ABSTRACT
This prospective study was conducted to compare risk factors and pregnancy outcomes between women with complete placenta previa and those with incomplete placenta previa diagnosed in mid-pregnancy.The study was carried out from April 2014 to December 2015,during which 70 patients with complete previa and 113 with incomplete previa between 20+0 weeks and 25+6 weeks of gestation were included.Maternal demographics and pregnancy outcomes were compared between the two groups.Comparisons between categorical variables were tested by chi-squared test and those between continuous variables by Student t test.Resolution ofprevia occurred in 87.43％ of the studied women.The mean gestational age at resolution was 32.1±4.4 weeks.Incidence of maternal age ≥35 years and incidence of prior uterine operation ＞3 were high in women with complete previa (28.6％vs.8.8％,P=0.003;28.6％ vs.8.8％,P=0.003).Resolution of previa occurred less often in complete previa group (74.3％ vs.95.6％,P=0.001).Women with complete previa admitted earlier (37.3±2.0 weeks vs.38.1±1.4 weeks,P=0.011) and delivered earlier (37.7±1.2weeks vs.38.3±1.4 weeks,P=0.025).Maternal age ≥35 years and prior uterine operation ＞3 increase the risk of complete previa in mid-pregnancy.Placenta previa is more likely to persist in women with complete previa than those with incomplete previa diagnosed in midpregnancy.What is more,women with complete previa in mid-pregnancy deliversearlier.
ABSTRACT
This prospective study was conducted to compare risk factors and pregnancy outcomes between women with complete placenta previa and those with incomplete placenta previa diagnosed in mid-pregnancy.The study was carried out from April 2014 to December 2015,during which 70 patients with complete previa and 113 with incomplete previa between 20+0 weeks and 25+6 weeks of gestation were included.Maternal demographics and pregnancy outcomes were compared between the two groups.Comparisons between categorical variables were tested by chi-squared test and those between continuous variables by Student t test.Resolution ofprevia occurred in 87.43％ of the studied women.The mean gestational age at resolution was 32.1±4.4 weeks.Incidence of maternal age ≥35 years and incidence of prior uterine operation ＞3 were high in women with complete previa (28.6％vs.8.8％,P=0.003;28.6％ vs.8.8％,P=0.003).Resolution of previa occurred less often in complete previa group (74.3％ vs.95.6％,P=0.001).Women with complete previa admitted earlier (37.3±2.0 weeks vs.38.1±1.4 weeks,P=0.011) and delivered earlier (37.7±1.2weeks vs.38.3±1.4 weeks,P=0.025).Maternal age ≥35 years and prior uterine operation ＞3 increase the risk of complete previa in mid-pregnancy.Placenta previa is more likely to persist in women with complete previa than those with incomplete previa diagnosed in midpregnancy.What is more,women with complete previa in mid-pregnancy deliversearlier.
ABSTRACT
Objective To explore the operative methods and clinical outcomes in emergency or sube- mergency repair for the complicated tissue defects in hand in first stage applying microsurgical technique. Methods From Jan.,2000 to Aug.,2005,49 emergency cases of complicated hand tissue defects were re- paired in the first stage with replantation,reconstruction,free flaps,combined finger reconstruction and flap transplantation,including 21 cases in mini tissue mass replantation or reconstruction,15 cases in replantation combined with free flap transplantation,8 cases in replantation and reconstruction combined with free flap transplantation,5 cases in combined multiple digits reconstruction with free flap transplantation.The free flap transplantation included the anterolateral femoral flap,the latissimus dorsi myocutaneous flap,the dorsalis pe- dis flap,the media pedis flap and the instep flap.Results All the flaps,the replanted and reconstruceted finger survived uneventfully except for one replanted finger necrosis.45 cases healed in the first stage and the other 4 cases healed in the second stage.During a follow-up from 6 months to 3 years postoperatively,a satis- factory appearance and function of the reconstructed hand was achieved.The excellent and good rate was 85.7% assessed with provisional functional assessment criterion for upper limbs issued by Chinese Society of Hand Surgery.Conclusion The emergency or subemergency repair for the complicated tissue defects in hand has the advantage of short-term treatment and desirable functional outcome.The emergency replantation and reconstruction combined with various flaps or tissue mass can be applied to repair tissue defect in hand in the first stage according to the position and area of the defect along with the technique level of the surgeon, having been proved to achieve desirable clinical outcomes.And the key points leading to a successful operation is the correct treatment for the raw surface of the defects,suitable choice for various flaps,logical design of combination pattern and prevention and timely treatment for vessel crisis.