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Objective:To explore the application value of uterine artery blood flow ultrasound parameters in evaluating the prognosis of threatened abortion during early pregnancy.Methods:In this non-randomized controlled prospective clinical study, 108 women with threatened abortion during early pregnancy (6-12 weeks of pregnancy) who received treatment in the Health Community Group of Yuhuan Second People's Hospital from July 2021 to December 2022 were included in the observation group. An additional 108 healthy women who were at the early stage of pregnancy were selected for the control group. Color Doppler ultrasound was performed in both groups to measure the ultrasonic parameters of uterine artery blood flow (peak systolic/end diastolic flow velocity, resistance index, pulsatility index) and compare their differences. The pregnant women in the observation group were followed up until 28 weeks of gestation, and their prognosis was analyzed. The pregnant women who had successfully insured their babies were included in the good prognosis group, and the pregnant women who had aborted their babies were included in the poor prognosis group. The ultrasonic parameters of uterine artery blood flow in the two groups were compared. Logistic regression analysis was used to analyze the correlation between ultrasound parameters of uterine artery blood flow and poor prognosis.Results:In the observation group, the systolic peak/end diastolic flow velocity, resistance index, and pulsatility index on the left side were (6.46 ± 1.71), (0.97 ± 0.30), (2.72 ± 0.89), respectively, and they were (6.49 ± 1.70), (0.96 ± 0.32), (2.70 ± 0.91) respectively on the right side, which were significantly greater than (3.90 ± 1.02), (0.64 ± 0.17), (1.36 ± 0.54), (3.91 ± 1.04), (0.62 ± 0.18), (1.35 ± 0.52) in the control group ( t = 13.36, 9.95, 13.58, 13.45, 9.62, 13.39, all P < 0.001). Twenty-eight-week follow-up results showed that 72 women (66.67%) in the observation group had successfully insured their babies and 36 women (33.33%) had aborted their babies. In the good prognosis group, the systolic peak/end diastolic flow velocity, resistance index, and pulsatile index were (7.95 ± 1.89), (1.22 ± 0.36), (3.06 ± 0.95) on the left side, and they were (7.45 ± 1.94), (1.24 ± 0.37), and (3.03 ± 0.96) on the right side, which were significantly greater than (4.72 ± 1.27), (0.77 ± 0.24), (1.74 ± 0.69), (4.74 ± 1.32), (0.75 ± 0.25), (1.77 ± 0.70) in the poor prognosis group ( t = 10.53, 7.73, 8.23, 8.55, 8.14, 7.76, all P < 0.001). Logistic regression analysis showed that peak systolic/end diastolic flow velocity and resistance index were risk factors for poor prognosis of threatened abortion during early pregnancy, while the pulsatility index had no significant correlation with poor prognosis of threatened abortion during early pregnancy. Conclusion:Uterine artery blood flow ultrasound parameters have a certain predictive value for the prognosis evaluation of threatened abortion during early pregnancy, which can provide an important reference for clinical fetal protection treatment and benefit the prognosis of pregnant women.
