Plasma motilin concentrations were measured in 135 women during the second and third trimesters of pregnancy and 3～5 d after delivery and the results were compared with those of 20 healthy nonpregnant women.The mean ...Plasma motilin concentrations were measured in 135 women during the second and third trimesters of pregnancy and 3～5 d after delivery and the results were compared with those of 20 healthy nonpregnant women.The mean plasma motilin concentration (323.96± 125.10 ng/L) in women during the second trimester of pregnancy was lower than in healthy nonpregnant women (366.12±96.23 ng/L) (P<0.05),but that was significantly higher than in women during the third trimester of pregnancy (121.04±27.00 ng/L) (P<0.01);the plasma motilin concentration in women during 3～5d after delivery (443.05±140.79 ng/L) was significantly higher than that in pregnant women (P<0.01).The results showed that pregnancy appears to have a profound inhibitory effect on plasma motilin,and this may partly be responsible for the gastrointestinal hypomotility associated with pregnancy.展开更多
Purpose: To assess the efficacy of medical methods for termination of pregnancy at 9 - 12 weeks of gestation. Methods: Between December 2008 and December 2010, the 116 consecutive women received 200 mg oral mifepristo...Purpose: To assess the efficacy of medical methods for termination of pregnancy at 9 - 12 weeks of gestation. Methods: Between December 2008 and December 2010, the 116 consecutive women received 200 mg oral mifepristone and after 24 - 36 hours they applied 800 μg vaginal misoprostol to medically terminate pregnancy. If the products of conception did not pass, three further doses of 400 μg misoprostol were given vaginally at three hours intervals to medically terminate pregnancy. Results: Of the 116 patients undergoing the procedure 104 (90%) aborted completely. Half of the patients aborted within 6 hours. After medical termination, five per cent of the women were treated because of infection, and five per cent needed a revisit to hospital because of excessive bleeding. Two women received a blood transfusion. Previous live births or previous inducted abortion is presented in the study results. Conclusions: Medical abortion at 9 - 12 weeks’ gestation is a safe alternative to surgery.展开更多
Objective:To compare the efficiency and related financial parameters of the double- and triple-marker test for the second-trimester maternal serum screening for Down's syndrome. Methods:The serum samples were coll...Objective:To compare the efficiency and related financial parameters of the double- and triple-marker test for the second-trimester maternal serum screening for Down's syndrome. Methods:The serum samples were collected from the 2^(nd) trimester pregnant women in this hospital and were examined for three biomedical markers[alpha-fetoprotein(AFP),freeβ-human chorionic gonadotropin(freeβ-hCG) and unconjugated estriol(uE_3)]by TR-FIA.The pregnancy outcomes were followed up and screening efficiency calculated for double-marker(AFP+freeβ-hCG) and triple-marker(AFP+ freeβ-hCG+uE_3) test. Results:(1)A total of 4,707 serum samples of 2^(nd) trimester pregnancy were collected in this study,of which 4,245 pregnancy outcomes got followed up by May 30,2009,with 462 cases lost to follow-up.The follow-up rate was 90.2%.3 cases of Down's syndrome,4 cases of other chromosome abnormalities and 1 case of neural tube defect (NTD) were found.There was no medically induced miscarriage by invasive tests.(2) Detection rate and false positive rate of triple marker test for Down's syndrome screening were 66.7%and 5.26%,respectively,while those in double marker test were 33.3%and 4.01%,respectively.The detection rate of all chromosome abnormalities was 75%in triple marker test and 37.5%in double marker test.The detection rate of NTD was 100%either in double or triple marker test.(3) It costs 499,375 RMB to avoid one Down's syndrome birth by using triple marker test and 781,200 RMB by using double marker test. Conclusion:Triple-marker test is superior to double marker test in 2nd trimester maternal serum screening for Down's syndrome,and costs less to avoid a Down's syndrome birth.展开更多
