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• 2015 Volume 23 Issue 6
  Published: 15 June 2015

    

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  Technical characteristics of manual vacuum aspiration: A systematic review

  ZHANG Wen, WU Shangchun

  2015, 23(6): 364.

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  Objective: To evaluate technical characteristics of manual vacuum aspiration (MVA).  Methods: We searched medical 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 2 RCTs were graded B and 3 were graded C. The degree of cervical dilation of MVA was lower than that of electric vacuum aspiration (EVA). The cervical dilation time of MVA was shorter than that of EVA. The times which the suction passed in and out of the uterus in MVA group were less than that of EVA, showing statistically significant difference ［WMD (95% CI) value was  -0.06 (-0.10，-0.01)］. Less noise was felt in MVA group than EVA group. Conclusion: Based on the current best evidence, MVA has better technical characteristics.
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  Survey on awareness of contraceptive knowledge and its influence factors among migrant women in Guangzhou

  GUI Yue'e, LI Yawen, ZUO Liandong, et al

  2015, 23(6): 368.

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  Objective: To explore the awareness of contraceptive knowledge and influence factors among migrant women in Guangzhou. Methods: A random cluster sampling method was adopted in the study. A total of 1108 migrant women were investigated with a questionnaire in Haizhu District, Baiyun District and Zengcheng District of Guangzhou. Results: About 85.92% of the respondents used contraception; 88.81% thought they knew more about  contraceptives. But the average score of the relevant knowledge questionnaire was 5.24 (the total score was 10). Multivariate logistic regression analysis showed influence factors of the awareness of contraceptive knowledge were the educational level and the history of artificial abortion (P<0.05). Conclusion: The contraceptive knowledge of migrant women is inadequate and the demand for contraceptive knowledge is very urgent in Guangzhou. It is important to improve  appropriate methods for the education on contraceptive knowledge for special population.
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  Analysis on mutation spectrum of thalassemia gene based on the level of hospital in Huizhou region

  ZHONG Zeyan, CHEN Jianhong, HE Hailin, et al

  2015, 23(6): 371.

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  Objective: To investigate the gene frequency, phenotype and characteristics of thalassemia in Huizhou, and to explore the clinical application value of prenatal screening and diagnosis of thalassemia. Methods: A total of 2000 results of hematology were randomly selected for an evaluation of positive rate of thalassaemia screening. The hemoglobin electrophoresis was used to analyze the hemoglobin of 540 screening positive samples. And frequencies of thalassaemia genotype were analyzed for abnormal results of hemoglobin samples. Further the prenatal diagnoses were used for 36 couples, who carried the same genotype of thalassemia. Results: The positive rates of hematology screening and hemoglobin electrophoresis detection were 45.60% (912/2000) and 78.70% (425/540), respectively. And 84.71% (360/425) was diagnosed as thalassemia. The gene frequency of thalassemia was 30.40% (608/2000) in population of Huizhou region based on the level of hospital. Among 35 genotype, the detectable rate of genotype of α-thalassemia was highest (53.18%), followed by β-thalassemia (26.35%) and complex-thalassemia (5.18%). There were two rare types of β-thalassemia, namely CD113/N and SEA-HPFH/N. About 66.67% (24/36) of amniotic fluid samples were diagnosed as thalassemia, including 29.17% of severe thalassemia. Conclusion: There was a high prevalence of thalassemia in Huizhou. The prevention and monitor should be promoted to control and reduce the incidence of thalassemia and the birth rate of severe birth defect.
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  Influencing factors of postpartum  glucose abnormalities among gestational diabetes women

  ZHANG Dandan, GAO Qin, BAI Fan, et al

  2015, 23(6): 376.

