米非司酮配伍米索前列醇用于利凡诺中期妊娠引产10例疗效观察

目的旨在评价利用米非司酮配伍米索前列醇用于利凡诺中期妊娠引产较传统的单纯应用利凡诺引产在产程发动、分娩时间的长短、病人承受的痛苦和有效地避免生殖道感染以及对病人身心健康方面存在的一系列优缺点进行了阐述。结果提示利凡诺配伍米非司酮引产优点多,疗效满意     

米非司酮联合利凡诺终止中期妊娠的疗效观察

目的探讨米非司酮用于终止中期妊娠的效果。方法将266例孕妇平均分为2组,A组术前口服米非司酮150mg,24h后羊膜腔注射利凡诺;B组采用传统方法治疗。结果A组较B组引产成功率高、产程短、出血少、产痛轻。结论米非司酮联合利凡诺引产效果肯定,便于推广应用。     

100例利凡诺引产病理观察和机制探讨

光镜、电镜观察100例利凡诺引产胎儿及附属器官,并观察胎盘的利凡诺药物荧光分布。其结果证明利凡诺对细胞膜系统有直接渗透和破坏作用。从而推论利凡诺引产对滋养叶细胞溶酶体膜的震动因子有所起动,促成内生性前列腺素的生成,发动分娩。     

米索前列醇在中期引产中的应用

我院自1996年8月至2001年6月将米索前列醇(Misopros-tol,以下简称米索)用于妊娠12～28周引产取得良好的效果。现报道如下。 一、资料与方法 1.引产对象:为本院门诊确诊为妊娠中期,自愿要求终止妊娠的248例健康妇女,均收入院进行引产,年龄最小17岁,最大35岁,平均26岁。     

米非司酮利凡诺联合用于疤痕子宫中孕引产的观察

对56例要求终止妊娠的疤痕子宫中孕者,观察组在行利凡诺羊膜腔注射前,给予米非司酮口服,对照组不给予米非司酮口服,观察两组注药到官缩开始时间,宫缩到胎儿娩出时间,胎盘残留及子宫疤痕、宫颈裂伤的的差异。观察组从注药到宫缩开始时间,宫缩到胎儿娩出时间明显缩短(P<0.01),胎盘残留及子宫疤痕官颈裂伤的发生率较对照组明显减少(P<0.01)。提示米非司酮利凡诺联合应用提高了疤痕子宫中期妊娠引产的安全性和有效性。     

利凡诺配伍维生素C终止16—24周中期妊娠临床观察

目的：探索妊娠１６－２４周引产方法的改良。方法：应用利凡诺１００ｍｇ加维生素Ｃ４０００ｍｇ羊膜腔内注射对１９８例１６２４周妊娠妇女（试验组）引产效果进行观察,同时随机选择２００例单用利凡诺引产的１６２４周妊娠妇女（对照组）做比较。结果：成功率,试验组为１００％,对照组为９６％。引产平均时间,试验组为３０７４小时,对照组为４４０８小时（Ｐ＜０．０１）。引产后清宫率,试验组为３２８３％,对照组为７４５０％（Ｐ＜０．０１）。引产后１小时平均出血量,试验组为１１６２５ｍｌ;对照组为１６９０３ｍｌ,两组比较有显著差异（Ｐ＜０．０１）。结果显示：应用利凡诺１００ｍｇ加维生素Ｃ４０００ｍｇ羊膜腔内注射终止１６２４周妊娠,有效安全,简便价廉,临床易推广应用。     

利凡诺用于大月份妊娠引产临床观察分析

利凡诺羊膜腔内注射是目前进行中期引产的主要方法之一。其作用基理是药物通过羊膜腔吸收，刺激子宫收缩，便胎盘胎膜发生组织坏死，前列腺素分泌增加，促进宫缩而引产。其优点：用药安全范围较大（羊膜腔内注入，安全量100mg，反应量120mg，中毒量为500mg）效果优良，药物制备，保存容易且便宜。     

自制小水囊引产的临床观察

目的观察自制小水囊引产的临床效果;方法选择我院2008年5月至2009年5月实施自制小水囊引产足月孕妇40例分为观察组和对照组进行比较;结果观察组平均总产程为（6．13&#177;1．65）h,对照组平均总产程为（10．20&#177;2．60）h。t=5．63,P〈0．001,两组有非常显著性差异;结论水囊引产安全、可靠、成功率高。     

浅析剖宫产后中期妊娠引产

目的 浅析剖宫产后中期的理想妊娠引产.方法 将我院2008年～2009年剖宫产中期妊娠引产患者68例,随机分为2组,治疗组34例给予利凡诺联合来非司酮引产;对照组34例给予利凡诺引产.观察两组引产结果与不良反应.结果 治疗组引产成功率、引产时间与对照组相比较,差异具有统计学意义,P＜0.05.治疗组产后2h内出血量、不良反应与对照组相比,无显著性差异,P＜0.05.结论 利凡诺联合米非司酮对剖宫产后中期妊娠引产具有效果好,成功率高及不良反应少等特点,值得临床推广使用.     

Calcium homeostasis in second trimester fetuses.

The concentrations of ionised calcium ions (Ca++), total calcium, parathyroid hormone, pH, total protein, albumin, sodium, and potassium were measured in paired fetal and maternal blood from pregnancies at 15 to 24 weeks' gestation. Pure fetal blood samples were obtained fetoscopically. The concentrations of fetal ionised calcium ions (n = 26); mean (SD) 1.33 (0.12) mmol/l (5.32 (0.48) mg/100 ml) and those of parathyroid hormone (n = 9); 68 (19) pmol/l (58 (16) micrograms/100 ml) were significantly higher than those of the mothers: 1.18 (0.09) mmol/l (4.7 (0.4) mg/100 ml), and 40 pmol/l (less than 34 micrograms/100 ml), respectively. There was no difference between measured fetal and maternal total calcium, pH, and electrolytes. The fetal total protein and albumin concentrations increased with gestation but were always lower than the equivalent maternal values. The calculated total calcium was 0.23-0.45 mmol/l (0.9-1.8 mg/100 ml) higher in the fetal than in maternal blood from the same pregnancy. There were no fetal arteriovenous differences in ionised calcium ions despite higher venous pH.     

