中华妇产科杂志最新文献

{"title":"[Progress in diagnosis and treatment of neuroendocrine carcinoma of cervix].","authors":"H J Yu, D Hu, Y Sun","doi":"10.3760/cma.j.cn112141-20230626-00287","DOIUrl":"10.3760/cma.j.cn112141-20230626-00287","url":null,"abstract":"子宫颈神经内分泌癌（NECC）是一种高度侵袭、预后不良的少见子宫颈癌。NECC主要通过病理形态学及免疫组化法检测进行诊断，除了突触素、嗜铬素A、CD56和神经元特异性烯醇化酶等特异性神经内分泌标志物外，胰岛素瘤相关蛋白1也有望协助诊断。随着磁共振成像（MRI）检查在子宫颈癌分期中的应用得到肯定，影像学检查也可为鉴别诊断和分期提供帮助。目前，NECC无标准治疗方案，主要通过借鉴小细胞肺癌的治疗经验形成以综合治疗为主的治疗模式，靶向治疗、免疫治疗也显示出巨大的潜力，但在治疗方案的选择上仍存在众多争议。近年来，NECC的诊治相关研究取得了一系列新成果，本文就NECC的诊断和治疗进展作全面综述，对不同期别NECC提出了不同于其他病理类型子宫颈癌的综合治疗模式，以期为后续相关研究和临床实践提供参考。.","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 9","pages":"716-720"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10311423","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":"[Research progress of disease inclusion in expanded carrier screening].","authors":"J Tan, J X Tan, B B Shao, Y Wang, Z F Xu","doi":"10.3760/cma.j.cn112141-20230113-00014","DOIUrl":"10.3760/cma.j.cn112141-20230113-00014","url":null,"abstract":"扩展性携带者筛查是出生缺陷一级预防的主要措施之一，在过去数年取得了长足发展，实现了单基因遗传病由被动诊治模式向主动预防模式的突破性转变，其可行性及临床应用价值得到了广泛认可。随着技术的进步，可筛查的单基因遗传病达千余种。但是，哪些单基因遗传病适合临床大规模筛查一直是产前诊断领域内争论的焦点。本文针对扩展性携带者筛查病种纳入的数量、疾病属性、受试者的意见、社会伦理学影响等方面的国内外研究进展进行综述，为扩展性携带者筛查在临床规范有序的开展提供依据。.","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 9","pages":"708-711"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10315040","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":"[Chinese expert consensus on diagnosis and treatment of female sexual dysfunction (2023 version)].","authors":"","doi":"10.3760/cma.j.cn112141-20230308-00108","DOIUrl":"10.3760/cma.j.cn112141-20230308-00108","url":null,"abstract":"女性性功能障碍（FSD）是全球的重要公共卫生问题。鉴于目前国内尚无针对FSD诊治的标准参考，中国整形美容协会科技创新与器官整复分会组织国内性医学领域、妇产科学领域、康复治疗领域、心理卫生领域以及中医领域的专家，结合国内外FSD研究现状制定本共识，以期为FSD临床诊治提供参考。本共识的制定严格遵循指南共识制定的通用原则，并按照循证医学原则划分证据等级并给出推荐等级。本共识定义了FSD，并对FSD的流行病学进行了概述，明确了性反应周期的四阶段学说以及FSD的常见病因与高危因素。本共识参考国际上普遍采用的分类原则对FSD进行了分类，包括：性欲减退功能障碍、性唤起功能障碍、性高潮功能障碍、生殖器或盆腔疼痛和插入障碍、与盆底功能障碍性疾病有关的性功能障碍、其他特指及未特指的性功能障碍。本共识对FSD的诊断和治疗提出了原则性的指导。FSD的诊断要重视病史采集，并合理应用性功能评估量表或问卷；体格检查尤其是生殖系统专科检查是必不可少的，必要时要进行辅助检查。FSD的治疗包括一般干预、心理干预（包含性感集中疗法、认知行为疗法、正念疗法等）、药物治疗（其中的激素治疗包含雌激素治疗和雄激素治疗）、阴道润滑剂和保湿剂、自我性刺激训练、盆底物理疗法（包含盆底肌训练、阴道扩张、手法按摩、电刺激和生物反馈等）、原发疾病的治疗、中医药治疗。.","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 9","pages":"641-649"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10315041","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":"[Relationships between hypertensive disorders in pregnancy and obstructive sleep apnea syndrome].","authors":"R Bai,&nbsp;J Y Wang,&nbsp;C Zhang,&nbsp;S D Hong,&nbsp;L Y Zhang,&nbsp;J Wei,&nbsp;Y Wang,&nbsp;J J Yang,&nbsp;X S Dong,&nbsp;F Han,&nbsp;G L Liu","doi":"10.3760/cma.j.cn112141-20230219-00074","DOIUrl":"10.3760/cma.j.cn112141-20230219-00074","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the impact of obstructive sleep apnea syndrome (OSAS) on pregnancy outcomes, especially the relationship between OSAS and hypertensive disorders in pregnancy (HDP). <b>Methods:</b> A total of 228 pregnant women with high risk of OSAS who underwent sleep monitoring during pregnancy in Peking University People's Hospital from January 2021 to April 2022 were collected by reviewing their medical records for retrospective analysis. According to the diagnosis of OSAS, the pregnant women were divided into OSAS group (105 cases) and non-OSAS group (123 cases). The non-parametric Mann-Whitney <i>U</i> test, <i>χ</i>² test or Fisher's exact test were used to compare the general data and maternal and fetal outcomes between the two groups, and the occurrence of each type of HDP was further compared. <b>Results:</b> (1) Compared with the non-OSAS group, the median pre-pregnancy body mass index (23.6 vs 27.6 kg/m²) and the proportion of snoring [28.9% (33/114) vs 59.2% (61/103)] in the OSAS group were higher, and the differences were both statistically significant (both <i>P</i><0.001). (2) The incidence of HDP [67.6% (71/105) vs 39.0% (48/123)] and gestational diabetes mellitus [GDM; 40.0% (42/105) vs 26.8% (33/123)] of pregnant women in the OSAS group were higher than those in the non-OSAS group, and the median delivery week was shorter than that in the non-OSAS group (38.4 vs 39.0 weeks). The differences were all statistically significant (all <i>P</i><0.05). Between-group differences for the delivery way, postpartum hemorrhage, the rate of intensive care unit admission, preterm birth, small for gestational age infants, neonatal asphyxia, the rate of neonatal intensive care unit admission, newborn birth weight and the proportion of umbilical artery blood pH<7.00 were not statistically significant (all <i>P</i>>0.05). (3) Compared with the non-OSAS group, the incidence of chronic hypertension [11.4% (14/123) vs 22.9% (24/105)] and chronic hypertension with superimposed pre-eclampsia [11.4% (14/123) vs 30.5% (32/105)] were higher in the OSAS group, and the differences were both statistically significant (both <i>P<</i>0.01). <b>Conclusion:</b> OSAS is related to HDP (especially chronic hypertension and chronic hypertension with superimposed pre-eclampsia) and GDM, which could provide a practical basis for the screening, diagnosis and treatment of OSAS in pregnant women at high risk.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 9","pages":"658-663"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10309498","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":"[Research progress on systemic effects of endometriosis].","authors":"X M Jia,&nbsp;H Y Liu,&nbsp;X Y Zhong","doi":"10.3760/cma.j.cn112141-20221226-00777","DOIUrl":"10.3760/cma.j.cn112141-20221226-00777","url":null,"abstract":"子宫内膜异位症（内异症）是妇科常见疾病，虽然内异症最常见的临床表现为疼痛、不孕、盆腔包块等，但是越来越多的数据表明，内异症不仅仅是一种局限于盆腔的疾病，而是一种全身性、系统性的疾病。内异症对全身的系统性影响在治疗中往往被忽视，本文就内异症对心血管、神经、代谢、免疫等多个系统产生的主要影响进行论述。内异症与心血管疾病之间存在关联性，这可能与内异症患者全身的系统性慢性炎症、氧化应激等有关。内异症对神经系统的影响（如：疼痛、焦虑、抑郁等）是一种重要且经常被忽视的系统表现。内异症对代谢有一定的影响，通过代谢组学研究能更好地理解内异症的病理生理过程并探索新的生物标志物。内异症患者中一些自身免疫性疾病的发病率较高，但内异症与免疫功能失调之间的关系仍有争论。越早认识内异症对全身的系统性影响将越有利于提早重视并预防，最大限度改善患者的生命质量及预后。.","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 9","pages":"712-715"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10309503","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 postoperative radiotherapy and analysis of prognostic factors in early-stage neuroendocrine carcinoma of cervix].","authors":"X C Song,&nbsp;H Zhang,&nbsp;S Zhong,&nbsp;X J Tan,&nbsp;S Q Ma,&nbsp;Y Jin,&nbsp;L Y Pan,&nbsp;M Wu,&nbsp;D Y Cao,&nbsp;J X Yang,&nbsp;Y Xiang","doi":"10.3760/cma.j.cn112141-20230614-00263","DOIUrl":"10.3760/cma.j.cn112141-20230614-00263","url":null,"abstract":"<p><p><b>Objective:</b> To evaluate the effect of postoperative radiotherapy and high-risk pathological factors on the prognosis of early-stage neuroendocrine carcinoma of cervix (NECC). <b>Methods:</b> A single-center retrospective cohort study of early-stage NECC in Peking Union Medical College Hospital from January 2011 to April 2022 were enrolled. The patients were treated with radical hysterectomy±adjuvant treatment. They were divided into postoperative non-radiation group and postoperative radiation group. The possible postoperative recurrence risk factors identified by univariate analysis were assessed using multivariate logistic regression. The Kaplan-Meier method was used to analyze the progression free survival (PFS), overall survival (OS), recurrence rate, and mortality rate. <b>Results:</b> (1) Sixty-two cases were included in the