中华妇产科杂志最新文献

{"title":"[Changes in the rates of preterm birth and multiparity over a 10-year period and multiparity as a possible risk factor for preterm birth].","authors":"Z X Li, Y N Liu, S T Qin, Y M Wei","doi":"10.3760/cma.j.cn112141-20240323-00178","DOIUrl":"10.3760/cma.j.cn112141-20240323-00178","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the changes of preterm birth rate and proportion of multipara in 10 years, and to explore the possibility of multipara as a risk factor for preterm birth. <b>Methods:</b> This study was a cohort study. The general clinical data and pregnancy outcomes of 53 979 parturients delivered in Peking University First Hospital from January 2013 to December 2022 were collected, and the changes of preterm birth rate and proportion of multipara in the past 10 years were analyzed retrospectively. Single factor and multivariate logistic regression analysis were used to explore the risk factors of spontaneous preterm birth and the influence of multipara on pregnancy outcome. <b>Results:</b> (1) The total preterm birth rate of 53 979 parturients was 8.3%(4 478/53 979), and the overall preterm birth rate showed an upward trend in the past 10 years, among which the preterm birth rate was higher in 2017 and 2018, which were 8.9% and 9.2% respectively. The proportion of multipara was 24.9% (13 440/53 979), which showed a trend of rising first, then declining and then stabilizing. In 2017 and 2018, the proportion of multipara was the highest, accounting for 35.0%. (2) Multivariate logistic regression analysis showed that multipara was a risk factor for spontaneous preterm birth before 37 weeks of pregnancy (<i>OR</i>=1.678, 95%<i>CI</i>: 1.523-1.850; <i>P</i><0.001), which was also a risk factor for spontaneous preterm birth before 34 weeks of pregnancy (<i>OR</i>=1.937, 95%<i>CI</i>: 1.632-2.301; <i>P</i><0.001). The high risk factors of spontaneous preterm birth also include multiple pregnancies, hyperglycemia during pregnancy, abnormal amniotic fluid volume, premature rupture of membranes, intrauterine infection, cervical incompetence, history of cervical surgery and abnormal uterine development. (3) Compared with primiparas, multiparas was older, had earlier delivery weeks, higher premature delivery rate, higher birth weight and fewer multiple pregnancies. Among pregnancy complications, the incidence of gestational diabetes mellitus, placenta previa, placenta implantation, urgent delivery and macrosomia was higher, while the incidence of pregnancy-induced hypertension, pre-eclampsia, intrahepatic cholestasis of pregnancy, oligohydramnios, fetal growth restriction, premature rupture of membranes, intrauterine infection and postpartum hemorrhage was lower, and the differences were statistically significant (<i>P</i><0.05). <b>Conclusions:</b> In recent 10 years, the overall rate of preterm birth is on the rise, and the risk factors of preterm birth are basically similar to those in previous studies. Multipara is a high-risk group of spontaneous preterm birth, and the risk of various pregnancy complications increases, which should be paid attention to in pregnancy care.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 9","pages":"682-691"},"PeriodicalIF":0.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142307215","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":"[Effect of baseline LH/FSH ratio in PCOS on IVF-ET outcomes: a retrospective cohort study].","authors":"C Y Wang, A H Wang, J Y Wang, J X Cheng, C M Liang, F M Pan, G Y Luo","doi":"10.3760/cma.j.cn112141-20240526-00300","DOIUrl":"10.3760/cma.j.cn112141-20240526-00300","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To exlplore the association between the baseline luteinizing hormone/follicle stimulating hormone (LH/FSH) ratio of polycystic ovary syndrome (PCOS) and in vitro fertilisation-embryo transfer outcomes. &lt;b&gt;Methods:&lt;/b&gt; This was a retrospective cohort study. A total of 2 868 PCOS patients were enrolled, all of the participants were patients in The First Affiliated Hospital of Anhui Medical University Hospital from October 2015 to October 2021. Propensity score