To explore the effects of aspirin on the apoptosis induced by hypoxia of human HTR-8/SVneo trophoblast cells,  the expressions of soluble fms-like tyrosine kinase receptor-1 (sFlt), and hypoxia-inducible factor-1α(HIF-1α) in the cells. Methods: The human HTR-8/SVneo trophoblasts cells were divided into normal control group and hypoxia model group (the cells were given 2% O2, 5% CO2, and 93% N2). The cells in the two groups were treated by low-dose aspirin (0.05 mmol/L), medium-dose aspirin (0.1 mmol/L), or high-dose aspirin (0.2 mmol/L). After culture, MTT method was used to measure the cell viability, flow cytometry was used to measure cell apoptosis level and cell cycle, serum medium Matrigel culture was used to measure the cell angiogenesis ability, and the levels of sFlt-1 and HIF-1α in cells were detected by RT-PCR and Western blotting method. Results: The OD value, the survival rate, the angiogenesis ability, and the HIF-1α mRNA and protein expressions of the cells in the hypoxia model group were significantly lower than those of the cells in the normal control group, and which of the cells after treated by low aspirin, medium-dose, and high-dose of aspirin had decrease gradudally. The apoptosis rate, the G1 phase rate, and the sFlt-1 mRNA and protein expressions of the cells in the hypoxia model group were significantly higher than those of the cells in the normal control group, and  which of the cells after treated by low aspirin, medium-dose, and high-dose of aspirin had increase gradudally (all P<0.05). Conclusion: The low dose of aspirin can promote the proliferation, angiogenesis, and inhibit apoptosis of HTR-8/SVneo cells under hypoxia. The mechanism is related to the low dose of aspirin inhibiting the expression of sFlt-1 and promoting the expression of HIF-1αof the HTR-8/SVneo cells under hypoxia.

2023 Vol. 31　(2):　240- [Abstract]（ 428 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

2023 Vol. 31　(2):　251- [Abstract]（ 394 ） HTML (0 KB)  PDF  (0 KB)  ( 25 )

 To explore the prevention of postoperative complications of the perioperative blood volume management for patients with early missed abortion after painless induced abortion. Methods: 158 patients with early missed abortion who wanted painless induced abortion were selected and were randomly divided into observation group (n=79) and control group (n=79) by random number table method from November 2020 to November 2021. The patients in the two groups were anesthetized with remifentanil injection combined with propofol, and the patients in the observation group were pretreated with blood volume expansion before anesthesia additionally. The operation time, the intraoperative blood loss, the propofol dosage, the levels of hemodynamic indexes and the pain score of visual analogue scale (VAS) at different time point before and after anesthesia, the changes of the levels of sex hormone indexes before and 3 months after operation, and the occurrences of adverse reactions and complications of the patients in the two groups were observed. Results: The propofol dosage of the patients in the observation group was significantly lower than that of the patients in the control group, the MAP value of the patients in the observation group at 5min after anesthesia was significantly higher than that of the patients in the control group, and the HR value of the patients in the observation group at 1min, 5min, or 10min after anesthesia was significantly lower than that of the patients in the control group. The VAS scores of the patients in the observation group at 6h, 12h, and 24h after operation were significantly lower than those of the patients in the control group. The levels of luteinizing hormone and follicle stimulating hormone of the patients in the observation group at 3 months after operation were significantly higher than those of the patients in the control group, while the levels of the estradiol and anti-Muller's hormone of the patients in the observation group were significantly lower. The incidences of the decreased blood pressure (15.2%), the increased heart (20.3%), the dizziness (10.1%), the nausea and vomiting (0) of the patients in the observation group were significantly lower than those (46.8%, 54.4%, 38.0%, and 10.1%) of the patients in the control group. In 3 months after operation, the total complication rate (5.1%) of the patients in the observation group was significantly lower than that (20.3%) of the patients in the control group (all P＜0.05). Conclusion: The perioperative blood volume management of painless induced abortion of the patients with early missed abortion can effectively reduce the dosage of anesthetics, stabilize the hemodynamics, reduce the operative pain and the reproductive function damage of the patients, and can decrease the incidences of adverse reactions and complications.

2023 Vol. 31　(2):　263- [Abstract]（ 378 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To explore the D-dimer/platelet (DPR) value and the angiogenesis inhibitory protein 1 (VASH-1) level of women after medical abortion, and its predictive value for the abnormal uterine bleeding of the women. Methods: A total of 123 pregnant women who wanted medical abortion were selected and were divided into group A (21 cases with abnormal uterine bleeding) and group B (102 cases without abnormal uterine bleeding) according to the situation of uterine bleeding from March 2019 to March 2022. The levels of the plasma D-dimer and platelets, and the serum VASH-1 of the women before abortion in the two groups were detected, and their DPR was calculated. The predictive value of the DPR and the VASH-1 level of the women after abortion for their abnormal uterine bleeding were evaluated by receiver operating characteristic curve (ROC). The related factors of the abnormal uterine bleeding of the women were analyzed by multivariate logistic regression. Results: The DPR (0.85±0.31×10-11 mg) and the VASH-1 level (567.32±84.15 ng/L) of the women in group A were significantly higher than those (0.57±0.24×10-11 mg and 319.64±68.53ng/L) of the women in group B (P＜0.05). There were significant differences in the abortion history, and the fibrinogen, D-dimer, and platelet levels of the women between the two groups (P＜0.05). ROC curve analysis showed that the area under the curve (AUC) of the DPR and the VASH-1 level for diagnosing abnormal uterine bleeding of the women after medical abortion were 0.852 and 0.809, the cut-off values of which were 0.71×10-11 mg and 323.48ng/L, the specificity of which were 62.2% and 53.6%, and the sensitivity of which was 93.5% and 93.5%. The AUC, the specificity, and the sensitivity of the combined of the DPR and the VASH-1 level for diagnosing abnormal uterine bleeding of the women after medical abortion were 0.904, 85.3%, and 87.1%, respectively. Multivariate analysis showed that the history of abortion, the fibrinogen level >4g/L, the high DPR value and the VASH-1 level of the women were the risk factors of their abnormal uterine bleeding after medical abortion (P＜0.05). Conclusion: The DPR and the VASH-1 level of the women with abnormal uterine bleeding after medical abortion are high, which can be used as the reference indexes for predicting their abnormal uterine bleeding.

