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。     

人工流产术雷米芬太尼镇痛半数有效剂量的测定

目的测定雷米芬太尼人工流产术镇痛半数有效剂量(ED50)。方法拟行人工流产术门诊患者40例,ASAⅠ~Ⅱ级。镇痛效果评估采用5级口述评分法(VRS-5)。单次静脉推注雷米芬太尼,剂量按序贯实验法进行调整,即前一例患者若VRS≥2分,则下一例患者接受的药物升高一个剂量梯度,若VRS≤1分,则下一例患者降低一个剂量梯度。剂量变化梯度定为0.2μg/kg。序贯资料采用Probit检验,计算ED50和95%可信区间。结果雷米芬太尼无痛人工流产术ED50为1.39μg/kg,95%可信区间为1.26~1.51μg/kg。结论雷米芬太尼无痛人工流产术ED50为1.39μg/kg。     

超声在早孕终止妊娠前的临床应用价值

目的:探讨超声在早孕终止妊娠前的临床应用价值.材料和方法:对230例临床诊断为早孕者行常规子宫、双附件超声检查,并与临床及人工流产后的病理诊断进行对比分析.结果:宫内妊娠213例,其中纵隔子宫并一侧宫内妊娠5例,双子宫并一侧宫内妊娠2例,残角子宫妊娠2例,超声诊断符合率100%.宫外孕与非妊娠超声诊断符合率分别为12/13与4/4.结论:超声检查对指导临床采用正确的方式终止妊娠,及时发现非正常妊娠,具有重要的价值,应作为早孕终止妊娠前的常规检查.     

米非司酮配伍米索前列醇终止早孕118例临床观察

就米非司酮配伍采米前列醇序贯用药终止７周内早孕１１８例进行临床观察，发现完全流产率９２．３７％，不全流产率５．９３％，持续妊娠率１．６９％。临床证明该方法方便、安全有效、副作用极小，但个别孕妇产生不全流产，引起出血过多及出血时间延长。不全流产率有随孕妇年龄、孕龄、孕次增加而增加的趋势。     

解脲脲原体与自然流产关系的探讨

采用聚合酶链反应技术对３２例自然流产患者的宫颈粘液及其中２２例清宫组织进行解脲脲原体（ＵＵ）检测，并与３０例人工流产妇女比较。结果表明：自然流产与ＵＵ寄生于宫颈无关（Ｐ＞０．０５），与宫内感染ＵＵ明显相关（Ｐ＜０．０５）。     

精子染色质结构分析的临床意义

目的探讨女方不明原因流产和不明原因不孕与其配偶精子染色质性状之间的关系;方法通过精子染色质结构分析(SCSA)对22例不明原因流产和36例不明原因不孕妇女配偶精子,以及20例正常对照者精子进行DNA完整性检测,并比较它们之间的差异;结果对照组与不明原因流产组以及不孕组之间精子DNA完整性存在差异,且差异具有统计学意义(P<0．05),而不明原因流产组与不孕组之间精子DNA完整性比较无明显差异(P>0．05);结论精子染色质结构分析有可能作为不明原因流产和不孕的辅助诊断方法在临床应用。     

A Subset of Patients With Recurrent Spontaneous Abortion Is Deficient in Transforming Growth Factor β-2-Producing “Suppressor Cells” in Uterine Tissue Near the Placental Attachment Site

PROBLEM : To determine if patients with unexplained recurrent miscarriage have a deficiency of decidual immunosuppressor cells that produce transforming growth factor β type 2, as has been found in mice with abortion due to rejection and/or trophoblast failure. METHODS : Decidual biopsy specimens were taken as near to the placental attachment site as possible under ultrasound guidance from first trimester legal termination (control) patients with recurrent miscarriage and non-viable pregnancy, and from patients with sporadic missed abortion. The tissue was tested for TGFβ-2⁺ suppressor cells by in situ hybridization, immunohistochemistry, and analysis of supernatants. RESULTS : TGFβ-2-related suppressor molecules similar but not identical to those identified in pregnant mice were released by decidual lymphoid cells. Fifty percent of 14 recurrent miscarriage patients showed a lack of suppressor cells and 59% were subnormal in comparison to 20 controls and 5 sporadic miscarriage patients, where 80–85% of the patients had detectable suppressor cells. CONCLUSIONS : Suppressor cell deficiency is compatible with a role for rejection and/or trophoblast failure in some patients with recurrent miscarriage. Presence of suppressor cells in most patients with missed abortion (4/5) is compatible with an alternative cause of fetal death, similar to findings reported in genetic fetal death mice.     

Paternal and Maternal Smoking Habits before Conception and During the First Trimester: Relation to Spontaneous Abortion

PURPOSE: This study examined the association between maternal smoking before and during the first trimester of pregnancy and spontaneous abortion.

METHODS: We have been conducting a hospital-based case-control study on risk factors for spontaneous abortion in the greater Milan area. We collected information from 782 cases of spontaneous abortions and 1543 controls (women who delivered at term healthy infants).

RESULTS: With respect to never smokers, the odds ratio (OR) were 0.7 (95%, confidence interval (CI), 0.5–1.0) for women who quit smoking and 1.3 (95% CI, 1.0–1.6) for those who continued during pregnancy. Women who smoked more than 10 cigarettes/day in the first trimester were at increased risk of miscarriage, with an OR of 1.4 (95% CI, 1.0–2.1). No relationship was evident between the number of cigarettes smoked before conception and the risk of abortion. Likewise, no association emerged between paternal smoking and miscarriage. Moreover, no significant interaction or modification effect was obtained when strata of age and other major characteristics were investigated.

CONCLUSIONS: The risk of abortion associated with cigarette smoking during the first trimester of pregnancy was measurable and noticeable in this population, and accounted for 9% (95% CI, 6–13%) of all cases. The increased risk of spontaneous abortion in women smoking during pregnancy is a further reason to encourage pregnant women to quit.