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15 June 2011, Volume 38 Issue 3
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Crisis in Obstetrics LIN Qi-de 2011, 38 (3):  171-171.  Abstract ( 1906 )   PDF (94KB) ( 5014 )   The article tries to summarize the fields involved in obstetric crisis，and the principles for the clinical management of obstetric emergency and obstetric critical diseases respectively. In addition, procedure and cautions related to transportation were described. Related Articles | Metrics

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An Implement of New Diagnostic Criteria for Diagnosing GDM YANG Hui-xia 2011, 38 (3):  172-173.  Abstract ( 2461 )   PDF (157KB) ( 5130 )   For many years，GDM has been defined as any degree of glucose intolerance with onset or first recognition during pregnancy. This limitations of definition were recognized for many years. After deliberations in 2008—2009，the International Association of Diabetes and Pregnancy Study Groups（IADPSG），recommended that high-risk women found to have diabetes at their initial prenatal visit，using standard criteria，receive a diagnosis of overt，not gestational， diabetes. The group recommended that all women not known to have diabetes undergo a 75 g OGTT at 24~28 weeks of gestation. The diagnosis of GDM is made when any of the following plasma glucose values are exceeded：fasting：5.1 mmol/L，1 h：10.0 mmol/L and 2 h：8.5 mmol/L. Related Articles | Metrics

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Extravillous Trophoblast in Spiral Arterial Remodeling and Pre-eclampsia TAO Jun;FAN Jian-xia 2011, 38 (3):  174-177.  Abstract ( 2494 )   PDF (212KB) ( 5153 )   Hypertensive disorders is a specific disease that occurs in pregnancy，which is still one of the main causes of maternal and neonatal death up till now. Pre-eclampsia is the most common and major type of this disease. Its etiology and pathogenesis have not been fully understood. At present，foreign scholars have revealed the process of extravillous trophoblast invasion and spiral arterial remodeling in vivo at the molecular and cellular level，mainly including the extravillous trophoblast invasion and the cell apoptosis of vascular smooth muscle cells and endothelial cells. A number of factors that impair this progress have been put forward. An in-depth study in their correlation with the pathogenesis of pre-eclampsia proposes many hypotheses and inferences， and make perfect the hypotheses of ischemia and hypoxia of placenta. This article reviews the development of this process and the correlation with pathogenesis of pre-eclampsia in recent years. Related Articles | Metrics

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Relationship Between Visfatin and Pre-eclampsia WU Jing-jing;YAN Jian-ying 2011, 38 (3):  178-181.  Abstract ( 1953 )   PDF (260KB) ( 5214 )   Visfatin is a newly discovered one of the main visceral fat factors secreted by fat cells，with complicated structure and genetic polymorphism，which can regulate glucose and lipid metabolism，increasing insulin sensitivity，promoting vascular smooth muscle cell maturation， involving in inflammatory response and angiogenesis，and formation of atherosclerosis and vascular endothelial cell damage and dysfunction. Pre-eclampsia is a pathology of unknown cause in pregnancy，seriously endanger the life of mother and child，vascular endothelial cell injury and dysfunction may lead to the ultimate incidence of pre-eclampsia and the emergence of the root causes of the clinical manifestations. People speculated that visfatin may be involved in a variety of ways to the pathogenesis of pre-eclampsia，as one of the focuses of current research. Related Articles | Metrics

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Re-evaluation of Magnesium Sulfate in Pre-eclampsia/eclampsia XIE Yan-li;JIANG Rong-zhen 2011, 38 (3):  182-185.  Abstract ( 1533 )   PDF (219KB) ( 5203 )   【Abstract】 Pre-eclampsia/eclampsia，a pregnancy-specific disease，with systemic vascular spasm，leading to multiple organ dysfunction，seriously harms the mother and child health. Magnesium sulfate with cardiovascular and central nervous system protection，is widely used in the treatment of pre-eclampsia/eclampsia. Therefore，the further study of magnesium sulfate in pre-eclampsia/eclampsia treatment and related mechanisms，will help to guide clinical medication and reduce infant mortality. Related Articles | Metrics

