深部浸润型子宫内膜异位症(deepinfiltrating endometriosis，DIE)指浸润深度≥5 mm的子宫内膜异位症(内异症)，是盆腔内异症的一种重要类型。由于常常累及重要脏器如肠道、输尿管以及膀胱等，而且与疼痛、不孕关系密切，严重影响患者的生存质量。加上治疗困难，手术治疗风险大，药物治疗效果不满意，复发机会多，因而成为内异症研究和治疗的热点和难点问题。

Abstract:With the increasing in incidence of placenta accreta as well as more requirements in fertility and life quality of public，the managements in this kind of invasive placental disease have updated recent years.And conservative management has been a key role rather than assistant therapy.In this article，we introduce various conservative managements including expectant management，medical conservative treatment and uterus preserving surgery，which are all applied commonly.

Abstract: The relationship between sexual transmitted disease(STD） pathogens and pelvic inflammatory disease is increasingly prominent: with the prevalence of sexually transmitted diseases，acute pelvic inflammatory disease is epidemic，and delay in treatment may lead to major sequelae，including chronic pelvic pain，ectopic pregnancy and infertility. The comprehensive treatment program of sexually transmitted pelvic inflammatory disease includes antibiotic therapy,surgery and treatment of patients’ sexual partner to avoid repeated infections.

Abstract:Although most patients with gestational trophoblastic neoplasms have optimistic prognosis due to their sensitivity to the chemotherapy, approximately ten to twenty-five percent of them might develop resistance to the primary chemotherapy.The present article gives a brief introduction to evaluating the prognosis and follow-up of the resistant gestational trophoblastic neoplasms.

Abstract: Chromosome disease includes the numerical abnormalities and structural abnormalities of chromosomes. For the numerical abnormalities, especially for those with the abnormality of autosomal number, parents should be suggested to terminate pregnancy. For fetus with karyotype of unbalanced structural abnormalities, parents also should be commended to terminate the pregnancy because of the deletion or duplication of genetic material. If the karyotype of fetus is a balanced structural abnormality in de novo, the parents should be suggested to continue pregnancy. If the karyotype of fetus is a balanced structural abnormality de novo, probably there are some risks of congenital defects, counseling parents the likely phenotypes. If the parents select to continue the pregnancy, ultrasonic inspection prenatal and follow-up clinical information postnatal should be performed.

Abstract: Mycoplasma infection is a clinically central issue.Common mycoplasma includes Ureaplasma urealyticum, Mycoplasma hominis and Mycoplasma genitalium. Various kinds of mycoplasmas play different roles in each disease states. Ureaplasma Urealyticum can cause urethritis, chorioamnionitis. While its carrier status in normal female vagina is highly spread, the clinical significance of UU is often exaggerated. Mycoplasma genitalium infection can lead to cervicitis, urethritis and pelvic inflammatory disease. But since in most areas of China Mycoplasma genitalium can' t be detected, it’s often overlooked. Mycoplasma hominis is common in bacterial vaginosis and pelvic inflammatory disease. Owing to these facts，when detecting different mycoplasma infections,different clinical situations must be considered.

Abstract:Polycystic ovary syndrome (PCOS) is a common metabolic dysfunction and heterogeneous endocrine disorder in women of reproductive age.PCOS is characterized by a clustering of hyperandrogenism, hyperinsulinemia, hypersecretion of LH, menstrual dysfunction, hirsutism, infertility and pregnancy and neonatal complications. PCOS also contributes to other long-term health risks, metabolic complications and psychological problems, such as type II diabetes mellitus (DM2), cardiovascular disease (CVD), poor self-esteem, venous thromboembolism (VTE) and anxiety. In addition, a wide range in the incidence of PCOS has been reported in small samples from different countries. As a result, most studies quoted a prevalence of PCOS ranging from 5% to 10%. However, previous reports from a variety of different countries demonstrate the diversity in the incidence of PCOS, and the prevalence of PCOS also depends on the criteria used to evaluate this syndrome. Different PCOS prevalence surveys have been carried out in specific populations using special diagnostic criteria.

