Objective: To analyze the difference of fertility intention and behavior of women of childbearing age from urban and rural in China, and to study its relevant influencing factors. Methods: 845 women of childbearing age of Jiangsu province were selected as the subjects, which included 425 urban women (urban group) and 420 rural women (rural group). The basic information，and the desire and the behavior to have the second child were investigated, and the relevant influencing factors of the second child were analyzed by questionnaires. Results: There were significant differences in the number of children, whether to have two children, the gender of the second child, and the time to have the second child between the two groups (P<0.05). The actual number of children of women in both groups was significant lower than the ideal number of children, and the ideal and actual number of children of urban women were significant lower than those of rural women (P<0.05). The willingness of women to have the second child in the two groups was no related to whether they themselves were only children or their education level (P>0.05), but was related to the family annual income and gender of the first child (P<0.05), and the willingness of rural women was related to their age (P<0.05). Multivariate analysis showed that the family annual income was the main influencing factor for having to the second child of urban women (P<0.05), but age, family annual income, and gender of the first child were the main influencing factors for having to the second child of rural women (P<0.05). Conclusion: The willing of the second child of urban and rural women is generally not high. The rural women have obvious gender preference for the second child. Economic factors are the main factors affecting the willingness and behavior of the second child of urban and rural women, and the willingness of the second child of rural women is also affected by age and gender of the first child. 

2020 Vol. 28　(4):　475- [Abstract]（ 565 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

Objective: To evaluate the safety and clinical efficacy of methotrexate combined with tetrahydrofolic acid intramuscular injection and oral mifepristone for treating scar pregnancy of women with ≤8 gestational weeks. Methods: 70 pregnant women with ≤8 gestational weeks were divided into control group and study group according to the random number table (35 cases in each group). The women in the control group were treated with methotrexate intramuscular injection and oral mifepristone, and the women in the study group were treated with methotrexate combined with tetrahydrofolic acid intramuscular injection and oral mifepristone. The levels of serum progesterone (P) and β-human chorionic gonadotropin (HCG) of women were measured before and after the treatment. QLQ-C30 scale was used for assessing quality of life, remission time of clinical symptoms and signs of all women. The clinical efficacy and side effects of women were compared between the two groups. Results: Compared with those before treatment, the levels of serum P and β-hCG, and scores of QLQ-C30 scale of women in both groups had decreased significantly, and those of women in the study groups were lower than those of women in the control group (P<0.05). After treatment, the postoperative bleeding time, hospitalization time, duration ofβ-hCG returned to negative, and menstrual recovery time of women in the study group were 11.9±4.0d, 16.9±3.2d, 16.5±4.5d, and 63.3±5.4d, respectively, which were significant lower than those of women in the control group. The effective rate of women in the study group was 91.4%, which was significant higher than that (71.4%) of women in the control group, but the incidence of fever and leukocyte decline rate were 2.9% and 5.7%, which were significant lower than those (17.1% and 22.9%) of women in the control group (P<0.05). Conclusion: Methotrexate combined with tetrahydrofolic acid intramuscular injection and oral mifepristone for treating women with scar pregnancy has definite curative effect, which can improve the quality of life of women and have less adverse reaction.

2020 Vol. 28　(4):　484- [Abstract]（ 298 ） HTML (0 KB)  PDF  (0 KB)  ( 38 )

Objective: To analyze the curative effect of three different doses of hormone for treating perimenopausal syndrome (PMS), and to study its influences on reproductive hormone and glycolipid metabolism of women with PMS. Methods: A total of 120 women with PMS were given menopause hormone therapy (MHT), and were randomly divided into group A (ultra low dose of MHT), group B (low dose of MHT), and group C (standard dose MHT) from June 2016 to November 2018. The levels of reproductive hormone, luteinizing hormone (LH), estradiol (E2) and follicle stimulating hormone (FSH) and glycolipid metabolism indexes, endometrial thickness (IMT), number of antral follicle count (AFC), and adverse reactions rate of women were compared among the three groups. Results: The effective rate of women in group B and C were 92.5% and 95.0%, which was significant higher than that (75.0%) of women in group A (P< 0.05). After treatment, both LH and FSH levels of women in the three groups had decreased significantly, while E2 level had increased significantly, and the change degree of the levels of LH, FSH and E2 of women in group C was the highest (P<0.05). After treatment, IMT and AFC level of women in group B and group C were significant higher than that of women in group A (P<0.05), and the incidence of adverse reactions of women in group C was significant higher than that of women in group A and B (P<0.05). Conclusion: Compared with those of low dose or ultra low dose of MHT used, the effect of standard dose for treating women with PMS has better in improving reproductive hormone level and glycolipid metabolism indexes. Low dose and standard dose MHT used has the similar effect in improving IMT and AFC. However, standard dose MHT used maybe have more adverse reactions, so the appropriate treatment options should be based on the actual situations of women with PMS.

