To investigate the association between the fat mass and obesity (FTO) related gene polymorphisms in rs9939609 and rs8050136 sites of pregnant women and their gestational diabetes mellitus (GDM) occurrence. Methods：The literatures about the association between the FTO related gene polymorphisms in rs9939609 and rs8050136 sites of the pregnant women and their GDM occurrence were searched from databases, such as Pubmed，EMBASE，and Wanfang，and web of science. The literatures were screened according to inclusion and exclusion criteria. Odds ratio（OR) and 95%CI were used to assess the association between the FTO related gene polymorphisms in rs9939609 and rs8050136 sites of the pregnant women and their GDM occurrence by random or fixed-effect models. Results：A total of 11 literatures were included in this meta-analysis，which were 2364 women with GDM and 4425 healthy pregnant women. In the three models of FTO related gen polymorphisms in rs9939609 site, the OR of AA to TT was 1.53 (95%CI：1.22-1.91，Ph=0.164), the OR of AA to TT+AT was 1.43 (95%CI  1.17-1.74, Ph=0.500), and the OR of AA+AT to TT was OR=1.22 (95%CI 1.04-1.44，Ph=0.054). It was suggested that FTO gene polymorphism in RS9939609 site of the women was associated with their GDM susceptibility. The subgroup analysis was conducted according to the sample size of the studies and the genotyping method of the women in the observation group, which had showed that FTO related gene polymorphism in RS9939609 site were all associated with the GDM susceptibility when the sample size >150 cases, or grouping by RT-PCR and Taq- MAN. 5 models of FTO related gene polymorphism in RS8050136 site gene had no statistical significance. Conclusion：FTO gene polymorphisms in rs9939609 site of the pregnant women may be a susceptible polymorphic locus of their GDM occurrence，while FTO gene polymorphisms in rs8050136 site may not be associated with their GDM occurrence.

2022 Vol. 30　(6):　1221- [Abstract]（ 458 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

2022 Vol. 30　(6):　1233- [Abstract]（ 749 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To understand the situation and the possible risk factors of adverse pregnancy outcomes of women of childbearing age in rural areas of Haikou, and to provide reference for reducing the occurrence of adverse pregnancy outcomes of Haikou. Methods: From January 1, 2019 to February 28, 2021, 2,335 rural married women of childbearing age in Haikou who participated in the national free pre-pregnancy healthy birth examination program were selected as the subjects. The pregnant situation during the first trimester of pregnancy and the pregnancy outcomes of these women were followed up. Results: Among 2335 women, 1356 women were pregnancy within 1 year after participation of the national free pre-pregnancy healthy birth examination program, with the pregnant rate of 58.1%. Among them, 93 (6.9%) women had adverse pregnancy outcomes. Multivariate logistic regression analysis showed that maternal age ≥35 years old, the value of body mass index ≥24 kg/m2, the education level of the women or their husband less than high school, the smoking or passive smoking, the exposure to harmful substances, and the reproductive tract infection were all the risk factors of their adverse pregnancy outcomes (P<0.05). Conclusion: It is suggested that local management departments should be strengthen the publicity and education, and the couples with risks of adverse pregnancy outcomes who planning to pregnancy should be counselling to avoid the adverse risks mentioned above, and should be strengthened the awareness of self health care and selfprotecting of reproductive tract, so as to reduce the occurrence of adverse pregnancy of the women.

2022 Vol. 30　(6):　1245- [Abstract]（ 294 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To explore the curative effect of B-ultrasound monitoring combined with desogestrel and estradiol tablet for treating intrauterine residue of patients with scar uterus after incomplete abortion. Methods: A total of 126 patients with intrauterine residue and scar uterus after incomplete abortion were selected and were divided into two groups (63 cases in each group) by random number table method from May 2018 to May 2020. The patients in the control group were treated by Motherwort combined with the follow up by B-ultrasound monitoring, while the patients in the observation group were treated with desogestrel and estradiol tablet combined with the follow up by B-ultrasound monitoring. The vaginal bleeding time, the removal time of intrauterine pregnancy residue, the changes of the uterine volume and the endometrial thickness, and the situation of menstrual recovery of the patients before and after treatment was compared between the two groups. Results: After treatment, the cure rate (88.9%) of the patients in the observation group was significantly higher than that (74.6%) of the patients in the control group, the vaginal bleeding time (5.7±1.1d) and the removal time of intrauterine pregnancy residue (4.7±2.1 d) of the patients in the observation group were significantly shorter than those (8.7±1.5d and 6.3±2.5 d) of the patients in the control group (P<0.05). The uterine volume and the endometrial thickness of the patients in both groups had decreased significantly after treatment, and which (145.39±38.31 cm3 and 0.89±0.28 cm) of the patients in the observation group were significantly lower than those (164.81±40.54cm3 and 1.42±0.33cm) of the patients in the control group (P<0.05). The time of the menstruation interval of the patients in both groups had increased significantly after treatment, and the menstrual period time and the menstrual volume of the patients in both groups had decreased significantly after treatment, and the change ranges of which of the patients in the observation group were significantly more than those of the patients in the control group (P<0.05). Conclusion: B-ultrasound monitoring combined with desogestrel and estradiol tablet for treating intrauterine residue of the patients with scar uterus after incomplete abortion can effectively stop bleeding, help removal of the pregnancy residues, effectively control endometrial thickness, improve the recovery of regular menstruation cycle, and which is conducive to the recovery of uterus.

