Archive

02 June 2014, Volume 30 Issue 6 Previous Issue    Next Issue

---

For Selected:

Download Citations EndNote Ris BibTeX

Toggle Thumbnails

Select

Identification and management for pregnancy with autoimmune disease. GUO Hong-xia，YANG Zi. 2014, 30(6): 403-406.  DOI: 10.7504/fk2014050102 Abstract ( )   PDF (903KB) ( )   Abstract:With the progress in immunology，pregnancy complicated with autoimmune diseases (AID) is increasingly being found. The interaction exists between pregnancy and AID，and often associated with adverse pregnancy outcomes. So，how to identify the high-risk population or underlying AID patients before pregnancy，how to find the sick during pregnancy，and how to properly assess and manage the diagnosed patients to reduce the impact of AID to the mother and fetus，are the important issues that need obstetric and multidisciplinary common concern.

Select

The diagnosis and treatment of pregnancy thrombocytopenia. YU Lin. 2014, 30(6): 406-410.  DOI: 10.7504/fk2014050103 Abstract ( )   PDF (915KB) ( )   Abstract：Pregnancy with thrombocytopenia in pregnancy that the platelets is lower than the normal by different causes.Pregnancy associate thrombocytopenia（PAT），Idiopathic thrombocytopenic purpura(ITP) and gestational hypertension disease are the main causes.the keys to treat gestational thrombocytopenia is finding out the causes，monitoring closely，severe cases should be treated with a series of treatments，including corticosteroids，immunoglobulin，but should be very careful of platelet infusion，for patients with TTP，platelet transfusion is forbidden.

Select

Treatment of premature rupture of membrane before 34 weeks of gestation. BAI Yu-xiang,QI Hong-bo. 2014, 30(6): 410-413.  DOI: 10.7504/fk2014050104 Abstract ( )   PDF (903KB) ( )   Abstract:According to pulmonary immaturity,many complications, poor pregnancy outcome, premature rupture of membranes before 34 weeks of gestation is much difficult to be treated.The general principles of PPROM treatment should be mastered in clinical: once the risk of infection is more serious than the risk of preterm complications, pregnancy termination should be considered.Gestation week need to be prioritized when treating PPROM. Different gestational age needs different treatment strategies.

Select

The maternal and fetal risk factors and management for stillbirth. FAN Shang-rong*, LIN Xiao-mei. 2014, 30(6): 413-415.  DOI: 10.7504/fk2014050105 Abstract ( )   PDF (887KB) ( )   Abstract：The most prominent maternal risk factors for stillbirth are pre-existing maternal disorders such as diabetes, and pregnancy complications such as antepartum haemorrhage,intrahepatic cholestasis of pregnancy，fetal growth restriction, monochorionic twins, and infections.Fetal and umbilical Doppler and ultrasound imaging may predict the causes of stillbirth.The administration of low-dose aspirin (60 80 mg) may prevent preeclampsia and adverse perinatal outcomes in high-risk pregnancy. Autopsy, placental examination, and testing for fetal maternal hemorrhage are basic tests for workup after fetal death.

Select

The conservative treatment of placenta increta. WANG Zhi-jian,WEI Yan-xing. 2014, 30(6): 415-418.  DOI: 10.7504/fk2014050106 Abstract ( )   PDF (904KB) ( )   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.

Select

Standardized interpretation and management of abnormal FHR in the second stage of labor. LI Fan-fan，DEGN Dong-rui. 2014, 30(6): 421-425.  DOI: 10.7504/fk2014050108 Abstract ( )   PDF (908KB) ( )   Abstract:Electronic fetal heart rate monitoring (EFM) has become the most widely used means of fetal monitoring currently in clinical obstetrics because of its many advantages over other methods such as simple，non-invasive and real-time. However，controversies still exist in relation to the definition and interpretation of the EFM graphics and no consensus has been reached in clinical decisions based on the results of monitoring. This article describes the latest standardized，simplified approach to the definition，interpretation，and management of electronic fetal heart rate monitoring.

