中华妇产科杂志最新文献

{"title":"[Clinical application value of combined focused ultrasound ablation surgery and hysteroscopy in the treatment of solitary type Ⅱ submucosal uterine fibroids with maximum diameter more than 5 cm].","authors":"H Y Cheng, C M Sang, Y J Kang, L Zhao, K Ding, S P Zhao","doi":"10.3760/cma.j.cn112141-20241022-00566","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241022-00566","url":null,"abstract":"<p><p><b>Objective:</b> To explore the effectiveness and application value of focused ultrasound ablation surgery (FUAS) combined with hysteroscopic surgery in treating solitary type Ⅱ submucosal uterine fibroids with maximum diameter >5 cm. <b>Methods:</b> Clinical data of 35 patients with a single type Ⅱ submucosal uterine fibroid with maximum diameter greater than 5 cm who underwent FUAS combined with hysteroscopic surgery at Qingdao Women and Children's Hospital from June 2020 to December 2023 were collected. The clinical characteristics, treatments and treatment outcomes were retrospectively analyzed. <b>Results:</b> (1) Clinical characteristics: the mean age of the 35 patients was (36.7±6.6) years, with a median maximum diameter of fibroids of 56 mm (range: 51-80 mm). All patients presented with symptoms of menorrhagia, median menstrual bleeding score was 5 points (ranged from 3 to 5 points), and 34 cases (97.1%, 34/35) had concomitant anemia, the mean hemoglobin was (83.1±13.8) g/L of 35 patients. (2) Treatments: all 35 patients underwent FUAS treatment initially, with a lesion ablation rate ranging from 69.7% to 97.9% (median:90.7%), and no complications occurred. After FUAS treatment, the volume of fibroids decreased in all patients, with a volume reduction rate ranging from 30.57% to 87.22% (median:76.03%). Hysteroscopic surgery was performed 3-14 months (median: 5 months) after FUAS to remove the necrotic fibroid tissue, achieving a 100.0% (35/35) fibroid resection rate. Only 1 patient developed complications of hyperhyderation syndrome during hysteroscopic surgery, and no complications occurred in the remaining patients. (3) Evaluation of efficacy: after FUAS pretreatment, the maximum diameter of fibroids in the 35 patients decreased significantly (<i>Z</i>=-5.171, <i>P</i><0.001), as did the volume of fibroids (<i>Z</i>=-5.159, <i>P</i><0.001). The hemoglobin level increased significantly compared to the level before FUAS in all cases (<i>t</i>=-8.657, <i>P</i><0.001), and median menstrual bleeding score decreased to 2 points (range: 1-3 points), significantly lower than original level (<i>Z</i>=-5.292, <i>P</i><0.001). At the 3-month follow-up after hysteroscopic surgery, all patients were free of anemia symptoms, with menstrual bleeding scores totally decreased to 1 point, significantly lower than that before hysteroscopic surgery (<i>Z</i>=-4.786, <i>P</i><0.001); hemoglobin level [(118.7±5.6) g/L] significantly increased compared to that before hysteroscopic surgery (<i>t</i>=-9.258, <i>P</i><0.001). All patients underwent gynecological transvaginal ultrasound re-examination, which did not reveal any residual fibroids. <b>Conclusion:</b> FUAS combined with hysteroscopic surgery is effective in treating solitary type Ⅱ submucosal uterine fibroids with maximum diameter >5 cm, providing a new treatment option for patients.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 5","pages":"363-371"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Feasibility analysis of laparoscopic total hysterectomy in patients with obliterated rectouterine pouch].","authors":"E N Liu, F Miao, Y F Zhou, Y Huang, L Zhang, C Peng","doi":"10.3760/cma.j.cn112141-20241118-00609","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241118-00609","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analysis the safety and feasibility of laparoscopic total hysterectomy in patients with obliterated rectouterine pouch. &lt;b&gt;Methods:&lt;/b&gt; A retrospective analysis was conducted on 197 patients who underwent laparoscopic total hysterectomy at Peking University First