2020 Vol. 28　(4):　492- [Abstract]（ 304 ） HTML (0 KB)  PDF  (0 KB)  ( 40 )

Objective: To investigate the influence of standardized treatment of pregnant women with gestational diabetes mellitus (GDM) on maternal and infant comprehensive indicators during pregnancy and lactation. Methods: 186 pregnant women with GDM were enrolled and were randomly divided into observation group and control group by table of random numbers from January 2017 to January 2018. The 95 women in the control group had received routine pregnancy management, and 91 women in the observation group had received standardized treatment. The pregnancy outcomes of women were compared between the two groups, and the metabolic related indicators of all women were detected during pregnancy, delivery, and lactation (till to 90 days after delivery). Results: After treatment, the adherence score, score of  disease/health knowledge, and rate of dietary to standard of women in the observation group were significant higher than those of women in the control group(P<0.05). The levels of FPG, 2hPG, HbAlc, TC, TG and LDL-C, and the cesarean section rate, the incidence of PHD, the abnormal rates of glucose and lipid metabolism, the incidences of macrosomia and neonatal hypoglycemia, the weight gain during pregnancy, the retention rates of of BMI and body weight of women in the observation group were significant lower than those of women in the control group before delivery and 90 days after delivery, while the levels of HDL-C, TP and ALB of women in the observation group were significantly higher (all P<0.05). Conclusion: Standardized treatment of women with GDM is beneficial to improve the metabolic status of women during pregnancy and lactation, and can improve the clinical outcomes of mother and infant.

2020 Vol. 28　(4):　500- [Abstract]（ 297 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

Objective: To explore the clinical value of reference range of blood glucose index of women without pregnancy used for evaluating healthy pregnant women, and to establish the normal reference range of blood glucose index of healthy pregnant women. Methods: The total of 750 pregnant women were selected as subjects, and were divided in group A (250 women during the first trimester of pregnancy), in group B (250 women during the second trimester of pregnancy), and group C (250 women during the third trimester of pregnancy) from January 2016 to December 2018. Another 250 healthy women without pregnancy were selected in group D. Fasting blood glucose level of women in the four groups were measured. Results: K-S test showed that the blood glucose level of women in the four groups had showed normal distribution (P>0.05). Fasting blood glucose level of women in group A, B and C was significant higher than that of women in group D (P<0.05), and the fasting blood glucose level of women in group B and C was significant higher than that of women in group A (P<0.05), but the fasting blood glucose level of women in group B had no significant different to that of women in group C (P>0.05). There was no significant different in blood glucose level of women in the four groups among women with different age (P<0.05). After calculated based on x±1.96s, the reference range of blood glucose level of women in group D, A, B and C were 4.02-5.40mmol/L, 3.91-5.83mmol/L, 4.32-5.97mmol/L, and 4.33-6.05mmol/L, respectively. Conclusion: It is unreasonable to evaluate the blood glucose level of pregnant women based on the reference range of blood glucose index of women without pregnant. The normal reference range of blood glucose index of pregnant women should be established in clinical practice, which can provide scientific evidence for early detection, prevention and intervention of GDM.

