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ZHOU Bin
Objective: To analyze contraceptive chosen of jiangxi women of childbearing age under the two child policy, and to provide evidence for improving the quality of family planning service. Methods: Based on the results of 2017 China Fertility Status Sample Survey, 4678 married or cohabiting Jiangxi women under 49 years old were included, and SPSS20.0 software was used to describe and analyze the situation of birth control method choices of these included women with different characteristics. Results: Among these women of childbearing age, 46.8% women had chosen sterilization and 30.6% women had chosen intrauterine devices (IUD), and sterilization and IUD were the main long-term contraception. 20.7% women had chosen condoms, while only 1.9% women had chosen subcutaneous implants, intrauterine injections, or oral contraceptive pill. Choices of birth control method was effected by marriage status, educational degree, health condition, children quantity, household registration type, employment status, age, average monthly income (P<0.05). 63.4% women in remarried families had chosen reversible contraception, which was 12.2 percentage points higher than that of women from first marriage families. The women with low education level had mainly chosen sterilization and IUD, but women with high education level had less chosen sterilization. The choice of sterilization by women from rural areas was significant higher than that of women from urban areas. Women from low family income had tended to choose sterilization and IUD, while women from high income family had chosen condoms at a higher rate. Conclusion: The publicity should be enhanced, the birth control knowledge of women of childbearing age should be improved, the content of contraceptive should be enriched, the informed choice of contraception and birth control measures of childbearing age women should be fully guaranteed, approaches should be innovative to expanding the availability and availability of free contraceptives, and scientific advocacy should be strengthen for increasing male acceptance and participation in contraception.
2019 Vol. 27 (11): 1422- [Abstract]（
313
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FU Yan1, YANG Yuxia1, HUANG Ling1, YU Ting2, ZHANG Bingzheng2, DUN Qianqian2, CHENG Siyu2, HUANG Limin2, YUAN Guihong1, MIN Juan1, GAO Xuemei1, ZHANG Yanping1
Objective: To explore the influence of family related factors on pregnancy intentions of women. Methods: A self-administered questionnaire survey was conducted on pregnant women who had come to Pingshan maternal and child health care hospital from July 2017 to April 2018. The questionnaire was divided into general situation questionnaire and pregnancy intention questionnaire. The family related factors on pregnancy intentions were analyzed by linear regression analysis. Results: In the family factors, women from non-only-child family (β=1.264, P=0.012), the husband without strong intention of fertility (β=1.341, P<0.001) or with strong intention of fertility (β=3.863, P<0.001), the score of the satisfaction degree of relationship between wife and husband at 6-8 points (β=1.197, P=0.016) and 9-10 points (β=1.440, P=0.002) were positively correlated with pregnancy intention of women. Conclusions: Family related factors are important factors for influencing pregnancy intention of women, which can be guidance and promoted for reducing the occurrence of unwanted pregnancy.
2019 Vol. 27 (11): 1426- [Abstract]（
290
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ZOU Xia，ZHANG Ying
Objective: To investigate the clinical eficacy of mifepristone and mirena for treating women with perimenopausal abnormal uterine bleeding caused by ovulatory disorders (AUB-O). Methods: 94 women with perimenopausal AUB-O were selected as the subjects from Nov 2015 to Nov 2017, and were divided into control group and observation group by the random number table (47 cases in each group). Women in the control group were treated by mifepristone tablets, and women in the observation group were inserted in mirena. The total effective rate, control bleeding time, complete hemostasis time, the changes of endometrial thickness and sex hormone levels before and after 3 months of treatment, and the rate of adverse reactions of women in the two groups were observed. Results: The total effective rate of women in the observation group was 93.6%, which was significant higher than that (78.7%) of women in the control group (P<0.05). The control bleeding time and complete hemostasis time of women in the observation group were 29.6±4.4 h and 65.4±7.2 h, which were significant shorter than those (33.8±4.4 h and 69.9±7.3 h) of women in the control group (P<0.05). After 3 months of treatment, the endometrial thickness, and the levels of serum estradiol (E2), luteinizing hormone (LH) and follicle stimulating hormone (FSH) of women in the observation group were significant lower than those of women in the control group (P<0.05). The incidence of adverse reactions during the treatment of women in the observation group was 12.8%, which was significant higher than that (29.8%) of women in the control group (P<0.05). Conclusion: The mirena used for treating perimenopausal AUB-O can hemostasis rapidly, improve endometrium, regulate the level of sex hormone, which’s curative effect is better than mifepristone with more safety, so it is worthy of popularization.
2019 Vol. 27 (11): 1430- [Abstract]（
310
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LIU Zhichao, YANG Jia, WANG Li, QIANG Mei
Objective: To explore the paternal epigenetic mechanism of fetal stop development. Methods: During March 2015 and April 2016, a total of 702 married men who visited doctors for pre-pregnancy examinations in the reproductive center of the maternal and child health care hospital of Shanxi province were selected in this study. Their demographic information and semen sample were collected. And the methylation levels of H19, Peg3 and Meg3 in sperm DNA were measured by pyrosequencing. Their newborn’s outcomes were followed up. In this study, 35 subjects with fetal stop development were included in fetal stop development group, and 35 subjects were selected in the control group by 1:1 pairing based on age, BMI, smoking, drinking and conception methods. Wilcoxon test was used to compare the levels of average methylation in three imprinted genes of sperm DNA and levels of the methylation at each individual CpG site. Results: The average level of DNA methylation of imprinting gene H19, Peg3 and Meg3 in human sperm had no significantly difference between fetal stop development group and control group (P>0.05). Further comparing the difference of the level of each CpG site between two groups, the methylation levels of CpG3 and CpG6 of Meg3 in fetal stop development group were significant lower than those in control group (P<0.05), while there were no significant difference in other CpG sites between the two groups (P>0.05). Conclusion: The decreasing of methylation level of Meg3 in sperm DNA may increase the risk of fetal stop development.
2019 Vol. 27 (11): 1434- [Abstract]（
341
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JIA Haijun, YE Jun, LEI Ping
Objective: To investigate the effect and clinical value of vasopressin combined with cerclage used before unruptured tubal interstitial pregnancy removal by laparoscopic. Methods: 67 women diagnosed with tubal interstitial pregnancy were selected as the research objects from January 2015 to June 2017. Based on the fertility requirements of women, 35 women in the study group had received laparoscopic tubal interstitial pregnancy removal after the pretreatment by vasopressin combined with cerclage, and 32 women in the control group had underwent laparoscopic wedge resection of ectopic pregnancy. The intraoperative and postoperative situations of women were compared between the two groups. Results: The volume of blood loss of women in the study group was 69.8±16.2ml, which was significant lower than that (80.2±19.1ml) of women in the control group (P<0.05). In the study group, the rate of unobstructed or partially unobstructed of fallopian tubes found by salpingography inspection half year after operation was 37.1%, and the rate of nature pregnancy in 2 years after operation was 65.7%. Conclusion: The pretreatment by vasopressin combined with cerclage before laparoscopic tubal interstitial pregnancy removal can effectively decrease the intraoperative blood loss, can effectively treat interstitial tubal pregnancy and retain the completeness of uterus and fallopian tube, which is benefit for treating those women who have fertility requirements.
