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Objective To observe the clinical application of extraperitoneal cesarean section(ECS) plus forceps vs transperitoneal cesarean sections(TCS) in repeated cesarean section.Methods 98 multiparous women with scar uterus for elective repeated cesarean sections were recruited retrospectively,47 cases for ECS plus forceps(group A),and 51 cases for TCS(group B).The multiparous women with hyperglycemia not controlled,severe preeclampsia,heart disease,placenta previa,premature rupture of membrane,a history of ＞ 1 cesarean section,myoma and/or ovarian neoplasm were excluded.Results Skin incision to baby delivery time and total operation time of group A were (7.7 ± 2.8) min and (42.8 ± 9.7) min,respectively,which were significantly shorter than (9.3 ± 3.2) min and (47.6 ± 9.4) min of group B,(t =2.700,2.497,P =0.008,0.014).There was significant difference in blood loss volume during the operation and postoperative 2 hours,which was (310.4 ± 106.3) mL,(365.3 ± 142.8) mL respectively(t =2.142,P =0.035).The Visual Analog Scale for pain (VAS pain) was (2.8 ± 1.8) in group A and (4.1 ± 1.9) in group B,respectively (t =3.252,P =0.002).The gastrointestinal function recovery mean time of group A was significantly shorter than that of group B (12.5 h versus 16.0h,t =2.771,P =0.007).And the postoperative febrile morbidity was significantly lower in group A than in group B(8.5％ versus 25.5％ ;x2 =4.918,P =0.033).The patients with chronic pelvic pain followed up after operation was 3 versus 12,and the difference was significant (x2 =5.143,P =0.026).There were no differences in neonatal Apgar score at 1 minute,birth asphyxia and wound healing rates.Conclusion ECS plus forceps can be safely used for repeated cesarean section,with the advantages of less operation time,less bleeding volume,lower postoperative morbidity,and fewer complications than TCS.
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Objective To investigate the relationship between the expression of glucose regulated protein 78 (GRP78) in the placental trophoblast cells and the pathogenesis of gestational diabetes mellitus (GDM).Methods All the patients were recruited from Qingdao Municipal Hospital from May 2013 to May 2014.Among them, fifty women with GDM were assigned to the GDM group, and fifty healthy women were defined as the control group.All of them received cesarean section because of breech presentation, contracted pelvis, scarred uterus or on mother's demand.Real-time PCR was conducted to analyze the expression of GRP78 mRNA in the trophoblasts.Immunohistochemistry was performed to detect the localization of GRP78 protein in the placentasl trophoblast cells.Results (1) GRP78 mRNA expressed in the cytoplasm of trophoblasts of both the GDM group and the control group.The GRP78 mRNA levels in the GDM group and the control group were 15.6±0.4 and 6.0±0.7, respectively.The relative expression level of GRP78 mRNA in the GDM group was 2.6 times of that in the control group, with statistically significant difference (P＜0.01).(2) The expression of GRP78 protein was found in the cytoplasm of the trophoblasts of the GDM group.It showed in deep, light brown or yellow after staining, according to the expression degree.The expression of GRP78 protein was also found in the cytoplasm of the trophoblasts of the control group, but it mainly showed yellow color (38/50).The strong positive rate of GRP78 protein in the GDM group (96％, 48/50) was higher than that in the control group (22％, 11/50;P＜0.01).Conclusion The expression of GRP78 increased in the placental trophoblast cells of GDM patients.It might suggest that GRP78 had some effect on the pathogenesis of GDM.
