中华妇产科杂志最新文献

{"title":"[Safety evaluation of Chinese-made robot-assisted laparoscopic sacrocolpopexy: a single-center, small-scale, single-arm study].","authors":"L Zhang, X X Wang, X Q Wang, Q Y Zhang, L H Zhang, Y Huang, Y Lu","doi":"10.3760/cma.j.cn112141-20241214-00670","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241214-00670","url":null,"abstract":"<p><p><b>Objective:</b> To describe the safety of using the Chinese-made robotic laparoscopic surgery system for laparoscopic sacrocolpopexy in the treatment of severe pelvic organ prolapse. <b>Methods:</b> A pilot descriptive clinical study was conducted, enrolling 16 severe pelvic organ prolapse patients at Peking University First Hospital from April 2023 to January 2024. Patients who consented to participate in this study underwent laparoscopic sacrocolpopexy for severe pelvic organ prolapse using Chinese-made robotic laparoscopic surgery system. Preoperative clinical basic data and perioperative data of the patients were collected, summarizing the data on perioperative bleeding and complications, and reviewed the surgical learning experience. The evaluation indicators related to the learning experience included: (1) efficiency evaluation: including equipment docking time, total surgery time, suturing time, mechanical arm operation time and hysterectomy time, which were timed and recorded during surgery; (2) equipment operability evaluation: including equipment operation task load assessment and intraoperative operation feeling score. The cumulative sum analysis method was used to quantify surgery time and fit the learning curve. <b>Results:</b> Sixteen patients were successfully enrolled and underwent surgery, including total hysterectomy with bilateral salpingo-oophorectomy or salpingectomy plus sacrocolpopexy, or sacrocolpopexy alone (for one case without uterus). The age of 16 cases was (56.7±7.6) years (ranged from 44 to 67 years), with body mass index of (25.4±2.5) kg/m². Concurrent procedures included anterior vaginal wall repair in 12 cases (12/16), posterior vaginal wall repair in 13 cases (13/16), tension-free vaginal tape obturator system in 1 case (1/16), and recto-uterine pouch hernia repair in 4 cases (4/16). The total surgery time was (355.8±91.1) minutes, with docking time at (6.7±4.9) minutes, robotic operative time at (267.6±81.4) minutes, robotic suturing time at (155.6±53.9) minutes, and hysterectomy time at (112.0±45.3) minutes. Learning curve analysis revealed inflection points at 6 cases for total surgery time (<i>P</i><0.001, <i>R</i>²=0.944) and robotic operative time (<i>P</i><0.001, <i>R</i>²=0.982), 5 cases for docking time (<i>P</i><0.001, <i>R</i>²=0.989), and 6 cases for robotic suturing time (<i>P</i><0.001, <i>R</i>²=0.907). Hysterectomy time had an inflection point at 5 cases (<i>P</i>=0.023, <i>R</i>²=0.700). Median blood loss was 30 ml (range: 10-1 000 ml), with severe bleeding in one patient (1/16). No conversions to open surgery or laparoscopy occurred, and no severe perioperative or postoperative complications were reported. <b>Conclusion:</b> The Chinese-made robotic laparoscopic surgery system demonstrates excellent short-time safety and ease of operation for laparoscopic sacrocolpopexy.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 3","pages":"183-192"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750109","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":"[Nomogram based on clinical and DCE-MRI characteristics for predicting the depth of myometrial invasion and grade of endometrioid endometrial carcinoma].","authors":"X L Ma, S Q Cai, J W Qiang, G F Zhang, J J Zhou, M S Zeng, X J Ren, R Jiang, M H Shen","doi":"10.3760/cma.j.cn112141-20241211-00658","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241211-00658","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To investigate the feasibility and value of nomogram based on base line clinical and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) characteristics for pretreatment predicting the depth of myometrial invasion and tumor grade of endometrioid endometrial carcinoma (EEC). &lt;b&gt;Methods:&lt;/b&gt; Preoperative baseline clinical characteristics and DCE-MRI characteristics of 194 EEC patients were prospectively collected at Obstetrics and Gynecology Hospital, Fudan University from October 2020 to January 2022 and used as a training set. Univariate analysis was conducted to compare baseline clinical characteristics and DCE-MRI quantitative parameters [including tumor volume, and mean, median, and standard deviation of volume transfer constant (K&lt;sup&gt;trans&lt;/sup&gt;), rate constant (K&lt;sub&gt;ep&lt;/sub&gt;), extravascular extracellular volume fraction (V&lt;sub&gt;e&lt;/sub&gt;), and initial area