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02 June 2023, Volume 39 Issue 6 Previous Issue   

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Optimizing interpregnancy interval to improve pregnancy outcome.   SHENG Chao, WANG Zhi-jian 2023, 39(6): 581-584.  DOI: 10.19538/j.fk2023060102 Abstract ( )   Both short（≤6-18 months）and long（＞60 months）interpregnancy interval（IPI）correlates with adverse maternal and fetal outcomes.In fetal outcome，short IPI increases the incidence of preterm birth，low birth weight and small for gestational age.In maternal outcome，long IPI increases the incidence of preeclampsia，short IPI increases the incidence of uterine rupture during trial of labor after previous cesarean section.Considering IPI is a potentially modifiable factor.It is recommended to advise the optimal interpregnancy interval in pregnant women individually after delivery in order to improve next pregnancy outcome.

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Management of pregnancy and selection of delivery mode in pregnant women with two cesarean sections.  SHI Xiao-ming, ZHAO Yang-yu 2023, 39(6): 584-588.  DOI: 10.19538/j.fk2023060103 Abstract ( )   With the implementation of three-child policy in China，the number of pregnant women with two cesarean sections has gradually increased，and their risk of pregnancy increases significantly.Sufficient pre-pregnancy consultation and strengthening the standardized management of pregnancy and delivery are the keys to ensuring the maternal and neonatal safety and improving the maternal and neonatal outcomes.

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Prediction and prevention of recurrent hypertensive disorders of pregnancy in pregnant women of advanced maternal age. DAI Li, ZHOU Rong 2023, 39(6): 588-593.  DOI: 10.19538/j.fk2023060104 Abstract ( )   Hypertensive disorders of pregnancy（HDP）is one of the most common complications in pregnant women of advanced maternal age，and also one of the risk factors for the recurrence of HDP.This article describes how to predict and prevent the recurrence of hypertensive disorders of pregnancy in pregnant women of advanced maternal age.

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Prevention and management of metabolic disorders after re-pregnancy in elderly obese women. ZHENG Fang-hui, ZHANG Yang, ZOU Li 2023, 39(6): 593-597.  DOI: 10.19538/j.fk2023060105 Abstract ( )   With the improvement of people's living standards and the implementation of the three-child policy，the incidence of gestational obesity and advanced pregnancy is increasing.Elderly and obese women with metabolic disorder before pregnancy are prone to metabolic diseases during pregnancy after their first pregnancy，which cannot be completely recovered after postpartum，leaving metabolic defects and injuries，which leads to the fact that elderly and obese women are more prone to metabolic diseases during their second pregnancy，causing adverse pregnancy outcomes.It is more difficult to manage maternal blood glucose，blood pressure and protect vital organ function when elderly and obese women become pregnant again.Therefore，it is very important for elderly and obese women to prevent metabolic diseases of pregnancy during their second pregnancy，which should be strengthened through pre-pregnancy-pregnancy-postpartum.

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Prediction and prevention of spontaneous preterm birth in pregnant women with history of cervical surgery. JIANG Xiang, YING Hao 2023, 39(6): 597-601.  DOI: 10.19538/j.fk2023060106 Abstract ( )   Premature birth seriously affects the short- and long-term outcomes of the offspring.Two thirds of them are spontaneous premature birth（SPTB）.Detection of high-risk factors and effective prophylactic treatment can effectively reduce the risk of SPTB.Cervical surgery，especially cervical conization，has been used to the management of cervical intraepithelial neoplasia（CIN），which tends to occur in women of childbearing age.Most of the literature reveals its association with increased risk of SPTB.The mechanism may be related to the destruction of the mechanical and immune barrier of the cervix by the surgery.The literature suggests that cervical elasticity might have a higher predictive value than cervical length for prediction for SPTB risks.Studies on its prevention strategies suggest that cerclage might increase the risk of premature delivery，but in view of the insufficient control of the confounding factors in the retrospective study，more definite conclusions need to be made by high-quality randomized controlled trials.

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Early detection and management of uterine rupture during pregnancy with multiple uterine surgeries.  WEN Jing-na, LIU Xiao-hua 2023, 39(6): 601-605.  DOI: 10.19538/j.fk2023060107 Abstract ( )   Uterine rupture is a serious obstetric complication.Even though the incidence rate is low，it is a major risk factor for maternal and perinatal morbidity and mortality.Uterine rupture occurs most frequently in women with a prior cesarean section and uterine surgery.With the implementation of the three-child policy，the number of elderly pregnant women who have had a history of uterine surgery is increasing，along with the increasing potential risk of uterine rupture，which deserves clinical attention.We aimed to provide the suggestions for the early detection，diagnosis and treatment of uterine rupture during pregnancy to avoid devastating maternal and perinatal complications.

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Labor management of vaginal delivery in elderly multipara.  YU Xin-yang, ZHANG Hua 2023, 39(6): 605-607.  DOI: 10.19538/j.fk2023060108 Abstract ( )   Elderly multipara refers to the multipara whose maternal age is over 35 years at the estimated date of delivery.The increase of the elderly multipara’s age and number of pregnancies increases risks for various complications and comorbidities significantly.In order to ensure the safety of mother and child during labor period，it’s necessary to make detailed evaluation before delivery，active management during labor，and targeted intervention of the complications and comorbidities during labor.

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Prevention and management of severe perineal laceration under the three-child policy. HE Jing, HONG Yan-yu 2023, 39(6): 607-611.  DOI: 10.19538/j.fk2023060109 Abstract ( )   Perineal laceration after vaginal delivery is more frequent in primiparous women，but it should not be underestimated in multiparas，especially in those with long interdelivery interval.There are obvious high-risk factors for severe perineal laceration.Good health guidance during pregnancy and standardized intrapartum management and midwifery techniques can reduce the occurrence of severe perineal lacerations.Once perineal laceration occurs， it should be identified early and sutured quickly.

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Etiological identification and monitoring of fetal growth restriction in pregnant women of advanced maternal age. QU Lin, SUN Li-zhou 2023, 39(6): 611-616.  DOI: 10.19538/j.fk2023060110 Abstract ( )   The number of advanced maternal age（AMA）adds up with the opening of the birth policy，and the risk of fetal growth restriction（FGR）in AMA increases.FGR is one of the common pregnancy complications in obstetrics，which can lead to fetal distress，stillbirth and other adverse pregnancy outcomes.The incidence of FGR involves multiple etiologies and factors，and there are still no effective intervention measures at present，so obstetricians must strengthen the management of AMA.We should identify the possible etiology，and make reasonable use of the existing monitoring means，so as to evaluate the intrauterine condition of the fetus comprehensively，and terminate the pregnancy timely.The adverse outcome of the perinatal infants should be minimized to improve the long-term prognosis.