Select

Vaginal birth after previous c-section. CHEN Qian. 2014, 30(6): 425-428.  DOI: 10.7504/fk2014050109 Abstract ( )   PDF (903KB) ( )   Abstract：The article introduced the safety, indication, risk, management in labor and induction with the labor with previous cesarean section. Prenatal counseling and monitoring are very important. 

Select

Antenatal neuroprotection for preterm infants. QIU Li-li，HU Ya-li. 2014, 30(6): 428-431.  DOI: 10.7504/fk2014050110 Abstract ( )   PDF (902KB) ( )   Abstract:Each year，more than 15 million babies are born preterm worldwide，which becomes the largest cause of neonatal deaths.In addition to its significant contribution to mortality，some effects of preterm birth on survivors are life-long impairing such as cerebral palsy，mental retardation，and so on.It is critical to prevent against neurological deficit in utero.Several randomized controlled trials and Cochrane reviews demonstrated that giving magnesium sulfate antenatally to women at risk of preterm birth could reduce the risk of the newborn cerebral palsy.However it remains elucidate detailed indications for different pretermbirth，magnesium sulfate dosage，treatment window and course.

Select

Standard management of anemia in pregnancy. TANG Yu-ping,YING Hao. 2014, 30(6): 431-434.  DOI: 10.7504/fk2014050111 Abstract ( )   PDF (904KB) ( )   Abstract：Anemia, a common complication during pregnancy affecting the health of mothers worldwide, two thirds of them being from Asia, has been an important problem of prenatal preventive health care. Blood volume expansion with a disproportionate plasma volume increase is an important reason for high incidence of anemia in pregnancy. Nutritional anemia, particularly iron deficiency anemia is common. The main managements of iron deficiency anemia are oral iron supplements and parenteral iron therapy. In addition, thalassemia, caused by genetic defect, threaten the health of mothers and fetuses. Therefore,prevention,detection and treatment at early stage are of great importance for the mothers and fetuses． 

Select

Expectant treatment of early-onset severe preeclampsia. ZHOU Qiong-jie,LI Xiao-tian. 2014, 30(6): 434-436.  DOI: 10.7504/fk2014050112 Abstract ( )   PDF (887KB) ( )   Abstract：The prevalence of early-onset severe preeclampsia is 0.3%. Expectant treatment is a reasonable approach for some patient: (1) transient laboratory abnormalities; (2) severe preeclampsia based solely on proteinuria; (3) severe preeclampsia based solely on fetal growth restriction; (4) severe preeclampsia based solely on blood pressure criteria.

Select

The expression of IGF-1R, VEGF-C and its relationship with cervical cancer lymph node metastasis. FU Gai-ling, XUE Ling-ling，ZHOU Xiao-liang. 2014, 30(6): 437-440.  DOI: 10.7504/fk2014050113 Abstract ( )   Abstract:Objective Explore the expression of IGF-1R, VEGF-C and its relationship with cervical cancer lymph node metastasis.Methods Selected 50 cases of cervical squamous carcinoma tissues as the experimental group, 30 cases of normal cervical tissue as control group, using immunohistochemical SP method research the expression of IGF-1R, VEGF-C.Results The experimental group, lymph node metastasis was the positive expression of IGF-1R and VEGF-C ([WTBX]P[WTBZ]<0.05).Lymphatic vessel density marked by D2-40 in IGF-1R, VEGF-C positive expression group was significantly higher than negative group, and both positive expression in the experimental group were positively correlated.Conclusion The expression of IGF-1R,VEGF-C associated with cervical lymph node metastasis, lymphatic channel transfer has certain value for early judgment of cervical squamous carcinoma, joint detection both are important indicator of prognosis, and could guide clinical treatment.

