ABSTRACT
ObjectiveTo explore the clinical characteristics and obstetric outcomes of pregnant women who underwent surgery for adnexal torsion at different gestational weeks. MethodsA retrospective study was done on 39 women who underwent surgery for adnexal torsion during pregnancy in the First Affiliated Hospital， Sun Yat-sen University between March 2013 and March 2023， with 18 cases in 1st trimester （<14 weeks）， 11 in 2nd trimester （14-27+6 weeks） and 10 in 3rd trimester （≥28 weeks）. The clinical characteristics， treatment and obstetric outcomes were compared among the three groups. ResultsThe 1st trimester group had higher proportion of assisted reproductive technology （ART） use than the 2nd and 3rd trimester groups （P=0.026）. There was no significant difference in the clinical manifestations， including abdominal pain， nausea， vomiting and fever among the three groups， while elevated white blood cells （WBC） counts was more commonly seen in the 2nd and 3rd trimester groups. Adnexal masses <5 cm in diameter occurred in 0， 18.2%， and 10.0% of cases in 1st， 2nd and 3rd trimester groups respectively （P=0.014）. No statistical significance was found in the location of twisted adnexa， number of circles or pathological nature. The 1st trimester group had a higher sensitivity of ultrasound in the diagnosis of adnexal torsion compared with the 2nd and 3rd trimester groups （77.8%， 36.4%， 20.0%； P=0.008）. More laparoscopic surgery were performed in the 1st trimester group than the other two groups （55.6% ， 27.3%， 0.0%； P=0.008）. There was no significant difference in gestational week of delivery， delivery mode， newborn gender， neonatal birth weight and follow-up of newborns among the three groups. The 3rd trimester group showed a higher risk of preterm delivery （P=0.050）. ConclusionsDuring the 1st trimester of pregnancy， adnexal torsion is more common in patients using ART and ultrasound plays a crucial role in the diagnosis. During the 2nd and 3rd trimester， adnexal torsion should be suspected in patients with abdominal pain and elevated WBC but no aspetic inflammation. Laparoscopic surgery is safe for adnexal torsion during pregnancy and can achieve a favorable maternal and neonatal outcome.
ABSTRACT
【Objective】 To explore the effects of gestational diabetes mellitus (GDM) and mid-pregnancy blood glucose levels on gestational weeks in Northwestern China. 【Methods】 For this prospective cohort study, we recruited the first-trimester pregnant women who underwent obstetrical examinations at Northwest Women’s and Children’s Hospital from July 2018 to July 2019 as the cohort. We investigated their socio-demographic characteristics and risk factors of adverse pregnancy outcomes. Additionally, we collected the OGTT test results of pregnant women in mid-pregnancy and followed up their pregnancy outcomes. The relationship of GDM and blood glucose levels with gestational weeks was analyzed by using the generalized linear model. 【Results】 A total of 2 434 subjects were included in this study. There were 668 pregnant women with GDM, with a ratio of 27.44%. GDM in pregnant women shortened the gestational weeks (β=-0.17, 95% CI: -0.28—-0.05). Fasting blood glucose, OGTT-1 h blood glucose, and OGTT-2 h blood glucose increased by 1 mmol/L; gestational weeks were shortened by 0.17 (95% CI: -0.28—-0.05), 0.05 (95% CI: -0.09—-0.02) and 0.07 (95% CI: -0.12—-0.03). Fasting blood glucose and OGTT-1 h blood glucose abnormalities shortened gestational weeks by 0.18 (95% CI: -0.31—-0.05) and 0.28 (95% CI: -0.47—-0.10) respectively. An increase by 1 mmol/L or abnormality of fasting blood glucose would increase preterm delivery risk by 1.44 (95% CI: 1.01-2.06) and 1.73 times (95% CI: 1.10-2.69), respectively. 【Conclusion】 GDM in pregnant women may shorten their gestational weeks; the abnormal and elevated fasting blood glucose, in particular, would increase the risk of preterm delivery. Therefore, we should carry out active health education to control the blood glucose and other risk factors of GDM patients and promote healthy pregnancy.
ABSTRACT
Objective To explore the relationship between fetal heart size and gestational weeks (GW). Methods The size of left atrium (LA), right atrium (RA), left ventricle (LV), right ventricle (RV), aorta (AO), pulmonary artery (PA), foramen ovale (FO), heart area (HA), thoracic area (TA), heart circumference (HC) and thoracic circumference (TC) were measured for 512 fetal hearts at 14-39 GW. The relationship between GW and the measurement was evaluated. Results The size of fetal heart chambers, AO, PA and ventricular septum (IVS) increased with the development of GW. The PA/AO, LA/RA, LV/RV, HC/TC and HA/TA were stable compared with different GW. Conclusion Fetal heart chambers increase with the development of GW. HA is correlated well with GW.