study, including 33 cases in postoperative non-radiation group and 29 cases in postoperative radiation group. (2) The median follow-up time was 37 months (ranged 12-116 months), with 23 cases (37%) experienced recurrences. There were 7 cases (11%) pelvic recurrences and 20 cases (32%) distant recurrences, in which including 4 cases (6%) both pelvic and distant recurrences. Compared with postoperative non-radiation group, the postoperative radiation group had a lower pelvic recurrence rate (18% vs 3%; <i>P</i>=0.074) but without statistic difference, a slightly elevated distant recurrence rate (24% vs 41%; <i>P</i>=0.150) and overall recurrence rate (33% vs 41%; <i>P</i>=0.513) without statistically significances. Univariate analysis showed that lymph-vascular space invasion and the depth of cervical stromal invasion≥1/2 were risk factors for postoperative recurrence (all <i>P</i><0.05). Multivariate analysis showed lymph-vascular space invasion was an independent predictor for postoperative recurrence (<i>OR</i>=23.03, 95%<i>CI</i>: 3.55-149.39, <i>P</i>=0.001). (3) During the follow-up period, 18 cases (29%, 18/62) died with tumor, with 10 cases (30%, 10/33) in postoperative non-radiation group and 8 cases (28%, 8/29) in postoperative radiation group, without significant difference (<i>P</i>=0.814). The postoperative 3-year and 5-year survival rate was 79.2%, 60.8%. The depth of cervical stromal invasion≥1/2 was more common in postoperative radiation group (27% vs 64%; <i>P</i>=0.011), and postoperative radiation in such patients showed an extended trend in PFS (32.3 vs 53.9 months) and OS (39.4 vs 73.4 months) but without statistic differences (<i>P</i>=0.704, <i>P</i>=0.371). Compared with postoperative non-radiation group, the postoperative radiation did not improve PFS (54.5 vs 37.3 months; <i>P</i>=0.860) and OS (56.2 vs 62.4 months; <i>P</i>=0.550) in patients with lymph-vascular space invasion. <b>Conclusions:</b> Postoperative radiation in early-stage NECC patients has a trend to reduce pelvic recurrence but not appear to decrease distant recurrence and overall recurrence, and has not improved morta","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 9","pages":"680-690"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10303019","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":"[Study on the predictive significance of PLR, SII and RPR in ovarian endometriotic cyst].","authors":"M M Li,&nbsp;X H Tang,&nbsp;L M Wang","doi":"10.3760/cma.j.cn112141-20230504-00200","DOIUrl":"10.3760/cma.j.cn112141-20230504-00200","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the predictive value of platelet-to-lymphocyte ratio (PLR), red blood cell distribution width to platelet count ratio (RPR) and systemic immune inflammation index (SII) in the staging and postoperative recurrence of ovarian endometrial cysts. <b>Methods:</b> Retrospective analysis was made on the clinical data of patients who underwent laparoscopic surgery for ovarian cysts in the Affiliated Hospital of Qingdao University from January 2018 to January 2020. The patients with ovarian endometriosis cyst confirmed by pathology after surgery were the observation group (<i>n</i>=350), and the patients with other benign ovarian cyst were the control group (<i>n</i>=150). The preoperative platelet count, platelet distribution width, absolute number of neutrophils, lymphocyte absolute number, absolute number of monocytes, red blood cell distribution width, and serum cancer antigen 125 (CA₁₂₅) of the patients in two groups were recorded, and PLR, neutrophil-to-lymphocyte ratio (NLR), RPR, SII, and systemic inflammation response index (SIRI) were calculated and analyzed. The general data of all patients and the follow-up data