Hospital, from July 2022 to July 2024. According to intraoperative observations, 197 patients were categorized into two groups: 58 cases with completely obliterated rectouterine pouch (obliterated group) and 139 cases with non-obliterated pouch (control group). General clinical characteristics, perioperative outcomes and 3-month follow-up after surgery were compared between two groups. &lt;b&gt;Results:&lt;/b&gt; (1) Baseline characteristics: the age of the obliterated group was (45.7±3.7) years, and the control group was (48.0±3.8) years (&lt;i&gt;P&lt;/i&gt;&lt;0.001). Primary complaint: dysmenorrhea prevalence was 53.4% (31/58) in the obliterated group, and was 35.3% (49/139; &lt;i&gt;P&lt;/i&gt;&lt;0.05) in the control group. Surgical indications: the proportion of adenomyosis and ovarian endometrioma was 77.6% (45/58) in the obliterated group, and was 51.1% (71/139; &lt;i&gt;P&lt;/i&gt;&lt;0.001) in the control group. No significant differences in body mass index, pelvic surgical history, or preoperative medication between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). (2) Intraoperative outcomes: the obliterated group demonstrated significantly higher rates of surgical interventions compared to the control group. Superficial endometriosis resection was performed in 91.4% (53/58) of the obliterated group versus 33.8% (47/139) in the control group (&lt;i&gt;P&lt;/i&gt;&lt;0.001). Deep infiltrating endometriosis excision was required in 82.8% (48/58) of the obliterated group, contrasting sharply with 10.1% (14/139) in the control group (&lt;i&gt;P&lt;/i&gt;&lt;0.001). Ureterolysis procedures were similarly elevated in the obliterated group (77.6%, 45/58) compared to the control group (7.9%, 11/139; &lt;i&gt;P&lt;/i&gt;&lt;0.001). Operative metrics revealed substantial intergroup disparities: the obliterated group exhibited a median surgical duration of 149.0 minutes (interquartile range: 114.0, 180.0 minutes), significantly prolonged relative to the control group's 91.0 minutes (77.0, 107.0 minutes; &lt;i&gt;P&lt;/i&gt;&lt;0.001). Estimated blood loss followed a parallel pattern, with median volumes of 50.0 ml (20.0, 100.0 ml) in the obliterated group versus 20.0 ml (10.0, 20.0 ml) in the control group (&lt;i&gt;P&lt;/i&gt;&lt;0.001). (3) Postoperative outcomes: the uterine weight of the obliterated group was 200.0 g (132.5, 260.0 g), and the control group was 240.0 g (180.0, 336.0 g; &lt;i&gt;P&lt;/i&gt;&lt;0.05). Hospital stay was prolonged in the obliterated group compared with the control group [7.0 days (6.0, 8.3 days) vs 6.0 days (5.0, 7.0 days); &lt;i&gt;P&lt;/i&gt;&lt;0.001]. The incidences of postoperative fever in the obliterated group and the control group were 20.7% (12/58) vs 12.2% (17/139; &lt;i&gt;P&lt;/i&gt;&gt;0.05). The incidences of minor complications in the obliterated group and the control group were 3.4% (2/58) vs 0 (0/","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 5","pages":"355-362"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149573","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Guideline for the prediction and prevention of pre‑eclampsia (2025)].","authors":"","doi":"10.3760/cma.j.cn112141-20241130-00636","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241130-00636","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 5","pages":"329-342"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of clinical characteristics of pregnancy-related uterine arteriovenous malformation].","authors":"Q Liu, P Peng, W L Chen, C Y Li, L R Teng, X Y Liu","doi":"10.3760/cma.j.cn112141-20241106-00592","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241106-00592","url":null,"abstract":"<p><p><b>Objective:</b> To explore the treatment methods and prognosis of pregnancy-related uterine arteriovenous malformation (UAVM). <b>Methods:</b> A retrospective analysis was conducted on clinical data from 81 patients with UAVM treated at Peking Union Medical College Hospital between March 2019 and March 2024. Clinical manifestations, diagnostic