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    02 February 2015, Volume 31 Issue 2 Previous Issue    Next Issue

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    The present situation and prospect of normal labor.
    LIU Xing-hui,DAI Li.
    2015, 31(2): 97-100.  DOI: 10.7504/fk2015010101
    Abstract ( )   PDF (914KB) ( )  

    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.

    Establish rapid response team at the delivery room to reduce the incidence of adverse pregnancy outcomes
    CHEN Dun-jin,DU Pei-li.
    2015, 31(2): 101-104.  DOI: 10.7504/fk2015010102
    Abstract ( )   PDF (902KB) ( )  

    Abstract: In regard of an increase in maternal mortality, the American College of Obstetricians and Gynecologists (ACOG) and the Joint Commission recommended creating obstetric rapid response teams. These recommendations include using drills to ensure competency during emergencies. The building of rapid response teams at the delivery room can early identify the deterioration signs of maternal and respond quickly, in order to significantly reduce maternal uterus resection rate and mortality rate, and make the maternal-fetal outcomes.

    The overview of the methods and value of pelvimetry.
    YU Xin-yang, QI Hong-bo.
    2015, 31(2): 109-112.  DOI: 10.7504/fk2015010103
    Abstract ( )   PDF (942KB) ( )  

    Abstract:Size and shape of the bony pelvis are important factors determining the progress of labor and delivery. For obstetricians, the internal and external pelvimetry is the manual examination of the pelvis to determine if it is adequate size for childbirth. Clinical evaluation of the pelvis, X-ray pelvimetry, three-dimensional reconstruction of pelvis based on computed tomography(CT) scan and magnetic resonance imaging(MRI) are the most common methods of pelvimetry. This article elaborates on the clinical significance and practicability of different kinds of methods, and assesses the clinical value of pelvimetry.

    Maternal position during labor.
    HE Jing, CHEN Lu.
    2015, 31(2): 112-116.  DOI: 10.7504/fk2015010104
    Abstract ( )   PDF (954KB) ( )  

    Abstract:Pelvis is an important variable element during labor. Intrapartum maternal postural adjustments can accelerate the progress of labor and promote natural childbirth. Each position has its own advantages and different influences on labor. We should identify potential anomalies of cephalopelvic factors in different staged of labor and provide proper posture guidance.

    Analgesia:current situation and urgent problems.
    SUN Wei-jie, QU Yuan.
    2015, 31(2): 116-120.  DOI: 10.7504/fk2015010105
    Abstract ( )   PDF (958KB) ( )  

    Abstract:Good obstetric care requires the availability of qualified personnel and equipment to administer general or regional anesthesia both electively and emergently. Good interpersonal relations between obstetricians and anesthesiologists are important, both should recognize the need to provide high-quality care for all patients. Labor analgesia health care system should be established.

    Methods and necessity of labor surveillance.
    HAN Huan,HUANG Yi-ying,YING Hao.
    2015, 31(2): 120-123.  DOI: 10.7504/fk2015010106
    Abstract ( )   PDF (946KB) ( )  

    Abstract:Labor surveillance is a method to assess the fetal′s well-being in the uterus and the process of labor by artifical or biophysical or biochemical methods,in order to identify intrauterine fetal anoxia and dystocia early.Fetal surveillance includes intermittent auscultation,cardiotocography,fetal scalp stimulation test,fetal scalp blood sampling and fetal pulse oximetry.Cardiotocography is always the most necessary and effective method.

    Intervention options and its necessity in the first-stage of labor.
    WANG Zi-lian,WU Yan-xin.
    2015, 31(2): 123-127.  DOI: 10.7504/fk2015010107
    Abstract ( )   PDF (962KB) ( )  

    Abstract:There has been a turning point in the course of spontaneous labor with the rapid development of the social economy and the change of the lifestyle. The new partogram, rather than the classical Friedman curve, derived since the advent of the active phase of the first stage of labor, during which more rapid cervical dilation occurs beginning at approximately 6 cm, so far is concerned and admissible. To date, more and more researches have identified the abnormal labor patterns in first-stage, protraction disorder or arrest disorder occur during the latent or active phase. Since then, management options for the first-stage disorders, including vaginal examination, AROM (artificial rupture of membranes), monitoring and management for abnormal uterine contractions, intrapartum fetal surveillance,are controversial. A major goal of this report is to investigate the utilization of the above managements during the first stage, which should be balanced between performing the trial of labor and avoiding the concomitant risk of operative and cesarean delivery.

    Evidence-based evaluation of reducing the episiotomy.
    SUN Li-zhou, HUANG Shi-yun.
    2015, 31(2): 127-131.  DOI: 10.7504/fk2015010108
    Abstract ( )   PDF (962KB) ( )  

    Abstract:Episiotomy is defined as operations expanding export birth canal in the second stage of vaginal delivery with a surgical incision in the perineum. Its introduction is lack of enough evidence. Nowadays more and more evidence show that the operation is associated with maternal perineal injury, pelvic floor dysfunction, postpartum sexual dysfunction, infection, pain, bleeding and so on. And lots of studies show that episiotomy is of no help to the outcome of the newborns. A number of comprehensive studies of the domestic and foreign researches are included in this article to discuss the unnecessary episiotomy from the angle of evidence-based medicine, which will help readers build reducing- episiotomy concept.