matching (1∶2.5) was conducted to regulate the non-random allocation of patients. Data were extracted from the hospital's medical records. Patients with baseline LH/FSH ratio&gt;2 were deemed as study group, patients with baseline LH/FSH ratio≤2 were deemed as control group. Single factor analysis was applied to compare the differences of pregnancy outcomes between two groups. &lt;b&gt;Results:&lt;/b&gt; After propensity score matching (1∶2.5), there were no statistically significant differences in baseline data between the two groups (all &lt;i&gt;P&lt;/i&gt;&gt;0.05), indicating that the data were comparable. In the study group, the total dose of gonadotropin (Gn) and duration of Gn were lower than those of the control group (&lt;i&gt;t&lt;/i&gt;=4.989, &lt;i&gt;P&lt;/i&gt;&lt;0.001; &lt;i&gt;t&lt;/i&gt;=3.267, &lt;i&gt;P&lt;/i&gt;=0.001), the rate of in vitro maturation was higher than that of the control group (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=4.938, &lt;i&gt;P&lt;/i&gt;=0.026), the number of retrieved oocytes and cleavage were higher than those of the control group (&lt;i&gt;t&lt;/i&gt;=-2.305, &lt;i&gt;P&lt;/i&gt;=0.021; &lt;i&gt;t&lt;/i&gt;=-2.816, &lt;i&gt;P&lt;/i&gt;=0.005), but there were no differences in the number and rate of high-quality embryos between the two groups (&lt;i&gt;t&lt;/i&gt;=-1.636, &lt;i&gt;P&lt;/i&gt;=0.102; &lt;i&gt;t&lt;/i&gt;=-0.123, &lt;i&gt;P&lt;/i&gt;=0.902). The incidence of moderate to severe ovarian hyperstimulation syndrome in the study group was significantly higher than that in the control group (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=17.277, &lt;i&gt;P&lt;/i&gt;&lt;0.001). Regardless of fresh embryo transfer or frozen-thawed embryo transfer cycles, the incidences of gestational diabetes mellitus in the study group were higher than those in the control group (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=9.174, &lt;i&gt;P&lt;/i&gt;=0.002; &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=4.204, &lt;i&gt;P&lt;/i&gt;=0.040) of singleton pregnancy. In the fresh embryo transfer cycle, the clinical pregnancy rate [30.30% (20/66) vs 47.75% (53/111)] and delivery rate [30.30% (20/66) vs 46.85% (52/111)] in the study group were lower than those in the control group (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=5.198, &lt;i&gt;P&lt;/i&gt;=0.023; &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=4.695, &lt;i&gt;P&lt;/i&gt;=0.030). In the frozen-thawed embryo transfer cycle, the delivery rate in the study group was higer than that in the control group [59.41% (423/712) vs 55.04% (1 053/1 913); &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=7.526, &lt;i&gt;P&lt;/i&gt;=0.023]. The clinical pregnancy rate and delivery rate of fresh embryo transfer cycle in the study group were significantly lower than those of frozen-thawed embryo transfer cycle (&lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=21.308, &lt;i&gt;P&lt;/i&gt;&lt;0.001; &lt;i&gt;χ&lt;/i&gt;&lt;sup&gt;2&lt;/sup&gt;=20.871, &lt;i&gt;P&lt;/i&gt;&lt;0.001), but there were no signi","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 8","pages":"608-616"},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072144","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":"[Preliminary exploration of the clinical warning value of ischemic modified albumin in the development of pre-eclampsia].","authors":"J M Shi, F Q Li, Z Yang, H L Liang, Y W Han, H D Zhang, S Wang","doi":"10.3760/cma.j.cn112141-20240415-00218","DOIUrl":"10.3760/cma.j.cn112141-20240415-00218","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;Objective:&lt;/b&gt; To explore the clinical warning value of ischemic modified albumin (IMA) and IMA to human serum albumin (HSA) ratio (IMAR) in the development of pre-eclampsia (PE) and its severity. &lt;b&gt;Methods:&lt;/b&gt; A total of 156 pregnant women with PE admitted to the Haidian District Maternal and Child Health Hospital of Beijing from April 2022 to March 2023 were collected as the PE group, and 156 healthy pregnant women with the same age and gestational age were matched as the control group. PE pregnant