[Clinical analysis of 45 cases of vaginal myomectomy].

OBJECTIVE: To evaluate the feasibility, clinical effect and safety of vaginal myomectomy. METHOD: From January 2002 to April 2004, 45 cases treated by vaginal myomectomy were analyzed as the study group, and 45 cases treated by abdominal myomectomy during the same period in our hospital were selected as the control group. Effects of operation and recovery of two groups were compared. RESULTS: There were no significant differences in the mean operating time, blood loss during operation between the study group, (76 +/- 21) minutes, (414 +/- 73) ml and the control group, (72 +/- 26) minutes, (404 +/- 68) ml. In the study group, the mean recovery time of bowel function (18 +/- 9) hours and average postoperative hospital stay (4.8 +/- 0.6) days were shorter than in the control group (31 +/- 8) hours, (7.8 +/- 0.4) days. For two groups menorrhagia were relieved after 6.8 months' follow-up, patients in the study group recovered more rapidly and felt more satisfactory with the effect of operation than patients in the control group. CONCLUSION: Vaginal myomectomy can be performed in selected patients with minimum operative injury, low complications and good short-time effect compared with abdominal myomectomy.

[Level of vitamin K-dependent coagulation factors in premature infants and the influence of maternal antenatal administration of vitamin K1 on their activity].

OBJECTIVE: Infants less than 35 weeks of gestational age are susceptible to peri-/intraventricular hemorrhage (PIVH). This may be due in part to low concentrations of vitamin K-dependent coagulation factors. This study was conducted to determine the umbilical cord blood activities of vitamin K-dependent coagulation factors II, VII, IX and X in premature infants to understand whether preterm infants have absence status of these factors the changes of theses factors' activities in premature infants' umbilical blood after vitamin K(1) was given to mothers antenatally and the preventing effectiveness of PIVH after maternal antenatal supplement of vitamin K(1). METHODS: Pregnant women in preterm labor at less than 35 weeks of gestational age were randomly selected to receive antenatal vitamin K(1) intramuscular or intravenous injections 10 mg per day for 2 to 7 days (vitamin K(1) group), or no vitamin K(1) treatment (control group). Dexamethone was antenatally given to both groups of pregnant women routinely. Vitamin K(1) group had 44 infants and the control group had 133 infants. During the same period, thirty full-term neonates' cord blood samples were obtained to determine theses factors to compare with those from the premature infants. The cranial ultrasound was performed by a same physician to understand whether the neonates were complicated with PIVH and its severity. RESULTS: The levels of vitamin K-dependent coagulation factors in umbilical blood in control group were significantly lower than those in full-term infants' cord blood (P < 0.05). However, in vitamin K(1) group, supplement of vitamin K(1) antenatally could significantly increase activities of factors II, VII and X in preterm infants' cord blood (P < 0.05). The total occurrence rates of PIVH in vitamin K(1) group and control group were 31.8% and 52.6%, respectively, (P = 0.017), and the frequency of severe PIVH in vitamin K(1) group and control group was 2.3% and 12.0%, respectively (P = 0.057). CONCLUSION: Preterm infants have absence status of vitamin K-dependent coagulation factors. Administration of vitamin K(1) to pregnant women at less than 35 weeks of gestational age resulted in significantly improved activities of vitamin K-dependent coagulation factors II, VII, and X, and a significantly decreased frequency of PIVH and less severe hemorrhage in preterm infants.