ABSTRACT
Objective To investigate the influencing factors of neonatal birth body mass in women with abnormal glucose metabolism during pregnancy. Methods A study was conducted on 1157 singleton gravidas, who were diagnosed and treated for abnormal glucose metabolism and delivered in the Department of Obstetrics and Gynecology, First Hospital, Peking University from January 2005 to December 2009, by reviewing the medical records. Based on the pre-pregnant body mass index, the selected cases were divided into 4 groups: low body mass group [ body mass index (BMI) ＜ 18.5 kg/m2, n =53], ideal body mass group ( BMI 18.5 - 23.9 kg/m2, n = 647 ), over body mass group ( BMI 24.0 - 27.9 kg/m2, n = 323 ),and obese group (BMI≥28.0 kg/m2, n = 134). 1157 newborns were divided by birth body mass into 3 groups: normal birth body mass group (body mass 2500 -4000 g, n =987), of which 545 cases of birth body mass 3000 -3500 g for the appropriate newborns, macrosomia group (body mass≥4000 g, n = 112);low birth body mass group (body mass ＜ 2500 g, n = 58 ). The following information was collected,including pre-pregnancy body mass, height, gestational age of diagnosis and body mass gain after diagnosis,maternal serum level of cholesterol, history of adverse pregnancy, and family history of diabetes, gestational age, delivering body mass, neonatal birth body mass. The influence of pre-pregnant BMI, body mass gain during pregnancy, gestational age of diagnosis, body mass gain after diagnosis, maternal serum level of cholesterol, family history of diabetes on the newborns' birth body mass was analyzed. The appropriate ranges of gestational body mass gain were calculated in women with abnormal glucose metabolism. Results ( 1 )The average neonatal birth body mass for each group respectively were (3142 ±333) g for low body mass group, (3339 ±476) g for the ideal body mass group, (3381 ±581) g for over body mass group, and (3368 ± 644) g for obese group. The neonatal birth body mass was increasing with maternal pre-pregnant BMI, and average birth body mass of the newborns in low body mass group was lower than other 3 groups,respectively, the difference was statistically significant ( P ＜ 0.05 ). The difference was not statistically significant ( P ＞ 0.05 ), when it was compared among the obese group, ideal weight group and over body mass group. (2)The body mass gain during pregnancy in women delivered normal birth weight newborn and delivered macrosomia for each group respectively were ( 13.5 ±4.5 ) and ( 17.1±5.4) kg for the ideal body mass group, ( 11.6 ± 4.9 ) and ( 15.3 ± 6.4 ) kg for the over body mass group, ( 10.3 ± 5.0) and ( 14.7 ±7.4) kg for the obese group. The difference was statistically significant in 3 groups (P ＜ 0.05 ). The difference of body mass gain during pregnancy in women delivered normal birth weight newborn and delivered macrosomia for low body mass group could not be compared statistically, because of only 1 case delivered macrosomia. (3)The gestational age of diagnosis in women who delivered normal birth weight newborn and macrosomia for the ideal body mass group respectively were ( 27.8 ± 5.8) and ( 29.8 ± 5.3 ) weeks, the difference was statistically significant ( P ＜0.05 ). The gestational age of diagnosis in gravidas who delivered normal birth weight newborn and macrosomia for the over body mass group respectively were ( 26.7 ± 6.8)and (30.2 ± 4.1 ) weeks, the difference was statistically significant ( P ＜ 0.05 ). The gestational age of diagnosis in women who delivered normal birth weight newborn for obese group was (26.2 ± 7.5 )weeks, less than that of pregnant women who delivered macrosomia [ ( 25.7 ± 9.3 ) weeks ], but the difference was not statistically significant (P ＞ 0.05 ). The difference of the diagnosed gestational age for low body mass group could not be compared statistically, because of only 1 case delivered macrosomia. (4)Tbe serum triglyceride (TG) levels of pregnant women who delivered macrosomia was (3.1 ± 1.5) mmol/L, higher than that of pregnant women who delivered normal birth weight newborn [ (2.7 ± 1.2) mmol/L], and the difference was statistically significant (P ＜ 0.01 ). The serum high density lipoprotein cholesterol (HDL-C) levels of pregnant women who delivered macrosomia was ( 1.4 ± 0.3 ) mmol/L, lower than that of pregnant women who delivered normal birth weight newborn [( 1.7 ±0.9) mmol/L], and the difference was