2019 Vol. 27 (11): 1438- [Abstract]（
255
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CAO Xiangyun1, REN Lele2, LI Qian1
Objective: To investigate the effect of sodium hyaluronate combined with estradiol valerate for preventing uterine cavity adhesion and improving uterine recovery of women with missed abortion after uterine curettage. Methods: 372 women with missed abortion who underwent painless uterine curettage from March 2017 to March 2018 were selected and divided randomly divided into four groups (93 cases in each group) by random numbers table. After uterine curettage, the women in group A were given sodium hyaluronate only, the women in group B were given estradiol valerate only, the women in group C were given sodium hyaluronate combined with estradiol valerate, and the women in group D were not given any drugs. The situation of postoperative recovery and rates of adverse reactions and intrauterine adhesions were compared among the four groups. Results: The duration of vaginal bleeding and abdominal pain, and menstrual recovery time of women in group C were the shortest, and the total amount of vaginal bleeding was the lowest. The incidences of lower abdominal pain, vaginal secretions increased, and menstrual volume decreasing of women in group B and C were significant lower than those of women in group A and D. The incidence of uterine adhesions of women in group A was the highest, but that of women in group C was the lowest (P<0.05). In group B and C, there were several women with adverse reactions such as dizziness, nausea, breast swelling and pain, which all were mild and selfrelief. Conclusion: Sodium hyaluronate combined with estradiol valerate for treating women with missed abortion after uterine curettage can more effectively accelerate endometrial repaired and menstrual recovery, can prevent uterine adhesions, and has less adverse reactions, which can be tolerated well by women.
2019 Vol. 27 (11): 1441- [Abstract]（
344
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LU Yanfei, SONG Haiguo, SU Jiawen, YANG Lijuan
Objective: To analyze the application value of different ultrasound methods for measuring cervical length of women with different cervical shapes during the second trimester pregnancy. Methods: The prgnant women with high risk factors of preterm birth who had accepted ultrasound examination were selected as the research objects. According to the cervical morphology, they were divided into the group A (women with straight cervix) and group B (women with unstraight cervix). The cervical length of all included women was measured by transperineal straight line method and transperineal track method. And the cervical length and the predictive efficacy for preterm labor were compared between the two different methods. Results: There was no significant difference in the cervical length of women in group A between the two different measurement methods (P>0.05). In group B, the the cervical length measured by transperineal track method was significant longer than that of women by transperineal straight line method (P<0.001). As for women with cervical length less than 2.5 in group A, there was no significant difference in the rate of preterm labor between the two different methods (P>0.05). As for women with cervical length less than 2.5 in group B,the rate of preterm labor of women mearsued by transperineal track method was significant higher than that of women mearsued by transperineal straight line method (P<0.05). There were no significant difference in the sensitivity, the specificity, the positive predictive value, and the negative predictive value for predicting preterm labor of women in group A between the two different methods (P>0.05). In group B, the sensitivity, the specificity, the positive predictive value, and the negative predictive value for predicting preterm labor of women mearsued by transperineal track method were significant higher than those of women by transperineal straight line method (P<0.05). Conclusion: As for women with straight cervix, the cervical length and the prediction value of preterm labor by transperineal straight line method and transperineal track method were in good consistency. And As for women with unstraight cervix, the measured cervical length by transperineal track method was more accurate than that by transperineal straight line method, and the value for predicting preterm labor was better than that by transperineal straight line method. There was no significant difference in the cervical length between measured through perineum and transvaginal measurement.
2019 Vol. 27 (11): 1445- [Abstract]（
287
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MA Lihui, GUO Lina
Objective: To analyze the effects of femoston and progynova for endometrial rehabilitation of patients with severe intrauterine adhesion after transcervical resection of adhesion (TCRA). Methods: 90 patients with severe intrauterine adhesion after TCRA were selected and were divided into the femoston group and the progynova group (45 cases in each group) according to the random number table. After surgical, the patients in femoston group were given femoston, and the patients in progynova group were given progynova. The uterine cavity morphology, menstrual recovery, uterine membrane status on ovulation day, adverse reactions rate, and pregnancy status of patients were compared between the two groups. Results: There was no statistically significant difference in postoperative uterine morphological recovery of patients between the two groups (P>0.05). The menstrual recovery efficiency of patients in femoston group was 84.4%, which was significantly higher than that (62.2%) of patients in progynova group (P<0.05). The intrauterine membrane thickness of patients on ovulation day in femoston group was 9.9±2.1mm, which was significant thicker than that(8.8±2.1mm) of patients in progynova group (P<0.05). The subendometrial blood flow parameters RI of patients in femoston group was 0.8±0.2, which was significant lower than that (0.9±0.1) of women in progynova group (P<0.05). There was no significant difference in endometrial classification subendometrial blood flow parameters (PI and S/D) of patients between the two groups (P>0.05). There was no significant difference in clinical pregnancy rate (55.6% vs.46.7%) of patients within 12 months after operation between the two groups (P>0.05). The average time from operation to pregnancy of patients in the femoston group was 5.3±2.7 mouths, which was significant shorter than that(7.0±3.3 mouths) of patients in progynova group (P<0.05), and there was no statistically significant difference in the incidence of adverse reactions of patients between the two groups (P>0.05). Conclusion: The femoston treating patients with severe intrauterine adhesion after TCRA can more effectively improve menstrual condition, increase the thickness of intrauterine membrane on ovulation day, and shorten the time from operation to pregnancy.
2019 Vol. 27 (11): 1448- [Abstract]（
339
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LIU xiaoning1, XU Qian1, SUN Yue1, LIU Zhen2
Objective: To investigate the application of ultrasound-guided transverse abdominal plane block for analgesia of women after cesarean section under general anesthesia. Methods: 102 women who underwent cesarean section under general anesthesia from June 2014 to August 2017 were selected as the research subjects and divided into two groups according to the different postoperative analgesia methods (51 cases in each group). The women in control group were given patient control intravenous analgesia (PCIA) after operation, and the women in study group had received ultrasound guided transversus abdominis plane block (TAPB) combined with PCIA. The postoperative prolactin levels, postoperative visual analogue scale (VAS), the dosage of analgesics, the press times of the analgesic pump, the incidence of postoperative complications, and the satisfaction of parturients were compared between the two groups. Results: The serum prolactin level of women in both groups at 6h and 12h, 24h or 48h after operation had increased (P<0.05), and the serum prolactin level of women in the study group was significant higher than that of women in the control group at 6h and 12h, 24h or 48h after operation (P<0.05). The analgesia drug dosage and the press times of analgesia pump of women in the study group during the postoperative 0-12h and postoperative 12-24h were significant lower than those of women in the control group (P<0.05). The VAS of women in both groups at 3h, 6h, 12h and 24h after operation had gradually reduce (P<0.05), and the VAS of women in the study group at 3h, 6h, 12h or 24h after operation was significant lower than that of women in the control group (P<0.05). The incidence rate of adverse reactions of women in the study group was significant lower than that of women in the control group (P<0.05).The satisfaction on analgesia of women in the study group was significant higher than that of women in the control group (P<0.05). Conclusion: Ultrasound guided TAPB was used for analgesia of women after cesarean section can obviously reduce the dosage of analgesic drugs and the press times of the analgesic pump, alleviate the postoperative pain, promote the postpartum lactation, and improve the satisfaction degree of womenn with less adverse reaction.
