体外受精—胚胎移植术后异位妊娠29例临床分析

目的 :探讨体外受精 -胚胎移植后异位妊娠的发生率及高危因素。方法 :对我院 1998年 9月～ 2 0 0 3年 3月接受体外受精 -胚胎移植后发生的异位妊娠 2 9例进行回顾性分析。结果 :异位妊娠发生率为 5 .8%。 2 9例异位妊娠中有 19例术前存在输卵管病变。结论 :体外受精 -胚胎移植术后发生异位妊娠的高危因素是输卵管病变、继发性不孕 ,年龄、子宫位置、移植术过程的困难程度等亦与之有关     

Prostaglandin E production by amniotic cells in relation to term and preterm labour

Summary. The rate of prostaglandin E (PGE) production was measured in collagenase-dispersed amniotic cells obtained from 14 women after spontaneous labour at term—seven after spontaneous preterm labour, nine after delivery by elective caesarean section at term and six after induction of labour at term. Cells were incubated with and without arachidonic acid and PGE was estimated by specific radioimmunoassay. Basal PGE output (pmol/10⁶ cells per 3 h) was highest in the spontaneous labour group, 27·5 (SEM 5·5) and lowest in the preterm labour group, 4 (SEM 1·2) ( P <0·001). Values in the elective section and induction groups were 13·6 (SEM 2·7) and 10 (SEM 3·1), respectively; these values were significantly higher than in the preterm labour group and the values after induction were significantly lower than after spontaneous labour. Addition of arachidonic acid resulted in a significant increase in PGE output in all groups, but the values after preterm labour remained significantly lower than those of any group at term. These data indicate that towards term there is a maturation in the PG synthetase activity of the amnion and that PGE output in this tissue is increased in spontaneous labour.     

Is centralized hospital care necessary for all insulin-dependent pregnant diabetics?

Summary. A retrospective population study in Northern Ireland examined the benefits of centralized care in insulin-dependent diabetic pregnancies. In the 5 years 1979–1983, there were 139 250 deliveries in Northern Ireland and of these 221 pregnancies occurred in 187 insulin-dependent diabetic patients; 100 were managed entirely in peripheral maternity units, 61 were referred from a peripheral unit to the Royal Maternity Hospital, Belfast and 60 were managed entirely in this central referral hospital. The patients referred from the periphery had the worst past obstetric history with a combined perinatal mortality rate of 200 per 1000. During the study period the perinatal mortality rate was 107 for the referred pregnancies, 33 for those managed entirely in the peripheral units and 18 for those managed at the Royal Maternity Hospital. If those pregnancies terminated for fetal abnormality, and deaths beyond the perinatal period are included, the figures for total fetal loss were 15.5%, 5.5% and 7.1% respectively. Overall the major congenital malformation rate was 7.5%, and for the respective groups 6.5%, 3.0% and 13.0%. For the general population during the same period the perinatal mortality rate was 1.4% and the major congenital malformation rate was 2.5%. Thus it is suggested that only peripheral hospitals which can offer combined antenatal/endocrine care and with a neonatal intensive care unit should undertake the management of the pregnant diabetic.