within 2 years after the operation of the observation group were statistically recorded to evaluate the diagnostic value of PLR, RPR and SII for ovarian endometrial cyst, and the predictive value of staging and recurrence within 2 years after the operation. <b>Results:</b> PLR, NLR, SII (median: 147.53, 1.86, and 488.70 respectively) and CA₁₂₅ (median: 59.41 kU/L) in the observation group were significantly higher than those in the control group, while RPR (median: 0.16) was lower than that in the control group, with significant differences (all <i>P</i><0.01). There was no significant difference in SIRI between the two groups (<i>P</i>>0.05). The PLR and SII (median: 122.73, 345.00) of the observation group at stage Ⅲ and Ⅳ were higher than those of patients at stage Ⅰ and Ⅱ, and the RPR was lower than that of patients with stage Ⅰ and Ⅱ, with significant differences (all <i>P</i><0.001). The PLR, NLR, SII, SIRI (median: 179.63, 2.75, 762.96, and 1.06 respectively) and CA₁₂₅ (median: 108.83 kU/L) in patients with recurrence were significantly higher than those in patients without recurrence 2 years after the operation, and the differences were statistically significant (all <i>P</i><0.001). The area under curve (AUC) of CA₁₂₅ in the diagnosis of ovarian endometriosis cyst was 0.951, the sensitivity was 85.7%, and the specificity was 93.0%, which were higher than those of PLR and SII; the AUC of PLR+SII+CA₁₂₅ in the diagnosis of ovarian endometriosis cyst was 0.952. The AUC of RPR predicting the stage of ovarian endometriosis cyst was 0.713, higher than PLR and SII, lower than CA₁₂₅; the AUC of RPR+SII+CA₁₂₅ in predicting the stage of ovarian endometriotic cyst was 0.825, with sensitivity of 68.7% and specificity of 85.7%","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 9","pages":"672-679"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10303018","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 relationship between embryo quality at different developmental stages and secondary sex ratio of single live births].","authors":"H Y Hao,&nbsp;N Jia,&nbsp;X B Song,&nbsp;C L Zhang,&nbsp;M Li,&nbsp;S D Zhang","doi":"10.3760/cma.j.cn112141-20230422-00186","DOIUrl":"10.3760/cma.j.cn112141-20230422-00186","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the effect of embryo quality at different developmental stages on the secondary sex ratio (SSR) of single live birth neonates. <b>Methods:</b> Data for patients with singleton live births after embryo transferred between January 2016 and January 2022 were retrospectively analyzed. The effect of embryo quality at different development stages on the SSR of 11 713 singleton live births were investigated. The association of SSR and embryo quality at different development stages was examined in univariate analysis and in a multivariate logistic regression model, after adjustment for confounders, using two models (Ⅰ and Ⅱ). <b>Results:</b> The age of both male and female, body mass index of both male and female, basal follicle stimulating hormone and estradiol, smoking of male, methods of insemination, methods of sperm extraction, types of transfer cycle and the number of embryo transferred were not related with SSR (all <i>P</i>>0.05). After adjustment for confounders, the probability of a male live birth was higher after transfer of good-quality blastula than after transfer of poorer-quality blastula (model Ⅰ: a<i>OR</i>=0.73, 95%<i>CI</i>: 0.65-0.82, <i>P</i><0.001; model Ⅱ: a<i>OR</i>=0.73, 95%<i>CI</i>: 0.65-0.82, <i>P</i><0.001). The quality of cleavage stage embryo was not associated with SSR (model Ⅰ: a<i>OR</i>=0.99, 95%<i>CI</i>: 0.87-1.13, <i>P=</i>0.937; model Ⅱ: a<i>OR</i>=0.99, 95%<i>CI</i>: 0.87-1.13, <i>P=</i>0.899). <b>Conclusions:</b> The SSR of singleton live births after embryo transfer is not correlated with the quality of cleavage stage embryo, but is correlated with the quality of blastula. Good-quality blastula transfer is more likely to result in a male live birth.