under the enhancement curve (iAUC)] between patients with deep myometrial invasion (DMI) and those with superficial myometrial invasion (SMI), as well as between high-grade and low-grade EEC. Multivariate logistics regression analysis was used to identify independent predictors for the construction of nomogram. An independent external testing set comprising 127 EEC patients was retrospectively collected from Zhongshan Hospital, Fudan University and Zhongshan Hospital, Fudan University (Xiamen Branch). The area under the receiver operating characteristic curve (AUC) and decision curve analysis (DCA) were used for evaluating the model's predictive performance and clinical net benefit, respectively. &lt;b&gt;Results:&lt;/b&gt; (1) The depth of myometrial invasion: univariate analysis showed that in the training set, the EEC patients with DMI differed significantly from those with SMI in clinical characteristics including higher proportion of postmenopausal state and overweight [body mass index (BMI)≥25 kg/m²], and abnormal levels of serum cancer antigen (CA)&lt;sub&gt;125&lt;/sub&gt;, CA&lt;sub&gt;199&lt;/sub&gt;, and human epididymis protein 4 (HE4), and in DCE-MRI quantitative parameters including tumor volume, and median, mean, and standard deviation of K&lt;sup&gt;trans&lt;/sup&gt;, median of V&lt;sub&gt;e&lt;/sub&gt;, as well as median, mean, and standard deviation of iAUC (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). Multivariate analysis showed that the patient's menstrual status, BMI, CA&lt;sub&gt;199&lt;/sub&gt;, tumor volume, and mean of iAUC were independent predictors of the depth of myometrial invasion, and constructed the nomogram (recorded as Nomogram_1), achieving an AUC of 0.861 (95%&lt;i&gt;CI&lt;/i&gt;: 0.803-0.919) in the training set. In the independent external testing set, the AUC was 0.876 (95%&lt;i&gt;CI&lt;/i&gt;: 0.815-0.938), with corresponding sensitivity of 82.0%, specificity of 80.7%, accuracy of 81.1%, positive predictive value (PPV) of 65.3%, and negative predictive value (NPV) of 91.0% for predicting DMI. (2) The EEC grade: univariate analysis showed that in the training set, high-grade EEC patients differed significantly from low-grade EEC in ","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 3","pages":"202-215"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751488","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":"[Carrier screening and prenatal diagnosis analysis of high-risk cases in 3 044 preconception and early pregnancy couples].","authors":"X L Fu, W Hou, M L Zhang, X X Xie, Y Meng, H H Zhou, Q D Zhao, J L Hu, G P Mo, Y P Lu","doi":"10.3760/cma.j.cn112141-20240928-00531","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240928-00531","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To carry out carrier screening among people of childbearing age, detect the pathogenic genes of monogenic genetic diseases and analyze the carrier status of pathogenic variants, so as to provide fertility guidance and intervention measures for high-risk families. &lt;b&gt;Methods:&lt;/b&gt; From August 2022 to August 2023, 1 533 families of childbearing age who met the criteria were recruited in the Chinese PLA General Hospital, including a total of 3 044 subjects. According to the standard enrollment procedure, 223 genes (197 autosomal recessive genes and 26 X-linked genes) of the subjects were tested. According to the screening results, genetic counseling and fertility guidance were provided to the subjects. Invasive prenatal diagnosis was performed for high-risk couples (both couples being carriers of the same autosomal recessive disease gene or the woman was a carrier of X-linked disease gene), and their pregnancy pattern, outcome and offspring phenotype were followed up. &lt;b&gt;Results:&lt;/b&gt; (1) A total of 3 044 cases from 1 511 couples and women of childbearing age from 22 families were included for carrier screening. Totally 1 503 families chose simultaneous screening and 30 families chose sequential screening out of the 1 533 families. Among the 3 044 subjects, 1 603 individuals carried at least one pathogenic or likely pathogenic variant, and the overall carrier rate was 52.66% (1 603/3 044). A total of 2 292 pathogenic or likely pathogenic variants were detected, and 0.75 variants (2 292/3 044) were detected per capita. (2) The three genes with the highest carrier rates were GJB2 (8.67%, 264/3 044), CYP21A2 (3.19%, 97/3 044) and PAH (3.09%, 94/3 044). There were 32 genes with a carrier rate ≥1/200, 17 genes with a carrier rate ≥1/100, and 7 genes with a carrier rate ≥1/50. (3) Thirty-eight high-risk families were identified. After excluding G6PD gene mutation, there were 33 high-risk families, of which 25 couples were carriers