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Objective:To investigate the effects of human placenta tablets combined with active folic acid and compound nutrient tablets on Th1 cytokines and hormone levels in pregnant patients with threatened miscarriage.Methods:A total of 226 pregnant patients with threatened miscarriage who received treatment in Linyi Traditional Chinese Medicine Hospital from April to September 2021 were included in this study. They were randomly divided into a control group and an observation group, with 113 patients in each group. The control group was treated with human placenta tablets. The observation group was treated with human placenta tablets combined with active folic acid and compound nutrient tablets. All patients were treated for 4 weeks. Before and after treatment, serum levels of Th1 cytokines, β-human chorionic gonadotropin, progesterone, and estradiol as well as the rate of success of protection against miscarriage, adverse reactions, and perinatal complications were compared between the two groups.Results:After 4 weeks of treatment, serum levels of interleukin-2, tumor necrosis factor-α, and interferon-γ in the observation group were significantly lower than those in the control group ( t = 27.53, 20.99, 31.69, all P < 0.001). Serum levels of β-human chorionic gonadotropin, progesterone, and estradiol in the observation group were (143.79 ± 9.56) IU/L, (36.43 ± 4.71) ng/L, (234.72 ± 13.29) pmol/L, which were significantly higher than (122.53 ± 7.47) IU/L, (29.32 ± 4.22) ) ng/L, (167.86 ± 8.93) pmol/L in the control group ( t = 18.63, 11.95, 44.39, all P < 0.001). The rate of success of protection against miscarriage in the observation group was significantly higher than that in the control group (92.9% vs. 76.1%, χ2 = 12.20, P < 0.05). There were no significant differences in the incidences of adverse reactions and perinatal compilations between the two groups (both P > 0.05). Conclusion:Human placenta tablets combined with active folic acid and compound nutrient tablets can improve serum levels of Th1 cytokines and hormones, and increase the rate of success of protection against miscarriage, without increasing the incidences of adverse reactions and perinatal complications.
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Objective To explore the effect of ritodrine hydrochloride combined with magnesium sulfate in gestational diabetes mellitus pregnant women with threatened premature labor.Methods 74 gestational diabetes mellitus pregnant women with threatened premature labor were selected as the research subjects.According to the digital table,they were randomly divided into observation group and control group,37 cases in each group.The control group was treated with magnesium sulfate,the observation group was treated with ritodrine hydrochloride combined with magnesium sulfate.During treatment and after drug withdrawal 3 days,the fasting blood glucose levels and postprandial 2h blood glucose levels during pregnancy,prolonged time,complications and neonatal conditions in the two groups were recorded.Results The total effective rate of the observation group was 97.30％,which was significantly higher than 83.78％ of the control group,the difference was statistically significant between the two groups(u =2.336,P =0.019).The fasting blood glucose and 2h postprandial blood glucose levels were higher than before treatment in the two groups,but there were no statistically significant differences between the two groups (t =1.904,P =0.060;t =1.698,P =0.093).After stopping the drug,the fasting blood glucose and 2h postprandial blood glucose of the two groups were reduced to the pre-treatment levels,but there were no statistically significant differences between the two groups (t =0.953,P =0.343;t =0.749,P =0.456).The average gestation duration prolonged time of the observation group was (22.59 ± 2.84)d,which was significantly longer than that of the control group(t =11.737,P =0.000).The neonatal birth weight and Apgar score of the observation group were significantly higher than those of the control group (t =12.746,P =0.000;t =10.159,P =0.000).The neonatal survival rate of the observation group was 97.30％,which of the control group was 93.78％,the difference was statistically significant between the two groups (x2 =3.944,P =0.047).Conclusion Ritodrine hydrochloride combined with magnesium sulfate in the treatment of gestational diabetes mellitus pregnant women with threatened premature labor has good results,and can prolong pregnancy,and has less complications.
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Objective To evaluate the curative effect of dydrogesterone and luteosterone in the treatment of threatened abortion.Methods PubMed,Chinese CNKI,Wanfang database were searched by computer.The randomized controlled trials (RCT) of dydrogesterone and luteosterone in the treatment of threatened abortion(RCT) were collected.Retrieval time was January 2011-March 2016.According to the inclusion and exclusion criteria,the two reviewers independently screened the literature,extracted data and evaluated the quality of themethod,the Rev Man 5.3 software was used for Meta analysis.Results In the final 8 RCT,a total of 1 438 patients were selected.Meta analysis showed:676 cases of 719 patients had clinically effective in the dydrogesterone group,and 605 cases of 719 patients had clinically effective in the luteosterone group(OR =2.94,95％ CI =2.04 ～ 4.24).The clinical effect of the dydrogesterone group was significantly higher than that of the luteosterone group(P ＜ 0.01).The funnel plot was basically symmetrical,and the publication bias was small.The occurrence incidence rate of adverse reactions of the dydrogesterone group was lower than that of the luteosterone group (OR =0.57,95％ CI =0.36 ～ 0.89,P =0.01).The backache relief time of the dydrogesterone group was significantly lower than that of the luteosterone group(MD =-4.96,95％CI =-5.18 ～-4.73,P ＜ 0.01).The relief time of abdominal pain of the dydrogesterone group was significantly lower than that of the luteosterone group (M D =-0.85,95 ％ CI =-1.23 ～-0.46,P ＜ 0.01).The hemostasis time of the dydrogesterone group was significantly lower than that of the luteosterone group (MD =-2.87,95％ CI =-3.52 ～-2.22,P ＜ 0.01).Conclusion Compared with the oral luteosterone,dydrogesterone in the treatment of threatened abortion has higher effective rate,less adverse reactions,and the relief time of backache and abdominal pain,hemostasis time is shorter,so dydrogesterone for threatened abortion is obviously better than luteosterone capsules,and it is worthy of clinical reference.
