中华妇产科杂志 Pub Date : 2026-03-25 DOI: 10.3760/cma.j.cn112141-20251128-00583

Q J Tian, K Q Hua, L M Feng

引用次数: 0

[Consensus on the diagnosis and treatment of thoracic aortic disease during pregnancy (2026)]. 【妊娠期胸主动脉疾病诊治共识（2026）】。

中华妇产科杂志 Pub Date : 2026-03-25 DOI: 10.3760/cma.j.cn112141-20251012-00478

引用次数: 0

[Risk assessment of subsequent drug resistance in patients with chemoresistant gestational trophoblastic neoplasia]. [耐药妊娠滋养细胞瘤患者后续耐药风险评估]。

中华妇产科杂志 Pub Date : 2026-03-25 DOI: 10.3760/cma.j.cn112141-20251026-00512

M Y Mao, F Jiang, X R Wan, F Z Feng, J J Yang, T Ren, J Zhao, Y Xiang

{"title":"[Risk assessment of subsequent drug resistance in patients with chemoresistant gestational trophoblastic neoplasia].","authors":"M Y Mao, F Jiang, X R Wan, F Z Feng, J J Yang, T Ren, J Zhao, Y Xiang","doi":"10.3760/cma.j.cn112141-20251026-00512","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20251026-00512","url":null,"abstract":"Objective: To investigate risk factors associated with subsequent drug resistance in patients with chemoresistant gestational trophoblastic neoplasia (GTN). Methods: Clinical and pathological data of GTN patients diagnosed and treated at Peking Union Medical College Hospital, Chinese Academy of Medical Science between January 2002 and June 2019 were retrospectively collected. Based on their prior treatment history and drug resistance status, GTN patients were divided into the chemoresistant group (n=248) and the primary treatment group (n=438) for comparison. Logistic regression analysis was used to evaluate the association between the International Federation of Gynecology and Obstetrics (FIGO, 2000) prognostic score and the risk of subsequent resistance in the chemoresistant group. Receiver operating characteristic (ROC) curve analysis was applied to assess the predictive value of the FIGO prognostic score for subsequent resistance; the Youden index of the FIGO score was calculated to determine its optimal cut-off value. Based on the cut-off value, the chemoresistant group was further stratified into two subgroups for prognosis comparison. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for subsequent resistance, and a novel scoring system was developed using these factors to predict the risk of subsequent resistance. Results: (1) The median FIGO prognostic score was significantly higher in the chemoresistant group than that in the primary treatment group (9 vs 7, P<0.001). The resistance rate and disease progression rate after the current treatment were significantly higher in the chemoresistant group [34.7% (86/248) and 11.3% (28/248), respectively] than those in the primary treatment group [14.8% (65/438) and 0.9% (4/438), respectively; both P<0.001]. Stratified analysis by FIGO prognostic score showed that, in each score stratum of FIGO prognostic score≥9, the resistance rate and disease progression rate were significantly higher in the chemoresistant group than in the corresponding stratum of the primary treatment group (all P<0.05). (2) FIGO prognostic score was significantly associated with subsequent resistance risk (OR=1.532, 95%CI: 1.359-1.726, P<0.001). The chemoresistant group was then divided into subgroups with FIGO prognostic score≥10 and <10. Compared with the FIGO prognostic score<10 subgroup, the FIGO prognostic score≥10 subgroup had significantly higher rates of subsequent resistance [13.5% (19/141) vs 62.6% (67/107), P<0.05], disease progression [2.1% (3/141) vs 23.4% (25/107), P<0.05] and recurrence [5.7% (8/141) vs 14.0% (15/107), P<0.05]. (3) Multivariate logistic regression analysis identified the following as independent risk factors for subsequent resistance: interval from index pregnancy≥12 months (OR=4.367, 95%CI: 2.199-8.927, P<0.001","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 3","pages":"218-226"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497759","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}