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Progress in Platelet Activation and Hypertensive Disorder Complicating Pregnancy LIANG Yuan;LI Zeng-yan 2011, 38 (3):  186-188.  Abstract ( 2117 )   PDF (181KB) ( 5082 )   The hypertensive disorder happened in pregnancy after 20 weeks，in China the average morbidity was 9.4%；it could be the second reasons which leads to death of the pregnant women. The pathogenesis had not yet completely clear，it might relate to vascular endothelial injury，activation of coagulation，fibrinolysis system and platelet dysfunction. Platelets were the smallest and non-nuclear components in the blood，when activated the platelet secretion， adhesion and aggregation then made up the platelet thrombus. In the recent years，lots of studies had shown that the activation，adhesion，aggregation and other functional changes of platelet played an important role in the progress of the disease. This article summarizes the research progress in platelet activation and hypertensive in pregnancy. Related Articles | Metrics

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Advancement in Study on Related Gene of Obstetric Cholestasis CAO Li-qiong;WANG Dong-mei 2011, 38 (3):  189-192.  Abstract ( 1858 )   PDF (248KB) ( 5132 )   Intrahepatic cholestasis of pregnancy（ICP）is a liver function unique to pregnancy，which usually manifests during late pregnancy. It is one of the two acquired cholestasis.The occurrence of ICP carries a high risk for the baby because of premature spontaneous delivery，meconium passage and sudden fetal death. However，the cause of ICP is unknown. There is increasing evidence that ICP might connect with hormone，genetic variability，immune and environmental factor. For the past few years，the investigation on relationship between pathogenesis and gene mutation has become a hot spot. It has become evidence that ICP is mainly correlate with gene mutation，including multidrug resistance protein 3（MDR3，ABCB4）gene，bile salt export pump（BSEP，ABCB11）and the familial cholestasis type 1（FIC1，ATP8B1）gene. Genetics may also play an important role in development of ICP. Related Articles | Metrics

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Progress in Study on Etiology of Intrahepatic Cholestasis of Pregnancy FAN Ting-ting;ZHAO Shu-wang 2011, 38 (3):  193-196.  Abstract ( 1763 )   PDF (239KB) ( 5211 )   Intrahepatic cholestasis of pregnancy （ICP） is classified as high-risk pregnancy that is a pregnancy-specific disease characterized by maternal pruritus in the third trimester，raised serum bile acids and closely related to adverse fetal outcomes，hence ICP has gradually drawn attention of obstetricians. However， so far， the etiology of ICP has not been fully understood due to its complexity. The possible factors of the cholestatic effects can be reproductive hormones and their metabolites in the bodies of genetically susceptible women. Besides that，environmental factors and other factors could be involved in the pathogenesis as well. The etiology and pathogenesis of ICP are yet to be further explored. Related Articles | Metrics

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Research on Pathogenesis of Gestational Diabetes Mellitus and its Influence on Maternal and Infant JIE Jin-hua;XU Rong-xian 2011, 38 (3):  197-200.  Abstract ( 2843 )   PDF (203KB) ( 5987 )   Risk factors of gestational diabetes mellitus（GDM）include age，obesity，ethnicity，adverse obstetrical and neonatal outcomes，and family history of diabetes. Insulin resistance plays a main role in GDM. Impact of GDM on mothers and fetals is intimately related to levels of glycaemic control. Women with GDM are increased risk of pre-eclampsia，polyhydramnios，shoulder dystocia or cephalopelvic disproportion，injury of birth canal， caesarean delivery and diabetes after years，while their infants tend to experience higher rates of macrosomia， preterm birth，morbidity and mortality. The offspring of these women are also at increased risk of obesity and metabolism syndrome in childhood. Related Articles | Metrics

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Management Strategy on Gestational Diabetes Postpartum CHANG Ying;CHEN Xu 2011, 38 (3):  201-203.  Abstract ( 2799 )   PDF (194KB) ( 5223 )   The incidence of gestational diabetes mellitus is increasing year by year，and it is the risk factor of developing diabetes，metabolic syndrome and cardiovascular disease in the future. Therefore，postnatal management of women with gestational diabetes mellitus is very important and is an important means to reduce postpartum complications. Postpartum management，including postnatal blood glucose screening，diabetes education，lifestyle changes，as well as postpartum contraception and other aspects. At present，post-natal management of gestational diabetes is still very lacking in close collaboration with multiple disciplines required. Related Articles | Metrics

