ABSTRACT
OBJECTIVES: To assess the effectiveness, safety, and acceptability of postplacental insertion of GyneFix postpartum intrauterine device (PPIUD) in women undergoing cesarean section (C-section). STUDY DESIGN: We conducted a prospective cohort study at 14 hospitals in four eastern coastal provinces of China between September 2017 and November 2020. A total of 470 women who underwent C-section and consented to the postplacental insertion of GyneFix PPIUD were enrolled, and 400 completed the 12-month follow-up. Participants were interviewed in the wards after delivery and followed up at 42 days, and months 3, 6, and 12 after delivery. We used Pearl Index (PI) to measure the rate of contraceptive failure, life-table method to measure the rate of PPIUD discontinuation, including IUD expulsion, and Cox regression model to explore the risk factors associated with discontinuation of the device. RESULTS: Nine pregnancies were detected during the first year after GyneFix PPIUD insertion: seven were due to device expulsion and two occurred with PPIUD in situ. The PIs for overall 1-year pregnancy rate and pregnancies with IUD in situ were 2.3 (95% CI: 1.1-4.4) and 0.5 (95% CI: 0.1-1.9), respectively. The 6- and 12-month cumulative expulsion rates for PPIUD expulsion were 6.3% and 7.6%, respectively. The overall 1-year continuation rate was 86.6% (95% CI: 83.3-89.8). We did not identify any patient with insertion failure, uterine perforation, pelvic infection, or excess bleeding due to GyneFix PPIUD insertion. Women's age, education, occupation, previous history of C-section, parity, and breastfeeding were not associated with removal of GyneFix PPIUD in the first year of use. CONCLUSIONS: Postplacental insertion of GyneFix PPIUD is effective, safe, and acceptable for women undergoing C-section. Expulsion is the most common reason for GyneFix PPIUD discontinuation and pregnancy. The expulsion rate for GyneFix PPIUD is lower than that for framed IUDs, but more evidence is needed for a firm verdict.
Subject(s)
Intrauterine Devices, Copper , Intrauterine Devices , Pregnancy , Female , Humans , Cesarean Section , Prospective Studies , Postpartum Period , Intrauterine Device Expulsion , Parity , China , Intrauterine Devices, Copper/adverse effectsABSTRACT
OBJECTIVE: To evaluate the value of fasting plasma glucose (FPG) value in the first prenatal visit to diagnose gestational diabetes mellitus (GDM). RESEARCH DESIGN AND METHODS: Medical records of 17,186 pregnant women attending prenatal clinics in 13 hospitals in China, including the Peking University First Hospital (PUFH), were examined. Patients with pre-GDM were excluded; data for FPG at the first prenatal visit and one-step GDM screening with 75-g oral glucose tolerance test (OGTT) performed between 24 and 28 weeks of gestation were collected and analyzed. RESULTS: The median ± SD FPG value was 4.58 ± 0.437. FPG decreased with increasing gestational age. FPG level at the first prenatal visit was strongly correlated with GDM diagnosed at 24-28 gestational weeks (χ(2) = 959.3, P < 0.001). The incidences of GDM were 37.0, 52.7, and 66.2%, respectively, for women with FPG at the first prenatal visit between 5.10 and 5.59, 5.60 and 6.09, and 6.10-6.99 mmol/L. The data of PUFH were not statistically different from other hospitals. CONCLUSIONS: Pregnant women (6.10 ≤ FPG < 7.00 mmol/L) should be considered and treated as GDM to improve outcomes; for women with FPG between 5.10 and 6.09 mmol/L, nutrition and exercise advice should be provided. An OGTT should be performed at 24-28 weeks to confirm or rule out GDM. Based on our data, we cannot support an FPG value ≥5.10 mmol/L at the first prenatal visit as the criterion for diagnosis of GDM.
Subject(s)
Blood Glucose/metabolism , Diabetes, Gestational/diagnosis , Fasting/blood , China , Female , Gestational Age , Humans , Pregnancy , Prenatal CareABSTRACT
The molecular cation CO+ is a very important transient molecular radical, and the spectra of the ion has been investigated by numerous researchers. Optical-heterodyne-magnetic-rotation-enhanced velocity modulation spectroscopy(OH-MR-VMS) was employed to measure the comet-tail system (A2 pi(i)-X2 sigma+) of 12C16O+ molecular ion. The vibrational rotation absorption spectra wereobserved in the near-infrared region, including three bands of (0, 3), (1, 4) and (3, 6). A set of precise molecular constants for the A2 pi(i) (v' = 0, 1, 3) were determined using the least-squares fit. This experiment has further proved that OH-MR-VMS is very valuable in measuring absorption spectra of molecular ions.