2023 Vol. 31　(2):　272- [Abstract]（ 467 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

 To analyze the risk factors of ectopic pregnancy of women, to investigate the clinical efficacy of mifepristone combined with methotrexate for treating these women, and to study its influence on the expressions of their serumβ-human chorionic gonadotropin (β-hCG) and carbohydrate antigen 125 (CA125). Methods: A total of 96 women with ectopic pregnancy (in group A) and 125 women with normal intrauterine pregnancy (in group B) were selected as the research objects from March 2019 to January 2021. The women in group A were divided into two groups according to different treatment methods, which included 48 women with treatment of mifepristone combined with methotrexate in group A1 and 48 women with treatment of methotrexate alone in group A2. Logistic regression model was used to analyze the risk factors of ectopic pregnancy. The results of pregnancy termination, the levels of β-hCG and CA125, and the pregnancy after 1 year and 6 months of follow-up of the women were compared between group A1 and group A2. Results: There were no significant differences in the marital status, the drinking history, the history of intrauterine device inserted, and the drug contraceptive history of the women between group A and group B (P＞0.05), but there were significant differences in the pregnancy history, the induced abortion history, the infertility history, the smoking history, the number of sexual partners, the gynecological inflammation history, and the pelvic operation history of the women between group A and group B (P＜0.05). Binary logistic regression analysis showed that the pregnancy history, the abortion history, the infertility history, the smoking history, the gynecological inflammation history, the pelvic surgery history, and ≥2 sexual partners were the independent risk factors of the ectopic pregnancy of the women (P＜0.05). In group A, the success rate of pregnancy termination (89.6%) of the women in group A1 was significantly higher than that (70.8%) of the women in group A2 (P＜0.05). After treatment, the serum β-hCG and CA125 levels of the women in group A1 were significantly lower than those of the women in group A2 (P＜0.05), and there were no significant differences in the rates of the intrauterine pregnancy (81.3% vs.72.9%), the ectopic pregnancy (6.3% vs.10.4%), and the secondary infertility (2.1% vs. 6.3%) of the women in 1.5 year after operation between group A1 and group A2 (P＞0.05). Conclusion: The pregnancy history, the abortion history, the infertility history, the smoking, the gynecological inflammation history, the pelvic operative history, and the sexual partners ≥2 of the women were the risk factors of their ectopic pregnancy. Mifepristone combined with methotrexate for treating the women with ectopic pregnancy can increase the effect of the treatment, which is beneficial to reduce the levels of β-hCG and CA125 of the women, with better safety.

2023 Vol. 31　(2):　281- [Abstract]（ 550 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To investigate the effects of selenium supplementation for patients with polycystic ovary syndrome (PCOS) on their asymmetric dimethyl arginine (ADMA) level, their cardiac metabolic risk factors, and sex hormones levels. Methods: 76 patients with PCOS were randomly divided into study group (34 cases) and control group (32 cases). The patients in the study group were given oralselenium-enriched yeast tablet 60 μg every day for 12 weeks, and the patients in the control group were given placebo. The levels of fasting blood glucose (FBG), serum insulin, total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), apolipoprotein AI (Apo-A1), and Apo-B 100 of the patients in the two groups were measured before and after intervention. The levels of serum total testosterone (T), sex hormone binding globulin (SHBG), and ADMA of the patients in the two groups were detected by ELISA. The insulin resistance (IR) of the patients in the two groups was calculated by homeostasis model assessment of IR (HOMA-IR). Results: After intervention, the levels of ADMA (52.4±18.64 ng/L) and T (0.49±0.31 ng/ml) of the patients in the study group were significantly lower than those (63.96±15.77 ng/L and 0.67±0.32 ng/ml) of the patients in the control group. The Apo-B100/Apo-A1 ratio (0.61±0.16) of the patients in the study group was significantly lower than that (0.67±0.19) of the patients in the control group (all P＜0.05). There were no significant differences in the levels of FBG, insulin, and other lipid, and the HOMA-IR value of the patients between the two groups (P＞0.05). Conclusion: The selenium supplementation for the patients with PCOS for 12 weeks has a positive effect on their ADMA and total T levels, and Apo B 100/Apo AI ratio, but which has no significant improvement on their other cardiac metabolic risk factors.

2023 Vol. 31　(2):　291- [Abstract]（ 426 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To observe the application effect of isthmus ligation combined with low-dose vasopressin by fractional injection of patients during laparoscopic excision of hysteromyoma, and to study its influence on the microcirculation of these patients. Methods: From January 2019-May 2022, 66 patients with laparoscopic excision of uterine fibroids were selected and were divided into two groups (33 cases in each group) by random single-blind drawing. The patients in the control group received traditional suture hemostasis combined with pituitary by one-time injection during the operation, and the patients in the observation group received uterine isthmus ligation combined with low-dose vasopressin by fractional injection during operation. The hemostatic efficacy, the surgical conditions, the changes of microcirculation indexes, such as diastolic blood pressure (DBP), systolic blood pressure (SBP), and heart rate (HR) before and after treatment, and the complications situation of the patients were compared between the two groups. 3 months of follow-up after treatment, the menstrual situation of the patients in the two groups were counted. Results: The intraoperative blood loss (52.6±7.9ml), the postoperative anal exhaust time (1.6±0.6d), and the hospitalization stay (4.7±1.1d) of the patients in the observation group were significantly shorter than those (74.3±9.6ml, 2.1±0.7d, and 6.0±1.3d) of the patients in the control group. The values of DBP, SBP, and HR of the patients in both groups after 15 min of treatment had increased significantly, and which (74.3±5.4 mmHg, 110.3±9.1 mmHg, and 75.5±4.6 times/min) of the patients in the observation group were significantly lower than those (78.0±6.1 mmHg, 117.0±10.0) mmHg, and 80.9±5.3 times /min) of the patients in the control group (P＜0.05). The total effective rate of hemostasis (97.0%) of the patients in the observation group was significantly higher than that (75.8%) of the patients in the control group (all P＜0.05). There was no significant difference in the incidence of postoperative complications (18.2% vs. 24.2%) of the patients between the two groups (P＞0.05). 3 months after treatment, the menstrual volume and menstrual period of the patients in both groups had decreased significantly, and which (46.1±2.2ml and 4.7±1.3d) of the patients in the observation group were significantly lower than those (52.7±3.1ml and 6.3±1.4d) of the patients in the control group (P＜0.05). Conclusion: The application of isthmus ligation combined with lowdose vasopressin by fractional injection of the patients during laparoscopic excision of uterine fibroids improves their hemostasis effect, is beneficial to the operation, promotes the recovery of the patients, and has less impact on the microcirculation system of the patients.

