Journal of Obstetrics and Gynaecology Research最新文献_第7页

Predictive value of abnormal expression of MPHOSPH9 in reintervention after high intensity focused ultrasound treatment of uterine fibroids MPHOSPH9异常表达对子宫肌瘤高强度聚焦超声治疗后再干预的预测价值。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-08 DOI: 10.1111/jog.16205

Jing Wang, Yingjie Xie, Chaoqiang Zeng, Lin Nie, Yang Yang

Aims

Aberrantly expressed MPHOSPH9 has been reported to be associated with poor prognosis in many diseases. Previous study indicates that MPHOSPH9 is abnormally expressed in patients with uterine fibroids (UFs). This study focused on the possible prognostic value of MPHOSPH9 in UFs patients after high intensity focused ultrasound (HIFU) treatment.

Methods

A total of 455 UFs patients participated in the study, including 95 patients who needed reintervention (Reintervention group) and 360 patients who did not need reintervention (Non-reintervention group) after HIFU treatment. They volunteered blood samples before HIFU treatment. The relative expression of MPHOSPH9 was assessed by qRT-PCR. Cox regression analysis was performed to assess the prognostic value of MPHOSPH9 and risk factors of postoperative reintervention.

Results

The expression of MPHOSPH9 was markedly elevated in Reintervention, compared to that of the Non-reintervention group (p < 0.001). Five-year follow-up results showed that among these postoperative patients, 95 patients required reintervention and the reintervention time mainly occurred during 10–40 months after surgery. The Cox regression analysis demonstrated that UFs size (hazard ratio = 2.769, 95% confidence interval: 1.366–5.610) and the high MPHOSPH9 expression level (hazard ratio = 3.160, 95% confidence interval: 1.506–6.630) were independent risk factors for postoperative reintervention.

Conclusions

The enhanced MPHOSPH9 was a potential candidate for predicting postoperative reintervention in UFs patients.

目的：在许多疾病中，异常表达的MPHOSPH9与不良预后相关。既往研究表明MPHOSPH9在子宫肌瘤（UFs）患者中表达异常。本研究的重点是MPHOSPH9在UFs患者接受高强度聚焦超声（HIFU）治疗后可能的预后价值。方法：共455例UFs患者参与研究，其中HIFU治疗后需要再干预的患者95例（再干预组），不需要再干预的患者360例（非再干预组）。他们在HIFU治疗前自愿提供血样。采用qRT-PCR检测MPHOSPH9的相对表达量。采用Cox回归分析评价MPHOSPH9的预后价值及术后再干预的危险因素。结果：与非再干预组相比，再干预组MPHOSPH9的表达明显升高(p)。结论：MPHOSPH9的表达增强是预测UFs患者术后再干预的潜在候选者。

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引用次数: 0

Utility of manual vacuum aspiration followed by curettage in the treating hydatidiform mole: A retrospective analysis 人工真空抽吸后刮除治疗葡萄胎的回顾性分析。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-08 DOI: 10.1111/jog.16210

Ui Aoki, Kosuke Yoshida, Yuko Yasui, Yuki Nishiko, Akira Yokoi, Nobuhisa Yoshikawa, Kimihiro Nishino, Eiko Yamamoto, Kaoru Niimi, Hiroaki Kajiyama

Aim

While manual vacuum aspiration (MVA) is commonly employed for early first-trimester abortions, its effectiveness in treating hydatidiform mole is still unclear. This study sought to evaluate the efficacy and safety of MVA in comparison to dilation and curettage (D&C) for managing hydatidiform mole.

Methods

We conducted a retrospective review of medical records for 198 patients with hydatidiform mole treated at Nagoya University Hospital between 2004 and 2023. After excluding cases with incomplete data, we compared 106 patients who underwent D&C with 60 patients treated with MVA followed by curettage. We evaluated the surgical duration, intraoperative blood loss, and the occurrence of post-molar gestational trophoblastic neoplasia (GTN) in both groups.

