ABSTRACT
Objective To assess the value of one-stage hybrid technique for treatment of pernicious placenta previa. Methods 12 patients with pernicious placenta previa who had received simultaneously Cesarean section and temporary balloon occlusion of abdominal aorta or internal iliac artery in the hybrid operation room were included in this study. 12 patients with pernicious placenta previa who had preserved balloon ducts in internal iliac artery before Cesarean section were chosen as a control group. Balloons were filled to control hemorrhage during the procedure. The hemodynamic parameters including blood pressure and heart rate were monitored during the opera-tion. Surgical duration ,amount of blood loss ,amount of blood transfusion ,volume of infusion ,urine volume during the procedure,postoperative volume of blood loss within 24 hours,uterine hysterectomy rate and neonatal conditions were compared between the two groups. Results During the operation,the blood pressure and heart rate in hybrid group were more stable. The mean surgical duration was(72 ± 8)min,the intraoperative mean amount of blood loss was(620 ± 95)mL,the mean amount of blood transfusion was(550 ± 40)mL,the mean volume of infusion was(1850 ± 160)mL,the mean amount of blood loss in 24 h after the operation was(75 ± 9) mL in the hybrid group,which were significantly lower than those in the control group(P<0.05 for all comparisons). No serious complications occurred in any of the two groups after the operation. There were no significant differences in neonatal conditions between the two groups. Conclusions One-stage hybrid technique has an obvious effect in the control of intraoperative bleeding in patients with pernicious placenta previa. It is worth popularizing in the hospital whose conditions are permitted.
ABSTRACT
Objective:To study the expression and significance of ADMA/NOS/NO/cGMP pathway in the maternal-fetal interface of patients with preeclampsia. Methods: 60 patients were selected and divided into severe preeclampsia group, mild preeclampsia group and gestational hypertensive group according to the disease condition, meanwhile 20 healthy pregnant women of singleton receiving cesarean section were chosen as control group. Levels of NO and cGMP in placenta of the four groups were detected and compared,and activities of total NOS in placenta were measured and compared. The expression of eNOS and iNOS in placental tissue was detected by immunohistochemistry SP method. High-performance liquid chromatography was used to detect the level of ADMA in HUVECs. Results:The levels of NO in placenta of severe and mild preclampsia groups were (7. 6±3. 6) and (11. 4±4. 3) μmol/g, which were statistically significantly lower than that in control group(P<0. 05). The levels of cGMP in placenta of severe and mild pre-clampsia groups were ( 3. 26 ± 0. 31 ) and ( 4. 53 ± 0. 42 ) pmol/g, which were aslo significantly lower than that in control group ( P<0. 05). In the four groups,the level of cGMP in placenta was positively correlated with the level of NO in placenta(r=0. 672). The activities of total NOS in placenta of severe and mild preeclampsia groups were (10. 4±3. 0)and (14. 8±1. 6)U/mg protein,which were statistically significantly lower than that in control group ( P<0. 05 ) . In placenta of the four groups, the activity of total NOS was positively correlated with the level of NO(r=0. 785). The expression of eNOS in placenta of severe and mild preeclampsia groups was statistically significantly lower than that in control group ( P<0. 05 ) , the expression of iNOS in severe preeclampsia group was significantly higher than that in the control group(P<0. 05). The levels of ADMA in HUVECs of severe preeclampsia group,mild pre-eclampsia group and gestational hypertensive group were statistically significantly higher than that in the control group(P<0. 05). The level of ADMA in HUVECs was negatively correlated with the level of NO in placenta of the four groups ( r=-0. 582 ) . Conclusion:ADMA/NOS/NO/cGMP pathway may play an important role in the pathogenesis of preeclampsia.