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Objective To investigate the influence of the genotype distribution of methylenetetrahydrofolate reductase (MTHFR) C677T,A1298C and methionine synthase reductase (MTRR) A66G in threatened abortion of Chinese Han gestationalage women in Sanya city,which involved in the folic acid biosynthetic pathway among.Methods One hundred and thirty-nine samples of case group and the same number of control group were recruited from Sanya region in Hainan Province.Genomic DNA was extracted from the mucosal epithelium of the subjects.The gene polyrnorphisms of MTHFR and MTRR were detected by Fluorescence quantitative PCR technology.The distribution frequencies of both case group and control group.were analyzed and compared,to investigate the effect of the gene polymorphisms on threatened abortion.Results Both the case group and the control group complied with Hardy-Weinberg law.The genotype frequency of MTHFR C677T,MTHFR A1298C and MTRR A66G were not significantly different.Conclusion This study suggests that the gene polymorphism which involved in folic metabolism was not significantly different from the group of threatened abortion and the control group,and whether the metabolism related genes are the risk factors of threatened abortion need to be further discussed.
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ConclusionBushen-Yitalpowder adjuvant to progesterone therapy can improve the clinical outcome in patients with early threatened abortion.
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Objective To investigate the treatment of threatened abortion progesterone maternal serum pro-gesterone -induced blocking factor (PIBF)levels and clinical significance,in order to be able to provide theoretical references of progesterone treatment of threatened abortion.Methods Threatened abortion women (study group)and non -threatened abortion women (control group),50 patients in the observation group given progesterone therapy, enzyme -linked immunosorbent assay (ELISA)was used to detect serum progesterone and PIBF levels of the obser-vation group before treatment and two weeks later,the control group was selected and named after two weeks.Results Observation group after treatment 47 patients progesterone tocolysis successful,success rate was 94.00%,tocolysis bleeding stop time 8.42d,abdominal pain time 11.32d.PIBF of the observation group was (313.52 ±90.43)mmol/L, which was lower than that of the control group (398.47 ±104.25)mmol/L,the difference was statistically significant (t =10.90,P 0.05).Conclusion Reduced PIBF during early pregnancy may be one of the reasons of threatened abortion,the use of progesterone therapy can increase PIBF expression,possibly through this pathway plays a role in tocolysis,so when using progesterone tocolysis monitoring PIBF levels helps evaluate the efficacy of tocolysis.