statistically significant (P＜0.01). The serum low-density lipoprotein cholesterol (LDL-C) and cholesterol level of pregnant women who delivered macrosomia respectively was ( 2.8 ± 0.8 ) and ( 5.4 ± 1.1 ) mmol/L, less than those of pregnant women who delivered normal birth weight newborn [ (3.0 ±0.9) mmol/L and (5.6 ±1.1) mmol/L], but the difference was not statistically significant (P ＞0.05). (5)The final regression model of variables into the top three were pre-pregnant BMI, body mass gain during pregnancy and maternal serum level of HDL-C, when analyzing the related factors of affecting neonatal birth body mass with multiple logistic regression analysis such as age, history of adverse pregnancy, family history of diabetes, prepregnancy BMI, body mass gain during pregnancy and after diagnosis of abnormal glucose metabolism,maternal serum level of cholesterol, abnormal glucose metabolism categories, gestational age and other factors ( P ＜ 0.01 ). Conclusion Pre-pregnant BMI, body mass gain during pregnancy and maternal serum level of HDL-C may affect the neonatal birth body mass whose mothers were complicated with abnormal glucose metabolism during pregnancy.
ABSTRACT
Objective To evaluate the effect of cesarean section (CS) and vaginal delivery (VD) on postpartum stress urinary incontinence (SUI) and pelvic floor muscles strength and to find out the correlated obstetric factors and preventions for postpartum SUI. Methods Totally, 788 women, who visited the antenatal clinics, delivered and had the follow-up at 6-8 weeks after delivery in Beijing Obstetrics and Gynecology Hospital in the year of 2008, were enrolled in this study and were divided into 3 groups: CS group (n=212); normal vaginal delivery (NVD) group (n=534) and forceps delivery (FD) group(n=42). Women in the NVD and FD group were merged into one VD group and then divided into SUI and non-SUI group. Information of delivery mode and the correlated obstetric factors were obtained through questionnaires and medical records. Femiscan pelvic floor muscle examine system was applied to measure the pelvic floor muscle strength to understand the relationship between postpartum SUI and pelvic floor muscle strength. Results (1) Incidence of SUI: The overall proportion of women who complained of urinary incontinence (UI) during pregnancy was 15.4% (121/788), and it was 15.9% (85/534), 11.9%(5/ 42) and 14.6% (31/212) in the NVD, FD and CS group, respectively(P>0.05). The overall incidence of postpartum SUI was 17. 1% (135/788), and it was 19.1% (102/534), 26.2% (11/42) and 10.4% (22/212) in the NVD, FD and CS group, respectively, with significant difference between the NVD and FD group, and between the CS and NVD group (all P < 0.01). (2) The associated obstetric factors of postpartum SUI: Among the VD group, 113 women were in the postpartum SUI group and 463 in the non-SUI group. Univariate analysis and logistic multivariate analysis showed that delivery mode, neonatal birth weight and UI during pregnancy were risk factors of postpartum SUI. CS decreased and higher neonatal birth weight and UI during pregnancy increased the risk of postpartum SUI. In the VD group, neonatal birth weight, forceps delivery and UI during pregnancy increased the incidence of postpartum SUI(P<0.01), but no correlation was found with labor analgesia, duration of labor, episiotomy, breast feeding, volume of postpartum bleeding, gestational weeks at delivery, induction and pre-pregnant BMI, etc (all P>0.05).(3) Pelvic floor electromyogram: Pelvic floor muscles strength in the CS group was significantly higher than that of the VD group [activity value: (19. 7±9.9) μv vs (14. 8±8.4) μv; work value: (84. 5±37.2) μv vs (78. 8±28.2) μv; peak value: (25.5±12. 5) μv vs (19. 7±11.8) μv, all P<0.01]. Among women in the VD group, the relaxation value and the ratio of relaxation value over activity value (r/a) in the postpartum SUI group were significantly lower than those in the non-SUI group [relaxation value: (1.7±1.8) μv vs (3.0±3.9) μv; r/a ratio: 0. 2±0. 2 vs 0. 3±0. 5, all P <0.01]. The r/a ratio in the VD group showed no difference compared to that in the CS group (0. 2±3.5 vs 0. 2±0. 2, P>0.05).Conclusion Women experienced vaginal delivery, either NVD or FD, have a higher incidence of postpartum SUI than those delivered through CS. UI during pregnancy, forceps delivery and neonatal birth weight are risk factors of postpartum SUI.