Select

Value of MRI in changes of endometrial carcinoma according to FIGO 2009 stage and misdiagnostic analysis. TENG Fei*, SUN Dan-dan*, YU Jing, WANG Ying-mei*, TIAN Wen-yan*, XUE Feng-xia*. 2014, 30(6): 441-447.  DOI: 10.7504/fk2014050114 Abstract ( )   Abstract：Objective To evaluate the diagnostic value of enhanced MRI in myomerial infiltration,cervical infiltration and lymph node metastasis of endometrial carcinoma and analyze the misdiagnostic factors.Methods From March 2009 to March 2013,167 patients with endometrial carcinoma in Department of Gynecology of Tianjin Medical University General Hospital were studied retrospectively. All patients underwent enhanced MRI scan before operation, MRI staging were compared with surgicopathologic staging and several factors that make accurate assessment of myometrial infiltration, cervical infiltration and lymph node metastasis difficult by MRI were analyzed. Results (1) The accuracy of MRI varied with the stage of tumor, the advanced stage the tumor, the lower the accuracy. The accuracy decreased as tumor grade increased. The differences of accuracy rate had statistically significant (P<0.05); The accuracy for the endometrioid type and non-endometrioid type were 79.74% and 64.29%, the differences of accuracy rate had statistically significant(P<0.05).(2) The sensitivity, specificity, diagnostic accuracy, positive and negative predictive values and ? value of MRI in identifying superficial myometrial infiltration were 91.79%, 90.91%, 91.62%, 97.62%, 73.17% and 0.758, respectively.Those for deep myometrial infiltration were 90.91%, 91.79%, 91.62%, 73.17%, 97.626% and 0.758, respectively. Those for cervical infiltration were 84.21%, 95.95%,9 4.61%, 72.73%, 97.93% and 0.750,respectively.Those for lymph node metastasis were 45.00%, 91.16%, 85.63%, 40.91%, 92.41% and 0.347,respectively. (3) The main causes of error in enhanced-MRI were myomas, cornual lesions, deep myometrial invasion, large tumor size, non-endometrioid tumor type and lower tumor grade( All P<0.05). Conclusion Enhanced MRI has a high accuracy and a low tendency to produce false negatives in identifying patients with deep myometrial invasion, cervical invasion, and pelvic lymph node metastasis. The main causes of error in preoperative prediction were myomas, cornual lesions, large tumor size, non-endometrioid tumor type, and lower tumor grade.

Select

Expression of HuR mRNA and protein,COX-2 protein in ovarian serous carcinoma and its clinical significance. CHENG Li, WANG Min,WANG Dan-dan,SHI Cong, SHUANG Ting,YAN Xiao-yu. 2014, 30(6): 448-452.  DOI: 10.7504/fk2014050115 Abstract ( )   Abstract：Objective To estimate the human antigen R mRNA and protein，COX-2 protein in ovarian serous tumors and understand their role in ovarian serous carcinoma genesis and progression and further to explore the relationship between HuR and COX-2. Methods The expression of HuR mRNA and protein, COX-2 protein were detected in 31 cases who underwent surgery for histologically verified ovarian serous carcinoma,22 cases verified ovarian serous benign tumor and 8 normal ovary tissues as control at the Department of Obstetrics and Gynecology, ShengJing Hospital, China Medical University between 2006 and 2008 by using RT-PCR，immunohistochemistry. Results （1）There is significant difference of expression of HuR mRNA between ovarian serous carcinoma and ovarian benign tumor,normal ovary tissue（P<0.05）. The expression of HuR mRNA was related with histological classification（P<0.05），however,which was not correlated with clinical staging，lymph node metastasis of ovarian serous carcinoma（P>0.05）.（2）Immunohistochemical staining analysis showed the relative content of HuR protein(IOD) and cytoplasmic HuR positve expression in ovarian serous carcinoma were statistically higher than that in ovarian benign serous tumor and normal ovary tissue([WTBX]P[WTBZ]<0.05).The relative content of HuR protein(IOD) and cytoplasmic HuR positive expression were related with histological classification（P<0.05），however，which were not correlated with clinical staging，lymph node metastasis of ovarian serous carcinoma （P>0.05）.（3）There was a trend of correlation between cytoplasmic COX-2 and clinical staging（P<0.05）, however，no significant association was found between cytoplasmic COX-2 and histological classification，lymph node metastasis of ovarian serous carcinoma（P>0.05）. According to Spearman rank correlation analysis,there is a positive correlation between HuR and COX-2 expression.Conclusion The overexpression of HuR is correlation with ovarian serous carcinoma genesis and progression，and it may well be that part of the tumor-promoting effect of HuR is dependent on induction of COX-2 expression.