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Objective To explore the relationship between pregnancy associated plasma protein A (PAPP-A) and threatened abortion,whether low level of PAPP-A in early pregnancy can be used as indicators to predict the pregnancy outcomes.Methods The level of serum PAPP-A was measured by double antibody sandwich enzyme-linked immunosorbent assay in 110 cases with threatened abortion (threatened abortion group) and 131 cases with normal intrauterine pregnancy (control group),and track to 20 weeks pregnant.Results The serum PAPP-A multiple of median (MOM) value was 1.02 ± 0.15 in control group,0.98 ± 0.17 in threatened abortion group,and there was no significant difference(P ＞ 0.05).In threatened abortion group,90 cases of spuc success,the serum PAPP-A MOM value was 1.03 ± 0.11,20 patients of spuc failure,the serum PAPP-A MOM value was 0.73±0.21,and there was significant difference (P ＜ 0.01).There was no significant difference in the serum PAPP-A MOM value between control group and the spuc success of threatened abortion group (P ＞ 0.05).Conclusion Pregnant women with PAPP-A levels embryonic development is closely related to the good,as one can predict miscarriage in pregnant women with threatened abortion outcome evaluation.
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Objective To establish monitoring indicators to predict the pregnancy outcome of threatened abortion. Methods In one hundred and five pregnancy patients, normal pregnancy was 35 cases ( normal pregnancy group), continued pregnancy was 35 cases(continued pregnancy group ), failure abortion was 35 cases (failure abortion group).The levels of cancer antigen 125(CA125),progesterone,estradiol, β -hunan chorionie gonadotrophin( β -hCG) were monitored and compared among three groups. Results The levels of progesterone,estradiol, β-hCG were lower in failure abortion group than those in normal pregnancy group and continued pregnancy group (P＜ 0.05); CA125 in failure abortion group was higher than that in normal pregnancy group and continued pregnancy group (P ＜0.05). The accuracy of combination progesterone,CA125,estradiol and β-hCG was 100.00% (28/28). Conclusion The integrated method which combination monitoring CA125, progesterone, estradiol, β -hCG can improve the prediction accuracy of the early outcome of abortion.
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It is essential to prolong the term as possible in the treatment of threatened premature delivery. We report a case of threatened abortion successfully treated with hochuekkito. The patient was 31 year-old pregnant woman with lower abdominal pain. She was diagnosed to be at the risk of premature delivery on 21 weeks and 5 days of gestation. Intravenous ritodrine hydrochloride was started and she had to stay in bed. Severe side effects of ritodrine hydrochloride such as palpitation, tachycardia, tremor, nausea, and loss of appetite were appeared and she was consulted to our department on 23 weeks and 1 day of gestation. Those symptoms were markedly improved after administration of hochuekkito extract. She delivered a male infant of 1230g birth weight on 28 weeks of gestation. Hochuekkito suppressed severe side effects, and enabled to continue the infusion of ritodrine hydrochloride, suggesting the usefulness of Kampo therapy in the treatment of threatened premature delivery.
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OBJETIVO: Estimar o efeito da malária sobre o curso da gestação em mulheres na região amazônica e investigar possíveis fatores de risco nessa população. MÉTODOS: Este estudo transversal é parte de um projeto maior para estudar malária e gravidez na região amazônica. Foram incluídas gestantes com malária atendidas na Fundação de Medicina Tropical do Amazonas que responderam a entrevistas estruturadas. Dados socio-econômicos, comportamentais e clínicos foram levantados na primeira consulta relacionada a cada novo episódio de malária na gestante. Todas as gestantes foram acompanhadas ao longo de sua gestação. Foram considerados os seguintes fatores de risco para alterações no curso da gestação: idade materna menor do que 20 anos, primeira gestação, primeira infecção malárica e espécie de plasmódio infectante. RESULTADOS: Foram avaliados 535 episódios de malária em 417 gestantes, sendo 20,56 por cento causados pelo P. falciparum, 78,69 por cento pelo P. vivax e 0,75 por cento pela associação dos dois parasitas. Alteração no curso da gestação foi um evento muito frequente (26,2 por cento). Ameaça de aborto ocorreu em 49 casos (25,5 por cento), aborto em dois (1,0 por cento), ameaça de parto prematuro em 74 (25,1 por cento) e parto prematuro em três (1,0 por cento). Ser primigesta e adolescente apresentou associação estatisticamente significativa com ameaça de parto prematuro e abortamento. CONCLUSÃO: A alteração no curso da gestação foi um evento muito frequente durante o episódio agudo de malária, embora a interrupção da gestação tenha tido baixa ocorrência em nossa casuística. Os resultados não evidenciaram um fator de risco de destaque, sugerindo que qualquer gestante pode apresentar ameaça de interrupção ou interrupção da gestação na vigência de episódio agudo de malária.