Objective To compare clinical efficacy for two cervical preparations for early secondtrimester pregnancy termination at 12-17 weeks gestation. Methods Seventy healthy women aged 18-41 years requesting legal terminatio...Objective To compare clinical efficacy for two cervical preparations for early secondtrimester pregnancy termination at 12-17 weeks gestation. Methods Seventy healthy women aged 18-41 years requesting legal termination of pregnancy at 12-17 weeks of gestation were equally randomized into two groups. Two cervical preparations, the Dilapan-STM combined with mifepristone and misoprostol （DMM） method, and the mifepristone combined with misoprostol （MM） method, were used to end early second-trimester pregnancy for group DMM and group MM, respectively. Clinical outcomes and complications for these two methods were compared. Results No differences were found on rates of successful abortion within 48 h and blood loss after abortion at 2 h between the two groups （P〉0.05）. DMM group had significant shorter induction-to-abortion interval and hospital stay compared with group MM （P〈0.01）. In both DMM and MM groups, side effects including nausea/vomiting, diarrhea, chills and rigors, and fever occurred, and incidences of these side effects were no difference （P〉0.05）. Conclusion DMM method would have similar clinical efficacies with MM method for early second-trimester pregnancy termination. Besides,DMM method has shorter induction-to-abortion interval and hospital stay, which benefits its clinical application.展开更多
Background:Vitamin D has been found to have more biological effects beyond the traditional research range,which involve in immunoregulation,occurrence,and development of tumor,reproduction,cell differentiation,and so ...Background:Vitamin D has been found to have more biological effects beyond the traditional research range,which involve in immunoregulation,occurrence,and development of tumor,reproduction,cell differentiation,and so forth.Herein,the influence of Vitamin D level in the second trimester of pregnancy on the Chinese pregnant women and fetal weight was investigated.Methods:Totally 1,612 pregnant women were followed up during the study,the 25-hydroxyvitamin D(25(OH)D)level was measured with ELISA at the 16th gestational week,and the fasting blood glucose was measured with hexokinase method using an automatic biochemistry analyzer at the same time.At week 24,oral glucose tolerance test(OGTT)was performed to test the blood glucose level(fasting blood glucose,1 h and 2 h after oral administration of glucose).Besides,other indices(e.g.,fetal birth weight)were recorded and analyzed by SPSS version 19.0 software.Results:Pearson’s correlation analysis indicated that the serum 25(OH)D had a negative correlation with blood glucose at 1 h after oral glucose administration at week 24 in OGTT(correlation coefficient:−0.03,P=0.01).However,it did not have correlations with the fasting blood glucose at weeks 16 and 24 as well as the blood glucose at 2 h after oral glucose administration at week 24.The Pearson’s correlation analysis was used to analyze the correlation between Vitamin D level in the pregnant women and fetal birth weight,and there was no correlation between them.Conclusion:The Vitamin D level in the second trimester of pregnancy had a negative correlation with blood glucose glucose at 1 h after oral glucose administration and had no correlation with fetal birth weight.展开更多
Objective:To investigate thyroid-stimulating hormone(TSH)levels and thyroid peroxidase antibody(TPOAb)in early pregnancy and to estimate the risk of development of gestational diabetes mellitus(GDM).Methods:The levels...Objective:To investigate thyroid-stimulating hormone(TSH)levels and thyroid peroxidase antibody(TPOAb)in early pregnancy and to estimate the risk of development of gestational diabetes mellitus(GDM).Methods:The levels of TSH,free thyroxine,free triiodothyronine,and TPOAb were retrospectively evaluated in 2333 pregnant women.All women recruited were divided into groups of TSH high(H),TSH low(L),TSH(H)TPOAb positive(+),TSH(H)TPOAb negative(-),TSH normal(N)TPOAb(+),TSH(L)TPOAb(+),TSH(L)TPOAb(-),and estimated the risk of GDM.Results:TSH level(X^(2)=13.0024,P=0.0015)and TSH combined TPOAb(X^(2)=20.0038,P=0.0012)were correlated to development of GDM.The level of TSH in 95 women was increased,and in 216 women were