Select

MRI-based three-dimensional reconstruction of cardinal ligament and uterosacral ligament in female. HUANG Lu*, CHEN Chun-lin*，LIU Ping*,PENG Cheng*，CHEN Lan*，CHEN Ruo-lan*，REN Dao-kun,TANG Lei, ZHONG Shi-zhen. 2014, 30(6): 453-456.  DOI: 10.7504/fk2014050116 Abstract ( )   Abstract：Objective To explore the method and significance of three-dimensional reconstruction of cardinal ligament and uterosacral ligament in female based on magnetic resonance imaging （MRI）. Methods Select 1 healthy young female volunteers undertake the high resolution thin proton density weighted scanning. MR images were imported into Mimics 10.01 for 3D reconstruction. Results Models of cardinal ligament and uterosacral ligament and its surrounding structures were successfully built. The reconstructed model of cardinal ligament and uterosacral ligament is of clear surface and can be continuously rotated in 3D space. Using the 3D measurement tool can also do the quantitative analysis about its morphology. Conclusion Using related software like Mimics with database collected through MRI, the model of cardinal ligament and uterosacral ligament could be successfully constructed, which may provide a platform for teaching of anatomy and quantitative study of ligament.

Select

Study on early clinical characteristics of mild and severe preeclampsia with regular prenatal care. SONG Ying，YANG Zi，SHEN Jie,WANG Jia-lue，CHEN Yang. 2014, 30(6): 457-461.  DOI: 10.7504/fk2014050117 Abstract ( )   Abstract：Objective Study on the early clinical features of mild pre-eclampsia (M-PE) and severe pre-eclampsia (S-PE) cases with regular prenatal care to investigate the clinical means and intervention timing to reduce the occurrence and development of S-PE. Methods Clinical observational data of pre-eclampsia cases with regular prenatal care in Peking University Third Hospital between January 2008 and December 2011 was collected. A cohort analysis study was conducted. The high risk factors and clinical characteristics were analyzed in mild and severe cases. These cases were subgrouped into routine prenatal care and reinforce prenatal care groups. Results 1.There was no significance difference of high risk factors and initial symptoms between M-PE and S-PE groups (P>0.05). 2. Clinical characteristics were analyzed in M-PE and S-PE of singleton pregnancy with isolated PE cases. 1) Warning clinical signs before meet the PE diagnostic criteria：Compared with M-PE group，the rate of prehypertension，hypoproteinemia，PLT declined were higher in S-PE group (P<0.05). Also，The rate of cases experienced albumin<29 g/L，PLT declined>40% were higher in S-PE group than M-PE group (P<0.05). 2) The interval time from warning signs to initial symptoms appearance in S-PE group was shorter than M-PE group (P<0.05).The time interval from warning signs to meet the PE diagnostic criteria in S-PE group was shorter than M-PE group (P<0.05). 3. The proportion of S-PE was much lower in reinforce prenatal care group than in routine prenatal care group (P<0.05). Compared with routine prenatal care group，though the initial symptoms appeared earlier in reinforce prenatal care group，but the onset of PE was later(P<0.05). 4. Multivariate regression analysis showed that overweight in early pregnancy (OR 2.480，[WTBX]P[WTBZ]=0.035)，prehypertension (OR 3.304，[WTBX]P[WTBZ]=0.046)，hypoproteinemia (OR 3.951，[WTBX]P[WTBZ]=0.035)，PLT decreased (OR 2.582，[WTBX]P[WTBZ]=0.047)，reinforce prenatal care(OR 0.321，[WTBX]P[WTBZ]=0.041) were independent risk factors affecting the severity of pre-eclampsia. Conclusion This study shows there was significant heterogeneity in warning clinical sign before disease onset between M-PE and S-PE groups. It is possible to monitor and manage the clinical symptoms earlier，and reduce the occurrence and development of PE，especially S-PE. Overweight in early pregnancy，prehypertension，hypoproteinemia，PLT decreased，and prenatal care were independent factors affecting the severity of pre-eclampsia.

