Phosphoglucomutase genetic polymorphism and human fertility.

We studied the phosphoglucomutase phenotype in relation to fertility parameters in a consecutive series of 204 women who had delivered a normal live-born child in Rome. A highly significant association was found between age of the women and phosphoglucomutase phenotype, suggesting a reduced rate of reproduction among women of phosphoglucomutase Type 1. Previous spontaneous abortion appears related to both age and phosphoglucomutase enzymatic type. An increased incidence of abortion in women of older ages was observed only in phosphoglucomutase Type 1. Gestational duration and fetal intrauterine growth rate are also significantly associated with maternal phosphoglucomutase phenotype. The pattern is complex, but also in this instance the influence of maternal age was evident. Considered altogether, the data suggest that phosphoglucomutase may have an important role in zygote development and survival through the whole span of intrauterine life.     

Is delayed childbearing changing gene frequencies in Western populations?

Experimental data and clinical observations suggest that delaying childbearing influences the biology of the mother-fetus relationship, with a negative effect on fetal development and predisposition to severe diseases such as type 1 diabetes. We reason that advanced maternal age may influence intrauterine selection, favoring genotypes that are more adapted to the intrauterine environment of less young women. In the present study we have investigated the relationship of maternal age to HP genotype and PGM1-Rh area (chromosome 1) that have been previously found to be associated with fertility and developmental parameters. HP phenotype was determined in 679 consecutive puerperae from the population of central Italy. PGM1 phenotype and Rh C phenotype were determined in 222 puerperae and 200 newborns. The HP 1,1 phenotype decreases and the HP 2,2 phenotype increases with maternal age. The proportion of phenotypes carrying both the Rh C and PGM1*1 alleles is much higher in puerperae older than 36 years than in puerperae of age 22 years. The frequency of the PGM1*1-Rh C haplotype increases and the frequency of the PGM1*2-Rh C haplotype decreases with maternal age. The changes in these genetic systems with advancing maternal age are similar in mothers and newborns. The delay of childbearing age, associated in Western countries with the fertility transition in addition to detrimental effects on intrauterine development and increased susceptibility to severe disorders, could bring about changes in the genetic composition of a population.     

Incidence of Induced Abortion in Uganda, 2013: New Estimates Since 2003

BackgroundIn Uganda, abortion is permitted only when the life of a woman is in danger. This restriction compels the perpetuation of the practice in secrecy and often under unsafe conditions. In 2003, 294,000 induced abortions were estimated to occur each year in Uganda. Since then, no other research on abortion incidence has been conducted in the country.MethodsData from 418 health facilities were used to estimate the number and rate of induced abortion in 2013. An indirect estimation methodology was used to calculate the annual incidence of induced abortions ─ nationally and by major regions. The use of a comparable methodology in an earlier study permits assessment of trends between 2003 and 2013.ResultsIn 2013, an estimated 128,682 women were treated for abortion complications and an estimated 314,304 induced abortions occurred, both slightly up from 110,000 and 294,000 in 2003, respectively. The national abortion rate was 39 abortions per 1,000 women aged 15–49, down from 51 in 2003. Regional variation in abortion rates is very large, from as high as an estimated 77 per 1,000 women 15–49 in Kampala region, to as low as 18 per 1,000 women in Western region. The overall pregnancy rate also declined from 326 to 288; however the proportion of pregnancies that were unintended increased slightly, from 49% to 52%.ConclusionUnsafe abortion remains a major problem confronting Ugandan women. Although the overall pregnancy rate and the abortion rate declined in the past decade, the majority of pregnancies to Ugandan women are still unintended. These findings reflect the increase in the use of modern contraception but also suggest that a large proportion of women are still having difficulty practicing contraception effectively. Improved access to contraceptive services and abortion-related care are still needed.     