approaches, treatment strategies and prognosis were evaluated. <b>Results:</b> (1) General Information: the age of patients with UAVM was (32.7±4.6) years, with median gravidity and parity of 1 (quartile range: 1, 2) and 0 (0, 1), respectively. Pregnancy termination methods included surgical abortion or curettage in 46 cases (57%, 46/81), medical induction in 17 cases (21%, 17/81), spontaneous abortion in 16 cases (20%, 16/81), vaginal delivery in 1 case (1%, 1/81), and laparoscopic pregnancy tissue removal in 1 case (1%, 1/81). (2) Clinical manifestations: clinical presentations comprised vaginal bleeding in 59 cases [73%, 59/81; median blood loss: 740 ml (440, 1 360 ml)], massive hemorrhage in 9 cases (11%, 9/81, and bleeding combined with lower abdominal pain in 8 cases (10%, 8/81). Ultrasonography revealed intrauterine masses in 65 cases [80%, 65/81; median size: 2.5 cm (1.8, 4.2 cm)]. Elevated serum human chorionic gonadotrophin-β subunit (β-hCG) levels were observed in in 55 cases [85%, 55/65; median: 62.6 U/L (14.9, 300.1 U/L)]. The median time to UAVM diagnosis via ultrasound was 30.0 days (16.0, 52.0 days) after pregnancy termination, with median peak systolic velocity (PSV) and resistance index of 59.8 cm/s (45.0, 79.6 cm/s) and 0.39 (0.36, 0.43), respectively. (3) Treatment and prognosis: treatment modalities included expectant management in 49 cases (36%, 29/81), medication in 13 cases (16%, 13/81), lesion resection in 31 cases (38%, 31/81), and uterine artery angiography in 8 cases (10%, 8/81; 5 confirmed as arteriovenous fistula). The median time of PSV returning to normal after treatment was 53.8 days (36.0, 93.4 days). The average time for β-hCG returning to normal was (60.4±20.4) days. The median return time of menses was 59.0 days (43.0, 75.4 days). <b>Conclusions:</b> Pregnancy-related UAVM carries a high risk of life-threatening hemorrhage, necessitating management in centers equipped for emergency uterine artery embolization. Informed consent must emphasize disease progression risks and prognosis. Treatment stratification should integrate clinical parameters and imaging features.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 5","pages":"348-354"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Association analysis on BRCA gene functional domain mutations and prognosis in patients with ovarian epithelial carcinoma and fallopian tube carcinoma].","authors":"M R Zhao, Y Q Yang, L Yu, L Zhang, Q J Chang, W W Cheng","doi":"10.3760/cma.j.cn112141-20250120-00030","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250120-00030","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the characteristics of BRCA gene mutations in patients with ovarian epithelial carcinoma and fallopian tube carcinoma, and to investigate the impact of mutations in the functional domains of the BRCA genes on the prognosis of patients. &lt;b&gt;Methods:&lt;/b&gt; This research collected a total of 273 patients diagnosed with primary ovarian epithelial carcinoma or fallopian tube carcinoma by pathological examination at the First Affiliated Hospital of Nanjing Medical University between January 2009 and December 2023.Data on their BRCA gene mutation status, clinicopathological data, and follow-up information were collected. A retrospective analysis was conducted to evaluate the association between BRCA gene mutations and patients' prognosis, including progression free survival (PFS) and overall survival (OS) time. &lt;b&gt;Results:&lt;/b&gt; Among the 273 patients with ovarian or fallopian tube carcinoma, 101 cases (37.0%, 101/273) were positive for BRCA gene mutations (BRCA-positive group), while 172 cases (63.0%, 172/273) were negative for BRCA gene mutations (BRCA-negative group). (1) Clinicopathological characteristics: compared with the BRCA-negative group, the BRCA-positive group had a younger age at diagnosis, lower proportion of postmenopausal status, and lower recurrence rate (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Additionally, the BRCA-positive group