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OBJECTIVE: To compare the effect of remote fetal monitoring and outpatient monitoring of high-risk pregnancy.METHODS: A total of 222 pregnant women delivered in Shengjing Hospital of China Medical University from December 2017 to December 2018（44 cases of hypertensive disorder complicating pregnancy,40 cases of gestational diabetes mellitus,22 cases of placental abnormalities,20 cases of preventive cervical cerclage,16 cases of scar uterus pregnancy,12 cases of umbilical cord around neck for 3 weeks or more,6 cases of multiple pregnancy,10 cases of twin pregnancy with one fetus dead in uterus,52 cases of patients without complications）were divided into two groups.In the observation group the fetus was monitored remotely at home,while the control group went to the hospital for fetal heart monitoring.The monitoring effect and neonatal status of the two groups were compared.RESULTS: The incidence of neonatal mild asphyxia in observation group and control group was 1.80% vs.4.50%,and there was no severe neonatal asphyxia.There was no significant difference in the incidence of premature delivery,neonatal weight or vaginal delivery rate（P>0.05）.CONCLUSION: Compared with monitoring in outpatient department,remote fetal monitoring can detect abnormalities in time and intervention can be performed,so it is equally effective for high-risk pregnancy.
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Objective To examine perinatal complications and outcomes of twin pregnancies in women aged over 40 years.Methods A retrospective study was performed on the clinical data of 3 127 twin pregnancies,managed in 12 national hospitals from January2013-December 2013,to analyze differences in perinatal complications and outcomes between women aged over 40 years,and those aged 35 to ＜40 years and 18 to ＜35 years.Results For twin pregnancies,the incidence of postpartum hemorrhage,abortion,early preterm birth,termination of gestation,very low birth weight infants,mild neonatal asphyxia,and preterm births in women aged over 0 years was significantly higher than in women aged 35 to ＜40 years and 18 to ＜35 years (P ＜ 0.05).Among women aged over 40 years and those aged 35 to ＜40 years,the incidence of gestational hypertension was not significantly higher than in women aged 18 to ＜35 years for twin pregnancies (P ＞ 0.05).Conclusion Women aged over 40 years with twin pregnancies were more likely to develop maternal complications and poor perinatal outcomes.Therefore,twin pregnancies in women aged over 40 years should receive comprehensive perinatal management to extend the gestation and improve the perinatal prognosis.
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Objective To investigate the change of indications of emergency obstetric hysterectomy and the clinical application of intraoperative interventions. And to provide evidence for prevention of hysterectomy and improvement of obstetric quality. Methods Clinical data were collected from 97 patients who received emergency obstetric hysterectomy at Shengjing Hospital of China Medical University between January 1st, 2004 and December 31st, 2013. The patients were divided into two groups by the time point of January 1st, 2009: the first group was cases treated between January 1st, 2004 and December 31st, 2008, while the second group was cases treated between January 1st, 2009 and December 31st, 2013. The clinical indicators, surgical indications, intraoperative interventions, and blood loss between the two groups were analyzed retrospectively. Results (1) Incidence:54 857 women delivered at Shengjing Hospital of China Medical University between January 1st, 2004 and December 31st, 2013. Of them, 97 patients received emergency obstetric hysterectomy, with an incidence of 0.177% (97/54 857). (2) The 17 patients delivered vaginally (18%,17/97) and 80 by caesarean section (83%,80/97). Forty-nine patients experienced repregnancy with scar uterus (51%, 49/97). About 41 patients underwent abdominal total hysterectomy (42%,41/97) and 56 received subtotal hysterectomy (58%,56/97). (3) The number of patients were comparable between the two groups (50 vs 47;P>0.05). (4) The main surgical indication was uterine inertia (45%, 44/97). The main causes of uterine inertia were excessive uterine tension (45%, 20/44) and placental abruption due to gestational hypertension (32%, 14/44). Of all the indications, 29 patients in the first group (58%, 29/50) and 15 patients in the second group (32%, 15/47) suffered from postpartum hemorrhage. Pathological placenta embedment occurred in 15 patients in the first group (30%, 15/50) and 25 patients in the second group (53%, 25/47). The incidences of postpartum hemorrhage due to uterine inertia or pathological placenta embedment were significantly different between the two groups (both P0.05). Postpartum hemorrhage was usually treated with uterine packing in the first group, but was preferentially treated with potent uterine contraction agents, arterial ligation, uterine balloon compression or B-Lynch suture in the second group. The therapeutic effects of these new treatments were significantly better than uterine packing (P<0.05). Conclusions The incidence of emergency obstetric hysterectomy did not change significantly in the past decade. However, the indications and intraoperative interventions have changed significantly in the second five years compared with the first five years. The main surgical indications were uterine inertia and postpartum hemorrhage due to pathological placenta embedment. Therefore, strict control of caesarean section indications was important to reduce emergency obstetric hysterectomy.
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Objective To explore the effects of microRNA(miR)-1283 on invasion,proliferation and apoptosis of HTR 8/SVneo cell line derived from human-trophoblast cells.Methods HTR-8/SVneo cells were divided into three groups,as-miR 1283 group was transfected with miR 1283 analogues,anti-miR-1283 group was transfected with miR-1283 inhibitors,and negative control group was transfected with non functional sequence.The levels of miR 1283 expression were detected by fluorescence quantitative polymerase chain reaction at 24 hours after transfection.The cell proliferation was measured by 3-(4,5)-dimethylthiazol-2-yl-(2,5)-diphenyl tetrazolium bromide assay at 24,48 and 72 hours after transfection.Apoptosis was evaluated by propidium iodide staining and flow cytometry at 48 hours after transfection.Transwell experiments were performed to evaluate cellular invasion abilities at 24 hours after transfection.Analysis of variance and Bonferroni method were applied as statistical methods.Results The level of miR 1283 in as miR 1283 group was higher than that in the negative control group with statistically significant difference (14.85±0.57 vs 7.08±0.20,P＜0.01).At 24,48 and 72 hours after transfection,the inhibitory rate of cell proliferation in as-miR-1283 group was (8.04 ± 0.27) ％,(32.47 ± 0.24) ％ and (9.23± 0.17) ％,higher than those in the negative control group [(0.72 ± 0.06) ％,(1.17 ± 0.04) ％ and (0.53 ± 0.05) ％] (P ＜ 0.01,respectively).Cell apoptosis rate was higher in as-miR 1283 group than in negative control group [(16.33 ± 0.40) ％ vs (9.39± 0.58) ％,P＜0.01].The transmembrane cell number was lower in as-miR-1283 group as comparing with the negative control group (7.25 ± 1.83 vs 16.33 ± 2.08,P＜0.01).miR-1283 expression,apoptosis and transmembrane cell number in anti-miR-1283 group had no statistical difference as compared to the negative control group (all P ＞ 0.05).Conclusions Up-regulated levels of miR-1283 could inhibit HTR-8/SVneo cell proliferation and invasion,but promote the cell apoptosis.