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Relationship Between Obesity and Pregnancy Complications DONG Sheng-wen;NIU Xiu-min 2011, 38 (3):  204-206.  Abstract ( 1603 )   PDF (212KB) ( 5072 )   The overweight and obesity are related with pregnancy induced hypertension， gestational diabetes mellitus，fetal macrosomia，cesarean section rate increased and thrombotic disease in pregnant women. Pre-pregnancy height，body mass and the increase of body weight during pregnancy are more important factors. Pregnancy obesity is increased year by year， with the adverse obstetric outcomes increasing，which has the significant effect on the occurrence of abnormal offspring，obesity，type 2 diabetes and other adult diseases. Summary of obesity with a variety of pregnancy complications and obstetric outcome relationship，suggests that control of body weight during pregnancy，screening pregnancy complications will help improve the quality of care during pregnancy，improving maternal and child outcomes for obese pregnant women to strengthen perinatal care and postpartum follow-up. Related Articles | Metrics

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Progress in Study on Diagnosis of Chorioamnionitis ZHAO Zhi-ying;YANG Ling-zhu 2011, 38 (3):  207-210.  Abstract ( 1584 )   PDF (201KB) ( 5507 )   Most chorioamnionitis is due to preterm premature rupture of membranes and is closely associated with preterm labor which induces three quarters of newnatal death.So we should pay intensive attention to the presence of chorioamnionitis，especially asymptomatic patients that is often neglected. Based on a large amount of literature， We can see the result about predictive value of chorioamnionitis from tradition bioindicator including erythrocyte sedimentation rate，white blood cell counting and the C-response protein，and from the modern molecular bioindicator including matrix metal proteinase，interleukin，tumor necrosis factor and so on.Serum bioindicators have the advantages of precision，fast and relatively noninvasive method，which is well documented in pregnants by present researchs. By the study of inflammatory cytokines，it is expected to offer new sensitive and available serum biomarkers for the prospective diagnosis of chorioamnionitis. Related Articles | Metrics

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Relationship Between the Expression of Endoplasmic Reticulum Protein （ERp44） and Pre-eclampsia in Placenta SUN Li-zhou;JIANG Zi-yan;REN Huai-bin 2011, 38 (3):  211-213.  Abstract ( 1596 )   PDF (477KB) ( 5096 )   Objective：This study was designed to investigate the relationship between endoplasmic reticulum protein（ERp44） expression and the pathogenesis of preeclampsia in preeclampsia placental villi. Methods：Immunohistochemistry, semi-quantitative RT-PCR and Western blot were used to detect the ERp44 gene and protein expression in preeclampsia and normal placental villi（both 20 cases）. Results：Immunohistochemistry showed that ERp44 staining were strongly positive in all the 20 pre-eclampsia placental villi, while the normal group showed negative staining；RT-PCR showed no significant difference in ERp44 mRNA in two groups（P＞0.05）；Western blot assay found that the ERp44 protein level in pre-eclampsia villi was significantly higher than normal group（P＜0.05）. Conclusions：The expression of ERp44 may be closely related to the pathogenesis of pre-eclampsia. Related Articles | Metrics