2022 Vol. 30　(6):　1254- [Abstract]（ 543 ） HTML (0 KB)  PDF  (0 KB)  ( 29 )

To explore the effects of the combined spinal-epidural anesthesia with different concentrations of ropivacaine used in cesarean section of pregnant women with gestational diabetes mellitus (GDM) on their postoperative pain and micro-circulation. Methods: A total of 96 pregnant women with GDM who wanted cesarean section in selected time were selected and were random divided in three groups (32 cases in each group) between June 2019 and October 2020. During the combined spinal-epidural anesthesia in the cesarean section, the women in group A were given 0.25% ropivacaine, the women were given in group B 0.375% ropivacaine, and the women in group C were given 0.5% ropivacaine. The anesthesia effect of the women was compared among the three groups. The degrees of static and dynamic postoperative pain of the women were evaluated by visual analogue scale (VAS). Before surgery, and at 24h and 48h after surgery, the micro-circulation indexes values of the women in the three groups were detected by nailfold micro-circulation tester. The mean arterial pressure (MAP) and heart rate (HR) values of the women in the three groups at 15min after anesthesia and 2h after surgery were monitored. The incidence of adverse reactions during anesthesia of the women was compared among the three groups. Results: The anesthesia block time, the Bromage score, and the sensory block level of the women in group C were significantly higher than those of the women in group A and group B, and the static VAS scores at 2 h and 4 h after cesarean section, and the dynamic VAS scores of the women in group C at 1 h, 2 h and 4 h after cesarean section were significantly lower than those of the women in group A and group B. The length and the width of loops of the women in group C at 24 h and 48 h after cesarean section were significantly higher than those of the women in group A and group B (all P<0.05). After 15 min of anesthesia, the MAP value of the women in group A was significantly higher than that of the women in group B and group C, the HR value of the women in group A was significantly lower than that of the women in group B and group C, and the incidence of total adverse reactions (6.3%) of the women in group A was significantly lower than that (18.8%) of the women in group B and that (31.3%) of the women in group C (all P<0.05). Conclusion: The combined spinal-epidural anesthesia with different concentrations of ropivacaine used in cesarean section of the women with GDM has better anesthetic effect, and 0.5% ropivacaine has the best postoperative analgesic effects and has the lowest influence on the micro-circulation of the women. While 0.25% ropivacaine has fewer effect on the maternal hemodynamics with lower incidence of adverse reactions.

2022 Vol. 30　(6):　1264- [Abstract]（ 365 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To investigate the effects of nalbuphine hydrochloride injection on the analgesic effect, depression, and recovery situation of women after cesarean section. Methods: From June 2019 to June 2020, 120 pregnant women who wanted cesarean section were randomly selected and were divided into two groups (60 cases in each group). Nalbuphine hydrochloride injection was given to the women in the observation group for postoperative analgesia, and sufentanil was given to the women in the control group for postoperative analgesia. The postoperative analgesic effect, the depression mood situation, the inflammatory factors levels, and the adverse reactions rate of the women after cesarean section were compared between the two groups. Results: The visual analogue scale (VAS) score of analgesia of the women in the observation group at 6h after analgesia (2.27±0.58 points), 24h after analgesia (1.74±0.52 points), and 48h after analgesia (0.96±0.36 points) were significantly lower than those (3.18±1.21 points, 2.41±2.15 points, and 2.02±1.17 points) of the women in the control group. The score (3.87±0.44 points) by Postpartum Edinburgh Postpartum Depression Scale (EPDS) of the women in the observation group was significantly lower than that (5.78±0.41 points) of the women in the control group. The levels of serum interleukin-6 and C-reactive protein of the women in the observation group at 24h and 48h after analgesia were significantly lower than of the women in the control group, and the incidence of adverse reactions (8.3%) of the women in the observation group was significantly lower than that (23.3%) of the women in the control group (all P<0.05). Conclusion: Nalbuphine hydrochloride injection after cesarean section has better postoperative analgesic effect of the women, can improve their depression and reduce their inflammatory response, and which can also improve their recovery after cesarean section.

2022 Vol. 30　(6):　1273- [Abstract]（ 468 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To analyze the characteristics of postpartum lipid metabolism of pregnant women with gestational diabetes mellitus (GDM), and to study its influencing factors. Methods: 164 pregnant women with GDM were selected in study group, and 160 pregnant women with normal glucose tolerance were selected in control group from January 2018 to October 2019. According to blood lipid indexes of the women in postpartum 6-8 weeks, the women in the study groups were further divided into group A (women with hyperlipidemia) and group B (women with normal blood lipid metabolism). The levels of blood lipid metabolism indexes of the women in postpartum 6-8 weeks were compared between the study group and the control group. The risk factors of postpartum hyperlipidemia of the women with GDM were analyzed. Results: The levels of total cholesterol (TC), triglyceride (TG), and low-density lipoprotein (LDL) of the women in the study group at delivery, and in 6 to 8 weeks after delivery were significantly higher than those of the women in the control group, while high density lipoprotein (HDL) level of the women in the study group was significantly lower than that of the women in the control group (P<0.05). The age, the proportion of poor blood glucose control, and the postpartum body mass index (BMI) value of the women in group A were significantly higher than those of the women in group B (P<0.05). There were no significant differences in the value of gestational weight gain, the proportion of primiparas, the insulin treatment rate, the gestational weeks at delivery, and the BMI value at enrollment in this study, and the newborn birth weight of the women between group A and group B (P>0.05). The levels of TC, TG, LDL, and 2h blood glucose level of oral glucose tolerance test (OGTT) of the women in group A were significantly higher than those of the women in group B (P<0.05), and there were no significant differences in the levels of HDL, FPG, and 1 h blood glucose of OGTT of the women between group A and group B (P>0.05). The postpartum BMI value, the poor blood glucose control, the abnormal increase of the levels of TC and TG during delivery, and 2h blood glucose level of OGTT during pregnancy were the independent risk factors of postpartum hyperlipidemia of the pregnant women with GDM (P<0.05). Conclusion: In postpartum 6-8 weeks, the women with GDM still has abnormal lipid metabolism, especially for those women with obese, with poor blood glucose control during pregnancy, and with the high levels of TC and TG during delivery, or with the high 2h blood glucose level of OGTT during pregnancy have the high risk of postpartum hyperlipidemia.