showed a higher prevalence of family history of gynecological malignancies and a higher rate of no visible residual disease (R0) resection, all with statistical significance (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). (2) Characteristics of BRCA gene mutations: among the 101 BRCA-positive patients, 74 cases (27.1%, 74/273) had BRCA1 gene mutations, 26 cases (9.5%, 26/273) had BRCA2 gene mutations, and 1 case (0.4%, 1/273) had indeterminate mutation records. According to the American College of Medical Genetics and Genomics (ACMG) 2015 guideline, mutations of uncertain significance accounted for 22.8% (23/101), likely pathogenic mutations accounted for 10.9% (11/101), and pathogenic mutations accounted for 59.4% (60/101), with 5.9% (6/101) unclassifiable. BRCA1 and BRCA2 genes have three (RING, DBD, BRCT) and two (RAD51-BD, DBD) major functional domains, respectively. Among the 89 BRCA-positive patients with detailed domain mutation data, the overall domain mutation rate was 40.4% (36/89), distributed as follows: DBD 14.6% (13/89), BRCT 12.4% (11/89), RING 4.5% (4/89), and RAD51-BD 9.0% (8/89). (3) Association between BRCA gene functional domain mutations and prognosis: among 77 patients with advanced stage (Ⅲ-Ⅳ) ovarian epithelial carcinoma in the BRCA-positive group with functional domain mutation data, the median PFS time was significantly longer in the 31 patients with domain mutations compared to the 46 patients with non-domain mutations (not reached during the follow-up period, vs 26.0 months; &lt;i&gt;P&lt;/i&gt;=0.035). However, there was no significant difference in median OS time between the two groups (not reached during t","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 5","pages":"372-382"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of the incidence and prognostic factors of port-site metastasis following laparoscopic surgery in patients with ovarian epithelial carcinoma].","authors":"X W Shi, D F Wang, G N Zhang, M Shi, Y Liu, J Zhang","doi":"10.3760/cma.j.cn112141-20250102-00002","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20250102-00002","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the incidence of port-site metastasis (PSM) after laparoscopic surgery in patients with epithelial ovarian cancer and prognostic factors influencing outcomes in those with abdominal wall PSM. &lt;b&gt;Methods:&lt;/b&gt; Clinicopathological and follow-up data of 22 ovarian epithelial cancer patients diagnosed with abdominal wall PSM after laparoscopic surgery, who were treated in the Sichuan Cancer Hospital between May 2014 and July 2023, were retrospectively collected. A retrospective analysis of PSM characteristics and prognostic factors influencing outcomes, was conducted in these patients. &lt;b&gt;Results:&lt;/b&gt; (1) Between May 2014 and July 2023, a total of 369 ovarian cancer patients with a history of laparoscopic surgery performed at other hospitals were admitted. Among them, 24 cases (6.5%, 24/369) were diagnosed with tumor lesions at the abdominal wall port sites via postoperative pathological examination, with a median interval time of 25.5 days (interquartile range: 19.5, 32.0 days) after laparoscopic surgery. Of these, 22 cases with complete clinicopathological and follow-up data were included in this study. (2) The age of the 22 PSM patients was (53.0±8.6) years, and the median follow-up time was 37.6 months (24.7, 63.4 months). Surgical-pathological staging revealed stage Ⅰ-Ⅱ disease in 4 cases and stage Ⅲ-Ⅳ disease in 18 cases. Histopathological differentiation included 5 cases of well-to-moderately differentiated tumors and 17 cases of poorly differentiated tumors. Pathological subtypes comprised 11 cases of high-grade serous adenocarcinoma, 5 cases of low-grade serous adenocarcinoma, and 6 cases of clear cell carcinoma or cystadenocarcinoma. Lymph node status was as follows: negative for lymph node metastasis (&lt;i&gt;n&lt;/i&gt;=16), positive (&lt;i&gt;n&lt;/i&gt;=5), and no lymphadenectomy performed (&lt;i&gt;n&lt;/i&gt;=1). Postoperative residual disease was categorized as no macroscopic residual disease (&lt;i&gt;n&lt;/i&gt;=13), residual disease ≤1 cm (&lt;i&gt;n&lt;/i&gt;=7), and residual disease &gt;1 cm (&lt;i&gt;n&lt;/i&gt;=2). (3) Following secondary cytoreductive surgery combined with postoperative adjuvant therapy, the median progression-free survival and overall survival (OS) time of the patients were 8.8 months (4.6, 14.3 months) and 27.7 months (15.5, 38.4 months), respectively. Univariate Cox regression analysis demonstrated that surgical-pathological stage, histopathological differentiation grade, and lymph node metastasis status were significantly associated with OS time in patients with abdominal wall PSM (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). In contrast, age, Eastern Cooperative Oncology Group performance status score, histopathological subtype, preoperative serum cancer antigen 125 level, presence of residual lesions after surgery and poly adenosine diphosphate ribose polymerase inhibitor usage showed no significant correlation with OS time (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). Multivariate Cox regression analysis identified surgical-pathological stage (&lt;i&gt;HR&lt;/i&gt;=4.579，95%&lt;i&gt;CI&lt;/i&gt;：1.111-18.866；&lt;","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 5","pages":"383-390"},"PeriodicalIF":0.0,"publicationDate":"2025-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144149561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Comparative analysis of the efficacy of dienogest and LNG-IUS in the treatment of intrinsic and extrinsic subtypes of adenomyosis].","authors":"L Liu, J Wang, X R Gao, M L Wang, M Li, C L Shang, H Y Guo","doi":"10.3760/cma.j.cn112141-20240924-00524","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240924-00524","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To compare the efficacy of dienogest (DNG) and levonorgestrel-releasing intrauterine system (LNG-IUS) in the treatment of intrinsic and extrinsic subtypes of adenomyosis. &lt;b&gt;Methods:&lt;/b&gt; Totally 232 patients were enrolled in the study who were diagnosed as adenomyosis by ultrasound or pelvic magnetic resonance imaging (MRI), and were classified into intrinsic and extrinsic subtypes according to different locations of lesions in MRI, treated with DNG (DNG group) or LNG-IUS (LNG-IUS group) in Peking University Third Hospital from July 2019 to December 2023. Clinical data of patients were retrospectively collected to analyze the clinical and imaging characteristics of different MRI subtypes of adenomyosis and whether there were differences in the therapeutic effects of DNG and LNG-IUS. &lt;b&gt;Results:&lt;/b&gt; (1) Among the 232 patients enrolled, 129 were intrinsic subtype and 103 were extrinsic subtype. Among the 129 patients treated with DNG, the numbers of intrinsic and extrinsic subtype were 69 and 60, respectively. And among the 103 patients treated with LNG-IUS, the numbers of intrinsic and extrinsic subtype were 60 and 43, respectively. The mean age in DNG group [(37.5±5.6) years] was lower than that in LNG-IUS group [(40.3±4.3) years, &lt;i&gt;P&lt;/i&gt;&lt;0.001]. There were no significant differences in other clinical features (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). (2) The visual analog scale (VAS) scores of dysmenorrhea and cancer antigen 125 (CA&lt;sub&gt;125&lt;/sub&gt;) levels in DNG group and LNG-IUS group were significantly decreased after treatment (all &lt;i&gt;P&lt;/i&gt;&lt;0.001), and hemoglobin levels were increased (both &lt;i&gt;P&lt;/i&gt;&lt;0.01). Compared between the two groups, the VAS score after treatment was lower in DNG group (&lt;i&gt;P&lt;/i&gt;&lt;0.001), and the hemoglobin level was increased more significantly in DNG group (&lt;i&gt;P&lt;/i&gt;=0.016). The complete remission rates of dysmenorrhea in DNG group and LNG-IUS group were 73.0% (89/122) and 29.5% (28/95), respectively (&lt;i&gt;P&lt;/i&gt;=0.039). The incidence of irregular bleeding in DNG group