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Objective To explore the feasibility and safety of vaginal delivery with scarred uterus after cesarean section.Methods Sixty two parturients after cesarean section undergoing trial vaginal delivery in our department from October 2016 to October 2017 were enrolled in study (study group);60 primiparous women admitted at the same period were taken as the control group.The successful rate of vaginal delivery,the duration of labor and the incidence of postpartum complications were analyzed.The postpartum depression was assessed with Edinburgh Postpartum Depression Scale 6 weeks after delivery and compared between two groups.Results The vaginal delivery was successful in 49 parturients of each group with a successful rate of 79.0％ (49/62) and 81.7％ (49/60) respectively (x2=0.13,P=0.71).The first and the second stages of labor in the study group were (364± 105)min and (54±31)min,respectively,which were shorter than those of the control group [(388±93)min and (63± 18)min,t=2.325,P=0.03;t=2.145,P=0.04].The incidence rates of postpartum hemorrhage,infection and urinary retention were 3.2％ (2/62) and 1.7％ (1/60),1.6％ (1/62) and 1.7％ (1/60),4.8％ (3/62) and 3.3％ (2/60) in study group and control group,respectively (x2=0.309,0.001 and 0.176,P＞0.05).The Apgar scores of the newborns in two groups were 8.7± 2.1 and 8.5± 1.8 (t=1.415,P=0.14) and the postpartum depression scores of the mothers were 13.7±4.3 and 12.4±3.2 (t=1.203,P=0.33),respectively.Conclusion Vaginal delivery can be chosen in parturients with scarred uterus after cesarean section,if preparations are adequate,indications of vaginal delivery are sufficient and the course of labor is closely monitored.
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Objective To study the feasibility and safety of measles vaccination in women of childbearing age and to understand the influence of measles vaccination on the fetal transmission measles antibody level of the infants.Methods From January 1,2012 to December 31,2012,600 women of childbearing age were included in this study.The measles IgG antibody was detected,then all participants were randomized according to the IgG level.The measles IgG antibody of participants in non-vaccinated group was detected predelivery in hospital by enzyme linked-immunosorbent assay (ELISA).That of participants in vaccinated group was detected 3 months after vaccination with measles mumps rubella combined vaccine and predelivery by ELISA.And measles nuclear protein fragment gene (measles virus nucleoprotein,MVN) in the blood was detected by reverse transcription polymerase chain reaction (RT PCR).A total of 368 participants gave birth within 2 years after vaccination,and 357 infants 8 months after birth were healthy.In non-vaccinated group,8 infants were diagnosed with measles within 8 months after birth.Finally,349 8-month infants were enrolled in the study,including 52 whose mothers in high antibody without vaccination group,65 whose mothers in high antibody with vaccination group,110 whose mothers in low antibody without vaccination group and 122 whose mothers in low antibody with vaccination group.The measles IgG antibody levels in the blood of all the 8-month infants were detected.Data were analyzed using t test,one-way ANOVA (Newman-Keuls was used for comparison between groups) and Pearson analysis.Results The measles IgG antibody level of expectant women in high antibody without vaccination group was significantly lower compared to that in high antibody with vaccination group ([268.5±74.9] IU/mL vs [578.3t208.1] IU/mL,Q=15.57,P＜0.01).That in low antibody without vaccination group was also significantly lower than low antibody with vaccination group ([169.4+42.3] IU/mL vs [584.7+195.8] IU/mL,Q=29.54,P＜0.01).The results of MVN RT-PCR after 3 months of vaccination showed no positive bands in all blood samples.Two of the expectant women in high antibody without vaccination group and one in low antibody without vaccination group were positive for MVN bands.Among 8-month infants,the levels of antibody in high antibody without vaccination group and high antibody with vaccination group were (106.3 ± 36.8) IU/mL and (291.8±86.5) IU/mL,respectively,which was statistically different (t=23.33,P＜0.01).Those in low antibody without vaccination group and low antibody with vaccination group were (87.1 ± 26.4) IU/mL and (274.0±72.5) IU/mL,respectively,which was statistically different (t =33.27,P＜0.01).The measles antibody level of expectant women was positively correlated with their 8-month infants (r=0.652,P＜0.01).All 8 infants who were diagnosed with measles were delivered by women without vaccination,and the measles infection rate of infants was significantly different between women with and without vaccination (P=0.002).Condusion It is feasible for women of childbearing age to receive measles vaccination,which can increase the measles IgG antibody level of both expectant women and their infants.
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Objective To evaluate the effect of pelvic floor muscle training in postpartum urinary incontinence. Methods A total of 355 postpartum women 6 weeks after delivery were randomly allocated to training group ( 182 cases) and control group ( 173 cases). The training group attended in one to one pelvic floor muscle training conduction. The control group received the customary information. The two groups finished the questionaire 6 months after delivery to understand the general state of health, duration of pregnancy, urinary tract symptom and urinary incontinence 6 weeks,6 months after delivery. Results Ten cases failed, 4 cases lost in the training group and 6 cases lost in the control group. Significantly fewer women in the training group were reported stress urinary incontinence compared with the control group 6 months after delivery [11.3%(19/168) vs. 21.0%(35/167)](P＜0.01). Significantly fewer frequency of nocturia in the training group was reported compared with the control group 6 months after delivery [(1.3 ± 0.3) times vs.(2.2 ± 0.4) times ] (P ＜ 0.01 ). Conclusion Pelvic floor muscle training plays a positive role in postpartum urinary incontinence.
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Objective To study the change of early carotid elasticity in perimenopausal women treated by hormone replacement therapy using e-tracking technique. Methods A total of 82 perimenopausal women with lower level of estradiol were randomly divided into two groups:41 cases in the treatment group and 41cases in the control group. Postmenopausal women in the treatment group were treated with Climnen. Before and 6 months after estrogen therapy,e-tracking technique was used to evaluate the carotid elastic modulus,such as the stiffness parameters (β), pressure-strain elastic modulus ( Ep), arterial compliances (AC), pulse wave conducting velocity (PWVβ) and augment index(AI). Results Compared with the normal group,datas of Ep,β,PWVβ and AI were significantly lower in treated group, while AC was obviously higher ( P ＜0.01). Conclusions E-tracking technique is a quick, simple and high accurate evaluating method for the change of carotid elasticity in perimenopausal women.