ABSTRACT
Objective To investigate the appropriate range of gestational weight gain in pregnant women with abnormal glucose metabolism.Methods A retrospective study was conducted on 661 term singleton pregnant women with gestational abnormal glucose metabolism,who delivered in the Department of Obstetrics and Gynecology of Peking University First Hospital from Jan.2005 to Dec.2007,by reviewing the medical records.All sujects were divided into 4 groups according to their body mass index (BMI) before pregnancy:group Ⅰ (n=40):BMI<18.5;group Ⅱ (n=400):BMI18.5-23.9;group Ⅲ (n=162):BMI 24.0-27.9;group Ⅳ (n=59):BMI≥28.0.The weight gain among different groups and that between women who delivered normal birth weight infant and maerosomia were analyzed.The weight gain of pregnant women who delivered babies weighing 3000～3500 g in each group was determined as the appropriate weight gain for that group.Results The same results were achieved that the weight gain in pregnant women who delivered macrosomia was significantly higher than those who delivered normal birth weight newborns in each group,ie,the weight gains for women who had macrosomia and normal birth weight infants were (17.0±5.2) kg and (14.1±4.7) kg in group Ⅱ,(16.8±7.3) kg and (11.9±5.1) kg in group Ⅲ and (18.3±6.7) kg and (11.2±5.4) kg in group Ⅳ,respectively (P<0.05).The appropriate ranges of weight gain for each group were (15.6±3.3) kg,(14.0-18.0) kg for group Ⅰ,(13.9±4.6) kg,(11.0-16.5) kg for group ]],(11.5±5.2)kg,(9.0-15.0) kgforgroup Ⅲ,(10.1±2.9) kg,(7.0-12.7) kg forgroup Ⅳ.Conclusions Appropriate weight gain based on prepregnant BMI,together with glucose monitoring in women with gestational abnormal glucose metabolism,is helpful for fetal weight control.
ABSTRACT
Objective: To investigate the clinical efficacy of needling Danzhong(CV 17) in the treatment of postpartum hypogalactia and provide clinical evidence for indications of the point. Methods: A multi-centre single-blind randomized controlled trial was carried out. Two hundred and seventy-six puerperal women with postpartum hypogalactia were randomly allocated into acupuncture group and herb group, and respectively treated for three consecutive days. The degree of mammary fullness, the amount of milk secreted, prolactin, baby weight, the frequency and volume of artificial feeding, the number of infant urination events, and the duration of baby crying were observed. The clinical curative effects on postpartum hypogalactia were compared. Results: Hypogalactia was effectively treated in both acupuncture and herb groups. There were statistically significant differences in degree of mammary fullness, amount of milk secreted, baby weight, the frequency and amount of artificial feeding, and the number of infant urination events between pretreatment and post-treatment, but no difference between the two groups. There was no significant difference in prolactin in the acupuncture group and there was a difference in prolactin in the herb group between pretreatment and posttreatment. Conclusion: Needling Danzhong(CV 17) can effectively promote lactation.
