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Objective To determine the safety and effectiveness of double balloon catheter for labor induction in women with previous cesarean section. Methods This was a retrospective case-control study. Data from Shenzhen maternal and child healthcare hospital and Shenzhen Longgang District Maternal and Child Healthcare Hospital between 2015. 01. 01 to 2018. 12. 31 were used. A total of 156 term pregnant women, with previous one low segment cesarean section (CS) and balloon catheter for labour induction were included as case group. A total of 156 term pregnant women with previous one low segment CS and sponta-neous onset of labor were included as control group. The vaginal delivery rate and maternal and infant out-comes were compared between the two groups. Results There was no significant difference in CS rate, va-ginal assisted rate and vaginal spontaneous rate between the two groups ( 20. 51％ vs 15. 38％, 8. 97％ vs 5. 77％, 70. 51％ vs 78. 85％ respectively, P >0. 05 ) . And there were no significant difference in the rates of intrauterine infection, uterine rupture, postpartum hemorrhage, blood transfusion, maternal and in-fant mortality and neonatal transfer between the two groups. Conclusions Our study indicates that induc-tion of labor with double balloon catheter is effective and safe in term pregnant women with previous one low segment CS. Women with previous CS and indications for labour induction should be informed about vaginal birth success rates and the alternative of elective repeat CS needs to be discussed.
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Objective To establish a suitable model for predicting the success of trial of labor after cesarean section (TOLAC) during the pregnancy at term.Methods Data for all deliveries at term with one cesarean delivery history in Shenzhen Maternity and Child healthcare hospital during 1 January 2012 to 31 December 2014 were reviewed.Variables associated with VBAC were identified and used to build a model to predict the outcome of TOLAC with multivariable logistic regression.Godness of fit and accuracy of the model were evaluated by ROC.Results A total of 531 women met inclusion criteria and underwent TOLAC.Of the women who underwent trial of labor, 448 (84.4％) had a successful VBAC, 83 failed, and 2 (0.38％) had uterine rupture.Multivariable logistic regression analysis showed that previous cesarean section (CS) time interval, neonatal birth weight (BW) and premature rupture of membranes (PROM) were independent factors affecting TOLAC outcome, and their Odds Ratios were 2.79, 1.002 and 0.244, respectively.The Logistic regression model was expressed as follows:P =1/[1 + exp (2.4 × neonatal BW + 1.03 × previous CS time interval-1.41 × PROM-10.24)].The Hosmer-lemeshow test showed that the model fitted well (x2 =123.45, P =0.996), and the prediction accuracy of the model was 86.77％.The model performed well with an AUC of 0.794 (P =0.000).Conclusions A predictive model, which contains three variables (previous CS time interval, neonatal BW and PROM), has been developed and its prediction efficiency and accuracy are satisfactory.The larger birth weight, the longer time interval from previous CS, and the absence of PROM are more likely to be failed in TOLAC.
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Objective:To investigate the role of serum RGS2 protein,Ang Ⅱ and AT1R in the Pathogenesis of Preeclampsia and it's impact on the severity of the disease.Methods:Totally 50 patients with PE collected from Shenzhen Maternity and Child Healthcare Hospital,Southern Medical University during October 2015-September 2016 were recruited as PE group(PE with FGR group 17 cases and PE without FGR group 33 cases),40 cases of healthy pregnant women were collected as the control group.ELISA was used to detect the serum RGS2 protein,Ang Ⅱ and AT1R levels.he differences between the groups were compared.Logistic regression was used to analyze the correlation between the three indexes and the severity of PE.Results:①In PE group plasma RGS2 protein,Ang Ⅱ,AT1R levels and systolic blood pressure,diastolic blood pressure,sampling gestational age,maternal gestational age,neonatal birth weight were higher than those in control group(P ＜ 0.05);There was no significant difference on RGS2 protein level,systolic blood pressure and diastolic blood pressure between PE with FGR group and PE without FGR group(P＞0.05),There was significant difference on the Ang Ⅱ,AT1R level and newborn weight(P ＜ 0.05).②Logistic regression analysis showed that RGS2 、Ang Ⅱ and AT1R were the independent risk factors of PE.(the crude odds ratio of RGS2,Ang Ⅱ and AT1R were ＞ 1,P ＜ 0.05.After adjust the sampling of gestational age the OR values were ＞ 1,P ＜0.05.After adjust the other two indicators the OR values were ＞ 1,P ＜0.05,except for Ang Ⅱ.).③RGS2 protein,Ang Ⅱ,AT1R levels were positively correlated with PE,systolic and diastolic blood pressure(P ＜ 0.05).Ang Ⅱ,AT1R levels were negatively correlated with neonatal birth weight (P ＜ 0.05).RGS2 was not related with neonatal birth weight (P ＞ 0.05).Conclusions:Plasma RGS2 protein,Ang Ⅱ and AT1R may be associated with the pathogenesis of PE and Ang Ⅱ and AT1R may be associated with the severity of the disease.