To systematically review the prevalence of fear of childbirth (FOC) among pregnant women in China, and to provide evidences for preventing and treating FOC of the women. Methods: The data bases of PubMed, Web of Science, Embase, Cochrane Library, CNKI, WanFang Data, VIP, and SinoMed were searched to collect the cross-sectional studies on the prevalence of FOC of the pregnant women in China from inception of these databases to March, 2023. Stata 17.0 software was used to perform the meta-analysis. Results：A total of 21 cross-sectional studies were included in this study, which involving 8815 pregnant women. The results of meta-analysis indicated that the total incidence of FOC of the pregnant women in China was 72.1% (95%CI 0.687-0.754). Subgroup analysis showed that the incidences of FOC investigated before and after 2020 were 73.6% (95%CI 0.690-0.783) and 70.7% (95% CI 0.658-0.755). The incidences of FOC of the women were 70.9% (95%CI 0.669-0.750) in south, and 74.9% (95%CI 0.686-0.812) in north. The incidences of FOC of the primipara and the multipara were 76.7% (95%CI 0.709-0.825) and 69.8% (95%CI 0.658-0.738). The incidences of the women with aged ≤29 years old and the women with aged >29 year old were 69.7% (95%CI 0.663-0.732) and 79.6% (95%CI 0.695-0.897). Conclusion: The incidence of FOC of the pregnant women in China is high, which should be paid more attention to screen early by medical staffs, and the related intervention should be conducted for these pregnant women.

2023 Vol. 31　(5):　1000- [Abstract]（ 478 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

 To analyze the trends on contraceptive use of married women of child-bearing age, and to explore the factors associated with implementation of long-acting contraceptive methods, in order to provide decision making basis for avoiding unwanted pregnancy and reducing induced abortion. Methods: Married women of childbearing age aged 15-49 years old who had taken contraceptive methods in the sampling survey database of National Health and Family Planning Commission in 2017 were analyzed. Chi square test and multiple Logistic regression analysis were used. Results: The proportion of long-acting irreversible contraceptive, long-acting reversible contraceptive, condom, other short acting contraceptive, and traditional contraceptive methods were 23.5%, 40.6%, 29.6%, 2.3%, and 4.0%, respectively. Since 2014, the proportion of condom use had been increasing year by year. The women of childbearing age were more likely to use long-acting contraception if they were older, were lower education level, had more children, were from ethnic minorities, had household registration, had an agricultural hukou, lived in rural areas, and worked in agriculture. Conclusion: The proportion of the married women of childbearing age using condoms shows a rapidly increasing trend. It is necessary to strengthen the construction of contraceptive counseling, publicity, and network team, and advocate high effective contraceptive methods for targeted populations, so as to avoid unwanted pregnancy.

2023 Vol. 31　(5):　1011- [Abstract]（ 364 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To analysis the status quo of unwanted pregnancy and the pregnancy outcomes of women of childbearing age in Hangzhou region. Methods: Hospitals in Hangzhou area were selected as the project site, and 6500 pregnant women who visited these project sites from January 2017 to December 2022 were randomly selected as the survey objects. The basic information and the related data of these pregnant women were collected by questionnaires and were statistically analyzed. Results: A total of 6454 valid questionnaires were collected, with an effective response rate of 99.3%, including 3680(57.0%) women in urban areas and 2774(43.0%) women in rural areas. 854(13.2%) women had unwanted pregnancy, of which, 73.8% women were ≥25 years old, 74.9% were education level of high school or below, and 70.0% of the women were married. Among the pregnant women with unwanted pregnancy, 331(38.8%) women were caused by contraceptive failure, and 523(61.2%) women were caused by failure to take contraceptive measures. The main reasons for contraceptive failure included no contraception during ovulation period and nonstandard use of condoms. The main reasons of failure to take contraceptive measures included believing not get pregnant during sex without contraceptive measures once in a while. There was no significant difference in the outcomes of unwanted pregnancy between the urban women and the rural women（P>0.05）. Conclusion: This survey finds that the unwanted pregnancies mainly occurred in the women over 25 years old, in the married women, in the women with relatively low education level. Strengthening the contraceptive knowledge publicity and education of the women of childbearing age and guiding them to contraceptive correctly can help prevent unwanted pregnancy.

2023 Vol. 31　(5):　1023- [Abstract]（ 459 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To improve the coverage rate of pregnancy health care services, ensure the safety of mother and infant, reduce the mortality rate during pregnancy, and improve the level of pregnancy health care services by implementing the comprehensive service model project of pregnancy health care. Methods: The comprehensive service model of pregnancy health care was piloted in Donggang district of Rizhao city. The situation before and after the implementation of the service model of pregnancy health care in 2017-2020 was compared, and the relevant data were analyzed. Results: After the implementation of the comprehensive health care service model during pregnancy, 7778 pregnant women had received the comprehensive health care services and had completed the pregnancy process. 7586 women had accepted prenatal examination. The number of pregnant women aged 30 to 34 had increased year by year, while the number of pregnant women aged 25 to 29 years old had decreased year by year. The proportion of the first child of the women had increased year by year, while the proportions of the second and the third child had decreased year by year(all P＜0.05). After the implementation of the project, the coverage rate of pregnancy health care had increased significantly, among which, the rate of prenatal examination(97.5%) of the women was significantly higher than that(93.4%, 93.1%) before the implementation of the project, the rate of ≥5 times of prenatal examination(94.3%) and the rate of early prenatal examination(95.6%) of the women also had increased significantly. The rate of hospital delivery of the women remained at 100%, the rate of cesarean section fluctuated at 35.1%. The rate of postpartum visits(93.3%) of the women after the implementation of the project had increased significantly, and the maternal mortality rate reached zero since the implementation of the project in 2019. Conclusion: This survey showed that the age of the pregnant women increased year by year, the proportion of the second or the third child decreased year by year, and the proportion of advanced women increased, so the pregnancy and perinatal management should be strengthened. Through the implementation of the comprehensive service model of pregnancy health care, the level of pregnancy health care services in the region, the various health service indicators, and maternal and infant safety have been significantly improved.