2023 Vol. 31　(2):　302- [Abstract]（ 369 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To investigate the efficacy and mechanism of antibiotics combined with Kangfuyan capsules for treating patients with chronic endometritis (CE) based on Tolllike receptor-nuclear factor κB (TLRs-NF-κB) signaling pathway. Methods: 92 patients with CE were selected and were randomly divided into two groups according to the ratio of 1:1 from January 2021 to January 2022. 46 patients in the control group were given routine antibiotic treatment, and 46 patients in the observation group were given antibiotics combined with Kangfuyan capsules. The clinical efficacy, the mRNA expressions of TLR2, TLR4, and NF-κB in peripheral blood mononuclear cells (PBMCs) before and after treatment, and the levels of serum TLRs-NF-κB-related inflammatory factors, such as tumor necrosis factor-α (TNF-α), interferon gamma (IFN-γ), interleukin-1β (IL-1β), IL-6, and IL-8 of the patients were compared between the two groups. Results: After 1 week and 2 weeks of treatment, the TCM syndrome scores of the patients in both groups had decreased significantly, and which (6.45±1.14 points and 4.33±0.81 points) of the patients in the observation group were significantly lower than those (7.59±1.22 points and 5.16±1.23 points) of the patients in the control group (P＜0.05). The mRNA levels of TLR2, TLR4 and NF-κB in PBMCs and the levels of serum TNF-α, IFN-γ, IL-1β, IL-6, and IL-8 of the patients in the two groups had decreased significantly, and which of the patients in the observation group were significantly lower than those of the patients in the control group (P＜0.05). The cure rate (78.3%) of the patients in the observation group was significantly higher than that (58.7%) of the patients in the control group, and the recurrence rate (2.8%) of CE of the patients in the observation group in 6 months of follow-up after operation was significantly lower than that (14.8%) of the patients in the control group (P＜0.05). The total effective rate (100.0% vs.95.7%) of the patients in the two groups had no significant difference (P＞0.05). Conclusion: Antibacterial drugs combined with Kangfuyan capsules for treating patients with CE can improve the clinical efficacy and reduce the risk of CE recurrence, and the mechanism of which may be related to regulating the TLRs-NF-κB signaling pathway and inhibiting the expression of its downstream inflammatory factors.

2023 Vol. 31　(2):　311- [Abstract]（ 361 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To investigate the effects of oxytocin combined with epidural anesthesia on the postpartum hemorrhage and the maternal and infant outcomes of primipara with singleton. Methods: A total of 106 primipara with singleton were selected and were divided into observation group (primipara with oxytocin combined with epidural anesthesia) and control group (primipara with epidural anesthesia) according to the random number table from May 2019 to May 2021. The labor time, the pain degree by visual pain scale (VAS), the postpartum hemorrhage volume, the maternal and infant outcomes, and the levels of stress response indexes, such as cortisol (Cor), norepinephrine (NE), and epinephrine (ADR) of the primipara were compared between the two groups. Results: The first, the second, and the total stages of labor of the primipara in the observation group were significantly shorter than those of the primipara in the control group. The VAS scores of the primipara in the observation group during the incubation period and the active period of the first stage of labor, during the second stage of labor, and during the third stage of labor were all significantly lower than those of the primipara in the control group. The blood loss of the primipara in the observation group in postpartum 30min (165.9±14.5ml), 2h (85.0±12.5 ml), or 24h (71.0±9.0 ml) was significantly lower than that (201.3±16.9 ml, 102.1±15.7 ml, or 84.3±12.3 ml) of the primipara in the control group. The levels of Cor, NE, and ADR of the primipara in the observation group when the orifice of the uterus opened to 3cm, the orifice of the uterus opened completely, or the delivery of baby were significantly lower than those of the primipara in the control group. The vaginal delivery rate (77.4%) of the primipara in the observation group was significantly higher than that (56.6%) of the primipara in the control group, while the cesarean section rate, the postpartum hemorrhage rate, the soft birth canal tear rate, and the neonatal asphyxia rate of the primipara in the observation group were significantly lower than those of the primipara in the control group (all P＜0.05). Conclusion: Oxytocin combined with epidural anesthesia used in the delivery of the primipara with singleton is beneficial to shorten the labor stage, reduce the amount of postpartum hemorrhage, and improve the maternal and infant outcomes.

2023 Vol. 31　(2):　320- [Abstract]（ 490 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To investigate the effects of different dosage of nalbuphine combined with sufentanil used in laparoscopic uterine myomectomy of patients on their pain mediators and hemodynamics. Methods: 102 patients who wanted laparoscopic uterine myomectomy were randomly selected and were divided into group A, group B, and group C (34 cases in each group) according to the random number table method from April 2019 to April 2022. All the patients in the three groups were given sufentanil induction anesthesia, and then the patients in group A, group B, and group C were given 0.15mg/kg, 0.25mg/kg, and 0.35mg/kg nalbuphine injection after the operation, respectively. The hemodynamic indexes and the pain medium indexes, such as the levels of substance P and prostaglandin E2 (PGE2), of the patients in the three groups before operation, at the time of injection of nalbuphine, and in the 6th hour after operation were recorded. The clinical operation indexes, the pain medium indexes, the hemodynamic indexes, the pain score by VAS, the sedation score (Ramsay), and the rate of adverse reactions of the patients were compared among the three groups. Results: The operation time and the sufentanil dosage of the patients had no significant differences among the three groups. The extubation time of the patients in group B (9.6±2.1min) was significantly less than that (12.2±2.3min) of the patients in group A and that (11.3±2.6min) of the patients in group C. There were significant differences in the values of mean arterial pressure and heart rate, and the levels of serum substance P and PGE2 of the patients among the three groups. The VAS scores of the patients at postoperative 24h in group A, in group B, and in group C were 3.18±0.46 points, 2.15±0.56 points, and 2.06±0.49 points, respectively, which had decreased gradually. The highest score of Ramsay of the patients in group A, in group B, and in group C were 1.59±0.61 points, 1.97±0.52 points, and 2.47±0.51 points, which had increased gradually. The incidence of adverse reactions (23.5%) of the patients in group C was significantly higher than that (2.9%) of the patients in group B and that (8.8%) of the patients in group A (all P＜0.05). Conclusion:  Overall consideration, 0.25mg/kg nalbuphine combined with sufentanil can play a better analgesic effect during the uterine myomectomy of the patients, and which can significantly improve the pain medium and hemodynamic level of these patients, with low adverse reactions and guaranteed safety.