was higher than LNG-IUS group, but there was no statistical significance [62.8% (81/129) vs 52.4% (54/103), &lt;i&gt;P&lt;/i&gt;=0.112]. (3) Among patients with intrinsic adenomyosis, the incidence of menorrhagia was significantly higher than in those with extrinsic adenomyosis (&lt;i&gt;P&lt;/i&gt;&lt;0.001), while the incidence and severity of dysmenorrhea were lower compared to extrinsic adenomyosis (&lt;i&gt;P&lt;/i&gt;=0.004, &lt;i&gt;P&lt;/i&gt;=0.007, respectively). After treatment with DNG and LNG-IUS, there were no statistically significant differences in VAS scores between patients with intrinsic and extrinsic adenomyosis (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). The incidence of irregular bleeding after DNG treatment was 78.3% (54/69) in intrinsic adenomyosis, which was higher than the 45.0% (27/60) observed in extrinsic adenomyosis (&lt;i&gt;P&lt;/i&gt;&lt;0.01). Similarly, the incidence of irregular bleeding after LNG-IUS treatment was 63.3% (38/60) in intrinsic adenomyosis, higher than the 37.2% (16/43) in extrinsic adenomyosis ","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 4","pages":"281-288"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143980712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Influencing factors of resampling failure for non-invasive prenatal testing and its influence on pregnancy outcomes].","authors":"C Liu, Y P Wang, L Y Zou, C H Yin","doi":"10.3760/cma.j.cn112141-20240822-00464","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240822-00464","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To evaluate the factors influencing test failure after resampling in non-invasive prenatal testing (NIPT) and to explore its impact on pregnancy outcomes. &lt;b&gt;Methods:&lt;/b&gt; The information of pregnant women who failed to undergo NIPT for the first time and resampled for testing in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2018 to January 2022 were collected and retrospectively analyzed. According to the results of resampled NIPT, the pregnant women were divided into the failure group (170 cases) and the success group(485 cases), and the general clinical data and pregnancy outcomes of the two groups were compared. &lt;b&gt;Results:&lt;/b&gt; (1) A total of 88 928 pregnant women underwent NIPT in Beijing Obstetrics and Gynecology Hospital during the study period, of which 1 299 (1.461%, 1 299/88 928) failed in the first NIPT. Among the 1 299 pregnant women who failed in the first NIPT, 720 were resampled for testing. Finally, 655 pregnant women who met the inclusion criteria and had complete clinical information and perinatal outcomes were collected. The success rate of resampling was 74.0% (485/655). Compared with the success group, the pregnant women in the failure group had a later gestational age at resampling, a higher pre-pregnancy body mass index (BMI) and a higher fetal fraction, and the differences were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.001). (2) Among the 485 pregnant women in the success group, 130 cases (26.8%, 130/485) were detected with chromosome aneuploidy. Among the 170 pregnant women in the failure group, 8 cases had abnormal amniocentesis, 2 cases had abnormal maternal serum screening of aneuploidy in the second trimester, 3 cases had abnormal ultrasound anomaly removal, and 157 cases had no abnormality. (3) The incidence of fetal or neonatal malformation in the failure group was significantly higher than that in the success group [11.2% (19/170) vs 5.8% (28/485), &lt;i&gt;P&lt;/i&gt;=0.019], but after adjusting for age and pre-pregnancy BMI, fetal or neonatal malformation was not associated with the success of resampling (&lt;i&gt;RR&lt;/i&gt;=0.675, 95%&lt;i&gt;CI&lt;/i&gt;: 0.346-1.319; &lt;i&gt;P&lt;/i&gt;=0.250). The incidences of gestational diabetes mellitus and hypertensive disorders in pregnancy in the failure group were significantly higher than those in the success group (all &lt;i&gt;P&lt;/i&gt;&lt;0.05), but after adjusting for age and pre-pregnancy