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 9","pages":"664-671"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10303015","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 effect and influencing factors of history-indicated cerclage or ultrasound-indicated cerclage in singleton pregnancy].","authors":"M Chen,&nbsp;C Y Shi","doi":"10.3760/cma.j.cn112141-20230318-00126","DOIUrl":"10.3760/cma.j.cn112141-20230318-00126","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the clinical effect and the influencing factors of ultrasound-indicated cerclage and history-indicated cerclage in singleton gestation. <b>Methods:</b> The clinical data of 272 singleton pregnant women with cervical incompetence who underwent McDonald cervical cerclage due to medical history indication (history-indicated group) or ultrasound indication (ultrasound-indicated group) in Peking University First Hospital from January 2010 to February 2021 were retrospectively analyzed. The general clinical data and maternal and fetal outcomes were compared between the history-indicated group (141 cases) and ultrasound-indicated group (131 cases). According to the gestational age at delivery, 272 pregnant women who underwent cervical cerclage were further divided into ≥34 weeks group (225 cases) and <34 weeks group (47 cases), and the influencing factors of preterm birth before 34 weeks of gestation were analyzed. <b>Results:</b> (1) The median gestational age at cerclage was 16.6 weeks in the history-indicated group and 23.4 weeks in the ultrasound-indicated group, and the median gestational age extension at delivery was 21.4 weeks and 14.7 weeks, respectively, with statistically significant differences between the two groups (all <i>P</i><0.05). (2) The full-term birth rate was 76.6% (108/141) in the history-indicated group and 71.0% (93/131) in the ultrasound-indicated group, the live birth rate was 97.2% (137/141) and 97.7% (128/131), and the median birth weight of live birth was 3 155 g and 3 055 g, respectively. The differences were not statistically significant (all <i>P</i>>0.05). Among 272 pregnant women with cervical cerclage, 265 neonates survived (97.4%, 265/272). The gestational age of 7 pregnant women who did not have live birth was ≤25 weeks of gestation (range: 19⁺¹-25 weeks), and they were all clinically infected or confirmed chorioamnionitis or pathogenic microorganisms carrying during pregnancy, and their families gave up. The minimum birth weight of the surviving neonate was 850 g (gestational week of delivery was 26⁺⁶ weeks). (3) Univariate analysis showed that compared with ≥34 weeks group, the body mass index (BMI) of pregnant women in <34 weeks group was higher at 6-7 weeks of gestation (median: 24.5 vs 25.4 kg/m²), shorter cervical length (CL) at 1-2 weeks after surgery [(31.1±8.4) vs (26.1±11.0) mm], shorter CL at 26-28 weeks of gestation after surgery (median: 26.3 vs 16.0 mm), and higher incidence of elevated C-reactive protein (CRP) before and after surgery and before delivery. The differences were all statistically significant (all <i>P</i><0.05). Multivariate logistic regression analysis showed that preterm birth before 34 weeks was negatively associated with CL at 26-28 weeks of gestation after cerclage (<i>OR</i>=0.902, 95%<i>CI</i>: 0.858-0.947; <i>P</i><0.001), and was positively correlated with elevated CRP before delivery (<i>OR</i>=3.492, 95%<i","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 9","pages":"650-657"},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10314715","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":"[Difference of urinary protein components and the correlation between urinary protein quantification and glomerular filtration rate in pregnant women with pre-eclampsia].","authors":"X Zhuang,&nbsp;Y Y Chen,&nbsp;C Wang,&nbsp;N Zhang,&nbsp;Y Zhang,&nbsp;J H Lin","doi":"10.3760/cma.j.cn112141-20230215-00069","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20230215-00069","url":null,"abstract":"<p><p><b>Objective:</b> To investigate the difference of urinary protein components in pregnant women with pre-eclampsia (PE) with different degrees of proteinuria and the correlation between 24-hour urinary protein quantification and estimated glomerular filtration rate (eGFR). <b>Methods:</b> Clinical data of 101 PE pregnant women who were delivered in Renji Hospital, Shanghai Jiao Tong University School of Medicine from July 2018 to June 2022 were retrospectively analyzed. According to 24-hour urinary protein quantification, they were divided into 3 groups, including 40 cases of mild proteinuria group (24-hour urinary protein quantification ≤2.0 g), 21 cases of moderate proteinuria group (2.0 g<24-hour urinary protein quantification ≤5.0 g), 40 cases of severe proteinuria group (24-hour urinary protein quantification >5.0 g). The general clinical data, urinary protein index and renal function index of PE pregnant women in 3 groups were compared. The eGFR was calculated based on age, serum creatinine (sCr), blood urea nitrogen (BUN) and serum albumin (sAlb). Correlation analysis was conducted between 24-hour urinary protein quantification and each index of eGFR. <b>Results:</b> (1) General clinical data: the median PE onset week (31 weeks) and delivery gestational week [(36.4±3.6) weeks] of PE pregnant women in the mild proteinuria group were later than those in the moderate proteinuria group [median PE onset: 22 weeks, delivery: (32.2±4.2) weeks] and severe proteinuria group [median PE onset: 25 weeks, delivery: (29.6±3.4) weeks]; systolic blood pressure, diastolic blood pressure, alanine aminotransferase, aspartate aminotransferase levels and the incidence of fetal growth restriction were lower than those in the moderate and severe proteinuria groups; median newborn birth weight (3 150 g) was higher than those in the moderate proteinuria group (1 305 g) and the severe proteinuria group (1 042 g), respectively. The differences were statistically significant (all <i>P</i><0.05). (2) Urinary protein index: the 24-hour urinary protein quantification, urinary microalbumin (mAlb) and urinary transferrin (TRF) levels of PE pregnant women in the mild proteinuria group, moderate proteinuria group and severe proteinuria group were increased successively, and the differences were statistically significant (all <i>P</i><0.05). The median urinary α1-microglobulin (α1-MG) level of PE pregnant women in the severe proteinuria group (50 mg/L) was significantly higher than those in the mild proteinuria group (17 mg/L) and moderate proteinuria group (22 mg/L; all <i>P</i><0.05), but there was no significant difference between the mild proteinuria group and the moderate proteinuria group (<i>P</i>>0.05). There was no significant difference in the median urinary β2-microglobulin (β2-MG) level among the 3 groups (<i>P</i>=0.632). (3) Renal function index: sAlb and eGFR of PE pregnant women in the mild proteinuria group, moderate proteinuria group and severe protei","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"58 8","pages":"582-588"},"PeriodicalIF":0.0,"publicationDate":"2023-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039511","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}