OBJECTIVE: To estimate the impact of malaria on the course of pregnancy in women from the Amazon region and to investigate possible risk factors in this population. METHODS: This cross-sectional study is part of a larger project to study malaria and pregnancy in the Amazon region. Pregnant women with malaria receiving care at the Amazon Tropical Medicine Foundation (Fundação de Medicina Tropical do Amazonas) who answered a structured interview were included in the study. Socioeconomic, behavioral and clinical data were collected in the first consultation relating to each new malaria attack. All the women were followed-up throughout their pregnancy. The following risk factors for impact of malaria on the course of pregnancy were considered: being younger than 20 years of age, first pregnancy, first malaria infection, and type of infecting plasmodium species. RESULTS: Five hundred and thirty-five malaria episodes were evaluated in 417 pregnant women, with 20.56 percent being caused by P. falciparum, 78.69 percent by P. vivax and 0.75 percent by the association of both parasites. Changes in the course of pregnancy were very frequent (26.2 percent). Threat of abortion was observed in 49 cases (25.5 percent), abortion in two (1.0 percent), threat of premature birth in 74 (25.1 percent), and premature birth in three (1.0 percent). First pregnancy and age < 20 years were significantly associated with threat of premature birth and abortion. CONCLUSION: Changes in the course of pregnancy were very frequent during acute malaria attacks, despite the low frequency of abortion. The present results do not highlight specific risk factors, suggesting that any pregnant woman may be at risk for the threat of abortion or for abortion during acute malaria attacks.
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Adolescent , Adult , Child , Female , Humans , Pregnancy , Young Adult , Malaria/epidemiology , Pregnancy Complications, Parasitic/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Risk Factors , Young AdultABSTRACT
0.05). The levels of progesterone and hCG in the inevitable group were significantly decreased to(36?17) nmol/L and(13 ?3) kU/L, respectively. The differences when compared to the other groups were statistically significant (P0.05). Conclusion LIF may play a role in the maintenance of normal pregnancy. Reduction of LIF expression in chorionic villi may induce the decrease of serum progesterone and hCG levels and, ultimately, cause inevitable abortion.
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[Objective] To observe the therapeutic effect of Shoutai Pill and Shixiao Powder for the treatment of threatened abortion with kidney deficiency and blood stasis. [Methods] Sixty inpatients and outpatients for quieting fetus in gynecology department of the First Affiliated Hospital of Guangzhou University of TCM were equally divided into 3 groups: group A was treated with Shoutai Pill and Shixiao Powder, group B with human chorionic gonadotropin (HCG) and group C with Shoutai Pill, Shixiao Powder and HCG. The effect on quieting fetus was evaluated by observing the disappearance time of symptoms such as vaginal bleeding, abdominal pain, lumbar ache, lower abdominal heaviness and distension. Changes of blood and urine HCG level and type B ultrasonic image were also examined to observe the effect and safety of Chinese medicine. [Results] The effective rate was 95% in group A, 70% in group B and 100% in group C, the difference being significant ( P0.05) . The result of follow-up showed that no terata was found in the three groups. [Conclusion] Chinese medicine with the actions of tonifying kidney and activating blood-stasis can prevent miscarriage and is safe without toxic and side effects.
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Objective To evaluate the effect of ZISHENYUTAIWAN in the treatment of threatened abortion. Methods From March to September 2000, ZISHENYUTAIWAN was used to treat 221 cases of early threatened abortion and 10 cases of late threatened abortion in 8 hospitals in Beijing. Results Effective rate of early threatened abortion is 91.89%. Conclusions ZISHENYUTAIWAN is effective and with less side effect for early threatened abortion.