2023 Vol. 31　(5):　1032- [Abstract]（ 386 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To explore the influence factors of the preterm delivery and low birth weight of the newborn of women with assisted reproductive technology(ART). Methods: 150 pregnant women with ART who had delivered in hospital from October 2018 to February 2022 were selected in this study. The situation of preterm delivery and low birth weight of the newborn of these women were counted. The baseline data and the situations of ovarian stimulation and embryo transplantation of the pregnant women with different pregnancy outcomes were collected. The influencing factors of the premature birth and the low body weight of the newborn of the women were analyzed by logistic regression. Results: There were significant differences in the value of body mass index(BMI), the number of pregnancies, and the percentages of the pregnancy induced hypertension and the premature rupture of membranes between the women with and without preterm delivery. There were significant differences in the BMI value, the number of pregnancies, and the percentage of premature rupture of membranes of the women between their newborn with and without low birth weight(P＜0.05). Logistic multiple factor regression analysis showed that the BMI value, the number of pregnancies, the pregnancy induced hypertension, and the premature rupture of membranes of the women with ART were the influencing factors for their preterm delivery. The BMI value, the number of pregnancies, and the premature rupture of membranes of the women with ART were the influencing factors for their newborn low birth weight(P＜0.05). Conclusion: The occurrences of premature birth and low body weight of the newborn of the pregnant women with ART are affected by many factors, so the reasonable intervention measures should be formulated for these women according to the influencing factors to reduce the occurrence of the adverse outcomes of their newborn.

2023 Vol. 31　(5):　1042- [Abstract]（ 447 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To investigate the effect of continuous infusion of phenylephrine to prevent hypotension of women during cesarean section caused by combined spinalepidural anesthesia, and to analyze its dose-effect relationship. Methods: A total of 150 pregnant women with full-term who underwent elective cesarean section in hospital were selected as the research subjects between October 2018 and February 2021. These women were divided into 6 groups(25 cases in each group) by random number table method. All women had received intrathecal injection of 10mg specific gravity of bupivacaine and 5 μg of sufentanil for anesthesia. Then, the women in the group A, in group B, in group C, in group D, in group E, and in group F were given intravenous infusion of 2 μg, 4 μg, 6 μg, 8 μg, 10 μg, and 12 μg of phenylephrine diluted with normal saline to 5ml, respectively. The infusion of the women in the six groups was stopped at the delivery of baby. The heart rate, the blood pressure value, the maternal adverse reactions rate, and the results of fetal umbilical artery blood gas analysis of the women in the six groups were observed and recorded during anesthesia. The systolic blood pressure value of the women returning to the basic value and above was considered effective treatment of hypotension. Logistic regression analysis was performed to help draw the dose-effect relationship curve. The median effective dose(ED50) and 95% effective dose(ED95) were calculated. The first occurrence time of hypotension during the operation, the treatment of hypotension, and the postoperative complications situations of the women in the six groups were recorded. Results: There were no significant differences in the basal systolic blood pressure value, the time of first hypotension occurrence, the operation time, the urine volume after operation, and the time of hospital stay of the women among the six groups(P>0.05). There were no significant differences in the incidences of bradycardia, nausea and vomiting, and chills of the women among the six groups(P>0.05), but the effective rate of preventing hypotension of the women in group A, in group B, in group C, in group D, in group E, and in group F had increased gradually(P＜0.05). The analysis showed that the values of ED50(95%CI) and ED95(95%CI) of phenylephrine for preventing hypotension of the women caused by the combined epidural during anesthesia were 6.3 μg(5.0-7.5 μg) and 12.3 μg(10.1-13.7 μg), respectively. The value of HR, SBP, CI, SVI, or SVV of the women in the six groups when the placental separation was significantly higher than those before anesthesia, before delivery, or at the end of operation(P＜0.05), but which of the women had no significant differences among the six groups. There were no significant differences in the 1min Apgar score and 5min Apgar score of the newborns, and the values of buffuer excess(BE), lactic acid, and PH of the women among the six groups(P>0.05). Conclusion: The values of ED50(95%CI) and ED95(95%CI) of phenylephrine for preventing hypotension of the women caused by the combined epidural during anesthesia are 6.3 μg and 12.3 μg.

2023 Vol. 31　(5):　1052- [Abstract]（ 479 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To explore the clinical efficacy analysis of nifedipine combined with labetalol for treating pregnant women with hypertensive disorder complicating pregnancy(HDCP), and to analyze its mechanism. Methods: 119 pregnant women with HDCP were selected and were divided into observation group(60 cases) and control group(59 cases) by random number table from February 2019 to December 2021. The women in the control group were treated with labetalol for 1 week, and the women in the observation group were treated with nifedipine combined with labetalol for 1 week. The clinical efficacy, the blood pressure value, the values of uterine artery hemodynamics, such as resistance index(RI), pulsation index(PI), and ratio of maximum blood flow velocity(S/D) in systolic and diastolic period, and the adverse pregnancy outcomes of the women were compared between the two groups. Results: After treatment, the total effective rate(95.0%) of the women in the observation group was significantly higher than that(81.4%) of the women in the control group. The values of systolic blood pressure(126.7±12.3 mmHg), diastolic blood pressure(77.8±5.8 mmHg), RI(0.45±0.04), PI(0.63±0.07), and S/D(1.78±0.12) of the women in the observation group were significantly lower than those(133.1±13.2 mmHg, 82.2±4.7 mmHg, 0.57±0.05, 0.75±0.08, and 1.96±0.15) of the women in the control group. The incidences of cesarean section(33.3%) and preterm delivery(13.3%) of the women in the observation group were significantly lower than those(54.2% and 28.8%) of the women in the control group(all P＜0.05). Conclusion: Nifedipine combined with labetalol for treating the pregnant women with HDCP can effectively reduce their blood pressure and improve their pregnancy outcomes, the main mechanism of which is related to the further regulate the uterine artery hemodynamics of the women.