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  Objective: To investigate influencing factors of postpartum  glucose abnormalities among gestational diabetes women. Methods: A total of 110 gestational women delivering in our hospital who were diagnosed as gestational diabetes and did oral glucose tolerance test (OGTT, 75g) after 2 months of delivery were recruited between Jan 2010 and June 2013. A questionnaire survey was conducted. Results: There were 76(69.09%) women with normal postpartum blood glucose levels, 34(29.91%) with glucose abnormalities, 13(11.82%) with impaired glucose tolerance, 21(19.09%) with type 2 diabetes. Single factor analysis showed that differences in pregnancy age, pre-pregnancy body mass index (BMI), prenatal BMI, family history of diabetes, postpartum exercise timing between normal and abnormal blood glucose groups had statistical significance between two groups (P<0.05). And the ethnicity, smoking history, alcohol consumption, abnormal maternal history, history of hypertension had no significant difference between two groups (P>0.05). Non-conditional logistic regression analysis showed that gestational age, pre-pregnancy BMI, family history of diabetes were independent risk factors of postpartum glucose abnormalities (P<0.05 ), and post-natal exercise was a protective factor (P<0.05). Conclusion: Old age, high pregnancy BMI, family history of diabetes are mainly high risks of postpartum glucose abnormalities.
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  Effect of high ligation of varicocele on lactate dehydrogenase-X activity and sperm DNA integrity

  DENG Tianqin, XIE Yuli, DENG Minzhi

  2015, 23(6): 380.

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  Objective: To explore the effect of high ligation of varicocele (VC) on lactate dehydrogenase-X activity and sperm DNA integrity in varicocele patients. Methods: Forty-two VC patients underwent high ligation of varicocele. Sperm parameters and LDH-X activity and sperm DNA integrity were analyzed before and 3 months after the operation recording to the WHO guidelines. Results: Compared with preoperation, semen volume, sperm concentration, the proportion of sperm progressive motility, sperm motility, sperm viability, sperm DNA fragmentation index, the LDH-X activity of seminal plasma and spermatozoa, the ratios of seminal plasma LDH-X and total spermatozoon LDH-X improved significantly after varicocelectomy from (3.78±1.96) ml to (3.92±1.95) ml, (14.65±7.58) 106/ml to (40.50±9.05) 106/ml, (23.34±11.51)% to (45.75±10.32)%, (45.2±9.21)% to (67.45±9.45)%, (37.74±16.71)% to (70.05±17.18)%, 31.3±16.6 to 18.2±8.3, (926.3±58.3) U/L to (682.0±43.5) U/L, (6.90±3.8) mU/106 to (21.1±9.2) mU/106 and 1.69±0.26 to 0.41±0.17, P<0.05). Conclusion: VC can change seminal plasma/sperm LDH-X activity and increase DNA damage, resulting in infertility. Varicocelectomy can effectively improve the sperm quality and DNA damage .
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  Effect of thyroid peroxidase antibody on glucose metabolism in pregnant women

  ZHOU Yue, NING Lifeng, WANG Huiping, et al

  2015, 23(6): 384.

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  Objective: To explore the effect of thyroid peroxidase antibody (TPOAb) on glucose metabolism in pregnant women. Methods: The study group included 625 pregnant women without abnormal fasting blood-glucose and abnormal thyroid function in early pregnancy. Maternal serum samples in the second trimester pregnancy were tested for thyroid hormones, such as thyroid-stimulating hormone (TSH), free thyroxine 4 (FT4), TPOAb and oral glucose tolerance test (OGTT). Results: The TSH concentration was higher in TPOAb positive women than TPOAb negative women (P<0.05). In TPOAb positive women, concentrations of 1h, 2h postprandial blood-glucose and the incidence rate of gestational diabetes mellitus were lower than those of TPOAb negative women, showing significant differences (P<0.05). A negative correlation was found between 1h, 2h postprandial blood-glucose and TPOAb (r=-0.102, -0.123, P<0.05). Conclusion: TPOAb could affect glucose metabolism in pregnant women. With the titer of TPOAb increases, the postprandial blood-glucose level decreases, showing a negative correlation. 
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  Reproductive outcomes in IVF/ICSI-ET among infertile women with congenital uterine malformation

  LONG Feng, ZHANG Haiying, MO Si'en, et al

  2015, 23(6): 387.

