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ZHANG Wen, WU Shangchun
Objective: To evaluate the effectiveness of manual vacuum aspiration (MVA). Methods: We searched med-ical databases including CBMdisc (1978-2014), CNKI (1979-2014), Wanfang Database (1982-2014), VIP Database (1989-2014), PubMed (1966-2014), Cochrane Library by compute and manually searched other related journals to screen randomized controlled trials (RCT) that involved in the comparison of MVA and Electric vacuum aspiration (EVA). The quality of included trials was assessed. RevMan5.0 software was used for meta-analysis. Results: Five trials were included, in which 3 RCTs were graded B and 2 were graded C. There were no significant differences in complete abortion rate, incomplete abortion rate and abortion failure rate ［RR (95%CI) values were 1.00（0.99，1.01），1.18（0.38,3.64），1.02（0.06,16.18), respectively］between MVA and EVA. Conclusion: Based on current best evidences, MVA has the similar effectiveness to EVA，even though lacking of high quality articles.
2015 Vol. 23 (4): 220- [Abstract]（
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CHEN Shaozhen, DAI Qiaoyun, ZHAO Jun, et al
Objective: To explore the status of preconception eugenics service in Pingshan District in order to provide suggestions to improve the service. Methods: Sorting preconception eugenics data and phone-interviewing people suffered glucose-6-phosphate dehydrogenase (G6PD) deficiency were conducted. Results: Forty-five people suffered low enzyme activities of G6PD out of 1150 respondents. By phone-interviewing, 48.89% of the interviewees received the test results, 22.73% get to know 'G6PD deficiency is an inherited disease' from doctors in charge of preconception care, 2.22% acquired the material of health education on the disease, 2.22% understood the disease could be inherited, 6.67% were seeking for the origin of the disease. After knowing the positive test results, 22.73% went panic and contacted family to inquire about the family medical history. Conclusion: The informing service of G6PD deficiency is gravely insufficient. The population lacks of the related knowledge. It should be emphasized to refine the service procedure and strengthen the consulting service of preconception care.
2015 Vol. 23 (4): 225- [Abstract]（
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JIANG Yiling, LI Kezhen
Objective: To explore the status of psychological status, social support and life quality of female infertility, in order to improve mental health for female infertility. Methods: Of 75 cases of infertile women and 75 women without infertility were recruited in Gynaecology and Obstetrics Department of Xinhua Hospital of Hubei Province from January 2013 to September 2014. The Self-Rating Anxiety Scale, Self-Rating Depression Scale, Self-Efficacy Scale, Social Support Research Scale and so on were used to evaluate the psychological status, social support and life quality. Results: Scores of anxiety, depression and feeling of shame in the infertility group were much higher than those of the control group (P<0.01), but the self-respect score was much lower than that of the control group (P<0.01). Scores of the objective support, subjective support and utilization of support in the infertility group were much lower than those of the control group (P<0.01). Scores of the physical role function, emotional role function, metal function, vigor, social function and work and study in the infertility group were much lower than those of the control group (P<0.01). Conclusion: Infertile women suffer severe anxiety, depression, feeling of shame and low feeling of self-respect, less social support and lower life quality. So we should take more emphasis on metal intervention in the treatment of infertile women.
2015 Vol. 23 (4): 229- [Abstract]（
62
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ZHANG Suzhi, LIU Jiangkun, ZHANG Yixin, et al
Objective: To analyze the current situation of long-term contraceptive measure use and its influencing factors among married couples in Hebei Province in order to find out more safe, appropriate, effective contraceptive technology. A stratified sampling method was used in the survey. Methods: We selected 33 provincial fixed monitoring sites of adverse reactions of family planning devices as the sample points in Hebei Province. Married couples who applied a long-term contraceptive measure from October 2011 to September 2013 were recruited. Results: In 13 082 married couples, 12 775 (97.65%) used intrauterine device (IUD), 287 (2.19%) took ligation of oviduct, 13 (0.1%) took male vasectomy, and 7 (0.05%) used subcutaneous implantation. In this study, urban residents accounted for 10.63 %, while rural residents for 89.37%. Respondents aged 20 to 29 years accounted for 75.11%. About 0.15% family had no child, and one-child. According to the last delivery way, natural labor accounted for 58.46%, while caesarean for 41.55%. Among the long-term contraceptive measure use, IUD insertion was taken up by the largest proportion who accounted for 97.65%, and ligation of oviduct accounted for 2.19%, male vasectomy for 0.1%, subcutaneous implantation for 0.05%. The long-term contraceptive measure use was decreased gradually with the increase in age. Conclusion: In long-term contraceptive measure use, IUD is inserted by the largest people in Hebei Province. Age, the last delivery way and the operation time are correlative with adverse reactions of IUD. The varieties of IUD tend to rationalization, diver sification. We should guide the married couples to select the appropriate contraception by themselves, and should strengthen the scientific and standardized management of long-acting contraception operations in health care sectors.