2023 Vol. 31　(2):　330- [Abstract]（ 557 ） HTML (0 KB)  PDF  (0 KB)  ( 24 )

To analyze the drug resistance of vaginal Escherichia coli (E. coli), and to detect the drug resistance genes of producing extended spectyum β-lactamases bacterial strain (ESBLs) of pregnant women during the third trimester of pregnancy. Methods: The samples vaginal secretions of the pregnant women during the third trimester of pregnancy were collected to detect the E. coli strains and to analyze the drug resistance of clinical antibiotics used commonly and the drug resistance genotypes from January 2022 to September 2022. Results: 298 strains of vaginal E. coli of the pregnant women during the third trimester of pregnancy had been obtained, which were sensitive to carbapenems, β-lactamase inhibitors, and aminoglycosides (amicacin) was 98.0% to 100.0%, but the higher resistant of which to penicillin, cephalosporin, sulfonamides, and quinolones was 72.8% to 38.9%. The positive detection rate of ESBLs was 47.7% (142/298 cases). The resistance rate of ESBLs-positive strains to penicillin, cephalosporins, monoamides, aminoglycosides, quinolones, sulfonamides, and other antibiotics was significantly higher than that of ESBLs-negative strains (P＜0.05). The drug-resistant genotypes of 142 strains (47.7%) EsBLS-producing E. coli were CTX-M (81.7%), TEM-1 (59.2%), SHV (21.1%), and OXA (2.1%). The genotype combinations were mainly CTXM-15 and TEM-1 (21.8%), CTXM-15 and TEM-1 (20.4%), and CTXM-15 (13.4%). The resistance rate for cefotaxime (CTX) of producing ESBL of E. coli of CTX-M type was significantly higher in than that of TEM type or SHV type. The resistance rate for ceftazidime (CAZ) of producing ESBL of E. coli of CTX-M type was significantly lower than that of type or SHV type (all P＜0.05). There was no significant difference in the resistance rate for other antibiotics of producing ESBL of E. coli among CTX-M type, TEM type, and SHV type (P＞0.05). Conclusion: The producing ESBLs strains of vaginal E. coli from the pregnant women during the third trimester of pregnancy are mainly TEM-1, CTX-M-15, and CTX-M-14. The treatments of vaginal E. coli by penicillin, cephalosporin, sulfonamides, and fluoroquinolones should be cautious in clinic.

2023 Vol. 31　(2):　340- [Abstract]（ 381 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To investigate the effect of dexmedetomidine combined with butorphanol for postoperative analgesia of women after cesarean section, and to study its influence on the stress response of these women. Methods: From January 2021 to June 2022, a total of 92 pregnant women who wanted elective cesarean section were selected and were randomly divided into two groups (46 cases in each group). The women in the control group were given 10mg butorphanol for postoperative self-controlled analgesia, and the women in the study group were given 0.5μg/kg dexmedetomidine by intravenous pump after baby delivery and then dexmedetomidine 0.2 μg/kg /h combined with 10mg butorphanol for postoperative self-controlled analgesia. The scores of visual analogue scales (VAS) and Ramsay, and stress response indexes of the women at different time points after cesarean section were compared between the two groups. And the situation of postoperative adverse reactions of the women in the two groups were recorded. Results: There were no significant differences in the scores of VAS and Ramsay, and the levels of serum stress response indexes of the women after cesarean section between the two groups (P＞0.05). The VAS score of the women in the study group at postoperative 12h, 24h and 48h were 2.03±0.54 points, 1.60±0.46 points, and 1.27±0.45 points, respectively, which were significantly lower than those (2.32±0.62 points, 1.95±0.5 points, and 1.62±0.49 points) of the women in the control group. The Ramsay score of the women in the study group at postoperative 12h, 24h and 48h were 2.02±0.46 points, 2.12±0.58 points, and 2.71±0.59 points, respectively, which were significantly higher than those (1.98±0.43 points, 2.53±0.61 points, 2.96±0.57 points) of the women in the control group. The levels of serum norepinephrine (272.20±24.84 pg/ml), endothelin-1 (73.32±10.05 pg/ml), and cortisol (266.32±32.05 ng/ml) of the women in the study group at postoperative 12h were significantly lower than those (317.75±25.19 pg/ml and 79.57±10.62 pg/ml, and 297.57±34.62 ng/ml) of the women in the control group. The incidences of vertigo (10.9%), and nausea and vomiting (4.4%) of the women in the study group after operation were significantly lower than those (32.6% and 21.7%) of the women in the control group (all P＜0.05). Conclusion: Application of dexmedetomidine combined with butorphanol for postoperative self-controlled analgesia of the women after cesarean section can achieve satisfactory analgesic and sedative effects, and which can alleviate the stress reaction of the women, with fewer adverse reactions.

2023 Vol. 31　(2):　353- [Abstract]（ 496 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To investigate the effects of Siebens domain management model for treating pregnant women with gestational diabetes mellitus (GDM) on their blood glucose level and pregnancy outcomes. Methods: A total of 198 pregnant women with GDM were selected as research subjects from September 2019 to September 2021. These women were divided into two groups (99 cases in each group) by random number table. The women in the control group were given routine management and the women in the experimental group were given Siebens domain management model. The levels of fasting plasma glucose (FPG), 2 hours postprandial blood glucose (2h PG), the hemoglobin Alc (HbAlc), the quality of life, and the adverse pregnancy outcomes of the women were compared between the two groups. Results: The levels of FPG, 2h PG, and HbAlc of the women in both groups after treatment had decreased significantly, and which of the women in the experimental group were significantly lower than those of the women in the control group. The score by SF-36 of the women in both groups had increased significantly, and which of the women in the experimental group was significantly higher than that of the women in the control group. The total incidence of adverse pregnancy outcomes (11.1%) of the women in the experimental group was significantly lower than that (39.4%) of the women in the control group (all P＜0.05). Conclusion: The application of Siebens domain management model in the pregnant women with GDM has significant efficacy, which can effectively manage the blood glucose level, improve the quality of life, and reduce the adverse pregnancy outcomes of these women.

2023 Vol. 31　(2):　362- [Abstract]（ 440 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To investigate the correlation between the serum vitamin D and miR-21 levels of women with recurrent spontaneous abortion (RSA) during re-pregnancy and their adverse pregnancy outcomes. Methods: A total of 104 women with RSA during re-pregnancy were selected in observation group from March 2019 to September 2021, and 40 normal pregnant women who had no history of spontaneous abortion were selected in control group during the same period. The serum vitamin D level of the women in the two groups was detected by chemiluminescence immunoassay, and the expression of miR-21 of the women in the two groups was detected by real-time fluorescence quantitative PCR. The predictive value of the levels of serum vitamin D and miR-21 of the women with RSA during re-pregnancy for their adverse pregnancy outcomes was evaluated by receiver operating characteristic (ROC) curve. The related factors affecting the adverse pregnancy outcomes of the women with RSA during re-pregnancy was explored by multivariate logistic regression. Results: The level of vitamin D (12.15±3.01 ng/ml) of the women in the observation group was significantly lower than that (26.51±4.43 ng/ml) of the women in the control group, and the miR21 level (2.96±0.65) of the women in the observation group was significantly higher than that (1.31±0.24) of the women in the control group (all P＜0.05). ROC curve analysis showed that the areas under the curve of the serum vitamin D level and miR-21 level of the women with RSA during re-pregnancy for predicting their adverse pregnancy outcomes were 0.834 and 0.842, the cut-off values of which were 19.32ng/ml and 2.14, the sensitivity of which were 79.8% and 81.0%, and the specificity of which were 82.3% and 83.8%. The area under the curve, the sensitivity, the specificity of the combined serum vitamin D and miR-21 levels of the women with RSA during re-pregnancy for predicting their adverse pregnancy outcomes were 0.897, 89.3%, and 81.9%, respectively. The incidence of adverse pregnancy outcomes (46.5%) of the women with low vitamin D level was significantly higher than that (14.8%) of the women with high vitamin D level, and which (44.9%) of the women with high miR-21 level was significantly higher than that (12.7%) of the women with low miR-21 level (all P＜0.05). Multifactor analysis showed that the vitamin D level ≤19.32ng/ml (OR=3.01, 95%CI: 1.46-6.20), and the miR-21 level >2.14 (OR=2.54, 95%CI: 1.38-4.67) were the influence factors of the adverse outcomes of the women with RSA after pregnancy (P＜0.05). Conclusion: The abnormal levels of serum vitamin D and miR-21 of the women with RSA during re-pregnancy are related to their adverse pregnancy outcomes, and the incidence of the adverse pregnancy outcomes of the women with low vitamin D level or high miR-21 level is high, both of the vitamin D level and the miR-21 level are expected to be the effective indicators for predicting the pregnancy outcomes of the women.

