Effects of Aspirin on Pregnancy Outcome and Serum Endothelin-1 and Thrombomodulin Levels in Pregnancy Patients with Chronic Hypertension

Objective: To investigate the effect of aspirin on pregnancy outcome and serum levels of endothelin-1 (ET-1) and thrombomodulin (TM) in pregnancy patients with chronic hypertension. Methods: Selected patients with chronic hypertension (mild to moderate) during pregnancy, who were enrolled and delivered in the Beijing Tongren Hospital Department of Obstetrics and Gynecology between January 1, 2019 and December 30, 2020. The patients were randomly divided into control group (60) and experimental group (60). The control group was treated with labetalol and the test group was treated with labetalol and aspirin. The therapeutic effect and pregnancy outcome of the two groups were compared. The serum levels of ET-1 and TM were measured before treatment and one week after treatment. Results: Systolic blood pressure (SBP) decreased significantly one week after treatment in the two groups (P < 0.05). One week after treatment, the values of ET-1 and TM in the experimental group were significantly lower than those in the Control Group, the difference is statistically significant (P < 0.05). The incidence of Preeclampsia, intrauterine growth retardation, oligohydramnios, placental abruption, Cesarean section and preterm birth in the experimental group was significantly lower than that in the control group. There was significant difference between the two groups, especially Preeclampsia and Intrauterine Growth Retardation (P < 0.05). Conclusion: Besides routine treatment, aspirin can improve the outcome of pregnant women with chronic hypertension, which may be related to the regulation of ET-1 and TM by aspirin.

Clinical Observation of Misoprostol before and after Painless Induced Abortion

Background: Though painless abortion is a safe, effective and excellent method of artificial abortion, intravenous anesthesia cannot effectively expand the cervix. Hard and tight cervix often affects the operation and easily inducesabortion complications. Misoprostol can induce uterine contraction and soften the cervix. Objective: To investigate the clinical effect of misoprostol on abortion before and after painless induced abortion. Methods: 600 case pregnant women were divided into three groups: A, B and C, 200 case in each group. All patients were anesthetized. In group A, misoprostol 0.2 ug was placed in the posterior fornix of vagina 2 hours before the operation of induced abortion;in group B, misoprostol 0.2 ug was not only placed in the posterior fornix of vagina 2 hours before the operation of induced abortion but also taken orally 2 hours and 6 hours after the operation;in group C, misoprostol was not used before and after the operation. The operation time, intraoperative bleeding volume, postoperative bleeding, the percentage of cervical relaxation and the rate of incomplete abortion among the three groups were compared. Results: Compared with group A and group B, the operation time of group C was longer and the amount of bleeding was more (P < 0.05), but there was no significant difference between group A and group B (P > 0.05). The duration of bleeding in group B was less than that in group A (P < 0.05). The percentage of cervical relaxation in group A and B was higher than that in group C (P < 0.05). The rate of incomplete abortion in group B < group A < group C (P < 0.05), and there was no residual uterine cavity in group B. Conclusion: The use of misoprostol before and after painless induced abortion can not only shorten the time of operation, reduce intraoperative and postoperative vaginal bleeding, but also has not incurred incomplete abortion(primary outcome).