未婚人工流产女性生殖健康知识知晓现状调查及其影响因素分析

摘要 目的：探究未婚人工流产女性生殖健康知识知晓现状,并分析其影响因素。方法：随机选取2018年3月~2021年5月期间在同济大学附属第一妇婴保健院计划生育科终止妊娠的未婚女性486例作为研究对象。其中,拒绝调查者21例,实际调查465例,应答率95.68%（465/486）,数据清理后有效问卷459份,有效率为98.71%（459/465）。调查未婚人工流产女性生殖健康知识知晓现状,未婚人工流产女性生殖健康知识知晓情况的危险因素采用单因素及多因素Logistic回归分析。结果：研究对象中,女性生殖健康知识知晓总分最低分17分,最高分为92分,平均（65.74±10.82）分;得分大于80分者179例,优良率为39.00%（179/459）。得分在80分及其以下的女性280例。未婚人工流产女性生殖健康知识知晓情况与年龄、女方文化程度、父母婚姻状况、流产次数、工作性质、居住地、恋爱经历、男方文化程度有关（P<0.05）。而与家庭月收入、更换工作次数无关（P>0.05）。年龄、男方文化程度工作性质、居住地、女方文化程度、流产次数、父母婚姻状况是未婚人工流产女性生殖健康知识知晓情况的影响因素（P<0.05）。结论：未婚人工流产女性生殖健康知识知晓水平一般,受到年龄、女方文化程度、父母婚姻状况等多种因素影响,应针对其影响因素特点加强生殖健康知识的宣教,以降低人工流产的风险。     

Incidence of Induced Abortion and Post-Abortion Care in Tanzania

Background

Tanzania has one of the highest maternal mortality ratios in the world, and unsafe abortion is one of its leading causes. Yet little is known about its incidence.

Objectives

To provide the first ever estimates of the incidence of unsafe abortion in Tanzania, at the national level and for each of the 8 geopolitical zones (7 in Mainland plus Zanzibar).

Methods

A nationally representative survey of health facilities was conducted to determine the number of induced abortion complications treated in facilities. A survey of experts on abortion was conducted to estimate the likelihood of women experiencing complications and obtaining treatment. These surveys were complemented with population and fertility data to obtain abortion numbers, rates and ratios, using the Abortion Incidence Complications Methodology.

Results

In Tanzania, women obtained just over 405,000 induced abortions in 2013, for a national rate of 36 abortions per 1,000 women age 15–49 and a ratio of 21 abortions per 100 live births. For each woman treated in a facility for induced abortion complications, 6 times as many women had an abortion but did not receive care. Abortion rates vary widely by zone, from 10.7 in Zanzibar to 50.7 in the Lake zone.

Conclusions

The abortion rate is similar to that of other countries in the region. Variations by zone are explained mainly by differences in fertility and contraceptive prevalence. Measures to reduce the incidence of unsafe abortion and associated maternal mortality include expanding access to post-abortion care and contraceptive services to prevent unintended pregnancies.     

Hospital Admission following Induced Abortion in Eastern Highlands Province,Papua New Guinea – A Descriptive Study

Background

In Papua New Guinea abortion is restricted under the Criminal Code Act. While safe abortions should available in certain situations, frequently they are not available to the majority of women. Sepsis from unsafe abortion is a leading cause of maternal mortality. Our findings form part of a wider, mixed methods study designed to identify complications requiring hospital treatment for post abortion care and to explore the circumstances surrounding unsafe abortion.

Methods

Through a six month prospective study we identified all women presenting to the Eastern Highlands Provincial Hospital following spontaneous and induced abortions. We undertook semi-structured interviews with women and reviewed individual case notes, extracting demographic and clinical information.

Findings

Case notes were reviewed for 56% (67/119) of women presenting for post abortion care. At least 24% (28/119) of these admissions were due to induced abortion. Women presenting following induced abortions were significantly more likely to be younger, single, in education at the time of the abortion and report that the baby was unplanned and unwanted, compared to those reporting spontaneous abortion. Obtained illegally, misoprostol was the method most frequently used to end the pregnancy. Physical and mechanical means and traditional herbs were also widely reported.