women were further divided into severe PE group (78 cases) and non-severe PE group (78 cases). Severe PE pregnant women were divided into emergency group (42 cases) and non-emergency group (36 cases) according to the disease progression time.All pregnant women were stratified according to their HSA levels (&lt;30 g/L, 30-32 g/L, ≥32 g/L), and the peripheral blood IMA, HSA, and IMAR of pregnant women in different periods and subgroups were compared, and also the difference of IMA levels in umbilical artery blood. Bivariate correlation analysis was used to explore the correlation between severe PE and IMA or IMAR, and receiver operating characteristic (ROC) curves was used to analyze the diagnostic value of IMA, HSA, and IMAR for PE and severe PE. &lt;b&gt;Results:&lt;/b&gt; (1) The IMA level and IMAR in peripheral serum of pregnant women in the PE group at diagnosis, and the IMA level in umbilical artery blood at delivery, and peripheral serum at 2 days after delivery were higher than those in the control group. The HSA level in peripheral serum was lower than that in the control group at diagnosis, and the differences were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.001). (2) The IMA level and IMAR in the peripheral serum of pregnant women with severe PE were higher than those in the non-severe PE group at diagnosis, while the HSA level were lower than those in the non-severe PE group. The differences were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). At diagnosis, the IMA level and IMAR in peripheral serum of pregnant women in the emergency group were higher than those in the non-emergency group, while the HSA level was lower than that in the non-emergency group. The differences were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.05). When diagnosed, the peripheral serum IMA levels of pregnant women in the PE group were compared between subgroups with HSA&lt;30 g/L, 30-32 g/L, ≥32 g/L, and there was no statistically significant difference (&lt;i&gt;F&lt;/i&gt;=0.366, &lt;i&gt;P&lt;/i&gt;=0.694). However, the IMAR was compared between the three subgroups, and the difference was statistically significant (&lt;i&gt;F&lt;/i&gt;=28.544, &lt;i&gt;P&lt;/i&gt;&lt;0.001), which increased with the decrease of HSA levels. In the subgroup with HSA≥32 g/L, the peripheral serum IMA level and IMAR of pregnant women in the PE group were higher than those in the control group at diagnosis, and the differences were statistically significant (all &lt;i&gt;P&lt;/i&gt;&lt;0.001). (3) The severe PE manifestations positively correlated with peripher","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 8","pages":"583-590"},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072145","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":"[Changes of cardiac structure and function in pregnant women with different types of hypertensive disorders in pregnancy and their influencing factors].","authors":"D Li, S H Yin, Z P Li, C Z Lin, Y Wei, Y Y Zhao","doi":"10.3760/cma.j.cn112141-20240402-00196","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240402-00196","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the changes in cardiac structure and function in women with different types of hypertensive disorders in pregnancy (HDP) and explore their influencing factors. <b>Methods:</b> A total of 1 967 pregnant women diagnosed with HDP who delivered at Peking University Third Hospital from January 1, 2014 to April 15, 2022 were included in the study. They were categorized into four groups based on specific HDP diagnoses: gestational hypertension (506 cases, 25.7%), pre-eclampsia (589 cases, 29.9%), pregnancy complicated with chronic hypertension (332 cases, 16.9%) and chronic hypertension with pre-eclampsia (540 cases, 27.5%). Differences in cardiac structure and function among four groups were retrospectively analyzed. Cardiac structure indicators included left atrial diameter (LAD), left atrial area (LAA), right atrial area (RAA), left ventricular end-diastolic diameter (LVEDD), interventricular septal thickness (IVST), left ventricular posterior wall thickness (LVPWT), systolic