BMI, only the incidence of gestational diabetes mellitus in the failure group was higher (&lt;i&gt;RR&lt;/i&gt;=0.630, 95%&lt;i&gt;CI&lt;/i&gt;: 0.426-0.932; &lt;i&gt;P&lt;/i&gt;=0.021). &lt;b&gt;Conclusions:&lt;/b&gt; For pregnant women who failed the initial NIPT, the success of the resampling test is associated with pre-pregnancy BMI and the gestational week at the time of resampling. Those who failed the resampling test are more likely to develop gestational diabetes mellitus. When providing genetic counseling for pregnant women who failed the initial NIPT, it is important to consider the successful rate of resampling","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 4","pages":"268-274"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of risk factors for severe postpartum hemorrhage during vaginal delivery of twin pregnancy].","authors":"X Y Guo, P B Yuan, Y Wei, Y Y Zhao","doi":"10.3760/cma.j.cn112141-20241120-00616","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241120-00616","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the risk factors for severe postpartum hemorrhage (SPPH) during vaginal delivery of twin pregnancy. <b>Methods:</b> A retrospective analysis was conducted on clinical data from twin pregnancies ≥28 weeks' gestation undergoing vaginal delivery at Peking University Third Hospital between January 2016 and December 2023. The twin pregnant women were divided into the SPPH group (postpartum hemorrhage ≥1 000 ml within 24 hours) with 22 cases and the non-SPPH group with 171 cases. The differences between the two groups were compared and the risk factors for SPPH were analyzed. <b>Results:</b> (1) The incidence of SPPH during vaginal delivery in twin pregnancies was 11.4% (22/193). The causes of SPPH included 12 cases (54.5%, 12/22) of simple uterine atony, 4 cases (18.2%, 4/22) of uterine atony combined with vaginal lacerations after forceps delivery, and 6 cases (27.3%, 6/22) of uterine atony combined with placental factors. (2) The age and postpartum hospital stay in the SPPH group were significantly higher than those in the non-SPPH group (all <i>P</i><0.05). Compared to the non-SPPH group, the proportion of hypertensive disorders in pregnancy, accreta placenta implantation, and anemia in the SPPH group were significantly increased, and the birth weight of newborn 1st, the sum of the birth weights of two newborns, the duration of the second stage of labor, and the proportion of labor followed induction were also significantly increased (all <i>P</i><0.05). (3) Multivariate analysis showed that age ≥38 years (<i>OR</i>=16.785, 95%<i>CI</i>: 2.679-105.166; <i>P</i>=0.003), the second stage of labor ≥90 minutes (<i>OR</i>=9.670, 95%<i>CI</i>: 2.532-36.930; <i>P</i>=0.001), hypertensive disorders in pregnancy (<i>OR</i>=5.945, 95%<i>CI</i>: 1.702-20.761; <i>P</i>=0.005), and anemia (<i>OR</i>=8.048, 95%<i>CI</i>: 2.086-31.049; <i>P</i>=0.002) were independent risk factors for SPPH in twin pregnancies during vaginal delivery. <b>Conclusions:</b> Anemia should be actively corrected during twin pregnancy. For twin pregnant women with advanced age, hypertensive disorders in pregnancy, or other risk factors of SPPH, if vaginal delivery is chosen, attention should be paid to the management of labor duration, dynamic assessment of the risk of postpartum hemorrhage, and proactive measures should be taken to ensure a smooth vaginal delivery and effectively reduce the incidence of SPPH.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 4","pages":"260-267"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143983799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Multi‑disciplinary treatment approach in cervical cancer care: chinese gynecologic oncologists consensus].","authors":"","doi":"10.3760/cma.j.cn112141-20241218-00682","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241218-00682","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 4","pages":"241-259"},"PeriodicalIF":0.0,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}