2020 Vol. 28　(4):　508- [Abstract]（ 243 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

Objective: To explore the value of serum brain natriuretic peptide (BNP) and troponin I (cTnI) levels for predicting adverse maternal and infant outcomes of pregnant women with heart disease. Methods: 64 pregnant women with heart disease were divided into group A (34 women with good pregnancy outcomes) and group B (30 women with adverse pregnancy outcomes). Serum BNP and cTnI levels of all women were measured during the third trimester of pregnancy (28 and 32 gestational weeks). The serum BNP and cTnI levels and cardiac function grading before delivery of women were compared between the two groups. Results: Compared with those of women during 28 gestational weeks in the two groups, the levels of serum BNP and cTnI were significant higher during 32 gestational weeks. The levels of serum BNP and cTnI of women in the group A during 32 gestational weeks were significant lower than those of women in group B (P<0.05). The proportion of grade I and II of women in group A was significant higher than that of women in group B, but the proportion of grade III and IV of women in group A was significant lower (P<0.05). The values increased of serum BNP and cTnI levels of pregnant women in both groups were positively correlated with their NYHA grade(r=0.910, 0.895, P<0.05). There was no significant difference in diagnostic sensitivity, specificity and accuracy for predicting adverse maternal and infant outcomes between serum BNP level and serum cTnI level (P>0.05). The AUC value, the sensitivity, the specificity, and the accuracy of the BNP level combined with the cTnI level detection were 0.841, 94.6%, 98.2% and 96.4%,respectively, which were significant higher than those of detection of serum BNP level or  cTnI level alone (P<0.05). Conclusion: The levels of serum BNP and cTnI of pregnant women with heart disease increase during the third trimester of pregnancy, which is closely related to their adverse maternal and infant outcomes. Monitoring serum BNP and cTnI levels of pregnant women can predict effectively the occurrence of adverse maternal and infant outcomes.

2020 Vol. 28　(4):　515- [Abstract]（ 250 ） HTML (0 KB)  PDF  (0 KB)  ( 34 )

Objective: To explore the effect of the second stage duration based on the new mode of labor on maternal and infant outcomes. Methods: 210 primiparas were divided in study group (150 primiparas with the second stage of labor≥2h) and control group (60 primiparas with the second stage of labor <2h) from March 2016 to July 2018. The primiparas in the study group were also divided in group A (59 primiparas with the second stage of labor 2-2.5h), group B (50 primiparas with the second stage of labor 2.5-3h), and group C (41 primiparas with the second stage of labor ≥3h). The rates of cesarean section and obstetric intervention, the incidences of maternal adverse outcomes, such as postpartum hemorrhage and postpartum fever, the incidences of neonatal adverse outcomes, such as asphyxia and hospitalization of were recorded and compared among these groups. Results: There were no significant difference in the rates of cesarean section, obstetric midwifery, maternal and neonatal adverse outcomes between group A and the control group (P>0.05). The rates of cesarean section, artificial rupture and oxytocin used, and the incidences of postpartum hemorrhage, postpartum fever and postpartum urinary retention of primiparas in group B and group C were significant higher than those of primiparas in control group (P<0.05). The rates of poor wound healing and lateral episiotomy of primiparas in group C were significant higher than those of primiparas in the control group (P<0.05). The incidence of macrosomia of primiparas in the B group was higher than that of primiparas in control group (P<0.05). The incidences of neonatal asphyxia, hospitalization, macrosomia, and low Apgar score, and value of abnormal umbilical artery blood pH in group C were significant higher than those in control group (P<0.05). Conclusion: Appropriate prolongation of the duration of the second stage of labor based on the new labor pattern can reduce the cesarean section rate of primiparas and doesn't increase the adverse outcomes of mother and neonate. However, the cesarean section rate, and the incidence of maternal postpartum hemorrhage and fever will increase when the second stage of labor over 2.5h, and the incidence of adverse outcomes such as neonatal asphyxia will increase when the second stage of labor over 3h.