Abstract: This text outline the research work in the Clinical and experimental about the ovulation with traditional chinese medicine,from the following several aspects:Traditional Chinese medicine dialectical treats、cycle therapy with Traditional Chinese medicine 、monotherapy、Acupuncture treatment、Traditional Chinese medicine external treatment，which indicated its good practical value、developmental prospect and some problems,The paper also put forward to the combination of traditional Chinese Medicine and western medicine on the basis of current problems.

Abstract：Hyperthyroidism in pregnancy is uncommon yet associated with adverse pregnancy outcomes. Antithyroid drugs as well as hyperthyroidism itself may lead to fetal and neonatal complications including stillbirth, low birth weight, goiter, hyperthyroidism, hypothyroidism and long-term sequelae. So in the prenatal care of pregnant women with hyperthyroidism, attention should also be attached to the possible fetal and neonatal complications to ensure timely diagnose and treatment.

Abstract:HCG trigger is important for inducing oocyte maturation and ovulation induction, which has also been thought one of the key points of ovulation induction and is closely related to the outcomes of ovulation induction.The timing of HCG trigger mainly depends on follicular diameter, serum estrogen and endometrial situation during ovulation induction. HCG and GnRH-a can be used for triggering during ovulation induction. The reasonable choice of triggering-drugs should be made according to different patients and ovulation induction protocols，which will be great helpful to improve the outcomes and decrease the complications.

Abstract：Gestational hyperthyroidism is a common thyroid dysfunction during early pregnancy. The cause of the gestational hyperthyroidism is believed to be a result of cross- reactivity between HCG and TSH at the thyroid receptor. Women with this disease have heat intolerance, sweating, mood swings, vomiting, heart palpitations and other symptoms. Serum TSH is frequently low and FT4 is high, and autoimmuantibodys are negative. Supportive therapy is recommended, while ATDs are not recommended.

Objective：To assess the prevalence of thyroid peroxidase autoantibody and relationships between thyroid function and TPOAb in the first trimester of pregnancy. Methods：A total of 611 women during the first trimester from Beijing Friendship Hospital are tested for serum TSH，FT4 and anti-TPO by chemilumino metric immunoanalysis . Women with previous thyroid diseases are excluded. We determine the reference intervals for TSH and FT4 and establish the prevalence of TPOAb by using gestational age-specific interval. The relationships between TSH，FT4 and TPOAb are analyzed. Results：(1)The median value of TPOAb is 38.9 mU/L，ranging from 6.4 to more than1 300 mU/L at 8-12 gestational week .(2)The cutoff value of TPOAb is 206.77 mU/L at the 90th percentile by using gestational age-specific interval. The positive rate of TPOAb is 10.8% (66/611).(3)A simple regression analysis shows that serum titer of TPOAb correlates with the levels of TSH and FT4 (P= 0.000 and 0.000). The median concentration of TSH is significantly greater in TPOAbpositive women than in TPOAbnegative women with increased value of 0.40 mU/L. The risk of abnormally high TSH in former is more than three times than in latter. Conclusion：TPOAb positive rate is 10.8% in first trimester. Determination of the gestational agespecific intervals for TSH，FT4 and TPOAb is of very importance to avoid overestimation of maternal thyroid dysfunction. Pregnant women with TPOAbpositive have a higher level of TSH and should be monitored closely for thyroid function. 

妇科恶性肿瘤多采用手术、化疗、放疗为主的综合治疗，多数患者通过综合治疗可以获得比较好的治疗结局。化学治疗是妇科恶性肿瘤治疗的主要方法之一，在手术后应用化学治疗（辅助性化疗），可以有效地控制亚临床的微小病灶，能够有效地提高妇科肿瘤治愈率。近年来研究结果也显示，术前化疗（新辅助化疗）可以增加宫颈癌、卵巢癌等多种妇科肿瘤的手术切除机会，同时对减少手术损伤、尽量保证机体的功能起一定的作用。但是有一部分妇科肿瘤患者由于对化疗不敏感，或经过治疗后发生化疗耐药，使得治疗效果不理想。尤其卵巢癌患者，大约有超过50%的卵巢癌患者在经过手术化疗后会发生急性的化疗耐药并死亡。如何提高这部分耐药患者的疗效是提高妇科肿瘤患者生存率的关键问题。