2015 Vol. 23 (4): 232- [Abstract]（
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HE Yuan, PENG Zuoqi, HAN Chengcheng, et al
Objective: To investigate the effect of a low carbohydrate diet on infertility among overweight and obese women with polycystic ovary syndrome (PCOS). Methods: A total of 151women with a clinical diagnosis of PCOS were divided into nutrition intervention group and control group. In the intervention group, patients received a low carbohydrate diet for 8 weeks, and the intervention included weight loss and maintenance phase. In the control group, patients received the general dietary recommendations. Body mass index (BMI) and pregnancy outcome were observed before and after a 8-weeks period in these two groups. Results: BMI decreased from (27.7±1.7) kg/m2 to (26.3±0.4) kg/m2 during the weight loss period, and to (25.7±1.5) kg/m2 during the weight maintenance period in the intervention group. The mean level of BMI was (27.6±1.8) kg/m2 and (27.4±1.9) kg/m2 from baseline to 8 weeks in the control group. There was a significant reduction in BMI between the intervention group and the control group (P<0.05). Moreover, the pregnancy rate of intervention group was 18%, with a significant difference compared with the control group (P<0.05). Conclusion: The low carbohydrate diet could effectively promote weight loss in PCOS patients, and improve the symptom of infertility induced by PCOS.
2015 Vol. 23 (4): 235- [Abstract]（
63
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LIAO Ding
Objective: To explore the relationship of nuchal translucency thickness and fetal developmental abnormalities to provide references for clinical prenatal diagnosis. Methods: We collected the data of 1321 pregnancy women with a gestational age of 11 to 13+6 weeks and 45 to 84 mm of crown rump length who were measured the nuchal translucency thickness (NT) value by ultrasound and underwent a follow-up to 1 weeks postpartum in our hospital. We compared the NT value of different weeks of gestation and different maternal age, calculated the sensitivity, specificity, positive predictive value and negative predictive value of the diagnosis of fetal abnormalities. Results: There were 46 cases whose NT value was not less than 3.0 mm, of which 24 cases with dysplasia (3 cases of abnormal karyotypes, 21 cases of abnormal structure). Twenty-six cases of dysplasia were found, of which 24 cases with not less than 3.0 mm of NT value , and 2 cases with less than 3.0mm of NT value (1 case of abnormal karyotypes, 1 cases of abnormal structure). Compared NT value of different gestational age and different maternal age, we found that there were significant differences among groups of 11 to 11+6, 12 to 12+6, and 13 to 13+6 weeks of gestation (P<0.05), but there were no significant differences in groups of different maternal ages (P>0.05). We also found that when the NT value was greater than or equal to 3.0 mm, the sensitivity was 92.31%, the specificity was 98.30%, the positive predictive value was 52.17%, and the negative predictive value was 99.84%. Conclusion: Fetal NT value has close relationship with abnormal development of fetus in early pregnancy. Fetal NT value rises with the increase of gestational age, but has nothing to do with the maternal age. When the NT value is not less than 3.0mm, the sensitivity, specificity, positive predictive value and negative predictive value are most balanced. And fetal NT value can be used as an important index for early screening of fetal abnormalities.
2015 Vol. 23 (4): 239- [Abstract]（
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KONG Rui, TIAN Li
Objective: To compare the efficacy of intracytoplasmic sperm injection (ICSI) and conventional in vitro fertilization (IVF) among non-severe-male infertility women with poor ovarian response. Methods: A total of 246 IVF/ICSI-embryo transfer (ET) cycles of non-severe-male infertility women with poor ovarian response were divided into IVF group and ICSI group. The fertilization rate, cycle cancellation rate, high quality embryo rate, clinical pregnancy rate and early abortion rate were retrospectively analyzed between two groups. Then 246 IVF/ICSI-ET cycles were divided into A group (>35 to 40 years old) and B group (>40 years old ) according to the age of women. The fertilization rate, cycle cancellation rate, high quality embryo rate and clinical pregnancy rate were retrospectively analyzed between two groups. Finally indicators mentioned above were respectively compared between IVF and ICSI group according to the number of oocytes retrieved (one to three). Results: There were no significant differences in the fertilization rate, cycle cancellation rate, high quality embryo rate, clinical pregnancy rate and early abortion rate when compared in three ways (P all >0.05). Conclusion: ICSI can not improve the fertilization results and clinical outcomes in non-severe-male infertility women with poor ovarian response. In particular, the old age and low number of oocytes retrieved are not indications of ICSI.
