ABSTRACT
Objective To investigate the suitable mode of induced termination of pregnancy at second trimester for women with scarred uterus.Methods A retrospective study was performed in 120 cases of second trimester pregnant women with scarred uterus,who requested termination of pregnancy in Department of Obstetrics,Ruijin Hospital of Shanghai Jiaotong University from January 2010 to July 2016.The indications of termination of pregnancy were fetal anomaly,serious pregnant complication,intrauterine fetal deaths and personal factors.The interval time of previous operation to this pregnancy were recorded.It was ＜ 2 years in 35 cases and ≥2 years in 85 cases.The patients with normal hepatic function began to take mifepristone combined with ethacridine lactate (group A,62 cases).The method of mifepristone combined with misoprostol was used in the patients who failed to amniotomy to inject ethacridine lactatebecause of oligohydramnios or small gestational age (group B,58 cases).The detail information of every patient was recorded,including age,gestational weeks,gravidity,parity,the mode of previous operation,previous operation time and indication,the mode of induced labor inthis pregnancy,the interval time from administration to uterine contraction,delivery or not and the interval time from induction to delivery,postpartum hemorrhage,the successful rate of induce labor,and placental retention ratio.Results (1) It had no significant difference between groups A and B in age,gravidity,parity and the interval time of previous operation to this pregnancy (P ＞ 0.05).There was significant difference between two groups in gestational weeks of induction (P ＜0.01).(2) It had no significant difference between two groups in successful rate of induction and postpartum hemorrhage (P ＞ 0.05),but the time from induction to regular uterine contractionand delivery in group B was significant shorter than that of group A (P ＜ 0.01).The rate of delivery with 24 hours in group B was 89.66％.It was significant higher than that of group A (22.58％,P ＜0.01).(3) The rate of retained placenta in group A (19.23％,10/52) was significant lower than group B (4g.7g％,20/41),but the ratio of residual of placenta and membranes in group A (75％,39/52) was significant higher than that of group B (48.78％,20/41).It was no significant difference between the over 2 years group and the less 2 years group in the incidence rate of complications including placental retention,residual of placenta and membranes and postpartum hemorrhage.It had no significant difference between two groups in incidence of severe pain (P ＞ 0.05).Conclusions Both of methods of mifepristone combined with misoprostol and the mifepristone combined with ethacridine lactate are feasible to induce second trimester termination of pregnancy for women with scarred uterus.
ABSTRACT
Objective To explore the efficacy of biomimetic physiotherapy in preventing adhesions and promote endometrial repair and growth after Transcervical resection of adhesions ( TCRA) . Methods A prospective case-control study method, from January 2016 to May 2017 in Hunan Maternal and Child Health Hospital underwent TCRA in 92 patients were randomly divided into study (45 cases) and control (47 cases) groups. The patients in the study group were treated with biomimetic therapy after TCRA, and were treated with artificial cycles. Three menstrual cycles were treated continuously. The control group was treated with hormone artificial cycle. The menstrual recovery, ovulation endometrium thickness, uterine ar-tery blood flow resistance index ( RI) and second-look hysteroscopy were observed and compared between two groups before and after 1 course of treatment. Results After 1 course of treatment, the efficiency of the study group was significantly better than that of the control group (P<0. 05), and the cure rate of the study group was significantly higher than that of the control group ( P<0. 05 ) . The endometrial thickness of the study group were increased significantly after ovulation (P<0. 05). The uterine artery blood flow resistance was decreased significantly after treatment in the study group (P<0. 05). Conclusions Bionic physiother-apy can improve pelvic circulation, promote endometrial growth, and prevent the formation of adhesions after TCRA to a certain extent.
ABSTRACT
Objective To remind the attention to contraceptive in cesarean section group by analyzing the treatment of 104 cases cesarean scar pregnancy (CSP).Methods From April 2009 to November 2012,104 patients with CSP treated in Department of Obstetrics and Gynecology,Wuhan Union Hospital were studied retrospectively.The incidence,treatment,and average in hospital days and average cost of hospitalization were analyzed.Results From 2009 to 2012,the number of CSP was 10,19,29,and 46 cases annually which accounted for the proportion of the corresponding period of gynecological patients were 0.33％,0.63％,0.97％,and 1.53％.Bilateral uterine artery embolization plus curettage was the most effective treatment.The average transfusion rate was 25％.The average amount of in-hospital days were (14 ± 8) days,the average cost of hospitalization were (12954.97 ± 3888.89) yuan.Conclusions The CSP incidence was increasing sharply in China.Although the current treatment methods could greatly reduce complications of CSP,it did harm to the patients and their family.The key to reduce the occurrence of CSP included reducing the rate of cesarean section,and strengthening contraceptive education after cesarean section.