2022 Vol. 30　(6):　1282- [Abstract]（ 290 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To study the diagnostic efficacy of ultrasound combined with serum creatine kinase (CK) and CXCL10 for hydatidiform mole, and to explore their predictive value for malignant transformation of hydatidiform mole. Methods: 88 patients with gestational trophoblastic disease were selected prospectively in study group from February 2018 to July 2021, which included 40 patients with malignant transformation of gestational trophoblastic disease in malignant group and 48 patients without malignant transformation in non-malignant group. In addition, 88 volunteers who underwent physical examination during the same period were selected in control group. The ultrasonic indexes of all these patients were examined, and their levels of serum CK and CXCL10 were detected, and the efficiencies of which for diagnosing hydatidiform mole and the malignant transformation of gestational trophoblastic disease were analyzed. Results: The levels of serum CK (109.76±1.17μg/ml) and CXCL10 (76.55±1.77 ng/ml) of the patients in the study group were significantly higher than those (29.98±1.01μg/ml and 40.26±1.74 ng/ml) of the patients in the control group, and which of the patients in malignant group (171.89μg/ml±8.24, and 92.59±5.97 ng/ml) were significantly higher than those (57.99±9.19μg/ml and 63.18±5.00 ng/ml) of the patients in the non-malignant group. In the case group the ultrasonic RI,PI and  PSV were lower than those in the control group, the  EDV was higher than those in the control group, and the RI, PI and PSV in the malignant group were lower than those in the non-malignant group, and the EDV was higher than those in the non-malignant group (all P<0.05). Receiver operating characteristic curve analysis showed that the areas under the curve and the specificity of ultrasound combined with serum CK and CXCL10 levels for diagnosing hydatidiform mole and the malignant transformation were 0.909 and 0.998, and 56.3% and 41.9%, which were all significantly higher than those diagnosed by ultrasound or serum CK and CXCL10 levels alone. Conclusion: Ultrasound combined with serum creatine kinase and CXCL10 levels for diagnosing hydatidiform mole and its malignant transformation has better efficacy, which can be as references in clinic.

2022 Vol. 30　(6):　1290- [Abstract]（ 314 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the influence of Newman health system intervention on the active coping style of patients after laparoscopic hysterectomy. Methods: From January 2019 to August 2020, 150 patients who wanted laparoscopic hysterectomy were selected as experimental subjects. According to the admission order, these patients were divided into two groups (75 cases in each group). The patients in the control group were given routine care, and the patients in the experimental group were given Newman health system intervention model combined with routine care. The negative emotion score by Hamilton anxiety scal), the disease replying status, and the postoperative rehabilitation indicators of the patients in the two groups were observed. The positive replying styles of the patients was compared between the two groups. Results: The scores of HAMA factors (0.90±0.70 points, 0.78±0.70 points, 0.80±0.61 points, 0.82±0.75 points, and 0.45±0.30 points) of the patients in the experimental group after intervention were significantly better than those (1.49±0.66 points, 1.25±0.66 points, 1.30±0.64 points, 1.40±0.66 points, and 0.77±0.50 points) of the patients in the control group. The positive replying style scores of the patients in the experimental group in different stages were 23.45±2.80 points, 25.55±3.10 points, and 26.58±3.15 points, respectively, the negative replying style scores of the patients in the experimental group in different stages were 8.05±1.65 points, 7.05±1.55 points, and 6.23±1.70 points, respectively. The average positive replying score of the patients in the experimental group in the three stages was 25.50±3.15 points and the average negative coping score of the three stages of the patients in the experimental group was 7.02±1.69 points, which were all better than those (18.70±2.30 points and 9.75±1.65 points) of the patients in the control group. The time of the first postoperative anal exhaust (12.12±2.20h), the postoperative analgesia score (3.55±1.50 points), the hospital stay time (4.00±0.50d), and the average hospitalization cost (12850.75±851.50 yuan) of the patients in the experimental group were significantly better than those (23.30±4.50h, 5.85±1.51 points, 5.96±1.20 days, and 15804.45±632.45 yuan) of the patients in the control group (all P<0.05). Conclusion: Newman health system intervention can improve the active response scores of the patients after laparoscopic hysterectomy, relieve their negative emotions, and improve their postoperative rehabilitation.

2022 Vol. 30　(6):　1300- [Abstract]（ 428 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To analyze the diagnostic value of transvaginal ultrasound combined with the levels of progesterone and β-human chorionic gonadotropin (β-HCG) of pregnant women for their threatened abortion during the first trimester of pregnancy. Methods: A total of 86 pregnant women with threatened abortion during the first trimester of pregnancy were selected in study group, and 90 normal pregnant women during the first trimester of pregnancy were selected in control group from May 2020 to April 2021. The serum P and β-HCG levels of these women were detected. The vaginal ultrasound was used to measure the diameters of their gestational sac and yolk sac, and the values of the resistance index (RI), peak systolic velocity (PSV), and acceleration time (ACT) of the ascending branch of the gestational sac and villous space arterial blood flow. The diagnostic values of vaginal ultrasound and the levels of the serum P and β-HCG for the threatened abortion of these women were analyzed. Results: The values of RI, ACT, and the yolk sac diameter of the women in the study group were significantly higher than those of the women in the control group, while the PSV value, the serum P and β-HCG levels, and the pregnancy sac diameter of the women in the study group were significantly smaller than those of the women in the control group (P<0.05). Receiver operating characteristic curve analysis showed that the area under the curve of the RI value, the PSV value, the ACT value, the sac diameter, the yolk sac diameter, the progesterone level, theβ-HCG level, and the combination of the sac diameter, the yolk sac diameter, the progesterone level, and theβ-HCG level were 0.798, 0.942, 0.658, 0.863, 0.804, 0.920, 0.946, and 0.997, respectively. Conclusion: The area under the curve, the sensitivity, and the specificity of transvaginal ultrasound combined with the levels of the serum P and β-HCG of the pregnant women for diagnosing their threatened abortion during the first trimester of pregnancy are higher, which can improve the diagnostic efficiency of threatened abortion with some clinical application value.