引用次数: 0

[Analysis of factors associated with clinical pregnancy outcomes of IUI in advanced-age and young women]. 高龄和年轻女性宫内节育器临床妊娠结局相关因素分析

中华妇产科杂志 Pub Date : 2026-03-25 DOI: 10.3760/cma.j.cn112141-20251013-00488

B B Tu, J Zhang, J Zhao, H Y Wang, S Huang

{"title":"[Analysis of factors associated with clinical pregnancy outcomes of IUI in advanced-age and young women].","authors":"B B Tu, J Zhang, J Zhao, H Y Wang, S Huang","doi":"10.3760/cma.j.cn112141-20251013-00488","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20251013-00488","url":null,"abstract":"Objective: To investigate the association between various factors and clinical pregnancy outcomes of intrauterine insemination (IUI) in both young and advanced-age women. Methods: This retrospective cohort analysis examined a total of 16 884 IUI cycles performed in Peking University Third Hospital between January 2017 and December 2022. The women were categorized into two groups based on age: the advanced-age group (≥35 years) and the young group (<35 years). Multivariate logistic regression models adjusted for confounders were conducted. Results: In the young group, anti-Müllerian hormone level (OR=1.050, 95%CI: 1.028-1.072, P<0.001), and cycle type (natural cycle vs ovarian stimulation cycle; OR=0.682, 95%CI: 0.578-0.806, P<0.001) were independent predictors of clinical pregnancy. In the advanced-age group, age (OR=0.932, 95%CI: 0.879-0.988, P=0.018), duration of infertility (OR=0.938, 95%CI: 0.893-0.985, P=0.011) and total progressive motile sperm count (TPMSC; OR=1.018, 95%CI: 1.002-1.034, P=0.028) were identified as independent predictors of clinical pregnancy. Conclusions: For women under 35 years old, ovarian stimulation is a favorable independent predictor of clinical pregnancy rate in IUI cycles, and its use could significantly improve clinical pregnancy outcomes. In contrast, for advanced-age women (≥35 years), only younger age, shorter duration of infertility and higher TPMSC are the primary positive independent predictors, and ovarian stimulation cannot be established as a viable strategy to improve pregnancy outcomes, thus a more proactive assisted reproductive treatment should be adopted.","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 3","pages":"195-202"},"PeriodicalIF":0.0,"publicationDate":"2026-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147497662","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}

引用次数: 0

[Analysis of influencing factors for abnormal uterine bleeding due to cesarean scar diverticulum]. 剖宫产瘢痕憩室致子宫异常出血的影响因素分析

