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Objective To investigate the changes of coagulation indexes in normal pregnant women in early and late pregnancy.Methods The coagulation indexes in early and late pregnancy including activated partial thromboplastin time (APTT),APTT ratio,prothrombin time (PT),PT ratio,prothrombin activity,international normalized ratio,fibrinogen (Fib) and thrombin time (TT) were retrospectively collected from 196 normal pregnant women delivered in Peking University First Hospital from August 2013 to September 2014.Differences in these indexes before and after the seventh gestational week of early pregnancy and in early and late pregnancy were compared.In addition,the normal reference values were calculated.Paired t test and sum-rank test were used for statistical analysis.The reference values were presented with P2.5-P97.5.Results In early pregnancy,some coagulation indexes after the seventh weeks were shorter than those before,such as APTT [30.3 (26.1-35.5) vs 32.1 (27.9-36.8) s,Z=25.850,P＜0.001] and TT [13.8 (12.2-16.0) vs 14.5 (12.3-16.4) s,Z=16.720,P＜0.001],but Fib [3.3 (2.5-4.3) vs 2.9 (2.2-3.8) g/L,Z=43.180,P＜0.001] became higher.APTT [(27.5± 1.6) vs (31.4±2.4) s,t=24.736,P＜0.001],PT [(9.7±0.5) vs (11.0±0.8) s,t=1 8.647,P＜0.001] and TT [(13.3 ±0.8) vs (14.2±1.0) s,t=9.255,P＜0.001] were significantly shorter,while Fib [(4.4±0.5) vs (3.1 ±0.4) g/L,t=-29.152,P＜0.001] was higher in late pregnancy than in early pregnancy.The reference values ofAPTT,PT,Fib and TT in early pregnancy were 26.5-36.0 s,9.4-12.4 s,2.4-4.0 g/L and 12.3-16.4 s,and those in late pregnancy were 25.0-31.2 s,8.8-10.6 s,3.4-5.4 g/L and 12.0-14.9 s,respectively.Conclusions The coagulation indexes of pregnant women change significantly since the beginning of early pregnancy.APTT,PT and TT are shorter,while Fib is higher in late pregnancy than in early pregnancy.
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Objective@#To investigate the changes of coagulation indexes in normal pregnant women in early and late pregnancy.@*Methods@#The coagulation indexes in early and late pregnancy including activated partial thromboplastin time (APTT), APTT ratio, prothrombin time (PT), PT ratio, prothrombin activity, international normalized ratio, fibrinogen (Fib) and thrombin time (TT) were retrospectively collected from 196 normal pregnant women delivered in Peking University First Hospital from August 2013 to September 2014. Differences in these indexes before and after the seventh gestational week of early pregnancy and in early and late pregnancy were compared. In addition, the normal reference values were calculated. Paired t test and sum-rank test were used for statistical analysis. The reference values were presented with P2.5-P97.5.@*Results@#In early pregnancy, some coagulation indexes after the seventh weeks were shorter than those before, such as APTT [30.3 (26.1-35.5) vs 32.1 (27.9-36.8) s, Z=25.850, P<0.001] and TT [13.8 (12.2-16.0) vs 14.5 (12.3-16.4) s, Z=16.720, P<0.001], but Fib [3.3 (2.5-4.3) vs 2.9 (2.2-3.8) g/L, Z=43.180, P<0.001] became higher. APTT [(27.5±1.6) vs (31.4±2.4) s, t=24.736, P<0.001], PT [(9.7±0.5) vs (11.0±0.8) s, t=18.647, P<0.001] and TT [(13.3±0.8) vs (14.2±1.0) s, t=9.255, P<0.001] were significantly shorter, while Fib [(4.4±0.5) vs (3.1±0.4) g/L, t=-29.152, P<0.001] was higher in late pregnancy than in early pregnancy. The reference values of APTT, PT, Fib and TT in early pregnancy were 26.5-36.0 s, 9.4-12.4 s, 2.4-4.0 g/L and 12.3-16.4 s, and those in late pregnancy were 25.0-31.2 s, 8.8-10.6 s, 3.4-5.4 g/L and 12.0-14.9 s, respectively.@*Conclusions@#The coagulation indexes of pregnant women change significantly since the beginning of early pregnancy. APTT, PT and TT are shorter, while Fib is higher in late pregnancy than in early pregnancy.