Results

The surgical duration and blood loss were similar between the MVA and D&C groups. The average surgical time was 13.2 min for D&C and 11.8 min for MVA (p = 0.145). Most cases in both groups experienced blood loss of less than 10 mL, with no significant difference (p = 0.066). Over a median follow-up period of 33.4 months, 25 cases developed post-molar GTN. All GTN cases originated from complete hydatidiform mole (25 of 132 cases, 18.9%), and none were from partial hydatidiform mole. Kaplan–Meier analysis, focusing only on patients with complete hydatidiform mole, indicated no significant difference in the time to onset of GTN between the D&C and MVA groups (p = 0.632).

Conclusions

MVA followed by curettage is a viable approach for treating molar pregnancy.

目的：虽然人工真空抽吸（MVA）通常用于早期妊娠流产，但其治疗葡萄胎的有效性尚不清楚。本研究旨在评估MVA与扩张和刮除（D&C）治疗葡萄胎的有效性和安全性。方法：回顾性分析2004年至2023年在名古屋大学医院治疗的198例葡萄胎患者的病历。在排除数据不完整的病例后，我们比较了106例接受D&C的患者和60例接受MVA后刮除的患者。我们评估了两组的手术时间、术中出血量和磨牙后妊娠滋养细胞瘤（GTN）的发生情况。结果：MVA组和D&C组的手术时间和出血量相似。D&C平均手术时间为13.2 min， MVA平均手术时间为11.8 min （p = 0.145）。两组患者出血量均小于10 mL，差异无统计学意义（p = 0.066）。在中位33.4个月的随访期间，25例发生磨牙后GTN。所有GTN病例均来自完全葡萄胎（25例，18.9%），部分葡萄胎无一例。Kaplan-Meier分析仅针对完全葡萄胎患者，D&C组与MVA组在GTN发病时间上无显著差异（p = 0.632）。结论：MVA +刮除是治疗磨牙妊娠的可行方法。

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引用次数: 0

Successful pain control of lymphangioma-suspected lesions in pregnancy with acetaminophen and opioids: A case report and literature review 对乙酰氨基酚和阿片类药物成功控制妊娠期疑似淋巴管瘤病变的疼痛：1例报告和文献复习。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-08 DOI: 10.1111/jog.16208

Haruna Kawatani, Takashi Shibata, Fumikazu Kotsuji, Hiroki Kato, Shigeki Nishikawa, Satoshi Nakago

Lymphangioma causing pain during pregnancy is not widely reported, but surgical treatment was performed in each of the reported cases. In our patient, lesions arose in the retroperitoneal cavity and caused intense pain from 17 weeks of gestation. However, surgical treatment was considered difficult because of the location of the lesion. The maximum dose of acetaminophen was administered, but pain relief remained unsatisfactory, and there were concerns about possible side effects of long-term use of high-dose acetaminophen on the fetus. Following attempts to control pain and reduce the acetaminophen dose, adding opioids was effective in controlling the pain and minimizing both dosages as much as possible. The patient was able to continue her pregnancy to term, avoiding highly invasive surgery during pregnancy. The combination of acetaminophen and opioids is reported here as an alternative treatment option to surgical procedures for intense pain caused by lesions such as lymphangioma in pregnancy.

在妊娠期间引起疼痛的淋巴管瘤并没有广泛的报道，但是在每一个报道的病例中都进行了手术治疗。在我们的病人，病变出现在腹膜后腔和引起强烈的疼痛从妊娠17周。然而，由于病变的位置，手术治疗被认为是困难的。给予最大剂量的对乙酰氨基酚，但疼痛缓解效果仍不理想，并且担心长期使用大剂量对乙酰氨基酚可能对胎儿产生副作用。在尝试控制疼痛和减少对乙酰氨基酚剂量后，添加阿片类药物可以有效地控制疼痛并尽可能减少这两种剂量。该患者得以继续妊娠至足月，避免了妊娠期间的高侵入性手术。据报道，对乙酰氨基酚和阿片类药物的联合使用是治疗妊娠期淋巴管瘤等病变引起的剧烈疼痛的替代治疗方法。

引用次数: 0

The impact of the trigger day progesterone, luteinizing hormone and their interaction on live birth rates in GnRH antagonist cycles

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-06 DOI: 10.1111/jog.16181

Onur Ince MD, MSc, Bulent Yilmaz MD

Aim

This study aims to assess the impacts of various trigger day progesterone (P₄) and luteinizing hormone (LH) levels on live birth rates (LBRs) in fresh in vitro fertilization (IVF) cycles, considering their elevation from stimulation and premature luteinization.