2019 Vol. 27 (11): 1452- [Abstract]（
318
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JIANG Yan, WANG Jie, CHI Kun
Objective: The study of the relationship between the block Level and the body position in the same proportion isobaric bupivacaine used for combined spinal and epidural anesthesia during caesarean section. Methods: From January 2016 to January 2019，75 women who wanted caesarean section were selected and divided into 3 groups (25 cases in each group). During caesarean section, all women had accepted the intervertebral space of L3-L4 was inserted into the subarachnoid cavity and the same proportion of bupivacaine (0.5%) was injected into the subarachnoid cavity. And women in group I adopted the supine position， women in group II adopted the trendelenburg position with 5°, and women in group III adopted the trendelenburg position with 10°. The effect of anesthesia，the relative and absolute plane of the sensory block after injection，the systolic blood pressure，heart rate, and cardiac output before and after the injection，and the adverse reactions such as nausea and vomiting，and vasoactive drug used of pregnant women in the three groups were observed. Results: The absolute plane and the relative plane of anesthesia block of women in group III were T7±1.21 and T5±1.38, which were significant higher than those (T8±1.56 and T6±1.35, T8±1.32 and T6±1.04) of women in group I and II (P<0.05). There were no significant difference in index of hemodynamics before and after the anesthesia, adverse reactions rate, and the dosage of vasoactive drugs used of women among the three groups (P>0.05). Conclusion: When women adopt the trendelenburg position with 10°during cesarean section, the same proportion isobaric bupivacaine used for combined spinal and epidural anesthesia has the best anesthesia effect, which has no adverse influence on hemodynamics and adverse reactions of women.
2019 Vol. 27 (11): 1456- [Abstract]（
221
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LI Xin，WANG Rui，QIAO Qiao，WANG Qiang，XIAO Ying WEN Jian
Objective: To study the effect of combined spinal and epidural anesthesia in cesarean section of women with pregnancy induced hypertension syndrome, and to expore its influence on hemodynamics and hemorheology of women. Methods: 87 women with pregnancy induced hypertension who experinced cesarean section were divided into observation group (41 cases) and control group (46 cases) from April 2017 to March 2018 according to simple randomization method. During cesarean section, continuous epidural anesthesia was used in the control group， and combined with spinal and epidural anesthesia was used in the observation group. The hemodynamics and hemorheology indicators of women and neonatal situation in both groups were analyzed. Results: The excellent rate of anesthesia of women in the observation group was 90.2%, which was significant higher than that (63.0%) of women in the control group (P<0.05). The anesthetic onset time, anesthetic dose, and VAS score of were women in the observation group were 3.4±0.4min, 1.4±0.2ml, and 2.8±0.3 score, respectively, which were significant lower than those (9.0±0.9min, 12.9±1.2ml, and 9.2±0.9 score, respectively) of women in the control group (P<0.05). After anesthesia, the heart index, acceleration index, value of left heart work, diastolic blood pressure, systolic blood pressure, heart rate, stroke index, and cardiac output of women in the observation group were significant lower than those of women in the control group (P<0.05). There was no significant difference in the Apgar score between the two groups (P>0.05). Conclusion: The combined spinal and epidural anesthesia can effectively stabilize hemodynamics and hemorheology of women with pregnancy induced hypertension during cesarean section. The anesthesia has a quick onset and better anesthesia efficacy with less anesthetic medicinal dose, which can alleviate the pain of women.
2019 Vol. 27 (11): 1460- [Abstract]（
286
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XU Guoyong, ZHOU Li, SUN Haotian, LIU Xiaoguo, CHEN Yanqin, YANG Shizhong
Objective: To investigate the effect of different doses of dexmedetomidine in patients undergoing laparoscopic myomectomy. Methods: From January 2018 to December 2018, 120 patients who experinced laparoscopic resection of uterine fibroids under grade I-II elective general anesthesia evaluated by American Society of Anesthesiologists (ASA) were included and randomly divided into the group A and the group B according to random number table (60 cases in each group). 45 minutes before anesthesia induction, the patients in group A were given 1.0μg/kg dexmedetomidine by nasal spray, while patients in group B were given 0.5μg/kg dexmedetomidine by nasal spray. Before and after tracheal intubation and anesthesia induction, the hemodynamic changes, plasma concentrations of epinephrine (E), norepinephrine (NE), and cortisol (Cor) at various time points of patients in the two groups were recorded. And the cough response rate, agitation score, and improved alert sedation score (MOAA/S) during extubation, the occurrence of adverse reactions after surgery, the operation time, as well as the amount of propofol used during operation of all patients were observed. Results: There were no significant differences in HR and MAP at different time points (T0, T0-2 and T0-3) after dexmedetomidine given by nasal spray of patients between the two groups (P<0.05).In group B, the HR and MAP of patients at T2, T3 and T4 were significant higher than those at T1 (P<0.05). In group A, the MAP of patients at T2 was significant higher than that at T1 (P<0.05). The HR and MAP of patients in group B at T2, T3 and T4 were significant higher than those of patients in the A group (P<0.05). The levels of E, NE and Cor at T2 were significant higher than those at T1 in both group at T1. The plasma levels of E, NE and Cor at T2, T3 and T4 of patients in group B were significant higher than those at T1，and those were significant higher than those of patients in group A (P<0.05). The cough response rate, agitation score, MOAA/S, and amount of propofol used of patients in group A were significant lower than those of patients in group B (P<0.05). There was no significant difference in the operation time between the two groups (P>0.05). Conclusion: The patients are given 1.0 μg/kg dexmedetomidine by nasal spray before anesthesia induction during laparoscopic resection of uterine fibroids can effectively inhibit the stress response during extubation, can maintain hemodynamic stability, reduce cough response, alleviate postoperative pain, and reduce the dasage of intraoperative anesthetics, which is beneficial to the rehabilitation of patients.
2019 Vol. 27 (11): 1464- [Abstract]（
263
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WU Jiafu1,XIE Weiwei1,FENG Zuoxuan1,FENG Xiaoling2
Objective: To investigate the influence of general anesthesia combined with epidural anesthesia on the level of related factors of women with gynecologic laparoscopic surgery. Methods: 94 women who planned to undergo gynecologic laparoscopic surgery laparoscopic were divided randomly into control group and observation group (47 cases in each group) from May 2016 to May 2018. The women in the control group had received general anesthesia, and the women in the observation group had received general anesthesia combined with epidural anesthesia. The indexes of stress response, coagulation function, endocrine and immune, and other indexes of women before anesthesia (T1), during pneumoperitoneum (T2), and 10min before operation end were measured and compared between the two groups. Results: At T1, there were no significant difference in the indexes between the two groups (P>0.05). At T2 and T3, there were significant differences in levels of stress response index (SOD, MDA, ET-1), coagulation function (APTT, PT, PLT, D-Dimer), endocrine index (NE, Cor, Ins, C-P, FT3, FT4), immune index(CD3+, CD4+, CD8+), and other related indexes (TXB2, 6-K-PGF1α, TXB2/6-K-PGF1α) of women between the two groups (P<0.05). Conclusion: General anesthesia combined with epidural anesthesia during gynecologic laparoscopic surgery can significantly improve related indicators, such as stress, coagulation, endocrine and immunity of women, which are more beniffit to the stability of vital signs, and can improve the operation smoothly.