Chromosome findings in 2,500 second trimester amniocenteses

We have analyzed the chromosome abnormalities found in 2,500 amniocenteses for prenatal diagnosis; 1,887 (75%) were performed because the maternal age was 34 years or more. Chromosome abnormalities were detected in 1.80% of those referred for advanced maternal age, 1.2% between ages 34 and 39 years and 4.6% 40 years and over. Of these, four occurred in women who would have been 34 years at delivery (2.9%). Trisomy 21 accounted for 50% of the chromosome abnormalities; sex chromosome abnormalities, for 25%; the remaining 25% was divided equally between trisomy 18 and partial trisomies and mosaics. Unexpected translocations were found in 0.4%, of which two-thirds were balanced and identified in one parent. The accuracy was 99.6%.     

Association of bacterial vaginosis with a history of second trimester miscarriage

The aim of this study was to determine whether bacterial vaginosis(BV) is associated with a history of recurrent pregnancy loss.A total of 500 consecutive patients attending the RecurrentMiscarriage Clinic were screened for the presence of BV. Inwomen who had had at least one late miscarriage BV was foundtwice as commonly (27/130; 21%) as in women who had had onlyearly losses (31/370; 8%) (P<0.001). The difference was evenlarger (26 versus 8%) if women who had had term pregnancieswere excluded. Moreover, BV was found three times more commonlyin Afro-Caribbean women [17 (29%) of 58] than in Caucasian women[36 (9%) of 379] and, in both groups of women, BV was diagnosedat least twice as frequently in those with a history of at leastone late miscarriage than in those who had experienced firsttrimester pregnancy losses only (P<0.001). The conditionoccurred twice as often among smokers than non-smokers and,in both groups, it was at least twice as common in women witha history of at least one late miscarriage as in those who hadhad early pregnancy losses only (P<0.001). However, the relationshipbetween BV and smoking was independent of ethnic origin. Womenwho douched with chloroxylenol were mostly Afro-Caribbean andhad BV more than twice as often as women who did not douche.     

Fetoplacental ratios in stillbirths and second trimester miscarriages

An abnormal fetoplacental (F/P) ratio is a risk factor for poor pregnancy outcomes including fetal death, but studies of F/P ratio among stillbirths are limited. In the Wisconsin Stillbirth Service Program cohort of second and third trimester fetal deaths, 1,022 were at ≥24 weeks with data on fetal and placental weight. Comparison with data for viable infants of the same gestational ages (GAs) showed that the F/P ratio increases more rapidly with GA for stillbirths than for viable infants. While placentas of stillborn infants are small at all GA, weights of deceased fetuses are lowest early in the second trimester, becoming nearly normal by term. Excess high F/P ratios are noted at all GAs, increasing toward term, while low ratios are frequent at early gestation but rare near term. Analysis by cause of death shows that F/P ratios are markedly elevated for placental and maternal causes (about 50% above the 90th centile), somewhat elevated for cord accidents, non‐hydropic fetal, and unknown causes (about 1/3 above the 90th centile), and variable with 40% below the 10th centile for hydropic stillbirths. Across all causes and GAs, placental weights are more abnormal than fetal weights, suggesting that diminished placental function may contribute to fetal demise even when non‐placental causes (e.g., premature membrane rupture, cord accidents, and chromosomal disorders) are identified. About half of all stillbirths have abnormal F/P ratios, suggesting that improvements in prenatal assessment of placental size and function might aid in identifying pregnancies at risk for demise; unfortunately, therapeutic options for ongoing pregnancies with diminished placental function remain limited.     

妊娠期高血压疾病患者孕中期血管内皮功能变化

目的探讨妊娠期高血压疾病患者在孕中期临床发病前的血管内皮功能的变化。方法对340例孕中期孕妇用超声行肱动脉血流介导的舒张功能（FMD）,血清内皮素（ET）、一氧化氮（NO）测定,并根据其随访的妊娠结局分为妊娠期高血压疾病组（妊高征组）和正常组,比较两组的FMD,ET,NO结果。结果 340例中有41例孕晚期发生妊娠期高血压疾病（妊高征组）,而其余299例未发生妊娠期高血压疾病（正常组）。孕中期妊高征组FMD、血清NO显著低于正常组,而血清ET显著高于正常组,差异均有显著性（P〈0.05）。在妊高征组内,重度子痫前期组FMD、血清NO显著低于轻度子痫前期组,而血清ET显著高于轻度子痫前期,差异有显著性（P〈0.05）。结论孕中期妊娠期高血压疾病潜在患者虽然血压正常,但已存在血管内皮损伤,可被超声、实验室等检出。     

孕中期孕妇血清标志物联合B超检测在产前筛查和产前诊断中的应用

目的探讨中孕期孕妇血清标志物β-HCG、AFP联合B超检测在产前筛查的作用。方法通过对我院2003年1月~2005年1月孕14~20w的孕妇,检测血清标志物β-HCG、AFP值,对筛查阳性的病例加强产前B超检测、诊断。结果尽早检出异常儿26例,均在孕28w终止妊娠。结论我们应当加大力度、扩大范围对孕妇进行产前血清学筛查并联合B超检测用于产前筛诊断,是有效的。