Conclusion

In a country with a low contraceptive prevalence rate and high unmet need for family planning, all reproductive age women need access to contraceptive information and services to avoid, postpone or space pregnancies. In the absence of this, women are resorting to unsafe means to end an unwanted pregnancy, putting their lives at risk and putting an increased strain on an already struggling health system. Women in this setting need access to safe, effective means of abortion.     

Rare phenotypes of placental alkaline phosphatase an analysis of relationships with some neonatal and maternal variables

Summary Placental alkaline phosphatase (Pl) polymorphism is due to the occurrence of three common alleles and more than fifteen rare ones at an autosomal locus. The high number and frequency (about 2%) of rare Pl alleles represent a very special case among polymorphic enzymes. Since the Pl gene is also special in that it is active only during intrauterine life, the allelic diversity and its maintenance may be connected with intrauterine environment and with fetal development.This study embraced 502 consecutive newborn infants from the white population of European descent of New Haven (Connecticut). Analysis of the relationship between rare Pl phenotypes and the following variables was carried out: gestational length, birth weight, maternal age, birth order, sex, fetal and maternal AB0 and Rh phenotypes, feto-maternal AB0 and Rh compatibility status, and previous spontaneous abortions.The results indicate a negative association of Pl rate types with the 0 phenotype in the mother and with male sex of the infant.The present data suggest that interactions with sex and with the AB0 system during intrauterine life may contribute to the maintenance of allelic, diversity in Pl system.     

Number and sex ratio of children and impact of parental diabetes in individuals with Type 1 diabetes

Diabet. Med. 29, 1268-1271 (2012) ABSTRACT: Objective To assess the number and sex ratio of children in individuals with Type?1 diabetes mellitus and the influence of parental diabetes on age at onset of Type?1 diabetes in our cohort. Methods In a cross-sectional study in a German region comprising 350?000 inhabitants, 697 subjects with Type?1 diabetes (364 women, 333 men) underwent a standardized assessment regarding the number and sex of their children and the family history of diabetes. Results Compared with 1.36 children per woman in the German background population, the total fertility rate in the calendar year of 2010 in our female cohort with Type?1 diabetes (age 18-49?years) was 0.88. Men with Type?1 diabetes had a fertility rate of 0.65. More men (51.1%) than women (35.7%; P?相似文献   

宫腔镜下宫腔粘连电切术后再粘连发生的因素调查分析

目的:调查与分析宫腔镜下宫腔粘连电切术后再粘连发生的因素,为预防术后再粘连的发生提供参考。方法:2016年2月到2018年11月选择在本院诊治的宫腔粘连患者112例,所有患者都给予宫腔镜下宫腔粘连电切术治疗,调查患者的一般资料,随访患者术后再粘连发生情况并进行多因素调查分析。结果:所有患者都顺利完成手术,围手术期无严重并发症发生;术后随访调查12个月,术后再粘连发生18例,发生率为16.1%。在112例患者中,不同病情、人流次数、宫腔操作次数、性生活年龄、产次患者的术后再粘连率对比差异都有统计学意义(P0.05)。多因素logistic回归方程结果显示病情、人流次数、宫腔操作次数、性生活年龄为影响患者术后再粘连发生的主要因素(P0.05)。结论:宫腔镜下宫腔粘连电切术后再粘连比较常见,其病情、人流次数、宫腔操作次数、性生活年龄为影响患者术后再粘连发生的主要危险因素。因此,术后提高女性的生活习惯和避孕意识,是防范宫腔粘再连的根本措施。     

