Objective:To evaluate the effect of bilateral hypogastric artery ligation(BHGAL)on women's pregnancy outcomes and fertility rates in cases with severe postpartum hemorrhage.Methods:Patients hospitalized in a terti...Objective:To evaluate the effect of bilateral hypogastric artery ligation(BHGAL)on women's pregnancy outcomes and fertility rates in cases with severe postpartum hemorrhage.Methods:Patients hospitalized in a tertiary care center between 2007 and 2018 were included in the study.The records of cases were obtained from the hospital database,retrospectively.Maternal demographic data,morbidities or complications associated with BHGAL surgery,any additional haemostatic interventional or surgical procedures,preoperative admission and lowest postoperative haematocrit-hemoglobin values,blood products given,type of anaesthesia,intensive care unit(ICU)and length of hospital stay were recorded.In cases without surgical sterilization,future fertility and subsequent pregnancy outcomes were assessed for at least two years after operation.Information was obtained through face-to-face or telephone interviews with patients whose long-term fertility and subsequent pregnancy outcomes were assessed.Results:Sixty-eight patients with BHGAL surgery history were included in the study.26 Of 37 cases(70%)that did not undergo surgical sterilization had a desire for pregnancy after the surgery.Six of these cases(23%)were diagnosed with secondary infertility.The fertility rate of these cases was 77%,and subsequent pregnancy was detected in 20 women.A total of 25 pregnancies,including first and second pregnancies,developed,and 15 of these pregnancies resulted in term delivery,six preterm births,one stillbirth,and three abortions.Conclusions:The postoperative pregnancy rate was found to be higher than the rate of women with infertility problems,and this surgery does not seem to adversely affect pregnancy outcomes.This is a tertiary center experience and cohort studies with large patient series are needed.展开更多
Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Majority of the recipients of these treatments are women within the reproductive age group, who...Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Majority of the recipients of these treatments are women within the reproductive age group, who according to literature may be at risk of adverse pregnancy outcomes. This pilot study is part of a study investigating adverse pregnancy outcomes among women who received Cryotherapy, Thermal ablation and Loop Electrosurgical Excision Procedure compared to the untreated women in Zambia. Materials and Methods: This descriptive study analyzed records of 886 (n = 443 treated and n = 443 untreated) women aged 15 - 49 years. The women were either screened with Visual Inspection with Acetic Acid or treated for Cervical Intraepithelial neoplasia at the Adult Infectious Disease Centre between January 2010 and December 2020. Women meeting the criteria were identified using the Visual Inspection with Acetic Acid screening records and telephone interviews to obtain the adverse pregnancy outcome experienced. Data were analysed using STATA version 16 to determine the prevalence and obtain frequency distribution of outcomes of interest. Univariate and multivariable binary logistic regression estimated odds of adverse pregnancy outcomes across the three treatments. Results: The respondents were aged 15 to 49 years. Adverse pregnancy outcomes were observed to be more prevalent in the treatment group (18.5%) compared to the untreated group (5.4%). Normal pregnancy outcomes were lower in the treated (46.3%;n = 443) than the untreated (53.7%;n = 443). The treated group accounted for the majority of abortions (85.2%), prolonged labour (85.7%) and low birth weight (80%), whereas, the untreated accounted for the majority of still births (72.7%). Women treated with cryotherapy (aOR = 2.43, 95% CI = 1.32 - 4.49, p = 0.004), thermal ablation (aOR = 6.37, 95% CI = 0.99 - 41.2, p = 0.052) and Loop Electrosurgical Excision Procedure (aOR = 9.67, 95% CI = 2.17 - 43.1, p = 0.003) had two-, six- and ten-times higher odds of adverse pregnancy outcomes respectively, relative to women who required no treatment. Conclusion: Adverse pregnancy outcomes are prevalent among women who have received treatment in Zambia. The findings indicate that treating Cervical Intraepithelial Neoplasia has been linked to higher chances of experiencing abortion, delivering low birth weight babies and enduring prolonged labor that may result in a caesarean section delivery. Cervical neoplasia treatments, particularly Loop Electrosurgical Excision Procedure, are associated with significantly increased odds of adverse pregnancy outcomes. It is essential to include information about prior Cervical Intraepithelial neoplasia treatment outcomes in obstetric care.展开更多
Objective:To systematically evaluate the relationship between herpes simplex virus type II(HSV-2)infection in pregnant women and the adverse pregnancy outcomes(preterm delivery,spontaneous abortion,stillbirth,monstrum...Objective:To systematically evaluate the relationship between herpes simplex virus type II(HSV-2)infection in pregnant women and the adverse pregnancy outcomes(preterm delivery,spontaneous abortion,stillbirth,monstrum,low birth weight,intrauterine growth retardation,premature rupture of membranes),so as to provide clinical guidance for the prevention and treatment of adverse pregnancy outcomes caused by HSV-2 infection in pregnant women.Methods:2140 articles were collected from PubMed,China National Knowledge Infrastructure(CNKI),and other databases for the past 20 years.According to the inclusion criteria,the literatures about the relationship between HSV-2 infection of pregnant women and adverse pregnancy outcomes were screened.The effect model was determined by heterogeneity test results,and the meta-analysis was carried out by RevMan 5.3 software.Results:The results of meta-analysis showed that the positive rate of HSV-2 was higher in the adverse pregnancy group than in the control group(odds ratio[OR]:7.92,95%confidence interval[Cl]:3.91-16.01),and the difference was statistically significant.Conclusion:HSV-2 infection will increase the risk of adverse pregnancy outcomes.Prevention and effective control of HSV-2 infection in early pregnancy can reduce the rate of adverse pregnancy outcome,which is of great significance to the promotion of eugenics.展开更多
BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a liver disorder that occurs in pregnant women and can lead to a range of adverse pregnancy outcomes.The condition is typically marked by pruritus(itching)and el...BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a liver disorder that occurs in pregnant women and can lead to a range of adverse pregnancy outcomes.The condition is typically marked by pruritus(itching)and elevated levels of liver enzymes and bile acids.The standard treatment for ICP has generally been ursodeoxycholic acid and ademetionine 1,4-butanedisulfonate,but the efficacy of this approach remains less than optimal.Recently,polyene phosphatidylcholine has emerged as a promising new therapeutic agent for ICP due to its potential hepatoprotective effects.AIM To evaluate the effect of polyene phosphatidylcholine/ursodeoxycholic acid/ademetionine 1,4-butanedisulfonate on bile acid levels,liver enzyme indices,and pregnancy outcomes in patients with ICP.METHODS From June 2020 to June 2021,600 patients with ICP who were diagnosed and treated at our hospital were recruited and assigned at a ratio of 1:1 via randomnumber table method to receive either ursodeoxycholic acid/ademetionine 1,4-butanedisulfonate(control group,n=300)or polyene phosphatidylcholine/ursodeoxycholic acid/ademetionine 1,4-butanedisulfonate(combined group,n=300).Outcome measures included bile acids levels,liver enzyme indices,and pregnancy outcomes.RESULTS Prior to treatment,no significant differences were observed between the two groups(P>0.05).Post-treatment,patients in both groups had significantly lower pruritus scores,but the triple-drug combination group had lower scores than the dual-drug combination group(P<0.05).The bile acid levels decreased significantly in both groups,but the decrease was more significant in the triple-drug group(P<0.05).The triple-drug group also exhibited a greater reduction in the levels of certain liver enzymes and a lower incidence of adverse pregnancy outcomes compared to the dual-drug group(P<0.05).CONCLUSION Polyene phosphatidylcholine/ursodeoxycholic acid/ademetionine 1,4-butanedisulfonate effectively relieves pruritus and reduces bile acid levels and liver enzyme indices in patients with ICP,providing a positive impact on pregnancy outcome and a high safety profile.Further clinical trials are required prior to clinical application.展开更多
BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal m...BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal management from prenatal to postpartum,in-hospital to out-of-hospital,and offline to online,thereby improving maternal and infant outcomes.Applying the Internet+continuous midwifery service management model to manage women with highrisk pregnancies(HRP)can improve their psycho-emotional opinion and,in turn,minimize the risk of adverse maternal and/or fetal outcomes.AIM To explore the effectiveness of a midwife-led Internet+continuous midwifery service model for women with HRP.METHODS We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital(affiliated to the Shanghai Jiao Tong University School of Medicine)from April to December 2022.Among them,239 pregnant women underwent routine obstetric management,and 200 pregnant women underwent Internet+continuous midwifery service mode management.We used the State-Trait Anxiety Inventory,Edinburgh Postnatal Depression Scale,and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.RESULTS The data showed that in early pregnancy,the anxiety and depression levels of the two groups were similar;the levels gradually decreased as pregnancy progressed,and the decrease in the continuous group was more significant[31.00(29.00,34.00)vs 34.00(32.00,37.00),8.00(6.00,9.00)vs 12.00(10.00,13.00),P<0.05].The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group,and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group[267.50(242.25,284.75)vs 256.00(233.00,278.00),74.00(69.00,78.00)vs 71.00(63.00,78.00),P<0.05].The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group,and nursing satisfaction was higher[10.50%vs 18.83%,8.50%vs 15.90%,24.00%vs 42.68%,89.50%vs 76.15%,P<0.05].CONCLUSION The Internet+continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.展开更多
Objective: To investigate the relationship between hepatitis B virus(HBV) positivity and pregnancy outcomes. Also, the association between HBV-related risk factors and HBV status was studied.Methods: A total of 100 HB...Objective: To investigate the relationship between hepatitis B virus(HBV) positivity and pregnancy outcomes. Also, the association between HBV-related risk factors and HBV status was studied.Methods: A total of 100 HBV positive pregnant women were recruited and the pregnancy outcomes were compared with 301 HBV negative women. Blood samples were collected and tested for HBV by HBs Ag ELISA. Data were collected for recruited subjects using interview questionnaire.Results: Data analysis showed that 51/100(51%) of the HBV-positive subjects gave a history of HBV in the family which was significantly higher than that of HBV-negative patients [41/301(13.6%) P = 0.001]. A significant association was found between positive history of surgery and HBs Ag positivity(P = 0.009). Then, pregnancy outcomes were stratified according to the HBV positivity. No significant association was found between HBV status and pregnancy outcomes(P > 0.05 for all).Conclusions: Positive family history of HBV and previous surgical procedures are associated with higher rate of HBV positivity. No association is found between HBV positivity and pregnancy outcomes.展开更多
<strong>Background:</strong> Adverse pregnancy outcomes continue to contribute substantially to maternal mortality as well as poor maternal and fetal health outcomes whose burden can be reduced by the init...<strong>Background:</strong> Adverse pregnancy outcomes continue to contribute substantially to maternal mortality as well as poor maternal and fetal health outcomes whose burden can be reduced by the initiation of preventive behaviors like the uptake of maternal health services. This continuous unacceptably high maternal mortality justifies a need for progressive research to better understand the predictors of the preventive behaviors of women towards adverse pregnancy outcomes. This study was conducted to assess levels of knowledge, attitudes about adverse pregnancy outcomes and preventive practices among women of reproductive age in Nassarawa local government area, Kano State, Nigeria. <strong>Methodology:</strong> The study was a cross-sectional descriptive study that employed a four-sectioned pretested researcher administered questionnaire to collect data on knowledge, attitude and practice of adverse pregnancy outcomes prevention among 164 consenting respondents in Kano State, Nigeria between November 2020 and December 2020. Responses were transformed and computed using SPSS version 26 to generate descriptive statistics. Regression analysis was done to test the degree of association between the predictors and practice of adverse pregnancy outcomes prevention with the level of significance set at a cut-off of p ≤ 0.05. <strong>Results:</strong> The findings showed that the majority of the respondents were between 20 - 24 years of age and had secondary educational attainment. Results further revealed that knowledge and attitude about adverse pregnancy outcomes which were both measured on 18-point scales, reported for the respondents’ mean scores of 9.46 (9.07 ± 9.85) and 10.72 (9.79 ± 10.62) respectively. The practice of adverse pregnancy outcomes prevention when assessed on a 15-point scale shows that respondents scored a mean of 7.42 ± 8.30 which denotes 53.4% of the level of prevention practice anticipated from the respondents. The study also showed a significant positive association between the level of knowledge (p = 0.010), attitude (p < 0.001) and prevention practice of adverse pregnancy outcomes.<strong> Conclusions:</strong> The findings reported an average but inadequate knowledge and neutral attitude that predicted unsatisfactory adverse pregnancy outcomes prevention practices among the examined reproductive-aged women, which calls for targeted health education on adverse pregnancy outcomes within the community in order to inform better prevention practices.展开更多
The Registered Nurses Association of Ontario Healthy Work Environments Best Practice Guideline recommends that employers promote safe, healthy workplaces. Healthy workplaces include addressing the unique needs of nurs...The Registered Nurses Association of Ontario Healthy Work Environments Best Practice Guideline recommends that employers promote safe, healthy workplaces. Healthy workplaces include addressing the unique needs of nurses who work while pregnant. The purpose of this descriptive study, summarizing information from 120 pregnancies reported by 95 nurses, was to determine if the workload of obstetrical nurses was associated with negative pregnancy outcomes, including preterm delivery and birth weight. Full-time obstetrical nursing work is a predictor of reduced birth weight, but not of preterm birth when compared to outcomes of obstetrical nurses working part time. One third of nurses reported pregnancy complications and most nurses experienced work-related and personal stress. Further research evaluating work modifications during pregnancy is indicated to improve birth outcomes.展开更多
Objective:The relationship between serum beta human chorionic gonadotropin(β-hCG)levels of patients(7 days after the transplantation of frozen-thawed embryos)and the pregnancy outcomes was investigated.Methods:This s...Objective:The relationship between serum beta human chorionic gonadotropin(β-hCG)levels of patients(7 days after the transplantation of frozen-thawed embryos)and the pregnancy outcomes was investigated.Methods:This study was designed as a retrospective clinical trial of 366 women who underwent frozen-thawed embryo transfers(FETs)in artificial cycles.Patients were divided into three groups:clinical pregnancy group,biochemical pregnancy group,and non-pregnant group according to their pregnancy outcomes.Serumβ-hCG levels were tested on day 4,7,9,11 and 14 after FET.Results:In the clinical pregnancy group,the serumβ-hCG levels after 7-day post-transplantation were significantly elevated(16.20 IU/L vs.3.07 vs.0.1 IU/L;P<0.05)compared with the other two groups.Furthermore,it was found that Area Under Curve(AUC=0.96)was significant with cut-off value higher than 4.26 IU/L(sensitivity=92.3%,specificity=90.2%)to predict the clinical pregnancy outcomes in the receiver operating characteristic(ROC)analysis ofβ-hCG concentrations on day 7 of post-transplantation.Conclusion:Our results suggested that the elevated serumβ-hCG levels on day 7 of post-transplantation could predict the positive clinical pregnancy outcomes in artificial FET cycles.展开更多
Objective:To evaluate cervical function and pregnancy outcomes after hysteroscopic resection of the complete uterine septum,duplicate cervix and vaginal septum with Metzenbaum scissors.Methods:Between January 2010 and...Objective:To evaluate cervical function and pregnancy outcomes after hysteroscopic resection of the complete uterine septum,duplicate cervix and vaginal septum with Metzenbaum scissors.Methods:Between January 2010 and December 2016,13 patients admitted to the Department of Obstetrics and Gynecology of Sir Run Run Shaw Hospital with complete uterine septum,duplicate cervix and vaginal septum,were enrolled into this study.The cervical and corporal septum was cut by Metzenbaum scissors,and residual septum was cut by micro scissors under hysteroscopy.The vaginal septum was cut with the unipolar electric knife.Results:The operation time was about 10±1.31 min.All the 13 patients present normal uterine cavities without scar formation under hysteroscopy at 3 months after operation,there was mild adhesions between anterior and posterior intrauterine wall on 2 cases.After operation,there were 13 pregnancies naturally conceived in 11 patients,10 deliveries.The live birth rate was 76.92%,the early miscarriage rate was 23.08%.The cesarean section ratewas 30%,the vaginal delivery ratewas 70%,and all were term births.Conclusion:The operation was simple,convenient,and fast,without any complications and cervical insufficiency.It was easy to have vaginal deliveries.展开更多
Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreat...Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.Method We conducted a retrospective cohort study of 14,254 infertile patients who had received IVFET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth,clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.Results The untreated PTB group had significantly lower clinical pregnancy(31.7% vs. 38.1%) and live birth(23.8% vs. 30.6%) rates than the non-PTB group(both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio(OR), 0.80;95% confidence interval(CI), 0.66–0.98;P = 0.028] in all patients and for increased miscarriage(OR, 4.19;95% CI,1.69–10.39;P = 0.002) and decreased live birth(OR, 0.45;95% CI, 0.24–0.83;P = 0.011) rates in patients with unexplained infertility.Conclusions Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.展开更多
<strong>Introduction:</strong> Hypertension is a major cause of maternal and perinatal morbidity and mortality. This study aims at exploring the outcomes of pregnancy and associated factors in hypertensive...<strong>Introduction:</strong> Hypertension is a major cause of maternal and perinatal morbidity and mortality. This study aims at exploring the outcomes of pregnancy and associated factors in hypertensive pregnant women in Comè district hospital from 2014 to 2016. <strong>Methods:</strong> This is a retrospective, analytical study carried out in June 2016, involving a total of 345 hypertensive patients. Socio-demographic and medical features, including pregnancy and foetal outcomes parameters, were recorded in the case files. Top-down stepwise logistic regression was performed at the 5% threshold. <strong>Results:</strong> The frequency of hypertensive disorders during pregnancy was estimated at 7.32% and unfavourable outcomes at 35.65%. The adverse maternal outcomes recorded were postpartum death and haemorrhage whereas adverse foetal issues were prematurity, low birth weight, low Apgar scores, stillbirth and death. Factors statistically associated with pregnancy outcome were paucigravida (OR = 2.01 ([1.05 - 3.88]), p = 0.035), history of stillbirth (OR = 4.75 ([1.01 - 22.1]), p = 0.048) and anticonvulsant therapy (OR = 0.32 ([0.19 - 0.54]), p < 0.001). <strong>Conclusion:</strong> Adequate monitoring via Antenatal Care (ANC) check-ups, timely recourse to care and an effective communication strategy should reduce hypertensive disorders incidence and adverse outcomes in pregnant women.展开更多
Objective:To establish the Chinese population's amniotic fluid deepest vertical pocket(DVP)reference curves for dichorionic twin pregnancies and to investigate DVP links with adverse perinatal outcomes.Methods:Thi...Objective:To establish the Chinese population's amniotic fluid deepest vertical pocket(DVP)reference curves for dichorionic twin pregnancies and to investigate DVP links with adverse perinatal outcomes.Methods:This retrospective cohort study,conducted at Peking University Third Hospital from August 2011 to December 2020,used data from 375 women aged 20 to 45 years who had dichorionic twin pregnancies that were confirmed through first-trimester ultrasound.After exclusions,reference curves were developed using 318 women with 3,299 DVP scans,and the data analyzed included maternal demographics,pregnancy outcomes,ultrasound measurements,and neonatal information.DVPs were assessed via ultrasound at regular intervals and grouped by gestational age(GA)for analyses.Linear mixed models were used to create amniotic fluid reference curves.Associations between abnormalities and adverse perinatal outcomes were examined using Chi-squared or Fisher's exact tests.Logistic regression provided both crude and adjusted odds ratios,adjusting for pre-pregnancy weight,age,ethnicity,parity,and conception mode.Significance was set at P<0.05 with 95%confidence intervals(CI),and the analyses were conducted using SPSS ver.26.0(IBM Corp.,Armonk,NY)and SAS ver.9.4(SAS Institute Inc.,Cary,NC,USA)software.Results:DVP increased from the first trimester to a maximum at 26 weeks(95%confidence interval(CI),2.7–8.3 cm for twin 1 and 2.8–7.9 cm for twin 2)and then decreased gradually toward term.Differences between twins 1 and 2 were significant after 26 weeks(95%CI for twin 1:5.3,5.5;95%CI for twin 2:4.4,4.5;P<0.010).Polyhydramnios of twin 1 increased the risk of large for GA.Oligohydramnios of twin 1 increased the risk of small for GA.Polyhydramnios of twin 2 increased the risk of small for GA,premature birth,and neonatal complications.Oligohydramnios of twin 2 increased the risk of preeclampsia,hypertensive disorder complicating pregnancy,and premature rupture of membranes.Conclusion:Reference curves for twin amniotic fluid volumes vary by GA and differ between twins,with potential implications for pregnancy outcomes.展开更多
Objective: In Cameroon, more than 80% of women suffering from cervical intraepithelial neoplasia (CIN) are within the reproductive age. This study intended to analyze the pregnancy outcomes following cervical treatmen...Objective: In Cameroon, more than 80% of women suffering from cervical intraepithelial neoplasia (CIN) are within the reproductive age. This study intended to analyze the pregnancy outcomes following cervical treatment in Cameroon. Methods: This was a cohort study with two years retrospective data collection involving 82 women who underwent cervical treatment for CIN in two Cameroonian hospitals from January 2015 to December 2017. Data were collected from CIN treatment to end of pregnancy where applicable. Data analysis was done using Epi Info software version 3.5.4. Results: We collected data from 82 patients aged 27 to 48 years, with a mean age of 36.5 (SD: 5.3) years. During the study period, 33 out of 82 participants became pregnant 40.2 [29.56 - 51.66]%. The factor associated with pregnancy occurrence after treatment was age less than 35 years (Odds ratio = 4.37 [1.7 - 11.2]. From the 33 pregnancies recorded, 17 (51.5%) ended in a delivery, amongst which 15 (88.2%) were vaginal. Conclusion: Pregnancy frequency over two years following cervical treatment for CIN was relatively good, and younger women (age 35 years) were significantly more like to have conceived compared to their older counterparts. Post-treatment delivery outcomes seem to be similar to those in the general population.展开更多
Objective:To investigate the effects of maternal body mass index(BMI)and gestational weight gain on maternal and neonatal outcomes in twin pregnancies.Methods:Five hundred cases of twin pregnancies were divided into a...Objective:To investigate the effects of maternal body mass index(BMI)and gestational weight gain on maternal and neonatal outcomes in twin pregnancies.Methods:Five hundred cases of twin pregnancies were divided into a low body weight group(68 cases),a normal weight group(355 cases),an overweight group(65 cases),and an obesity group(12 cases)according to the World Health Organization(WHO)Body Mass Index(BMI)classification guidelines Results:Comparison of weight gain during different pregnancies revealed that pregnant women were mainly of low weight and average weight.The higher the BMI before pregnancy,the higher the incidence of excessive weight gain during pregnancy.The incidences of gestational diabetes mellitus(GDM)and premature rupture of membranes in women with low weight gain were significantly higher than those in women with average weight gain and high weight gain(P<0.05).The incidences of gestational hypertension,preeclampsia,and anemia in women with high weight gain were significantly higher than those in women with low weight gain and average weight gain(P<0.05).The incidence of neonatal birth weight,fetal distress,and macrosomia in the high weight gain group was significantly higher than those in the low weight gain and average weight gain groups(P<0.05).The birth weight of newborns in low-weight gain mothers was significantly lower than that of normal-weight gain mothers(P<0.05).Conclusion:Poor maternal and infant outcomes were common in women with insufficient or excessive weight gain during pregnancy.Therefore,for women with twin pregnancies,weight management is crucial to ensure maternal and infant health.展开更多
Aim To assess whether adverse pregnancy outcomes in women with adenomyosis are different according to the method of conception and the concurrent of uterine leiomyoma(UL).Methods We performed a retrospective study.Fif...Aim To assess whether adverse pregnancy outcomes in women with adenomyosis are different according to the method of conception and the concurrent of uterine leiomyoma(UL).Methods We performed a retrospective study.Fifty-three singleton pregnancy cases complicated with adenomyosis were included in this study.In the study group,15 women became pregnant with assisted reproductive technology(ART)and 21 women combined with UL.Pregnancy outcomes were compared between ART and non-ART,UL and non-UL groups.Results The prevalence for such complications as hypertensive disorder complicating pregnancy(HDCP)and postpartum hemorrhage(PPH)were significantly higher in the women conceived by ART(33.3%vs.5.3%,P=0.023)and(53.3%vs.23.7%,P=0.037),respectively.And women concurrent with UL of which the diameter≥4cm were more likely to have severe PPH(44.4%vs.0%,P=0.021).Conclusion ART may increase the risk of adverse pregnancy outcomes such as HDCP and PPH in women with adenomyosis and UL of which the diameter≥4cm may further increase the risk of severe PPH.展开更多