2019 Vol. 27 (11): 1468- [Abstract]（
291
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SUN Danli, SONG Yuchen, HAN Yaqing
Objective: To explore the effect of GnRH-α combined with estradiol valerate reverse addition therapy for patients with (EMS). Methods: 120 patients with EMS were randomly divided into the experimental group and the control group (60 cases in each group) by random numbers table from January 2016 to May 2018. The patients in the experimental group were given GnRH-α combined with reverse addition therapy, and the patients in the control group were given GnRH-αonly. The VAS scores and modified Kupperman scale (MKS) scores, and levels of serum CA125, E2, LH and FSH of patients in both groups were compared before and after treatment. Results: After treatment, VAS scores and MKS scores of patients in the experimental group were 1.7±0.5 points and 10.5±3.2 points, which were significant lower than those (2.0±0.7 points and 15.0±3.9 points) of patients in the control group (P<0.05). The serum CA125 level of patients in the experimental group was 23.0±6.7 U/L, which was significant lower than that (30.0±8.5 U/L) of patients in the control group (P<0.05). The levels of E2 and LH of patients in the experimental group were 144.2±23.0 pmol/L and 1.94±0.81 U/L, which were significant higher than those (126.5±25.2 pmol/L and 1.80±0.68 U/L) of patients in the control group (P<0.05). The incidences of insomnia, hot flashes, mood swings and osteoporosis of patients in the experimental group were significant lower than those of patients in the control group (P<0.05). There was no significant difference in the incidence of fatigue of patients between the two groups (P>0.05). Conclusion: GnRH-α combined with reverse addition used for treating patients with EMS can relieve pain and perimenopausal symptoms, and can reduce the adeverse effect on hormone level of patients.
2019 Vol. 27 (11): 1473- [Abstract]（
314
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SONG Jin1，MA Zilong1，CHEN Huijing1，WANG Qiang2
Objective: To investigate the expressions of miR-16 and miR-182 in peripheral blood of women with somatoform disorder (SFD), and to study the relationships between the miR-16 and miR-182 levels and the clinical features. Methods: 115 women with SFD were selected into the study group from March 2017 to December 2018, and 118 health women were selected in the control group during the same period. Real-time fluorescence quantitative polymerase chain reaction (qRTPCR) was used to detect the expression levels of miR-16 and miR-182 in plasma of women in both groups. The relationships between the expressions of miR-16 and miR-182 in peripheral blood plasma of women with SFD and their clinical characteristics were analyzed. The symptom checklist 90 (SCL-90) was used for evaluated all women, and the risk factors of SFD were analyzed. Results: The expression levels of miR-16 and miR-182 in peripheral blood of women in the study group were 1.57±0.38 and 1.70±0.41, which were significant higher than those (1.02±0.30 and 1.09±0.33) of women in the control group (P<0.05). The relative expression levels of miR-16 and miR-182 in peripheral blood plasma of women with SFD were correlated with depression and anxiety factors (P<0.05). The average score of SCL-90 of women in the study group was 2.84±0.65 points, which was significant higher than that (1.72±0.39 points) of women in the control group (P<0.05). The relative expression levels of miR-16 and miR-182 were positively correlated with the mean score of SCL-90 (P<0.05). The levels of miR-16, miR-182 and SCL-90 score were all risk factors of SFD (P<0.05). Conclusion: The expressions of miR-16 and miR-182 in peripheral blood plasma of women with SFD are up-regulated, which are expected to be clinical indicators for diagnosing SFD.
2019 Vol. 27 (11): 1477- [Abstract]（
264
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BU Chunyan, FAN Yongzhou, WANG Suying, GUE Zhankun
Objective: To investigate the efficacy of magnesium sulfate injection combined with low molecular weight heparin sodium for treating women with severe preeclampsia, and its effects on the levels of coagulation protein (GSN) and free vitamin D binding protein (VDBP), coagulation function, and pregnancy outcomes. Methods: 82 women with severe preeclampsia were randomly divided into two groups (41 cases in each group). The women in the control group were given magnesium sulfate antispasmodic treatment, while women in the observation group were given magnesium sulfate combined with low molecular weight heparin sodium. The curative effect, complication, pregnancy outcomes, and the changes of serum GSN and VDBP levels before and after treatment of all included women were observed. Results: After treatment, the values of SBP and DBP, FIB level, and 24-hour urinary protein of women in the observation group were 120.35±4.62 mmHg, 92.31±5.14 mmHg, 2.79±1.24 g/L, and 0.29±0.02 g, which were significant lower than those (140.23±5.32 mmHg, 105.32±5.15 mmHg, 3.35±1.16 g/L, and 1.42±0.12 g) of women in the control group (P<0.05). The levels of plasma GSN, VDBP, PT, and AP of women in the observation group were 263.51±69.57μg/ml, 183.69±53.29μg/ml, 15.12±3.15s, and 37.04±8.09 s, which were significant higher than those (183.59±45.87 μg/ml, 136.25±39.54μg/ml, 12.45±2.16s, and 29.15±6.27s) of women in the control group (P<0.05). The incidences of eclampsia, placental abruption, fetal growth restriction, cesarean section, and postpartum hemorrhage of women in the observation group were 0.0%, 2.4%, 0.0%, 53.7%, and 2.4%, which were significant lower than those (14.6%, 14.6%, 9.8%, 85.4%, and 17.1%) of women in the control group (P<0.05). Conclusion: Magnesium sulfate injection combined with low molecular weight heparin sodium for treating women with severe preeclampsia can significantly reduce blood pressure, urinary protein and blood viscosity, decrease plasma GSN and VDBP levels, and improve pregnancy outcomes.
2019 Vol. 27 (11): 1482- [Abstract]（
307
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ZHANG Anhong, XU Guiqin, ZHANG Wenqin, SUN Bo
Objective: To study the relationship between the levels of metastasis suppressor gene-1 (KiSS-1) and B lymphocyte tumor-2 gene (Bcl-2) in placenta tissues of pregannat women and their severe preeclampsia situation and pregnancy outcomes. Methods: 60 pregannat women with severe preeclampsia who had experinced cesarean section from January 2017 to June 2018 were randomly selected in experimental group, and 30 normal pregnant women who had also experinced cesarean section were randomly selected in control group during the same period. Maternal placenta tissues of all included women were collected immediately after delivery. RT-PCR, Western blot, and immunohistochemical methods were used to detect the levels of KiSS-1 and Bcl-2 in placenta tissues. The levels of KiSS-1 and Bcl-2, perinatal outcomes of women were compared between the two groups. And the relationship between the levels of KiSS-1 and Bcl-2 in placenta tissues and the perinatal outcomes was analyzed. Results: The relative absorbance of KISS-1/beta-actin and Bcl-2 /beta-actin, and the positive expression rates of KiSS-1 and Bcl-2 of women in the experimental group were significant higher than thoe of women in the control group (P<0.05). The incidences of fetal distress, intrauterine growth restriction, neonatal asphyxia, premature infants, and low birth weight infants in the experimental group were significant higher than those in the control group, but the neonatal weight and Apgar score were significant lower (P<0.05). There were no significant different in perinatal mortality between the two groups (P>0.05). The expressions of KiSS-1 and Bcl-2 in placenta tissues were negatively correlated with neonatal asphyxia rate, neonatal weight, and Apgar score (P<0.05). Conclusion: The expression levels of KiSS-1 and Bcl-2 in placenta are closely related to severe preeclampsia and perinatal outcomes, which maybe have a new idea for preventing and treating women with pregnancy induced hypertension.
