Combination of ultrasound pelvimetry and fetal sonography in predicting cephalopelvic disproportion.

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Study of drug control over postoperative hemorrhage after selective caesarean section

Objective: To compare the efficacy and safety of carbetocin and oxytocin in the prevention of postpartum hemorrhage after selective caesarean section. Methods: Two hundred and sixteen pregnant women who were going to deliver by caesarean section were randomly divided into two paralleled and controlled groups, of which the oxytocin group(group A) contained 105 women and the carbetocin group(group B) 111 women. 20 IU of oxytocin was administrated during operation for both groups, 10 IU directly into uterus and 10 IU intravenously. When the operation was over, 20 IU of oxytocin was dripped for group A lasting for 8 hours, while for group B 100μg of carbetocin was immediately injected intravenously for 1 minute. Blood loss as well as hemoglobin alteration was measured for the comparison of the effect of the two drugs. Blood biochemical indicators were introduced for the evaluation of the safety of carbetocin including the function of liver and kidney and the fasting glucose.Results: No significant difference was revealed between the two groups concerning the postpartum hemorrhage within 24 hours, the postpartum hemorrhage incidence and the changes of hemoglobin. There was no significant difference in the change of liver and kidney function, fasting glucose and electrolyte changes as well.Conclusions: Carbetocin has a similar effect and safety of oxytocin in controlling the blood loss of selective caesarean section.     

Optimal management of postpartum hemorrhage

目的　讨论产后出血干预治疗的合理方案。方法　回顾性分析 15例行干预性治疗的严重产后出血的病人的临床特点及方法。结果　 15例患者中子宫切除者 9例 ,行动脉栓塞治疗 7例 (2例切除子宫后又行栓塞治疗 ) ,行病灶挖除术 1例。需行干预性治疗的产后出血的原因依次为 :DIC ,子宫动 -静脉瘘及血管畸形 ,胎盘异常 ,子宫肌瘤及子宫裂伤。结论　应针对产后出血的不同原因、部位及性质选择合理有效的干预治疗。合理的治疗方案是抢救病人生命 ,保留生育功能 ,尽可能减少创伤的关键。     

胰岛素样生长因子-Ⅰ及胰岛素样生长因子结合蛋白-3与胎儿宫内发育的关系

目的 检测孕妇静脉血、脐血中胰岛素样生长因子－Ⅰ (IGF－Ⅰ )及胰岛素样生长因子结合蛋白-3(IGFBP-3)水平,探讨 IGF－Ⅰ、 IGFBP-3与胎儿宫内发育的关系。方法 采用美国 DSL公司试剂盒。总计 81例孕妇,其中正常孕妇 38例,妊娠糖尿病孕妇 20例,正常妊娠分娩巨大儿孕妇 23例,采用放射免疫方法测定。 结果 正常组及巨大儿组孕妇静脉血 IGF-I与新生儿体重呈正相关 (r=0.653, r=0.640,两组 P均     

妊娠合并甲状腺功能减退症或亚临床甲状腺功能减退症77例临床分析

Objective To investigate the maternal and fetal outcomes of pregnant women with hypothyroidism or subclinical hypothyroidism. Methods From Jan. 2005 to Mar. 2008, clinical records of 77 women with hypothyroidism (n=57) or subclinical hypothyroidism (n = 20) during pregnancy who delivered at Peking Union Medical College Hospital were reviewed. The basic information, maternal complications and neonatal outcomes of the patients were compared with 79 healthy women who delivered during the same period. Results The prevalence of maternal hypothyroidism during the study period was 0.74% ,and that of maternal subclinical hypothyroidism was 0.26%. The mean neonatal birth weight of women with hypothyroidism was lower than that of the control [(3191.8±659.47 g) vs (3301.9±423. 1 g), P<0.05], the incidence of abnormal glucose metabolism was higher (24.6% vs 11.4% ,P<0.05), and small for gestational age infants were more common than in the control group (12. 3% vs 2. 5%, P<0. 05). The maternal and fetal outcomes of women with subclinical hypothyroidism during pregnancy showed no difference compared with the control. Conclusions Early screening for the high risk women and appropriate management are important to improve the neonatal and fetal outcomes of women with hypothyroidism and subclinical hypothyroidism during pregnancy.     

引产对孕41周孕妇的母儿结局影响

目的 探讨引产对孕41周、无妊娠合并症孕妇母儿结局的影响.方法 选择北京协和医院妇产科2002年9月至2007年4月收治的孕41-41周+0、无妊娠合并症的初产妇374例,按临产与否分为引产组225例,其中药物(包括应用缩宫素和地诺前列酮)引产173例,人工破膜引产5例,人工破膜+药物引产47例;自然临产组149例.分别对两组孕妇的一般情况、分娩方式、产后并发症、新生儿窒息发生情况、住院天数及费用等进行回顾性分析.结果 (1)引产组的剖宫产率(44.0%,99/225)明显高于自然临产组(18.1%,27/149),两组比较,差异有统计学意义(P<0.05).(2)引产组及自然临产组产后出血发生率分别为2.7%(6/225)和1.3%(2/149)、产褥病率分别为0.9%(2/225)和0.7%(1/149)、切口延期愈合发生率为0.9%(2/225)和0.7%(1/149)、尿潴留发生率分别为4.4%(10/225)和3.4%(5/149)、产时损伤发生率分别为0.4%(1/225)和0、羊水Ⅲ度污染发生率分别为11.6%(26/225)和13.4%(20/149)、新生儿窒息发生率分别为1.3%(3/225)和2.0%(3/149),两组孕妇以上各指标分别比较,差异均无统计学意义(P>0.05).(3)在阴道顺产中,第一产程时间引产组平均为413 min,自然临产组平均为461 min,两组比较,差异无统计学意义(P>0.05);第二产程时间引产组平均为40 min,自然临产组为48 min,两组比较,差异有统计学意义(P<0.05);引产组阴道顺产中第二产程超过60 min的发生率为17.1%(20/117),自然临产组为28.8%(34/118),两组比较,差异有统计学意义(P<0.05);引产组急产发生率为5.1%(6/117),自然l临产组为0,两组比较,差异有统计学意义(P<0.05).(4)住院天数自然临产组平均为(5.7±1.9)d,引产组为(6.9±2.7)d,两组比较,差异有统计学意义(P相似文献   