of the same autosomal recessive gene, 9 women were carriers of X-linked gene, and 1 family was double high-risk couple with both autosomal recessive and X-linked gene. After further excluding the GJB2 c.109G&gt;A mutation, 21 high-risk families were identified. Preimplantation genetic testing for monogenic disease was performed in 12 families after genetic counseling. Prenatal diagnosis was completed in 4 out of 5 high-risk families who conceived naturally. Two fetuses carried the parental variants and terminated the pregnancy, one fetus did not carry the parental variants but was induced due to trisomy 21 syndrome, and one fetus was a carrier of congenital disorders of glycosylation type 1a. &lt;b&gt;Conclusions:&lt;/b&gt; Carrier screening effectively identifies high-risk genetic disease families and provides reproductive guidance to prevent the birth of affected children. However, establishing multidisciplinary team is essential for managing complex cases. Implementation should prioritize prenatal institutions with gen","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 3","pages":"161-170"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751471","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":"[Advances of targeting EZH2 in gynecological malignancies].","authors":"Y S Jiao, C Li, Y Xiang","doi":"10.3760/cma.j.cn112141-20240815-00455","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240815-00455","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 3","pages":"236-240"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751469","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":"[Effects of continuous positive airway pressure on maternal and neonatal outcomes in pregnant women with obstructive sleep apnea syndrome].","authors":"Z L Tu, R Bai, L Y Zhang, J Y Wang, S D Hong, J J Yang, J Wei, Y Wang, Y N Liu, X S Dong, F Han, G L Liu","doi":"10.3760/cma.j.cn112141-20240808-00444","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240808-00444","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To analyze the effect of continuous positive airway pressure (CPAP) on maternal and neonatal outcomes in pregnant women with obstructive sleep apnea syndrome (OSAS), especially on the incidence of hypertensive disorder in pregnancy (HDP) in women with moderate to severe OSAS. &lt;b&gt;Methods:&lt;/b&gt; A total of 180 pregnant women with OSAS who were diagnosed through sleep monitoring during pregnancy due to high-risk factors of OSAS and registered in Peking University People's Hospital from January 2021 to May 2024 were selected as the study subjects. Clinical data were collected from medical records for retrospective analysis. According to whether they received standardized treatment with CPAP, they were divided into the CPAP treatment group (42 cases) and the control group (138 cases). The CPAP treatment group consisted of 9 pregnant women with moderate to severe OSAS, while the control group consisted of 34 pregnant women with moderate to severe OSAS. The maternal and neonatal outcomes, the incidence of HDP, placental weight after delivery and placental weight/neonatal birth weight ratio were compared between the two groups. &lt;b&gt;Results:&lt;/b&gt; (1) The average gestational age of pregnant women in the CPAP treatment group was higher than that in the control group [(38.7±1.0) vs (38.0±1.4) weeks], the proportion of infants small for gestational age (SGA) in the CPAP treatment group was lower [0 (0/42) vs 12.3% (17/138)], and the birth weight of infants in the CPAP treatment group was bigger [(3 396±475) vs (3 082±710) g); the differences between the two groups were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). There were no significant differences between the CPAP treatment group and the control group in terms of delivery mode, rates of postpartum hemorrhage and preterm birth, umbilical artery blood gas analysis pH&lt;7.1, lactate≥6.0 mmol/L, base excess&lt;-12.0 mmol/L and the incidence of gestational diabetes mellitus and HDP (all &lt;i&gt;P&lt;/i&gt;&gt;0.05). (2) The placental weight of the CPAP treatment group was significantly lower than that of the control group [(554.0±70.6) vs (615.7±119.1) g], the placental weight/newborn birth weight ratio of the CPAP treatment group was significantly lower than that of the control group (median: 0.17 vs 0.19), and the differences were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). (3) The incidence of HDP in pregnant women with moderate to severe OSAS in the CPAP treatment group was lower than that in the control group [1/9 vs 61.8% (21/34)], and the difference was statistically significant (&lt;i&gt;P&lt;/i&gt;&lt;0.05). &lt;b&gt;Conclusions:&lt;/b&gt; CPAP treatment could prolong the gestational age