Cytogenetic diagnosis using midtrimester fetal blood samples: Application to suspected mosaicism and other diagnostic problems

Cytogenetic studies on fetal blood cells obtained at 18–25 weeks gestation have provided information for decision making in 25 cases identified as being at high risk of having an abnormal fetus. In particular, in the 21 cases studied to consider the possibility of true mosaicism, confirmation in fetal blood was obtained in three, one of which presented as a pseudomosaic on the original amniotic fluid cell study. Fetal blood was also informative in two cases (one positive and the other negative) in which a diagnosis of the fragile X syndrome was being considered. Furthermore, when high risk pregnancies presented late in gestation (21–24 weeks), these methods allowed for a rapid cytogenetic diagnosis. The procedure has proved useful in most of these cases since the couples involved had indicated that they would probably have terminated the pregnancy without the reassurance of normal fetal lymphocyte studies. Since the technique carries a much higher risk of pregnancy loss than does amniocentesis, its use should only be considered when there are compelling indications.     

利凡诺与米非司酮联合引产的临床研究

目的 :探讨利凡诺与米非司酮联合用于中期妊娠引产的临床效果。方法 :选择 16 0例中期妊娠妇女随机分研究 A组与 B组及对照组。研究 A组与 B组口服米非司酮 15 0 m g后 ,研究 A组经腹羊膜腔注入利凡诺 5 0 m g,研究 B组注入利凡诺 10 0 m g,对照组单用利凡诺 10 0 m g。结果 :研究组与对照组引产成功时间、引产腹痛、宫颈撕裂及副作用的比较均有差异性 ,研究 A组比 B组副作用小 ,利凡诺用量减少一半 ,但引产效果一样。结论 :利凡诺 5 0 mg配伍米非司酮联合引产 ,是用于中期妊娠引产较理想的方法。     

利凡诺联合米非司酮应用于初产妇中孕引产的临床疗效观察

目的：观察利凡诺中孕引产（初产妇）中加入米非司酮的效果。方法：67例自愿要求引产的初产妇随机分为实验组37例和实验对照组30例。利凡诺引产中加入口服米非司酮作为实验组；单用利凡诺引产做实验对照组，观察羊膜腔内利凡诺注射后距开始规律宫缩时问及分娩时间、总产程、产后出血量、软产道撕伤率、疼痛程度等多项目做比较。结果：加入米非司酮的实验组，在引产时间，总产程，宫颈裂伤率，宫缩疼痛程度、引产成功率等方面与实验对照组有显著差异，（P值〈0．01）。结论：利凡诺引产结合米非司酮，因后者具有软化、扩张宫颈的作用，使引产时间较单用利凡诺明显缩短，显著降低了宫颈裂伤率，减轻宫缩疼痛，引产成功率高，是有效、安全的引产方法之一。     

Gynecologic masses: value of magnetic resonance imaging

Forty-two women with gynecologic abnormalities were studied with the use of magnetic resonance imaging. Magnetic resonance imaging correctly assessed the origin of the pelvic mass in all patients. In the evaluation of leiomyoma, magnetic resonance imaging accurately depicted the number, size, and location of the lesion. In the evaluation of endometrial carcinoma, magnetic resonance imaging depicted the location of the lesion, the presence of cervical extension, and the depth of myometrial penetration in the majority of the cases. In the analysis of adnexal cysts, magnetic resonance imaging was sensitive in localizing the lesion and was able to distinguish serous from hemorrhagic fluid. This preliminary report indicates that magnetic resonance imaging may become a valuable imaging modality in the diagnosis of gynecologic abnormalities.     

米非司酮与利凡诺联合应用于中期妊娠引产的效果观察及护理

目的探讨米非司酮与利凡诺联合用于中期妊娠引产的效果,并总结护理要点。方法2007年8月一2008年8月选择100例中期妊娠妇女,随机分为研究组及对照组各50例。研究组口服米非司酮150nag后,经腹羊膜腔注入利凡诺100mg引产,对照组单用利凡诺100mg引产。观察两组宫缩开始时间、胎儿娩出时间、疼痛程度、产后出血量、清官率、宫颈损伤等指标。结果两组孕妇引产时间、腹痛、清官率、宫颈撕裂伤发生率比较,均P〈0．05,差异具有统计学意义。研究组效果优于对照组。结论米非司酮与利凡诺联合用于中期妊娠引产,避免了单用利凡诺引产发动宫缩与宫颈成熟不同步所致的宫缩较强、疼痛较重、产程较长等缺点,值得在临床上应用。适时提供针对性的引产护理,有利于孕妇产后恢复。     