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Objective To investigate the effects of gestational diabetes mellitus (GDM) on the growth rate of fetuses.Methods This was a retrospective study.Women who had deliveries in Peking University First Hospital between January 2012 and June 2013 were enrolled.Matched by maternal age,they were divided into four groups with 100 cases in each group:macrosomic fetuses of mothers with GDM (GDM-macrosomia group),normal birth weight infants of mothers with GDM (GDM-non-macrosomia group),macrosomic fetuses of mothers with normal pregnancy (normal-macrosomia group),and normal birth weight infants of mothers with normal pregnancy (normal-non-macrosomia group).The fetal abdominal circumference was measured at 20+1-24,28+1-32,32+1-37 weeks and 37+1 weeks to delivery under prenatal ultrasound.The growth rate of fetal abdominal circumference was calculated (abdominal circumference/gestational weeks).The analysis of variance,the least significant difference-t test and Student's t test were used for statistical analysis.Results At early pregnancy [(9.2±2.6) weeks of gestation] and 20+1-24,28+1-32,32+1-37 weeks and 37+1 weeks to delivery,the weight and body mass index (BMI) of the mothers in GDM-macrosomia group were higher than those in the other three groups (all P＜0.05).The body weight of the mothers increased by (15.5±5.4),(13.5±3.6),(16.4±4.1) and (16.2±4.3) kg,respectively,compared with early pregnancy.At 20+1-24,28+1-32,32+1-37 weeks and 37+1 weeks to delivery,the fetal abdominal circumference of GDM-macrosomia group was (182.0± 13.9),(270.7± 17.7),(335.2±21.3) and (362.3± 18.7) mm,respectively,being higher than that in GDM-non-macrosomia group [(176.8± 13.0),(256.6± 13.5),(313.2± 17.5) and (335.8± 15.5) mm] and normal-nonmacrosomia group [(176.9± 11.8),(260.0± 14.2),(310.6± 21.4) and (334.5 ± 16.1) mm] (all P＜0.05).The fetal abdominal circumference of GDM-macrosomia group was even higher than normal-macrosomia group at 32+1-37 weeks [(335.2±21.3) vs (326.1 ± 19.1) mm,t=4.01,P＜0.05].The changes of the growth rate of fetal abdominal circumference were consistent with the fetal abdominal circumference.Conclusions GDM accelerates fetal growth.
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BACKGROUND:Tissue patch is used to increase bone mass after mandibular molar extraction, which is conducive to late-stage repair, but it is unexpectedly found that after implantation of tissue patch, incidence of dry socket is significantly reduced.OBJECTIVE:To assess the efficacy of tissue patch for the control of dry socket caused by mandibular molar extractionvia the method of systematic review. METHODS:MEDLINE (OVID), CENTRAL, EMBASE and CBM were searched for clinical randomized controled trials and clinical controled trials. The keywords were “dry socket, tissue patch, acelular dermis matrix, tooth extraction” in English and Chinese. The references of the included studies and 19 Chinese dental journals were hand-searched. Two reviewers independently assessed the risk of bias using Cochrane Colaboration’s tool, and extracted data. Meta-analysis was delivered with Revman 5.1.RESULTS AND CONCLUSION:Eight studies, including five randomized controled trials and three clinical controled trials, were included. Totaly 2 052 participants were involved. Seven of the included studies had moderate risk of bias and one had high risk of bias. Meta analysis showed that implantation of the tissue patch into the extraction socket could reduce 86% of the risk of dry socket (relative risk=0.14, 95% confidence interval [0.08, 0.26], P < 0.000 01). Sensitivity analysis showed that this outcome was relatively stable. Implantation of tissue patch into extraction socket could significantly reduce the risk of dry socket, but more randomized controled trials are needed.