2019 Vol. 27 (11): 1486- [Abstract]（
275
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ZHAO Haiyan1, XU Ruiyan2, NING Fang1
Objective: To investigate the effect of nitric oxide (NO) inhalation combined with sildenafil for treating neonates with pulmonary hypertension, and to study the influence of NO inhalation combined with sildenafil on vascular endothelium and cytokines of neonates. Methods: 68 neonates with pulmonary hypertension were randomly divided into the observation group and the control group (34 cases in each group). Neonates in the control group were treated by NO inhalation, and neonates in the observation group were treated by NO inhalation combined with sildenafil. The clinical efficacy, the values of oxygen partial pressure (PaO2) before and after treatment, carbon dioxide partial pressure (PaCO2), blood oxygen saturation (SaO2) and pulmonary systolic pressure (PASP), and the levels of N-terminal pro-brain natriuretic peptide (NT-proBNP), tumor necrosis factor-α(TNF-α), interleukin-8 (IL-8),ischemia-inducing factor (HIF-1α), endothelin-1 (ET-1) and NO of neonates were compared between the two groups. Results: The total effective rate of neonates in the observation group was 94.1%, which was significant higher than that (70.6%) of neonates in the control group (P<0.05). After treatment, the values of PaO2 before treatment (82.71±10.35mmHg) and SaO2 after treatment (96.57±3.36%) of neonates in the observation group were significant higher than those of neonates in the control group, but the values of PaCO2 (35.05±8.19mmHg) and PASP (25.39±6.34mmHg) of neonates in the observation group were significant lower (P<0.05). The levels of NT-proBNP (341.65±118.68 ng/ml), TNF-α (4.59±0.81 ng/ml), IL-8 (2.96±0.52 ng/ml), HIF-1α(304.51±45.29 pg/ml), and ET-1 (46.21±25.27pg/ml) of neonates in the observation group were significant lower than those of neonates in the control group, while level of NO (27.03±11.79μmol/L) of neonates in the observation group was significant higher (P<0.05). Conclusion: NO inhalation combined with sildenafil can significantly improve the vascular endothelial function of neonates with pulmonary hypertension, regulate the expression of cytokines such as inflammatory factors, and improve the clinical therapeutic effect of neonatal pulmonary hypertension.
2019 Vol. 27 (11): 1490- [Abstract]（
293
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WANG Zhongde, YUE Xin, MOU Kai
Objective: To investigate the changes of serum amino acid and acylcarnitine levels of women with gestational diabetes mellitus (GDM), and to explore their relationship with insulin resistance of women. Methods: 63 pregnant women with GDM were selected in the study group, and 58 normal pregnant women were included in the control group. The blood glucose levels of all included women were detected at 0h, 1h and 2h in the 75g oral glucose tolerance test (OGTT) during 24-28 gestational weeks. Serum insulin levels were determined by chemiluminescence method, and serum amino acid and acylcarnitine levels were determined by high performance liquid chromatography-tandem mass spectrometry. Results: The levels of fasting serum alanine (ALA), arginine (ARG), glycine (GLY), methionine (MET), acetyl carnitine (C2), Malonyl carnitine (C3DC)+C4OH, isovalerylcarnitine (C5DC)+C6OH, and hexanoyl meat the alkali(C6) of women in the study group were 266.2±53.6 umol/l, 21.1±5.6 umol/l, 171.6±40.1 umol/l, 13.6±2.8 umol/l, 7.68±2.44 umol/l, 0.05±0.02 umol/l, 0.06±0.01 umol/l, and 0.03±0.01 umol/l, respectively, which were significant higher than those (245.1± 43.7 umol/l, 18.5±5.8 umol/l, 156.7±32.9 umol/l, 11.9±2.5 umol/l, 5.84±1.76 umol/l, 0.04±0.01 umol/l, 0.05±0.01, and 0.02±0.01umol/l,vrespectively) of women in the control group (P<0.05 or 0.01). The levels of carnitine included free carnitine (C0) and Diacyl carnitine (C6DC) of women in the study group were 17.08±3.46 umol/l and 0.035±0.013 umol/l, which were significant lower than those (18.71±3.32umol/l and 0.044±0.015umol/l) of women in the control group (P<0.01). Pearson correlation analysis had showed that serum levels of ALA, ARG, MET, C2, C3DC+C4OH, C5DC+C6OH of women in study group were positive correlation to the levels of fasting insulin, 2h blood glucose, and insulin resistance index (HOMAIR) of women, while the levels of GLY and C6 of women were positively correlated to the 2h blood glucose level of women (P<0.05). Conclusion: The amino acid and acyl carnitine metabolism of women with GDM are abnormal, which may aggravate the degree of insulin resistance of women with GDM.
2019 Vol. 27 (11): 1494- [Abstract]（
273
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BIAN Haiyan1, LIU Zhaolong2, ZHAO Bo2
Objective: To study the expression of serum monocyte chemoattractant protein (MCP)-1, interleukin(IL)-18, and lipoprotein (LP)a of preeclampsia women with sleep apnea hypopnea syndrome (SAHS). Methods: From March 2016 to March 2018, 60 women with preeclampsia combined with SAHS were selected in group A, 50 women with preeclampsia only were selected in group B, and 50 healthy pregnant women were selected in group C. The levels of MCP-1, IL-18 and LP (a), and the values of sleep apnea hypopnea index (AHI) and the value of the lowest oxygen saturation (LSaO2) of women in three groups were detected, and their significance in group A was analyzed. Results: The serum MCP-1, IL-18, LP(a) levels and AHI value of women in group A were significant higher than those of women in group B and C, but the LSaO2 value was significant lower (P<0.05). The serum MCP-1, IL-18 and LP(a) of women in group B were significant higher than those of women in group C (P<0.05), but there were no significant difference in values of AHI and LSaO2 of women between the group B and group C (P>0.05). Pearson correlation analysis showed that there was a positive correlation between the serum levels of MCP-1, IL-18, LP(a) and the values of AHI and LSaO2 (P<0.05).The logistical regression analysis showed that the serum MCP-1, IL-18 and LP(a) levels were the risk factors for preeclampsia complicated with SAHS (P<0.05).The ROC curve analysis showed that the sensitivity of serum MCP-1 level, IL-18 level and LP(a) level for diagnosing preeclampsia combined with SAHS were 78.5%, 80.5% and 81.0%, respectively. The specificity of serum MCP-1 level, IL-18 level and LP(a) level for diagnosing preeclampsia combined with SAHS were 74.1%, 78.3%, and 75.3%, respectively. Conclusion: The serum MCP-1, IL-18 and LP(a) are involved in the occurrence and development of preeclampsia combined with SAHS, which provides new idea for clinical diagnosis and treatment of preeclampsia combined with SAHS.
2019 Vol. 27 (11): 1498- [Abstract]（
253
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MU Juan, MIAOZhijing, ZHANG Yue, MIAO Miao, DAI Yongmei
Objective: To explore the influence of dietary nutrition interventions on dietary nutrition intake and maternal and infant outcomes of pregnant women. Methods: 300 pregnant women were randomly divided into observation group and control group (150 cases in each group) from September 2017 to September 2018. The woman in the control group had received routine dietary guidance, and the women in the observation group were given individualized dietary nutrition guidance. The situations of dietary nutrition intake and pregnancy outcomes of women were compared between the two groups. Results: The fat and sodium levels of women in the observation group were significant lower than those of women in the control group (P<0.05), but the levels of protein, calcium, iron, zinc, folic acid and vitamin A were significant higher (P<0.05). There were no significant difference in carbohydrate level, gestational weeks, rates of gestational hypertension and premature rupture of membranes of women, Apgar score, neonatal birth weight, and preterm birth rate between the two groups (P>0.05). The different value of BMI, and the incidences of gestational diabetes and anemia, polyhydramnios or oligohydramnios, cesarean section, and postpartum hemorrhage of women, and low body mass, macrosomia and fetal distress rates in observation group were significant lower than those of women in the control group (P<0.05). Conclusion: Individualized dietary nutrition intervention during pregnancy can improve the nutritional status of women, and can improve maternal and infant outcomes.