2023 Vol. 31　(5):　1063- [Abstract]（ 431 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To explore the effects of epidural anesthesia with different doses of dexmedetomidine during cesarean section of women on their hemodynamics and incidence rate of chills. Methods: 112 pregnant women who wanted cesarean section were selected and were randomly divided into group A(37 cases), group B(37 cases), and group C(38 cases) between January 2019 and June 2022. Dexmedetomidine of 0.2μg/kg, dexmedetomidine of 0.5μg/kg, and dexmedetomidine of 0.8μg/kg were given the women in group A, in group B, and in group C during cesarean section, respectively. The values of hemodynamics indexes, such as systolic blood pressure(SBP) and heart rate(HR), before anesthesia(T1), after 5 min of administration(T2), at skin incision(T3), and at the end of surgery(T4), the analgesic effect and recovery quality, such as complete block time and Steward recovery score, the degree of chills during peri-anesthesia period and occurrence of adverse reactions, and the values of postpartum levator hiatus and pelvic floor indexes, such as levator hiatus diameter(LHD) and levator urethral gap(LUG) of the women were compared among the three groups. Results: The change amplitude of the SBP and HR values, and the LHD and LUG levels of the women in group A were significantly higher than those of the women in group B and those of the women in group C, the incidence of chills during anesthesia(35.1%) of the women in group A was significantly higher than that(13.5%) of the women in group B and that(13.2%) of the women in group C. The Steward recovery score(3.61±1.02 points) of the women in group A was significantly lower than that(4.37±1.28 points) of the women in group B and that(4.51±1.37 points) of the women in group C, but which of the women in group B had no significantly different from those of the women in group C. The total occurrence of adverse reactions of the women in group A(8.1%) or in group B(10.8%) was significantly lower than that(34.2%) of the women in group C(all P＜0.05). Conclusion: Dexmedetomidine of 0.5μg/kg·h used in cesarean section under epidural anesthesia of the women can stabilize their intraoperative hemodynamics, and which has good analgesic effect, can reduce the risk of chills and adverse reactions, can ensure the maternal recovery quality, and can improve the postpartum levator hiatus and pelvic floor condition.

2023 Vol. 31　(5):　1072- [Abstract]（ 398 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To explore the effect of combined spinal and epidural anesthesia in different positions during cesarean section, and to study its impact on the newborns. Methods: 90 full term pregnant women who wanted elective cesarean section from July 2020 to July 2022 were randomly divided into group A(45 cases with sitting position of lumbar anesthesia epidural anesthesia puncture) and group B(45 cases with lying position of lumbar anesthesia epidural anesthesia puncture). The anesthesia effect, the hemodynamic indicators values, the adverse reactions rate, and the neonatal outcomes of the women were compared between the two groups. Results: The total amount of ephedrine(8.5±1.5mg) of the women in group A was significantly lower than that(10.3±1.8mg) of the women in group B, and the time of ephedrine reached to T5(9.4±2.7min) and the time of ephedrine reached to the final block plane(12.7±2.9min) of the women in group A were significantly shorter than those(13.8±2.7min and 16.5±3.1min) of the women in group B. The analgesic effect of the women in group A was significantly better than that of the women in group B, the hemodynamic indexes values after anesthesia of the women in group A were significantly better than those of the women in the group B. The overall incidence of postoperative nausea, vomiting, headache, hypotension and postpartum hemorrhage(15.6%) of the women in group A was significantly lower than that(35.6%) of the women in group B(P＜0.05), and there were no significant differences in the neonatal asphyxia and the neonatal 5min Apgar score after birth between the two groups(P>0.05). The neonatal umbilical arterial blood pH value(7.32±0.05) of the women in group A was significantly higher than that(7.27±0.09) of the women in group B(P＜0.05). Conclusion: The anesthesia effect and the hemodynamic indicators values of the sitting position for combined spinal and epidural anesthesia puncture during cesarean section are better than those of the lying position puncture, with less postoperative adverse reactions of the women and without significant influence on the newborns.

2023 Vol. 31　(5):　1082- [Abstract]（ 526 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )

To analyze the efficiency of biofeedback electrical stimulation combined with pelvic floor muscle rehabilitation by Kegel training for treating perimenopausal women with female sexual dysfunction(FSD), and to study its influence on the pelvic floor muscle strength of the women. Methods: 80 perimenopausal women with FSD were selected as the study subjects from May 2020 to May 2022. These women were divided into two groups(40 cases in each group) by the random number table method. The women in the control group were given pelvic floor muscle rehabilitation training by Kegel training combined with local application of estrogen in the vagina for 8 weeks continuously. The women in the study group were treated with biofeedback electrical stimulation on the basis of the treatment in the control group for 8 weeks continuously. The scores of Female Sexual Function Index(FSFI), Self-rating Anxiety Scale(SAS), Self-rating Depress Scale(SDS), and the pelvic floor muscle strength grade of the women in the two groups before and after treatment were evaluated, and which of the women were compared between the two groups. Results: The FSFI scores of the women in the two groups after treatment had increased significantly, and the SAS and SDS scores of the women in the two groups after treatment had decreased significantly(P＜0.05). The score of FSFI(31.18±2.31 points) of the women in the study group was significantly higher than that(23.34±5.08 points) of the women in the control group, and the pelvic floor muscle strength grade of the women in the study group was significantly higher than that of the women in the control group. The scores of SAS(44.06±3.35 points) and SDS(45.81±5.22 points) of the women in the study group were significantly lower than those(53.54±2.39 points and 57.10±3.61 points) of the women in the control group(all P＜0.05). Conclusion: The local application of estrogen combined with biofeedback electrical stimulation and Kegel training of pelvic floor muscle rehabilitation for treating the perimenopausal women with FSD can significantly improve their sexual function and psychological state, and can enhance their pelvic floor muscle strength.

