紧急宫颈环扎术在宫颈机能不全中的应用

目的研究紧急宫颈环扎术在宫颈机能不全中的应用。方法将2015年12月～2018年12月所收治的80例宫颈机能不全孕妇作为研究对象,分成实验组与对照组,每组各40例。对照组进行常规药物治疗,实验组进行宫颈环扎术治疗,对比两组临床效果。结果实验组孕妇足月生产率、胎儿阿氏评分、延长孕周及临床治疗满意程度均明显高于对照组孕妇,组间比较差异有统计学意义(P0.05)。结论紧急宫颈环扎术在宫颈机能不全患者治疗中的应用效果显著,能够提高孕妇足月生产率,降低流产率,有效延长孕妇孕周,同时提高患者对于临床治疗的满意程度,值得临床推广与使用。     

复发性流产76例临床分析

目的：通过统计以了解我院复发性流产特点,为提出预防和治疗对策提供数据指导,并据此提出干预对策,避免流产的再次发生。方法回顾性分析我院2011年1月～2013年7月76例复发性流产患者的临床资料,对复发性流产的因素进行总结。结果三组的免疫异常项目、CD3^＋CD19^＋＞12%、CD56^＋CD16^＋＞12%及DD ＞260ng/mL的异常发生率均超过20%,封闭抗体阴性异常率甚至接近100%。结论免疫因素是与复发性流产关系最为密切的因素,母体对胎儿的排斥造成复发性流产。     

Investigating the optimal preconception TSH range for patients undergoing IVF when controlling for embryo quality

Purpose

The ideal thyroid-stimulating hormone (TSH) range for infertile women attempting conception has not been determined. Current recommendations include optimizing the preconception TSH value to ≤2.5 mIU/L, which is the established goal for pregnant women. The aim of this study was to determine if there is a distinct range of TSH ≤2.5 mIU/L for infertile women undergoing in vitro fertilization (IVF) that improves reproductive outcomes.

Methods

One thousand five hundred ninety-nine euploid blastocyst transfer cycles were evaluated in which TSH measurements were obtained 8 days after embryo transfer. Only euploid embryo transfers were included in an effort to control for embryo quality. Patients were separated into TSH groups utilizing 0.5 mIU/L increments. Implantation, live birth, and miscarriage rates among the TSH groups were compared. Outcomes for individuals on thyroid hormone supplementation and those not requiring supplementation were evaluated.

Results

There was no difference in implantation (p = 0.56), live birth (p = 0.36), or miscarriage rates (p = 0.10) between TSH groups. Receiver operating characteristic (ROC) curves for implantation, live birth, and miscarriage approached the line of no discrimination, signifying that there is no value of TSH within the recommended range for pregnancy (≤2.5 mIU/L) that predicts IVF outcomes better than other values in this range. Live birth rates for patients requiring thyroid hormone supplementation and those not on medication were similar (p = 0.86).

Conclusions

The recommended TSH range for pregnancy (≤2.5 mIU/L) may be applied to infertile patients attempting conception without a need for further adjustment.     

Evaluation of the efficacy of traditional Chinese medicine for the reproductive and pregnancy outcomes in women with endometriosis: A nationwide population-based study

ObjectivePatients with endometriosis may seek traditional Chinese medicine (TCM) to help them conceive. The present study aims to evaluate the effects of TCM on reproductive and pregnancy outcomes in patients with endometriosis.Materials and methodsThe patients with endometriosis taken from the National Health Insurance (NHI) research database between 2000 and 2012 were divided into two cohorts based on the use of TCM treatment. The two cohorts were matched by age and comorbidities and followed up until a new diagnosis of infertility, ectopic pregnancy, or miscarriage. Multivariable Cox proportional hazards models were used to evaluate the hazard ratio (HR) of reproductive and pregnancy outcomes.ResultsA total of 5244 patients with endometriosis were analyzed, including 1748 TCM users and 3496 matched control subjects. The proportion of infertility was higher in TCM users than in non-TCM users (adjusted hazard ratio [HR]: 1.34, 95% confidence interval [CI]: 1.13–1.60). However, there was no significant difference in the proportion of ectopic pregnancies between TCM users and non-TCM users (adjusted HR: 0.82, 95% CI: 0.60–1.13). There was no significant difference in the proportion of miscarriages between TCM users and non-TCM users (adjusted HR: 1.23, 95% CI: 0.95–1.61).ConclusionTCM treatment showed insignificant efficacy in decreasing the risk of ectopic pregnancy and miscarriage in patients with endometriosis.     

Maternal Age at Marriage and Adverse Pregnancy Outcomes: Findings from the India Human Development Survey, 2011-2012

Study Objective

This study aimed to examine the association between maternal age at marriage and selected pregnancy outcomes: stillbirth, miscarriage, and complications during pregnancy, labor, and postpartum period.

Restrained expectations in late pregnancy following loss

OBJECTIVE: To describe women's late pregnancy after loss experiences (from 25 weeks gestation to birth), document the timing and frequency of their common discomforts and events, and explore changes in these experiences over time. DESIGN: A longitudinal, qualitative study of pregnancy calendar entries and field notes. SETTING: Prenatal care providers and community canvassing in Central New York and the Internet. PARTICIPANTS: Pregnant women (N= 69) with a history of perinatal loss. MAIN OUTCOME MEASURES: Women's pregnancy calendar entries and field notes. RESULTS: Thematic data analysis yielded two main themes and several subthemes: (a) Precarious Pregnancy Security with subthemes of Informed Awareness and Varying Emotions and (b) Prudent Baby Preparations with subthemes of Physical, Social, and Emotional Preparation. CONCLUSION: Women reported an increased sense of security about the pregnancy and baby over time but this security was easily shaken. For women with a history of later or multiple loss, anxiety may remain high or increase as the due date approaches. Fetal movement is the most common barometer of fetal well-being during this part of pregnancy. With a better understanding of pregnancy after loss, clinicians can have a positive impact on women's prenatal experiences.