2019 Vol. 27 (11): 1502- [Abstract]（
234
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ZHOU Ling, WANG Li, ZHANG Yan，CHEN Xiufang
Objective: To analyze cesarean delivery rate and cause percentage of cesarean delivery in recent 5 years, and to explore the effective measures to decrease cesarean delivery rate. Methods: The date of 5070 women who had deliveried by cesarean section from January 1, 2014 to December 30, 2018 was retrospectively reviewed. The cesarean delivery rate and cause percentage of cesarean delivery of women in each year were calculated. Results: The rate of cesarean delivery every year were 36.2% (1260 cases), 39.6 % (1362 cases), 43.1 % (1136 cases), 35.5% (689, cases), or 30.2% (623 cases) from 2014 to 2018. The proportion of cesarean delivery increased year by year from 2014 to 2016, and that decreased year by year from 2017 to 2018 (P<0.05). In the cause of cesarean delivery, the proportion of no clear reason was the highest, and the proportion of fetal distress was the second highest.Conclusion： Reducing cesarean delivery in primary pregnancy, avoiding overdiagnosis of fetal distress, and increasing the rate of vaginal trial delivery after cesarean section (VBAC) maybe the effective measurement to reduce cesarean delivery rate.
2019 Vol. 27 (11): 1506- [Abstract]（
305
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YING Xunxun, XU Xiuling, JIN Yang
Objective: To analyze the contraceptive status and its influencing factors of women of childbearing age. Methods: From May 2018 to May 2019, 581 women of childbearing age from Hangzhou traditional Chinese medicine hospital, provincial maternal and child health care hospital and Run Run Shaw hospital were randomly selected in this investigation, and their status of contraception were surveyed by questionnaire, and the influencing factors of contraception were analyzed. Results: The average score of knowledge of contraception in these 581 women was 8.4±3.1 points. The regression analysis showed that the score of contraceptive knowledge of women was higher, which include that women with high school education or above, received contraception education, pregnancy ≥2 times, or their husband with positive attitude towards contraception (P<0.05). Among 581 women, 210 (36.1%) women had choosen condoms, 169 (29.1%cases) women had choosen intrauterine devices, 96(16.5%) women had choosen oral contraceptives, 56(9.6%) women had choosen female ligation, 7(1.2%) women had choosen male ligation, 12(2.1%) women had choosen contraceptiveinjection, and 31(5.3%) women hadn’t choosen any contraception. Those women with low contraceptive knowledge level had higher percentage of choosing condoms or not using any contraception. Conclusion: The contraceptive used of women of childbearing age is at a medium level, so the education of contraceptive knowledge for women should be strengthened. And at the same time, the contraceptive knowledge education of their husbands also should be strengthened, and the implementation of contraceptive should be promoted for reducing the occurrence of unwanted pregnancy.
2019 Vol. 27 (11): 1509- [Abstract]（
400
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DING Hongyan, XU Hongge, ZHANG Ting
Objective: To explore the influence of laparoscopy on levels of sex hormones and neuroendocrine hormones, and pain stress indexes of patients with benign ovarian tumors. Methods: The data of 96 patients with benign ovarian tumors from January 2017 to June 2018 were retrospective analyzed. The included women were divided into in observation group and control group (48 cases in each group). Patients in the control group had undergone routine surgery, and patients in the observation group had undergone laparoscopic surgery. The levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol (E2), progesterone (P), adrenocorticotropic hormone (ACTH), cortisol (COR), β-endorphin (β-EP), substance P (SP), interleukin-6 (IL-6) and prostaglandin-E2 (PGE2)of patients were compared between the two groups. Results: 1 month or 3 months after operation, the levels of FSH and LH of patients in both groups had increased significantly, and those of women in the control group were significant higher than those of patients in the observation group (P<0.05). 1 month or 3 months after operation, the levels of E2 and P patients in both groups had decreased significantly, and those of women in the control group were significant lower than those of patients in the observation group (P<0.05). The levels of ACTH, COR and β-EP of patients in the control group had increased significantly1 month after operation and 3 months after operation. The levels of ACTH, COR and β-EP of patients in the observation group had increased significantly 1 month after operation, but those of patients had no changed 3 month after operation (P>0.05). 3 months after operation, the levels of ACTH, COR and β-EP of patients in the control group were significant lower than those of patients in the observation group (P<0.05). The levels of SP, IL6 and PGE2 of patients in both groups had increased significantly after operation, and those of women in the observation group were significant lower than those of patients in the control group (P<0.05). Conclusion: Laparoscopic surgery has fewer side effects on the levels of sex hormones and neuroendocrine hormones, and pain stress indexes of patients with benign ovarian tumors.
2019 Vol. 27 (11): 1512- [Abstract]（
272
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JIANG Jiaying, LIU Hong
Objective: To investigate the prevention and treatment methods for treating massive bleeding of women with caesarean scar pregnancy (CSP) during or after abortion, and to analyze their prognosis. Methods: The clinical data of 102 women with CSP who had bleeding during or after abortion from January 2010 to May 2018 were analyzed retrospectively. And the clinical treatment methods and prognosis of these included women were analyzed. Results: In the 102 women, 36 women with massive bleeding were in group A, and 66 women with less amount bleeding were in group B. The gestational weeks, the proportion of more than 8 gestational weeks, the proportion of uterine diameter or mass diameter > 60 mm, and uterine scar thickness of women had significant different between the two groups (P<0.05). Logistic regression analysis showed more than gestational weeks and mass diameter >60 mm were independent risk factors for massive bleeding. In group A, 3 women had experinced total or subtotal hysterectomy for treating bleeding, 5 women had experinced uterine cavity tamponade, and 25 women had experinced uterine artery embolization (UAE) (5 women treated by UAE only, 8 women treated by UAE combined with MTX, 8 women treated by UAE combined with curettage through hysteroscopy or ultrasound guidance, 7 women treated by UAE combined with transabdominal scar pregnancy clearance and repair). In group B, 31 women treated by conservative treatment (MTX combined with MF), 35 women treated by surgery (19 women treated by curettage through hysteroscopy or ultrasound guidance, and 16 women treated by transabdominal scar pregnancy clearance and repair). All women had hemostasis successfully, and the hemostasis time and recovery time of women treated by surgical were shorter than those of women by conservative treatment. Conclusion: Women with history cesarean section should beware CSP and massive bleeding after abortion. UAE used for hemostasis can emergency treating vaginal bleeding effectively, and drug combination therapy is necessary. Conservative surgery or transabdominal scar pregnancy clearance and repair is also as a complementary treatment method.