双胎妊娠一胎宫内死亡的临床分析

目的:探讨双胎妊娠一胎宫内死亡的原因及处理方法。方法:对本院2013年1月～2017年6月住院分娩的双胎妊娠一胎宫内死亡的病例进行回顾性分析。结果:双胎妊娠一胎宫内死亡28例,占同期双胎分娩的1.63%,占同期双胎胎盘送检的4.33%。6例孕28周,14例孕28～34周,8例孕周34周。全部孕产妇均无出血倾向或发生凝血功能障碍。产妇年龄23～45周岁,平均31.3周岁;初产妇23人,经产妇5人。应用辅助生殖技术受孕5例,自然受孕23例;剖宫产7例,顺产21例;确诊一胎儿死亡时间为孕12周余～34周余。主要致死原因为脐带因素13例次(46.43%),胎盘因素12例次(42.86%),双胎输血综合征及纸样胎共5例次(17.86%),胎儿畸形4例次(18.18%)。结论:孕中晚期双胎之一胎儿宫内死亡妊娠不足34周,应在密切监护母胎情况下行期待治疗,单绒毛膜囊双胎34周后可以分娩,双绒毛膜囊双胎可妊娠至36周。     

Sequential aspects of spontaneous abortion: maternal age, parity, and pregnancy compensation artifact

At least 3 hypotheses predict that spontaneous abortion risk differs during reporductive history: genuine maternal age effects change individual risks; genuine birth order effects change individual risks; and variant individual risks, which are really independent of both age and parity, produce an artifactual association of risk with age in populations of women. The availability of large numbers of reproductive histories recorded on magnetic tape by the Collaborative Study on Cerebral Palsy provides an opportunity to weigh these hypotheses. Information was gathered between mid-1959 and mid-1966 by 13 hospitals, mostly east of the Mississippi. Random samples of essentially all women registering in the obstetric clinics of the collaborating institutions entered the study. Generally, these women came from poorer urban areas. Data are taken from the interviews at 1st registrations only. At this time, women had prior reproductive histories of varying lengths. The data are analyzed to yield broad comparative evaluations of the maternal age, parity, and artifact hypotheses. When the logit transforms of abortion risks were regressed on maternal age, the linear component was positive and significant at the 1% level in every ethnic group. In all categories except blacks, the fit to such a simple model was quite adequate. Fit in the case of the blacks was disturbed by the high rate among 13-year olds and the low rate among 37-year olds. The 37-year old black sample was the only one to depart markedly from the trend of increased risk at high age. Primary analysis of birth order defects used Slater's (1962) rank order statistic on a group of histories. In every ethnic category the observed mean value of Slater's statistic exceeds its expected value of 0.5; every standardized deviation has a negligibly small probability when tested against the normal distribution. The conclusin is that spontaneous abortions tend to come late in a reproductive history. The white data showed a definite trend contrary to expectation under the pregnancy compensation hypothesis. Although not significant in the "o" (liveborn) versus "x" (abortion) contrast, the lowering trent in maternal age with prior abortion experience was signifixant for the longer histories. Equally surprising was the apparent positive finding in the black data. In sum, the data clearly showed that among women with histories mixing spontaneous abortions and live births, risk of abortion was greater at higher parity. Although the women sampled tended to be young, and increase of risk with age was demonstrated in the white sample. These effects were not because of sample biases. Black age effects were possibly confounded with pregnancy compensation artifact which can mimic aging influence in unselected samples.     

Urinary iodine and thyroid function in a population of healthy pregnant women in the North of Spain

BackgroundIodine is an essential trace element for the synthesis of thyroid hormones, which are keys in maternal metabolism during pregnancy as well as in neurological development during fetal and postnatal life. This was a prospective study on iodine status and thyroid function in women during pregnancy in the Basque country to assess whether there was any relationship among maternal urinary iodine, maternal thyroid function and thyrotropin (TSH) in newborns, and to explore any difference in women experiencing miscarriages.MethodsWe analyzed TSH, free T₄ (FT₄), free T₃ (FT₃), thyroid peroxidase antibody (TPO-Ab) titers in serum and urinary iodine concentrations (UIC) in 2104 women in the first trimester of pregnancy and in 1322 of them in their second trimester. We obtained neonatal TSH levels in 1868 cases.ResultsIn the first (T1) and second trimesters (T2), the median UICs were 88.5 μg/L and 140 μg/L, respectively. No relationship was found between UIC and FT₄, or maternal and neonatal TSH. In T1 and T2, 9.7% and 7.5% of women were TPO-Ab positive, respectively. The total miscarriage rate was 10%. The percentage of miscarriages in healthy women was 8.9%, lower than in women with overt hypothyroidism (21.2%; p < 0.001) and than in women with subclinical hypothyroidism (15.6%; p < 0.025). The miscarriage rate was not higher in TPO-Ab-positive women.ConclusionsIn this study most women had iodine deficiency during pregnancy. Neonatal TSH is not correlated with maternal UIC during pregnancy. Pregnant women with hypothyroidism have a higher rate of miscarriages.     

