Objective: To explore the effect of family planning policy adjustment on the relationship between maternal service supply and demand of Beijing. Methods: Data of maternity bed, health personnel and permanent childbearingage women were used to analyze statistical indicators include institutional density, bed density, doctor density, nurse density and bed utilization rate. Results: In the initial stage of policy adjustment, the quantity of maternity services of Beijing was sufficient but the supply side structural problems were more prominent. Highquality maternity services were in short supply and mainly concentrated in the central district, and the shortage was more extrusive in suburban district. Some childbearingage women had gone to other districts for maternity services. From 2017 to 2020, due to policy adjustments, maternity services demand would increase 25%26%, and 22762389 maternity beds should be increased. Highquality maternity services demand would increase 31%, and 1220 maternity beds should be increased. The childbearingage women who comply with family planning policy and had a child in Chaoyang, Haidian, Fengtai, and Changping district accounted for 58.9%, and the maternity services demand in these areas would significantly increase. Conclusion: Beijing should enhance the supporting for weak areas, balance the distribution of resources, and implement the hierarchical referral system, and strengthen the support of medical insurance policy to grassroots medical institutions.

2018 Vol. 26　(3):　175- [Abstract]（ 432 ） HTML (0 KB)  PDF  (0 KB)  ( 80 )

Objective: To know the characteristics of free prepregnancy health exam’s target population including eugenic knowledge and to understand motivation, satisfaction of participation, main causes of nonparticipation and to provide inspiration for future work. Methods: Two groups of individuals living in Baoshan district who ever participated in or did not participated in the free prepregnancy exam（participation group or noparticipation group） were enrolled in this study. There were approximately 600 individuals in each group. A questionnaire survey was conducted to collect demographic information, knowledge level, awareness, satisfaction, participation motivation, willingness, and reasons for nonparticipation. Statistical differences were confirmed by both univariate χ2 test and multivariate Logistic regression for analyzing the association between participation and knowledge level. Results: Individuals in the participation group were more likely to live in south sector of Baoshan district and also experienced higher level of education. Other demographic characteristics were not significantly different between groups. The individuals in participation group had higher awareness in the necessity of prepregnancy exam, government’s providing of free exam, folic acid’s effect on nerve growth, hazards of overdrinking, and the necessity of consulting before administration of over the counter drugs (OTCs). Most common motivation of individuals participated in the free prepregnancy exam was for eugenic consideration (96.2%). There were 51.4% of individuals who were very satisfied with this service and 46.4% who were basically satisfied. Lacking of time accounted for 45.7% of all causes of nonparticipated in the free prepregnancy exam, preferring higher level of service accounted for 35.8% of all causes, and lacking of knowledge accounted for 20.6% of all causes. There were 92.3% of all subjects willing to recommend this service to others. Conclusion: The target population who accepted free prepregnancy exam has good knowledge of eugenics, but has cognitive deficiencies on the risk of alcoholism, high temperature, and noise. The knowledge level is correlation to participation or nonparticipation free prepregnancy exam, which should be further researched and interpretation. Based on the free service well known, related government can try to combine with free charging services for enhancing current service quality and comprehensive service to meet the need of individuals.

2018 Vol. 26　(3):　184- [Abstract]（ 616 ） HTML (0 KB)  PDF  (0 KB)  ( 112 )

Objective: To investigate the effect of Baofukang suppository combined with estrogen ointment on treating senile vaginitis, and to explore its influence on hormone levels of patients. Methods: A total of 168 elderly patients with vaginitis admitted to Wuhan Children's Hospital were enrolled in this study. They were divided into three groups (56 cases in each group) by random number table method. The patients in Baofukang suppository group were given Baofukang suppository, the patients in estrogen ointment group were given hormone ointment, and the patients in combination therapy group were given Baofukang suppository combined with estrogen ointment. The treatment effect, the hormone level of patients, and rate of adverse reactions of drug were compared among the three groups. Results: The total effective rate (98.2%) of patients in combination group was significant higher than that of patients in Baofukang suppository group (83.9%) and estrogen ointment group (85.7%). The levels of E2, FSH, P and LH of patients were significantly improved after treatment, and the improvement degree of hormone levels of patients in combination group was higher than the that of patients in other two groups (P<0.05). The incidence of adverse reactions of patients in the three groups had no significant difference (P>0.05). Conclusion: Baofukang suppository or estrogen ointment used alone has a positive therapeutic effect on senile vaginitis. However, Baofukang suppository combined estrogen ointment treating senile vaginitis can achieve better therapeutic effect, can regulate hormone levels better, and is safety, so it is worthy of clinical application.