Methods

This retrospective cohort study included the first ovarian stimulation cycles with GnRH antagonist protocol of 1253 patients who underwent intracytoplasmic sperm injection and fresh embryo transfer at a tertiary clinic's IVF center between 2010 and 2016. Participants were divided into four groups based on trigger day serum P₄ and LH levels, using the 90th percentile thresholds for P₄ (1.7 ng/mL) and LH (5.2 IU/L). The primary outcome measure was LBR.

Results

The LBRs observed in the respective groups were as follows: P₄ < 1.7 ng/mL and LH <5.2 IU/L (21.3%, 214/1005); P₄ < 1.7 ng/mL and LH ≥5.2 IU/L (19.1%, 22/115); P₄ ≥ 1.7 ng/mL and LH <5.2 IU/L (19.3%, 23/119); and P₄ ≥ 1.7 ng/mL and LH ≥5.2 IU/L (28.6%, 4/14). There were no statistically significant differences between the groups (p = 0.782). Additionally, a multivariate generalized additive model, adjusted for female age, body mass index, infertility duration, number of embryos transferred, and embryo transfer day, found that the interaction between LH and P₄ levels did not significantly predict LBRs (p = 0.533). However, univariate analysis identified an optimal trigger day P₄ range between 0.58 and 1.69 ng/mL for achieving higher LBRs, demonstrating a non-linear relationship. Furthermore, total FSH and LH dosages during stimulation had a statistically significant combined effect on trigger day P₄ levels (p = <0.001), with the addition of LH leading to lower P₄ levels compared to cycles stimulated with recombinant FSH alone.

Conclusions

The relationship and interaction between trigger day LH and P₄ levels do not significantly influence LBRs, as variations in LH do not alter the effect of P₄, suggesting that the impact of P₄ elevation on LBRs is independent of its cause, whether from ovarian stimulation or premature luteinization.

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引用次数: 0

Efficacy of ultrasound-indicated cerclage without prior preterm birth 无早产的超声指示环切术的疗效。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-05 DOI: 10.1111/jog.16173

Naoko Suga, Akari Koizumi, Ai Takamizu, Norikazu Ueki, Koyo Yoshida, Shintaro Makino

Aim

Our study aimed to evaluate the effectiveness of ultrasound-indicated cerclage in singleton pregnancies with cervical shortening (<25 mm), excluding those with a history of preterm birth (PTB) and infection/inflammation.

Materials and methods

Among the 1556 women admitted for a cervix measuring <25 mm via transvaginal ultrasound at Juntendo University Urayasu Hospital between January 2001 and December 2023, our study focused on 47 singleton patients with no prior history of PTB. After receiving information on both risks and benefits, 25 patients opted for ultrasound-indicated cerclage (cerclage group), while 22 chose expectant management (expectant management group). All participants underwent screening for infection/inflammation of the lower genital tract. The primary outcome, the rate of PTB (<37 weeks', <34 weeks', and <28 weeks' gestation), was assessed in both groups.

Results

The cerclage group demonstrated a significantly lower rate of PTB before 37 and 34 weeks' gestation. Although there was no statistically significant difference, the cerclage group exhibited a delay of 3.6 weeks in the average week of gestation compared to the expectant management group. Notably, the hospitalization period in the cerclage group was significantly reduced by 42 days.

Conclusion

Performing an ultrasound-indicated cerclage in cases of a short cervical length <25 mm without a prior history of PTB and infection/inflammation reduces the rates of PTB (<37 and <34 weeks' gestation) and hospitalization period.

目的：我们的研究旨在评估超声提示环切术在单胎妊娠宫颈缩短中的有效性。材料和方法：在1556名接受宫颈测量的妇女中，结果：环切术组在妊娠37周和34周前的PTB发病率显著降低。虽然没有统计学上的显著差异，但与准管理组相比，结扎组的平均妊娠周延迟了3.6周。值得注意的是，结扎组的住院时间明显减少了42天。结论：对宫颈长度较短的患者行超声指示的环切术

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引用次数: 0

Treatment for low-grade and high-grade endometrial carcinoma after recurrence/relapse before the molecular targeted therapy era: A retrospective, propensity score-matched cohort study 分子靶向治疗时代前复发/复发后低级别和高级别子宫内膜癌的治疗：一项回顾性、倾向评分匹配的队列研究