Retrospective audit of different antenatal screening policies for Down's syndrome in eight district general hospitals in one health region

ObjectiveTo compare the effectiveness of different screening policies for the antenatal detection of Down''s syndrome.DesignRetrospective six year survey.SettingMaternity units of eight districts.ParticipantsWomen who completed their pregnancies between 1 January 1994 and 31 December 1999 (155 501 deliveries).Results335 cases of Down''s syndrome were identified, 323 in continuing pregnancies or liveborn children. Of these, 171 were identified antenatally. Seven different screening policies were used, in three principal groups: serum screening offered to all mothers, maternal age with serum screening or nuchal translucency available to limited groups, and maternal age combined with anomaly scans. The districts that used serum screening detected 57%, those using maternal age plus serum or nuchal translucency screening 52%, and those using a maternal age of ⩾35 and anomaly scans detected 54%. The least successful district, which offered amniocentesis only to women aged over 37 years, detected only 31%. If amniocentesis had been offered from 35 years, as in all other districts, the detection rate would have risen to 54%. Across the region 15% (range 12-20%) of pregnant women were 35 years or more at delivery, and 58% (33-69%) of infants with Down''s syndrome were born to women in this age range.ConclusionsCurrent additional serum or nuchal translucency screening techniques for antenatal detection of Down''s syndrome are less advantageous than previously supposed. More pregnant women were aged over 35 than has been presumed in statistical models used in demonstration projects of serum screening and, as a result, the proportion of affected fetuses in this age group is much greater than predicted.

What is already known on this topic

Serum screening for Down''s syndrome has been presumed to be more effective than screening by maternal ageThere have been no controlled studies comparing serum screening with screening by maternal age, and its greater efficacy has been presumed from mathematical modelling, which assumed that only 5% of pregnant women were aged over 35 yearsThe modelling predicted that only 20-30% of cases of Down''s syndrome would arise in women aged over 35 and made no allowance for the effects of routine anomaly scanning

What this study adds

15% of pregnant women were aged over 35 years, more than double the 5-7% presumed in statistical models of screening58% of babies with Down''s syndrome were born to women aged 35 years or moreSerum screening and nuchal scanning did not achieve significantly higher antenatal detection rates of Down''s syndrome than the use of maternal age and routine anomaly scanning     

Thyroid Autoimmunity and Recurrent Spontaneous Abortion in Iran: A Case-Control Study

ObjectiveTo determine the association of thyroglobulin antibodies (TG-Ab) and thyroid peroxidase antibodies (TPO-Ab) with recurrent spontaneous abortion in a euthy-roid, nonpregnant population of women in Iran.MethodsIn this case-control study conducted between November 2003 and September 2006 in Tehran, Iran, non pregnant women with a history of 3 or more consecutive pregnancy losses and age-matched, healthy parous women without a history of reproductive problems were assessed. Thyroid function tests were performed, which included assessment of thyroid-stimulating hormone, triiodothyro nine, thyroxine, and the presence of TG-Ab and TPO-Ab.ResultsA total of 641 patients and 269 controls were included. Mean age (± SD) was 30.6 ± 6.4 years (range, 16-51 years) in the patient group and 30.05 ± 6.6 years (range, 18-48 years) in the control group. Thyroid antibodies were present in 157 of 641 patients (24.5%) and in 34 of 269 controls (12.6%) (P < .001). The presence of thyroid antibodies was significantly associated with recurrent abortion independent of the impact of age with an odds ratio of 2.24 (95% confidence interval, 1.5-3.35).ConclusionsIn this population of women in Iran, TG-Ab and TPO-Ab were identified more frequently in women with recurrent abortions compared with controls, and thyroid autoimmunity was independently associated with a higher risk of recurrent abortion. (Endocr Pract. 2008;14:458-464)     

