Assessment of serum sex hormones and pregnancy outcomes in patients with threatened miscarriage treated with baotailing capsule combined with dydrogesterone

Lei Chunhua; Zhang Qian; Jiang Lixia; Wang Yu; Li Dan

doi:10.3969/j.issn.1672-8157.2025.05.030

Abstract：Objective To explore the application value of baotailing capsule combined with dydrogesterone for threatened abortion(TA)based on serum sex hormones levels and pregnancy outcomes.Methods TA patients treated in Northwest Women's and Children's Hospital from January 2022 to January 2023 were selected as the research subjects.Taking age,body mass index(BMI),gestational age,and gravidity as matching variables and adopting propensity score matching method,79 pairs of effective cases were matched according to 1:1 and included in study group and control group respectively.The patients in the control group were treated with oral dydrogesterone tablets while those in the study group were given baotailing capsule combined with dydrogesterone.The disappearance duration of clinical symptoms(abdominal pain,waist soreness,vaginal bleeding)were recorded in the two groups.The levels of serum sex hormones(progesterone(P),estradiol(E2),β-human chorionic gonadotropin(β-hCG)),serum inflammatory factors(interleukin-4(IL-4),interleukin-10(IL-10),transforming growth factor β(TGF-β))and uterine artery hemodynamic indica-tors(resistance index(RI),systolic-diastolic ratio(S/D),pulsatility index(PI))were compared between the two groups before and 4 weeks after treatment.Adverse reactions and pregnancy outcomes during treatment were recorded.Results After 4 weeks of treatment,the duration of abdominal pain,waist soreness and vaginal bleeding in the study group was(4.25±0.81)d,(8.32±1.10)d and(6.23±0.84)d,which was shorter than that of(4.58±0.88)d,(8.86±1.15)d and(6.55±0.96)d in the control group(t=2.452,3.016,2.230,P=0.015,0.003,0.027).The levels of serum P,E2,β-hCG and TGF-β in study group and control group after treatment were(31.69±7.59)pg·mL-1,(2 370.12±92.06)ng·L-1,(5 250.11±443.06)U·L-1,(55.03±6.04)pg·mL-1;(29.15±6.97)pg·mL-1,(2 169.57±86.33)ng·L-1,(4 113.62±346.27)U·L-1,(52.57±5.88)pg·mL-1,which were higher than those before treatment((26.41±6.72)pg·mL-1,(913.41±48.22)ng·L-1,(3 001.98±288.05)U·L-1,(43.66±4.67)pg·mL-1;(26.59±6.84)pg·mL-1,(914.02±48.36)ng·L-1,(2 998.97±287.95)U·L-1,(43.72±4.69)pg·mL-1),and they were higher in the study group than in the control(t=2.191,14.124,17.964,2.594,P=0.030,<0.001,<0.001,0.010).The levels of serum IL-4 and IL-10 in study group and control group after treatment were(2.09±0.68)ng·L-1,(28.84±3.11)pg·mL-1;(2.33±0.75)ng·L-1,(30.13±4.06)pg·mL-1,which were lower than those before treatment((2.51±0.82)ng·L-1,(37.69±4.59)pg·mL-1;(2.53±0.83)ng·L-1,(37.74±4.62)pg·mL-1),and they were lower in the study group than in the control(t=2.107,2.242,P=0.037,0.026).The levels of RI,S/D and PI in study group and control group((0.76±0.11),(2.27±0.31),(2.05±0.38);(0.82±0.18),(2.40±0.34),(2.25±0.42))were lower than those before treatment((0.96±0.29),(4.41±0.65),(3.14±0.52);(0.97±0.30),(4.38±0.61),(3.16±0.53)),and they were lower in the study group then in the control(t=2.528,2.511,3.139,P=0.013,0.013,0.002).The total incidence of adverse reactions during treatment was 6.33%(5/79)in the study group and 7.59%(6/79)in the control,showing no statistical significance between the two groups(χ2=0.098,P=0.755).The full-term pregnan-cy rate was 90.67%(68/75)in study group,which was higher than that of 78.08%(57/73)in the control group(χ2=4.464,P=0.035).However,the abortion rate was 2.67%(2/75)in the study group and 12.33%(9/73)in the control group(χ2=5.020,P=0.025).The premature birth rate showed no significant difference between the two groups(6.67%(5/75)vs 9.59%(7/73)(χ2=0.424,P=0.515)).Conclusion Baotailing capsule combined with dydrogesterone is effective for the treatment of TA patients because it can quickly relieve the clinical symptoms,enhance the serum sex hormones,alleviate the inflammatory response and reduce the abortion rate.