function indicators included left ventricular ejection fraction (LVEF), lateral systolic mitral annular velocity (Sm), diastolic function indicators included peak early diastolic mitral in flow velocity (E)/peak late diastolic mitral in flow velocity (A), and E/peak early diastolic myocardial velocity of the lateral mitral annulus early diastolic velocity (Em). Influencing factors on cardiac structure and function were analyzed using generalized linear regression. Influencing factors were assessed by generalized linear regression. <b>Results:</b> (1) General clinical data: the differences in age, gestational week at delivery, blood pressure, proportion of diabetes, and length of hospital stay were statistically significant among four different HDP types (all <i>P</i><0.05). (2) Compared with pregnant women with pregnancy complicated with chronic hypertension, pre-eclampsia, and gestational hypertension, those with chronic hypertension with pre-eclampsia had larger LAD, LAA, RAA and LVEDD (all <i>P</i><0.001), thicker IVST and LVPWT (all <i>P</i><0.001), and reduced left ventricular diastolic function (E/A, lateral Em, E/Em) and systolic function (lateral Sm; all <i>P</i><0.001). Pregnant women with gestational hypertension had the least changes in cardiac structure and function. Compared with pregnant women with pre-eclampsia, those with pregnancy complicated with chronic hypertension had smaller RAA (<i>P</i><0.001) and lower E/A (<i>P</i><0.001), with no significant difference in other indicators (all <i>P</i>>0.05). (3) Chronic hypertension with pre-eclampsia, pregnancy complicated with chronic hypertension, and pre-eclampsia were associated with larger LAD, LAA, and LVEDD, and lower lateral Em (all <i>P</i><0.05). <b>Conclusions:</b> Different types of HDP are associated with distinct changes in cardiac structure and function. Chronic hypertension with pre-eclampsia demonstrates the most pronounced alterations, followed by pre-eclampsia and","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 8","pages":"600-607"},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072215","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":"[Risk factors analysis and prediction model construction of major adverse cardiovascular events in pregnant women with valvular heart disease].","authors":"J Q Zeng, H F Zhang, J Zhang, D Yang, D W Zhang, Z L Bao","doi":"10.3760/cma.j.cn112141-20240410-00209","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240410-00209","url":null,"abstract":"<p><p><b>Objective:</b> To analysis the risk factors for major adverse cardiovascular event (MACE) in pregnant women with valvular heart disease (VHD) and to construct a risk prediction model. <b>Methods:</b> The clinical data of 245 pregnant women with VHD who were hospitalized in Beijing Anzhen Hospital from January 1, 2012, to June 1, 2023 were retrospectively analyzed, including general information, pre-pregnancy and pregnancy-associated cardiac conditions, and MACE. Univariate analysis and logistic regression models were employed to identify risk factors for MACE during pregnancy among pregnant women with VHD. Furthermore, a predictive model was constructed and internal validation was conducted using bootstrap techniques. <b>Results:</b> (1) Among 245 pregnant women with VHD, the incidence of MACE was 18.0% (44/245), and the most common MACE was heart failure (61.4%, 27/44). The mitral valve was the most frequently affected valve (64.9%, 159/245). Prior to pregnancy, the most common type of valve surgery undertaken was mechanical valve replacement, representing 31.4% (77/245) of surgeries. In contrast, among those pregnant women who did not undergo valve surgery before pregnancy, the most common lesion type was mitral regurgitation (17.6%, 43/245). (2) Comparing the maternal and infant outcomes of warfarin, low molecular weight heparin (LMWH) and LMWH sequential with warfarin, the fetal loss rate (36%, 15/42) and malformation rate (7%, 3/42) were the highest, but the MACE rate (12%, 5/42) was the lowest in warfarin group. The fetal loss rate (1/19), malformation rate (1/19) and artificial valve thrombosis rate (0) of LMWH sequential with warfarin were the lowest, and the fetal loss rate and artificial valve thrombosis rate of the three anticoagulation methods were statistically significant (all <i>P</i><0.05). (3) There were no significant differences in gestational age, age of diagnosis of heart disease, weight at delivery, pre-pregnancy body mass index, proportion of multiparous women and chronic medical history between women with MACE and those without MACE (all <i>P</i>>0.05). (4) Binary logistic regression analysis identified the following as risk factors for MACE during the second trimester of pregnancy among pregnant women with VHD: pre-pregnancy cardiac symptoms, history of corrective surgery for congenital heart disease, pregnancy risk grade Ⅴ, anticoagulation with LMWH during pregnancy, and arrhythmia (all <i>P</i><0.05). Based on the results of multivariate analysis, a receiver operating characteristic curve was constructed, with an area under the curve of 0.837, indicating good discriminative ability. The calibration plot demonstrated a close alignment between the standard curve and the calibration prediction curve, suggesting excellent calibration of the model. <b>Conclusions:</b> Pregnant women with VHD are at a high risk of experiencing MACE during gestation. Five risk factors, including pre-pregnancy cardiac symptoms, history","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 8","pages":"591-599"},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072146","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 of plasma metabolic markers in unexplained recurrent spontaneous abortion based on non-target metabolomics approach].","authors":"Q Liu, L N Chen, Y M Li, J Sun, Y X Wang","doi":"10.3760/cma.j.cn112141-20240222-00109","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240222-00109","url":null,"abstract":"<p><p><b>Objective:</b> To screen plasma metabolic markers in patients with unexplained recurrent spontaneous abortion (URSA) by non-target metabolomics approach. <b>Methods:</b> From September 2022 to May 2023, the plasma of 23 URSA pregnant women with threatened abortion who visited the outpatient clinic of Gansu Provincial Maternity and Child-care Hospital in the first trimester (URSA group) was collected, and the plasma of 22 healthy pregnant women in the first trimester who underwent prenatal examination during the same period (normal control group) was collected. Plasma metabolomics was analyzed by ultra performance liquid chromatography (UPLC) coupled with mass spectrometry (MS), fold change analysis, principal component analysis and partial least square discriminant analysis were applied to screen for differential metabolites, and the metabolites and their pathways associated with URSA were screened using receiver operating characteristic (ROC) curve and pathway enrichment analysis. <b>Results:</b> There were no significant differences in age, body mass index and gestational weeks between URSA and normal control group(all <i>P</i><0.05). Metabolomics analysis using UPLC-MS showed that a total of 526 metabolites were detected from plasma, of which 33 were found to be differential metabolites associated with URSA based on the screening standards. Six potential metabolites with large area under the curve (AUC) were identified by ROC curve analysis, including phosphatidylethanolamine (AUC=0.972, 95%<i>CI</i>: 0.920-1.000), santene hydrate (AUC=0.902, 95%<i>CI</i>: 0.786-0.982), L-leucine (AUC=0.884, 95%<i>CI</i>: 0.772-0.960), cembrene (AUC=0.881, 95%<i>CI</i>: 0.758-0.956), caffeine (AUC=0.875, 95%<i>CI</i>: 0.756-0.962), and 4-hydroxybenzoic acid propyl ester (AUC=0.864, 95%<i>CI</i>: 0.732-0.946). The AUC for the combined diagnosis of URSA by the six metabolites was 0.983 (95%<i>CI</i>: 0.929-1.000). Pathway enrichment analysis of the differential metabolites showed that the pathogenesis of URSA was associated with a variety of metabolic pathways including caffeine metabolism, glycerophospholipid metabolism, and unsaturated fatty acid biosynthesis. <b>Conclusion:</b> The plasma metabolic profiles of pregnant women with normal pregnancies versus URSA differ in early pregnancy, and six potential metabolites such as phosphatidylethanolamine, santene hydrate, L-leucine, cembrene, caffeine, 4-hydroxybenzoic acid propyl ester, and their metabolic pathways may be involved in the pathogenesis of URSA.