2019 Vol. 27 (11): 1517- [Abstract]（
322
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XING Lili, HUANG Lei,ZHAO Baixin, JIAO Fangjie
Objective: To analyze the value of luteum blood classification by transvaginal color doppler ultrasound for predicting the effect of drug treatment of women with tubal pregnancy. Methods; 123 women with tubal pregnancy by drug therapy were selected as the study subjects from January 2016 to December 2016, and the women were divided into group grade 0, group grade 1, group grade 2, and group grade 3 according to luteal blood classification detected by transvaginal color doppler ultrasonography. The levels of blood β-HCG and tubal pregnancy mass changes at different times of women after drug treatment were compared among the four groups. Results: There were no significant difference in bloodβ-hCG level and the mean diameter of tubal pregnancy mass before treatment among the four groups (P>0.05). On the 1st ,5th, 7th , and 14th day after treatment, the decreased degree of β-hCG level of women in group grade 2 and group grade 3 was significant less than that of women in group grade 0 and group grade 1 (P<0.05),but there was no significant difference in the decreased degree of β-hCG level of women between group grade 0 and group grade 1 (P>0.05). On the5th, 7th, and 14th day after treatment, the decreased degree of the diameter of fallopian tube pregnancy mass of women in group grade 2 and group grade 3 was significant less than that of women in group grade 0 and group grade 1 (P<0.05), but there was no significant difference in the decreased degree of the diameter of fallopian tube pregnancy mass of women between group grade 0 and group grade 1 (P>0.05).The effective rate of women in group grade 3 was the lowest (P<0.05), but there was no significant difference in the effective rate of women among the other three groups (P<0.05). The time of the mass disappearance or the time of bloodβ-hCG retured to normal level of women in group grade 3 was the longest (P<0.05), but those of women in group grade 0 had no significant different to those of women in group grade 1 (P<0.05). Conclusion: luteum blood classification by transvaginal color doppler ultrasound can predict the effect of drug treatment of women with tubal pregnancy. The classification is higher, the treatment time is longer and the curative effect is poor.
2019 Vol. 27 (11): 1522- [Abstract]（
318
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SHEN Wei, XIA QiuMin, ZHANG Zhengyin, WANG Yating, ZHANG Baohua
Objective: To identify the optimal time of detection and threshold of homocysteine (HCY) for predicting the occurance of pregnancy induced hypertensionin (PIH), and to provide evidence for clinical prevention of PIH early. Methods：718 pregnant women were selected in this study, which included 106 women with PIH, 372 women with other pregnant diseases. 240 normal pregnant women were selected as comparison subjiects duringthe same period. The serum HCY levels of all included women were detected in the 16th, 24th, and 30th getional week. Logistic regression analysis, Random forest analysis, Decision tree model, and ROC curve analysis were conducted. Results：HCY level was an independent risk factor for the occurrence of PIH (P＜0.01). The mean decrease gini (MDG) of the serum HCY level in the 24th and 30th gestional week were 41.744 and 46.928, which accounted for a larger proportion in all classification factors. HCY level of women detected in the 24th gestional week had the best value for predicting PIH. Its diagnostic threshold, the area under the curve (AUC), the sensitivity, and the specificity were 11.13umol/L, 0.84, 54.7%, 96.2%,respectively. Conclusion: The serum HCY level of pregnant women detected in the 24th gestional week has value for predicting PIH. When ≥24.5 years old pregnant women have HCY level ≥11.13 umol/L, or when pregnant women with gestational diabetes mellitus have HCY level form 11.13umol/L to 8.95umol/L, they maybe the probability of occurrence of PIH.
2019 Vol. 27 (11): 1526- [Abstract]（
303
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CHEN Juan
Objective: To explore the value of the levels of serum β-human chorionic gonadotropin (β-HCG), glycoprotein 125 (CA125), progesterone (P) and insulin-like growth factor-II (IGF-II) for predicting the outcomes of women with threatened abortion. Methods: 120 pregnant women with threatened abortion were selected in study group, and 240 normal pregnant women were selected in the control group. The serum levels of β-HCG, CA125, P and IGF-II of women at 6-8 gestional weeks were compared between the two groups. The women in the study group were further divided study group 1 (women with continuing pregnancy) and study group 2 (women with abortion) based on outcomes after treatment.The receiver operating curve (ROC) was used to analyze the value of the four indicators for predicting the pregnancy outcomes of all women. Results: The serum levels of β-HCG, P and IGF-II of women in the study group were significant lower than those of women in the control group, but the serum CA125 level was significant higher (P<0.05). After treatment, the serum levels of β-HCG, P and IGF-II of women in the study group 2 were significant lower than those of women in the study group 1, but the serum CA125 level was significant higher (P<0.05). The sensitivity, the specificity, and the area under the curve (AUC) of β-HCG level for predicting adverse outcomes was 87.2%, 76.4%, and 0.825, respectively. The sensitivity, the specificity, and the AUC of CA125 level for predicting adverse outcomes was 73.3%, 65.2%, and 0.704, respectively. The sensitivity, the specificity, and AUC of P level for predicting adverse pregnancy outcomes was 86.8%, 74.0%, and 0.821, respectively. The sensitivity, the specificity, and AUC of IGF-II level for predicting adverse outcomes was 53.3%, 61.44%, and 0.579, respectively. Conclusion: The levels of serum β-HCG, CA125, P and IGF-II of women with threatened abortion change significantly, and the levels of serum β-HCG, CA125, P have certain clinical value for predicting the adverse pregnancy outcomes of women with threatened abortion.
2019 Vol. 27 (11): 1529- [Abstract]（
305
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ZHAO Aihua1, HAN Qingxiao2
Objective: To investigate the effect of cervical dilatation balloon for promoting cervical maturation of full term women with scar uterus during vaginal trial delivery, and to study its influence on maternal and infant outcomes. Methods: The data of 76 full-term pregnant women with history cesarean section (>2 years) who had experienced vaginal trial delivery from April 2014 to July 2019 were analyzed retrospectively. The included women were divided group A (41 women had accepted promoting cervical maturation by cervical dilatation balloon during vaginal trial delivery) and group B (35 women had accepted promoting cervical maturation by oxytocin during vaginal trial delivery), and 40 full-term pregnant women without scar uterus who had also accepted promoting cervical maturation by cervical dilatation balloon were seleceted in group C during the same period. The cervical Bishop score, labor duration (first and second stage), 24 h postpartum hemorrhage, delivery mode, neonatal birth weight and Apgar score, and the incidences of adverse maternal and infant outcomes were compared among the three groups. The effect of promoting cervical maturation by cervical dilatation balloon was evaluated. Results: The cervical Bishop score of women in the three groups had increased significantly after labor induction intervention. The cervical Bishop score, the total effective rate of promoting cervical maturation, and the vaginal induction rate of women in group A and group C were significant higher than those of women in group B (P<0.05), but those had no significant difference between group A and group C (P>0.05). The incidences of fetal distress, induced labor failure, persistent occipital transverse position, and labor stagnation of women had no significant difference among the three groups (P>0.05) No postpartum hemorrhage of women was found in the three groups. There were no significant difference in the incidences of neonatal asphyxia, soft birth canal laceration, acute chorioamniotic meningitis, 24 h postpartum hemorrhage, and neonatal birth weight, and Apgar score among the three groups (P>0.05). Conclusion: As for full term pregnant women with scar uterus during vaginal trial delivery, cervix dilation balloon can promot cervical maturation and increase the success rate of vaginal induced labor, and can improve maternal and infant outcomes.