2022 Vol. 30　(6):　1311- [Abstract]（ 335 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

2022 Vol. 30　(6):　1318- [Abstract]（ 353 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

To analyze the correlation between the level of serum interferon γ -induced protein 16 (IFI16) of pregnant women with preeclampsia (PE) and their uterine artery blood flow parameters. Methods: From January 2019 to December 2020, 116 pregnant women with PE from Linping branch of the second affiliated hospital of medical college of Zhejiang university were selected in study group, which included 81 women with mild PE in group A and 35 women with severe PE in group B. 90 healthy pregnant women were selected in control group. The systolic peak/end-diastolic flow rate（S/D), the resistance index（RI), and the pulse index（PI) of uterine artery blood flow parameters of these women were detected by ultrasound. And the serum IFI16 level of these women was detected. Results: The levels of serum IFI, S/D, RI, and PI of the women in the study group were significantly higher than those of the women in the control group, and which of the women in group B were significantly higher than those of the women in group A (all P<0.001). The uterine artery RI value of the pregnant women with IFI≥11.4ng/mL in group A was significantly higher than that of the pregnant women with IFI <11.4ng/mL, and the uterine artery S/D, , and PI values of the pregnant women with IFI≥16.2ng/ml in group B were significantly higher than that of the pregnant women with IFI <16.2ng/ml (all P<0.05). The serum IFI16 level of the women in group A was positively correlated with their uterine artery PI value (P<0.05), but was no correlation with their S/D and PI values (P>0.05). The serum IFI16 level of the women in group B was positively correlated with their S/D, PI, and RI values of uterine artery (P<0.05). Conclusion: IFI16 of the pregnant women is involved in the development of their PE, and which has correlation with their uterine artery blood flow parameters.

2022 Vol. 30　(6):　1327- [Abstract]（ 319 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To explore the changes of serum 25-hydroxyvitamin D ［(OH)D］ and pre-S1 antigen (PreS1Ag) levels of pregnant women with hepatitis B virus (HBV) infection, and to study their correlation with the prognosis of the perinatal infants. Methods: A total of 109 pregnant women with HBV infection were selected and were divided into 41 women with infection symptom in group A and asymptomatic 68 women in group B from August 2018 to June 2020. Another 62 normal pregnant women were enrolled group C during the same period. The levels of serum 25-(OH) D and PreS1Ag of the women were compared among the three groups. The correlation between the serum 25-(OH) D and PreS1Ag levels of the women and their perinatal infants was analyzed. Results: The serum 25-(OH) D level of the women in group A (20.17±1.09 ng/ml) was significantly lower than that of the women in group B or group C, and the positive rate of PreS1Ag of the women in group A (75.6%) was significantly higher than that of the women in group B or group C. The incidences of the pregnancy complications and the adverse pregnancy outcomes of the women in group A were significantly higher than those of the women in group B or group C (all P<0.05). There were no significant differences in the incidences of the pregnancy complications and the adverse pregnancy outcomes of the women between group B and group C (P>0.05). The range of the serum 25-(OH)D levels of the women with PreS1Ag positive were mainly in the two intervals of 10-19 ng/mL and 20-29 ng/ml. The incidence of perinatal adverse prognosis (46.3%) of the women with PreS1Ag positive was significantly higher than that (11.9%) of the women with PreS1Ag negative (P<0.05). The serum 25-(OH) D level of the women in group A was correlated with their PreS1Ag positive rate and their perinatal adverse prognosis (P<0.05). Conclusion: The abnormal changes of serum 25-(OH) D and PreS1Ag levels of the pregnant women with HBV infection will affect the prognosis of their perinatal infants. The incidence of adverse prognosis of perinatal infants of the women with PreS1Ag positive or with low serum 25-(OH) D level is higher, which indicates that early intervention and treatment for those women with PreS1Ag positive or with low serum 25-(OH)D level can improve the prognosis of their perinatal infants in clinic.

2022 Vol. 30　(6):　1335- [Abstract]（ 322 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the expression levels and the correlation of serum vitamin E and D, and total bilirubin and indirect bilirubin of pregnant women with pregnancy induced hypertension (PIH). Methods: 40 pregnant women with PIH gestational hypertension were selected in study group, and 50 normal pregnant women undergoing physical examination were selected in control group from May 2017 to May 2018. The expression levels of serum vitamin E and D, and total bilirubin and indirect bilirubin of the women in the two groups were detected, and the correlation between which of the women and the PIH was analyzed. Results: The levels of vitamin E (23.46±1.97 ng/ml), vitamin D (9.42±1.98 ng/ml) and the total bilirubin (94.00±9.31 mg/L) of the women in the study group were significantly lower than those (29.21±3.45 ng/ml, 20.42±7.10 ng/mL, and 15.20±11.39 mg/L) of the women in the control group, but the indirect bilirubin level (3.97±1.02μmol/L) of the women in the study group was significantly higher than that (3.06±0.72μmol/L) of the women in the control group (all P<0.05). In the study group, there were significant differences in the levels of serum vitamin E and D, and total bilirubin and indirect bilirubin levels among the women with different family history, with different urinary protein level, and with different value of body mass index before pregnancy (P<0.05). The vitamin E level of the women with PIH was positively correlated with their vitamin D and indirect bilirubin levels, and which was negatively correlated with their total bilirubin level. The Vitamin D level of the women with PIH was positively correlated with their total bilirubin level, and which was negatively correlated with their indirect bilirubin level. The total bilirubin level of the women with PIH was negatively correlated with their indirect bilirubin level (all P<0.05). Conclusion: The levels of the serum vitamin E and D, and total bilirubin and indirect bilirubin of the pregnant women with PIH are abnormal, which are related to the family history of hypertension, the urinary protein level, and the prepregnancy body mass index value of the women. There are correlations among the levels of the serum vitamin E and D, and total bilirubin and indirect bilirubin each other.