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<p><b>BACKGROUND</b>Lead exposure during pregnancy contributes to fetal abortion and/or teratogenesis. Endoplasmic reticulum (ER) apoptosis can be induced by various pathological conditions when ER function is disturbed. However, it is unclear whether ER stress and apoptosis play a role in the etiology of lead-exposed disease status. We aimed to investigate whether lead induced placental apoptosis and subsequent toxicity is initiated by ER apoptosis via caspase-12.</p><p><b>METHODS</b>Sixty-three female Wistar rats were exposed to lead in drinking water during various gestational periods. Blood lead level was determined by atomic absorption spectrophotometry. Placental cytoplasmic organelles were examined by electronic microscopy. Placental caspase-12 mRNA expression was evaluated by qRT-PCR. TUNEL assay was used to determine the placental apoptosis.</p><p><b>RESULTS</b>Lead exposure significant induced ER apoptosis compared to that of the controls (P < 0.05), accompanied with increased caspase-12 mRNA expression. Significant differences of caspase-12 mRNA expression levels were observed among the four groups (F = 13.78, P < 0.05). Apoptotic index (AI) was significantly increased in experimental groups compared to that of the controls (F = 96.15, P < 0.05). In lead-exposed groups, trophoblast cells underwent degeneration and fibrin deposition; Mitochondria were swollen and decreased in number; ER swelling, expansion, and vacuolization were observed.</p><p><b>CONCLUSION</b>Lead exposure contributes to placental apoptosis, as well as increased caspase-12 mRNA expression, which in turn promoted ER stress.</p>
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Animals , Female , Pregnancy , Rats , Apoptosis , Endoplasmic Reticulum Stress , Lead , Toxicity , Placenta , Cell Biology , Rats, WistarABSTRACT
Objective To retrospectively analyze the main factors of abnormal umbilical blood flow in different stage after 24 weeks' gestation,and to evaluate its treatment outcomes.Methods 256 cases with abnormal umbilical blood flow were selected.The abnormality happened in different stages after 24 weeks' gestation and they were inspected and treated routinely.Latency factors of the different stage were analyzed to discover the primary reason,and the treatment outcomes were compared.Results The significant differences of constructional proportion were observed in different stage(x2 =25.60,P ＜ 0.05).The influence factors of different stages were as following:hypertension relative disease (33.33 ％) between 24 and 27 weeks' gestation,the umbilical cord factor (16.67 ％) ; the incidence rate of abnormal umbilical blood was 42％ between 28 and 36 weeks' gestation,including hypertension disease(28.70％),the umbilical cord factor(15.74％) ;umbilical cord (31.37％) between 37 and 40 weeks' gestation,although gestation period hypertension disease reduced,but still accounted for 22.54％,the placenta factor was 12.74％.After treatment,the cure rate had significant differences (x2 =11.16,P ＜0.01),89.58％ (24-27 week),80.55％ (28-36 week),69.60％ (37-40 week).Conclusion The hypertension relative diseases and abnormal cord are the primary factors which caused abnormal umbilical blood,24-37 gestation week is the key stage for the inspection and treatment,especially for the hypertension relative diseases.
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Objective To study the related factors of postpartum depression (PPD) and the effects of intervening measures to PPD incidence. Methods 1 597 pregnant women selected from our antenatal care clinic were investigated by using the hospital anxiety and depression questionnaire (HAD) during pregnancy and the Edinburgh postpartum depression scale (EPDS) after childbirth.All the enrolled women were randomlyd divided into control group and intervening group by the proportion of 1 to 2.Six intervening measures were used in the latter group. Results (1) There were 49 women whose HAD≥11 score (anxiety-depression mood)with 28 cases (57.1%) had got postpartum depression in the control group.In the intervening group,however,there were 94 women whose HAD≥11 score with 24 cases (25.5%) had got postpartum depression.There is a significant difference between the two groups ( P
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Objective To investigate the significance of metallothionein (MT) expression in the placenta of women exposed to low level lead during pregnancy. Methods Sixty-seven pregnant women with blood lead level ranging from 1.5 ?mol/L to 4.8 ?mol/L were randomly selected from the Department of Obstetrics of Qingdao Municipal Hospital between Mar 2005 and Mar 2006. Among them, 35 were with blood lead level less than 2.9 ?mol/L(group A) and 32 more than 2.9 ?mol/L(group B). Immunohistochemical streptavidin-peroxidase-biotin methods were used to observe the expression of MT in the placental tissue. Results (1)Among the 67 pregnant women,the highest level of blood lead was 4.7 ?mol/L , and the lowest level was 1.6 ?mol/L .The blood lead level of groups A and B was (1.7?0.3) ?mol/L, and (3.1?0.4) ?mol/L, with a significant difference between them(P