Popularizing labor analgesia in China.

In China many women in labor are young primigravidas whose fear of labor pain leads them to request cesarean deliveries. While the rate of cesarean deliveries has reached 50% in many hospitals, less than 1% of women in labor are given neuraxial analgesia. The necessary equipment is seldom available in China and many physicians have misconceptions about the risks associated with neuraxial analgesia, which are low with the ultra-low-dosages used today. However, attitudes have begun to change. Meetings held in China have brought together Chinese physicians and world experts on the various epidural and combined spinal-epidural techniques. Thanks to the information and support provided at these meetings clinical trials were carried out, more than 5000 women benefited from labor analgesia, and publications appeared in Chinese journals. An effective, safe, and cost-effective way to provide analgesia to women in labor may slow the increase in cesarean delivery rates across China and improve women's health in general.

[Role of urotensin II gene in the genetic susceptibility to gestational diabetes mellitus in northern Chinese women].

OBJECTIVE: To investigate the relationship between the polymorphism of site rs228648 in urotensin II gene and the genetic susceptibility to gestational diabetes mellitus in northern Chinese women. METHODS: Genotyping was conducted to investigate the polymorphism of site rs228648 (G-A) in urotensin II gene among 70 unrelated gestational diabetes mellitus (GDM) subjects and 70 normal controls. DNA samples isolated from leucocyte of the control and study groups were analyzed for single-nucleotide polymorphisms of the urotensin II gene at positions rs228648 using polymerase chain reaction and restriction analysis. RESULTS: (1) The distribution of genotype frequencies of site rs228648 accorded with Hardy-Weinberg's equation law, being colony representative. (2) The frequency of G allele of site rs228648 was 70.7% in GDM group, significantly higher than that in the control group (57.9%, P < 0.05); and the frequency of A allele of site rs228648 was 29.3% in GDM group, significantly lower than that in the control group (42.1%, P < 0.05). There was no significant difference in the frequency of G/G genotype between GDM group and control group (52.9% vs 41.4%, P > 0.05). (3) Women in control group were more likely to be homozygous for the allele A of site rs228648 than women with GDM. The frequency of A/A genotype of rs228648 was negatively correlated with GDM group. By the logistic procedure, after adjustment by age and gestational weeks, the odds ratio was 0.312, and Wald Confidence Limites were 0.108 to 0.900 (P = 0.031). CONCLUSION: Urotensin II gene may contribute to the genetic susceptibility to gestational diabetes mellitus in northern Chinese population. G allele of site rs228648 is related to GDM possibly, and that homozygosis A of site rs228648 is likely to be an important protecting factor for GDM.