Select

Clincal effectiveness of the induction of labor in women with previous uterine scar at the second and third trimester. LI Qi-han*,QIAO Chong*,YANG Xiao-mei*,ZHANG Liang*,ZHANG Ying. 2014, 30(6): 462-465.  DOI: 10.7504/fk2014050118 Abstract ( )   Abstract： Objective To investigate the methods and clinical effectiveness of the induction of labor in women with previous uterine scar at the second and third trimester. Methods A retrospective study was performed in 98 cases of pregnant women with scarred uterus，who requested termination of pregnancy due to fetal abnormality or maternal complications in Shengjing Hospital of China Medical University

Select

The analysis of the changes in Xinjiang Uigur female obstetric diameters and the morphology. KE Yan*, SONG Xiao-lei*,LIU Ping, CHEN Chun-Lin,BIAN Xue-feng,FAN Xia, XIA Ying-hong. 2014, 30(6): 466-470.  DOI: 10.7504/fk2014050119 Abstract ( )   Abstract:Objective To analyze the changes in Xinjiang Uigur female obstetric diameters and the morphology.Methods 400 cases of the Uigur childbearing-age women in Xinjiang with pelvic CT were performed, and the pelvimetric data which were measured by means of digital pelvic measurement technology and two-dimensional reconstruction of CT measurement method and compared with 20 years ago, conventional X-ray measurement data were analyzed.Results The pelvis of the gynecoid type and flat type are significantly increased compared with that of the 20 years ago group (P<0.05), the percentage of flat type increased significantly.The obstetric diameters are visibly different only in the pelvic inlet and the pelvic depth, but there was no significant difference in the mid pelvis and the pelvic outlet (P>0.05).Transverse diameter of pelvic inlet was significantly increased (P<0.05), but conjugate of the inlet and sacropubic diameter was significantly reduced (P<0.05).Synchondroses pubis height and sacrum length was significantly reduced (P<0.05), but sacral curvature had no significant difference(P>0.05).Conclusion The percentage of flat type pelvis increased significantly in Xinjiang Uigur female.The pelvic inlet are changing into the elliptical form.The obstetric diameters of the mid pelvis and the pelvic outlet changed little.The Pelvic depth are lowered.

Select

The correlation between abortion during early pregnancy and serum sex hormone binding globulin level in patients with recurrent spontaneous abortion. ZHOU Jia-ren，WANG Xiao-yan, CHI Xin-shu, LIAN Si-yu,SUN Qian, JIN Zhen. 2014, 30(6): 471-474.  DOI: 10.7504/fk2014050120 Abstract ( )   Abstract：Objective To study character of the serum sex hormone binding globulin (SHBG) level and insulin resistance in patients with history of recurrent spontaneous abortion during early pregnancy, evaluate the outcome of pregnancy. Methods 122 patients with history of recurrent spontaneous abortion registered for treatment in the Shengjing Hospital of China Medical University between June 2011 and June 2013 were selected into case group. 56 healthy women during early pregnancy were selected into control group.In pregnancy 8-10 weeks,data and serum specimens of women were collected in the cases group and the control group. To detect the indexes of SHBG, fasting blood glucose (FPG),fasting insulin (FINS), estradiol (E2), testosterone (T), dehydroepiandrosterone sulfate (DHEAS). Serum SHBG determination by enzyme linked immunosorbent assay (ELISA) method. FPG determinate by oxidase method. FINS,E2,T,DHEAS detected by chemiluminescence immunoassay.Results （1）Maternal body height, diastolic blood pressure and detecting gestational weeks in comparison, their difference in case group and in control has no statistical significance（P>0.05).The age of pregnancy women in case group and in control group in comparison, their difference has statistical significance（P<0.05).The body weight, body mass index, systolic blood pressure, previous pregnancy and history of recurrent spontaneous abortion in case group and in control group in comparison, their difference has statistical significance (P<0.01). （2）The SHBG,FPG,FINS,HOMA-IR and DHEAS in case group and in control group in comparison, their difference has statistical significance (P<0.01).The E2 and T of pregnancy women in case group and in control group in comparison, their difference has no statistical significance（P>0.05). （3）Body height, body mass index,SHBG and DHEAS in analysis of multiplicity were the influencing factors on recurrent spontaneous abortion (P<0.01). Conclusion Insulin resistance in early pregnancy women with history of recurrent spontaneous abortion increased than normal pregnant women，and HOMA-IR decreased than normal pregnant women. SHBG were one of the influencing factors on recurrent spontaneous abortion.