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Influence on Using Antioxidant to Pregnant Outcome YANG Yi-ke;LIN Jian-hua;LIN Qi-de;ZHANG Wei-yuan 2011, 38 (3):  214-217.  Abstract ( 2893 )   PDF (239KB) ( 5219 )   Objective：To apply the antioxidants（Vitamin C，Vitamin E，Salvia Miltiorrhiza L：SML） preventively to the pregnant women，to investigate the influence of using the antioxidants to the obstetrical complications，the conditions of delivery and perinatal. Methods：From April 2005 to July 2006，3 485 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research project. The participants were randomly divided into two groups：1 607 cases included in antioxidant group with administration of vitamins and SML; 1 878 cases were in control group without any medicine given. Every participant was under monitoring for the pregnant complications，the delivery condition and perinatal condition. Results：①The incidence of membrane disorders，the fetal distress and amniotic fluid abnormalities in antioxidant group were lower than that in control group（P ＜0.01）.Nevertheless，there was no difference between two groups in the morbidity of GDM，PIH and ICP（P ＞0.05）. ②The average delivery week of antioxidant group and control group were 39.17w vs. 39.08w（P ＞0.05），and the average newborn weight of two group were 3 388.29 g vs. 3 374.81 g（P ＞0.05）. There was no difference in the incidence of premature labor，low-birth weight and giant babies between two groups（P ＞0.05）. ③The maternal mortality of anti-oxidant group and control group were 0 vs. 0.11%（P ＞0.05），and the perinatal mortality of two groups were 0.44% vs. 0.11%（P ＞0.05）. ④The newborn morbidity in antioxidant group were lower than control group（P ＜0.01），especially in newborn jaundice. Conclusions：There were no influence to the delivery weeks，the newborn weight，premature labor，low-birth weight of newborn，giant babies，the maternal and perenatal motality with using the antioxidants. Whereas，the antioxidants could give some help for preventing some obstetrical complications and newborn diseases，especially in the preventing PROM and newborn jaundice which effects were confirmed. Related Articles | Metrics

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A Retrospective Analysis of 40 Cases Obstetrical Abdominal Compartment Syndrome LI Zhi-quan;WANG Chen-hong 2011, 38 (3):  218-221.  Abstract ( 1713 )   PDF (267KB) ( 5093 )   Objective：To improve the accuracy of early diagnosis of obstetrical abdominal compartment syndrome （ACS） by investigating its risk factors，clinical characteristics，diagnosis and treatment outcome. Methods：The clinical data of forty obstetrical abdominal compartment syndrome patients were retrospectively analyzed. The cases received conservative treatment and cesarean-section separately. Results：The prevalence of hydramnios，proteinuria and hypoalbuminemia were the highest among the risk factors； Abdominal distention and oliguria were the major clinical characteristics；Primary laboratory abnormalities were massive ascites（37.5%） and hyperuricemia（50%）. Of forty cases，14 cases（35%，14/40）were misdiagnosed. All cases experienced rehabilitation discharge. Conclusions：Acute hydramnios due to various causes and capillary leak syndrome complicated by preeclampsia are the leading cause of the obstetrical abdominal compartment syndrome，early clinical identification and quickly effcient treatment play a key role in improving prognosis． Related Articles | Metrics

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Diagnosis and Treatment of 6 Cases with Mirror Syndrome LI Zhi-quan;WANG Chen-hong;TU Xin-zhi 2011, 38 (3):  222-224.  Abstract ( 3468 )   PDF (195KB) ( 5329 )   Objective：To explore the clinical features，diagnosis and treatment of mirror syndrome. Methods：The clinical data including clinical symptoms and physical signs，laboratory and ultrasound examination，gross and microscopic placental examination and outcomes of both mother and fetus in 6 cases with mirror syndrome at our hospital from 2009 to 2010 were analyzed retrospective，and relative literatures were reviewed. Results：6 cases with mirror syndrome was presented the triad of maternal edema，hydrops fetalis and hydropic placenta. 6 cases have several characteristics such as anemia and hemodilution［Hb（86.00±10.88） g/L和HCT 0.267 7±0.026 7］， hypopoteinemia［ALB（ 21.53 ± 3.12） g/L］， albuminuria and proteinuria，elevated uric acid ［UA（551.50±63.02） μmo/L］.In addition，elevated blood pressure was present in 4 cases. Conclusions：Mirror syndrome can be diagnosed as the development of maternal edema in association with hydrops fetalis or hydropic placenta. Some cases can present preeclampsia-like symptoms.An important characteristic of mirror syndrome that distinguishes it from preeclampsia is maternal hemodilution. Once mirror syndrome is diagnosed，the cause of hydrops should be corrected as soon as possibly. Diuretic and limitation of fluid input volume also should be considered. Related Articles | Metrics