中华妇产科杂志 Pub Date : 2026-02-25 DOI: 10.3760/cma.j.cn112141-20250507-00197

Q Xu, H Duan, Y Y An, L Gan

{"title":"[Analysis of influencing factors for abnormal uterine bleeding due to cesarean scar diverticulum].","authors":"Q Xu, H Duan, Y Y An, L Gan","doi":"10.3760/cma.j.cn112141-20250507-00197","DOIUrl":"10.3760/cma.j.cn112141-20250507-00197","url":null,"abstract":"Objective: To study the influencing factors for abnormal uterine bleeding (AUB) due to cesarean scar diverticulum (CSD). Methods: Clinical data were collected from all 7 007 patients of reproductive age who underwent outpatient hysteroscopy between June 2018 and November 2019 in the Gynecological Minimally Invasive Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Patients diagnosed with CSD by hysteroscopy under B-ultrasound monitoring were selected and divided into the AUB group and the non-AUB group according to whether they presented with AUB. SPSS 26.0 was used to analyze the factors affecting AUB in the two groups, and to analyze the risk factors for AUB in patients with CSD by multifactorial binary logistic regression. The predictive value of residual myometrial thickness for AUB was analyzed using the receiver operating characteristic (ROC) curve. Results: (1) After inclusion and exclusion criteria, a total of 686 patients with CSD were included in this study, including 469 patients in the AUB group and 217 patients in the non-AUB group. There were statistically significant differences in age, residual myometrial thickness, length of CSD, whether combined with chronic endometritis, number of cesarean deliveries and time from last cesarean to hysteroscopy (all P<0.05). (2) Multivariate binary logistic regression analysis showed that residual myometrial thickness (OR=0.586, 95%CI: 0.488-0.704), length of CSD (OR=1.927, 95%CI: 1.086-3.421), whether combined with chronic endometritis (OR=1.537, 95%CI: 1.028-2.299) and number of cesarean deliveries (OR=2.020, 95%CI: 1.223-3.335) were independent influencing factors for AUB due to CSD (all P<0.05). (3) The area under the ROC curve for residual myometrial thickness to predict AUB was 0.670, and the cut-off value for residual myometrial thickness was 2.95 mm. All the 686 patients were divided into two groups based on the cut-off value of residual myometrial thickness, and the risk of AUB in patients with residual myometrial thickness≤2.95 mm was 2.582 times higher than that in patients with residual myometrial thickness>2.95 mm (OR=2.582, 95%CI: 1.853-3.599). The difference was statistically different (P<0.001). Conclusions: Reduced residual myometrial thickness, increased CSD length, combined chronic endometritis, and increased number of cesarean deliveries may significantly increase the risk of AUB due to CSD. For patients with the combination of these risk factors, treatment requires comprehensive assessment and individualized selection of treatment options. The likelihood of residual myometrial thickness≤2.95 mm due to iatrogenic factor should be reduced in order to reduce the risk of AUB in patients with CSD and improve their prognosis.","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 2","pages":"114-120"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324950","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}

引用次数: 0

[Genetic aetiology of spontaneous abortion detected by exome sequencing]. 外显子组测序检测自然流产的遗传病因。

中华妇产科杂志 Pub Date : 2026-02-25 DOI: 10.3760/cma.j.cn112141-20250812-00374

T T Liu, F C Qiao, Y X Liang, C P Zhang, Z F Xu, Y Wang

{"title":"[Genetic aetiology of spontaneous abortion detected by exome sequencing].","authors":"T T Liu, F C Qiao, Y X Liang, C P Zhang, Z F Xu, Y Wang","doi":"10.3760/cma.j.cn112141-20250812-00374","DOIUrl":"10.3760/cma.j.cn112141-20250812-00374","url":null,"abstract":"Objective: To explore the potential pathogenic genes and variants of spontaneous abortion by exome sequencing (ES). Methods: From September to December 2024, 20 spontaneous abortion samples with no chromosomal abnormalities detected by chromosomal microarray analysis (CMA) in the Women's Hospital of Nanjing Medical University were selected for familial ES detection. According to the American College of Medical Genetics and Genomics (ACMG) guidelines (2015 edition), the pathogenicity of the sequencing results was interpreted, and the possible pathogenic or pathogenic gene variants were verified by Sanger sequencing. Results: Of the 20 patients with spontaneous abortion, 2 were found to have genetic variants that might be related to spontaneous abortion: KYNU gene c.766G>T(p.Gly256Ter) and c.235C>T(p.Gln79Ter) compound heterozygous variants, which were likely pathogenic (paternal) and pathogenic (maternal), respectively, and were associated with xanthurenic aciduria and vertebral-heart, kidney, limb deficiency syndrome type 2 (VCRL2). DNM1L gene c.185C>T(p.Pro62Leu), a likely pathogenic variant, was a de novo variant, which was associated with mitochondrial and peroxisome fission-deficient encephalopathy. Conclusions: ES technology could facilitate the genetic diagnosis of spontaneous abortion, and provide theoretical basis and guidance for subsequent genetic counseling and subsequent pregnancies.","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 2","pages":"121-127"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324948","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}