2019 Vol. 27 (11): 1532- [Abstract]（
353
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MA Jing1, DEN Peipei1, HAN Ruiyu1, LIU Wenjiao2, CUI Tong2, AN Qi3, GU Yiqun3, WANG Shusong1,2
Objective: To investigate the relationship between the diabetes of men and their semen quality. Methods: The data of 168 infertility men from September 2016 to February 2017 were retrospective analyzed. The included men were divided into group A (74 cases with normal fasting glucose), group B (62 cases with fasting glucose impaired), and group C (32 cases with diabetes) according to the level of fasting blood glucose. CASA system was used to detect the semen parameters of all men. Results: There were significant difference in total number of spermatozoa, the sperm concentration, and the percentage of sperm moving forward (P<0.05). The total number of spermatozoa of men in 20-25 years old was the lowest. As for the men in 26-30 years old, the percentage of sperm moving forward of men in group B and C was significant lower than that of male in group A (P<0.05). Correlation analysis showed that the sperm concentration, total sperm count, and the percentage of sperm moving forward of man was significantly negative correlation to fasting glucose concentration (P<0.05). Logistic regression analysis showed that the risk of abnormal semen quality of overweight or obesity men in group C was 3.667 times of that of normal weight men in the group A, and the interaction index (S) of overweight or obesity with hyperglycemia was 1.43, RERI was 0.798, and attribution percentage (AP) was 21.76%. Conclusion: Hyperglycemia can decrease the semen quality, and hyperglycemia and overweight or obesity may increase the risk of abnormal semen.
2019 Vol. 27 (11): 1537- [Abstract]（
367
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ZA Luo1, DIAO Yulan2
Objective: To analyze the correlation between serum AOPP and CysC levels during the third pregnancy trimester of women with early onset preeclampsia and their pregnancy outcomes. Methods: 98 women with early onset preeclampsia were selected in study group from March 2016 to May 2018, and 98 healthy pregnant women were selected in control group during the same period. The AOPP and CysC levels from peripheral venous blood of women were detected. In the study group, the AOPP and CysC levels and pregnancy outcomes of women were compared among women with different severity preeclampsia. And the correlation analysis was performed. Results: The levels of AOPP and CysC of women in the study group were 76.17±9.33μmol/L and 1.39±0.37 mmol/L, which were significant higher than those (58.09±10.58μmol/L and 0.77±0.18 mmol/L) of women in the control group (P<0.05). The levels of AOPP and CysC of women with severe early onset preeclampsia were 81.37±9.75μmol/L and 1.62±0.51 mmol/L, which were significant higher than those (71.93±11.08μmol/L and 1.18±0.27 mmol/L) of women with mild early onset preeclampsia (P<0.05).The levels of AOPP and CysC of women with poor pregnancy outcomes were significant higher than those of women with good pregnancy outcomes (P<0.05).Correlation analysis showed that AOPP and CysC levels were significantly negatively correlated with pregnancy outcomes of women with early onset preeclampsia (P<0.05).Conclusion: The serum levels of AOPP and CysC of women with early onset preeclampsia are significant higher than those of healthy pregnant women. The AOPP and CysC levels are significantly negatively correlated with pregnancy outcomes, and the levels of AOPP and CysC are higher, the pregnancy outcomes are worser.
2019 Vol. 27 (11): 1541- [Abstract]（
286
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WANG Rui, ZHANG Ting
Objective: To investigate the relationship between dietary energy intake or weight gain of pregnant women with prepregnancy normal body mass index (BMI) during pregnancy and their pregnancy outcomes. Methods: From April 2015 to December 2018, 306 pregnant women were investigated by questioner. Results: The average weight before pregnancy of these 306 women was 52.7±7.9kg, their average weight before delivery was 69.7±8.6kg, and their average weight gain during pregnancy was 16.8±4.0 kg. According to the recommended intake of nutrients provided in the third trimester pregnancy by the Chinese dietary guidelines, with the increasing of total energy intake, gestational weeks when delivery, pregnancy age, or exercise during pregnancy, the weight gain during pregnancy increased gradually. The weight gain during pregnancy of women with less education level had significant more than that of other women (P<0.05). As the weight gain during pregnancy of pregnant women by tertiles, all women divided into three groups, which included 75 women with 11.0-15.0 kg gain, 109 women with 15.1-19.0 kg gain, and 122 women with 19.1-23.0kg gain, and there were significant different in the rates cesarean section, premature delivery, fetal distress, and low-weight children among the three groups. With the weight gain during pregnancy increasing, the incidence of adverse outcomes, the proportion of cesarean section and fetal distress had increased (P<0.05). Conclusion: The more dietary energy intake during pregnancy of women with pre-pregnancy normal BMI, the more weight gain during pregnancy, which may lead to adverse pregnancy outcomes.
2019 Vol. 27 (11): 1544- [Abstract]（
283
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LIU Yuexia1, WANG dongxu2, WEI Juhong1, WU Deqing1
Objective: To analyze the value of serum VEGF, PlGF and sFlt-1 levels of pregnant women during the third trimester pregnancy for predicting placenta accrete. Methods: The pregnant women with high risk factors of placenta accrete were selected as subjects from January 2014 to December 2018. According to postpartum diagnostic results, the included women were divided into group A (women without placenta accrete), group B (women suspected placenta accrete), and group C (women with placenta accrete). In addition, all women were further divided into group C 1 (women with placental adhesion) and group C 2 (women with placenta increta) according to the depth of villi invasion. The difference of serum levels of VEGF, PLGF and sFlt-1 of pregnant women and their value for predicting placenta accrete were compared among these groups. Results: The serum levels of VEGF and PLGF of women in group C were significant higher than those of women in group A and B, and sFlt-1 level of women in group C was significant lower (P<0.05). There were no statistically significant differences in levels of VEGF, PLGF and sFlt-1 of women between group A and B (P>0.05). The serum levels of VEGF and PLGF of women in group C 2 were significant higher than those of women in group C 1 (P<0.05), but there were no significant difference in sFlt-1 level of women between group C 1 and C 2 (P>0.05). ROC curve analysis showed that VEGF and PLGF levels had values for predicting placenta accrete (P<0.001). The area under ROC curve, sensitivity, and the specificity of VEGF level were 0.812, 83.1%, and 66.7%, respectively. The area under ROC curve, the sensitivity, and the specificity of PLGF level were 0.749, 86.2%, and 60.3%, respectively. While sFlt-1 level had no value for predicting placenta accrete (P>0.05). Conclusion: The levels of serum VEGF, PLGF and sFlt-1 of pregnant women with placenta accrete during the third trimester pregnancy are abnormal, in which, the levels VEGF and PLGF have some value for predicting placenta accrete and can help for predicting depth of villi invasion.
2019 Vol. 27 (11): 1548- [Abstract]（
287
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JIA Yihong1, WANG Lili2, ZHAO Min3
Objective: To investigate the effect of tumor necrosis factor-α (TNF-α), interleukin-10 (IL-10), and tumor necrosis factor alpha-induced protein-2 (TIPE2) on maternal-fetal immune regulation. Methods: Immunohistochemistry was used to detect the expression levels of TIPE2, TNF-α and IL-10 in the villus tissues of 30 women with recurrent spontaneous abortion (study group) and 33 women with unwanted pregnancy after artificial abortion (control group). Results: The expression rate of TNF-α in the villus tissue of women in the study group was 63.3%, which was significant higher than that (30.3%) of women in the control group, the expression rates of IL-10 and TIPE2 were 6.7% and 23.3%, which were significant lower than those (60.6% and 57.6%) of women in the control group. TIPE2 level was negatively correlated with TNF-αlevel (r=0.752, P<0.05), and TIPE2 level was positively correlated with IL-10 level (0.915, P<0.05). Conclusion: TIPE2 maybe correlated with the balance of Th1/Th2 of maternal-fetal interface in the mechanism of recurrent abortion.
2019 Vol. 27 (11): 1552- [Abstract]（
294
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