2023 Vol. 31　(5):　1094- [Abstract]（ 540 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To explore the application effect of pelvic floor Glazer surface electromyography for evaluating the postpartum rehabilitation of pelvic floor muscle function. Methods: 120 parturients suffering from pelvic floor dysfunction in outpatient department were selected and divided into two groups(60 cases in each group) according to random number table method from January 2020 to January 2022. The parturients in the control group received routine pelvic floor muscle rehabilitation treatment for three months, while the parturients in the observation group received pelvic floor muscle rehabilitation treatment based on Glazer pelvic floor surface electromyography evaluation for three months. The treatment effect of the parturients were compared between the two groups. Results: The mean values of tolerance test(25.37±4.21μV), sustained contraction(27.96±2.57μV), and rapid contraction(38.67±3.65μV) of the parturients in the observation group after treatment were significantly higher than those(20.10±4.06μV, 19.64±2.54μV, and 29.76±4.01μV) before treatment(P＜0.05). The pelvic floor muscle strength score, sexual communication score, sexual response score, sexual attitude score, sexual body image score, sexual satisfaction score, bladder compliance, maximum urethral closure pressure, abdominal urine leakage point pressure of the parturients in both groups after treatment had increased significantly, and which of the parturients in the observation group were significantly higher than those of the parturients in the control group. The sexual anxiety score, the maximum urinary flow rate, and the scores by self-rating anxiety scale and Edinburgh postpartum depression scale of the parturients in both groups after treatment had improved significantly, and which(16.69±1.73 points, 21.43±1.47 ml/ min, 41.64±4.72 points, and 11.25±4.49 points) of the parturients in the observation group were significantly better than those(21.03±2.12 points, 19.18±1.52ml/ min, 48.73±5.18 points, and 16.10±4.73 points) of the parturients in the control group(all P＜0.05). Conclusion: The application value of pelvic floor surface electromyography evaluation in the postpartum rehabilitation of pelvic floor muscle function is better, which helps to improve the quality of sexual life, promote bladder function recovery, reduce the negative emotions, and enhance the treatment outcomes of the patients.

2023 Vol. 31　(5):　1105- [Abstract]（ 454 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To investigate the effects of psychological intervention during painless delivery under spinal anesthesia of women on the lactation, the emotional state, and the maternal and child outcomes of the women. Methods: A total of 114 pregnant women who wanted painless delivery under spinal anesthesia were selected and were divided two groups(57cases in each groups) according to the random number table method from September 2020 to September 2022. The women in control group were given routine nursing intervention, and the women in study group were given psychological nursing intervention except the routine nursing intervention. The labor duration, the situations of lactation and pain, the negative emotions before and after delivery, the delivery mode, the maternal and infant outcomes, and the clinical nursing satisfaction of the women were compared between the two groups. Results: The durations of the first stage, the second stage, and the third stage of labor, and the total labor duration of the women in the study group were significantly lower than those of the women in the control group, while the lactation yield lactation yield in the study group was significantly higher than that of the women in the control group. The score of visual analog scale(VAS) of the women in both groups after analgesia and at the end of analgesia had decreased significantly, and which of the women in the study group was significantly lower than that of the women in the control group. After delivery, the scores of self-rating of anxiety(SAS) and self-rating of depression(SDS) of the women in both groups had decreased significantly, and which of the women in the study group were significantly lower than those of the women in the control group. The natural delivery rate(89.5%) of the women in the study group was significantly higher than that(64.9%) of the women in the control group. The cesarean section rate of the women in the study group was significantly lower than that of the women in the control group. The total incidence of adverse maternal and infant outcomes(14.0%) of the women in the study group was significantly lower than that(31.6%) of the women in the control group, and the total clinical satisfaction rate(96.5%) of the women in the study group was significantly higher than that(82.5%) of the women in the control group(all P＜0.05). Conclusion: Psychological nursing during painless delivery under spinal anesthesia of women has positive impacts on shortening the duration of labor, relieving the pain and bad mood, improving the maternal and infant outcomes and clinical nursing satisfaction of these women.

2023 Vol. 31　(5):　1116- [Abstract]（ 473 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To evaluate the dietary nutritional status of advanced women with infertility during assisted reproduction by diet balance index-16(DBI-16). Methods: 914 advanced pregnant women(≥35 years old) who had accepted assisted reproductive technology were selected in this study from June 2021 to June 2022. The diet of these women in the past 1 month was investigated by a semi-quantitative diet frequency questionnaire, and the dietary nutritional status of the women was evaluated by DBI-16. Results: There were no significant differences in the DBI HBS score among the women with different age, body mass index(BMI), or education levels(P＞0.05). The DBI LBS and DBI dietary quality distance(DQD) values of the women with 35-36 years old, with BMI <25kg/m2, or with university education level were significantly lower(P＜0.05), which of the women with 35-36 years old, with 37-38, and with ≥39 years old had increased gradually, which of the women with BMI≥25 kg/m2 and with BMI＜25 kg/m2 had increased gradually, and which of the women with university education level or above, the women with senior high school  and junior college education levels, and the women with primary school and junior high school education levels had increased gradually(P＜0.05). There was no significant difference in the score of DBI-16 among the patients with different household registration or job types(P＞0.05). Among 914 women, 76.8% women consumed cereals nearly or reached the recommended daily level, and 23.2% women consumed cereals excessively. The daily fruit intake of 76.8% women approached or reached the recommended amount, and 23.2% women of which excessived. The daily intake of eggs and meat products of 66.3% women approached or reached the recommended amount, and 33.7% women of which excessive. The daily milk intake of 17.7% women of approached or reached the recommended levels, and 82.3% women of which were insufficient. The daily intake of fish and shrimp of 47.1% women approached or reached the recommended levels, and 53.0% women of which were insufficient. The daily intake of legumes of 58.9% women approached or reached the recommended levels, and 41.1% women of which were insufficient. The daily oil intake of 23.4% women approached or reached the recommended level, and 76.6% women of which exceeded the recommended level. The daily salt intake of 56.5% women approached or reached the recommended level, and 56.5% women of which were above the recommended level. The daily salt intake of 69.4% women approached or reached the recommended level, and 30.6% women of which were insufficient. 69.4% women consumed more than 8 kinds of food and 10.7% women consumed 5-7 kinds of food. The dietary quality of DBI HBS, DBI LBS and DBI DQD of 914 women was mostly divided into low level and almost no problem, followed by the medium level, and the high level. Conclusion: In the advanced women with infertility after assisted reproduction, the women with≥37 years old, the women with BMI ≥25 kg/m2, or the women with lower educational level have poor dietary nutritional status, which have a large space to improve their poor dietary nutritional status nutrition. There is a low level of imbalance in the overall dietary quality of the advanced women with infertility after assisted reproduction.