2023 Vol. 31　(2):　371- [Abstract]（ 382 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To explore the clinical value of the vitamin D level combined with the anti-Müllerian hormone (AMH) level for predicting the pregnancy outcomes of infertile patients after in vitro fertilization-embryo transfer (IVF-ET). Methods: The clinical data of 402 infertile patients who had undergone IVF-ET from May 2019 to December 2021 were analyzed retrospectively. According to the pregnancy outcomes after IVF-ET, these patients were divided into group A (220 patients with clinical pregnancy) and group B (182 patients without clinical pregnancy). The levels of serum vitamin D and AMH of the patients in the two groups were detected after admission. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive value of the serum vitamin D and AMH levels of the patients for their pregnancy outcomes after IVF-ET. The influencing factors of the pregnancy outcomes of the infertile patients after IVF-ET were analyzed by multivariate logistic regression analysis. Results: The serum vitamin D and AMH levels of the patients in group B were significantly lower than those of the patients in group A (all P＜0.05). ROC curve showed that the areas under curve of the serum vitamin D level and the AMH level of the patients for predicting their pregnancy outcomes after IVF-ET were 0.768 and 0.816, the cut-off values of which were 5.86ng/ml and 15.10ng/ml, the sensitivity of which were 93.2% and 93.2%, and the specificity of which were 54.2% and 67.6%. The area under curve, the sensitivity, and the specificity of the combined levels of serum vitamin D and AMH of the patients for predicting their pregnancy outcomes after IVF-ET were 0.892, 86.3%, and 85.3%, respectively. Multivariate logistic regression analysis showed that the low serum vitamin D level, the low AMH level, the low fertilization rate, and the advanced age of the infertility patients were all the factors affecting their pregnancy after IVF-ET (P＜0.05). Conclusion: Both the serum vitamin D level and the AMH level of infertile patients without pregnancy after IVF-ET are low, and the combined levels of serum vitamin D and AMH of the patients can be as the effective indicators for predicting their pregnancy outcomes after IVF-ET.

2023 Vol. 31　(2):　380- [Abstract]（ 453 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To investigate the diagnostic values of the endometrial basal blood flow parameters and endometrial thickness of women examined by transvaginal twodimensional ultrasound for their intrauterine adhesions (IUA) and the degree of IUA. Methods: 100 women with IUA were selected in group A, and were divided into 15 cases with ⅠIUA in group A1, 20 cases with ⅡIUA in group A2, 31 cases with Ⅲ IUA in group A3, 19 cases with ⅣIUA in group A4, and 15 cases with ⅤIUA in group A5 according to the degree of IUA by the classification criteria of the European Society for Gynecological Endoscopy in 1998 from January 2019 to January 2022. Another 100 healthy women were selected in group B. The values of pulse index (PI), the resistance index (RI), systolic to diastolic flow rate ratio (S/D), and the endometrial thickness (EN) of the women were compared between group A and group B, and among group A1, group A2, group A3, group A4, and group A5. The diagnostic efficacy of the combined values of PI, RI, S/D, and ET of the women for their IUA and the degree of IUA was analyzed. Results: The values of PI, S/D, and RI of the women in group A were significantly higher than those of the women in group B, while the ET value of the women in group A was significantly lower. The values of PI, S/D, and RI of the women in group A1, group A2, group A3, group A4, and group A5 had increased gradually, while the ET value of the women had decreased gradually (all P＜0.05). Through analysis, the specificity of the combined detections of PI, S/D, RI, and EN of the women for diagnosing their IUA was 97.0%, which was significantly higher than that (89.0%, 88.0%, 55.0%, or 74.0%) of the PI, S/D, RI, or EN detection alone. Based on the results of the analysis of receiver operator characteristic curve, the area under the curve of the combined values of PI, S/D, RI, and EN of the women for diagnosing their IUA, and I IUA, ⅡIUA, Ⅲ IUA, Ⅳ IUA, and Ⅴ IUA were 0.984, 0.879, 0.896, 0.802, 0.847, and 0.862, respectively, which had all increased significantly (all P＜0.05). Conclusion: The parameters of endometrial basal blood flow and endometrial thickness examined of the women by transvaginal two-dimensional ultrasound for diagnosing their IUA and the degree of IUA have some clinical guidance values.

2023 Vol. 31　(2):　389- [Abstract]（ 366 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To explore the influence factors of nephrotic syndrome of pregnancy (NSP) of women during pregnancy, and to study their efficiency for screening NSP in clinic and predicting the pregnancy outcomes of these women. Methods: From January 2018 to January 2022, the clinical data of 39 pregnant women with NSP (in study group) and 54 pregnant women with pregnancy-induced hypertensive severe preeclampsia and without NSP (in control group) were selected in this study. The baseline data, the blood pressure values, the laboratory indexes levels of the women in the two groups were collected and were comparison analyzed. Multivariable logistic regression model was used to analyze the risk factors of NSP. According to the situation of neonatal asphyxia, these women were divided into group A (women with adverse pregnancy outcomes) and group B (women with normal pregnancy outcomes), and the differences of the risk factors indicators of the women were compared between group A and group B. Receiver operating characteristic (ROC) curve was drawn to analyze the values of the risk factors for screening NSP in clinic and diagnosing the adverse pregnancy outcomes of these women. Results: The systolic blood pressure (SBP) value, and the levels of fasting blood glucose (FBG), homocystatin C (CysC), total cholesterol (TC), triglyceride (TG), and urea nitrogen (BUN) of the women in the study group were significantly higher than those of the women in the control group, while the homocysteine (Hcy), plasma total protein (TPP) and albumin (Alb) levels of the women in the study group were significantly lower than those of the women in the control group (P＜0.05). The risk factors of NSP of the women were SBP, FBG and CysC, and the protective factors of NSP of the women were Alb and TPP (P＜0.05). The area under curve (AUC) of the level of SBP, FBG, Alb, CysC, or TTP for screening of NSP in clinic was > 0.75, and the sensitivity or the specificity of which was > 70.0%. The SBP value and the FBG level of the women in group A were significantly higher than those of the women in group B (P＜0.05). The AUC level of the SBP value and the FBG level for predicting the adverse pregnancy outcomes of the women were 0.800 and 0.814, the sensitivity of which were 73.3% and 86.3%, and the specificity of which were 77.0% and 80.0%. Conclusion: The SBP value, and the levels of FBG, CysC, Hcy, Alb, and TPP of the pregnant women with NSP are abnormal. The SBP value, and the levels of FBG, CysC, Alb, TPP of the women are all the influencing factors of NSP occurrence, and all of which can be used as the sensitive indicators for clinical screening NSP of these women. The SBP value and the FBG level can be used as the sensitive indicators for predicting the neonatal asphyxia of the women with NSP.

