ABSTRACT
<p><b>BACKGROUND</b>Thin endometrium is associated with poor reproductive outcomes; estrogen treatment can increase endometrial thickness (EMT). The aim of this retrospective cohort study was to investigate the factors influencing the effectiveness of estrogen treatment and reproductive outcomes after the treatment in patients with thin endometrium.</p><p><b>METHODS</b>Relevant clinical data of 101 patients with thin endometrium who had undergone estrogen treatment were collected. Possible factors influencing the effectiveness of treatment were analyzed retrospectively by logistic regression analysis. Eighty-seven infertile women without thin endometrium who had undergone assisted reproduction served as controls. The cases and controls were matched for age, assisted reproduction method, and number of embryos transferred. Reproductive outcomes of study and control groups were compared using Student's t-test and the Chi-square test.</p><p><b>RESULTS</b>At the end of estrogen treatment, EMT was ≥8 mm in 93/101 patients (92.1%). Effectiveness of treatment was significantly associated with maximal pretreatment EMT (P = 0.017) and treatment duration (P = 0.004). The outcomes of assisted reproduction were similar in patients whose treatment was successful in increasing EMT to ≥8 mm and the control group. The rate of clinical pregnancy in patients was associated with the number of good-quality embryos transferred in both fresh (P = 0.005) and frozen-thawed (P = 0.000) embryo transfer cycles.</p><p><b>CONCLUSIONS</b>Thinner EMT before estrogen treatment requires longer treatment duration and predicts poorer treatment outcomes. The effectiveness of treatment depends on the duration of estrogen administration. Assisted reproductive outcomes of patients whose treatment is successful (i.e., achieves an EMT ≥8 mm) are similar to those of controls. The quality of embryos transferred is an important predictor of assisted reproductive outcomes in patients treated successfully with exogenous estrogen.</p>
Subject(s)
Female , Humans , Male , Pregnancy , Endometrium , Estrogens , Therapeutic Uses , Infertility, Female , Drug Therapy , Therapeutics , Pregnancy Rate , Retrospective StudiesABSTRACT
OBJECTIVE To explore the risk factors of gas gangrene after open trauma for its early diagnosis and precaution.METHODS The data of 42 patients with gas gangrene after open trauma from Aug 2003 to Aug 2008,were collected.The risk factors of gas gangrene after open trauma had been retrospectively analyzed from the cause of the injuries,the distribution of latent period,wound,systemic symptoms,laboratory examination and treatment.RESULTS Gas gangrene after injury was related with open wounds for various reasons.Latent period of gas gangrene was 24-72 h.Early risk factors of gas gangrene among them mainly included degloved or avulsed skin-injury(100%),musce trauma(100.00%),contaminated wound and retained foreign bodies(95.24%),weak pulse of peripheral artery(95.24%),nervous injury(90.48%),and lower temperature of skin aound the wound(83.33%).There were obviously systemic symptoms in infective stage but in early stage were not.CONCLUSIONS Gas gangrene is extremely rare in injury patients but it is life-threatening.So more attention should be paid to the risk factors in order to decrease the incidence of gas gangrene after trauma.Improving the prognosis of patients;the wounded locations should be effectively treated early so as to improve the prognosis.
ABSTRACT
<p><b>OBJECTIVE</b>To investigate the compliance of standard antenatal care (ANC) model with 12-13 visits currently used in Beijing region, and to assess the efficacy of this model in reducing adverse maternal and perinatal complication.</p><p><b>METHODS</b>The clinical data of 544 women who delivered at Peking Union Medical College Hospital (West Section) from January 1, 1999 to December 31, 2002 were retrospectively reviewed and analyzed. Three areas were addressed in this paper: compliance of pregnant women with standard ANC model; association of maternal and perinatal complication with different number of ANC visits; effectiveness of screening for risk factors at the first ANC visit.</p><p><b>RESULTS</b>A median of 8 ANC visits was made in 544 cases, of whom 22 cases (4.0%) never had ANC visit before delivery. The women were divided into three groups according to the status of residence and education levels: temporary residents in Beijing city (group A), permanent residents with middle or low education level (group B), and permanent residents with high education level (group C). The average number of ANC visits in group A was 4.55 +/- 3.1, which was much lower than in group B (8.71 +/- 2.2) and in group C (9.56 +/- 2.1) (P < 0.001). The mean duration of gestation at the first ANC visit in group A was (25.44 +/- 8.8) weeks much longer than (15.58 +/- 5.8) weeks in group B and (14.24 +/- 3.2) weeks in group C (P < 0.001). Among 544 cases, 93 (17.1%) had ANC visit for 0-3 times, 299 (55.0%) for 4-9 times and 152 (27.9%) for > or = 10 times. There was no statistical difference among varied number of ANC visits when the results were pooled for pregnancy induced hypertension, gestational diabetes mellitus, vaginal bleeding at the second and third trimesters, postpartum hemorrhage, fetal macrosomia, premature rupture of membrane, and fetal distress (P > 0.05). An increase in the number of ANC visits was associated with the decreased rates of fetal growth restriction (P < 0.05) and premature delivery (P < 0.05), whereas it was paralleled with increased rates of anemia and cesarean section (P < 0.001). It was found that 35.6% of women who developed maternal and perinatal complications would be identified through screening for risk factors at the first ANC visit.</p><p><b>CONCLUSIONS</b>Standard ANC model is currently not well complied. It has limited efficacy in reducing most maternal and perinatal complications. A more practical and effective ANC model for low educated women and temporary residents needs to be explored.</p>