2018 Vol. 26　(3):　195- [Abstract]（ 509 ） HTML (0 KB)  PDF  (0 KB)  ( 45 )

Objective: To observe the predictive effect of serum progesterone detection combined with uterine spiral arterial flow ultrasound on pregnancy outcome in patients with threatened abortion. Methods: 400 women with early pregnancy from Chongqing Banan district people's hospital were selected as research subjects between August 2015 and August 2017, which Included 200 women with normal pregnancy (normal pregnant group), 138 early threatened abortion women with tocolysis successful (tocolysis success group), 62 early threatened abortion women with tocolysis failure (tocolysis failure group). Serum progesterone of all pregnant women in the three groups was detected. PI, RI and S/D of uterine spiral and uterine arteries of women in the three groups were detected by color doppler ultrasonography. Serum progesterone and uterine spiral artery blood flow index were compared among the three groups. Results: There was difference in serum progesterone level of women among the three groups (F=10.593, P=0.000<0.05), and there was no difference in PI, RI and S/D of uterine artery among the three groups (F=1.028, 1.359 and 0.948；P=0.168, 0.105 and 0.199>0.05), but there was difference in PI, RI and S/D of uterine spiral artery among the three groups (F=11.514, 9.329 and 2.779；P=0.000, 0.000 and 0.023<0.05). The sensitivity, specificity and accuracy of serum progesterone combined with PI and RI of uterine spiral artery to predict the pregnancy outcome of early threatened abortion were 85.48%, 97.63% and 95.75%, respectively. Conclusion: The serum progesterone value and uterine spiral arterial blood flow index in pregnant women with early threatened abortion are different from those of normal pregnant women. The value of serum progesterone, PI and RI of uterus spiral artery can be used as a diagnostic and prognostic indicator for early threatened abortion. The using of combination of these three indicators can improve the prediction specificity and accuracy of pregnant outcome of women with early threatened abortion, so it should be paid more attention to.

2018 Vol. 26　(3):　202- [Abstract]（ 458 ） HTML (0 KB)  PDF  (0 KB)  ( 53 )

Objective: To explore influencing factors on the clinical outcome of women with poor ovarian responders during in vitro fertilizationembryo transfer (IVFET) or intracytoplasmic sperm injection (ICSI). Methods: A retrospective analysis was conducted and the data was collected from 122 IVFET/ICSI cycle patients with poor ovarian response from the reproductive medicine center of the general hospital of Tianjin medical university between Jan. 2012 and Sep. 2016. All included patient were divided into pregnant group (n=26) and nonpregnant group (n=96). And all the patients were also divided into group A (＜35 years old, n=21) , group B(3540 years old, n=36)and group C (＞40 years old, n=65)according to their age. Results: There were significant different in age and endometrial thickness between the pregnant group and the nonpregnant group(P＜0.05). The implantation rate and pregnancy rate of patients over 40 years old decreased significantly. Logistic regression analysis results showed that age and endometrial thickness had contributed to clinical outcome. Conclusion: Age and the endometrial thickness are the important influencing factors on the outcome of women with poor ovarian responders in IVFET/ICSI.

2018 Vol. 26　(3):　211- [Abstract]（ 1012 ） HTML (0 KB)  PDF  (0 KB)  ( 142 )

Objective: To explore the influence of the progesterone level increased in the late follicular phase on pregnant outcomes when in vitro fertilization or intracytoplasmic sperm injection embryo transplantation (IVF/ICSIET) , to explore the relationship between the level of progesterone (P) increased and the number of retrieved oocytes and serum E2 levels on HCG day, and try to investigate the threshold value of the number of retrieved oocytes and the threshold value of HCG E2 when the progesterone concentration over 0.5 nmol/L in the late follicular phase. Methods: The clinical data of total 1517 patients with infertility treated by IVF/ICSIET in the third affiliated hospital of Zhengzhou university from January 1st 2008 to December 31st 2015 were selected in this study. All the patients were divided into three groups according to the serum progesterone level, which included low concentration group (P < 0.3nmol/L), middle concentration group (1 < p < 1.5 nmol/ml), and high concentration group (P > 1.5 nmol/ml). The general situation, medication, clinical characteristics and outcome of pregnancy were compared among the three groups. Results：The embryo implantation rate and the clinical pregnant rate of patients in high concentration group were statistically significant lower than those of patients in middle concentration group and low concentration group (P<0.05).  The Gn dosage of patients in high concentration group was significant higher than that of patients in low concentration group and middle concentration group (P<0.05). There was no significant different in the high quality embryo formation rate among the three groups (P>0.05). The analysis of ROC curve showed that the least number of retrieved oocytes was 10.5 piece and E2 level was 11558.3pmol/L when P > 0.5nmol/L in the late follicular phase. The number of retrieved oocytes and E2 level had the positive correlation with the progesterone level increased. Conclusions: The progesterone level increased in the late follicular phase has no influence on quality of the embryos, but decreases the embryo implantation rate and the clinical pregnant rate. The number of retrieved oocytes and E2 level on the HCG day has the positive correlation.

2018 Vol. 26　(3):　219- [Abstract]（ 2269 ） HTML (0 KB)  PDF  (0 KB)  ( 177 )

Recurrent spontaneous abortion (RSA) has been contributed to various factors. Generally, etiological therapy can bring great pregnancy outcome to women with determined cause. However, it is hard to choose a specific clinical intervention for up to 40% cases that suffering with RSA, whose underlying cause have not yet been identified, named as unexplained recurrent spontaneous abortion (URSA). Therefore, how to bring benefit to those women is a big challenge in reproductive medicine. According to the hypothesis of the underlying etiology of URSA, the latest treatments can be divided into different aspects, including the intervention to abnormal chromosome and imbalanced alloimmunity, and empiric therapy. The theoretical foundations of different treatments and their feasibility as well as effectiveness evaluated by clinical studies can offer some guidance to future clinical treatment and study.

2018 Vol. 26　(3):　233- [Abstract]（ 404 ） HTML (0 KB)  PDF  (0 KB)  ( 135 )