Causes of low utilization of amniocentesis by women of advanced maternal age

Abstract

The objectives of this study were to determine current usage of amniocentesis by women of advanced maternal age in a southwestern Ohio county and to determine potential usage levels by surveying women not utilizing the procedure to understand their reasons. For women age 35 and older giving birth in Hamilton County, Ohio, the estimated percentage using amniocentesis was 3.9 in 1978, 7.6 in 1979, and 13.3 in 1980. Approximately comparable statewide utilization rates were 7.0, 11.5, and 17.2 respectively. A telephone survey during the summer of 1980 of 81 Hamilton County women age 35 and older recently giving birth to a normal baby found four main reasons why they did not utilize amniocentesis: (1) they did not feel at an increased risk (29.6 per cent); (2) they had never heard of the test (24.7 per cent); (3) they were opposed to abortion (21.0 per cent); and (4) no one suggested they have the test done (19.8 per cent). Their physicians reported that 81 per cent of these women had received prenatal counseling. Thus, of those counseled, over two‐thirds apparently missed at least one essential message of the counseling they were presumably provided. These findings, coupled with 47.7 per cent of women who knew about amniocentesis saying they would most likely use it if they became pregnant again and their physician recommended it, indicate that utilization of prenatal diagnosis by at least 50 per cent of women age 35 and older is likely with greater public education and greater support of the procedure by obstetricians.     

The Potential of Medical Abortion to Reduce Maternal Mortality in Africa: What Benefits for Tanzania and Ethiopia?

Background

Unsafe abortion is estimated to account for 13% of maternal mortality globally. Medical abortion is a safe alternative.

Methods

By estimating mortality risks for unsafe and medical abortion and childbirth for Tanzania and Ethiopia, we modelled changes in maternal mortality that are achievable if unsafe abortion were replaced by medical abortion. We selected Ethiopia and Tanzania because of their high maternal mortality ratios (MMRatios) and contrasting situations regarding health care provision and abortion legislation. We focused on misoprostol-only regimens due to the drug''s low cost and accessibility. We included the impact of medical abortion on women who would otherwise choose unsafe abortion and on women with unwanted/mistimed pregnancies who would otherwise carry to term.

Results

Thousands of lives could be saved each year in each country by implementing medical abortion using misoprostol (2122 in Tanzania and 2551 in Ethiopia assuming coverage equals family planning services levels: 56% for Tanzania, 31% for Ethiopia). Changes in MMRatios would be less pronounced because the intervention would also affect national birth rates.

Conclusions

This is the first analysis of impact of medical abortion provision which takes into account additional potential users other than those currently using unsafe abortion. Thousands of women''s lives could be saved, but this may not be reflected in as substantial changes in MMRatios because of medical abortion''s demographic impact. Therefore policy makers must be aware of the inability of some traditional measures of maternal mortality to detect the real benefits offered by such an intervention.     

Plasma Protein Profile of Lactating Women from Two Primary Health Centers in Jakarta,Indonesia