2022 Vol. 30　(6):　1344- [Abstract]（ 289 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To analyze the changes of serum inflammatory factors levels of pregnant women with intrauterine infection of group B streptococcus（GBS) during the third trimester of pregnancy, and to study the influence of the GBS infection on the pregnancy outcomes of the women. Methods: A total of 80 pregnancy pregnant women with intrauterine GBS infection from April 2018 to November 2019 were selected in observation group retrospectively, and 80 healthy pregnant women who received regular antenatal examination during the same period were selected in control group. The levels of serum hypersensitivity C-reactive protein (hS-CRP), tumor necrosis factor -α (TNF-α), interleukin-6 (IL-6), and procalcitonin (PCT) of the women in the two groups were detected. The pregnancy outcomes of the women in the two groups were followed up. The different levels of serum inflammatory factors were compared among the women with different pregnancy outcomes. The influence of the serum inflammatory factors of the women on their adverse pregnancy outcomes were analyzed. Results: The levels of serum hS-CRP (9.16±2.67 mg/L), TNF-α (72.67±16.65 ng/L), IL-6 (122.59±20.16 ng/L), and PCT (80.61±16.77 pg/ml) of the women in the observation group were significantly higher than those of the women in the control group, and which of the pregnant women with adverse pregnancy outcomes were significantly higher than those of the women with normal pregnancy outcomes. The incidences of the premature delivery (15.0%), the premature rupture of membranes (16.3%), the amniotic fluid contamination (30.0%), the puerperal infection (18.8%), the fetal distress (23.8%), and the neonatal asphyxia (17.5%) of the women in the observation group were significantly higher than those of the women in the control group (all P<0.05). There were no significant differences in the incidences of physiological jaundice and neonatal infection of the women between the two groups (P>0.05). Logistic multifactor regression analysis showed that the abnormal increase of HS-CRP, TNF-α, IL-6, and PCT levels of the women with intrauterine GBS infection during the third trimester of pregnancy were the risk factors of their adverse pregnancy outcomes (P<0.05). Conclusion: The levels of the serum inflammatory factors, such as hs-CRP, TNF-α, IL-6, PCT, of the pregnant women with intrauterine infection of GBS during the third trimester of pregnancy are abnormal increase, and which are all related to their adverse pregnancy outcomes.

2022 Vol. 30　(6):　1352- [Abstract]（ 312 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

 To explore the application value of magnetic resonance imaging (MRI) combined with four-dimensional ultrasound for screening fetal heart malformation. Methods: The clinical data of 103 pregnant women with suspected fetal heart malformation from February 2017 to February 2020 were selected for analysis retrospectively. MRI and four-dimensional ultrasonography examinations were performed in all of these women before delivery, and 48 newborns with heart malformation were confirmed by the results of follow up after birth or autopsy as the gold standard. The positive predictive value, the negative predictive value, and the accuracy rate of the diagnosis of heart malformation of newborns were compared between MRI and ultrasonography. The chromosome karyotype analyses of 48 newborns with heart malformation was performed. Results: As for 103 pregnant women with suspicious fetal heart malformation, the positive predictive value, the negative predictive value, and the diagnostic accordance rate of the four-dimensional ultrasonography for diagnosing the fetal heart malformation were 87.0%, 86.0%, and 86.4% respectively. The positive predictive value, the negative predictive value, and the diagnostic accordance rate of MRI for diagnosing the fetal heart malformation were 78.3%，79.0%，and 78.6%, respectively. The positive predictive value, the negative predictive value, and the diagnostic accordance rate of four-dimensional ultrasonography combined with MRI for diagnosing the fetal heart malformation were 91.7%, 92.7%, and 92.2%, respectively. There were no significant differences in the positive predictive value and the negative predictive value among four-dimensional ultrasonography, MRI, and four-dimensional ultrasonography combined with MRI (P>0.05), but there was significant difference in the diagnostic accordance rate among them (P<0.05). In 48 women with fetal heart malformation, 40 cases were found by four-dimensional ultrasonography, 36 cases were found by MRI, and 44 cases were found by four-dimensional ultrasonography combined with MRI. The area under the curve of four-dimensional ultrasonography, MRI, and fourdimensional ultrasonography combined with MRI for diagnosing fetal heart malformation were 0.862, 0.784, and 0.922, respectively (P<0.05), the sensitivity of which were 83.3%, 75.0%, and 91.7%, respectively, and the specificity of which were 89.1%, 81.8%, and 92.7%, respectively. In 48 cases of fetal heart malformation, there were 15 cases with trisomy 18, 5 cases with trisomy 13, 4 cases with normal karyotype, 7 cases with 47XYY, 4 cases with XO syndrome, and 8 cases with trisomy 21. Conclusion: MRI combined with four-dimensional ultrasound for screening fetal heart malformation is beneficial to improve the accuracy. The proportion of chromosomal abnormalities of the fetus with heart malformations is higher.