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-05 DOI: 10.1111/jog.16197

Masao Okadome, Kenzo Sonoda, Rina Nagayama, Toshiaki Saito, Kumi Shimamoto, Ai Nio, Yu Yoshida, Ayano Tsubomi, Shinichiro Yamaguchi, Kazuya Ariyoshi

Aim

To compare the prognosis of low-grade endometrial carcinoma (LG-EC) with that of high-grade endometrial carcinoma (HG-EC) after first recurrence/relapse before the molecular targeted therapy era.

Methods

Recurrent/relapsed endometrial cancer was diagnosed in 155 women at our hospital between January 26, 1999 and February 26, 2019. Fifty of these women received paclitaxel–carboplatin, two received doxorubicin–cisplatin, and one received docetaxel–carboplatin as postoperative chemotherapy. Two women who did not receive postoperative chemotherapy received paclitaxel–carboplatin for their first recurrence/relapse. The prognosis in these 55 women was retrospectively investigated using propensity score matching.

Results

Twenty-five women had LG-EC and 30 had HG-EC. Cox proportional hazards analysis identified response to chemotherapy for the first recurrence/relapse to be a statistically significant determinant of progression-free survival and HG-EC to be a significant determinant of overall survival. After propensity score matching, median overall survival was better in women with LG-EC than in those with HG-EC (82 months [95% CI 27–not reached] vs. 31 months [95% CI 2–47], p = 0.0127). Three women survived for at least 10 years without recurrence after completion of treatment. The interval between postoperative chemotherapy and first recurrence was more than 6 months. The recurrences resolved after multimodal treatment or aggressive chemotherapy followed by 5–12 cycles of chemotherapy other than paclitaxel–carboplatin if received postoperatively.

Conclusions

The prognosis was poorer in patients with recurrent/relapsed HG-EC than in those with recurrent/relapsed LG-EC before the molecular targeted therapy era. There were no long-term recurrence-free survivors after repeat paclitaxel–carboplatin chemotherapy.

目的：比较分子靶向治疗时代前低级别子宫内膜癌（LG-EC）与高级别子宫内膜癌（HG-EC）首次复发/复发后的预后。方法：1999年1月26日至2019年2月26日在我院诊断为复发/复发子宫内膜癌的155例妇女。其中50名妇女接受了紫杉醇-卡铂，2名接受了阿霉素-顺铂，1名接受了多西他赛-卡铂作为术后化疗。两名未接受术后化疗的妇女首次复发时接受了紫杉醇-卡铂治疗。采用倾向评分匹配法对这55名妇女的预后进行回顾性调查。结果：25例女性有LG-EC， 30例女性有HG-EC。Cox比例风险分析发现，首次复发/复发对化疗的反应是无进展生存期的统计学显著决定因素，HG-EC是总生存期的显著决定因素。倾向评分匹配后，LG-EC患者的中位总生存期优于HG-EC患者（82个月[95% CI 27-未达到]vs. 31个月[95% CI 2-47]， p = 0.0127）。3名妇女在完成治疗后存活了至少10年没有复发。术后化疗至首次复发间隔6个月以上。多模式治疗或积极化疗后，如果术后接受紫杉醇-卡铂以外的化疗5-12周期，复发消失。结论：分子靶向治疗时代之前，HG-EC复发/复发患者的预后较LG-EC复发/复发患者差。重复紫杉醇-卡铂化疗后没有长期无复发幸存者。