Abstract:Cervicoisthmic cerclage is the main procedure for cervical incompetence. Laparoscopic cervicoisthmic cerclage is an alternative and effective method for those who have the history of transvaginal approach or abnormal cervical anatomy. Laparoscopic cervicoisthmic cerclage can be carried out before pregnancy or during first trimester pregnancy.For women who have a fetal demise in the second trimester, vaginal delivery can still be achieved after cutting or removal of Mersilene tape through laparotomy or laparoscopy. Cesarean section should be performed for women with term pregnancy. Laparoscopic cervicoisthmic cerclage is one of the most effective procedures for the treatment of cervical incompetence. However, there is still lack of strong evidences from randomized clinical trials, especially from domestic research;to support that laparoscopic cervicoisthmic cerclage should be the standard procedure in the treatment of cervical incompetence.

Abstract: In recent years, the vaginal delivery rate is decreasing,while the cesarean section is increasingly used due to the development of medicine and the social factors.This paper is to review the present situation of the vaginal delivery rate and to achieve the purpose of decreasing the cesarean section rate and promoting the vaginal delivery.

Abstract:The success rates of any artificial reproduction techniques depend on a correct protocol for ovarian stimulation. This can be decided only by proper assessment of ovarian reserve and ovarian response before commencing ovarian stimulation, including age, basal hormonal biomarkers, AFC, AMH,etc. But there is no specific marker which can independently assess ovarian reserve and ovarian response, and the exact assessment should be through combined application markers.

Abstract：Recurrent spontaneous abortion (RSA) is defined as the occurrence of three or more consecutive abortions with the same partner. Scholars in recent years have proposed that two consecutive spontaneous miscarriages should be included in the scope of RSA, because the abortion risk for future pregnancy is up to 50%,the clinical manifestation should be paid more attentionnow. RSA is a complex multifactorial problem associated with chromosome, reproductive tract anatomic, endocrinologic, infection, immune etiologies and pre-thrombotic state, but asubstantial proportion of RSA, up to 40%, are due to unexplained or unknown etiologies. The complex etiology made RSA one of diseases to be treated difficulty and a hot spots in the present clinical research work.

Abstract:The situation that patients had not established conceive after at least 3 times embryo transfer during in vitro fertilization and embryo transfer (IVF-ET) practise has been called as recurrent implantation failure. Etiology study of recurrent implantation failure has been a cutting area companied with controversy of its criterion for many years. All the factors that affect on gamete or embryo, endometrium microenvironment and somatic factors which effect on both embryo and endometrium could be as the candidates for recurrent implantation failure.

The causes of 40%～50% of the patients with recurrent spontaneous abortion are unknown, studies have found that there must be significant correlation between the disease and genetics. In order to offer new mind to find the causes of RSA,people have to know more genetics research advance.

Abstract：Emergent cerclage may be defined as that performed in the setting of advanced cervical dilation with bulging membranes. It's an emergency operation that can save normal but immature fetus. Previous studies have indicated that the success rate of operation was 72.72%. That means emergent cerclage is a good remedy when the treatment of cervical incompetence is not timely. However, it may have serious complications if we can't grasp the opportunity and master the indications of the operation. So grasp the operation indications strictly, pay more attention in operative procedure and give good postoperative monitoring can improve the success rate of emergent cerclage.

Abstract: The preeclampsia is a pregnancy-specific systemic disease. The cause of preeclampsia is unknown. We are concerned pregnancy nutrition in reducing the pathogenesis of preeclampsia. Control of risk factors for early prevention of eclampsia is helpful. Early nutritional supplements can improve maternal and fetal pregnancy outcomes.We should ensure that all pregnant women during pregnancy reasonable and adequate nutrient intake. The prevention of the occurrence of preeclampsia has important clinical implications.We need further research to provide more evidence about the role of nutritional supplements during pregnancy in the prevention of preeclampsia.