2022 Vol. 30　(6):　1360- [Abstract]（ 372 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

To investigate the correlation between the serum microRNA-543（miR-543) and microRNA-135a（miR-135a) levels of the patients with intrauterine adhesion (IA) after hysteroscopic separation and their recurrence of IA, and to study the value of the miR-543 and miR-135a levels of the patients for predicting their recurrence of IA. Methods: 127 patients with IA who wanted hysteroscopic uterine adhesion separation were selected as the research objects from December 2019 to December 2020. According to the re-examination on the 3rd-7th day in the end of three menstrual cycles after the operation, the patients were divided into group A (34 cases with recurrence of IA) and group B (93 cases without recurrence of IA). Real-time fluorescent quantitative PCR （qRT-PCR) method was used to detect the serum levels of miR-543 and miR-135a of the patients at 24 h after operation in the two groups. Pearson method was used to analyze the correlation between the serum miR-543 and miR-135a levels of patients and the recurrence of their IA. Receiver operating characteristic（ROC) curve was used to analyze the predictive value of the serum miR-543 and miR-135a levels for the recurrence of IA. Logistic regression analysis was used to analyze the factors affecting the recurrence of IA after hysteroscopic surgical. Results: The course of disease and the serum Mir-135a level of the patients in group A were significantly more than those of the patients in group B, and the mir-543 level of the patients in group A was significantly lower (P<0.05). The serum Mir-543 level of the patients in group A was negatively correlation with their Mir-135a level (r=-0.539, P<0.05). The area under the curve (AUC), the specificity, and the sensitivity of the serum Mir-543 level for predicting the recurrence of IA were 0.897, 76.3%, and 91.2%, respectively. The AUC, the specificity, and the sensitivity of the serum Mir-135a level for predicting the recurrence of IA were 0.864, 92.5%, and 70.6%, respectively. The AUC, the specificity, and the sensitivity of serum Mir-543 level combined with Mir-135a for predicting the recurrence of IA were 0.947, 88.2%, and 94.1%, respectively. Mir-135a was an independent risk factor of the postoperative recurrence of IA (P<0.05), and Mir-543 was a protective factor of the postoperative recurrence of IA (P<0.05). Conclusion: Recurrence of IA after hysteroscopic treatment of the patients is related to the levels of their serum miR-543 and miR-135a, and the serum levels of miR-543 and miR-135a have certain predictive values for the recurrence of IA.

2022 Vol. 30　(6):　1369- [Abstract]（ 438 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

 To analyze the clinical value of the levels of serum troponin Ⅰ（CTn Ⅰ) and plasma brain natriuretic peptide（BNP) combined with the value of Tei index for assessing the myocardial injury degree of neonates after neonatal asphyxia. Methods: 86 neonates with myocardial injury after asphyxia were selected as study subjects from January 2018 to January 2021. According to the asphyxia degree, these neonates were divided into group A（48 neonates with mild asphyxia, Apgar score 4-7 points) and group B（38 neonates with severe asphyxia, Apgar score 0-3 points). Meanwhile, 30 normal full-term neonates without asphyxia were selected in group C. The levels of serum CTnI and plasma BNP of the neonates in the three groups were detected, and the Tei index of the neonates was measured by cardiac color Doppler ultrasound. The correlation among the CTnⅠlevel, BNP level, and Tei index value of the neonates was analyzed. The Receiver operating characteristic (ROC) curve was used to analyze the values of the CTnⅠlevel, BNP level, and Tei index of the neonates value for predicting their myocardial injury degree. Results: The CTnⅠlevel, BNP level, and the Tei index value of the neonates in group B, group A, and group C had decreased gradually, and which of the neonates in group A and group B after treatment had significantly decreased (all P<0.05). Spearman correlation analysis showed that the levels of serum CTn Ⅰ and plasma BNP of the neonates were positively correlated with their Tei index value (P<0.05). ROC curve analysis showed that the levels of serum CTnⅠand plasma BNP combined with Tei index value of the neonates after neonatal asphyxia for predicting the degree of their myocardial injury had the highest of sensitivity (94.3%) and the highest of area under curve (0.833) of the neonates (P<0.05). Conclusion: The serum CTnⅠlevel, the plasma BNP level, and the Tei index value of the neonates after neonatal asphyxia are correlation each other, all of them can be used to assess the neonatal myocardial injury and cardiac function after asphyxia, which provides reference for clinical treatment.

2022 Vol. 30　(6):　1379- [Abstract]（ 327 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

To analyze the correlation between venous catheter blood flow spectrum parameters of pregnant women and their inhibinA and Netrin-1 levels, and to study the diagnostic value of the blood flow spectrum parameters and the levels of inhibinA and Netrin-1 of the women for their fetal chromosomal abnormality. Methods: A total of 100 pregnant women with suspected fetal chromosomal abnormalities who had accepted examination of color Doppler ultrasonography were selected from July 2018 to July 2020. According to the gold standard of fetal chromosomal karyotype analysis, 52 cases with confirmed fetal chromosomal abnormalities were selected in study group, and 48 cases without confirmed fetal chromosomal abnormalities were selected in control group. The values of venous catheter blood flow spectrum parameters, such as resistance index (RI), pulsatile index (PI), and S/a of the women were compared between the two groups. The correlation between the values of RI, PI, S/a of the women and their inhibinA and Netrin-1 levels was analyzed. The diagnostic value of the values of RI, PI, and S/A for fetal chromosomal abnormalities was also analyzed. Results: The values of RI, PI, and S/a of the women in the study group were significantly higher than those of the women in the control group, and which of the women with fetal chromosomal abnormality, nervous system abnormality, and heart abnormality had increased gradually. The expression levels of inhibinA and Netrin-1 of the women with fetal chromosomal abnormalities, nervous system abnormality, and heart abnormality had decreased gradually (all P<0.05). In the study group, the values of RI, PI, and S/a of the women were positively correlated with their different disease types, while the levels of inhibinA and Netrin-1 of the women were negatively correlated with their different disease types, the values of RI, PI, and S/a of the women were negatively correlated with their inhibinA and Netrin-1 levels (all P<0.05).The combined values of RI, PI, and S/a for diagnosing fetal chromosome abnormality was significantly higher than that RI value, PI value, or S/a value alone, the area under the curve and the sensitivity of which were 0.847 and 98.2%. Conclusion: Venous catheter blood flow spectrum parameters values and the levels of inhibinA and Netrin-1 of the pregnant women have some clinical diagnostic value for their fetal chromosomal abnormalities.