2020 Vol. 28　(4):　524- [Abstract]（ 236 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

Objective: To investigate the influence of severe spontaneous vacuolation on the potential of embryonic development on the 5th day (D5) after insemination. Methods: The clinical data of the women experienced in vitro fertilization and embryo transfer (IVF-ET) or intracytoplasmic sperm injection (ICSI) from January 2016 to December 2017 were retrospective analyzed. 873 embryos with severe spontaneous vacuolation on the D5 after insemination were selected in study group, and 5709 embryos without abnormal morphology were randomly selected in control group. The blastocyst rate, high quality blastocyst rate, and clinical outcomes of women on the 6th day (D6) after insemination were compared between the two groups. Results: The blastocyst rate and high quality blastocyst rate of women in the study group were 8.3% and 22.2%, which were significant lower than those(27.9% and 65.2%) of women in the control group (P<0.05). In terms of clinical outcomes, there were no significant different in pregnancy rate and live birth rate of women after embryo transfer with single embryo resuscitation or combined resuscitation with normal embryos between the two groups (P>0.05). Conclusion: Although the formation of severe spontaneous vacuolation on the D5 after insemination can affect the blastocyst available rate and highquality blastocyst rate on the D6, the blastocyst available rate of women with the formation of severe spontaneous vacuolation on the D5 after insemination has the similar clinical outcomes of women without abnormal morphology of embryos.

2020 Vol. 28　(4):　533- [Abstract]（ 299 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

Objective: To explore the possible influencing women with pregnancy and intrauterine device (IUD) in situ, and to provide evidence for clinical safe application of IUD. Methods: The date of 5896 women with pregnancy and IUD in situ from 116 national monitoring sites for adverse drug reactions between 2016 and 2018 were analyzed retrospectively. Results：Among them, there were 4206（71.34%）women were inserted IUD for the first time. The IUD location was changed in 2814 women (47.7%). In the early stage of IUD used, the incidence of women with pregnancy was relatively high, followed by a downward trend. Conclusion: Young women inserted IUD should be strengthened the imaging examination of the IUD position in the early stage of IUD used for reducing the incidence of pregnancy with IUD in situ effectively. It is necessary to carry out further research on the types of IUD with high proportion of pregnancy with IUD in situ.

2020 Vol. 28　(4):　539- [Abstract]（ 353 ） HTML (0 KB)  PDF  (0 KB)  ( 33 )

Objective: To observe the changes of the levels vitamin A, vitamin E and helper T cell of women with early-onset preeclampsia, and to analyze the risk factors related to early-onset preeclampsia. Methods: 2,650 normal pregnant women were included in group A between December 2016 and May 2018, which included 350 women with early-onset preeclampsia were included in group B and the other women without preeclampsia were in group A. The levels of vitamin A, vitamin E and helper T cell in peripheral venous blood of women were recorded and compared between the two groups. The suspicious factors affecting the early-onset preeclampsia were analyzed. Results: The levels of serum vitamin A  and vitamin E, and the Th2 percentage of women in group B were 0.24±0.15mg/L, 4.92±0.18mg/L, and 1.04±0.17%, which were significant lower than those (0.47±0.18mg/L, 10.75±4.57mg /L, and 1.60±0.29%) of women in group A, but the Th 1 percentage and Th1/Th2 value of women in group B were 21.01±3.96% and 20.41±5.75, which were significant higher than those (12.31±2.50% and 7.93+1.46) of women in group A (all P<0.05). Multiple pregnancy, age ≥35 years old, medical complications, vitamin E deficiency, and prenatal BMI abnormalities were independent risk factors of early-onset preeclampsia. Conclusion: The pregnant women with early-onset preeclampsia lack vitamin A and vitamin E, and have the immune balance disorder. Multiple pregnancy, age ≥35 years old, medical complications, lack vitamin E, and abnormal prenatal BMI are independent risk factors of early-onset preeclampsia, so it should be paid more attention in clinic practice.