重复剖宫产对妊娠结局的影响

目的 探讨重复剖宫产对孕产妇及围产儿结局的影响.方法 回顾性分析1998年1月1日至2007年12月31日,在北京协和医院妊娠超过28周行再(多)次剖宫产手术分娩的产妇共412例,根据剖官产次数分为再次剖宫产组(repeated caesarean section group,RCS组,394例)和多次剖宫产组(multiple caesarean section group,MCS组,18例),随机选取同期行初次剖宫产手术分娩的480例为初次剖宫产组(first caesarean section group,FCS组)作为对照,分析三组孕妇的一般临床资料、产时产后并发症及围产儿结局.结果 近十年我院再次剖官产率为4.1%,呈逐年上升趋势.(1)一般临床资料比较:RCS组及MCS组平均年龄分别为(33.7±4.3)岁,(34.5±5.1)岁,大于FCS组(31.5±4.3)岁(P<0.05).RCS组及MCS组平均孕次分别为(3.5±1.4)次,(4.7±1.5)次,多于FCS组(2.1±1.2)次(P<0.05).(2)盆腔粘连发生率:RCS组及MCS组分别为13.5%和50.0%,高于FCS组(0.4%)(P<0.05).(3)子宫破裂发生率:RCS组(1%)高于FCS组(0%)(P<0.05).(4)RCS组及MCS组平均分娩孕周分别为(38.1±1.8)周,(37.3±2.5)周,与FCS组[(38.9±2.1)周]比较差异有统计学意义(P<0.05).结论 再 (多)次剖宫产发生率逐年上升,其显著增加盆腔粘连及子官破裂的发生率,但并不增加围产儿并发症的发生率.     

妊娠合并甲状腺功能减退症或亚临床甲状腺功能减退症77例临床分析

Objective To investigate the maternal and fetal outcomes of pregnant women with hypothyroidism or subclinical hypothyroidism. Methods From Jan. 2005 to Mar. 2008, clinical records of 77 women with hypothyroidism (n=57) or subclinical hypothyroidism (n = 20) during pregnancy who delivered at Peking Union Medical College Hospital were reviewed. The basic information, maternal complications and neonatal outcomes of the patients were compared with 79 healthy women who delivered during the same period. Results The prevalence of maternal hypothyroidism during the study period was 0.74% ,and that of maternal subclinical hypothyroidism was 0.26%. The mean neonatal birth weight of women with hypothyroidism was lower than that of the control [(3191.8±659.47 g) vs (3301.9±423. 1 g), P<0.05], the incidence of abnormal glucose metabolism was higher (24.6% vs 11.4% ,P<0.05), and small for gestational age infants were more common than in the control group (12. 3% vs 2. 5%, P<0. 05). The maternal and fetal outcomes of women with subclinical hypothyroidism during pregnancy showed no difference compared with the control. Conclusions Early screening for the high risk women and appropriate management are important to improve the neonatal and fetal outcomes of women with hypothyroidism and subclinical hypothyroidism during pregnancy.     

胎儿影像学异常的临床处理策略

产前诊断（prenatal diagnosis）又称宫内诊断（intrauterine diagnosis），是指在胎儿出生前，通过各种检查手段对胎儿先天性缺陷或遗传性疾病进行的诊断，是多学科相结合的一门学科。胎儿影像学检查是产前诊断中极为重要的组成部分。胎儿影像学检查主要为超声检查，也包括磁共振成像技术（MRI）等。     

妊娠合并甲状腺功能减退症或亚临床甲状腺功能减退症77例临床分析

Objective To investigate the maternal and fetal outcomes of pregnant women with hypothyroidism or subclinical hypothyroidism. Methods From Jan. 2005 to Mar. 2008, clinical records of 77 women with hypothyroidism (n=57) or subclinical hypothyroidism (n = 20) during pregnancy who delivered at Peking Union Medical College Hospital were reviewed. The basic information, maternal complications and neonatal outcomes of the patients were compared with 79 healthy women who delivered during the same period. Results The prevalence of maternal hypothyroidism during the study period was 0.74% ,and that of maternal subclinical hypothyroidism was 0.26%. The mean neonatal birth weight of women with hypothyroidism was lower than that of the control [(3191.8±659.47 g) vs (3301.9±423. 1 g), P<0.05], the incidence of abnormal glucose metabolism was higher (24.6% vs 11.4% ,P<0.05), and small for gestational age infants were more common than in the control group (12. 3% vs 2. 5%, P<0. 05). The maternal and fetal outcomes of women with subclinical hypothyroidism during pregnancy showed no difference compared with the control. Conclusions Early screening for the high risk women and appropriate management are important to improve the neonatal and fetal outcomes of women with hypothyroidism and subclinical hypothyroidism during pregnancy.