decreased.Of the 2333 pregnant women,546 patients were diagnosed with GDM,with a prevalence of 23.40%.The prevalence of GDM was 35.78%and 28.70%for the TSH high(H)and TSH low(L)pregnant women,respectively.The increased TSH(P=0.0013,odds ratio:2.09,confidence interval:1.34-3.28)was correlated to increase GDM incidence.TSH(H)TPOAb(+)(n=29),TSH(H)TPOAb(-)(n=58),TSH normal(N)TPOAb(+)(n=265),TSH(L)TPOAb(+)(n=30),TSH(L)TPOAb(-)(n=154)were in this study.The prevalence of GDM was 51.72%,29.31%,23.02%,26.67%,and 29.87%for the TSH(H)TPOAb(+),TSH(H)TPOAb(-),TSH(N)TPOAb(+),TSH(L)TPOAb(+),and TSH(L)TPOAb(-)pregnant women,respectively.Only the TSH(H)TPOAb(+)pregnant women had a significant higher incidence of GDM(P=0.0018,odds ratio:3.63,confidence interval:1.62-8.16).Trimester specific results showed that only second trimester had higher GDM risk either analyze TSH or the combination of TSH and TPOAb.Conclusion:Elevated TSH level and TPOAb positive in the second trimester of pregnancy were correlated to an increased risk of GDM.展开更多
The management of preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation is intractable, due to pulmonary immaturity, many complications, poor pregnancy outcomes. In particular, the pre-viable PPRO...The management of preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation is intractable, due to pulmonary immaturity, many complications, poor pregnancy outcomes. In particular, the pre-viable PPROM (<23 weeks of gestation) is much more difficult to be treated. The clinical recommendation is to terminate the pregnancy as soon as possible. The pregnancy outcomes of PPROM in the early second-trimester of two twin pregnant women in our hospital were reported to explore the treatment protocols. The pregnancies of the two women developed PROM at 12 and 16 weeks of gestation, respectively. After expectant treatment, they were deliveried successfully at 34+6 and 34+4 weeks of gestation, respectively. The assessment of growth and development of infants was normal during the following six months after birth. Therefore, if PPROM occurs in the early second-trimester of pregnancy, the management of PPROM should be individualized, it’s a long process which should include comprehensive communication between patients and families regarding alternative treatment options (including expectant management) and risks and benefits of the procedure. In the absence of spontaneous labor or occurrence of complications that would prompt delivery (intra-amniotic infection, abruptio placenta, cord prolapse), and fetal status is normal, the patients should proceed with expectant treatment, induction of labor is commonly performed in pregnancies with PPROM ≥34 weeks of gestation.展开更多
Background：The rate of cesarean delivery has significantly increased in China in the last decade.Women with prior cesarean history tend to have a higher risk of uterine rupture during termination of the pregnancy in ...Background：The rate of cesarean delivery has significantly increased in China in the last decade.Women with prior cesarean history tend to have a higher risk of uterine rupture during termination of the pregnancy in mid-trimester than those without such a history.The aim of our study was to evaluate the influences of the potential risk factors on uterine rupture in women with prior cesarean.Methods：We conducted this retrospective study of women with prior cesarean section,who underwent mid-trimester pregnancy termination between January 2006 and December 2013 in Peking Union Medical College Hospital.The protocol was oral administration ofmifepristone and misoprostol for the patients with the gestational ages below 16 weeks or intra-amniotic injection of ethacridine lactate （EL） for those with at least 16 weeks of gestational ages.The thickness of the lower uterine segment （LUS） was measured before the termination of pregnancy.Logistic regression was used to study the risk factors of uterine rupture.Results：The total rate of successful abortion was 93.9％ （62/66）.Four patients failed in induction,and one of them received curettage,whereas the other three experienced uterine rupture （4.5％）.The successful rates of abortion were 85.7％ （30/35） for women treated with mifepristone-misoprostol and 86.1％ （31/36） for those treated with