BACKGROUND Gestational anemia is a serious public health problem that affects pregnant women worldwide.Pregnancy conditions and outcomes might be associated with the presence of gestational anemia.This study investiga...BACKGROUND Gestational anemia is a serious public health problem that affects pregnant women worldwide.Pregnancy conditions and outcomes might be associated with the presence of gestational anemia.This study investigated the association of pregnancy characteristics with anemia,exploring the potential etiology of the disease.AIM To assess the association of pregnancy parameters with gestational anemia.METHODS A nested case-control study was conducted based on the Chinese Pregnant Women Cohort Study-Peking Union Medical College Project(CPWCS-PUMC).A total of 3172 women were included.Patient characteristics and gestational anemia occurrence were extracted,and univariable and multivariable logistic regression models were used to analyze the association of pregnancy parameters with gestational anemia.RESULTS Among the 3172 women,14.0% were anemic,46.4% were 25-30 years of age,21.9%resided in eastern,15.7%in middle,12.4%in western 18.0% in southern and 32.0%in northern regions of China.Most women(65.0%)had a normal prepregnancy body mass index.Multivariable analysis found that the occurrence of gestational anemia was lower in the middle and western regions than that in the eastern region[odds ratio(OR)=0.406,95%confidence interval(CI):0.309-0.533,P<0.001],higher in the northern than in the southern region(OR=7.169,95% CI:5.139-10.003,P<0.001),lower in full-term than in premature births(OR=0.491,95% CI:0.316-0.763,P=0.002),and higher in cases with premature membrane rupture(OR=1.404,95% CI:1.051-1.876,P=0.02).CONCLUSION Gestational anemia continues to be a health problem in China,and geographical factors may contribute to the situation.Premature birth and premature membrane rupture may be associated with gestational anemia.Therefore,we should vigorously promote local policy reformation to adapt to the demographic characteristics of at-risk pregnant women,which would potentially reduce the occurrence of gestational anemia.展开更多
Background: The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association b...Background: The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes.Methods: This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models.Results: Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively (P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively (P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes.Conclusions: We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.展开更多
Background:It is currently unknown whether patients with a fever after controlled ovulation during egg retrieval could increase the risk of pelvic infection or not,and fever itself may affect endometrial receptivity o...Background:It is currently unknown whether patients with a fever after controlled ovulation during egg retrieval could increase the risk of pelvic infection or not,and fever itself may affect endometrial receptivity or embryo quality with poor pregnancy outcomes.The aim of this study was to analyze the outcomes of patients with fever during oocyte retrieval after the first frozen-thawed embryo transfer(FET)cycle.Methods:This was a 1:3 retrospective paired study matched for age.In this study,58 infertility patients(Group 1)had a fever during the control ovulation,and the time of the oocyte retrieval was within 72 hours,they underwent ovum pick up and whole embryo freezing("freeze-all"strategy).The control subjects(Group 2)are 174 patients matched for age who underwent whole embryo freezing for other reasons.The baseline characteristics,clinical data of ovarian stimulation,and outcomes,such as the clinical pregnancy rate,ongoing clinical pregnancy rate were compared between the two groups in the subsequent FET cycle.Results:All patients had no pelvic inflammatory disease after oocyte retrieval.Anti-Mullerian hormone(AMH)levels(4.2 vs.2.2,P<0.001)were higher in group 2,and the number of oocytes retrieved,and fertilization rate were lower in group 1(P<0.001),but the endometrial thickness,the number of embryo transfers,and the type of luteal support supplementation were similar between the two groups.Regarding pregnancy outcomes in the subsequent FET cycle,the implantation rate,clinical pregnancy rate,early spontaneous rate,ectopic pregnancy rate,and ongoing pregnancy rate were all not significantly different.Further regression analyses showed that the clinical pregnancy rate and ongoing pregnancy rate were also not significantly different.Conclusions:Transvaginal ultrasound-guided follicular puncture for oocyte retrieval is a safe and minimally invasive method for patients with fever.Moreover,the fever had almost no effect on embryo quality.展开更多
Objective:To investigate the effects of endometrial stimulation timings and techniques on pregnancy outcomes in patients without prior embryo transfer(ET).Methods:We included a total of 10 studies related to the impac...Objective:To investigate the effects of endometrial stimulation timings and techniques on pregnancy outcomes in patients without prior embryo transfer(ET).Methods:We included a total of 10 studies related to the impact of endometrial stimulation on the pregnancy outcome of infertile patients with the first ET from 2010 to 2019.These studies were found by searching databases including China Science and Technology Journal Database(VIP),Chinese Biological Med(CBM),Chinese Medical Current Content(CMCC),China National Knowledge Internet(CNKI),WanFang Med Online,Cochrane Library,Web of Science,PubMed,Medline,ScienceDirect,and EMBASE.A total of 1,983 cycles were included,of which 725 were cycles with endometrial stimulation.Clinical outcomes included clinical pregnancy,implantation,abortion,multiple pregnancy,and live birth rate.Results:The implantation rate(IR)was higher in the fresh cycle endometrial stimulation group than in the control group(relative risk[RR]=1.21,95%confidence interval[CI]=1.03-1.42;P=0.02),but there were no significant between-group differences in the live birth rate(LBR)and abortion rate(AR).Subgroup analysis showed that whether follicular or luteal endometrial stimulation was performed before the ET cycle had no effect on the clinical pregnancy outcome,and endometrial stimulation on the day of oocyte retrieval reduced the clinical pregnancy rate(CPR)(RR=0.37,95%CI=0.19-0.75;P=0.005).Whether the technique involved the use of a curette or catheter,there was no significant between-group difference in CPR.Conclusions:Fresh cycle endometrial stimulation can improve the embryo IR in patients without prior ET,but it cannot increase CPR,LBR,or AR.Subgroup analysis showed that different endometrial stimulation timings and techniques did not significantly improve CPR and that endometrial stimulation on the day of oocyte retrieval reduced CPR.展开更多
文摘Objective:To evaluate the effect of bilateral hypogastric artery ligation(BHGAL)on women's pregnancy outcomes and fertility rates in cases with severe postpartum hemorrhage.Methods:Patients hospitalized in a tertiary care center between 2007 and 2018 were included in the study.The records of cases were obtained from the hospital database,retrospectively.Maternal demographic data,morbidities or complications associated with BHGAL surgery,any additional haemostatic interventional or surgical procedures,preoperative admission and lowest postoperative haematocrit-hemoglobin values,blood products given,type of anaesthesia,intensive care unit(ICU)and length of hospital stay were recorded.In cases without surgical sterilization,future fertility and subsequent pregnancy outcomes were assessed for at least two years after operation.Information was obtained through face-to-face or telephone interviews with patients whose long-term fertility and subsequent pregnancy outcomes were assessed.Results:Sixty-eight patients with BHGAL surgery history were included in the study.26 Of 37 cases(70%)that did not undergo surgical sterilization had a desire for pregnancy after the surgery.Six of these cases(23%)were diagnosed with secondary infertility.The fertility rate of these cases was 77%,and subsequent pregnancy was detected in 20 women.A total of 25 pregnancies,including first and second pregnancies,developed,and 15 of these pregnancies resulted in term delivery,six preterm births,one stillbirth,and three abortions.Conclusions:The postoperative pregnancy rate was found to be higher than the rate of women with infertility problems,and this surgery does not seem to adversely affect pregnancy outcomes.This is a tertiary center experience and cohort studies with large patient series are needed.