Abstract:A widely agreed-upon definition for the diagnosis of cervical insufficiency has yet to be achieved. The advent of ultrasonic cervical length measurement has added an additional criterion to the definition of cervical insufficiency. During the midtrimester of pregnancy the cervical length shorter than 25 mm by vaginal sonography without uterine contraction is suspicious of cervical insufficiency. Cerclage indicated by ultrasound for women with singleton gestations, no prior preterm birth history is no significant benefit for reduction of the preterm birth rate, however vaginal progesterone, either 90-mg gel or 200-mg suppository, is associated with reduction in PTB and perinatal morbidity and mortality when the CL<20mm. Either vaginal progesterone or cerclage or cervical pessary are equally efficacious in the prevention of preterm birth in women with a sonographic short cervix in the midtrimester, singleton gestation, and previous preterm birth history. The selection of the optimal treatment may depend upon adverse events, cost and patient/clinician preferences.

Treating uterine fibroids with uterine artery embolization(UAE) can make fibroids mortify, shrink or even disappear, improving the clinical symptoms, and keep the physiological function of the uterus. UAE has become an effective, minimally invasive treatment method which can retain the uterus. However, some serious complications appeared in the clinical application, which even make patients die. The key to get good curative effect and avoid complications is to deal with the following issues appropriately: selecting the appropriate cases, using appropriate embolic agents and embolization particles, embolisming target artery fibroids accurately, controlling the degree of embolization, and detecting and handling complications in time.

Abstract：Gestational diabetes mellitus is defined as any abnormal carbohydrate intolenrance that begins or is first recognized during pregnancy and the prevalence has been increasing in the recent years. GDM has adverse effects on maternal and fetal outcomes which include perinatal effects and remote effects. Effective control of blood glucose and appropriate weight growth can improve the outcomes.

Hysteroscopic myomectomy is the first choice in treating submucous myoma. The successful operation and the treatment effect depend on the type of submucous myoma and the operation skills. The indications for surgery， fibroids in diameter and the myometrial free margin are still controversial issues. The latest view: the myometrial free margin is no longer a limiting factor for hysteroscopic resection of submucous myoma，it is not a static parameter but a dynamic index.

myoma of uterus is the most common tumor of the female genitalia systems. Surgery is the principal method to treat myoma ，transvaginal therapy include transvaginal hysterectomy and transvaginal myomectomy. To compare with abdominal and laparoscopic operations，transvaginal operations have advantage and limitations. Sufficient evaluation and make correct choice about operation，it is the necessary avoid injury conditions to avoid injurg and ensure medical treatment safe.

Abstract:Women of childbearing age，abnormal thyroid function affect the process and outcome of the pregnancy.Clinical hypothyroidism and subclinical hypothyroidism cause infertility，spontaneous abortion，hypertensive disorders in pregnancy，preterm delivery，placental abruption，fetal distress and incidence of low birth weight children，can also lead to mental retardation in newborns，should recommended preconception，pregnancy，thyroid function tests.

         过期妊娠（postterm pregnancy）指孕周达到或超过42 周（从末次月经算起）仍未分娩，晚期足月妊娠（late-term pregnancy）指孕周达41+0周至41+6周。世界各地报道的发生率不同，部分原因在于不同地区对超过预产期后的处理方式有所不同。准确判定孕周对于过期妊娠的诊断和处理至关重要。由于晚期足月妊娠和过期妊娠所致的围生儿病率与死亡率升高，需要加强胎儿状况的监测和及时的引产。为此，美国妇产科医师学会（ACOG）在循证医学研究的基础上，颁布了该指南，期望对晚期足月和过期妊娠的规范处理有指导价值。

Abstract: Pregnancy women may facing various nutritional problems during pregnancy including excess or insufficient energy intake, imbalance of macronutrients, deficiency of micronutrient . Based on evidences of developmental origins of health and disease (DOHaD), the fetal hypothalamic - pituitary - adrenaline-axis response, oxidative stress and epigenetic mechanisms can be permanently changed by these nutritional problems. The susceptibility to chronic non-communicable disease in adulthood is changed. Obstetricians should intervene the nutritional problems based on uptodate evidences to improve the health of the whole population.