in pregnant women with OSAS, reduce the incidence of SGA, increase the birth weight of infants, and reduce the incidence of HDP in pregnant women with moderate to severe OSAS, and is worth promoting in clinical practice. The improvement of neonatal outcomes by CPAP treatment is closely related to the placenta, which is worthy of further ex","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 3","pages":"171-176"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751472","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":"[The risk and perioperative management for cesarean delivery at the second stage of labor].","authors":"L Y Li, X Y Guo, Y Wei","doi":"10.3760/cma.j.cn112141-20240919-00511","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240919-00511","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 3","pages":"231-235"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751142","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":"[Value of high-risk HPV viral load in cervical cancer screening and triage: a real world retrospective study based on cervical cancer screening program in Quanzhou, China].","authors":"Y Q Chen, Q M Huang, M L Hong, Y Q Zhu, Y L Gao, L Y Chen, L Y Chen","doi":"10.3760/cma.j.cn112141-20241210-00657","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241210-00657","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To evaluate the clinical value of high-risk human papillomavirus (HPV) viral load for the cervical cancer screening and triage of high-risk HPV positive populations without additional tests. &lt;b&gt;Methods:&lt;/b&gt; (1) This study conducted a retrospective analysis of 29 720 women aged 35-64 years who received cervical cancer screening in Quanzhou, China, in 2021. Fourteen high-risk HPV types (including HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68) were detected for cervical cancer primary screening using hybrid capture-chemiluminescence method. High-risk HPV positive samples were further subjected to HPV 16/18 genotyping using hybrid capture-chemiluminescence method. Among them, HPV 16/18 positive women were directly referred to colposcopy, while the other 12 high-risk HPV positive samples were further subjected to liquid based cytology test. Those with abnormal or suspicious cytology were referred to colposcopy. Biopsies were taken for histopathological examination of suspicious or abnormal individuals under colposcopy. (2) Ten cases of colposcopy loss or refusal to undergo examination were excluded, and the data from the 29 710 cases were analyzed. The HPV viral loads of the other 12 high-risk HPV positive populations were focused and evaluated their HPV viral loads for further cervical intraepithelial neoplasia (CIN) Ⅱ and above lesions (CINⅡ&lt;sup&gt;+&lt;/sup&gt;) triage in cervical cancer screening. &lt;b&gt;Results:&lt;/b&gt; (1) Among 29 720 women, 2 487 women (8.37%, 2 487/29 720) were positive for high-risk HPV, including 807 women (2.72%, 807/29 720) were positive for HPV 16/18 and 1 680 patients (5.65%, 1 680/29 720) were positive for the other 12 high-risk HPV types. Among 1 680 women who tested positive for the other 12 high-risk HPV types, 573 patients were atypical squamous cell carcinoma of unclear significance or above, 346 patients were CIN Ⅰ, 122 patients were CIN Ⅱ-Ⅲ, 9 patients were squamous cell carcinoma patients, and 4 patients were adenocarcinoma in situ. The immediate risk of CIN Ⅱ&lt;sup&gt;+&lt;/sup&gt; in HPV 16/18 positive women (11.13%) was approximately four times higher than that of other 12 high-risk HPV positive women (2.74%). (2) Through the viral load analysis of the other 12 high-risk HPV types, we found that the viral load of the other 12 high-risk HPV provide a good value for the pathological results, with a clinical cutoff (CO) value of 11.21 relative light unit/CO (RLU/CO) for the CINⅡ&lt;sup&gt;+&lt;/sup&gt; detection. Except for HPV 16/18 positive patients, when the viral load values of the other 12 high-risk HPV types were greater than 10 RLU/CO, these patients had a higher risk of CINⅡ&lt;sup&gt;+&lt;/sup&gt;, with a positive predictive value of 31.29%. CINⅡ&lt;sup&gt;+&lt;/sup&gt; was not found in any of the other 12 high-risk HPV positive with viral load values less than or equal to 10 RLU/CO. &lt;b&gt;Conclusions:&lt;/b&gt; Using hybrid capture-chemiluminescence HPV tests for HPV 16/18 genotyping, combined with the viral loads (&gt;10 RLU/CO) of th","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 3","pages":"193-201"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751168","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":"[Short-term efficacy of mid-urethral sling with autologous fascia lata sling in the treatment of stress urinary incontinence].","authors":"Y