Induced abortion and risk of small-for-gestational-age birth

Objective  To investigate the possibility of an association between previous induced abortion and subsequent birth of a small-for-gestational-age (SGA) infant.
Design  Case–control study.
Setting  General and university hospitals.
Methods  Cases were 555 women who delivered SGA babies. Controls were 1966 women who gave birth at term (>37 weeks of gestation) to healthy infants of normal weight on randomly selected days at the hospital where cases had been identified. All women in the case and control categories were interviewed on the obstetric wards by one of a team of six interviewers. During the interviews, information was obtained regarding general socio-demographic factors, personal characteristics and habits, gynaecological and obstetric history, general anamnesis, family history of obstetric and gynaecological diseases, and the age of the father of the child. Further information on current pregnancy and delivery was also collected. We used conditional multiple logistic regression (with age as the matching variable), with maximum likelihood fitting, to obtain odds ratios and their corresponding 95% CIs. Included in the regression equations were terms for education, plus terms significantly associated in this data set with the risk of SGA birth (smoking in pregnancy, history of SGA, gestational hypertension and parity).
Population  Women admitted to a general and a university hospital.
Results  No significant increase in the risk of SGA birth was observed in women with a previous induced abortion [odds ratio (OR) 1.0; 95% CI 0.6–1.7]. The OR for SGA birth was 1.2 (95% CI 0.7–2.1) for preterm and 1.0 (95% CI 0.7–1.4) for term SGA births.
Conclusion  This study found no association between risk of SGA birth and induced abortion.     

569名未婚女性人工流产原因分析

目的:了解未婚人流女性特征,分析其人流原因。方法:采用分层整群多阶段抽样方法,以统一匿名调查表,由统一培训的专业医生对2004年10月~2005年5月在16个抽样单位行人流术的全部未婚女性进行调查。结果:569名调查对象平均年龄20.5岁,伴侣平均年龄23.8岁,月均性生活次数7.4次,33%的被调查者有既往怀孕史。本次人流原因主要为未避孕(71.7%),其原因主要是侥幸心理、不懂避孕和怕麻烦。避孕套是被调查者中知晓率和使用率最高的避孕方法。以百分制计算,被调查者避孕方法和知识的得分分别为60.4分和64.8分,其避孕知识主要来自媒体。结论:未婚女性性活跃、意外妊娠风险认识低、性和生殖健康知识贫乏,应加强未婚人群的性观念和性行为道德教育,根据其年龄和心理特征,提供相关的生殖健康知识和服务,并加强对媒体相关宣传的规范管理。     

Update on medication abortion

This article provides an overview of medication abortion in the United States 6 years after the approval of mifepristone (RU486; Mifeprex; Danco Laboratories, LLC, New York, NY) by the US Food and Drug Administration (FDA). The adoption of mifepristone is considered in the context of epidemiologic data on abortion, abortion access, and the safety of abortion. The risks of medication and aspiration abortion are discussed in the context of abortion-related mortality, recent experience with obstetric and gynecologic infection with Clostridium sordellii, and the limits of scientific knowledge on the incidence of this infection in women. Innovative protocols studied since FDA approval of mifepristone are presented, and implications for clinical practice are discussed.     

米非司酮配伍米索前列醇终止早孕用药方法的探讨

作者对１２０例妊娠４９ｄ以内的孕妇采用４种不同的服药方法进行药物流产，其中使用第３、４种用药方法的孕妇均于加用米索前列醇后８ｈ内排出孕囊，且２ｈ内排出率明显增加，与常规用药方法比较有显著性差异（Ｐ＜０．０１），同时对用药机理作了讨论。     