 前置胎盘是产科严重出血和子宫切除的主要原因。由于十几年来我国初次剖宫产率非常高，随着二胎政策的开放，产科出现一个不得不面对的严重临床问题：“瘢痕子宫覆盖其上的前置胎盘”，即凶险型前置胎盘。除了关注“前置胎盘”+“剖宫产史”引起的凶险型前置胎盘以外，还需关注孕前进行子宫肌瘤剔除术尤其是肌瘤剔除时进入宫腔的孕妇，如果胎盘着床在瘢痕之处，也要关注胎盘植入问题。凶险型前置胎盘常常会伴有胎盘植入子宫肌层甚至会累及膀胱、肠管等周围器官，在产前、产时和产后发生严重出血，在临床处置时常常需要其他学科的支持（如泌尿外科、普外科、ICU等），若处理不当会引起严重不良结局，故而给产科临床带来巨大的挑战。

Uterine fibroids are the most common benign tumor of female genital organs，the incidence of 20% to 40%，it is noteworthy that the literature in recent years have reported some types of special uterine fibroids，the clinician and pathologist in the diagnosis and treatment may be misdiagnosed as malignant，This article summarizes a relatively common type of pathological features，diagnosis and treatment of priorities，in order to reduce misdiagnosis，select the appropriate surgical approach to avoid overtreatment.

宫颈机能不全又名宫颈内口闭锁不全、宫颈口松弛症、宫颈功能不全 (cervical incompetence，cervical insufficiency，incompetent cervix)，是指妊娠后，在达到足月妊娠前宫颈展平、变薄，宫颈管扩张、变宽的临床状态，最终导致中期妊娠流产或早产。宫颈机能不全是引起中期妊娠习惯性流产及早产的常见原因。据统计，宫颈机能不全患者早产率是非宫颈机能不全者3.3倍，占全部早产的8%～9% ，自然早产的40%～50% ，早破水的20%～30%。预防早产，包括重视宫颈机能不全的防治是值得研究的问题。

There is no effective medical therapy to date. GnRHa are useful preoperatively. Aromatase inhibitors and SERM may be useful in postmenopausal woman with symptomatic myoma. Lowdose mifepristone is a relatively cheap drug with minimal sideeffects. The use of Levonorgestrelreleasing intrauterine system has been shown to reduce menstrual blood loss with idiopathic menorrhagia or menorrhagia due to leiomyomas.

在世界范围内，宫颈癌是女性第4位常见的恶性肿瘤。2012年，全球全年发生宫颈癌528 000例，年死亡数为266 000例。85%宫颈癌发生于发展中国家，并且在这些国家宫颈癌居癌症死因的首位。2014年美国大约有12 360例新发的宫颈癌病例，4 020例死亡。尽管美国妇女宫颈癌的发病率不断下降，但宫颈癌仍是一个主要的世界性健康问题。最近美国国立综合癌症网络（National Comprehensive Cancer Network，NCCN）公布了《2015年NCCN宫颈癌临床实践指南》，该指南的诊治建议适用于鳞状细胞癌、腺癌和腺鳞癌，其他类型的宫颈癌不在本指南的范围。为使大家更好地了解新版指南，现对其进行简要解读。

Abstract：Women with gestational diabetes mellitus（GDM）in most cases can receive dietary instruction and self-monitoring of blood glucose teaching in an outpatient setting. Target thresholds of a fasting glucose less than 5.3 mmol/L and 1-hour postprandial glucose less than 7.8 mmol/L as well as 2-hour postprandial glucose less than 6.7 mmol/L have been suggested by ADA in 2012.

Abstract:Awareness and countermeasure of polycystic ovary syndrome constantly update and develop. In this paper, we summarized its etiology, pathophysiology, diagnosis and treatment, and proposed six countermeasures. Those are: giving emphasis on polycystic ovary syndrome epidemiology and on new medical ideas and research model, to carry out research on oocytes development, embryonic development and on endometrial abnormalities of PCOS, giving attention to Chinese medicine treatment and to build a good platform for their research.

Abstract：Polycystic ovary syndrome (PCOS) is a common endocrine disorder that is associated with recurrent miscarriage. Despite the many studies that have investigated the prevalence of PCOS in recurrent miscarriage, but the mechanisms are unclearly. The possible mechanisms by which PCOS could cause recurrent miscarriage are considered: hyperandrogenaemia, obesity and hyperinsulinaemia are the most likely candidates. There is some evidence to suggest that weight loss, ovarian drilling and metformin could help to reduce the rate of miscarriage.