{"title":"Treatment for low-grade and high-grade endometrial carcinoma after recurrence/relapse before the molecular targeted therapy era: A retrospective, propensity score-matched cohort study","authors":"Masao Okadome, Kenzo Sonoda, Rina Nagayama, Toshiaki Saito, Kumi Shimamoto, Ai Nio, Yu Yoshida, Ayano Tsubomi, Shinichiro Yamaguchi, Kazuya Ariyoshi","doi":"10.1111/jog.16197","DOIUrl":"10.1111/jog.16197","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>To compare the prognosis of low-grade endometrial carcinoma (LG-EC) with that of high-grade endometrial carcinoma (HG-EC) after first recurrence/relapse before the molecular targeted therapy era.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Recurrent/relapsed endometrial cancer was diagnosed in 155 women at our hospital between January 26, 1999 and February 26, 2019. Fifty of these women received paclitaxel–carboplatin, two received doxorubicin–cisplatin, and one received docetaxel–carboplatin as postoperative chemotherapy. Two women who did not receive postoperative chemotherapy received paclitaxel–carboplatin for their first recurrence/relapse. The prognosis in these 55 women was retrospectively investigated using propensity score matching.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Twenty-five women had LG-EC and 30 had HG-EC. Cox proportional hazards analysis identified response to chemotherapy for the first recurrence/relapse to be a statistically significant determinant of progression-free survival and HG-EC to be a significant determinant of overall survival. After propensity score matching, median overall survival was better in women with LG-EC than in those with HG-EC (82 months [95% CI 27–not reached] vs. 31 months [95% CI 2–47], <i>p</i> = 0.0127). Three women survived for at least 10 years without recurrence after completion of treatment. The interval between postoperative chemotherapy and first recurrence was more than 6 months. The recurrences resolved after multimodal treatment or aggressive chemotherapy followed by 5–12 cycles of chemotherapy other than paclitaxel–carboplatin if received postoperatively.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The prognosis was poorer in patients with recurrent/relapsed HG-EC than in those with recurrent/relapsed LG-EC before the molecular targeted therapy era. There were no long-term recurrence-free survivors after repeat paclitaxel–carboplatin chemotherapy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":16593,"journal":{"name":"Journal of Obstetrics and Gynaecology Research","volume":"51 1","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142932049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A case of third trimester uterine prolapse resulting in vaginal delivery by placement of an intravaginal balloon 孕晚期子宫脱垂导致阴道分娩放置阴道内球囊一例。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-02 DOI: 10.1111/jog.16201

Satoshi Tezuka, Ken Fukuhara, Yusaku Terai, Yu Tanaka, Hikaru Kiyokawa, Tetsuro Honda

Pregnancies complicated by uterine prolapse are rare, occurring in 1 in 10 000 to 15 000 deliveries. We report a case of uterine prolapse at 36 weeks of gestation that resulted in vaginal delivery by placement of a colpeurynter (intravaginal balloon). The patient was a 33-year-old pregnant woman with a history of uterine prolapse during her previous pregnancy. At 36 weeks and 4 days of gestation, she presented to her previous physician with uterine prolapse and genital bleeding. Due to severe edema of the uterine cervix, she was referred to our hospital for specialized care. The cervix was manually repositioned into the vagina and the patient was discharged. Concerned about recurrence of uterine prolapse and cervical incarceration at delivery, labor was induced at 39 weeks and 5 days of gestation by oral prostaglandin preparations with concurrent placement of a colpeurynter, resulting in vaginal delivery. Colpeurynter placement is a simple procedure and may be useful in preventing uterine prolapse at delivery.

妊娠合并子宫脱垂是罕见的，发生在1万至15 000分娩。我们报告一例子宫脱垂在妊娠36周，导致阴道分娩放置阴道输尿管（阴道内球囊）。患者为33岁孕妇，既往妊娠有子宫脱垂史。在妊娠36周零4天，她以子宫脱垂和生殖器出血就诊于之前的医生。由于宫颈严重水肿，她被转诊到我院接受专科治疗。将宫颈重新插入阴道，患者出院。考虑到分娩时子宫脱垂和宫颈嵌顿的复发，在妊娠39周5天时口服前列腺素制剂并同时放置阴道输尿管引产，导致阴道分娩。阴道输尿管放置是一个简单的程序，可能有助于防止分娩时子宫脱垂。

引用次数: 0

Can maternal serum soluble fms-like tyrosine kinase-1 to placental growth factor levels at term anticipate adverse pregnancy outcomes? 足月母体血清可溶性样酪氨酸激酶-1与胎盘生长因子水平是否能预测不良妊娠结局？

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-02 DOI: 10.1111/jog.16191

Sarah A. Corker, Thomas J. Cade, Shaun P. Brennecke

Aim

To evaluate if maternal serum soluble fms-like tyrosine kinase-1(sFlt-1) to placental growth factor (PlGF) ratio levels at term can anticipate the following adverse pregnancy outcomes: small for gestational age neonates; operative delivery for suspected fetal welfare compromise; and neonatal compromise.