2020 Vol. 28　(4):　546- [Abstract]（ 331 ） HTML (0 KB)  PDF  (0 KB)  ( 31 )

Objective: To analyze the value of serum Vitamin (V) A and E levels of pregnant women with preeclampsia during 28 gestational weeks for predicting their pregnancy outcomes. Methods: 427 women before pregnancy (in group A) and 573 pregnant women within gestational 20 weeks (in group B, included 53 women with preeclampsia) were selected as the research objects from June 2017 to November 2018. Serum VA and VE levels and liver and kidney function of all included women were detected, and their pregnancy outcomes were statistically analyzed. Results: The average serum VA and VE levels of women during 20 gestational weeks in group B had no significant different to those of women in group A (P>0.05), but the abnormal rate of VE level of women in group B was significant lower, the rates of VA deficiency and abnormal were significant higher (P<0.05). In group B, the incidence of preeclampsia was 9.3%. In 28 gestational weeks of women in group B, the serum levels of VA and VE, the values of blood urea nitrogen (BUN) and serum creatinine (SCR) of women with mild and severe preeclampsia were significant higher than those of women without preeclampsia, and those of women with severe preeclampsia were significant higher than those of women with mild preeclampsia (P<0.05). Serum levels of VA and VE of women were negatively correlated with their values of BUN and SCR (P<0.05). The area under the ROC curve predicted by serum VA and VE levels was 0.829 and 0.915, their sensitivity were 61.9% and 65.5%, and their specificity were 92.3% and 86.9%. Conclusion:  Pregnant women prone to have VA deficiency. And abnormal VA and VE levels may predicte adverse pregnancy outcomes of pregnant women with preeclampsia, so the monitoring and supplementation of VA and VE should be emphasized during pregnancy.

2020 Vol. 28　(4):　553- [Abstract]（ 292 ） HTML (0 KB)  PDF  (0 KB)  ( 38 )

Objective: To evaluate the efficacy of FH of cervical cells combined with TCT or high-risk HPV detection for screening cervical cancer and precancerous lesions. Methods: 128 women who had experience cervical cancer screening were selected as subjects from January 2016 to January 2018. All these included women underwent gynecological examination, cervical histopathological examination, FH, TCT and high-risk HPV detection, and were all confirmed by cervical histopathological examination lastly. Pathological diagnosis showed 13 women with cervical precancerous lesions, which included 5 women with HSIL and 8 women LSIL. 3 women with cervical cancer and 112 women without any cervical lesions were confirmed by pathological examination. ROC curve was used to analyze the efficacy of FH, TCT and high-risk HPV detection for screening cervical cancer and precancerous lesions. Results: The area under ROC curve (AUC) of FH, TCT and high-risk HPV detection were 0.814, 0.895 and 0.937, respectively. There was no significant difference between FH and TCT (P>0.05), but the screening efficacy of cervical cancer HPV detection was the best. The AUC of FH combined with TCT, FH combined with HPV, and TCT combined with HPV were 0.793, 0.903 and 0.950, respectively, which of TCT combined with HPV was the best. Conclusion: FH detection as uterine epithelial cell stability has the advantages of simple operation, fast, and low cost for screening cervical cancer, which screening efficacy is similar to that of TCT, but slightly worse than that of HPV detection, so FH detection combined with TCT or HPV detection can improve the accuracy of diagnosis.

2020 Vol. 28　(4):　562- [Abstract]（ 318 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

Objective: To investigate the effect of transverse uterine circular bundling suture combined with romethamine for treating hemorrhage during cesarean section. Methods: 160 pregnant women who wanted cesarean section were divided randomly in observation group and control group (80 cases in each group) from January 2018 to December 2018. The women in the observation group were given transverse uterine circular bundling suture combined with romethamine for treating hemorrhage during cesarean section, and the women in the control group were given routine treatment. The amount of bleeding during operation of women during cesarean section, and the incidence of postpartum hemorrhage 2 hours and 24 hours after operation were recorded and compared between the two groups. Results: The intraoperative hemorrhage volume, hemorrhage volume postpartum 2h , and hemorrhage volume postpartum 24h of women in the observation group were 157.3±28.9ml, 208.2±50.8ml, and 310.5±60.2ml, respectively, which were significant higher than those (183.7±27.9ml, 357.5±52.2ml, 448.6±75.5ml, respectively) of women in the control group. The incidence of postpartum hemorrhage of women in the observation group was 16.3% (13/80), which was significant lower than that (36.3%, 29/80) of women in the control group (all P<0.05). There were 3 women with postoperative fever in the observation group and 5 cases in the control group, but all of them had been cured by antibiotics without reoperation, intussusception, or related puerperal complications, and their abdominal incision were healed withⅠlevel, and they all were hospital discharge on schedule. Conclusion: Uterine transverse circular bundling suture combined with romethamine is a simple, safety, effective, and rapid stopped bleeding without special requirements for surgical instruments and equipment, which can control hemorrhage caused by uterine inertia during or after cesarean section.