甘遂中期妊娠引产的效果与其安全性：附6062例报告

本文报道了应用50%甘遂乙醇注射液羊膜腔内注射,进行中期妊娠引产6062例的临床经验。常用剂量为0.5ml～0.8ml,1次注射成功率为99.37%,平均引产时间27.37小时。中药甘遂引产法是一种安全、高效、简便、经济的中期妊娠引产方法。     

中期妊娠羊膜腔内注射依沙吖啶引产出血的高危因素

目的 采用羊膜腔内注射依沙吖啶终止中期妊娠,分析其引产出血的高危因素。方法 选取同济大学附属第一妇婴保健院计划生育科2017年2月—2018年2月327例中期妊娠采用依沙吖啶引产患者,孕周在16～26周,收集患者年龄、孕周、双顶径、引产原因、前次分娩方式、既往孕次、胎盘位置、胎盘娩出情况、胎儿情况等临床资料,回顾性分析以上因素与引产出血量的相关性。结果 中期妊娠引产后出血受多因素影响,胎盘因素（胎盘粘连）是最主要高危因素,居于首位,其次为胎儿因素（双胎及死胎）,最后为既往孕次。结论 依沙吖啶引产术前充分了解病史、评估高危因素,采取恰当的处理,对引产成功、减少出血并发症发生具有重要意义。     

中期妊娠引产方法探讨

目的 探讨安全有效的中期妊娠方法。方法 将1996－2000年本院收治的要求引产的195例中期妊娠孕妇随机分成三组：A组，68例，以利凡诺尔羊膜腔内注射引产；B组，66例，以米非斯酮＋米索前列醇口服引产；C组，61例，以米非斯酮口服＋利凡诺尔羊膜腔内注射引产，比较三种方法的引产效果。结果 A、C两组引产成功率均为100％，而B组只有89．4％（59／66）；产程A组最长，B组最短，组间均有显著性差异（P＜0．01）；产后2h出血量C组明显少于A组（P＜0．01），而其它各组间无显著性差异（P＞0．05）；宫颈裂伤A、B组各有2例，而C组无1例宫颈裂伤。结论 非米斯酮和利凡诺尔联合应用为中期妊娠理想的引产方法。     

不同剂量米非司酮配合米索前列醇中期妊娠引产效果观察

目的:观察不同剂量米非司酮联合米索前列醇用于中期妊娠引产的临床效果。方法:分别采用不同剂量的米非司酮联合米索前列醇进行中期妊娠引产,比较两种方法的疗效。结果:大剂量组宫缩规律至引产结束时间、总引产时间、出血量及清宫率均明显低于小剂量组,差异有统计学意义(P<0.05);两组并发症发生率比较,差异无统计学意义(P>0.05)。结论:大剂量米非司酮联合米索前列醇用于中期妊娠引产时间短,安全性高,不良反应少。     

Effect of vaginal pH on the efficacy of vaginal misoprostol for induction of midtrimester abortion

AIM: To evaluate the effect of vaginal pH on the efficacy of misoprostol for induction of midtrimester abortion. METHODS: The study comprised 110 women, with a gestational age of 14-26 weeks, with a missed abortion as an indication for the induction of abortion. On admission, the vaginal pH was measured and two groups were generated: (A) those with pH<5 (n=63); and (B) those with pH >or= 5 (n=47). All of the women received intravaginal misoprostol tablets moistened with 3 mL of 5% acetic acid, 200 microg every 4 h for a maximum of 5 doses within 24 h. If the patient did not have adequate uterine contractions, the same regimen was repeated over the following 24 h and if no response was achieved, this was considered a failure of therapy. RESULTS: All patients aborted within 48 h. A significant positive correlation between vaginal pH and the misoprostol application-abortion interval was found. The mean induction-abortion interval was significantly shorter in group A compared to group B (12.1 vs 23.6 h, P<0.001), with abortion rates at 24 h being 100% and 63.8%, respectively. Moreover, a significantly lower dose of misoprostol was used in group A with a lower incidence of fever and abdominal pain. CONCLUSION: Vaginal pH influences the efficacy of misoprostol administered vaginally for the induction of midtrimester abortion. The presence of this relationship, despite premoistening misoprostol with an acidifying agent, suggests that the effect of vaginal pH might extend beyond affecting the pharmacokinetics of the drug.