</p>","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 8","pages":"628-635"},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072147","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 genetic counseling and transfer strategies of mosaic embryos in PGT‑A].","authors":"","doi":"10.3760/cma.j.cn112141-20240208-00088","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240208-00088","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 8","pages":"577-582"},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072216","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":"[Clinical significance of lympho-vascular space invasion in different molecular subtypes of endometrial carcinoma].","authors":"Y M Li, Z Y Zhai, H Li, L W Li, Z H Shen, X B Zhang, Z Q Wang, J L Wang","doi":"10.3760/cma.j.cn112141-20240529-00307","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240529-00307","url":null,"abstract":"<p><p><b>Objective:</b> To analyze the lympho-vascular space invasion (LVSI) in different molecular subtypes of the cancer genome atlas (TCGA) molecular subtypes of endometrial cancer (EC) and to evaluate the prognostic value of LVSI in EC patients with different molecular subtypes. <b>Methods:</b> A total of 258 patients diagnosed EC undergoing surgery in Peking University People's Hospital from January 2016 to June 2022 were analyzed retrospectively. Among 258 patients, 14 cases were classified as POLE-ultramutated subtype, 43 as high-microsatellite instability (MSI-H) subtype, 155 as copy-number low (CNL) subtype, and 46 as copy-number high (CNH) subtype. Fifty-four patients were positive for LVSI, while 203 tested negative. <b>Results:</b> (1) The incidence of LVSI was found to be highest in the CNH subtype (32.6%,15/46), followed by the MSI-H subtype (27.9%, 12/43), the CNL subtype (16.9%, 26/154), and the POLE-ultramutated subtype (1/14), with statistically significant differences (<i>χ</i>²=7.79, <i>P</i>=0.044). (2) Staging and deep myometrial invasion were higher in the LVSI positive group than those in the LVSI negative group (all <i>P</i><0.05), except for the POLE-ultramutated subtype. The grade, lymph node metastasis, and the expression of nuclear antigen associated with cell proliferation (Ki-67) were significantly higher in LVSI positive patients than those in LVSI negative EC patients with both MSI-H and CNL subtypes (all <i>P</i><0.05). In CNL subtypes patients, LVSI was also associated with age, histology subtype,and progesterone receptor (PR; all <i>P</i><0.05). (3) Of the 257 EC patients, 25 cases recurred during the follow-up period, with a recurrence rate of 9.7% (25/257); among them, the recurrence rate of LVSI positive patients was 22.2% (12/54), which was significantly higher than those with LVSI negative (6.4%, 13/203; <i>χ</i>²=12.15, <i>P</i><0.001). During the follow-up period, none of the 14 patients with POLE-ultramutated had recurrence; among CNL patients, the recurrence rate was 19.2% (5/26) in LVSI positive patients, which was significantly higher than that in LVSI negative ones (5.5%, 7/128; <i>χ</i>²=3.94, <i>P</i>=0.047); where as no difference were found in both MSI-H [recurrence rates in LVSI positive and negative patients were 2/12 and 9.7% (3/31), respectively] and CNH subtype [recurrence rates between LVSI positive and negative patients were 5/15 and 9.7% (3/31), respectively] EC patients (both <i>P</i>>0.05). After log-rank test, the 3-year recurrence free survival (RFS) rate were significantly lower in LVSI positive patients from CNL subtype and CNH subtype than those in LVSI negative patients (CNL: 80.8% vs 94.5%; CNH: 66.7% vs 90.3%; both <i>P</i><0.05). (4) Lymph node metastasis (<i>HR</i>=6.93, 95%<i>CI</i>: 1.15-41.65; <i>P</i>=0.034) had a significant effect on the 3-year RFS rate of EC patients with MSI-H subtype. Multivariate analysis revealed that PR expression ","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 