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Objective To explore the long term effects of gestational diabetes mellitus (GDM)on offsprings of affected women.Methods One hundred and twenty-four singleton pregnant women with GDM,who delivered in Department of Obstetrics and Gynecology,Peking University First Hospital from June 14,2006 to December 31,2007,were enrolled as the study group.Ninety-eight singleton pregnant women with normal glucose metabolism who delivered at the corresponding period were enrolled as the control group.The follow-up study was performed from November 6,2010 to January 31,2011 on their offsprings.Anthropometry indexes,including height,weight,waist circumference,systolic and diastolic blood pressure (DBP),triceps skin fold (TSF) and sub-scapular skin fold (SSF) were measured.According to the development standard of children less than five years old issued by World Health Organization in 2006,there were six detailed evaluation indicators including length/height for age z-score (HAZ),weight for age z-score (WAZ),weight for length/ height z score (WHZ),body mass index (BMI) for age z-score (BAZ),triceps skin folds for agez-score (TSFZ) and sub-scapular skin folds for age z-score (SSFZ).Chi-square,t-test or variance analysis were applied.Results (1) No statistical difference on age,birth weight,sex,height,weight,BMI,waist circumference,blood pressure,TSF and SSF was found between offsprings of study and control group (P＞0.05).(2) Offsprings in both groups were further divided into macrosomia and non-microsomia subgroups,i.e.GDM macrosomic subgroup (n =15),GDM nonmacrosomic subgroup (n=109),control macrosomia subgroup (n=6) and control non-macrosomia subgroup (n=92).Significant difference was shown amont the four subgroups in weight [(19.8±3.9),(17.0±1.9),(17.7±1.7)and (17.2±1.7) kg,F=6.238,P＜0.001],BMI (17.6±2.6,16.0±1.2,16.6±1.1 and 16.2±1.1,F=5.901,P＜0.001),waist circumference [(53.6±5.3),(49.9±2.7),(50.9±3.3) and (50.4±0.9) cm,F=5.307,P＜0.001],WHZ (1.40±1.44,0.45±0.81,0.88±0.75 and 0,60±0.87,F=5.269,P=0.002),HAZ (1.22±0.78,0.47±0.82,0.98±0.74 and 0.50±1.00,F=3.668,P=0.013),WAZ (1.68±1.23,0.58±0.79,1.15±0.85and 0.71±0.93,F=7.361,P＜0.001) and BAZ (1.41±1.52,0.42±0.84,0.81±0.76 and 0.60±0.90,F=5.210,P =0.002).While comparing between each two subgroups,there was statistical difference between GDM macrosomia subgroup and GDM non macrosomia subgroup,and between GDM marosomia subgroup and control non-macrosomia group.(3) While comparing GDM macrosomia and GDM non-macrosomia subgroup with control group [weight (17.2±2.5) kg,BMI (16.2± 1.4),waist circumference (50.5 ± 3.6) cm,DBP (55.2 ± 6.9)mm Hg,SSF(6.1 ± 1.8) mm,WHZ (0.62±0.87),HAZ (0.53±0.99),WAZ (0.73±0.92),BAZ(0.61±0.89)],the weight (F=9.283,P＜0.001),BMI (F=8.707,P＜0.001),waist circumference (F=7.934,P＜0.001),DBP(F=3.123,P=0.046),SSF (F=3.499,P=0.032),WHZ (F=7.639,P＜0.001),HAZ(F=4.709,P=0.010),WAZ (F=10.302,P＜0.001) and BAZ (F=7.689,P＜0.001) was higher in GDM group than the control group.(4) The proportions of overweight and obesity were higher in GDM macrosomia subgroup than in GDM non-macrosomia and control groups [overweight:9/15 vs24.8％ (27/109) and 24.5％ (24/98),x2 =8.870,P=0.012; obesity:5/15 vs 7.3％(8/109) and 9.2％(9/98),x2=10.083,P=0.006].If all subjects were divided into macrosomia and non-macrosomia group,then the proportion of overweight and obesity was higher in the former group [overweight:52.4％ (11/21) vs24.4％(49/201),x2=7.560,P=0.006; obesity:28.6％ (6/21)vs 7.9％(16/201),x2 =9.047,P=0.003].Conclusions GDM may have long term adverse effect on the development of offsprings at three-four-year-old with higher incidence of obesity or high diastolic blood pressure in macrosomic babies of GDM mothers than in non macrosomic babies of GDM mothers or babies of non GDM mothers.