2020 Vol. 28　(4):　569- [Abstract]（ 323 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

Objective: To investigate the effect of different iodine nutrient level of pregnant women during the first, second or third trimesters of pregnancy on their thyroid function and thyroid hormone levels. Method: 210 pregnant women were selected in this study from May 2018 to February 2019, which included 72 women in group A (during the first trimesters of pregnancy), 70 women in group B (during the second trimesters of pregnancy) and 68 women in group C (during the third trimesters of pregnancy). The levels of urine iodine, serum thyroid stimulating hormone (TSH), free triiodothyronine (FT3), and free thyroxine (FT4) of women were detected and compared among the three groups. Results: The rate of iodine deficiency of women in group A was 38.9%, which was significant higher than those of women in group B and C (P<0.05). Thyroid dysfunction of women in group A and B was mainly manifested as hypoFT4 and subclinical hypothyroidism, and the hyperthyroidism might exist in a few women in group C. The thyroid dysfunction rate of women with iodine deficiency in group A was 66.7%, which was significant higher than that of women in group B or C (P<0.05). The incidence of thyroid dysfunction of women with iodine overdose in group C was 30.0%, which was significant higher than that of women in group A or B (P<0.05). Conclusion: Iodine nutrition level of pregnant women during the second or third trimesters of pregnancy is basically appropriate, but iodine deficiency is still prevalent during the first pregnancy. The iodine nutritional level of pregnant women, especially those women during the first of pregnancy, should be closely monitored. If the pregnant women with urinary iodine < 150 ug/L or > 250 ug/L, their thyroid function should be screened.

2020 Vol. 28　(4):　576- [Abstract]（ 357 ） HTML (0 KB)  PDF  (0 KB)  ( 38 )

Objective: To analyze the clinical value of amniotic fluid cell culture combined with fluorescence in situ hybridization (FISH) for diagnosing fetal chromosomal abnormalities of pregnant women during the second and third trimesters of pregnancy. Methods: 2904 pregnant women during the second or third trimesters of pregnancy were selected, and their fetal chromosomal abnormalities were diagnosed by amniotic fluid cell culture combined with FISH. The diagnostic results were analyzed, and the advantages and disadvantages of the two diagnostic methods were summarized. Results: Of 2904 amniotic fluid specimens, 2815 (96.9%) were successfully cultured. The samples after inoculation and cultured were divided into two groups for karyotype analysis. The results of chromosome analysis of 2815 amniotic fluid specimens in the two groups were identical. Among 2815 successfully cultured specimens, 139 cases (4.9%) were found to have abnormal karyotypes. FISH was successfully detected in 2904 amniotic fluid samples with a success rate of 100.0%. FISH found 90 cases with chromosome abnormality, which was consistent with that result by amniotic fluid cell karyotype analysis. The other 3 cases with chromosomal deletion and duplication, 44 cases with structural abnormalities, and 2 cases with chimeras detected by karyotype were not detected by FISH. Conclusion: The success rate of amniotic fluid cell culture of women during the second or third trimesters of pregnancy is worthy of affirmation, which combined with FISH can achieve rapid and early diagnosis of chromosome number abnormalities, so it is a beneficial complement to traditional cytogenetic methods.

2020 Vol. 28　(4):　583- [Abstract]（ 302 ） HTML (0 KB)  PDF  (0 KB)  ( 38 )

Objective: To investigate the situation of postpartum pelvic organ prolapsed (POP) of postpartum women, and to study its influence factors. Methods: 1030 postpartum women of childbearing age from January 2015 to December 2018 were selected as subjects. The incidence of postpartum POP and its risk factors were investigated. Results: There were 725 (70.4%) women with postpartum POP, which included 551 (53.5%) women with anterior vaginal wall bulging, 502 (48.7%) women with vaginal posterior wall bulging, 81 (7.9%) women with uterine prolapsed. Postpartum POP of women were mainly anterior vaginal wall prolapsed, and the degree of prolapse was mainly I class. From 2015 to 2018, the incidence of postpartum POP of women of childbearing age was 65.9%, 68.8%, 72.7% and 74.2%, respectively, which had no significant difference in the incidence of postpartum POP among different year (P=0.147). While the linear chi-square showed a significant increase in the incidence of postpartum POP of women (χ2=5.218, P=0.022). Multi-classified ordered logistic regression model showed that parity≥2 times, vaginal delivery, perineal laceration, and gestational hypertension were risk factors of postpartum POP. Conclusion: The incidence of postpartum POP of women of childbearing age has an upward trend. The parity≥2 times, vaginal delivery, perineal laceration, and gestational hypertension are high risk factors of postpartum POP.