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  Objective: To explore reproductive outcomes of infertile women with congenital uterine malformation who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) and embryo transfer (ET), and to evaluate the effect of the number of transferred embryos on the clinical outcome. Methods:Clinical data of 99 infertile patients with congenital uterine malformation who underwent IVF/ICSI-ET from Jan 2012 to Aug 2013 were studied retrospectively. Patients were grouped according to the following types of uterine malformation: 24 unicornate, 45 septate, 17 didelphys, 9 bicornuate, 4 arcuate. Their clinical data and outcomes were compared. The IVF/ICSI-ET cycles were grouped according to the number of transferred embryos: single, double and triple. Clinical outcomes were compared. Results: We conducted a retrospective analysis of data from 99 patients undergoing 151 IVF/ICSI-ET cycles. Patients with uterine malformation had lower pregnancy rate (32.45%) and implantation rate (19.93%) than those without malformation (P<0.05). Compared with patients without malformation, patients with uterine malformation had higher miscarriage rate (40.82%, P<0.05). There were no significant differences in pregnancy rate, implantation rate, multiple pregnancy rate, baby take-home rate, gestation weeks, weight of newborn when the various types of uterine malformation were compared (P>0.05). Patients with arcuate uterus had no miscarriage and premature delivery and 2 clinical pregnancies were full-term birth. Patients with unicornate uterus and septate uterus had higher miscar-riage rate and lower full-term birth rate when compared with those with bicornuate uterus and didelphys uterus (66.67%, 55.00% vs. 25.00%, 20.00%; 38.46%, 40.00% vs. 50.00%, 60.00%), but the differences had no statistical significance (P>0.05). There were no significant differences in pregnancy rate, implantation rate, baby take-home rate among three groups according to the number of transferred embryos (P＞0.05). Patients in single embryo transfer group had no multiple pregnancy and miscarriage. There were no significant differences in multiple pregnancy rate and miscarriage rate between double embryo transfer group and triple embryo transfer group (P>0.05). Conclusion: Clinical pregnancy rate and implantation rate are worse and the incidence of miscarriage is higher in patients of uterine malformation compare with patients without malformation. Patients with arcuate uterus have better clinical outcomes than those with unicornate uterus and septate uterus. The number of transferred embryos should be limited in the patients of uterine malformation and multiple pregnancy should be reduced to decrease the occurrence of miscarriage and premature delivery and improve the pregnancy outcome.
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  Two kinds of early intervention after medical abortion

  CHEN Weihong，YU Saifen，ZHENG Xiuling, et al

  2015, 23(6): 392.

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  Objective: To compare clinical effects of two kinds of early intervention after medical abortion. Methods: A total of 921 healthy early pregnant women seeking for medical abortion in our hospital were randomly divided into three groups: routine therapy group, Marvelon group and sequential therapy group. Totally 310 women took routine antibiotics and uterotonics, 306 women received Marvelon and 305 were given sequential therapy with estrogen and progestin. The duration and the amount of vaginal bleeding, thickness  of endometrium, the time of menstruation restore and complete abortion rate were recorded in regular follow-up after abortion. Results: The amount of vaginal bleeding in sequential therapy group was less than that in routine group and Marvelon group. The duration of vaginal bleeding in sequential therapy group and Marvelon group was significantly shorter than that in routine group (P<0.05). There was statistical significance of menstruation restore time between three groups (P<0.05). The complete abortion rate was 91.8% in sequential therapy group, 86.3% in Marvelon group and 80.6% in routine group, showing significant differences among three groups (P<0.01). Conclusion: Early intervention using sequential therapy with estrogen and progestin or Marvelon can increase the complete abortion rate, shorten the duration of vaginal bleeding and menstruation restore time in patients subjected to medical abortion, and the effect of sequential therapy with estrogen and progestin is better than that of Marvelon.
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  Effect of a low dose of mifepristone in treatment of perimenopausal abnormal uterine bleeding associated with ovulatory dysfunction

  ZHANG Xiaojin

  2015, 23(6): 395.