ABSTRACT
Objective To evaluate the different effect of 50 g glucose challenge test (GCT) on screening the glucose intolerance at different gestational age. Methods Two thousand pregnant women were divided into 2 groups(1000 in each). Women in group A received 50 g GCT at 14 and 28 gestational weeks respectively and 75 g oral glucose tolerance test (OGTT) were performed in those cases with abnormal 50 g GCT. 50 g GCT was performed after fasting at 14 gestational weeks and repeated one hour after a meal at 28 gestational weeks. Women in group B were screened by 50 g GCT at 28 gestational weeks and followed by 75 g OGTT for those with abnormal 50 g GCT. The diagnostic effect of 50 g GCT for screening at different weeks of gestation with different ways was evaluated. Results (1)The rate of abnormal result of 50 g GCT was higher in fasting cases than that of cases testing after meal (15.6% vs 12.2%, P
ABSTRACT
0.05). Conclusion Spasfon can effectively improve cervical dilatation during labor and it is well tolerated by both mother and newborn.
ABSTRACT
Objective Severe preeclampsia, and hemolysis, elevated liver enzymes, and low platelet syndrome (HELLP) are serious complications of pregnancy, and evidence suggests a genetic basis for these conditions. A G1528C mutation in the alpha-subunit of the mitochondrial trifunctional protein (MTP) gene has been identified in association with these conditions. The aim of this study is to explore the carrier rate of the G1528C mutation in the MTP gene in pregnant women with severe preeclampsia, HELLP syndrome and in their newborns, as well as in a normal pregnant population, so as to determine its association with maternal liver disease among women in Beijing. Methods A multicenter, prospective, case control study was carried out. Polymerase chain reaction - restriction fragment length polymorphism (PCR-RFLP) was used to screen the G1528C mutations in the MTP gene. One hundred and forty cord blood samples from cases with severe preeclampsia (n=130) and HELLP syndrome (n=10) were collected. Ninety maternal peripheral blood samples among them (84 from severe preeclampsia and 6 from HELLP syndrome) were also collected for screening the common disease-causing mutation in Caucasians. Five hundred and sixty cord blood samples and 90 maternal peripheral blood samples obtained from normal pregnant women served as controls. Results The G1528C mutations in the MTP gene were not found in samples from women with severe preeclampsia and their newborns, from women with HELLP syndrome and their new borns, as well as in samples from the normal pregnant women and their new borns. Conclusions The common disease-causing mutation of G1528C in MTP gene in Caucasians is probably not a common mutation in Chinese Han people in Beijing. Further study is needed to expand the sample size among HELLP syndrome and maternal liver diseases in Chinese population.
ABSTRACT
Objective To observe the effects of phlorohlucinol on cervical dilatation. Methods Totaling 250 normal parturients were randomized into four study groups (50 in each group) and control group (n=50). Phloroglucinol was given in the study groups(group1,2,3 and 4)at the dose of 40 mg to the cervix and/or 160 mg and 200 mg intravenously during the latent phase. The control group (group1) received only atropine (0.5 mg) intravenously. Results The overall speed of cervical dilatation in the study group was (2.82?1.82) cm/h and (1.78?1.01) cm/h in the control group. The mean time of the first stage of labor was (14.23?1.11) h and (17.71?2.23) h in the study and control group, respectively (P
ABSTRACT
Objective To observe the effects of diazepam on the cervix in relieving spasm, eliminating edema and improving dilation during the latent phase of labor. Methods One hundred normal parturients were randomly devided into study group ( n =50) and control group ( n =50). The study group was injected diazepam 10 mg in the cervix during the latent phase. The control group was given 10 mg of diazepam by intravenous injection. Results The dilating speed of cervix in study group was 2.81?1.92 cm/h. The mean time of the first stage of labor was 11.13?1.21 h, while the control group was 1.98?0.92 cm/h and 13.34?0.44 h respectively. The differences between two groups were statistically significant ( P