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Define a Normal Referrence Range for the Internal Diameter of Fetal Colon in Late Pregnant Term by Ultrasonography WU Chao;WANG Ling-hon 2011, 38 (3):  225-226.  Abstract ( 2408 )   PDF (153KB) ( 5163 )   Objective：To construct a normal value range for the internal diameter of fetal colon in late pregnant term . Methods：193 cases of healthy pregnant women with normal singleton pregnacies at 36～40 weeks+3 days of gestation. Measured the maximum internal diameter of fetal colon. Results：The normal mean and the 95% prediction limits were defined. Conclusions：The present data provide a normal value range of fetal colon in different gestational age of late pregnant term，may evaluate the development of fetal colon and serve as a reference values in the detection of anomalies of the fetal bowel by ultrasound. Related Articles | Metrics

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MRKH Syndrome and Current Development of Vaginoplasty FU Qing -rui;SHI Hui-rong;JI Mei 2011, 38 (3):  227-230.  Abstract ( 2799 )   PDF (258KB) ( 5141 )   The hypothesis of polygenic/multifactorial causes for MRKH syndrome（congenital utero-vaginal aplasia） has been reinforced，as well as familial heredity and aggregation. Vaginoplasty is the main treatment method. With the application and improvement of laparoscopic operation and tissue engineering technique，researchers have been trying to continuously develop and innovate vaginoplasty，then evaluate the effectiveness of different procedure by long-term follow-up. The article below will overview the causes，the main methods of operation of MRKH and their follow-up results. Related Articles | Metrics

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Clinical Application of the Ethinylestradiol/Drospirenone in Non-contraceptive Field ZHU Ying;SHI Hui-rong 2011, 38 (3):  231-233.  Abstract ( 1687 )   PDF (202KB) ( 5130 )   The Ethinylestradiol （0.03 mg）/Drospirenone （3 mg） is a novel combined oral contraceptive （Yasmin）. Unlike other progestogens，Drospirenone is a novel progestin that is structurally related to 17-alpha-spirolactone and has progestogen activity，anti-mineralocorticoid and anti-androgenic activity. Yasmin has been proven to be an effective and well tolerated contraceptive with an acceptable bleeding pattern and a good safe profile. It can improve the symptoms of water retention and hyperandrogenism. It is better than other progestin containing oral contraceptives in terms of weight control and premenstrual syndrome. There are bright prospects for the added benefits of Yasmin as oral contraceptive. Related Articles | Metrics

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Progress in Study of MicroRNA in Gynecological Malignant Tumor LI Xiang;LU Yan-ming;ZHANG Shu-lan 2011, 38 (3):  234-236.  Abstract ( 2039 )   PDF (221KB) ( 5185 )   MicroRNA is a kind of non-coded single stranded micromolecule RNA，generally existing in animal、plant genome.It integrates with its target mRNA by means of complete or incomplete complementary method in post-transcriptional level to regulate the expression of target mRNA，and then affects biological character.Update study and research show that，miRNA participates a series of important process in vital process，and also correlates closely with human disease. miRNA plays an important role of genesis，diagnosis，therapy and prognosis of malignant tumors. Related Articles | Metrics

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Research on Gene Polymorphism and Human Papilloma Virus Associated Cervical Cancer ZHANG Hong-xiu;CHEN Yan;JIN Ping 2011, 38 (3):  237-240.  Abstract ( 1716 )   PDF (205KB) ( 5084 )   Cervical cancer is one of the most common cancer in female genital malignant tumor. And infection of HPV is considered as the main causes of cervical cancer. The gene of HPV fused with gene of cervical tissues，and thus leading to cervical lesions，progress from chronic inflammation，low grade dysplasia to high degree of dysplasia slowly，and then canceration.Currently，researchers of the world is devoting their mind to explore the pathogenesis of cervical cancer and gene of HPV，looking for early diagnosis，effective treatment and prognosis of new target gene.It has become a hot-spot to research gene mutation and polymorphisms in cancer from the molecular level in recent years，and gene diagnosis and treatment of cancer therapy is expected to become a new direction.Now，this paper reviewed genes involved in development of cervical carcinoma. Related Articles | Metrics