EL.There was a significant difference in the mean LUS thickness between the uterine rupture group （3.0 ± 2.0 mm） and the nonrupture group （7.0 ± 3.0 mm） （P ＜ 0.05）.The LUS thickness of＜3 mm was associated with uterine rupture during mid-trimester pregnancy termination in women with prior cesarean （odds ratio,94.0; 95％ confidence interval 4.2-2106.1） after adjusted maternal age,gestational age,interdelivery interval and prior cesarean section.Severe bleeding that required transfusion occurred in one case （1.5％）.Conclusions：Both the mifepristone-misoprostol and the EL regimens were effective and safe for the termination of mid-trimester pregnancy in women with prior cesarean.A thinner LUS is associated with a relatively high risk of uterine rupture.展开更多
文摘Plasma motilin concentrations were measured in 135 women during the second and third trimesters of pregnancy and 3～5 d after delivery and the results were compared with those of 20 healthy nonpregnant women.The mean plasma motilin concentration (323.96± 125.10 ng/L) in women during the second trimester of pregnancy was lower than in healthy nonpregnant women (366.12±96.23 ng/L) (P<0.05),but that was significantly higher than in women during the third trimester of pregnancy (121.04±27.00 ng/L) (P<0.01);the plasma motilin concentration in women during 3～5d after delivery (443.05±140.79 ng/L) was significantly higher than that in pregnant women (P<0.01).The results showed that pregnancy appears to have a profound inhibitory effect on plasma motilin,and this may partly be responsible for the gastrointestinal hypomotility associated with pregnancy.
文摘Purpose: To assess the efficacy of medical methods for termination of pregnancy at 9 - 12 weeks of gestation. Methods: Between December 2008 and December 2010, the 116 consecutive women received 200 mg oral mifepristone and after 24 - 36 hours they applied 800 μg vaginal misoprostol to medically terminate pregnancy. If the products of conception did not pass, three further doses of 400 μg misoprostol were given vaginally at three hours intervals to medically terminate pregnancy. Results: Of the 116 patients undergoing the procedure 104 (90%) aborted completely. Half of the patients aborted within 6 hours. After medical termination, five per cent of the women were treated because of infection, and five per cent needed a revisit to hospital because of excessive bleeding. Two women received a blood transfusion. Previous live births or previous inducted abortion is presented in the study results. Conclusions: Medical abortion at 9 - 12 weeks’ gestation is a safe alternative to surgery.
文摘Objective:To compare the efficiency and related financial parameters of the double- and triple-marker test for the second-trimester maternal serum screening for Down's syndrome. Methods:The serum samples were collected from the 2^(nd) trimester pregnant women in this hospital and were examined for three biomedical markers[alpha-fetoprotein(AFP),freeβ-human chorionic gonadotropin(freeβ-hCG) and unconjugated estriol(uE_3)]by TR-FIA.The pregnancy outcomes were followed up and screening efficiency calculated for double-marker(AFP+freeβ-hCG) and triple-marker(AFP+ freeβ-hCG+uE_3) test. Results:(1)A total of 4,707 serum samples of 2^(nd) trimester pregnancy were collected in this study,of which 4,245 pregnancy outcomes got followed up by May 30,2009,with 462 cases lost to follow-up.The follow-up rate was 90.2%.3 cases of Down's syndrome,4 cases of other chromosome abnormalities and 1 case of neural tube defect (NTD) were found.There was no medically induced miscarriage by invasive tests.(2) Detection rate and false positive rate of triple marker test for Down's syndrome screening were 66.7%and 5.26%,respectively,while those in double marker test were 33.3%and 4.01%,respectively.The detection rate of all chromosome abnormalities was 75%in triple marker test and 37.5%in double marker test.The detection rate of NTD was 100%either in double or triple marker test.(3) It costs 499,375 RMB to avoid one Down's syndrome birth by using triple marker test and 781,200 RMB by using double marker test. Conclusion:Triple-marker test is superior to double marker test in 2nd trimester maternal serum screening for Down's syndrome,and costs less to avoid a Down's syndrome birth.