Methods

A retrospective analysis of a single hospital database containing antenatal soluble fms-like tyrosine kinase-1 to placental growth factor (sFlt-1/PlGF) ratio results together with associated demographic, clinical and investigative information. Subjects with antenatal sFlt-1/PlGF measurements taken ≥37 weeks' gestation were analyzed. sFlt-1/PlGF ratio cut-offs of <38, 38–110, 111–201 and >201 were tested against the following outcomes: birthweight ≤10th and ≤3rd centiles; operative delivery for suspected fetal welfare compromise; 5 min Apgar score; and neonatal admissions for extra care.

Results

Statistically significant associations were found between sFlt-1/PlGF ratios 111–201 and birthweights ≤10th centile (p < 0.01, odds ratio [OR] 3.04, 95% confidence interval [CI] 1.52–6.10), and between operative delivery for suspected fetal welfare compromise and sFlt-1/PlGF ratios 111–201 (p = 0.04, OR 2.21, 95% CI 1.03–4.75) and >201 (p = 0.01, OR 4.73, 95% CI 1.45–15.4).

Conclusions

This study indicates that maternal serum sFlt-1/PlGF ratios performed at term may subsequently help identify significantly small-for-gestational age fetuses and operative delivery for suspected fetal welfare compromise. Further prospective studies may confirm these findings and substantiate the clinical importance of sFlt-1/PlGF measurements in assisting the management of pregnancies at term.

目的：评估临产时母体血清可溶性瘤样酪氨酸激酶-1（sFlt-1）与胎盘生长因子（PlGF）的比值是否能预测以下不良妊娠结局：胎龄偏小的新生儿；因怀疑胎儿福利受损而进行的手术分娩；以及新生儿受损：方法：对包含产前可溶性酪氨酸激酶-1与胎盘生长因子（sFlt-1/PlGF）比值结果以及相关人口学、临床和检查信息的单个医院数据库进行回顾性分析。对妊娠≥37周时进行产前sFlt-1/PlGF测量的受试者进行了分析。sFlt-1/PlGF比值临界值201与以下结果进行了测试：出生体重≤第10百分位数和≤第3百分位数；因怀疑胎儿福利受损而进行的手术分娩；5分钟Apgar评分；新生儿入院接受额外护理：结果：发现sFlt-1/PlGF比率111-201与出生体重≤10百分位数（p 201 (p = 0.01, OR 4.73, 95% CI 1.45-15.4)）之间有统计学意义：这项研究表明，在足月时进行的母体血清sFlt-1/PlGF比值随后可帮助识别明显小于胎龄的胎儿，并在怀疑胎儿福利受损时进行手术分娩。进一步的前瞻性研究可能会证实这些发现，并证实sFlt-1/PlGF测量在协助足月妊娠管理方面的临床重要性。

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引用次数: 0

Prolonged prothrombin time in hyperemesis gravidarum as an indicator of vitamin K deficiency 妊娠剧吐凝血酶原时间延长作为维生素K缺乏的指标。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2025-01-02 DOI: 10.1111/jog.16198

Nozomi Ouchi, Yoshimitsu Kuwabara, Mirei Yonezawa, Jun Ogawa, Sayuri Kasano, Masahiko Kato, Ryuhei Kurashina, Tomoko Ichikawa, Ikuno Kawabata, Shunji Suzuki

Aim

Maternal vitamin K (VK) deficiency can lead to fetal complications such as cerebral hemorrhage and bone malformations. In this study, we aimed to analyze changes in prothrombin time (PT) and protein induced by VK absence or antagonist II (PIVKA-II) in patients with severe hyperemesis gravidarum with suspected VK deficiency.

Methods

We compared 151 patients with severe hyperemesis gravidarum treated with intravenous nutrition to 46 patients undergoing cervical suturing or benign ovarian tumor surgery before mid-pregnancy.

Results

In the hyperemesis group, coagulation factors, including PT (s), prothrombin activity, INR, and APTT, showed a significant shift toward fibrinolysis compared to control (p < 0.001). The changes were within the normal range, except for PT (s), which was prolonged (14.6 ± 1.4 s). PIVKA-II was measured 25 times in 11 cases of hyperemesis and significantly correlated with PT (s). Moreover, VK was supplemented in four cases with severe VK deficiency, promptly normalizing both PT (s) and PIVKA-II.