主动免疫恢复T辅助细胞平衡治疗习惯性流产

目的:寻求安全、有效地治疗不明原因习惯性流产(UHA)的方法,并探讨主动免疫治疗前后的细胞因子的免疫功能变化及T辅助细胞的平衡状态。方法:①对35例UHA患者采用丈夫肘静脉血20 m l分离淋巴细胞行主动免疫治疗(妊娠前治疗两次,妊娠后治疗两次);②采用酶联免疫吸附方法对68例UHA患者及30例正常妇女外周血IL-2、IL-4、IL-10、IFN进行检测;③对29例主动免疫后妊娠成功者治疗前后的IL-2、IL-10、Th1/Th2进行检测。结果:①主动免疫组33例妊娠,妊娠成功并分娩29例,妊娠成功率87.88%(29/33),未经主动免疫治疗的对照组妊娠成功率26.67%(8/30),两组相比差异有显著性(P<0.010);②68例UHA患者较正常妇女外周血中IL-2明显升高(P<0.01),IL-10降低(P<0.05),Th1/Th2比值增高(P<0.05);③29例UHA患者主动免疫治疗后妊娠成功者IL-10显著上升(P<0.1),Th1/Th2比值下降(P<0.05)。结论:UHA患者Th1、Th2平衡异常,主动免疫治疗可诱导Th1向Th2转移,恢复Th1、Th2之间的平衡,可用于UHA的治疗。     

口服抗原对巨噬细胞共刺激分子CD80/CD86表达的影响

目的探讨口服抗原对巨噬细胞(M)共刺激分子CD80/CD86表达的影响及其在诱导妊娠免疫耐受中的作用。方法自然流产小鼠(CBA/J×DBA/2)分为免疫组和未免疫组,免疫组分别口服滋养细胞膜抗原(TMA2)和卵清蛋白(OVA),以正常妊娠小鼠(CBA/J×BALB/c)作为对照组。采用双标记流式细胞分析技术,分别检测各组小鼠脾脏及肠系膜淋巴结(MLN)CD80 M和CD86 M的表达。结果MLN内,未免疫组CD80 M表达明显高于对照组(P<0.05),而CD86 M含量明显低于对照组(P<0.001);TMA2免疫组CD80 M含量明显低于未免疫组(P<0.05);OVA免疫组CD86 M含量明显高于未免疫组(P<0.001)。脾脏内,CD80 M表达在各组间比较无显著差异;CD86M表达,未免疫组明显低于对照组(P<0.05),TMA2免疫组显著低于未免疫组(P<0.05),OVA免疫组则显著高于未免疫组(P<0.001)。结论流产的发生与M表面共刺激信号CD80/CD86异常有关;口服适当抗原可改变CD80/CD86 M表达模式,诱导妊娠免疫耐受的形成。     

重庆城乡育龄妇女中介生育率变量研究

影响妇女生育率的直接因素,如妇女已婚比、避孕及人工流产等的定量分析是卫生人口统计分析中的重要内容。本文应用美国人口学者Bongaarts提出的中介生育率变量模型就重庆城乡妇女生育率直接影响因素作一定量研究     

子宫肌瘤170例手术原因分析

子宫肌瘤１７０例手术原因分析柯美秀（湖北省沙市第一人民医院沙市４３４０００）子宫肌瘤是女性生殖器官中最常见的良性肿瘤。统计资料表明２０％的３０岁以上妇女在子宫上有大小不等、单个或多个肌瘤存在。由于瘤体不大，无月经失调等临床症状，未引起注意而被忽视［１...     

复发性自然流产患者绒毛滋养细胞FasL的表达

目的探讨复发性自然流产患者(RSA)绒毛滋养细胞FasL的表达与正常者有无差异。方法应用免疫组化和RT-PCR法,检测RSA患者和正常早孕妇女的绒毛滋养细胞FasL在蛋白水平和mRNA水平的表达,并进行图象分析和比较。结果免疫组化结果显示,绒毛合体滋养细胞和细胞滋养细胞的胞浆和胞膜上均有FasL表达,FasL在2组的定位无差异,但正常组绒毛滋养细胞FasL表达(PU=18.03±4.69)强于RSA组(PU=13.59±3.73),P<0.050。RT-PCR结果表明RSA组绒毛组织FasL在mRNA水平的表达为0.18±0.05,低于正常组0.27±0.06,差异有显著性意义(P<0.01)。结论不明原因RSA患者的绒毛滋养细胞FasL表达弱于正常者,滋养细胞FasL的表达减少可能在复发性自然流产中起重要作用。