Objective To investigate the relation of Human Leukocyte Antigen-DRs to Pre-eclampsia/eclampsia （PE/E） by reviewing the observational studies on PE/E. Methods We searched the MEDLINE/PubMed, EMBASE, The Cochrane Library and CBMdisc to July 2005, by combining free text with MeSH words. We assessed the quality of included studies, extracted and analyzed data. Results The odds ratio of fetal-maternal HLA-DR4 antigen frequency in case group versus control group was 2. 60 （95% CI 1.87 to 3.60） with statistical significance. The antigen frequencies of＇other fetal-maternal HLA-DRs in case and control groups were not statistically significant. The antigen frequencies of the couple HLA DRs were not statistically significant between case and control groups. We found that neither the HLA-DR sharing between the couples nor between fetus and mothers in case and control groups were statistically significant. Conclusions The antigen frequencies of HLA-DRs between the couples may have no association with the development of PE/E. The fetal gene types may be related to the development of PE/E. The HLA-DR sharing in mothers and fetus and the couples may have no association with the development of PE/E.
Objective To compare the outcome of uterine exteriorisation repair with in situ in caesarean section. Methods A randomized controlled trial with 220 cases were recruited. Woman with term singleton pregnancy underwent caesarean section and without severe complication were randomly allocated to the two groups (112 cases in exteriorisation group and 108 cases in situ group). Women in treatment group received exteriorisation when the uterus was sutured, While others had the uterus repaired in situ as control. Main outcome measures included perioperative haemodynamic parameters, loss of blood, changes in haemoglobin concentration, duration of operation, postoperative pain score and febrile days, gastrointestinal discomforts and function recovery as well as postoperative maternal morbidity.Data were analyzed by SPSS 11.0. Results Haemoglobin concentration dropped in both groups after caesarean section, and the drops in control group was significantly higher than that of treatment group (t=-2.902, P=0.004). In both groups, pulse before operation was markedly higher than when suturing the uterus and postoperation (Plt;0.05), but no difference was observed between the two groups. Systolic blood pressure of treatment group was lower than that of control group before operation, when suturing the uterus and after operation (F=5.246, P=0.022), but there was no difference among these 3 time points within the group. Onset of flatus was earlier in control group than in treatment group (t=5.567, P=0.000). No difference was identified between the two groups when receiving the different suturing methods. No severe maternal morbidity was observed.Conclusions Uterine exteriorisation and in situ repair have similar effects on intra- and postoperative outcomes. In routine process.