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  Objective: To explore the clinical effect and safety of a low dose of mifepristone for the treatment of perimenopausal abnormal uterine bleeding associated with ovulatory dysfunction Methods: From September 2012 to September 2014 in our hospital clinical data of 150 patients experiencing perimenopausal abnormal uterine bleeding associated with ovulatory dysfunction were recruited. According to the random number method, they were divided into the observation group and the control group (75 cases in each group). Women in the observation group were given 10 mg of mifepristone orally once a day, while those in the control group received 25 mg of mifepristone orally once a day. A treatment course of 3 months was conducted. Serum levels of estradiol (E2) and progesterone (P), follicle stimulating hormone (FSH), luteinizing hormone (LH), testosterone (T) and the change of endometrial thickness of the two groups before and after treatment were recorded and compared in order to evaluate the curative effect and clinical safety, as well as the pharmacokinetic parameters. Results: In the observation group the total effective rate was 97.3% while that in the control group was 100.0%, showing no significant difference (χ2 = 2.027, P>0.05). After treatment, P, E2, FSH and LH levels in the observation group significantly decreased (P all< 0.05), but there was no statistically significant difference between two groups (P all>0.05). There were no significant difference in terms of average hemorrhage control time and fully-controlled bleeding time between two groups (P>0.05). Endometrial thickness of two groups after treatment were all significantly decreased (P all<0.05), but there was no statistical significance between two groups (P>0.05). In the treatment group Tmax, Cmax, AUC0-t and t1/2 on 1st and 90th day after the treatment had no significant change (P>0.05); but on the 90th day Cmax and AUC0-t of the control group were significantly higher than those on the first day (P<0.05). In the observation group the incidence rate of adverse reaction was significantly lower than that in the control group (χ2 = 7.292, P<0.05). Conclusion: Compared with a large dose of mifepristone, a low dose of mifepristone has better curative effect as well as higher clinical safety.
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  Comprehensive intervention on less bone mineral density among perimenopausal women

  HE Qiong, LAI Juying

  2015, 23(6): 399.

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  Objective: To explore the effect of comprehensive intervention with calcium supplements, sex hormone and health guidance on the bone mineral density among perimenopausal women. Methods: From January 2011 to December 2011 in our hospital 1600 perimenopausal women were recruited. Their medical history was recorded, and the presence of abnormal menstruation and menopause symptoms were also evaluated. A total of 736 patients who were screened as less bone mineral density were randomly divided into the observation group and the control group (368 cases in each group). Women in the observation group were given calcium supplements, sex hormone and health guidance while the control group only received drug intervention. One year later the bone mineral density and sex hormone levels of two groups were measured. Results: One year after treatment, the total effective rate in the observation group was 88.3%, significantly higher than that in the control group (71.7%, χ2=4.645, P<0.05); Testosterone and estradiol (E2), follicle stimulating hormone (FSH) level of the observation group were improved significantly (t= 33.0666, 12.2751, 11.7441, P all< 0.05), while the control group had no improvement (t= 0.8488, 0.3299, 0.5045, P all> 0.05). Endometrial thickness of two groups before and after treatment had no significant difference (t = 0.3507, 0.4587, P>0.05). During treatment two cases of breast mass in the observation group and one in the control group were found, which were confirmed by pathology as breast fibroma, and there was no significant difference between two groups (χ2= 0.876, P>0.05). Conclusion: The comprehensive intervention with calcium supplements, sex hormone combined with health guidance is good and safe, worthy of clinical promotion among perimenopausal women with less bone mineral density.