8","pages":"617-627"},"PeriodicalIF":0.0,"publicationDate":"2024-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142072217","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 guidelines for diagnosis and treatment of vulvovaginal candidiasis (2024 edition)].","authors":"","doi":"10.3760/cma.j.cn112141-20240326-00185","DOIUrl":"https://doi.org/10.3760/cma.j.cn112141-20240326-00185","url":null,"abstract":"","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 7","pages":"499-504"},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757426","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":"[Relationship between amniotic fluid inflammatory factors and pregnancy outcomes after emergency cervical cerclage].","authors":"L X Wu, L Bao, L Q Zhu, Y C Guo, Y Liu, J P Tan, H Chen, J P Zhang, Y L Liu","doi":"10.3760/cma.j.cn112141-20240229-00132","DOIUrl":"10.3760/cma.j.cn112141-20240229-00132","url":null,"abstract":"<p><p><b>Objective:</b> To explore the relationship between amniotic fluid and peripheral blood inflammatory factors and the pregnancy outcomes after emergency cervical cerclage, and to identify effective indicators for predicting adverse pregnancy outcomes after the procedure. <b>Methods:</b> A case-control study was conducted, including pregnant women who were hospitalized at Sun Yat-sen Memorial Hospital, from January 1, 2013, to July 31, 2019, and underwent emergency cervical cerclage due to cervical dilatation at gestational age between 16 and 28 weeks. A total of 85 pregnant women who underwent amniocentesis for the detection of amniotic fluid inflammatory factors during the perioperative period were included. Based on whether their baby was perinatal death, the participants were divided into the case group (28 cases with perinatal death) and the control group (57 cases with live births). Univariate logistic regression analysis was performed to identify risk factors associated with adverse pregnancy outcomes, followed by multivariate logistic regression analysis to establish a regression model and nomogram. <b>Results:</b> (1) The levels of tumor necrosis factor α (TNF-α), interleukin (IL)-1β, IL-6, IL-8, IL-10 in the amniotic fluid during the perioperative period and postoperative serum C-reactive protein (CRP) were significantly higher in the case group compared to the control group (all <i>P</i><0.05). The case group underwent emergency cervical cerclage at an earlier gestational age compared to the control group, and their cervical dilation was greater than that of the control group (all <i>P</i><0.05). However, there were no significant differences in the white blood cell counts, neutrophil percentage, and the level of preoperative CRP in the peripheral blood of pregnant women during the perioperative period (all <i>P</i>>0.05). (2) Univariate logistic regression analysis showed that the levels of amniotic fluid WBC, TNF-α, IL-1β, IL-2 receptor (IL-2R), IL-6, IL-8, IL-10, postoperative CRP in the peripheral blood, gestational age at cerclage and cervical dilation were associated with adverse pregnancy outcomes (all <i>P</i><0.05). Multivariate regression analysis indicated that only the levels of amniotic fluid WBC and TNF-α were independent risk factors for perinatal death. (3) Based on clinical practice, a multivariate logistic regression model was constructed including the levels of amniotic fluid TNF-α, WBC, gestational age at cervical cerclage, and cervical dilation. A nomogram and calibration curve were plotted, which suggested its good predictive value for adverse pregnancy outcomes. <b>Conclusions:</b> During the perioperative period of emergency cervical cerclage, the levels of amniotic fluid WBC, TNF-α, IL-1β, IL-2R, IL-6, IL-8, IL-10 are associated with adverse pregnancy outcomes, with amniotic fluid WBC and TNF-α showing the closest relationship. However, there is no significant correlation between maternal peripheral hemog","PeriodicalId":10050,"journal":{"name":"中华妇产科杂志","volume":"59 7","pages":"522-529"},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141757429","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}