关键词:

先兆流产, 地屈孕酮, 硝苯地平, 妊娠结局, miRNA-141, miRNA-518e

Abstract:

Objective　To study the effects of dydrogesterone combined with nifedipine on the improvement of pregnancy outcomes and serum miRNA-141 and miRNA-518e in patients with threatened abortion. Methods　One hundred and seventeen patients with threatened abortion admitted to Shaanxi Provincial Tuberculosis Prevention and Control Hospital from May 2020 to May 2023 were selected, and were divided into a combination group (58 cases) and a reference group (59 cases) by the computer random odd-even number method. The reference group was treated with nifedipine 10 mg/time, 3 times/day, for 3 days, and the dosage was adjusted to 20 mg/time, 3 times/day; they took the medicine until their symptoms completely disappeared. The combination group were treated with dydrogesterone on the basis of the reference group; the first dose was 40 mg, then the dosage was 10 mg/time every other 12 h; they took the medicine until their symptoms completely disappeared. The pregnancy outcomes, reproductive hormone levels, uterine artery blood flow parameters, and serum levels of miRNA-141 and miRNA-518e were compared between the two groups. t and χ² tests were applied. Results　The abortion rate of the combination group was lower than that of the reference group, but the full-term pregnancy rate was higher than that of the reference group [3.45% (2/58) vs. 15.25% (9/59) and 86.21% (50/58) vs. 64.41% (38/59)], with statistical differences between the two groups (both P<0.05). After 30 days' treatment, the levels of reproductive hormones in both groups were significantly higher than those 1 day before the treatment, and the increases in combination group were better than those in the reference group (all P<0.05). After 30 days' treatment, all the uterine artery blood flow parameters in both groups were lower than those 1 day before the treatment, and the down-regulation amplitudes in combination group were better than those in the reference group (all P<0.05). After 30 days' treatment, the serum levels of miRNA-141 and miRNA-518e in both groups were lower than those 1 day before the treatment, and the levels in combination group were lower than those in the reference group [(20.73±1.82) vs. (24.81±2.09) and (15.97±1.45) vs. (22.50±2.03)], with statistical differences between the two groups (both P<0.05). Conclusion　Dydrogesterone combined with nifedipine for patients with threatened abortion can improve their pregnancy outcomes, reproductive hormones, and uterine artery blood flow, and negatively regulate the expression of miRNA-141 and miRNA-518e.

Key words:

Threatened abortion, Dydrogestone, Nifedipine, Pregnancy outcomes, MiRNA-141, MiRNA-518e