Conclusions

Monitoring VK deficiency using PT (s) and PIVKA-II, with timely VK supplementation, may help prevent fetal complications in severe hyperemesis gravidarum.

目的：母体维生素K （VK）缺乏可导致胎儿并发症，如脑出血和骨骼畸形。在本研究中，我们旨在分析怀疑VK缺乏的严重妊娠剧吐患者凝血酶原时间（PT）和蛋白的变化。方法：将151例经静脉营养治疗的重度妊娠剧吐患者与46例妊娠中期前行宫颈缝合或卵巢良性肿瘤手术的患者进行比较。结果：在剧吐组中，凝血因子，包括PT (s)、凝血酶原活性、INR和APTT，与对照组相比，显示出纤溶的显著转变(p结论：使用PT (s)和PIVKA-II监测VK缺乏，及时补充VK，可能有助于预防严重妊娠剧吐的胎儿并发症。

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引用次数: 0

Correlation between the 5-tier fetal heart rate pattern classification at delivery and Apgar scores 分娩时5级胎儿心率模式分类与Apgar评分的相关性。

IF 1.6 4区医学 Q3 OBSTETRICS & GYNECOLOGY

Journal of Obstetrics and Gynaecology Research

Pub Date : 2024-12-30 DOI: 10.1111/jog.16199

Mariko Watanabe, Norikazu Watanabe, Mika Fukase, Keiko Yamanouchi, Satoru Nagase

Aim

In Japan, the fetal heart rate pattern on cardiotocography is usually categorized into five levels for intrapartum management; however, studies on the 5-tier cardiotocography classification are limited. This study aimed to determine the correlation between 5-tier cardiotocography levels at delivery, neonatal Apgar scores and perinatal prognosis using a perinatal registry database.

Methods

This retrospective study used the 2018 Perinatal Registry Database of the Japan Society of Obstetrics and Gynecology. Apgar scores and perinatal prognosis were compared between patients with Japan Society of Obstetrics and Gynecology intrapartum cardiotocography levels 1–2, and levels 3–5.

Results

In total, 240 987 cases were registered, with 114 201 full-term deliveries comprising 84 703 vaginal and 29 498 cesarean deliveries. For vaginal delivery cases, the crude odds ratios of 1-min Apgar score ≤3 for levels 3 (odds ratio: 1.7, 95% confidence interval: 1.4–2.0, p < 0.0001), levels 4 (odds ratio: 5.9, 95% confidence interval: 5.1–6.9, p < 0.0001), and levels 5 (odds ratio: 49.2, 95% confidence interval: 37.5–64.5, p < 0.0001) were significantly higher than those for levels 1–2 (odds ratio: 1.0). Moreover, the crude odds ratios of 5-min Apgar score ≤ 3 for levels 4 (odds ratio: 4.8, confidence interval: 2.7–8.7, p < 0.0001), and levels 5 (odds ratio: 71.1, confidence interval: 32.6–155.1, p < 0.0001) were significantly higher than those for levels 1–2 (odds ratio: 1.0). Similarly, in cases of cesarean delivery, it showed a similar trend to case of vaginal delivery cases.

Conclusion

The 5-tier cardiotocography classification can predict severe neonatal asphyxia.

目的：在日本，通常将胎心摄影上的胎儿心率模式分为五个级别，用于分娩时的管理；然而，关于5层心脏造影分类的研究有限。本研究旨在通过围产期登记数据库确定分娩时5级心血管造影水平、新生儿Apgar评分和围产期预后之间的相关性。方法：采用日本妇产科学会2018年围产期登记数据库进行回顾性研究。比较日本妇产学会分娩期心脏造影分级1-2级和3-5级患者的Apgar评分和围产儿预后。结果：共登记240 987例，足月分娩114 201例，其中阴道分娩84 703例，剖宫产29 498例。对于阴道分娩病例，3级1 min Apgar评分≤3的粗优势比（优势比：1.7,95%可信区间：1.4 ~ 2.0,p）结论：5级心脏科分级可预测新生儿重度窒息。

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引用次数: 0