文摘Background: Cervical Intraepithelial neoplasia treatments have become essential interventions to manage cervical lesions. Majority of the recipients of these treatments are women within the reproductive age group, who according to literature may be at risk of adverse pregnancy outcomes. This pilot study is part of a study investigating adverse pregnancy outcomes among women who received Cryotherapy, Thermal ablation and Loop Electrosurgical Excision Procedure compared to the untreated women in Zambia. Materials and Methods: This descriptive study analyzed records of 886 (n = 443 treated and n = 443 untreated) women aged 15 - 49 years. The women were either screened with Visual Inspection with Acetic Acid or treated for Cervical Intraepithelial neoplasia at the Adult Infectious Disease Centre between January 2010 and December 2020. Women meeting the criteria were identified using the Visual Inspection with Acetic Acid screening records and telephone interviews to obtain the adverse pregnancy outcome experienced. Data were analysed using STATA version 16 to determine the prevalence and obtain frequency distribution of outcomes of interest. Univariate and multivariable binary logistic regression estimated odds of adverse pregnancy outcomes across the three treatments. Results: The respondents were aged 15 to 49 years. Adverse pregnancy outcomes were observed to be more prevalent in the treatment group (18.5%) compared to the untreated group (5.4%). Normal pregnancy outcomes were lower in the treated (46.3%;n = 443) than the untreated (53.7%;n = 443). The treated group accounted for the majority of abortions (85.2%), prolonged labour (85.7%) and low birth weight (80%), whereas, the untreated accounted for the majority of still births (72.7%). Women treated with cryotherapy (aOR = 2.43, 95% CI = 1.32 - 4.49, p = 0.004), thermal ablation (aOR = 6.37, 95% CI = 0.99 - 41.2, p = 0.052) and Loop Electrosurgical Excision Procedure (aOR = 9.67, 95% CI = 2.17 - 43.1, p = 0.003) had two-, six- and ten-times higher odds of adverse pregnancy outcomes respectively, relative to women who required no treatment. Conclusion: Adverse pregnancy outcomes are prevalent among women who have received treatment in Zambia. The findings indicate that treating Cervical Intraepithelial Neoplasia has been linked to higher chances of experiencing abortion, delivering low birth weight babies and enduring prolonged labor that may result in a caesarean section delivery. Cervical neoplasia treatments, particularly Loop Electrosurgical Excision Procedure, are associated with significantly increased odds of adverse pregnancy outcomes. It is essential to include information about prior Cervical Intraepithelial neoplasia treatment outcomes in obstetric care.
基金supported in part by grants from Science and Technology Innovation Team Project of Xi'an Medical University,China(2021TD14)Industrialization Project of Shaanxi Provincial Department of Education,China(20JC031)the First Affiliated Hospital of Xi'an Medical University,China(XYFYPT-2021-02).
文摘Objective:To systematically evaluate the relationship between herpes simplex virus type II(HSV-2)infection in pregnant women and the adverse pregnancy outcomes(preterm delivery,spontaneous abortion,stillbirth,monstrum,low birth weight,intrauterine growth retardation,premature rupture of membranes),so as to provide clinical guidance for the prevention and treatment of adverse pregnancy outcomes caused by HSV-2 infection in pregnant women.Methods:2140 articles were collected from PubMed,China National Knowledge Infrastructure(CNKI),and other databases for the past 20 years.According to the inclusion criteria,the literatures about the relationship between HSV-2 infection of pregnant women and adverse pregnancy outcomes were screened.The effect model was determined by heterogeneity test results,and the meta-analysis was carried out by RevMan 5.3 software.Results:The results of meta-analysis showed that the positive rate of HSV-2 was higher in the adverse pregnancy group than in the control group(odds ratio[OR]:7.92,95%confidence interval[Cl]:3.91-16.01),and the difference was statistically significant.Conclusion:HSV-2 infection will increase the risk of adverse pregnancy outcomes.Prevention and effective control of HSV-2 infection in early pregnancy can reduce the rate of adverse pregnancy outcome,which is of great significance to the promotion of eugenics.
文摘BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a liver disorder that occurs in pregnant women and can lead to a range of adverse pregnancy outcomes.The condition is typically marked by pruritus(itching)and elevated levels of liver enzymes and bile acids.The standard treatment for ICP has generally been ursodeoxycholic acid and ademetionine 1,4-butanedisulfonate,but the efficacy of this approach remains less than optimal.Recently,polyene phosphatidylcholine has emerged as a promising new therapeutic agent for ICP due to its potential hepatoprotective effects.AIM To evaluate the effect of polyene phosphatidylcholine/ursodeoxycholic acid/ademetionine 1,4-butanedisulfonate on bile acid levels,liver enzyme indices,and pregnancy outcomes in patients with ICP.METHODS From June 2020 to June 2021,600 patients with ICP who were diagnosed and treated at our hospital were recruited and assigned at a ratio of 1:1 via randomnumber table method to receive either ursodeoxycholic acid/ademetionine 1,4-butanedisulfonate(control group,n=300)or polyene phosphatidylcholine/ursodeoxycholic acid/ademetionine 1,4-butanedisulfonate(combined group,n=300).Outcome measures included bile acids levels,liver enzyme indices,and pregnancy outcomes.RESULTS Prior to treatment,no significant differences were observed between the two groups(P>0.05).Post-treatment,patients in both groups had significantly lower pruritus scores,but the triple-drug combination group had lower scores than the dual-drug combination group(P<0.05).The bile acid levels decreased significantly in both groups,but the decrease was more significant in the triple-drug group(P<0.05).The triple-drug group also exhibited a greater reduction in the levels of certain liver enzymes and a lower incidence of adverse pregnancy outcomes compared to the dual-drug group(P<0.05).CONCLUSION Polyene phosphatidylcholine/ursodeoxycholic acid/ademetionine 1,4-butanedisulfonate effectively relieves pruritus and reduces bile acid levels and liver enzyme indices in patients with ICP,providing a positive impact on pregnancy outcome and a high safety profile.Further clinical trials are required prior to clinical application.