2023 Vol. 31　(5):　1126- [Abstract]（ 364 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To explore the curative effect of the focus excision(FER) combined with uterine artery blockade(UAB) and uterine artery embolization(UAE) for treating patients with type III cesarean scar pregnancy(CSP). Methods: A retrospective analysis was performed on 92 patients with type III CSP between January 2019 and January 2021. According to different surgical methods, these patients were divided into group A(39 cases with UAB combined with FER) and group B(53 cases with UAE combined with FER). The operation time, the intraoperative blood loss, the postoperative intrauterine drainage volume, the hospitalization time, the hospitalization cost, the stopping time of postoperative vaginal bleeding, the recovery time of temperature to normal, the difference value of β human chorionic gonadotropin(β-HCG), in the 1st day after surgery, and the menstruation recovery time of the patients were compared between the two groups. The occurrence of the postoperative complications of the patients in both groups was recorded. Results: The operative time(33.0±2.5 min), the blood loss(82.2±13.6 ml), the postoperative uterine drainage volume(19.9±3.1 ml), the time of hospital stay(6.0±1.6 d), and the hospitalization cost(10.9 ±4.7 thousand yuan) of the patients in A group were all significantly lower than those(39.8±2.8 min, 119.5±20.2 ml, 25.0±5.0 ml, 8.7±2.1 d, and 14.4±5.2 thousand yuan) of the patients in group B(P＜0.05). There were no significant differences in the stopping time of postoperative vaginal bleeding, the recovery time of temperature to normal, the difference value ofβ-HCG in the 1st day after surgery, and the menstruation recovery time of the patients between the two groups(P>0.05). There was no significant difference in the incidence of postoperative complications(18.0% vs.22.6%) of the patients between the two groups(P>0.05). Conclusion: Compared with those of UAE combined with FER for treating the patients with type III CSP, UAB combined with FER for treating the patients can reduce their intraoperative blood loss, their postoperative intrauterine drainage volume, their hospitalization stay time, and their hospitalization cost, with few complications and significant curative effect.

2023 Vol. 31　(5):　1135- [Abstract]（ 424 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To explore the expressions of βhuman chorionic gonadotropin(β-hCG) and inflammatory factor of patients with cesarean scar pregnancy(CSP) after hysteroscopy treatment, and to study their predictive values for the efficacy of hysteroscopy treatment. Methods: 107 patients with CSP treated in hospital from June 2020 to June 2021 were analyzed retrospectively. According to the surgical treatment methods, these patients were divided into control group and study group. Uterine artery embolization was performed in 51 patients in the control group and scar lesion resection under hysteroscopy was performed in 56 patients in the study group. The levels of β-HCG before and after surgery and interleukin 6(IL-6) and tumor necrosis factor α(TNFα) in the 1st month after surgery of the patients in the two groups were detected. The predictive values of the levels of β-hCG, IL-6, and TNF α of the patients for their efficacy of hysteroscopy treatment was analyzed by receiver operator characteristic(ROC) curve. Results: The serum β-hCG level of the patients in the two groups in 72h after surgery was significantly lower than before surgery, and which of the patients in the study group was significantly lower than that of the patients in the control group. The IL-6 and TNF-α levels of the patients in the two groups in 1 month after surgery were significantly lower than those of the patients before surgery, and which of the patients in the study group were significantly lower than those of the patients in the control group(all P＜0.05). The sensitivity of the levels of β-hCG, IL-6, and TNF-α for predicting the curative effect of hysteroscopy treatment were 91.1%, 73.2%, and 87.5%, respectively, and the specificity of the levels of β-hCG, IL-6, and TNF-α for predicting the curative effect of hysteroscopy treatment were 82.4%, 80.4%, and 45.1%, respectively, and the areas under the curve of the levels of β-hCG, IL-6, and TNF-α for predicting the curative effect of hysteroscopy treatment were 0.956, 0.833, and 0.816, respectively. Conclusion: The expression levels of β-hCG and inflammatory factors of the patients with CSP increase abnormally and are reduced by the hysteroscopic treatment, and which have higher values for predicting the efficacy of hysteroscopic treatment.

2023 Vol. 31　(5):　1143- [Abstract]（ 416 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To investigate the chorionicity of twins, the level of serum Krüppel like factor 8(KLF 8), and the neonatal outcomes of pregnant women with early onset preeclampsia. Methods: The clinical data of 112 women with early onset preeclampsia from January 2020 to January 2022 were enrolled in experimental group, and other healthy pregnant women were included in control group during the same period.  The rate of twin chorionicity and the serum KLF 8 level of the women were compared between two groups. The clinical characteristics of the women with different neonatal outcomes and the the risk factor associated with the early onset preeclampsia of the women were analyzed. Results: The incidence of the twins’chorionicity(12.5%) of the women in the experimental group was significantly higher than than that(1.8%) of the women in the control group. The level of serum KLF 8(15.63 ±2.14 pg/ml) of the women in the experimental group was significantly lower than that(36.63±2.04 pg/ml) of the women in the control group. The gestational weeks and the serum KLF 8 level of the women with poor neonatal outcomes in the experimental group were significantly lower than those of the women with normal neonatal outcomes(all P＜0.05). Logistic regression analysis showed that the twins’ chorionicity, the decrease of serum KLF 8 level, the less gestational weeks, the placental abruption, and the eclampsia history of the women were all the independent risk factors of their poor neonatal outcomes(P＜0.05). Conclusion: The twins’ chorionicity and the serum KLF 8 level of the pregnant women may be related to their early onset preeclampsia and neonatal outcomes.