2022 Vol. 30　(6):　1388- [Abstract]（ 355 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To investigate the value of chromosome microarray（CMA) technique combined with karyotype analysis for prenatal genetic diagnosis of fetuses with various abnormalities. Methods: 80 pregnant women who underwent invasive prenatal diagnosis and had abnormal genetic results were selected as the research subjects from January to December 2019. The diagnostic indications mainly included the structural abnormalities and abnormal soft indicators by ultrasound, and the screening high-risk, the no-invasive prenatal screening（NIPT) positive, the pregnant women with advanced age, etc. Both karyotyping and CMA testing were all given to these women during the same gestational weeks, and the detection rates and differences of various high-risk situation of the fetuses of the women by which were analyzed. Results: Among the 27 women with abnormal fetal structure and soft index by ultrasound, the positive women were detected by karyotype and CMA were 11 cases and 24 cases, respectively, and 20 women had no completely consistent of results by karyotype and CMA. In the women with normal results by karyotype, 15 women had microdeletion/microduplication of chromosome were detected by CMA additionally. In the women with normal results by CMA, 1 case with polymorphism of chromosome (46, XN,1qh+) and 2 cases with chromosomal structural variations (45, XN, der (13;14) (q10; Q10), and 46, XN, inv (9) (p12q13)) were found by karyotype analysis additionally. In 22 women with the histories of abnormal pregnancy, 15 women with submicrostructural aberrations (22q11.21 microdeletion syndrome, 16p11.2 microdeletion syndrome, Xp22.31 microdeletion syndrome, etc.), and with the heterozygotic deletion/ uniparental diploid (LOH/UPD) were detected by CMA additionally, and 4 cases with polymorphism of chromosome by CMA. In addition, karyotype combined with CMA also could detect the balance aberrations, submicroscopic copy number variation, LOH/UPD, and chimerism, and other abnormal chromosome of the pregnant women with advanced age, with serological screening high-risk situation, with NIPT screening high-risk situation, with phenotypic/chromosomal abnormalities of one spouse, or with inbreeding high-risk situation. Conclusion: Karyotype analysis combined with CMA used in the pregnant women with different prenatal diagnosis indications can efficiently detect their balance aberrations, micro-deletion/micro-duplication, LOH/UPD, lowproportion mosaicism, etc., which can provide scientific evidences for evaluating the prognosis of their fetus and their reproduction.

2022 Vol. 30　(6):　1397- [Abstract]（ 357 ） HTML (0 KB)  PDF  (0 KB)  ( 28 )

To study the effects of smooth endoplasmic reticulum congeries (sERC) of oocyte of women in intracytoplasmic sperm injection (ICSI) cycle on their embryonic development and pregnancy outcomes. Methods: In this study, 120 women with ICSI assisted reproduction from January 2020 to July 2020 were collected as the research objects retrospectively, and were divided into group A (52 cases with positive sERC) and group B (68 with negative sERC). The embryonic development, the clinical outcomes, and the deformity rate of live born infants were compared between the two groups. Results: There were no significant differences in the number of eggs obtained, the rates of the mature egg, the fertilization, the optimal embryo, and the embryo implantation of the women between the two groups (P>0.05). The rates of blastocyst formation (23.1%), the clinical pregnancy (38.5%), and the live birth (28.9%) of the women in group A were significantly lower than those (41.2%, 57.4%, and 51.5%) of the women in group B, and the abortion rate (19.2%) of the women in group A was significantly higher than that (5.9%) of the women in group B. The incidences of multiple malformations (6.7%) and the cardiovascular malformations (20.0%) of the live birth newborns in group A were significantly higher than those (0.0% and 2.9%) of the live birth newborns in group B (all P<0.05). Conclusion: Abnormal sERC of oocytes of the women during ICSI has certain impact on their embryonic development and pregnancy outcomes.

2022 Vol. 30　(6):　1408- [Abstract]（ 341 ） HTML (0 KB)  PDF  (0 KB)  ( 27 )

To investigate the association between the postpartum hemorrhage after cesarean delivery of women with placenta previa and their placental attachment site and the levels of prostaglandin E1（PGE1) and glutathione peroxidase 1（GPX1), and to study the diagnostic values of the levels of PGE1) and GPX1 for placenta previa. Methods: From June 2019 to June 2021, 52 women with placenta previa who underwent cesarean section for pregnancy termination were included in observation group, and another 50 women without pregnancy comorbidities who also underwent cesarean section due to maternal pelvis size, fetal size, or maternal hip girth were included in control group. The peripheral venous blood of the women in the two groups was collected immediately after cesarean section, and the serum PGE1 and GPX1 levels of the women were detected. The postpartum hemorrhage of the women were calculated by volumetric method combined with weighing method. The postpartum hemorrhage and the serum PGE1 and GPX1 levels of the women were compared between the two groups, and which of the women with different clinical characteristics in the observation group were also observed and compared. The value of the serum PGE1 and GPX1 levels of the women for predicting their postpartum hemorrhage was analyzed. Results: The levels of serum PGE1 (41.15±10.17 pg/ml) and GPX1 (34.15±3.36 U/L) of the women in the observation group were significantly lower than those (53.64±12.16 pg/ml and 47.45±5.56 U/L) of the women in the control group. The incidence of postpartum hemorrhage (50.0%) of the women in the observation group was significantly higher than that (4.0%) of the women in the control group (P<0.05), the average blood loss (1164.59±179.58 ml) of the women in the observation group was significantly higher than that (619.69±56.69 ml) of the women in the control group. In the observation group, the serum levels of PGE1 and GPX1 of the women with postpartum massive hemorrhage were significantly lower than those of the women without postpartum massive hemorrhage, which of the women with placenta attachment position in the uterine anterior wall, the women with placenta implantation, or the women with central placenta previa were all significantly lower than those of the women without placenta attachment position in the anterior wall, the women without placenta implantation, or the women without central placenta previa. In the observation group, the average postpartum blood loss of the women with placenta attachment position in the uterine anterior wall, the women with placenta implantation, or the women with central placenta previa was all significantly higher than those of the women without placenta attachment position in the anterior wall, the women without placenta implantation, or the women without central placenta previa (all P<0.05). Pearson linear correlation analysis showed that the serum PGE1 and GPX1 levels of the women with placenta previa after cesarean section were negatively correlated with their postpartum blood loss (P<0.05). Drawing receiver operating characteristic curve, the postpartum serum PGE1 level (AUC=0.759) and the GPX1 level (AUC=0.749) of the women with placenta previa had certain value efficacy for predicting their postpartum hemorrhage, and the combined levels of the serum PGE1 and GPX1 had the best predicted efficacy for postpartum hemorrhage (AUC=0.826). Conclusion: Detection of the serum PGE1 and GPX1 levels of the women with placenta previa after cesarean section has certain guiding significance in evaluating their postpartum hemorrhage in clinic.