Background:Plasma protein profile test is a potential laboratory method to assess nutritional status especially albumin and globulins levels which reflects protein adequacy. The purpose of this study is to evaluate plasma protein profile of lactating women from two primary health centers in Jakarta.Methods:A cross-sectional study was conducted involving lactating women attending routine maternal examinations in two public primary health centers in Jakarta, Indonesia. The mother’s plasma total protein, albumin, globulin, and immunoglobulin levels were measured.Results:Sixty lactating women were recruited, mostly were 28 years old, slightly overweight, bearing two children, and their recent children were 2 months old. The mean total protein level was 8.13 g/dl, albumin 5.00 g/dl, globulin 3.18 g/dl, albumin: globulin ratio 1.558, mean total IgG level of 1255.98 and mean total IgM level of 135.819. All the measured plasma protein parameters were shown to be not correlated with maternal age, maternal BMI, or maternal parity.DiscussionThe plasma total protein, albumin, globulin, as well as total IgG and IgM level of lactating women in Jakarta were within normal range. These biochemical parameters were shown to be not correlated with anthropometrical data such as maternal age and BMI. The small and relatively homogenous samples were supposed to be the cause of such findings.Conclusion:The plasma protein profile of lactating women in Jakarta was adequate. Further studies are required to evaluate the eligibility of plasma protein profile as biochemical parameter of nutritional status in lactating women.Key Words: Blood protein, lactation, protein, albumin/globulin, immunoglobulin M/G     

Alpha-fetoprotein in Abortion

The clinical value of maternal serum alpha-fetoprotein (AFP) as a guide to the outcome of threatened abortion was assessed. After the thirteenth week of gestation, abortion occurred more frequently (10/12) in women with abnormal serum AFP levels than in those (2/12) whose AFP concentrations were within the normal range. Low levels were present in women with blighted ovum and high concentrations were associated with intrauterine fetal death. In legal first and second trimester abortions, the circulating maternal AFP levels in postabortion samples were often higher than before abortion, irrespective of whether abortion was performed instrumentally or induced with prostaglandins. Maternal serum AFP levels provide a new means for prediction of the outcome of threatened abortion.     

剖宫产产妇并发医院感染的临床特征及相关影响因素研究

目的:探讨剖宫产产妇并发医院感染的临床特征及相关影响因素,并提出相应的防控措施。方法:选取自2014年1月至2016年12月间在我院妇产科进行剖宫产手术的产妇4112例,记录产妇感染发生的情况(感染率、感染部位及病原菌分布),并统计分析产妇的基本情况,包括年龄、体质量指数(BMI)、住院时间、基础疾病等基本情况。结果:进行剖宫产的产妇合并发生医院感染的感染率为4.89%(201/4112);感染部位主要为手术切口感染、泌尿道感染、生殖道感染、盆腔感染、呼吸道感染及皮肤感染,其中手术切口感染所占比例为45.77%;医院感染病例中共培养出5种病原菌共51株,包括金黄色葡萄球菌、葛兰氏阴性杆菌、副流感嗜血菌、粪肠球菌及耐甲氧西林金黄色葡萄球菌;感染因素中年龄、BMI、住院时间、基础疾病情况、医护人员操作的熟练程度、手术时间、术中出血量、术后尿管留置时间及抗菌药物应用与剖宫产产妇并发医院感染之间具有紧密联系(P0.05),而首次剖宫产手术与剖宫产产妇并发医院感染之间无联系(P0.05)。结论:剖宫产产妇并发医院感染的发生率较高,而且多种感染因素影响其发生,因此在临床上应采取相应的防控措施,降低感染率,保证产妇和新生儿的身心健康。     

The efficacy and acceptability of the "prostaglandin impact" in inducing complete abortion during the second week after the missed menstrual period

Clinical research was undertaken using PGF2a (prostaglandin) to induce abortion in 22 pregnant women at 12 +/- 1 days following their missed menstrual period. The PG was administered in a 5 mg single intrauterine dose through the cervix for a 10-minute period. The PG administration caused increased uterine contraction within 20 minutes and raised intrauterine pressure which was sustained for 2 hours. During the initiation of the intrauterine pressure, bleeding started and progesterone and estradiol levels decreased and continued to do so. In those patients who had been sedated, side effects were minimal. At 24 hours following the PG administration, progesterone had been withdrawn at a rate of 44%, bleeding was continuing, and cervical dilatation was at approximately 1 cm. Complete abortion was achieved in 20 out of the 22 women. It is believed that the abortion was effected through the action of endogenous PG, due to the withdrawal effect on progesterone of the exogenously-administered PG.