引用次数: 0

[Association of fat distribution and TGR5 expression with clinicopathological features and prognosis in patients with endometrial carcinoma]. [子宫内膜癌患者脂肪分布及TGR5表达与临床病理特征及预后的关系]。

中华妇产科杂志 Pub Date : 2026-02-25 DOI: 10.3760/cma.j.cn112141-20250814-00377

X L Zhao, G H Chu, F Yu, L Jia, Y Nan

{"title":"[Association of fat distribution and TGR5 expression with clinicopathological features and prognosis in patients with endometrial carcinoma].","authors":"X L Zhao, G H Chu, F Yu, L Jia, Y Nan","doi":"10.3760/cma.j.cn112141-20250814-00377","DOIUrl":"10.3760/cma.j.cn112141-20250814-00377","url":null,"abstract":"Objective: To investigate the effects of visceral fat and subcutaneous fat distribution and the expression level of serum Takeda G protein-coupled receptor 5 (TGR5) on the clinicopathologic features and postoperative recurrence and metastasis of patients with endometrial cancer (EC). Methods: This was a retrospective cohort study. A total of 146 EC patients who underwent laparoscopic radical resection of EC at Northwest Women and Children's Hospital from March 2020 to March 2024 were enrolled as the EC group, and 153 concurrent patients with benign endometrial lesions were enrolled as the control group. The EC group was followed up for 1 year after the surgery to analyze the prognosis. Depending on whether recurrence and metastasis occurred, the EC group was further divided into the recurrence or metastasis subgroup (n=45) and the non-recurrence or metastasis subgroup (n=101). Age, obstetric history, body mass index (BMI), serum TGR5 level, visceral fat area (VFA) and subcutaneous fat area (SFA) were collected and compared between the recurrence or metastasis subgroup, non-recurrence or metastasis subgroup and the control group. The area under curve, sensitivity, specificity and the Youden index of the predictive value of TGR5 expression level, VFA level, SFA level, and BMI in patients in the EC group were analyzed using receiver operating characteristic (ROC) curves. Based on the cut-off value determined by the Youden index, the patients in the EC group were further classified into high-expression/high-level and low-expression/low-level groups. Univariate and multivariate Cox proportional hazards regression models were used to identify the risk factors for recurrence and metastasis of patients in the EC group in 1 year. The one-year recurrence and metastasis of EC patients with different serum TGR5 expression levels, VFA levels, SFA levels and BMI were analyzed, survival curves were plotted and data of recurrence-free survival (RFS) were obtained using the Kaplan-Meier method. ROC curves were constructed to evaluate the diagnostic efficacy of serum TGR5 expression level, VFA level, SFA level, BMI and their combined indicators. Results: The serum TGR5 expression level, VFA level, SFA level and BMI were significantly higher in the recurrence or metastasis subgroup compared to the non-recurrence or metastasis subgroup (all P<0.05). Furthermore, all four indicators in both the recurrence or metastasis subgroup and the non-recurrence or metastasis subgroup were significantly higher than those in the control group (all P<0.05). When the serum TGR5 expression level was 7.7 μg/L, the VFA level was 90.4 cm², the SFA level was 221.6 cm², and the BMI was 23.9 kg/m², the Youden index reached its maximum value for each respective parameter. Cox regression analyses revealed that serum TGR5≥7.7 μg/L (HR=6.382, 95%CI:2.151-18.939, P=0.001), VFA≥90.4 cm² (HR=6.914, 9","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 2","pages":"138-146"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324965","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}

引用次数: 0

[Research progress on exosomal circular RNA in the diagnosis and treatment of malignant ovarian tumor]. 【外泌体环状RNA在卵巢恶性肿瘤诊治中的研究进展】。

中华妇产科杂志 Pub Date : 2026-02-25 DOI: 10.3760/cma.j.cn112141-20250610-00268

L Chen, C F Man, Y J Zhou, Y Fan

引用次数: 0

[Analysis of maternal and fetal outcomes and related factors of recurrence in women with a history of pre-eclampsia]. 【先兆子痫患者的母胎结局及复发相关因素分析】。

中华妇产科杂志 Pub Date : 2026-02-25 DOI: 10.3760/cma.j.cn112141-20250820-00388

C L Zhang, W Y Zhang, S W Wu

{"title":"[Analysis of maternal and fetal outcomes and related factors of recurrence in women with a history of pre-eclampsia].","authors":"C L Zhang, W Y Zhang, S W Wu","doi":"10.3760/cma.j.cn112141-20250820-00388","DOIUrl":"10.3760/cma.j.cn112141-20250820-00388","url":null,"abstract":"Objective: To investigate the maternal and neonatal outcomes of women with a history of pre-eclampsia (PE) and the risk factors for recurrence. Methods: A total of 176 singleton pregnant women with a history of PE who received regular prenatal examination and hospitalized for delivery in Beijing Obstetrics and Gynecology Hospital, Capital Medical University from January 2020 to December 2024 were collected. According to the pregnancy outcome, they were divided into normal pregnancy group (92 cases) and recurrent pregnancy group (84 cases, including 45 cases of recurrent PE and 39 cases of gestational hypertension). The previous pregnancy, general condition and pregnancy outcomes of the current pregnancy were compared between the two groups. Multivariate logistic regression was used to analyze the influencing factors of hypertensive disorder in pregnancy in pregnant women with a history of PE. Results: (1) Previous pregnancy: there were no significant differences in the incidence of gestational age≥28 weeks, early onset PE, severe PE, hemolysis, elevated liver enzymes, and low platelet count syndrome (HELLP syndrome), delivery mode in the previous pregnancy, neonatal survival rate and fetal growth restriction between the normal pregnancy group and the recurrent pregnancy group (all P>0.05). (2) The current pregnancy: the pre-pregnancy body mass index (BMI) of the normal pregnancy group was significantly lower than that of the recurrent pregnancy group [(23.0±3.8) vs (25.6±4.7) kg/m2, P=0.014], and there were no significant differences in other general data between the two groups (all P>0.05). The neonatal birth weight in the normal pregnancy group was significantly higher than that in the recurrent pregnancy group [(3 280±586) vs (3 020±700) g, P=0.010], and the incidence of fetal growth restriction was significantly lower than that in the recurrent pregnancy group [5.4% (5/92) vs 19.0% (16/84), P=0.005]. However, there were no significant differences in the mode of delivery, gestational age at delivery, full-term delivery rate, the same gender as the previous pregnancy, neonatal asphyxia, placental abruption, and postpartum hemorrhage between the two groups (all P>0.05). (3) Multivariate analysis: after adjusting the confounding factors, including previous gestational age of PE onset, previous early onset PE, previous severe PE, previous HELLP syndrome, maternal age, weight gain during pregnancy, delivery interval, mode of conception, use of low-dose aspirin, and gestational diabetes mellitus, the results showed that pre-pregnancy BMI was an independent risk factor for recurrence of hypertensive disorders in pregnancy (OR=1.12, 95%CI: 1.03-1.22; P=0.008). Conclusions: Women with a history of PE are prone to develop hypertensive disorders in pregnancy again. Controlling pre-pregnancy BMI could significantly reduce the recurrence rate. Attent","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"61 2","pages":"97-103"},"PeriodicalIF":0.0,"publicationDate":"2026-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324975","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}

引用次数: 0

[Advances in the application of next generation sequencing for pathogenesis researches of adenomyosis]. [下一代测序技术在子宫腺肌症发病机制研究中的应用进展]。

中华妇产科杂志 Pub Date : 2026-02-25 DOI: 10.3760/cma.j.cn112141-20250521-00227

X X Liu, J Guo, L Wang, M Shi, X H Xu, G Y He

引用次数: 0

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