2022 Vol. 30　(6):　1416- [Abstract]（ 554 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To investigate the influence of serum glycocholic acid（CG) level and time of pregnancy termination of pregnant women with intrahepatic cholestasis of pregnancy (ICP) on the outcomes of their perinatal infants. Methods: 112 pregnant women with ICP were selected in study group and 69 healthy pregnant women were selected in control group from July 2018 to July 2020. According to the serum CG level of the women in the study group, the women were divided into group A (63 women with low level CG of 2.7-13.5mg/L) and group B (49 women with high level CG of≥13.5mg/L). And according to the time of the pregnancy termination of the women in the study group, the women were also divided into group C (46 women with termination of pregnancy during <36 gestational weeks) and group D (466 women with termination of pregnancy during ≥36 gestational weeks). The serum CG level of all these women was detected by automatic biochemical analyzer. And the adverse outcomes of the perinatal infants were compared among these groups. The influencing factors of the adverse outcomes of the perinatal infants of the women with ICP were analyzed. Results: The levels of serum total bilirubin (TBIL) (14.79±3.36μmol/L), aspartate transaminase (AST) (65.61±4.63 U/L), alanine transaminase (ALT) (89.57±11.23 U/L), and CG (15.47±6.34 mg/L) of the women in the study group were significantly higher than those (6.37±2.83μmol/L, 15.27±2.82 U/L, 14.35±3.26 U/L, and 1.63±0.54 mg/L) of the women in the control group. The incidence of perinatal adverse outcomes of the women in group B was significantly higher than that of the women in group A, and which of the women in group C was
significantly higher than that of the women in group D (all P<0.05). Multivariate logistic regression analysis showed that the serum CG level ≥13.5mg/L (OR=2.16, 95%CI: 1.30-3.57) and the time of pregnancy termination <36 gestational weeks (OR=2.10, 95%CI= 1.29-3.42) of the women with ICP were the risk factors of the adverse outcomes of their perinatal infants (P<0.05). Conclusion: Abnormal high level of serum CG and the time of termination of pregnancy <36 gestational weeks of the pregnant women are closely related to the occurrence of the adverse outcomes of their perinatal infants, so it suggests that termination of pregnancy after 36 gestational weeks for the pregnant women with ICP can reduce the adverse outcomes of their perinatal infants.

2022 Vol. 30　(6):　1425- [Abstract]（ 284 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

 To investigate the risk factors of cesarean section caused by intrapartum fever of full-term primipara with singleton. Methods: A retrospective case-control study was used to collect the clinical data of 1073 full-term primipara with singleton and cephalic fetus who had accepted cesarean section from January 1, 2019 to December 31, 2019. 172 primipara with intrapartum fever or suspected intrauterine infection as the main indications of cesarean section were selected in observation group, and 901 cases with other indications of cesarean section were selected in control group. The clinical data of the primipara were compared between the two groups. The data were analyzed by univariate analysis and binary logistic regression. Results: The utilization rate of labor analgesia of the primipara in the observation group was 91.9% (158/172), which was significantly higher than that (81.8%, 737/901) of the primipara in the control group, and the modified OR was 2.410 (95%CI 1.339-4.337). The median value (25%,75%) of the neonatal weight in the observation group was ［3647.0 (3343.8-3850.0) g］, which was significantly higher than that ［3495.0 (3250.0-3782.0) g］ of the neonatal weight in the control group, and the modified OR was 1.001 (95%CI 1.000-1.001). The rate of gestational hypertension of the primipara in the observation group was 4.7%, which was significantly lower than that (10.0%) of the primipara in the control group, and the modified OR was 0.451 (95%CI 0.212-0.959). Conclusion: The risk of the cesarean section because of intrapartum fever of the primipara during labor analgesia is 2.4 times higher than that of the primipara without labor analgesia. The risk of the cesarean section because of intrapartum fever of the primipara with big fetus is higher. The gestational hypertension of the primipara is a protective factor of their cesarean section because of intrapartum fever.

2022 Vol. 30　(6):　1432- [Abstract]（ 289 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

2022 Vol. 30　(6):　1441- [Abstract]（ 323 ） HTML (0 KB)  PDF  (0 KB)  ( 26 )

With the widely application of assisted reproductive technology (ART), a lot of evidences suggest that ART increases the risk of adverse pregnancy outcomes and pregnancy complications, such as ectopic pregnancy and miscarriage, and the increase of the incidence rate of preterm birth and low birth weight. At the same time, some pregnancy complications, such as gestational diabetes mellitus and gestational hypertension disease, of the pregnant women after ART are also significantly higher than those of the pregnant women after nature pregnancy. Complex infertility factors and ART related program of the infertile population may be responsible for these adverse pregnancy outcomes. Therefore, the population with ART is high-risk pregnant women, so more attention should be paid to the pre-pregnancy intervention and pregnancy examination of the ART population, and appropriate ART techniques should be selected according to the characteristics of infertility patients, so as to reduce the risk of adverse pregnancy outcomes and pregnancy complications.

2022 Vol. 30　(6):　1451- [Abstract]（ 424 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )