Objective To explore the clinical characteristics and management of ovarian tumor complicated by pregnancy and its influence on the pregnancy outcome, so as to provide diagnostic and therapeutic experiences. Methods A total of 248 cases were surgically and pathologically diagnosed as ovarian tumor complicated by pregnancy in The 202 Military Hospital from January, 2003 to December, 2009, and their clinical data were analyzed retrospectively. Results The incidence rate of ovarian tumor complicated by pregnancy was 0.49%. Among total 248 cases, 131 (52.82%) were benign tumors, of which 22.18% were ovarian mature teratomas; 113 (45.57%) were tumourlike lesions, of which most were ovarian chocolatecyst and lutealcyst, and 4 (1.61%) were malignant tumors. There were 212 cases treated by tumorectomy or salpingo-oophorectomy, and 3 of 4 cases with malignant tumors took postoperative chemotherapy. A total of 192 cases were diagnosed by regular antenatal care and ultrasound examination, accounting for 77.42% of the total sample size found during pregnancy. Among 14 cases receiving emergency operations, 9 were complicated by torsion, and the other 5 were by rupture. There were 67 cases receiving operation from the 14th to 18th gestational week, and 57 cases had full-time pregnancy. Conclusion Ultrasonography and pelvioscopy are of principal importance in the diagnosis and detection of ovarian tumor complicated by pregnancy which should be treated by tumorectomy, and suitable surgery intervention during second trimester is safe.
Objective To investigate the adverse pregnant outcomes of hospitalized pregnant women in Lanzhou city, and analyze the corresponding risk factors and provide basis for the further research on better child-bearing and child-rearing. Methods In two provincial-level hospitals and one provincial-level specialized hospital, the method of cluster random sampling was applied to extract 6 825 medical records from January 2004 to December 2005. The relevant information was abstracted and correlative analyses were undertaken. Results The incidence of adverse pregnancy outcomes for the hospitalized pregnant women in Lanzhou city was 14.65%. Single-factor unconditional logistic regression analyses displayed that the variables with statistical significance were the number of previous pregnancies, the number of previous child delivery, abortion history, abnormal gestation history, and past medical history, whereas multi-factor unconditional logistic regression analyses revealed that the adverse pregnancy outcomes were positively correlated with abnormal gestation history and the number of previous pregnancies with statistical significance. Conclusion The incidence of adverse pregnancy outcomes for the hospitalized pregnant women in Lanzhou city is quite high. Abnormal gestation history and the number of previous pregnancies are the main risk factors for the adverse pregnancy outcomes.
Objective To explore the correlation between adverse pregnancy outcomes and previous bearing status. Methods The related information of pregnant and postnatal women was extracted from 6825 hospitalized records in two general hospitals and one special hospital, which were selected by the method of cluster sampling, and the related rate and correlation analyses were calculated. Results Women who had abortion history were much easier to cause adverse pregnancy outcomes compared to those who had no abortion history, with the incidence rates of 16.83% and 13.31%, respectively; the incidence rates of adverse pregnancy outcomes of women who ever had zero, one, and two or more than twice of delivery were 14.14%, 16.34% and 22.78%, respectively; the rates of women on their third or more than third, second, first or zero pregnancy were 49.14%, 18.05%, 14.22% and 12.88%, respectively; and the rates of adverse pregnancy outcomes of women with abnormal and normal gestation history were 31.06% and 14.21%, respectively. Conclusion The previous abortion, delivery times and abnormal gestation history are highly related to adverse pregnancy outcomes. Therefore, in order to reduce adverse pregnancy outcomes, it is necessary to make an effective family planning and decrease abortion and pregnancy.
ObjectiveTo explore the influence of treatment against syphilis on pregnancy outcome and neonatal prognosis. MethodsThe data of 5224 cases of pregnant women from January to December 2013 were analyzed. All the pregnant women were screened by toluidine red unheated serum test (TRUST) method. Then, T.pallidum passive partideag glutining assay (TPPA) was used to confirm those positive cases from TRUST. At last, 128 cases of syphilis in those pregnant women were confirmed. According to whether the pregnant women accepted antenatal examination and treatment, they were divided into treatment group and non-treatment group. The pregnancy outcome and neonatal prognosis of these two groups of women were then compared and analyzed. ResultsThe pregnancy outcome of these two groups had comparatively big difference, but without significant difference (χ2=3.34, P>0.05). The neonatal prognosis of the two groups was significantly different (χ2=9.14, P<0.05). Moreover, TPPA showed positive in all newborn infants, and TURST showed 85 positive cases. ConclusionEarly finding and treatment of pregnant women with syphilis by screening before pregnancy or during the early period of pregnancy can reduce abortion, stillbirth, fetal abnormalities, and the incidence of neonatal congenital syphilis.
ObjectiveTo explore the relationship between the diet during pregnancy and gestational diabetes mellitus (GDM), and analyze the effect of GDM on weight gain, outcome and complication of mother and infant. MethodsWe selected 128 GDM pregnant women and 267 non-GDM pregnant women who were investigated by semi-quantitative food frequency method during September 2009 to March 2011. Then, we collected relevant information and the data were analyzed by t-test and chi-square test. ResultsThere were statistically significant differences between the two groups in total calorie, carbohydrate, fat and protein intakes per day (P<0.05). In general, the rates of insufficient weight gain and excessive weight gain during pregnancy in the GDM group were significantly higher than the non-GDM group (P<0.05), while proper weight gain rate was significantly lower (P<0.01). The risk of hydramnion, intrahepatic cholestasis and pregnancy-induced hypertension in the GDM group was significantly higher than the non-GDM group (P<0.05), while there was no significant difference between the two groups in premature delivery, cesarean section or premature membrane ruptures (P>0.05). Apgar scores were significantly different at minute 1 and 5 between the infants in the two groups (P<0.05). The incidence of fetal death, malformation, mild neonatal asphyxia and fetal macrosomia in the GDM group was significantly higher than the non-GDM group (P<0.05). No significant differences between the two groups in low birth weight infant, cord entanglement and fetal distress were detected (P>0.05). ConclusionGDM can lead to high incidence of poor outcome and complication. It is vital to strengthen the examination and keep balanced dietary structure, in order to reduce the complication and improve the health of mother and child.
ObjectiveTo systematically evaluate the association between passive smoking during pregnancy and adverse birth outcomes in Chinese, as well as to provide evidence for the prevention of adverse birth outcomes. MethodsWe electronically searched the CNKI, VIP, WanFang Data, PubMed and EMbase databases to collected cohort studies about the association between passive smoking during pregnancy and adverse birth outcomes in Chinese. The search date was from January 1st 1980 to 30th August, 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data and assessed the risk bias of included studies. Then meta-analysis was performed using RevMan 5.1 software. ResultsA total of 24 studies were included in the meta-analysis. The results of meta-analysis showed that, the passive smoking during pregnancy was associated with increased risks of preterm (RR=1.97, 95%CI 1.38 to 2.80), low birth weight (RR=1.94, 95%CI 1.37 to 2.76), birth defects (RR=2.01, 95%CI 1.58 to 2.56), neonatal asphyxia (RR=3.34, 95%CI 1.76 to 6.33), small-for-gestational age (RR=2.62, 95%CI 1.49 to 4.63), stillbirth (RR=3.10, 95%CI 2.00 to 4.80) and spontaneous abortion (RR=1.37, 95%CI 1.19 to 1.59). ConclusionPassive smoking during pregnancy is associated with increased risks of adverse birth outcomes.
Objective To systematically review the endometrial receptivity evaluated by transvaginal ultrasound and predict the clinical pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods PubMed, The Cochrane Library, EMbase, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on transvaginal ultrasound evaluation of endometrial receptivity to predict the clinical pregnancy outcome of IVF-ET from inception to December 1st, 2021. Two researchers independently screened literature, extracted data and evaluated the risk of bias of the included studies. RevMan 5.4 software and Stata 16.0 software were used to perform meta-analysis. Results A total of 24 cohort studies and 1 case-control study were included. The total sample size was 6 632 cases, including 3 340 in non-pregnancy group and 3 292 in pregnancy group. The results of meta-analysis showed that there was no difference in endometrial volume (MD=−0.11, 95%CI −0.33 to 0.11, P=0.34) or uterine artery S/D (MD= −0.04, 95%CI −0.17 to 0.09, P=0.55) between the two groups. The endometrial thickness measured on human chorionic gonadotrophin (HCG) day in the non-pregnant group (MD=−0.48, 95%CI −0.77 to −0.18, P=0.001) was thinner than that in the pregnant group. On embryo transfer (ET) day, uterine artery pulsatility index (PI) (MD=0.08, 95%CI 0.02 to 0.15, P=0.01) and resistance index (RI) (MD=0.01, 95%CI 0.01 to 0.01, P<0.000 01) were higher than those in the pregnancy group. Conclusion Endometrial volume and uterine artery S/D measured during IVF-ET were not correlated with clinical pregnancy outcome, while endometrial thickness measured on HCG day and uterine artery PI and RI measured on ET day were correlated with clinical pregnancy outcome. Transvaginal ultrasound evaluation of endometrial receptivity has a certain predictive value for clinical pregnancy outcome of IVF-ET. Due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explored the influence of disease changes, weight gain, eosinophil levels and other factor in pregnancy women with asthma. MethodsCase records of gestational asthma patients produced in the obstetrics department of Peking University People's Hospital from October 2010 to October 2020 were collected, and refer to electronic medical records of clinics (pre-pregnancy and pregnancy). According to the disease control (asthma related unplanned respiratory clinics, emergency or hospitalization), patients were divided into pregnancy stable group and pregnancy fluctuation group. The basic characteristics, pre-pregnancy asthma control, weight gain during pregnancy and peripheral blood eosinophil level before labor were retrospectively analyzed. The cause of asthma attacks, clinical characteristics and distribution of gestational time in pregnancy fluctuations were described. Peripheral blood eosinophil levels in different period during pregnancy in the stable group were analyzed. ResultsTotally 124 cases of natural pregnancy singleton were enrolled in the study. The age was (32.3±3.9) years old. There were 71 patients in stable group and 53 patients in fluctuation group. The proportion of pre-pregnancy instability in the fluctuating pregnancy group was higher than that in the stable pregnancy group (P<0.05). The proportion of intermittent medication before pregnancy was higher in the fluctuating pregnancy group than in the stable pregnancy group (P<0.05). Peripheral blood eosinophil count before labor and the number of cases with eosinophil count≥0.15×109/L before labor were higher in the fluctuation group (all P<0.05). The proportion of hypertentive diseases in pregnancy and fetal distress in uterus were higher in the fluctuation group (all P<0.05). The common cold was the common trigger factor (38.2%) and asthma recurrences occur between 13 and 36 weeks of gestation (65.8%) in fluctuation group. In further analysis of subgroup (the stable group), peripheral blood eosinophil count in early pregnancy (P<0.05) and pregnant metaphase (P<0.05) were higher than before delivery. The number of cases with eosinophil count>0.15×109/L in pregnant metaphase (P<0.05) was higher than before delivery. ConclusionsAsthma fluctuates during pregnancy is associated with adverse maternal and fetal outcomes. It is very important and critical that asthma control before pregnancy, weight gain management and eosinophil level monitoring of patients with asthma during pregnancy. The whole management is imperative in women with asthma during pregnancy.
ObjectiveTo investigate the clinical characteristics of epileptics with pregnancy and then provide reference for standardized management of epileptics with pregnancy. MethodsFrom June 2012 to June 2021, epileptics with pregnancy who delivered in Jinan Central Hospital were selected as the research subjects. The clinical data such as the application of Antiseizure medications (ASMs) during pregnancy, seizure frequency, pregnancy outcomes, delivery ways, offspring feeding ways and the incidence of complications were investigated and analyzed. ResultsAmong 36 epileptics with pregnancy, 20 cases (55.56%) were treated with ASMs alone, 5 cases (13.88%) were treated with combined medication, and 11 cases (30.56%) were treated without ASMs during pregnancy. 15 cases (41.67%) adhered to systematic application of ASMs, 17 cases (47.22%) did not adhere to systematic application of ASMs, and 4 cases (11.11%) had unknown medication history. The frequency of seizures increased in 5 cases, decreased in 7 cases and unchanged in 24 cases during pregnancy. Pregnancy outcomes: full-term delivery in 33 cases (91.67%), preterm delivery in 1 case (2.78%) and abortion in 2 cases (5.56%). Delivery mode: cesarean section in 31 cases (91.18%), vaginal delivery in 3 cases (8.82%). After delivery, 4 cases (11.76%) were fed with milk powder and 30 cases (88.24%) were breast-fed. Complications: There were 6 cases complicated with anemia (16.67%), 5 cases complicated with gestational hypertension (13.89%), 3 cases complicated with gestational diabetes (8.33%), 4 cases complicated with premature rupture of membranes (11.11%), 2 cases complicated with fetal growth restriction (5.56%), 2 cases complicated with oligohydramnios (5.56%), 3 cases complicated with fetal distress (8.33%) and 3 cases complicated with neonatal asphyxia (8.33%). ConclusionsThe proportion of epileptics with pregnancy who were systematically treated with ASMs was low and the seizures were poorly controlled. There is a lack of standardized management for such patients in clinical practice.