自然流产的辅助检查和过度检查OA

Auxiliary testing for spontaneous abortion pri-marily includes assessment of the status of the current preg-nancy and maternal safety,as well as etiological evaluation based on the number and gestational age of previous preg-nancy losses and the patient's clinical characteristics,thereby providing a basis for the management of subse-quent pregnancies.In early spontaneous abortion,transvag-inal ultrasonography should be the principal diagnostic mo-dality.When necessary,dynamic changes in serum β-hu-man chorionic gonadotropin and clinical findings should be incorporated to determine the location of the pregnancy,embryonic viability,and the number of gestational sacs.In late spontaneous abortion,in addition to assessing fetal via-bility,particular attention should be paid to the cervix,fetal membranes,placenta,fetal growth and development,and maternal complications.A single spontaneous abortion in the absence of specific high-risk factors generally does not warrant comprehensive etiological investigation.By con-trast,patients with recurrent spontaneous abortion should undergo stratified evaluation based on their reproductive history and clinical phenotype,with attention paid to genet-ic factors,uterine and intrauterine structure,antiphospho-lipid syndrome and coagulation-related factors,endocrine and metabolic disorders,autoimmune diseases,infection-related factors,and male-related factors.Excessive testing remains common in the clinical management of spontane-ous abortion at present,and may lead to overinterpretation of abnormal findings,treatment without an adequate evi-dence base,and increased psychological and financial bur-dens on patients.Auxiliary testing for spontaneous abortion should therefore be guided by evidence-based medicine,with consideration given to the reliability of the testing method,the target population,the influence of the findings on clinical decision-making,and whether the correspond-ing intervention can improve pregnancy outcomes.Clinical practice should shift from indiscriminate comprehensive screening to targeted,stratified evaluation,thereby reduc-ing unnecessary testing and interventions.