基金supported by Science and Technology Planning Project of Guangdong Province, China (No. 2010B031600250)Scientific and Technical Personnel Serving Company in Guangdong Action Items, China (No. 2009GJE00008)
文摘Objective To compare clinical efficacy for two cervical preparations for early secondtrimester pregnancy termination at 12-17 weeks gestation. Methods Seventy healthy women aged 18-41 years requesting legal termination of pregnancy at 12-17 weeks of gestation were equally randomized into two groups. Two cervical preparations, the Dilapan-STM combined with mifepristone and misoprostol （DMM） method, and the mifepristone combined with misoprostol （MM） method, were used to end early second-trimester pregnancy for group DMM and group MM, respectively. Clinical outcomes and complications for these two methods were compared. Results No differences were found on rates of successful abortion within 48 h and blood loss after abortion at 2 h between the two groups （P〉0.05）. DMM group had significant shorter induction-to-abortion interval and hospital stay compared with group MM （P〈0.01）. In both DMM and MM groups, side effects including nausea/vomiting, diarrhea, chills and rigors, and fever occurred, and incidences of these side effects were no difference （P〉0.05）. Conclusion DMM method would have similar clinical efficacies with MM method for early second-trimester pregnancy termination. Besides,DMM method has shorter induction-to-abortion interval and hospital stay, which benefits its clinical application.
文摘Background:Vitamin D has been found to have more biological effects beyond the traditional research range,which involve in immunoregulation,occurrence,and development of tumor,reproduction,cell differentiation,and so forth.Herein,the influence of Vitamin D level in the second trimester of pregnancy on the Chinese pregnant women and fetal weight was investigated.Methods:Totally 1,612 pregnant women were followed up during the study,the 25-hydroxyvitamin D(25(OH)D)level was measured with ELISA at the 16th gestational week,and the fasting blood glucose was measured with hexokinase method using an automatic biochemistry analyzer at the same time.At week 24,oral glucose tolerance test(OGTT)was performed to test the blood glucose level(fasting blood glucose,1 h and 2 h after oral administration of glucose).Besides,other indices(e.g.,fetal birth weight)were recorded and analyzed by SPSS version 19.0 software.Results:Pearson’s correlation analysis indicated that the serum 25(OH)D had a negative correlation with blood glucose at 1 h after oral glucose administration at week 24 in OGTT(correlation coefficient:−0.03,P=0.01).However,it did not have correlations with the fasting blood glucose at weeks 16 and 24 as well as the blood glucose at 2 h after oral glucose administration at week 24.The Pearson’s correlation analysis was used to analyze the correlation between Vitamin D level in the pregnant women and fetal birth weight,and there was no correlation between them.Conclusion:The Vitamin D level in the second trimester of pregnancy had a negative correlation with blood glucose glucose at 1 h after oral glucose administration and had no correlation with fetal birth weight.
文摘Objective:To investigate thyroid-stimulating hormone(TSH)levels and thyroid peroxidase antibody(TPOAb)in early pregnancy and to estimate the risk of development of gestational diabetes mellitus(GDM).Methods:The levels of TSH,free thyroxine,free triiodothyronine,and TPOAb were retrospectively evaluated in 2333 pregnant women.All women recruited were divided into groups of TSH high(H),TSH low(L),TSH(H)TPOAb positive(+),TSH(H)TPOAb negative(-),TSH normal(N)TPOAb(+),TSH(L)TPOAb(+),TSH(L)TPOAb(-),and estimated the risk of GDM.Results:TSH level(X^(2)=13.0024,P=0.0015)and TSH combined TPOAb(X^(2)=20.0038,P=0.0012)were correlated to development of GDM.The level of TSH in 95 women was increased,and in 216 women were decreased.Of the 2333 pregnant women,546 patients were diagnosed with GDM,with a prevalence of 23.40%.The prevalence of GDM was 35.78%and 28.70%for the TSH high(H)and TSH low(L)pregnant women,respectively.The increased TSH(P=0.0013,odds ratio:2.09,confidence interval:1.34-3.28)was correlated to increase GDM incidence.TSH(H)TPOAb(+)(n=29),TSH(H)TPOAb(-)(n=58),TSH normal(N)TPOAb(+)(n=265),TSH(L)TPOAb(+)(n=30),TSH(L)TPOAb(-)(n=154)were in this study.The prevalence of GDM was 51.72%,29.31%,23.02%,26.67%,and 29.87%for the TSH(H)TPOAb(+),TSH(H)TPOAb(-),TSH(N)TPOAb(+),TSH(L)TPOAb(+),and TSH(L)TPOAb(-)pregnant women,respectively.Only the TSH(H)TPOAb(+)pregnant women had a significant higher incidence of GDM(P=0.0018,odds ratio:3.63,confidence interval:1.62-8.16).Trimester specific results showed that only second trimester had higher GDM risk either analyze TSH or the combination of TSH and TPOAb.Conclusion:Elevated TSH level and TPOAb positive in the second trimester of pregnancy were correlated to an increased risk of GDM.