2023 Vol. 31　(5):　1152- [Abstract]（ 430 ） HTML (0 KB)  PDF  (0 KB)  ( 20 )

To study the correlation between the ultrasound parameters values of the fetal middle cerebral artery (MCA) and the umbilical artery (UmA) of fetuses and the pregnant women uterine artery (UtA) and the risk assessment of the fetal intrauterine distress. Methods: The clinical data of 120 pregnant women from January 2020 to December 2020 were collected. These women were divided into observation group and control group (60 cases in each group) according to the occurrence of the fetal intrauterine distress. The values of UtA and fetal MCA and UmA, the outcomes of newborns, and the situation of fetal intrauterine distress were compared between the two groups. Results: The values of ultrasonic hemodynamic parameters, such as resistance index (RI) and pulsation index (PI), the value of maximum systolic blood velocity ratio to diastolic blood velocity (S/D) of UtAof the women in the observation group were significantly higher than those of the women in the control group (P<0.05).The values of PI and S/D of fetal MCA and UmA in the observation group were significantly different from those of the fetuses in the observation group (P<0.05), but the RI values of MCA and UmA of the fetuses had no significant differences between the two groups (P>0.05). The rate of neonatal Apgar score of 8-10 points (66.7%) and the neonatal body weight (2675.5±27.6g) in the observation group were significantly lower than those (90.0% and 3117.5±31.2g) in the control group, but the rates of cesarean section (70.0%) and the premature delivery (40.0%) of the women in the observation group were significantly higher than those (11.7% and 10.0%) of the women in the control group. The incidences of fetal distress, neonatal growth restriction, and neonatal asphyxia of the women in the observation group were significantly higher than those of the women in the control group (all P<0.05). Conclusion: The hemodynamics of fetal MCA and UmA, and UtA of the pregnant women with fetal distress during the third trimester of pregnancy are abnormal, which should be paid attention in clinic and the monitoring of which should be strengthened for providing guidance in clinical intervention.

2023 Vol. 31　(5):　1161- [Abstract]（ 321 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

To investigate the correlation between the vaginitis of patients and their infections of high risk human papillomavirus. Methods: The clinical data of 1747 patients who underwent cervical cancer screening by human papilloma virus (HPV) detection combined with TCT and vaginal secretion detections in the gynecological outpatient department from January 2021 to September 2022 were analyzed retrospectively. Among them, 423 patients with positive high risk HPV (HR HPV) were selected in observation group, and 1324 patients with negative HPV were selected in control group. The detection of vaginitis of the patients was compared between the two groups. The risk factors of HR HPV infection of the patients were analyzed. Results: The detected rate of bacterial vaginosis (BV) and vulvovaginal candidiasis (VVC) of the patients in the observation group were 23.2% and 7.1%, which were significantly higher than those (15.2% and 4.5%) of the patients in the control group (all P<0.05). There were no significant differences in the detection rates of trichomoniasis vaginitis (TV) (1.7% vs. 1.4%) and aerobe vaginitis (AV) (14.9% vs.16.2%) of the patients between the two groups (P>0.05). Logistic regression analysis showed that the infections of BV and VVC of the patients were the risk factors of their HR HPV infection. Conclusion: The occurrences of BV and VVC of the patients are correlated with their HR HPV infection, while the occurrences of TV and AV of the patients are not influencing their HR HPV infection.

2023 Vol. 31　(5):　1168- [Abstract]（ 334 ） HTML (0 KB)  PDF  (0 KB)  ( 21 )

To explore the correlation between the infections of mycoplasma and chlamydia in reproductive tract of women of childbearing age and their human papillomavirus (HPV) infection. Methods: 567 women of childbearing age who had been given genital tract mycoplasma culture and chlamydia antigen detection from March 2019 to October 2022 were collected. According to the results of the detections of the cervical discharge, these women were divided into group A (women with mycoplasma infection), group B (women with chlamydia infection), group C (women with mycoplasma and chlamydia mixed infection), and control group D (women without infection). The positive rate of HPV of the women was compared among the four groups. The influence of mycoplasma and chlamydia infections of the women on their HPV infection risk was analyzed by logistic regression with the age and other factors included as the covariables. Results: The chlamydia infection rate of the women of childbearing age was 3.4% (19/567), the mycoplasma infection rate was 7.8% (44/567), and the mixed infection rate of chlamydia and mycoplasma was 2.8% (16/567). The positive rate of HPV of childbearing age was 19.7% (112/567), and the highest rate was mainly in the women aged 25-35 years old. The higher positive rates of HPV subtypes infection of the women were all the high-risk HPV, such as HPV 52, HPV 16, and HPV 58. The positive rate of HPV of the women was different among the four groups, with the highest rate (87.5%) of the women in group C, and followed by that (65.9%) of the women in group A. Multiariable logistic regression analysis showed that the mixed infection of mycoplasma and chlamydia in genital tract of the women was the risk factor of their HPV infection (OR=1.732, 95% CI 1.253-1.905). Conclusion: The mixed infection of mycoplasma and chlamydia in genital tract of the women of childbearing age increases the risk of HPV infection，so both of mycoplasma and chlamydia of the women should be paid more attention to screening to prevent their HPV infection.