文摘BACKGROUND There are many drawbacks to the traditional midwifery service management model,which can no longer meet the needs of the new era.The Internet+continuous midwifery service management model extends maternal management from prenatal to postpartum,in-hospital to out-of-hospital,and offline to online,thereby improving maternal and infant outcomes.Applying the Internet+continuous midwifery service management model to manage women with highrisk pregnancies(HRP)can improve their psycho-emotional opinion and,in turn,minimize the risk of adverse maternal and/or fetal outcomes.AIM To explore the effectiveness of a midwife-led Internet+continuous midwifery service model for women with HRP.METHODS We retrospectively analyzed the clinical data of 439 women with HRP who underwent prenatal examination and delivered at Shanghai Sixth People's Hospital(affiliated to the Shanghai Jiao Tong University School of Medicine)from April to December 2022.Among them,239 pregnant women underwent routine obstetric management,and 200 pregnant women underwent Internet+continuous midwifery service mode management.We used the State-Trait Anxiety Inventory,Edinburgh Postnatal Depression Scale,and analysis of delivery outcomes to compare psychological mood and the incidence of adverse delivery outcomes between the two groups.RESULTS The data showed that in early pregnancy,the anxiety and depression levels of the two groups were similar;the levels gradually decreased as pregnancy progressed,and the decrease in the continuous group was more significant[31.00(29.00,34.00)vs 34.00(32.00,37.00),8.00(6.00,9.00)vs 12.00(10.00,13.00),P<0.05].The maternal self-efficacy level and strategy for weight gain management were better in the continuous group than in the traditional group,and the effective rate of midwifery service intervention in the continuous group was significantly higher than in the control group[267.50(242.25,284.75)vs 256.00(233.00,278.00),74.00(69.00,78.00)vs 71.00(63.00,78.00),P<0.05].The incidence of adverse delivery outcomes in pregnant women and newborns and fear of maternal childbirth were lower in the continuous group than in the traditional group,and nursing satisfaction was higher[10.50%vs 18.83%,8.50%vs 15.90%,24.00%vs 42.68%,89.50%vs 76.15%,P<0.05].CONCLUSION The Internet+continuous midwifery service model promotes innovation through integration and is of great significance for improving and promoting maternal and child health in HRP.
文摘Objective: To investigate the relationship between hepatitis B virus(HBV) positivity and pregnancy outcomes. Also, the association between HBV-related risk factors and HBV status was studied.Methods: A total of 100 HBV positive pregnant women were recruited and the pregnancy outcomes were compared with 301 HBV negative women. Blood samples were collected and tested for HBV by HBs Ag ELISA. Data were collected for recruited subjects using interview questionnaire.Results: Data analysis showed that 51/100(51%) of the HBV-positive subjects gave a history of HBV in the family which was significantly higher than that of HBV-negative patients [41/301(13.6%) P = 0.001]. A significant association was found between positive history of surgery and HBs Ag positivity(P = 0.009). Then, pregnancy outcomes were stratified according to the HBV positivity. No significant association was found between HBV status and pregnancy outcomes(P > 0.05 for all).Conclusions: Positive family history of HBV and previous surgical procedures are associated with higher rate of HBV positivity. No association is found between HBV positivity and pregnancy outcomes.
文摘<strong>Background:</strong> Adverse pregnancy outcomes continue to contribute substantially to maternal mortality as well as poor maternal and fetal health outcomes whose burden can be reduced by the initiation of preventive behaviors like the uptake of maternal health services. This continuous unacceptably high maternal mortality justifies a need for progressive research to better understand the predictors of the preventive behaviors of women towards adverse pregnancy outcomes. This study was conducted to assess levels of knowledge, attitudes about adverse pregnancy outcomes and preventive practices among women of reproductive age in Nassarawa local government area, Kano State, Nigeria. <strong>Methodology:</strong> The study was a cross-sectional descriptive study that employed a four-sectioned pretested researcher administered questionnaire to collect data on knowledge, attitude and practice of adverse pregnancy outcomes prevention among 164 consenting respondents in Kano State, Nigeria between November 2020 and December 2020. Responses were transformed and computed using SPSS version 26 to generate descriptive statistics. Regression analysis was done to test the degree of association between the predictors and practice of adverse pregnancy outcomes prevention with the level of significance set at a cut-off of p ≤ 0.05. <strong>Results:</strong> The findings showed that the majority of the respondents were between 20 - 24 years of age and had secondary educational attainment. Results further revealed that knowledge and attitude about adverse pregnancy outcomes which were both measured on 18-point scales, reported for the respondents’ mean scores of 9.46 (9.07 ± 9.85) and 10.72 (9.79 ± 10.62) respectively. The practice of adverse pregnancy outcomes prevention when assessed on a 15-point scale shows that respondents scored a mean of 7.42 ± 8.30 which denotes 53.4% of the level of prevention practice anticipated from the respondents. The study also showed a significant positive association between the level of knowledge (p = 0.010), attitude (p < 0.001) and prevention practice of adverse pregnancy outcomes.<strong> Conclusions:</strong> The findings reported an average but inadequate knowledge and neutral attitude that predicted unsatisfactory adverse pregnancy outcomes prevention practices among the examined reproductive-aged women, which calls for targeted health education on adverse pregnancy outcomes within the community in order to inform better prevention practices.
文摘The Registered Nurses Association of Ontario Healthy Work Environments Best Practice Guideline recommends that employers promote safe, healthy workplaces. Healthy workplaces include addressing the unique needs of nurses who work while pregnant. The purpose of this descriptive study, summarizing information from 120 pregnancies reported by 95 nurses, was to determine if the workload of obstetrical nurses was associated with negative pregnancy outcomes, including preterm delivery and birth weight. Full-time obstetrical nursing work is a predictor of reduced birth weight, but not of preterm birth when compared to outcomes of obstetrical nurses working part time. One third of nurses reported pregnancy complications and most nurses experienced work-related and personal stress. Further research evaluating work modifications during pregnancy is indicated to improve birth outcomes.
文摘Objective:The relationship between serum beta human chorionic gonadotropin(β-hCG)levels of patients(7 days after the transplantation of frozen-thawed embryos)and the pregnancy outcomes was investigated.Methods:This study was designed as a retrospective clinical trial of 366 women who underwent frozen-thawed embryo transfers(FETs)in artificial cycles.Patients were divided into three groups:clinical pregnancy group,biochemical pregnancy group,and non-pregnant group according to their pregnancy outcomes.Serumβ-hCG levels were tested on day 4,7,9,11 and 14 after FET.Results:In the clinical pregnancy group,the serumβ-hCG levels after 7-day post-transplantation were significantly elevated(16.20 IU/L vs.3.07 vs.0.1 IU/L;P<0.05)compared with the other two groups.Furthermore,it was found that Area Under Curve(AUC=0.96)was significant with cut-off value higher than 4.26 IU/L(sensitivity=92.3%,specificity=90.2%)to predict the clinical pregnancy outcomes in the receiver operating characteristic(ROC)analysis ofβ-hCG concentrations on day 7 of post-transplantation.Conclusion:Our results suggested that the elevated serumβ-hCG levels on day 7 of post-transplantation could predict the positive clinical pregnancy outcomes in artificial FET cycles.
基金supported by the Department of Education of Zhejiang Province,China(Y201534677).
文摘Objective:To evaluate cervical function and pregnancy outcomes after hysteroscopic resection of the complete uterine septum,duplicate cervix and vaginal septum with Metzenbaum scissors.Methods:Between January 2010 and December 2016,13 patients admitted to the Department of Obstetrics and Gynecology of Sir Run Run Shaw Hospital with complete uterine septum,duplicate cervix and vaginal septum,were enrolled into this study.The cervical and corporal septum was cut by Metzenbaum scissors,and residual septum was cut by micro scissors under hysteroscopy.The vaginal septum was cut with the unipolar electric knife.Results:The operation time was about 10±1.31 min.All the 13 patients present normal uterine cavities without scar formation under hysteroscopy at 3 months after operation,there was mild adhesions between anterior and posterior intrauterine wall on 2 cases.After operation,there were 13 pregnancies naturally conceived in 11 patients,10 deliveries.The live birth rate was 76.92%,the early miscarriage rate was 23.08%.The cesarean section ratewas 30%,the vaginal delivery ratewas 70%,and all were term births.Conclusion:The operation was simple,convenient,and fast,without any complications and cervical insufficiency.It was easy to have vaginal deliveries.
