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02 February 2018, Volume 34 Issue 2 Previous Issue    Next Issue

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Microenvironment of maternal-fetal interface and preterm birth. MENG Nan，ZHANG Si-ya 2018, 34(2): 135-140.  DOI: 10.19538/j.fk2018020103 Abstract ( )   Preterm birth means that a baby is born before 37 weeks of pregnancy.At present，preterm birth occurs in about 15 million infants, and 1 million among them die within 1 month. Therefore，preterm birth，as a global problem，induces heavy burden on the society. So it is urgent to investigate the mechanisms of preterm birth and find appropriate methods to prevent the incidence of preterm birth. Here we explore three aspects of maternal-fetal interface microenvironment：trophoblast, decidua，and immue cells，to explain how microenvironment change of fetal-maternal interface plays a role in preterm birth.

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Genital tract infection and preterm birth. SUN Wen，LIU Shi-liang 2018, 34(2): 140-143.  DOI: 10.19538/j.fk2018020104 Abstract ( )   Genital tract infection is an important risk factor of preterm birth，and their relationship varies with gestational age.Except for the vagina，the cervix and placenta have independent bacterial colonization；however，the association between preterm birth and the microbiome of the cervix and placenta needs further study.Currently，there is no consensus on whether antibiotics should be used in genital tract infection during pregnancy.

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Determination of residual amniotic fluid and perinatal outcomes in preterm premature rupture of membranes. GONG Xun，DENG Dong-rui 2018, 34(2): 143-146.  DOI: 10.19538/j.fk2018020105 Abstract ( )   Preterm premature rupture of membrane（PPROM）occurs often.Oligoamnios leads to poor perinatal outcomes.This article focuses on adverse perinatal outcomes which are caused by preterm premature rupture of membranes and their mechanism.According to the guidelines of preterm premature rupture of membranes，this paper presents the treatments of PPROM with oligoamnios and expects to cause the attention to this disease.

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Cerclage for cervical insufficiency to prevent preterm birth. LI Xue，ZHANG Hong 2018, 34(2): 146-150.  DOI: 10.19538/j.fk2018020106 Abstract ( )   Cervical insufficiency（CI），described as the inability of the uterine cervix to retain a pregnancy in the absence of the signs and symptoms of clinical contractions，which is one of the main reasons leading to second-trimester pregnancy loss and preterm birth.Pathogenesis of CI is uncertain.The acquired CI such as prior loop electrosurgical excision procedure，cone biopsy and prior vaginal radical trachelectomy brings new challenges.At present there is no guideline or consensus for the screening and management of CI.Compared with expectant treatment，role of cervical cerclage remains controversial.The article attempts to review the relevant studies on the cervical cerclage for the treatment of cervical insufficiency.

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Progestogen for the prevention of preterm birth. FEI Kui-lin，ZHANG Wei-she 2018, 34(2): 150-154.  DOI: 10.19538/j.fk2018020107 Abstract ( )   The incidence of preterm birth remains high，and even keeps rising year by year.Premature birth，along with the premature infants it causes，is an important cause of perinatal death and disability.This is due to the unsatisfactory effect of the prevention and treatment of preterm birth，in which emphasis has been given to integrated therapy.The application of progestogen has also achieved a certain effect in recent years，but not without controversy.This article reviews clinical research and expert consensus at home and abroad，hoping that it will benefit the clinical practice.

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Prevention and treatment of preterm birth in twin pregnancy. YUAN Peng-bo，ZHAO Yang-yu 2018, 34(2): 154-158.  DOI: 10.19538/j.fk2018020108 Abstract ( )   The rate of preterm labor in twin pregnancy was significantly higher than that of singleton pregnancy.Preterm labor was one of the leading causes of infant mortality，and the exact mechanism was not clear.Preterm birth prevention and treatment could improve the outcome of the infants.The ultrasonographic measurements of cervix length and fetal fibronectin test have certain predictive value for preterm labor in twin gestation.The treatment with vaginal progesterone，cerclage of cervix，and pessary insertion might have certain effects on the preterm birth control of twins，but the previous studies don't have consistent conclusions and there is still a lot of controversy in the clinical application.

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Use of antenatal corticosteroids for premature birth. WU Jian-li，ZHU Qi-ying 2018, 34(2): 158-160.  DOI: 10.19538/j.fk2018020109 Abstract ( )   Preterm birth is a main cause of high perinatal neonatal mortality and morbidity in the world.The incidence of respiratory distress syndrome，intraventricular hemorrhage and necrotizing enterocolitis in premature infants can be effectively reduced by using antenatal corticosteroids.The use of antenatal corticosteroids varies across different countries，so we summed up the evidence-based proof in the use of glucocorticoids to guide clinical practice.

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Application of antibiotics in PPROM. SUN Xiao，SHI Chun-yan 2018, 34(2): 160-164.  DOI: 10.19538/j.fk2018020110 Abstract ( )   The causes of PPROM are multifactorial，but infection is the primary cause.Infection appears to either as a cause or as a consequence of PROM.Application of antibiotics in PPROM can reduce the morbidity rate and prolong the duration of pregnancy.After the diagnosis of PPROM，it is necessary to screen B streptococcus carriage of the vagina and perianal region and perform culture of midstream urine，and use broad spectrum antibiotics at the same time for those who expect to prevent miscarriage.The antibiotic regimen consists of 48 hours of intravenous therapy followed by five days of oral medications with a combination of ampicillin and erythromycin.It may be reasonable to administer erythromycin alone for women who are allergic to ampicillin.For positive group B streptococcus carriage or penicillin allergens appropriate antibiotics should be used.The benefit is greater at earlier gestational ages（＜32 weeks）.Induction is recommended at later gestational ages（＞34 weeks）.The use of antibiotics is according to individual circumstances.Women with PPROM and positive group B streptococcus carriage should receive intrapartum GBS prophylaxis to prevent vertical transmission regardless of earlier treatments.For those seriously infected，the use of broad-spectrum antibiotics should be used.