2023 Vol. 31　(5):　1176- [Abstract]（ 335 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To explore the detection and characteristics of fetal malformations diagnosed by ultrasound during different gestational weeks. Methods: The clinical data of 170 pregnant women with diagnosed fetal malformation during different gestational weeks from January 2020 to December 2022 were selected in this study. All these women were examined by ultrasound, and the pathological examination of the fetus after termination of pregnancy or the delivery outcomes were taken as the gold standard for the diagnosis of fetal malformation. Results: Among 170 women, there were 163 cases with fetal malformation detected by B-ultrasound during pregnancy, and there were 7 cases with missed fetal malformation by B-ultrasound, including 3 cases during the first trimester of pregnancy, 3 cases during the second trimester of pregnancy, and 1 case during the third trimester of pregnancy. Among 170 women, 66 women had chosen to give birth, and 104 women had accepted the termination of pregnancy. 66 newborns of the women who had chosen to give birth had survived in 1 month of follow-up after born. There were 163 women with fetal malformation detected, including neurological malformations, thoracic and abdominal wall malformations, cardiovascular malformations, facial and neck malformations, limbs, spine malformations, urinary system malformations, and other fetal malformations. 4 fetuses with multiple malformations were detected during the second trimester of pregnancy, 159 fetuses with single malformations were detected. Among 163 fetuses with malformations detected, there were 35 (21.5%) cases with cardiovascular malformations, 32 (19.6%) cases with thoracic and abdominal wall malformations, 30 (18.4%) cases with facial and neck malformations, 25 (15.3%) cases with urinary system malformations, and 22 (13.5%) cases with central nervous system malformations. 48 fetuses with malformations detected during the first trimester of pregnancy, there were 15 (31.3%) cases with central nervous system malformations, 11 (22.9%) cases with thoracic and abdominal wall malformations, and 10 (20.8%) cases with NT/NF thickening alone. 85 fetuses with malformations detected during the second trimester of pregnancy, there were 32 (37.7%) cases with cardiovascular malformations and 17 (20.0%) cases with facial and neck malformations. 30 fetuses with malformations detected during the third trimester of pregnancy, there were 12 (40.0%) cases with urinary system malformations, which was more than other malformations. The diagnostic sensitivity and accuracy of B-ultrasound for diagnosing the fetal malformation during the first trimester of pregnancy were 93.8% and 93.8%, which during the second trimester of pregnancy were 96.5% and 96.5%, and which during the third trimester of pregnancy were 96.7% and 96.7%. Conclusion: The fetal abnormalities during different gestational weeks all can be found by ultrasound.

2023 Vol. 31　(5):　1186- [Abstract]（ 358 ） HTML (0 KB)  PDF  (0 KB)  ( 17 )

 To study the correlation between the levels of serum D dimer (D D), nitric oxide (NO), nitric oxide synthase (NOS) of pregnant women with gestational diabetes mellitus (GDM) and the risk of their postpartum hemorrhage (PH). Methods: The clinical data of 212 pregnant women with GDM from January 2019 to August 2021 were selected in this study. According to the occurrence of PH, these women were divided into group A (54 women with PH) and group B (158 women without PH). The levels of D D, NO, and NOS, and other general data of the women were compared between the two groups. The levels of serum D D, NO, and NOS of the women with GDM for predicting their PH was analyzed by receiver operator characteristic (ROC) curve, and the risk factors of PH of the women with GDM were analyzed by Logistic analysis. Results: The levels of D D (1628.32 ±69.55 mu g/L), NO (110.54 ±30.18 u mol/L),and  NOS (26.78± 4.18 mm U/ml) of the women in group A were significantly higher than those (851.02±45.65μg/L, 2.15±10.60μmol/L, and 19.04± 4.03 U/ml) of the women in group B (all P<0.05). ROC curve analysis showed that the area under the curve of the levels of D D, NO, and NOS of the women with GDM for predicting their PH were 0.810, 0.820, 0.765, respectively, and the increase of the levels of D D, NO, and NOS of the women were their independent risk factors of PH. The D D level of the women with GDM was positively correlated with their NO and NOS levels, and the NO level of the women with GDM was positively correlated with their NOS level (P<0.05). Conclusion: The levels of serum D D, NO, and NOS of the women with GDM are related to their PH, and the abnormal increase of which have clinical values of the women with GDM for predicting their PH.

2023 Vol. 31　(5):　1196- [Abstract]（ 468 ） HTML (0 KB)  PDF  (0 KB)  ( 16 )

To investigate the efficacy of laparoscopic nervesparing radical hysterectomy (LNRSH) with preserving pelvic nerve and traditional laparoscopic pradical hysterectomy (LRH) without preserving pelvic nerve for treating patients with early cervical cancer nerve, and to study their effects on the postoperative bladder function, rectal function, and quality of sexual life of the these patients. Methods: The clinical data of 80 patients with early cervical cancer from January 2018 to December 2021 were collected retrospectively. These patients were divided into group A (36 patients with LNRSH) and group B (44 patients with LRH) according to different surgical methods. The clinical efficacy, surgical conditions, and postoperative recovery of the patients were compared between the two groups. Results: The operation time (247.6±46.6min) of the patients in group A was significantly longer than that (212.5±37.5min) of the patients in group B (P<0.05), the amount of intraoperative blood loss and the length of vaginal resection of the patients had no significant different between the two groups (P>0.05). The time of catheter used (11.3±2.2d), the exhaust time (2.4±0.3d), and the defecation time (3.7±0.4d) of the patients in group A were significantly shorter than those (13.6±2.6d, 2.8±0.5d, and 4.5±0.4 d) of the patients in group B. The rate of catheter removal (63.9%) of the patients in group A in the 10th day after surgery was significantly higher than that (40.9%) of the patients in group B. The incidences of urinary retention (2.8%), diarrhea (11.1%), and tenesmus (5.6%) of the patients in group A in the 10th day after surgery were significantly lower than those (16.7%, 29.6%, and 22.7%) of the patients in group B. The scores of the different dimensionality of FSFI of the patients in group A in the 6th month after surgery were significantly higher than those of the patients in group B. The total score of FSFI (24.8±6.5 points) of the patients in group A in the 6th month after surgery was significantly higher than that (22.5±4.2 points) of the patients in group B. The incidence of sexual dysfunction (41.7%) of the patients in group A in the 6th month after surgery was significantly lower than that (75.0%) of the patients in group B (all P<0.05). Conclusion: The effect of LNRSH for treating the patients with early cervical cancer is similar to that of LRH, and which has less influence on the postoperative bladder function, the rectal function, and the quality of sexual life of the patients.