2023 Vol. 31　(2):　397- [Abstract]（ 348 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To investigate the expressions and clinical significances of microtubule associated protein light chain 3 (LC3), Beclin1, and high mobility group protein B1 (HMGB1) in placenta tissue of pregnant women with placenta previa and placenta implantation. Methods: 96 pregnant women with placenta previa were included in group A and 75 healthy pregnant women with cesarean delivery were included in group B from January 2019 to December 2020. The expression levels of LC3, Beclin1, and HMGB1 in the placenta tissues of the women in the two groups were detected. The women in group A were further divided into group A1 (women with placenta implantation) and group A2 (women without placenta implantation), thereafter, the risk factors affecting the occurrence of placenta implantation were explored. Results: There was no significant difference in the age of the women between group A and group B. The gestational weeks when delivery of the women in group A was significantly less than that of the women in group B, and the gravidity number, the parity number, the number of previous cesarean section, and the time from last cesarean section to this pregnancy of the women in group A were significantly higher than those of the women in group B (P＜0.05). There were 42 (43.8%) cases in group A1 and 54 (56.3%) in group A2. There were no significant differences in the age, the gestational weeks when delivery, and the gravidity of the women between group A1 and group A2. There were significant differences in the parity number, the number of previous cesarean section, the time from last cesarean section to this pregnancy, the previa type, the placenta position, and the expression levels of LC3, Beclin1, and HMGB1 of the women between group A1 and group A2 (P＜0.05). The expression levels of LC3 (1.03±0.13), Beclin1 (1.58±0.43), and HMGB1 (1.67±0.29) in placental tissue of the women in group A were significantly higher than those (1.06±0.12, 1.07±0.12, and 0.68±0.09) of the women in group B. The expression levels of LC3, Beclin1, and HMGB1 (1.93±0.37, 1.72±0.52, and 1.13±0.15) of the women in group A1 significantly higher than those (1.46±0.34, 1.39±0.40, and 1.13±0.15) of the women in group A2 (all P＜0.05). Multiple logistic analysis showed that the factors affecting the occurrence of placenta previa of the pregnant women included the gestational weeks, the gravidity number, the parity number, the number of previous cesarean section, the time from last cesarean section to this pregnancy, and the levels of LC3, Beclin1, and HMGB1. The factors affecting the occurrence of placenta implantation of the women with placenta previa included the parity number, the number of previous cesarean section, the time interval since last cesarean section, the type of placenta previa, the placenta location, and the expression levels of LC3, Beclin1, and HMGB1. Conclusion: The expressions of LC3, Beclin1, and HMGB1 proteins in placenta tissues of the women with placenta previa increase, and which of the women with placenta previa complicating placenta implantation are higher. The high expressions of LC3, Beclin1, and HMGB1 of the women are the risk factors of their development of placenta previa and placenta implantation.

2023 Vol. 31　(2):　407- [Abstract]（ 736 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To investigate the predictive value of the parameters of elastography of cervix (E-cervix) of pregnant women for their cervical sensitivity, and to study the correlation between these parameters of the women and their cervical dilation time during active stage of labor. Methods: 124 full-term pregnant women with singleton who were hospitalized for induce labor from May 2021 to January 2022 were analyzed retrospectively. These women were divided into group A (66 women with sensitive cervix for dilation) and group B (58 women without sensitive cervix for dilation) according to the time of uterine orifice dilation during labor induction. The elastic imaging parameters of the women in the two groups at 12h before labor induction were evaluated by E-cervix technique and the Bioshop score of the women in the two groups was also evaluated. Receiver operating characteristic (ROC) curve was drawn to analyze the predictive values of ECervix parameters and Bioshop score for the cervical sensitivity. The cervical dilation time of the women was compared between the two groups. Pearson correlation coefficient was used to analyze the correlation between the cervical dilation time of the women and their E-Cervix parameters. Results: The Bishop score (3.26±0.56 points) of the women in group A was significantly lower than that (3.89±0.87 points) of the women in group B, and the values of E-Cervix elastic imaging parameters of the women in group A were significantly higher than those of the women in group B (all P＜0.05). ROC curve analysis showed that the area under the curve (0.869) of E-Cervix parameters for evaluating the cervical sensitivity was significantly higher than that (0.746) of the Bishop score. The sensitivity and the specificity of E-Cervix parameters for evaluating the cervical sensitivity were 87.4% and 82.7%. The cervical dilation time (190.0±58.6min) of the women in group A was significantly shorter than that (226.8±57.6min) of the women in group B (all P＜0.05). Pearson correlation analysis showed that the cervical dilation time of the women was positively correlated with their E-Cervix parameters (P＜0.05). Conclusion: E-Cervix can effectively predict the cervical sensitivity of the pregnant women, and the parameters of E-Cervix are positively correlated with the cervical dilation time.