Select

 Analysis of prognostic factors of 160 cases with epithelial ovarian cancer. DU Jun-yao*,DU Zhen-guang,CHANG Lu,RAO Jun,LI Lian-kun*. 2014, 30(6): 475-478.  DOI: 10.7504/fk2014050121 Abstract ( )   Abstract:Objective To assess prognostic factors impacted on overall survival in patients with epithelial ovarian carcinoma．Methods Totally 160 patients with stages I-IV epithelial ovarian carcinoma admitted in Liao-ning Provincial Cancer Hospital from Jan. 2006 to Dec. 2007 were analyzed by retrospective analysis．Results The prognosis of epithelial ovarian carcinomas were related to the number of labors，stage, peritoneal metastasis, the size of residues lesions, the number of courses of chemotherapy, sensitivity to platinum and the level of CA125 after 2-3 courses of chemotherapy (P<0．05).Compared with stage Ⅳ, the risk of mortality was 0.164 for stage Ⅰ(95%CI 0.035-0.775),0.175 for stage Ⅱ(95%CI 0.037-0.820),0.359 (95%CI 0.184-0.704 ) for stage Ⅲ ([WTBX]P[WTBZ]<0.05). The risk of mortality was 0.368，(95%CI 0.209~0.647) for the patients received ≥6 courses of chemotherapy,in comparison with patients received ＜6 courses of chemotherapy（P<0.01）.The risk of mortality in the patients insensitive to platinum was 4.434 times higher than that in patients sensitive to platinum (95%CI 2.454-8.012, P<0.01). The risk of mortality in the patients of serum CA125＞35 kU/L after 2-3 courses of chemotherapy was 2.062 times higher than that in patients CA125≤35 kU/L (95%CI 1.190-3.572,[WTBX]P[WTBZ]=0.01).Conclusion The major independent prognostic factor of epithelial ovarian carcinoma is stage， the number of course of chemotherapy，sensitivity to platinum and the level of CA125 after 2-3 courses of chemotherapy.

Select

The association between increased serum E2/P and the altered expression of TRAF3 during the “window of implantation” in women with recurrent implantation failure. LIU Bei-yu，LI Jie，XIA Ting-ting，XU Shao-yuan. 2014, 30(6): 479-483.  DOI: 10.7504/fk2014050122 Abstract ( )   Abstract：Objective To analyze serum level of Estradiol (E2),Progesterone (P)，E2/P，endometrial histological dating,Estrogen receptor (ER),Progesterone receptor (ER)，and expression of TNF receptor-associated factor 3 (TRAF3) between women with unexplained recurrent implantation failure and fertile controls during the window of implantation，and discuss their association with repeated embryo implantation failure.Methods A total of 34 women (15 of them had RIF，19 of them were fertile controls) were recruited into this study.Endometrial sample was collected during “window of implantation” by micro biopsies.Western blot analysis and immunohistochemistry of TRAF3 were performed for localization and semi-quantitative analysis between two groups.Results There were no differences of serum E2，P，endometrial stromal/glandular ER，PR and normality of histological dating during “window of implantation” between RIF and controls.The serum E2/P was significantly higher in RIF group compared with controls ([WTBX]P[WTBZ]=0.026).Positive staining for the TRAF3 was seen in both epithelial cells and stromal compartments，with a much more intense staining in epithelial cells than stromal cells.Semi-quantitative results demonstrate a significant decrease of TRAF3 in women with RIF.Conclusion This study demonstrated the expression and localization of TRAF3 in endometrium of women with RIF during implantation window.The higher ratio of E2/P may have an effect on the local endometrial molecular expression.