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The Research Progress of Vascular Endothelial Growth Factor and Cervical Cancer Metastasis PENG Xiao-lian;WU Yi-lin 2011, 38 (3):  241-244.  Abstract ( 2200 )   PDF (204KB) ( 5230 )   Vascular endothelial growth facto（VEGF） is a potent mitogen of angiogenesis.It can induce angiogenesis and lymphangiogenesis in tumor.Furthermore，VEGF significantly associates with lymphatic metastasis and prognosis of cervical carcinoma.VEGF causes hyperpermeable formation of vessel，leading to resistance to blood flow and impair blood supply and therefore compromise the distribution and effectiveness of conventional cytotoxic therapies.Aantagonist may induce the morphological normalization of tumor vasculature and increase drug uptake. It is currently a hot topic in molecular targeted therapies of cervical carcinoma. Related Articles | Metrics

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Preoperative Treatment of Gonadotrophin Releasing Hormone Agonist in Laparoscopic Excision of Ovarian Endometriotic Cysts YUAN Jian-huan;WANG Xi-hong;FANG Fu-rong;HE Yan-zhen;ZHANG Chun-ni;MO Rui-tin 2011, 38 (3):  245-246.  Abstract ( 2775 )   PDF (253KB) ( 5039 )   Objective：To study the value of preoperative treatment of gonadotrophin releasing hormone agonist （GnRHa） in laparoscopic excision of ovarian endometriotic cysts（LEOEC）. Methods：64 cases of LEOEC were analyzed retrospectively，of which 35 cases（study group） accepted the preoperative treatment of GnRHa for 3 months，and the other 29 cases （control group） accepted no preoperative treatment. Results：The operating time，blood loss，the cases whose ovary were coagulated and whose ovarian endometriotic cyst could be almost entirely separated in the study group and control group were （53.0±17.6） min versus （74.0±27.9） min，（29.0±13.7） mL versus （43.0±27.2） mL，6 cases（17.1%） versus 18 cases（62.1%），23 cases（65.7%） versus 1 cases（3.45%），respectively. Conclusion：Preoperative treatment of GnRHa is helpful for LEOEC，which includes minimizing the operating time and the blood loss，making the procedure more easier. Related Articles | Metrics

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Ultrasounic Diagnosis of Congenital Oblique Vaginal Septum Syndrome LI Hui-dong;WU Zhong-yu 2011, 38 (3):  247-249.  Abstract ( 2139 )   PDF (454KB) ( 5184 )   Objective：To discuss the ultrasound features and the correct diagnostic methods of congenital oblique vaginal septum syndrome（OVSS）. Method：To analyze clinical symptoms and ultrasound characteristics of 10 cases of OVSS confirmed by the operation. Results：All cases have double uterus，double cervix，haematocele and kidney absence on the oblique septum side.It’s difficult to make a diagnosis of OVSS during the pregnancy. Conclusions：The image characteristics of congenital OVSS are significant .Ultrasound can be used as a preferred and reliable method in diagnosis of OVSS. Related Articles | Metrics

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Laparoscopic Cervical Cerclage Using Cerclage Tape——Two Cases Report and Literature Review XIA En-lan;LIU Yu-huan;HUANG Xiao-wu;ZHENG Jie;YU Dan;MA Ning;LI Yun-fei;QU Jing 2011, 38 (3):  250-252.  Abstract ( 3289 )   PDF (454KB) ( 5269 )   Objective：To evaluate the effectiveness and feasibility on treatment of cervical incontinence by cervical cerclage surgery using cerclage tape. Methods：Case 1 owing to cervical incontinence was performed vaginal cerclage during 21w gestation，during 23w gestation she suffered from inevitable abortion and was performed vaginal cerclage again but failed. Finally she was performed abdominal cerclage at non pregnant condition. Case 2 had 5 times mid trimester abortion because of cervical incontinence. She was performed laparoscopic cerclage at non pregnant condition. Both surgeries were going smoothly.Results：Case 1 got pregnant 1 year and 3 months after surgery. At 35+6 w a live girl was born by cesarean section with indication of central placenta previa. Baby’s birth weight was 2 900 g.Case 2 was not pregnant for one year after surgery. HSG shown bilateral tube occluded. Liquid cannulation was performed twice afterwards but tube was still blocked. Conclusions：As for an alternative method, abdominal/laparoscopic cerclage at non pregnant condition is effective to treat cervical incontinence women who had history of mid-trimester abortion even failed of vaginal cerclage. Related Articles | Metrics