2023 Vol. 31　(5):　1205- [Abstract]（ 542 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

To explore the application effect of s the education in the school for pregnant women combined with health education based on teaching back in pregnant women with gestational diabetes mellitus (GDM). Methods: 83 pregnant women with GDM were grouped by random numbers. 41 women in the control group were given routine perinatal health education, and 42 women in the observation group were given education in the school for pregnant women combined with health education based on teaching back. The self-management ability, the blood glucose level, and the pregnancy outcomes of the women with GDM before and after intervention were compared between the two groups. Results: The self-management score (96.2±7.6 points) of the women in the observation group after intervention was significantly higher than that (62.5±6.0 points) of the women in the control group (P<0.05). The levels of fasting plasma glucose (4.82±0.36mmol/L) and 2h postprandial blood glucose (5.82±0.29 mmol/L) of the women in the observation group after intervention were significantly lower than those (5.94±0.39 mmol/L and 6.88±0.37mmol/L) of the women in the control group (all P<0.05). The rates of cesarean section (4.7%), the gestational hypertension (2.4%), and the neonatal hypoglycemia (0) of the women in the observation group were significantly lower than those (19.5%, 17.1%, and 12.2%) of the women in the control group (all P<0.05). Conclusion: The education in the school for pregnant women combined with health education based on teaching back for the women with GDM can improve their self-management ability and improve their blood glucose control level and pregnancy outcomes effectively.

2023 Vol. 31　(5):　1215- [Abstract]（ 317 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

 To explore the predictive value of the levels of serum Fibulin 3 and angiopoietin 2(Ang 2) of pregnant women during the first trimester of pregnancy for their hypertensive disorders of pregnancy(HDP). Methods: A total of 118 pregnant women with HDP were selected in observation group from April 2020 to April 2022, and according to the severity of HDP, these women were divided 54 women with gestational hypertension in group A, 43 women with mild eclampsia in group B, and 21 women with severe eclampsia in group C. The adverse pregnancy outcomes of the women in the observation group were recorded. In addition, 120 healthy pregnant women with singleton pregnancy who accepted antenatal examination were selected in control group during the same period. Enzyme linked immunosorbent assay was used to detect the serum Fibulin 3 and Ang 2 levels of these women during the first trimester of pregnancy. Receiver operating characteristic curve(ROC) was used to evaluate the diagnostic value of the levels of serum Fibulin 3 and Ang 2 of the women for their HDP. Pearson Correlation analysis was conducted to explore the correlation between the levels of serum Fibulin 3 and Ang 2 of the women and their adverse pregnancy outcomes. Results: The levels of serum Fibulin 3(54.26±9.75 ng/ml) and Ang 2(12.52±3.56 ng/ml) of the women in the observation group were significantly lower than those(80.95±10.33 ng/ml and 18.22±3.98 ng/ml) of the women in the control group, and which of the women in group A, in group B, and in group C had decreased gradually(all P<0.05). ROC curve analysis showed that the area under the curve(AUC) of the serum Fibulin 3 level and the Ang 2 level of the women for predicting their HDP were 0.859 and 0.873, the cutoff values of which were 67.87ng/ml and 30.68ng/ml, the specificity of which were 63.1% and 69.6%, and the sensitivity of which were 92.4% and 92.4%. The AUC, the specificity, and the sensitivity of the combined levels of Fibulin 3 and Ang 2 of the women for predicting their HDP were 0.906, 87.2%, and 89.5%, respectively. In the observation group, the levels of serum Fibulin 3 and Ang 2 of the women with adverse pregnancy outcomes were significantly lower than those of the women with normal pregnancy outcomes. The levels of serum Fibulin 3 and Ang 2 of the women were negatively correlated with their fetal growth restriction, fetal distress, fetal distress, and neonatal death(all P<0.05). Conclusion: The serum Fibulin 3 and Ang 2 levels of the pregnant women with HDP decrease, which are related to the severity of HDP and the adverse pregnancy outcomes of the women. The combined serum Fibulin 3 and Ang 2 levels of the women for predicting their HDP has higher value.

2023 Vol. 31　(5):　1223- [Abstract]（ 384 ） HTML (0 KB)  PDF  (0 KB)  ( 22 )

Cervical cancer is a disease with a high incidence rate among gynecological tumors. Cervical intraepithelial neoplasia(CIN) is an early pathological stage of cervical cancer. Human papillomavirus(HPV) is closely related to the occurrence and development of CIN. Understanding the molecular characteristics, epidemiological characteristics, pathogenic mechanism of HPV, and the correlation between HPV and CIN is of great significance for the diagnosis, prevention, treatment, and prognosis of CIN. In recent years, the academic community has carried out more in-depth research on the correlation between HPV and CIN from the molecular level to the gene level, and which has been reviewed in this paper.

2023 Vol. 31　(5):　1232- [Abstract]（ 412 ） HTML (0 KB)  PDF  (0 KB)  ( 18 )

Platelet rich plasma (PRP) is a high concentration of platelet plasma, which is used in many clinical disciplines. This paper aims to summarize and evaluate the role of PRP in the field of reproductive medicine, including the thin endometrium, the repeated implantation failure (RIF), the chronic endometritis, and the poor ovarian function, etc. It is expected to provide evidences for the clinical treatment of PRP in the field of reproduction and for the future scientific research.

2023 Vol. 31　(5):　1242- [Abstract]（ 485 ） HTML (0 KB)  PDF  (0 KB)  ( 19 )