Q Guan, J F Yang, J S Han, Y T Wang, K Zhang, Y Yao, B Yu","doi":"10.3760/cma.j.cn112141-20240921-00515","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240921-00515","url":null,"abstract":"<p><p><b>Objective:</b> To observe the safety and short-term efficacy of using an autologous fascia lata sling (AFLS) for tension-free mid-urethral sling (MUS) in the treatment of stress urinary incontinence (SUI). <b>Methods:</b> Between February 2022 and December 2023, 11 patients with SUI underwent AFLS-MUS. Preoperative data were recorded, including basic patient information and completion of urinary distress inventory 6 (UDI-6). During surgery, AFLS was harvested through a small incision using a tendon extractor, and used as a sling for transobturator or retropubic MUS. Perioperative indicators were recorded, including surgical approach, operation time, intraoperative blood loss, postoperative hospital stay, duration of catheterization, perioperative complications (Clavien-Dindo classification), and surgical costs. Follow-ups included outpatient physical examination at 2 months postoperatively, and telephone follow-up at 6 months, 1 year, and annually thereafter. Follow-up content included the presence or absence of urinary leakage symptoms, UDI-6, satisfaction, patient global impression of improvement (PGI-I), and complications. <b>Results:</b> The age of the 11 patients was (54.8±10.9) years (range: 41-72 years), with body mass index of (23.9±1.8) kg/m² (range: 21.4-27.3 kg/m²). All patients experienced urinary leakage after coughing, sneezing and physical activity, with positive SUI provocation tests. The preoperative UDI-6 was 50.0±21.6 (range: 16.7-79.2), the result of 1-hour pad test was (18.9±12.0) g (range: 2.5-71.2 g). Four cases underwent MUS only, with operation time of (98.0±13.3) minutes (range: 86-117 minutes), and intraoperative blood loss of (17.5±5.0) ml (range: 10-20 ml); 7 cases also underwent pelvic floor repair simultaneously. The postoperative hospital stay was (3.5±2.0) days (range: 2-9 days). The duration of catheterization was (4.5±3.8) days (range: 2-11 days), with postoperative urinary retention in three cases, one of which underwent sling release surgery due to severe postoperative voiding difficulty 1 week after MUS, with no other complications of Clavien-Dindo grade 2 or above. The cost of AFLS harvest plus MUS was (2 762±293) yuan. At the 2-month outpatient follow-up, all patients were free of urinary leakage symptoms, with UDI-6 of 2.3±1.9 (range: 0-8.3); satisfaction was \"very satisfied\" in 10 cases and \"fairly satisfied\" in 1 case, with PGI-I all being \"much better\", and pelvic examinations were normal. Telephone follow-up showed one case lost to follow-up, and the remaining 10 cases had follow-up time of (18.6±4.9) months (range: 7-26 months), all without urinary leakage, with UDI-6 of 2.7±2.6, satisfaction rated as \"very satisfied\", and PGI-I all \"much better\". <b>Conclusion:</b> This modified AFLS-MUS for the treatment of SUI shows good short-term efficacy and high safety in harvest site, with the need for more data accumulation and long-term follow-up.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 3","pages":"177-182"},"PeriodicalIF":0.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750962","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":"[Effectiveness and pregnancy outcomes of emergency cervical cerclage versus cerclage with cervical length <10 mm: a retrospective study].","authors":"Malipati Maerdan, X Y Wang, C Y Shi, L J Wang, R H Zhao, J F Liang, X Sun, X X Zhang, M Y Zhang, H X Yang","doi":"10.3760/cma.j.cn112141-20241118-00607","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241118-00607","url":null,"abstract":"<p><p><b>Objective:</b> To explore the surgical efficacy of cervical cerclage with cervical length (CL) <10 mm and emergency cerclage. <b>Methods:</b> From January 2013 to June 2022, a total of 98 singleton pregnant women who underwent ultrasound-indicated cervical cerclage because of CL<10 mm in the second trimester and underwent emergency cervical cerclage because of cervical dilation found by physical examination in Peking University First Hospital were enrolled. The differences in clinical data between the <34 weeks delivery group (25 cases) and the ≥34 weeks delivery group (73 cases) were compared. Meanwhile, according to different cervical status, they were divided into CL<10 mm group (43 cases) and cervical dilatation group (55 cases), and the cervical dilatation group was further divided into cervical dilatation <4 cm group and cervical dilatation ≥4 cm group. The clinical data and pregnancy outcomes of pregnant women with different cervical status were compared. <b>Results:</b> (1) There were