    Applications of Laborpro system to the research and management of labor.
    SHI Qi1,2, ZHU Wen-ping1, QI Hong-bo1.
    2015, 31(2): 132-136.  DOI: 10.7504/fk2015010109
    Abstract ( )  

    Abstract: Objective To investigate the application of the Laborpro system to the research and management of labor. Methods The prospective study was designed and 36 singleton term, vertex pregnancies were recruited. The Laborpro system was used to conduct internal pelvimetry, and the data were collected by vaginal examination (VE) vs. anal examination (AE). The system calculations of dilation of cervix and fetal head station were compared with routine vaginal examination measurements. The measurers were blinded to the system results, and 72 and 69 measurements were involved respectively.Results The anteroposterior diameter of pelvic outlet by AE was longer than that by VE about 1 cm. The system result of cervical dilatation was bigger than manual result, and the station of fetal head was higher. The accuracy of assessment of labor progress by senior midwives was better than that by junior midwives:(79.59% vs. 53.85%)and(76.27% vs. 53.84%).Conclusion Laborpro system offers and advanced technique to measure pelvic, monitor and study labor. The standard guideline of midwife training should be built by using this system appropriately.

    Outcomes and prognostic factors of cervical cancer in 264 patients of stage Ⅱb-Ⅲ.
    DU Jun-yao,ZHANG Xin,LI Lian-kun.
    2015, 31(2): 137-141.  DOI: 10.7504/fk2015010110
    Abstract ( )  

    Abstract: Objective To evaluate the outcomes and the prognostic factors in advanced cervical cancer. Methods Totally 264 patients with stages Ⅱb-Ⅲ advanced cervical cancer treated in Liaoning Cancer Hospital&Institute from Mar. 2007 to Oct. 2008 were analyzed retrospectively.Results The median follow-up time was 75 months.The 2-year and 5-year overall survival (OS) was respectively 77.7% and 65.5%. The 2-year and 5-year disease-specific survival(DSS) was respectively 78.1% and 66.5%. The 2-year and 5-year disease-free survival(DFS) was respectively 72.7% and 64.2%.The results of univariate analysis showed that the prognostic factors of cervical cancer were related to stage(Ⅱb versus Ⅲ, P<0.01),tumor size(<4 cm、4~6 cm、>6 cm,P<0.01), the pathological type (squamous carcinoma versus adenocarcinoma, P<0.01),vagina invasion (none,upper,middle,lower, P<0.01),pelvic and/or para-aortic lymph nodes metastasis (pelvic and para-aortic negative,only pelvic positive, pelvic and para-aortic positive, without CT, P<0.01) and the nadir hemoglobin (>110 g/L, 95~110 g/L, 75~<95 g/L, 52~<75 g/L, P<0.01).The outcomes of multivariate analysis showed that these clinical characteristics,including stage, the pathological type,pelvic and/or para-aortic nodes and the treatment arm,were associated with OS ,DSS and DFS. The hemoglobin before treatment was associated with DFS ,but not with OS or DSS. Conclusion The patients have poor prognosis with stage Ⅲ, adenocarcinoma, pelvic and/or para-aortic nodes positive, radiotherapy alone and the nadir hemoglobin<75 g/L.

    Analysis of reproductive prognosis in 64 cases of complete septate uterus with duplicated cervix and longitudinal vaginal septum after hysteroscopic septum resection.
    HUANG Li-na*,JIANG Jing-yi,WU Rui-jin.
    2015, 31(2): 142-144.  DOI: 10.7504/fk2015010111
    Abstract ( )  

    Abstract: Objective To evaluate the reproductive prognosis of patients with duplicated cervix and longitudinal vaginal septum undergoing hysteroscopic septum resection of the complete septate uterus.Methods Sixty-four patients with complete septate uterus and duplicated cervix and longitudinal vaginal septum underwent hysteroscopic septum resection. All patients were divided into recurrent abortion group (n=26) and infertility group (n=38) according to their obstetrical situation. The pregnancy outcomes of these patients were followed up by telephone or out-patient clinic.Results In recurrent abortion group, there were 25 women with 31 pregnancies.The abortion rate declined from 83.1%(54/65)to 41.9% after operation(13/31).The full-term pregnancy rate, premature delivery and living birth increased to 35.5%(11/31),19.3 %(6/31)and 54.8%(17/31)respectively (P<0.05). In infertile group, there were 18 women pregnant (18/38),including 12 full-term labor. In the research objects,the cases of premature labor and full-term labor were 32 .The premature delivery rate was 28.1%(9/32)and the full-term pregnancy rate was 71.9%(23/32).In the research objects,the incidence of placental adherence was 21.9%(7/32),and the incidence of postpartum hemorrhage was 25.0%(8/32). Conclusions The pregnancy rates and reproductive prognosis in the women with complete septate uterus and duplicated cervix and longitudinal vaginal septum is improved after hysteroscopic septum resection.

