Objective To explore the clinical characteristics and management of ovarian tumor complicated by pregnancy and its influence on the pregnancy outcome, so as to provide diagnostic and therapeutic experiences. Methods A total of 248 cases were surgically and pathologically diagnosed as ovarian tumor complicated by pregnancy in The 202 Military Hospital from January, 2003 to December, 2009, and their clinical data were analyzed retrospectively. Results The incidence rate of ovarian tumor complicated by pregnancy was 0.49%. Among total 248 cases, 131 (52.82%) were benign tumors, of which 22.18% were ovarian mature teratomas; 113 (45.57%) were tumourlike lesions, of which most were ovarian chocolatecyst and lutealcyst, and 4 (1.61%) were malignant tumors. There were 212 cases treated by tumorectomy or salpingo-oophorectomy, and 3 of 4 cases with malignant tumors took postoperative chemotherapy. A total of 192 cases were diagnosed by regular antenatal care and ultrasound examination, accounting for 77.42% of the total sample size found during pregnancy. Among 14 cases receiving emergency operations, 9 were complicated by torsion, and the other 5 were by rupture. There were 67 cases receiving operation from the 14th to 18th gestational week, and 57 cases had full-time pregnancy. Conclusion Ultrasonography and pelvioscopy are of principal importance in the diagnosis and detection of ovarian tumor complicated by pregnancy which should be treated by tumorectomy, and suitable surgery intervention during second trimester is safe.
Objective To explore the maternal and neonatal outcomes of different types of severe preeclampsia premature birth. Methods The pregnant outcomes of 142 patients with severe preeclampsia premature birth (the study group) were compared with 311 patients with spontaneous premature birth (the control group). Singleton pregnancy was divided into three stages by gestational age: very early premature birth (28-31+6 weeks), moderate premature birth (34-36+6 weeks) and mild premature birth (32-33+6 weeks). Multiple-pregnancy was divided into two stages: lt;34 weeks of gestation group and ≥34 weeks of gestation group. Results he rates of antenatal care and the average birth weight of trial group were much lower than those of control group. he rates of cesarean delivery and complications of trial group were much higher than those of control group. he total neonatal mortality and neonatal intensive care unit (NICU) hospitalization rate of singleton pregnancy in trial group was much higher than that of control group (Plt;0.05). In very early premature birth, neonatal outcomes were particularly bad, but there was no diference between trial group and control group. In moderate premature birth and mild premature birth, the incidences of neonatal pneumonia and the aspiration syndrome of trial group were higher than those of control group, and the duration of NICU hospitalization was longer in trial group than in control group. he incidences of heart failure and postpartum hemorrhage in twin pregnancy combined with severe preeclampsia were particularly high. Conclusion Severe preeclampsia signiicantly afects fetal growth and perinatal outcomes; the average birth weight in each trial group of singleton pregnancy is much lower than that of control group. In moderate premature birth and mild premature birth, the neonatal adverse outcomes of trial group are much higher than those of control group. he total neonatal mortality and NICU hospitalization rate of singleton pregnancy in trial group is much higher than that of control group. In very early premature birth, morbidity and mortality of the newborn is closely related to gestational age. Women of multiple-pregnancy complicated with severe preeclampsia require more concerns about health care in order to prevent heart failure and postpartum hemorrhage.
ObjectiveTo explore the influence of treatment against syphilis on pregnancy outcome and neonatal prognosis. MethodsThe data of 5224 cases of pregnant women from January to December 2013 were analyzed. All the pregnant women were screened by toluidine red unheated serum test (TRUST) method. Then, T.pallidum passive partideag glutining assay (TPPA) was used to confirm those positive cases from TRUST. At last, 128 cases of syphilis in those pregnant women were confirmed. According to whether the pregnant women accepted antenatal examination and treatment, they were divided into treatment group and non-treatment group. The pregnancy outcome and neonatal prognosis of these two groups of women were then compared and analyzed. ResultsThe pregnancy outcome of these two groups had comparatively big difference, but without significant difference (χ2=3.34, P>0.05). The neonatal prognosis of the two groups was significantly different (χ2=9.14, P<0.05). Moreover, TPPA showed positive in all newborn infants, and TURST showed 85 positive cases. ConclusionEarly finding and treatment of pregnant women with syphilis by screening before pregnancy or during the early period of pregnancy can reduce abortion, stillbirth, fetal abnormalities, and the incidence of neonatal congenital syphilis.