significant differences in the proportion of preoperative CL<10 mm and the degree of preoperative cervical dilation between the <34 weeks delivery group and the ≥34 weeks delivery group (all <i>P</i><0.05). (2) After cervical cerclage, compared with women in the cervical dilatation group, the prolonged gestational age in the CL<10 mm group was longer [(10.5±4.6) vs (14.3±3.4) weeks], the gestational age at delivery was later (median: 35.7 vs 38.0 weeks), the preterm birth rates before 37 and 34 weeks were lower, the late abortion rate was lower [9% (5/55) vs 0 (0/43)], and the newborn birth weight was higher, the differences were statistically significant (all <i>P</i><0.05). (3) Compared with the cervical dilation ≥4 cm group, the prolonged gestational age of the cervical dilatation <4 cm group was longer [(7.5±5.3) vs (11.1±4.2) weeks], the gestational age at delivery was later (median: 29.2 vs 36.0 weeks), and the birth weight of the newborn was higher (all <i>P</i><0.05). The late abortion rate of cervical dilatation <4 cm group was lower than that of cervical dilatation ≥4 cm group [7% (3/45) vs 2/10; <i>P</i>=0.220]. <b>Conclusions:</b> Timely cervical cerclage in individuals with CL<10 mm could reduce preterm birth rate before 34 weeks gestation, and the pregnancy outcome is better than that of individuals with cervical dilation. Moreover, the pregnancy outcome of cervical cerclage in women with cervical dilation <4 cm is significantly better than that in women with cervical dilatation ≥4 cm.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 2","pages":"114-120"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514848","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 between HPV outcome and vaginal microecology in women with persistent high-risk HPV infection: a prospective cohort study].","authors":"Z Zhang, X N Zong, H H Bai, L Y Fan, T Li, Z H Liu","doi":"10.3760/cma.j.cn112141-20241020-00562","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20241020-00562","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the association between high-risk human papillomavirus (hrHPV) persistent infection and vaginal microecology. <b>Methods:</b> A total of 53 women were enrolled in the gynecological clinic of Beijing Obstetrics and Gynecology Hospital from January 2020 to January 2021, including 7 women without HPV and 46 women with hrHPV infection. Among the hrHPV infected women, 24 woemn who did not use any drugs were classified as the observation group and the other 22 women who were given standardized interferon vaginal administration for 3 months were regarded as the treatment group. Vaginal secretions of all women were taken for Gram-stained microecological test at the time of enrollment and at the 4, 8, and 12 month follow-up. HPV turning negative was taken as the end point of follow-up. <b>Results:</b> (1) Women of hrHPV persistent infection in the observation and treatmnet groups had more times of abortions (<i>P</i>=0.180). (2) The hrHPV negative conversion rate was 17% (4/24) in the observation group and 36% (8/22) in the treatment group, but the difference was not significant (<i>P</i>=0.183). The median hrHPV negative conversion time were 11.0 months and 7.5 months in the observation and treatment groups, respectively, and the difference was statistically significant (<i>P</i>=0.001). (3) Vaginal microecology was generally normal at the time of enrollment and at the end of follow-up in women with HPV natural negative conversion in the observation group. While vaginal microecological disorders were more common in women with hrHPV persistent infection in the observation and treatmnet groups, including high vaginal pH value, poor vaginal cleanliness, poor grade of Lactobacillus and increased vaginal clutter bacteria, and the vaginal microecological situation did not improve after the 12-month follow-up. (4) In the treatment group, women who turned HPV negative within six months all had normal vaginal microecology when enrollment (5/5). While those who turned negative six months later had a higher proportion of vaginal clutter bacteria (2/3), a poor grade of Lactobacillus (2/3) and a higher proportion of vaginal dysbiosis (2/3). <b>Conclusions:</b> (1) Interferon therapy could shorten the negative turning time of hrHPV. (2) Women with normal vaginal microecology have the ability to naturally clear hrHPV. (3) The vaginal microecological Gram-stain test has limited value in predicting hrHPV clearance, perhaps due to its inability to detect Lactobacillus subtypes.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"60 2","pages":"121-127"},"PeriodicalIF":0.0,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143514843","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}