2015 Vol. 23 (4): 242- [Abstract]（
55
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LUO Xiaohuan, XIA Wei, SU Ning, et al
Objective: To analyze clinical effects of different ovarian stimulation protocols among women with polycystic ovary syndrome undergoing intrauterine insemination (IUI). Methods: A retrospective study was conducted to analyze 634 IUI cycles for patients with PCOS from January 2010 to December 2013. According to different ovarian stimulation protocols, patients were divided into 8 groups (CC, LE, HMG, FSH, CC+HMG, CC+FSH, LE+HMG, LE+FSH). The essential characteristics, follicular development situation, endometrial thickness, duration and dose of gonadotropin (Gn) used, pregnancy outcomes and complications were evaluated among 8 groups. Results: The total number of dominant follicles and the total number of ruptured follicles in Gn groups（FSH, HMG）and groups combined with CC (CC+HMG, CC+FSH) were significantly greater than those of simple oral drugs (CC, LE) and groups combined with LE（LE+HMG, LE+FSH, P<0.05). The rate of mono mature follicle in LE group was the highest (82.89%, P<0.01). The days to human chorionic gonadotropin (hCG) injection in HMG group, CC + HMG group, LE + HMG group were significantly greater than those of simple oral drug groups (P<0.05). Significant differences were found in the average thickness of endometrium and the number of endometrial thickness less than 8mm at IUI day between CC group and the remaining groups (P<0.05). The duration and dose of Gn used in combination groups (CC+HMG, CC+FSH, LE+HMG and LE+FSH) were significantly less than those of Gn groups (P<0.05). Clinical pregnancy rate of CC group was the lowest (P<0.05), and clinical pregnancy rates of the remaining groups had no significant differences (P>0.05). A total of 4 cases of mild ovarian hyper-stimulation syndrome (OHSS) occurred in Gn groups and 14 cases of multiple pregnancy were found in Gn groups (n=11) and combination groups (n=3). Conclusion: The clinical pregnancy rate of CC is the lowest that may be associated with the anti-estrogen effects which plays a role in endometrial thickness. The rate of mono mature follicle of LE group is the highest and women in LE group achieve a satisfactory clinical pregnancy rate. The clinical pregnancy rates of combination group are equal to those of Gn groups, but combination groups is worth promoting due to the the less duration and dose of Gn used as well as lower rates of OHSS and multiple pregnancy.
2015 Vol. 23 (4): 246- [Abstract]（
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GAN Dingzhu, LI Laibao, WU Shangchun
Objective: To evaluate the effect of standard training for post-abortion care (PAC) consultants and to analyze potential influencing factors. Methods: A questionnaire involving in the concept of PAC, consulting skills of PAC, the related knowledge on compound oral contraceptives and intrauterine contraception as well as the basic knowledge of family planning was used before and after training respectively. Data was analyzed with SPSS20 Software. Results: The scores of 431 consultants were 52.1±12.0 before the training and 73.2±7.7 after the training, showing statistically significant difference (P＜0.05). The scores of consultants were quite related to their occupation and educational levels. All consultants gave positive feedback and affirmation of this training. Conclusion: A series of standard training should be conducted for PAC consultants due to the insufficient of PAC knowledge.
2015 Vol. 23 (4): 275- [Abstract]（
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ZHANG Yahong, JING Yuan, HUANG Zhilan, et al
Objective: To observe the effect of intrauterine device (IUD) insertion immediately after induced abortion among women who experienced cesarean section within one year. Methods: A total of 410 women seeking for induced abortion were divided into three groups according to the history of cesarean section and the operation time, in which 132 women in group A underwent cesarean section less than one year, 97 in group B had scarred uterus more than 1 years, and 181 women in group C had no history of cesarean section. The incidence of side effects and contraceptive effects were compared among three groups. Results: There was no significant difference in the incidence of side effects 1, 3, 6, 12 months after IUD insertion among three groups (P>0.05). No amenorrhea and intrauterine adhesion were found. The removal rates of three groups were highest (2.31 per 100 woman-years, 3.16 per 100 woman-years, and 2.27 per 100 woman-years, respectively) within 6 months after IUD insertion, while there was no significant difference among three groups (P>0.05). No pregnancy with IUD in situ was found in three groups. The IUD expulsion was found in one women. The cumulative continuation rate within 12 months were 94.49 per 100 woman-years in group A, 94.62 per 100 woman-years in group B and 95.40 per 100 woman-years in group C, showing no significant differences (P>0.05). Conclusion: IUD insertion immediately after induced abortion could be safe and feasible among women experiencing cesarean section within one year.
2015 Vol. 23 (4): 280- [Abstract]（
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