2020 Vol. 28　(4):　589- [Abstract]（ 305 ） HTML (0 KB)  PDF  (0 KB)  ( 30 )

Objective: To investigate the value of thromboelastography (TEG) for guiding massive transfusion (MT) in postpartum hemorrhage (PPH) treatment, and to study its influence on clinical prognosis. Methods: 47 puerpera with severe PPH were enrolled in this study from January 2016 to June 2018. TEG was used to detect coagulation function and guide MT treatment. The blood infusion before and after TEG detection and the blood transfusion based on different TEG parameters was observed. The clinical prognosis of puerpera was analyzed. Results: TEG detection showed that the patients with PPH had hypocoagulable state. In puerpera with Angle <53°, R value >10 min, and MA<37 mm, the amount of leukocyte suspension (LPRC), and the dosages of virus inactivated frozen plasma and cryoprecipitate had significantly increased (P<0.05). After adjusting the transfusion composition according to the TEG parameters, the R and K values had significantly shortened, the MA value, Angle value and CI value had been corrected, and the coagulation function had been improved significantly (P<0.05). These 47 puerpera had been successfully rescued without death. Conclusion: TEG detection can fully reflect the coagulation status of patients, and it has certain guiding significance for MT in the treatment of PPH, which may help to improve the clinical prognosis.

2020 Vol. 28　(4):　596- [Abstract]（ 289 ） HTML (0 KB)  PDF  (0 KB)  ( 35 )

Objective: To investigate the status of infertility of officers and soldiers of forces from a regional army troop. Methods: A total of 4200 officers and soldiers from a regional army troop were included in this survey and their data was analyzed. Results: In this survey, the incidence of infertility was 10.0% (420/4200), the highest ratio (59.2% or 45.7%) of the male or female infertile officers was aged in 31-35 years old, and the highest ratio (43.4% or 24.3%) of infertility time of the male or female infertile officers was 3-5 years. Only 60.5% of the infertility had received treatment. Bivariate correlation analysis showed that infertility time was positively correlated with marriage age (r=0.988, P<0.01). In 385 male infertile officers and soldiers, azoospermatism accounted for the highest proportion (22.1%), accessory gonad abnormality accounted for the second highest proportion (19.4%), and then was sperm malformation (16.6%). Among the 35 female infertile officers and soldiers, the fallopian tube factor accounted for the highest proportion (50.3%), the ovarian factor accounted for the second highest proportion (12.4%), and then was endocrine factor (9.4%). Conclusion: The infertility of infertile officers and soldiers from the army troop has some characteristics, and the propaganda of reproduction-related knowledge in army should be strengthen and be given relevant policy support and target treatment for improving the status of reproductive health.

2020 Vol. 28　(4):　604- [Abstract]（ 321 ） HTML (0 KB)  PDF  (0 KB)  ( 36 )

Objective: The number of multiple gestations and adverse pregnancy outcomes have substantially increase, which primarily relate to a more wide use of assisted reproduction techniques. In the latest twenty years, multifetal pregnancy reduction has become a remedial measure to lessen maternal morbidity and fetal mortality by reducing the number of fetuses. However, due to the complexity of multiple pregnancies, the difference of chorionicity, the initial number of fetuses, especially the rise of high risk pregnant women after two-child policy, there are some disputes in the appropriate technique, the ideal timing of multifetal pregnancy reduction, and further pregnant management to perform selective termination. The purpose of this study was to review the method and timing of multifetal pregnancy reduction according to chorionicity and the initial number of fetuses.

2020 Vol. 28　(4):　621- [Abstract]（ 300 ） HTML (0 KB)  PDF  (0 KB)  ( 32 )