  • 1PCOSRSA

  • 2PCOS

  • 3


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  • 4

  • 5HCGPE2B

  • 6HCGPHCG

  • 12


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2

  • 3034

  • 6

  • 144-5/26-28


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  • 426-817102

  • 164cm55kgBMI=20.45


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  • B3-6mm6-8


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  • LH 6.50IU FSH5.2IUPRL120IU

  • E2 30ng/mlP 0.8ng T0.5g

  • D-530g/LAPTT


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  • 2ACAIgGIgM

  • 2-GP-Ab

  • DNA


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  • NK CD3/CD16CD56 24%

  • BCD3/CD1919%

  • 6ASAbAOAbEMAbHCGAb


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  • 1ACA2-GP-1Ab

  • 2

  • 3D-530gAPTT

  • 4NKB12%


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  • 1

  • 2

  • 3

  • 4


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  • 1

  • 5mg

  • APA

  • APAAPA1-2


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2

  • D-50-100mg

  • 3ACA2-GP-Ab1


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  • 423

  • 2


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  • 262.5mg/d3FSH75IU /d 18mm0.1mg ()

  • 12-14


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  • /GnRH-aFlare-upLHFSH,LHFSH2436GnRH-aHCG


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  • 232

  • -HCG350IU38ng/ml

  • ACA2-GP-Ab

  • D-650gAPTT

  • NKCD3/CD16CD56 27%

  • BCD3/CD1922%


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  • 1LIT

  • 2VitE

  • 340mg/dHCG8-1010mgbid12-16


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  • 4

  • 5000U/bid20D-5000IU3D-

  • D-APTT3-41D-0.3mg/LAPTT1.5


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  • 20mg24hP7ng/ml(22.26nmol/L)

  • 200mg,24hP710ng/mL

  • P


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  • 5

  • IVIG 10821234-6NKB26NKB12%B


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  • 1

  • 2

  • 3


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3

  • 30527-85D-1500ug/L0-28512


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  • 36HCG

  • P12.95ng/ml-HCG 740IU

  • 1750IU

  • D-958g/LFbgPT

  • APTT

  • ACAIgGIgM

  • 2-GP-Ab


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  • NKCD3/CD16CD56 29%

  • BCD3/CD194.5%

  • 43B64mm


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  • 1VitE

  • 2HCG

  • 35000IU/

  • 2

    4

  • 520%500ml/


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  • 1-2-HCGP

  • 8-HCG20P27ng40mg0.2/d

  • 5IgM

  • 3-4

  • 8D-1257g/LFbgPTAPTT20


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  • 11D-780ug-HCGP

  • 2

  • 13

  • 15

  • 2, D-1/d1


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  • VTEPE (GVC)IUGR


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  • (GVC)

  • /


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-

PAGT35%-78% GMP140<20g/L

APTT 30-44s

D- 0.3-0.8mg/L

FDP


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  • D

  • D

  • 0-0.55mgL

  • D


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  • D-

  • D-


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  • D-D-


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  • ng/ml nmol/L

  • 7 24.5 76.4

  • 8 28.6 89.2

  • 9-12 38 118.6

  • 13-16 45.5 142

  • 17-20 63.3 197.5

  • 21-24 110.9 346

  • 25-34 165.3 514.8

  • 35 202 630


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-HCG

  • 3weeks LMP5-50IU/L

  • 4weeks LMP5-426IU/L

  • 5weeks LMP18-7340IU/L

  • 6weeks LMP1080-56500IU/L

  • 7-8weeks LMP7650-229000IU/L

  • 9-12weeks LMP25700-288000IU/L


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