    The characteristic of uterine artery pulsatility index in women with recurrent implantation failure evaluated by color Doppler ultrasound.
    QU Qing-lan*, YIN Wei-hong, WANG Xin-rong*, LIU Xue-mei*, WANG Wen-juan*.
    2015, 31(2): 145-148.  DOI: 10.7504/fk2015010112
    Abstract ( )  

    Abstract: Objective To investigate the value of uterine artery pulsatility index (UAPI) and its correlation factors in patients with recurrent implantation failure (RIF). Methods Between Mar. 2012 and Aug. 2013, forty RIF patients, forty infertility patients who become pregnant after in vitro fertilization- embryo transfer technology and forty infertility patients with implantation faliure after the first time in vitro fertilization- embryo transfer technology were analysed retrospectively. UAPI and endometrial thickness were examined by transvaginal Doppler during the humanchorionic gonadotropin (HCG) injection day, meanwhile estrogen (E2) and progestogen (P) were determined.Results UAPI values were higher in RIF patients than in other two groups(P<0.05), but no difference was found in endometrium thickness, estradiol and progesterone level(P>0.05). We observed no correlation between UAPI and endometrial thickness, E2 or P level. Conclusion The measurement of UAPI on HCG day helps to evaluate endometrium receptivity and assess the implantation rate.

    Clinical value of transvaginal color Doppler ultrasonography in the diagnosis of cesarean scar pregnancy.
    SUN Yi*, NIE Xiao-cui.
    2015, 31(2): 149-152.  DOI: 10.7504/fk2015010113
    Abstract ( )  

    Abstract: Objective To explore the clinical value of transvaginal color Doppler ultrasonography in the diagnosis of cesarean scar pregnancy (CSP). Methods The imaging and clinical data of 64 cases of CSP diagnosed by transvaginal ultrasound between October 2012 and October 2014 in Shenyang Women and Children’s Hospital were collected to analyze the correlation between ultrasonographic features and clinical outcomes.Results Among the 64 cases, 59 cases(92.2%)were CSP proved by pathology and 5 cases were inevitable abortion. Based on ultrasonographic features, 59 cases of CSP were divided into 2 types(41 cases of gestational sac type and 18 cases of mixed echo type). Forty-one cases of gestational sac type were divided into 3 subtypes. The first subtype (24 cases) was gestational sac edge located in the incision. The second subtype (15 cases) was gestational sac fully implanted in the incision. The third subtype (2 cases) was gestational sac protruding into the bladder direction. Cases of the first subtype were treated by hysteroscopy mainly. The second, third subtypes and the mixed echo type were treated by laparoscopy mainly.Conclusion Transvaginal color Doppler ultrasonography is an effective method in the diagnosis of CSP. Correct ultrasound typing and accurate scar thickness measurement may contribute to selecting the individualized treatment.

    A clinical analysis and prognosis of 70 cases of primary ovarian clear cell carcinoma.
    TONG Xiao-jing,WANG Xiao-bin,LI Lian-kun.
    2015, 31(2): 153-155.  DOI: 10.7504/fk2015010114
    Abstract ( )  

    Abstract: Objective To investigate clinical characteristics and prognostic factors of ovarian clear cell carcinoma (OCCC).Methods Clinical data of 70 patients with primary ovarian clear cell carcinoma hospitalized in Department of Gynecology,Liaoning Cancer Hospital,China from January 1984 to December 2010 were retrospectively reviewed.

    Analysis of methods for reducing incidence of urinary retention after cervical cancer radical hysterectomy.
    CHEN Qing-qing*,ZHANG Yi*,MENG Xiang-kai*,WANG Hua-li.
    2015, 31(2): 156-159.  DOI: 10.7504/fk2015010122
    Abstract ( )  

    Abstract: Objective To investigate the effective methods for reducing the incidence of urinary retention after the cervical cancer radical hysterectomy.Methods A retrospective analysis was performed,including 188 cases of IA2 ~ⅡA phase cervical cancer patients underwent radical hysterectomy in the First Hospital of China Medical University from January 2001 to December 2008.Application of drugs to improve bladder compliance and to exercise bladder function after the surgery.To observe the recovery of postoperative bladder function and long-term follow-up was done.Results In 188 cases,the urinary retention happened in 28 out of them which constitute 14.89%(28/188) in total.The residual urine volume was 100-200 mL of 14 people,>200-300 mL of 7 people,>300-400 mL of 6 people,1 was more than 800 mL (808 mL).Conclusion It is crucial to decrease the occurence of urinary retention after the cervical cancer radical hysterectomy by exercising the bladder function and early application of drugs that improve the bladder compliance.