Objective To systematically review the endometrial receptivity evaluated by transvaginal ultrasound and predict the clinical pregnancy outcome of in vitro fertilization-embryo transfer (IVF-ET). Methods PubMed, The Cochrane Library, EMbase, Web of Science, CNKI, WanFang Data and VIP databases were electronically searched to collect studies on transvaginal ultrasound evaluation of endometrial receptivity to predict the clinical pregnancy outcome of IVF-ET from inception to December 1st, 2021. Two researchers independently screened literature, extracted data and evaluated the risk of bias of the included studies. RevMan 5.4 software and Stata 16.0 software were used to perform meta-analysis. Results A total of 24 cohort studies and 1 case-control study were included. The total sample size was 6 632 cases, including 3 340 in non-pregnancy group and 3 292 in pregnancy group. The results of meta-analysis showed that there was no difference in endometrial volume (MD=−0.11, 95%CI −0.33 to 0.11, P=0.34) or uterine artery S/D (MD= −0.04, 95%CI −0.17 to 0.09, P=0.55) between the two groups. The endometrial thickness measured on human chorionic gonadotrophin (HCG) day in the non-pregnant group (MD=−0.48, 95%CI −0.77 to −0.18, P=0.001) was thinner than that in the pregnant group. On embryo transfer (ET) day, uterine artery pulsatility index (PI) (MD=0.08, 95%CI 0.02 to 0.15, P=0.01) and resistance index (RI) (MD=0.01, 95%CI 0.01 to 0.01, P<0.000 01) were higher than those in the pregnancy group. Conclusion Endometrial volume and uterine artery S/D measured during IVF-ET were not correlated with clinical pregnancy outcome, while endometrial thickness measured on HCG day and uterine artery PI and RI measured on ET day were correlated with clinical pregnancy outcome. Transvaginal ultrasound evaluation of endometrial receptivity has a certain predictive value for clinical pregnancy outcome of IVF-ET. Due to the limited quality and quantity of included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo investigate the clinical characteristics of epileptics with pregnancy and then provide reference for standardized management of epileptics with pregnancy. MethodsFrom June 2012 to June 2021, epileptics with pregnancy who delivered in Jinan Central Hospital were selected as the research subjects. The clinical data such as the application of Antiseizure medications (ASMs) during pregnancy, seizure frequency, pregnancy outcomes, delivery ways, offspring feeding ways and the incidence of complications were investigated and analyzed. ResultsAmong 36 epileptics with pregnancy, 20 cases (55.56%) were treated with ASMs alone, 5 cases (13.88%) were treated with combined medication, and 11 cases (30.56%) were treated without ASMs during pregnancy. 15 cases (41.67%) adhered to systematic application of ASMs, 17 cases (47.22%) did not adhere to systematic application of ASMs, and 4 cases (11.11%) had unknown medication history. The frequency of seizures increased in 5 cases, decreased in 7 cases and unchanged in 24 cases during pregnancy. Pregnancy outcomes: full-term delivery in 33 cases (91.67%), preterm delivery in 1 case (2.78%) and abortion in 2 cases (5.56%). Delivery mode: cesarean section in 31 cases (91.18%), vaginal delivery in 3 cases (8.82%). After delivery, 4 cases (11.76%) were fed with milk powder and 30 cases (88.24%) were breast-fed. Complications: There were 6 cases complicated with anemia (16.67%), 5 cases complicated with gestational hypertension (13.89%), 3 cases complicated with gestational diabetes (8.33%), 4 cases complicated with premature rupture of membranes (11.11%), 2 cases complicated with fetal growth restriction (5.56%), 2 cases complicated with oligohydramnios (5.56%), 3 cases complicated with fetal distress (8.33%) and 3 cases complicated with neonatal asphyxia (8.33%). ConclusionsThe proportion of epileptics with pregnancy who were systematically treated with ASMs was low and the seizures were poorly controlled. There is a lack of standardized management for such patients in clinical practice.