2023 Vol. 31　(2):　416- [Abstract]（ 404 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To explore the expressions and clinical significance of miR-1287-5p and homeobox A7 (HOXA7) in cervical cancer of patients. Methods: The clinical data of 92 patients with cervical cancer from June 2013 to January 2017 were collected in this study. The expression of miR-1287-5p and HOXA7 in cervical cancer tissue and in paracancerous tissue were detected by qRT-PCR. Pearson analysis was applied to analyze the correlation between the MiR-1287-5p level in cervical cancer tissues of the patients and their HOXA7 expression level. Kaplan-Meier survival curves were applied to analyze the correlation between the MiR-1287-5p and HOXA7 expression levels of the patients with cervical cancer and their prognosis. COX regression was applied to analyze the risk factors affecting the prognosis of the patients with cervical cancer. Results: The miR-1287-5p level (0.71±0.16) in cervical cancer tissue was significantly lower than that (1.03±0.05) in paracarcinoma tissue, and the HOXA7 mRNA level (1.51±0.24) was significantly higher than that (1.02±0.03) in paracarcinoma tissue (all P＜0.05). The miR-1287-5p level in cervical cancer tissue was negatively correlated with the HOXA7 level (r=-0.484, P＜0.05). The MiR-1287-5p and HOXA7 expression levels in cervical cancer tissue of the patients were associated with their human papillomavirus (HPV) infection, their lymph node metastasis, their differentiation status of cancer, and their FIGO staging (P＜0.05).  Kaplan-Meier analysis showed that the survival rate of the patients with high MiR-1287-5p expression level was significantly higher than that of the patients with low Mir-1287-5p expression level (logrank=12.471, P=0.000), and the survival rate of the patients with low HOXA7 expression level was significantly higher than that of the patients with high Mir-1287-5p expression level (logrank=5.180, P=0.023). Multivariate COX regression analysis showed that the positive HPV infection, the low tissue differentiation of cancer, the FIGO stage Ⅲ-Ⅳ of cancer, the low expression level of Mir-887-5p, and the high expression level of HOXA7 of the patients with cervical cancer were the independent risk factors of their poor prognosis (P＜0.05). Conclusion: The expression level of miR-1287-5p in cancer tissues of the patients decreases, and the expression level of HOXA7 in cancer tissues of the patients increases, and the abnormal expression levels of both which influence the prognosis of the patients with cervical cancer.

2023 Vol. 31　(2):　424- [Abstract]（ 422 ） HTML (0 KB)  PDF  (0 KB)  ( 23 )

To investigate the clinical values of the level of serum soluble vascular endothelial growth factor receptor-1 (sflt-1) and the values of the arterial blood flow parameters by ultrasound, such as resistance index (RI), pulsatility index (PI), and systolic to diastolic peak velocity ratio (S/D) for predicting the preeclampsia (PE) of pregnant women. Methods: 106 pregnant women with high-risk factors of PE were enrolled as the research objects. The peripheral venous blood of these women was collected from 16 to 20 gestational weeks for detecting the level of their serum sflt-1 by enzyme-linked immunosorbent assay (ELISA). The uterine artery blood flow parameters of these women during 20-24 gestational weeks were measured by Doppler ultrasound. 48 women with confirmed PE were included in study group, and 58 women with normal blood pressure were included in control group. The serum sflt-1 level and the values of arterial blood flow parameters by ultrasound of the women were compared between the two groups. Receiver operator characteristic (ROC) curve was drawn to analyze the value of the serum sflt-1 level and the values of arterial blood flow parameters of the women for predicting their PE. Results: The values of systolic blood pressure (SBP) and diastolic blood pressure (DBP), and the levels of blood albumin and blood nitrogen of the women at diagnosis in the study group were significantly higher than those of the women in the control group, and the placental mass and the birth weight of newborns in the study group were significantly lower than those of the women in the control group (P＜0.05). The serum sflt-1 level (27.15±3.78 mg/L), and the values of RI (0.92±0.18), PI (1.52±0.21), and S/D (4.16±1.11) of the women in the study group were significantly higher than those (5.49±1.14mg/L, 0.73±0.16, 1.01±0.18, and 3.63±0.79) of the women in the group (P＜0.05). ROC analysis showed that the value of the serum sflt-1 levels of the women for predicting their PE was similar to that of the values of RI and PI, and the value of S/D of the women for predicting their PE was the lowest. The value of the combined RI, PI, and S/D values of the women for predicting their PE was significantly higher than that of RI value, PI value, or S/D value alone, and the area under the curve (AUC) of which was 0.856. The predictive efficacy of the combination of the serum sflt-1 level and the values of RI, PI, and S/D of the women for their PE was the highest (AUC=0.920). Conclusion: The serum sflt1 level and the values of uterine artery blood flow parameters PI, RI and S/D by color ultrasound Doppler of the pregnant women with PE increase abnormally. The predictive efficacy of the combination of the serum sflt-1 level and the values of RI, PI, and S/D of the women for their PE is high, and which can be used as the reference indexes for clinical screening or predicting PE of the women.

2023 Vol. 31　(2):　434- [Abstract]（ 348 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To explore the diagnostic value of dual-energy CT parameters combined with color Doppler ultrasound for the cervical cancer pelvic lymph node metastasis of patients. Methods: The clinical data of 155 patients with cervical cancer who had been confirmed from June 2019 to June 2022 were selected and were divided into group A (108 cases without metastasis) and group B (47 cases with metastasis) according to the situation of pelvic lymph node metastasis. The dualenergy CT parameters and the color Doppler ultrasonography performance characteristics of the patients in the two groups were analyzed, and the diagnostic efficacy of the dual-energy CT parameters combined with color Doppler ultrasonography characteristics for the pelvic lymph node metastasis of cervical cancer of the patients was evaluated. Results: Among the 47 patients in group B, 41 (87.2%) patients were diagnosed with lymph node metastasis of cervical cancer by color ultrasound, which showed the irregular circular or abnormal fused shape, the internal uniform low echo, the abundant blood flow signals of dot and stripe, and the low RI value. Among the 108 patients in group A, 86 (79.6%) patients were not diagnosed with lymph node metastasis by color ultrasonography, which showed the no obvious space occupying lesions, the isoecho or slightly hypoecho of internal echo, no rich of the blood flow was, and the high RI value. In 155 cases of cervical cancer, the internal CT manifestations of lesions were the low echo, the uneven, the most edges with irregular, some of them with calcification foci, the round or oval lymph nodes, the blurred edges, the obvious enhancement, and the low density in center. The values of the quantitative parameters in arterial and venous phases by dual-energy CT, such as λHU, NIC, and IC of the patients in group B were significantly higher than those of the patients in group A (P＜0.05). The area under the curve (AUC) of the values of λHU, NIC, and IC in arterial phase for diagnosing the lymph node metastasis of cervical cancer of the patients were 0.831, 0.818, and 0.836, respectively, which were slightly higher than those (0.800, 0.772, and 0.721, respectively) in venous phase. The AUC, the sensitivity, and the specificity of the values of color ultrasound performance characteristics of the patients for diagnosing their lymph node metastasis were 0.834, 87.2%, and 79.6%, respectively. The AUC, the sensitivity, and the specificity of the values of λHU, NIC, and IC in arterial stage combined with the color ultrasound performance characteristics of the patients for diagnosing their lymph node metastasis of cervical cancer were 0.963, 93.6%, and 89.8%, respectively, and the diagnostic efficacy of the values of λHU, NIC, and IC in arterial stage combined with the color ultrasound performance characteristics of the patients for diagnosing their lymph node metastasis of cervical cancer was significantly higher than that of the λHU value, the NIC, or the IC value in arterial stage, or the color ultrasound performance characteristics alone (P＜0.05). Conclusion: The values of dual-energy CT parameters in arterial stage combined with color Doppler ultrasound performance characteristics of the patients have high diagnostic value for their cervical cancer pelvic lymph node metastasis.