基金supported by the National Natural Science Foundation No. 81400041 and No. 81871212the National Natural Science Foundation of China Youth Fund Project No. 81400038cohort study project of the Peking University Third Hospital Y70545-04。
文摘Objective Prior pulmonary tuberculosis(PTB) on chest X-ray(CXR) was commonly found in infertile patients receiving examinations before in vitro fertilization and embryo transfer(IVF-ET). It was unclear whether untreated PTB would affect pregnancy outcomes after IVF-ET.Method We conducted a retrospective cohort study of 14,254 infertile patients who had received IVFET at Peking University Third Hospital in 2017. Prior PTB was defined as the presence of signs suggestive of old or inactive PTB on CXR, with or without a clinical TB history. Patients who had prior PTB on CXR but had not received a clinical diagnosis and anti-TB therapy were included for analysis. Live birth,clinical pregnancy, and miscarriage rates were compared between the untreated PTB and non-PTB groups.Results The untreated PTB group had significantly lower clinical pregnancy(31.7% vs. 38.1%) and live birth(23.8% vs. 30.6%) rates than the non-PTB group(both P < 0.001). Multivariate analysis revealed that untreated PTB was a risk factor for decreased live birth rate [odds ratio(OR), 0.80;95% confidence interval(CI), 0.66–0.98;P = 0.028] in all patients and for increased miscarriage(OR, 4.19;95% CI,1.69–10.39;P = 0.002) and decreased live birth(OR, 0.45;95% CI, 0.24–0.83;P = 0.011) rates in patients with unexplained infertility.Conclusions Untreated PTB was associated with adverse pregnancy outcomes after IVF-ET, especially in patients with unexplained infertility, highlighting the clinical significance of PTB in this specific patient population.
文摘<strong>Introduction:</strong> Hypertension is a major cause of maternal and perinatal morbidity and mortality. This study aims at exploring the outcomes of pregnancy and associated factors in hypertensive pregnant women in Comè district hospital from 2014 to 2016. <strong>Methods:</strong> This is a retrospective, analytical study carried out in June 2016, involving a total of 345 hypertensive patients. Socio-demographic and medical features, including pregnancy and foetal outcomes parameters, were recorded in the case files. Top-down stepwise logistic regression was performed at the 5% threshold. <strong>Results:</strong> The frequency of hypertensive disorders during pregnancy was estimated at 7.32% and unfavourable outcomes at 35.65%. The adverse maternal outcomes recorded were postpartum death and haemorrhage whereas adverse foetal issues were prematurity, low birth weight, low Apgar scores, stillbirth and death. Factors statistically associated with pregnancy outcome were paucigravida (OR = 2.01 ([1.05 - 3.88]), p = 0.035), history of stillbirth (OR = 4.75 ([1.01 - 22.1]), p = 0.048) and anticonvulsant therapy (OR = 0.32 ([0.19 - 0.54]), p < 0.001). <strong>Conclusion:</strong> Adequate monitoring via Antenatal Care (ANC) check-ups, timely recourse to care and an effective communication strategy should reduce hypertensive disorders incidence and adverse outcomes in pregnant women.
基金supported by Beijing Municipal Science&Technology Commission (Z201100005520074)Peking University Third Hospital (BYSYDL2021004)National Clinical Research Center for Obstetrics and Gynecology (BYSYSZKF2021003).
文摘Objective:To establish the Chinese population's amniotic fluid deepest vertical pocket(DVP)reference curves for dichorionic twin pregnancies and to investigate DVP links with adverse perinatal outcomes.Methods:This retrospective cohort study,conducted at Peking University Third Hospital from August 2011 to December 2020,used data from 375 women aged 20 to 45 years who had dichorionic twin pregnancies that were confirmed through first-trimester ultrasound.After exclusions,reference curves were developed using 318 women with 3,299 DVP scans,and the data analyzed included maternal demographics,pregnancy outcomes,ultrasound measurements,and neonatal information.DVPs were assessed via ultrasound at regular intervals and grouped by gestational age(GA)for analyses.Linear mixed models were used to create amniotic fluid reference curves.Associations between abnormalities and adverse perinatal outcomes were examined using Chi-squared or Fisher's exact tests.Logistic regression provided both crude and adjusted odds ratios,adjusting for pre-pregnancy weight,age,ethnicity,parity,and conception mode.Significance was set at P<0.05 with 95%confidence intervals(CI),and the analyses were conducted using SPSS ver.26.0(IBM Corp.,Armonk,NY)and SAS ver.9.4(SAS Institute Inc.,Cary,NC,USA)software.Results:DVP increased from the first trimester to a maximum at 26 weeks(95%confidence interval(CI),2.7–8.3 cm for twin 1 and 2.8–7.9 cm for twin 2)and then decreased gradually toward term.Differences between twins 1 and 2 were significant after 26 weeks(95%CI for twin 1:5.3,5.5;95%CI for twin 2:4.4,4.5;P<0.010).Polyhydramnios of twin 1 increased the risk of large for GA.Oligohydramnios of twin 1 increased the risk of small for GA.Polyhydramnios of twin 2 increased the risk of small for GA,premature birth,and neonatal complications.Oligohydramnios of twin 2 increased the risk of preeclampsia,hypertensive disorder complicating pregnancy,and premature rupture of membranes.Conclusion:Reference curves for twin amniotic fluid volumes vary by GA and differ between twins,with potential implications for pregnancy outcomes.
文摘Objective: In Cameroon, more than 80% of women suffering from cervical intraepithelial neoplasia (CIN) are within the reproductive age. This study intended to analyze the pregnancy outcomes following cervical treatment in Cameroon. Methods: This was a cohort study with two years retrospective data collection involving 82 women who underwent cervical treatment for CIN in two Cameroonian hospitals from January 2015 to December 2017. Data were collected from CIN treatment to end of pregnancy where applicable. Data analysis was done using Epi Info software version 3.5.4. Results: We collected data from 82 patients aged 27 to 48 years, with a mean age of 36.5 (SD: 5.3) years. During the study period, 33 out of 82 participants became pregnant 40.2 [29.56 - 51.66]%. The factor associated with pregnancy occurrence after treatment was age less than 35 years (Odds ratio = 4.37 [1.7 - 11.2]. From the 33 pregnancies recorded, 17 (51.5%) ended in a delivery, amongst which 15 (88.2%) were vaginal. Conclusion: Pregnancy frequency over two years following cervical treatment for CIN was relatively good, and younger women (age 35 years) were significantly more like to have conceived compared to their older counterparts. Post-treatment delivery outcomes seem to be similar to those in the general population.
文摘Objective:To investigate the effects of maternal body mass index(BMI)and gestational weight gain on maternal and neonatal outcomes in twin pregnancies.Methods:Five hundred cases of twin pregnancies were divided into a low body weight group(68 cases),a normal weight group(355 cases),an overweight group(65 cases),and an obesity group(12 cases)according to the World Health Organization(WHO)Body Mass Index(BMI)classification guidelines Results:Comparison of weight gain during different pregnancies revealed that pregnant women were mainly of low weight and average weight.The higher the BMI before pregnancy,the higher the incidence of excessive weight gain during pregnancy.The incidences of gestational diabetes mellitus(GDM)and premature rupture of membranes in women with low weight gain were significantly higher than those in women with average weight gain and high weight gain(P<0.05).The incidences of gestational hypertension,preeclampsia,and anemia in women with high weight gain were significantly higher than those in women with low weight gain and average weight gain(P<0.05).The incidence of neonatal birth weight,fetal distress,and macrosomia in the high weight gain group was significantly higher than those in the low weight gain and average weight gain groups(P<0.05).The birth weight of newborns in low-weight gain mothers was significantly lower than that of normal-weight gain mothers(P<0.05).Conclusion:Poor maternal and infant outcomes were common in women with insufficient or excessive weight gain during pregnancy.Therefore,for women with twin pregnancies,weight management is crucial to ensure maternal and infant health.
基金“Natural Science Foundation of Beijing Municipality”[No:7222206].
文摘Aim To assess whether adverse pregnancy outcomes in women with adenomyosis are different according to the method of conception and the concurrent of uterine leiomyoma(UL).Methods We performed a retrospective study.Fifty-three singleton pregnancy cases complicated with adenomyosis were included in this study.In the study group,15 women became pregnant with assisted reproductive technology(ART)and 21 women combined with UL.Pregnancy outcomes were compared between ART and non-ART,UL and non-UL groups.Results The prevalence for such complications as hypertensive disorder complicating pregnancy(HDCP)and postpartum hemorrhage(PPH)were significantly higher in the women conceived by ART(33.3%vs.5.3%,P=0.023)and(53.3%vs.23.7%,P=0.037),respectively.And women concurrent with UL of which the diameter≥4cm were more likely to have severe PPH(44.4%vs.0%,P=0.021).Conclusion ART may increase the risk of adverse pregnancy outcomes such as HDCP and PPH in women with adenomyosis and UL of which the diameter≥4cm may further increase the risk of severe PPH.
文摘BACKGROUND Gestational anemia is a serious public health problem that affects pregnant women worldwide.Pregnancy conditions and outcomes might be associated with the presence of gestational anemia.This study investigated the association of pregnancy characteristics with anemia,exploring the potential etiology of the disease.AIM To assess the association of pregnancy parameters with gestational anemia.METHODS A nested case-control study was conducted based on the Chinese Pregnant Women Cohort Study-Peking Union Medical College Project(CPWCS-PUMC).A total of 3172 women were included.Patient characteristics and gestational anemia occurrence were extracted,and univariable and multivariable logistic regression models were used to analyze the association of pregnancy parameters with gestational anemia.RESULTS Among the 3172 women,14.0% were anemic,46.4% were 25-30 years of age,21.9%resided in eastern,15.7%in middle,12.4%in western 18.0% in southern and 32.0%in northern regions of China.Most women(65.0%)had a normal prepregnancy body mass index.Multivariable analysis found that the occurrence of gestational anemia was lower in the middle and western regions than that in the eastern region[odds ratio(OR)=0.406,95%confidence interval(CI):0.309-0.533,P<0.001],higher in the northern than in the southern region(OR=7.169,95% CI:5.139-10.003,P<0.001),lower in full-term than in premature births(OR=0.491,95% CI:0.316-0.763,P=0.002),and higher in cases with premature membrane rupture(OR=1.404,95% CI:1.051-1.876,P=0.02).CONCLUSION Gestational anemia continues to be a health problem in China,and geographical factors may contribute to the situation.Premature birth and premature membrane rupture may be associated with gestational anemia.Therefore,we should vigorously promote local policy reformation to adapt to the demographic characteristics of at-risk pregnant women,which would potentially reduce the occurrence of gestational anemia.
基金supported by grants from the Shanghai Health and Family Planning Commission(Nos.20184Y0362,20204Y0431)the Shanghai Municipal Education Commission–Gaofeng Clinical Medicine Grant Support(No.20161430)supported by the funding of retrospective studies from Shanghai Sixth People’s Hospital.
文摘Background: The potential impact of β cell function and insulin sensitivity on adverse pregnancy outcomes in women with gestational diabetes mellitus (GDM) remains uncertain. We aimed to investigate the association between β cell dysfunction, insulin resistance, and the composite adverse pregnancy outcomes.Methods: This observational study included 482 women diagnosed with GDM during pregnancy. Quantitative metrics on β cell function and insulin sensitivity during pregnancy were calculated using traditional equations. The association of β cell dysfunction and insulin resistance with the risk of the composite adverse pregnancy outcomes was investigated using multivariable-adjusted logistic regression models.Results: Multivariable-adjusted odds ratios (ORs) of adverse pregnancy outcomes across quartiles of homeostatic model assessment for insulin resistance (HOMA-IR) were 1.00, 0.95, 1.34, and 2.25, respectively (P for trend = 0.011). When HOMA-IR was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 1.34 (95% confidence interval 1.16-1.56) for each 1-unit increase in HOMA-IR. Multivariable-adjusted ORs of adverse pregnancy outcomes across quartiles of homeostatic model assessment for β cell function (HOMA-β) were 1.00, 0.51, 0.60, and 0.53, respectively (P for trend = 0.068). When HOMA-β was considered as a continuous variable, the multivariable-adjusted OR of adverse pregnancy outcomes was 0.57 (95% CI 0.24-0.90) for each 1-unit increase in HOMA-β. However, other quantitative metrics were not associated with the composite adverse pregnancy outcomes.Conclusions: We demonstrated a significant association of β cell function and insulin sensitivity with the risk of adverse pregnancy outcomes. We have provided additional evidence on the early identification of adverse pregnancy outcomes besides the glycemic values.
文摘Background:It is currently unknown whether patients with a fever after controlled ovulation during egg retrieval could increase the risk of pelvic infection or not,and fever itself may affect endometrial receptivity or embryo quality with poor pregnancy outcomes.The aim of this study was to analyze the outcomes of patients with fever during oocyte retrieval after the first frozen-thawed embryo transfer(FET)cycle.Methods:This was a 1:3 retrospective paired study matched for age.In this study,58 infertility patients(Group 1)had a fever during the control ovulation,and the time of the oocyte retrieval was within 72 hours,they underwent ovum pick up and whole embryo freezing("freeze-all"strategy).The control subjects(Group 2)are 174 patients matched for age who underwent whole embryo freezing for other reasons.The baseline characteristics,clinical data of ovarian stimulation,and outcomes,such as the clinical pregnancy rate,ongoing clinical pregnancy rate were compared between the two groups in the subsequent FET cycle.Results:All patients had no pelvic inflammatory disease after oocyte retrieval.Anti-Mullerian hormone(AMH)levels(4.2 vs.2.2,P<0.001)were higher in group 2,and the number of oocytes retrieved,and fertilization rate were lower in group 1(P<0.001),but the endometrial thickness,the number of embryo transfers,and the type of luteal support supplementation were similar between the two groups.Regarding pregnancy outcomes in the subsequent FET cycle,the implantation rate,clinical pregnancy rate,early spontaneous rate,ectopic pregnancy rate,and ongoing pregnancy rate were all not significantly different.Further regression analyses showed that the clinical pregnancy rate and ongoing pregnancy rate were also not significantly different.Conclusions:Transvaginal ultrasound-guided follicular puncture for oocyte retrieval is a safe and minimally invasive method for patients with fever.Moreover,the fever had almost no effect on embryo quality.
文摘Objective:To investigate the effects of endometrial stimulation timings and techniques on pregnancy outcomes in patients without prior embryo transfer(ET).Methods:We included a total of 10 studies related to the impact of endometrial stimulation on the pregnancy outcome of infertile patients with the first ET from 2010 to 2019.These studies were found by searching databases including China Science and Technology Journal Database(VIP),Chinese Biological Med(CBM),Chinese Medical Current Content(CMCC),China National Knowledge Internet(CNKI),WanFang Med Online,Cochrane Library,Web of Science,PubMed,Medline,ScienceDirect,and EMBASE.A total of 1,983 cycles were included,of which 725 were cycles with endometrial stimulation.Clinical outcomes included clinical pregnancy,implantation,abortion,multiple pregnancy,and live birth rate.Results:The implantation rate(IR)was higher in the fresh cycle endometrial stimulation group than in the control group(relative risk[RR]=1.21,95%confidence interval[CI]=1.03-1.42;P=0.02),but there were no significant between-group differences in the live birth rate(LBR)and abortion rate(AR).Subgroup analysis showed that whether follicular or luteal endometrial stimulation was performed before the ET cycle had no effect on the clinical pregnancy outcome,and endometrial stimulation on the day of oocyte retrieval reduced the clinical pregnancy rate(CPR)(RR=0.37,95%CI=0.19-0.75;P=0.005).Whether the technique involved the use of a curette or catheter,there was no significant between-group difference in CPR.Conclusions:Fresh cycle endometrial stimulation can improve the embryo IR in patients without prior ET,but it cannot increase CPR,LBR,or AR.Subgroup analysis showed that different endometrial stimulation timings and techniques did not significantly improve CPR and that endometrial stimulation on the day of oocyte retrieval reduced CPR.