基金National Key Research and Development Program of China(No. 2018YFC1002900)National Natural Science Foundation of China(No. 81671527)。
文摘The management of preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation is intractable, due to pulmonary immaturity, many complications, poor pregnancy outcomes. In particular, the pre-viable PPROM (<23 weeks of gestation) is much more difficult to be treated. The clinical recommendation is to terminate the pregnancy as soon as possible. The pregnancy outcomes of PPROM in the early second-trimester of two twin pregnant women in our hospital were reported to explore the treatment protocols. The pregnancies of the two women developed PROM at 12 and 16 weeks of gestation, respectively. After expectant treatment, they were deliveried successfully at 34+6 and 34+4 weeks of gestation, respectively. The assessment of growth and development of infants was normal during the following six months after birth. Therefore, if PPROM occurs in the early second-trimester of pregnancy, the management of PPROM should be individualized, it’s a long process which should include comprehensive communication between patients and families regarding alternative treatment options (including expectant management) and risks and benefits of the procedure. In the absence of spontaneous labor or occurrence of complications that would prompt delivery (intra-amniotic infection, abruptio placenta, cord prolapse), and fetal status is normal, the patients should proceed with expectant treatment, induction of labor is commonly performed in pregnancies with PPROM ≥34 weeks of gestation.
文摘Background：The rate of cesarean delivery has significantly increased in China in the last decade.Women with prior cesarean history tend to have a higher risk of uterine rupture during termination of the pregnancy in mid-trimester than those without such a history.The aim of our study was to evaluate the influences of the potential risk factors on uterine rupture in women with prior cesarean.Methods：We conducted this retrospective study of women with prior cesarean section,who underwent mid-trimester pregnancy termination between January 2006 and December 2013 in Peking Union Medical College Hospital.The protocol was oral administration ofmifepristone and misoprostol for the patients with the gestational ages below 16 weeks or intra-amniotic injection of ethacridine lactate （EL） for those with at least 16 weeks of gestational ages.The thickness of the lower uterine segment （LUS） was measured before the termination of pregnancy.Logistic regression was used to study the risk factors of uterine rupture.Results：The total rate of successful abortion was 93.9％ （62/66）.Four patients failed in induction,and one of them received curettage,whereas the other three experienced uterine rupture （4.5％）.The successful rates of abortion were 85.7％ （30/35） for women treated with mifepristone-misoprostol and 86.1％ （31/36） for those treated with EL.There was a significant difference in the mean LUS thickness between the uterine rupture group （3.0 ± 2.0 mm） and the nonrupture group （7.0 ± 3.0 mm） （P ＜ 0.05）.The LUS thickness of＜3 mm was associated with uterine rupture during mid-trimester pregnancy termination in women with prior cesarean （odds ratio,94.0; 95％ confidence interval 4.2-2106.1） after adjusted maternal age,gestational age,interdelivery interval and prior cesarean section.Severe bleeding that required transfusion occurred in one case （1.5％）.Conclusions：Both the mifepristone-misoprostol and the EL regimens were effective and safe for the termination of mid-trimester pregnancy in women with prior cesarean.A thinner LUS is associated with a relatively high risk of uterine rupture.