2023 Vol. 31　(2):　443- [Abstract]（ 418 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To investigate the related factors of labor progress of primiparas, and to study their impact on the postpartum complications of these primiparas. Methods: The clinical data of 100 primiparas with natural delivery in hospital from May 2021 to May 2022 were collected retrospectively. These primiparas were divided into group A (primiparas with normal labor) and group B (primiparas with prolonged labor) according to the progress of labor during delivery. The clinical data during pregnancy and the delivery indicators of the primiparas were compared between the two groups. The possible factors affecting the progress of labor of the primiparas were analyzed. Results: Among the 100 primiparas, there were 27 (27.0%) cases in group B and 73 (73.0%) cases in group A. There were significant differences in the age, the newborn body weight, and the weight gain during pregnancy, and analgesia during labor of the primiparas between the two groups (P＜0.05). Logistic regression analysis showed that age of primipara ≥35 years old, the newborn body weight ≥4 kg, the excessive weight gain during pregnancy,  and no analgesia during labor of the primiparas were all the factors influencing the prolongation of labor of the primipara. After the adjustment of the confounding factors, such as age and newborn body weight, the excessive weight gain during pregnancy and no labor analgesia of the primipara were also associated with their prolongation of labor (all P＜0.05). The incidence of postpartum complications of the primiparas with excessive weight gain during pregnancy (44.4%) was significantly higher than that (19.1%) of the primiparas with normal weight gain during pregnancy, and that (22.7%) of the primiparas with insufficient weight gain during pregnancy. The incidence of postpartum complications (37.3%) of the primipara without analgesia during labor was significantly higher than that (17.1%) of the primiparas with analgesia (all P＜0.05). Conclusion: The excessive weight gain during pregnancy and no labor analgesia of the primiparas are related to their progress of labor, and which will affect the incidence of postpartum complications of the primiparas. Therefore, the pregnancy management and labor intervention can be conducted accordingly to the excessive weight gain during pregnancy and no labor analgesia of the primiparas for ensuring the progress of labor smoothly.

2023 Vol. 31　(2):　451- [Abstract]（ 1169 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To analyze the effects of weight gain during pregnancy and blood lipid level of pregnant women with singleton on their adverse pregnancy outcomes and neonatal body composition. Methods: A total of 206 pregnancy women with singleton who underwent prenatal examination and delivery in the hospital were selected by convenient sampling method from June 2021 to June 2022. These women were divided into group A (women with good pregnancy outcomes) and group B (women with adverse pregnancy outcomes) according to the pregnancy outcomes of these women. The general data, the weight gain during pregnancy, and the blood lipid levels of the women were compared between the two groups. The influencing factors of the adverse pregnancy outcomes of the women in the two groups were explored by Logistic regression analysis. The weight gain during pregnancy, the status of blood lipid and the adverse pregnancy outcomes, and the situation of the newborn body composition, such as percentage of body fat and fat weight, of the women in the two groups were analyzed. Spearman correlation was used to analyze the correlation between the weight gain and the blood lipid status during pregnancy of the women and their newborn body composition. Results: Among 206 pregnant women, there were 37 cases in group B and 169 cases in group A. There were significant differences in the age, the pre-pregnancy body mass index (BMI), the weight gain during pregnancy, and the blood lipid levels of the women between the two groups (P＜0.05). Logistic regression analysis showed that the maternal age, the pre-pregnancy BMI, the pregnancy weight gain, and the dyslipidemia of the women were all the factors influencing their adverse pregnancy outcomes. After adjusting the confounding factors, such as age and pre-pregnancy BMI of the women, the pregnancy weight gain and the dyslipidemia of the women were still the independently correlated with their adverse pregnancy outcomes (all P＜0.05). The percentages of the body fat and the fat weight of the newborn of the women with excessive weight gain during pregnancy were significantly higher than those of the women with appropriate weight gain or insufficient weight gain during pregnancy, and which of the women with abnormal lipid metabolism were significantly higher than those of the women with normal lipid metabolism (all P＜0.05). Spearman correlation analysis showed that the weight gain and dyslipidemia of the women during pregnancy were positively correlated with the body fat percentage and fat weight of their newborn (P＜0.05). Conclusion: The excessive weight gain and abnormal lipid metabolism during pregnancy of the women with singleton pregnancy are the risk factors of their adverse pregnancy outcomes, and which will adversely affect the neonatal body composition of the women. So, the management of weight and blood lipid during pregnancy should be strengthened for controlling the weight gain and the blood lipid level of the women during pregnancy.

2023 Vol. 31　(2):　460- [Abstract]（ 355 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

 To explore the best induction timing of pregnant women with suspected macrosomia by comparing the pregnancy outcomes of the women who undergone selective induction of labor during 39 gestational weeks and during 41 gestational weeks. Methods: A controlled prospective clinical trial was conducted to select 726 singleton pregnant women with suspected macrosomia and vertex presentation during 39 gestational weeks in this study from July 1st, 2018 to June 30th, 2021. These women were divided into two groups according to their personal wishes, which included 298 women with selective labor induction during 39 gestational weeks in observation group, and the other 428 women who still hadn’t delivered till 41 gestational weeks and had selective labor induction during 41 gestational weeks in control group. The outcomes of the mothers and infants were observed and compared between the two groups. Results: The rate of cesarean section (18.8%) of the women in the study group was significantly lower than that (45.6%) of the women in the control group. The body weight of newborns (4030±485g), the rate of macrosomia (75.5%)，the incidence of neonatal 5 min Apgar score <7 point (3.7%), and the neonatal umbilical artery blood PH <7.20 (3.0%) of the women in the observation group were significantly lower than those (4180±465g, 92.5%, 5.1%, and 14.4%) of the women in the control group (P<0.05). Conclusion: For the pregnant women with suspected macrosomia, the selective induction of labor during 39 gestational weeks can increase the rate of their successful vaginal delivery without increasing the incidence of the adverse maternal outcomes，and can reduce the adverse infants outcomes.

2023 Vol. 31　(2):　470- [Abstract]（ 543 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

Gestational diabetes mellitus (GDM) of the women is the abnormality of glucose tolerance that first occurrence or discovery during pregnancy, and has serious adverse effects on the mother, the fetus, and the baby, and which as the most common pregnancy complication has been become one of the current research hotspots. The oral glucose tolerance tests (OGTT) in China are mainly performed during 24-26 gestational weeks, but at this time, the time window left for clinical treatment is already very short, and the screening process is tedious, and time-consuming and labor-intensive, with poor compliance of these pregnant women. At present, the extensive researches have been achieved on the early predictors of GDM. This article focuses on the metabolic indicators for predicting GDM during the first trimester of pregnancy.

2023 Vol. 31　(2):　480- [Abstract]（ 349 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )