Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, i...Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 ： 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging （MRI）. The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.展开更多
The antiphospholipid syndrome(APS)is a multi-systemic disease being characterized by the presence of antiphospholipid antibodies that involves both arterial and venous systems resulting in arterial or venous thrombosi...The antiphospholipid syndrome(APS)is a multi-systemic disease being characterized by the presence of antiphospholipid antibodies that involves both arterial and venous systems resulting in arterial or venous thrombosis,fetal loss,thrombocytopenia,leg ulcers,livedo reticularis,chorea,and migraine.We document a previously unreported case of a 37-year-old female in whom APS was first manifested by infarction and cecal perforation following cesarean section.At laparotomy the underlying cause of colonic perforation was not clear and after resection of the affected bowel an ileo-colostomy was performed.The diagnosis of APS was established during post-operative hospital stay and the patient was commenced on warfarin.Eventually,she made a full recovery and had her stoma reversed after 4 mo.Pregnancy poses an increased risk of complications in women with APS and requires a more aggressive approach to the obstetric care.This should include full anticoagulation in the puerperium and frequent doppler ultrasound monitoring of uterine and umbilical arteries to detect complications such as preeclampsia and placental insufficiency.展开更多
目的：探讨产前预测新生儿出生体重的方法，为降低产时并发症（产后出血、软产道裂伤、生殖道瘘、肩难产、新生儿窒息）提供科学依据。方法：根据孕前体重指数（Body Mass Index，BMI）将研究对象分为高体重组、标准体重组、低体重组。...目的：探讨产前预测新生儿出生体重的方法，为降低产时并发症（产后出血、软产道裂伤、生殖道瘘、肩难产、新生儿窒息）提供科学依据。方法：根据孕前体重指数（Body Mass Index，BMI）将研究对象分为高体重组、标准体重组、低体重组。孕期增重〉18kg，定为高增重组；孕期增重9—18kg，定为标准增重组；孕期增重〈9kg，定为低增重组。分别计算各组新生儿平均体重、巨大儿发生率、低体重儿发生率。应用超声测量胎儿腹围（Fetal Abdominal Circumference，FAC），分析胎儿腹围与新生儿出生体重的关系。结果：各组新生儿平均体重、巨大儿发生率、低体重儿发生率均有差异，差异有统计学意义。FAC≥36cm时，巨大儿发生率83．33％，明显高于非巨大儿发生率，差异有统计学意义。多因素逐步回归分析新生儿出生体重与孕前BMI最相关，与孕期增重、FAC也相关，得出预测新生儿体重的回归方程式：新生儿出生体重=106．204＋90．999X孕前BMI＋31．756X孕期增重＋27．613×FAC。预测巨大JI,I~H性率91．84％，剖宫产率77．55％。556例孕妇中无1例产时并发症。结论：联合应用超声测量、孕妇孕前体重指数（BMI）及孕期增重预测新生儿出生体重的方法值得推广应用。展开更多
Objective: To explore the characteristics of closed abdominal injury in pregnancy women and its treatment.Methods: The clinical data of 37 pregnancy patients with closed abdominal injury treated in our hospital from J...Objective: To explore the characteristics of closed abdominal injury in pregnancy women and its treatment.Methods: The clinical data of 37 pregnancy patients with closed abdominal injury treated in our hospital from June 1993 to June 2003 were collected and analyzed.Results: All the 37 patients were treated with operation. Among them 2 early pregnancy patients with intestinal rupture and 1 patient with retroperitoneal hematoma were treated under laparoscope; in other 34 pregnancy patients laparotomy was performed. Of the 34 patients 8 used cesarean section because premature separation of placenta and enlarged womb interrupted the management of intra-abdominal organ injury. In the 37 patients 33 ( 89.1%) were cured, 4 ( 10.8%) die, postoperative complication rate was 16.2% (6/37). Two patients ( 5.4%) suffered from abdominal cavity infection, 3 ( 8.1%) from pulmonary infection, and 1 ( 2.7%) had multi-organ failure.Conclusions: For pregnancy patients with closed abdominal injury, besides obsteric diseases intra-abdominal injury should be given much attention. Accurate diagnosis and timely treatment can gain the time to save the life of both mother and fetus.展开更多
文摘Objective To investigate the early diagnosis and treatment of cesarean scar pregnancy （CSP）. Methods Clinical data of 28 patients with CSP in Peking Union Medical College Hospital from January 1994 to April 2007, including age, interval from the last cesarean delivery to diagnosis, clinical presentation, location of the lesion, process of diagnosis and treatment, outcome, and follow-up, were retrospectively analyzed. Re, salts CSP constituted 1.05 % of all ectopic pregnancies, and the ratio of CSP to pregnancy was 1 ： 1 221. The mean age of the group was 31.4 years. Twenty-six women had only one prior cesarean delivery. The interval from the last cesarean delivery to diagnosis ranged from 4 months to 15 years. The most common presenting symptoms of CSP were amenorrhoea and vaginal bleeding. Seventeen cases were misdiagnosed as early intrauterine pregnancies and 2 were misdiagnosed as gestational trophoblastic tumor. The other 9 were diagnosed definitely before treatment. The diagnosis was made based on cesarean delivery history, gynecologic examination, ultrasound, and magnetic resonance imaging （MRI）. The treatment of CSP included systemic or local methotrexate administration, conservative surgery, and hysterectomy. The conservative treatment was successful in 24 cases. All of the 28 women were cured through individual therapies. Conclusions CSP is rare and usually misdiagnosed as other diseases. Ultrasound is valuable for diagnosing CSP, and MRI can be used as an adjunct to ultrasound scan. Early diagnosis offers the options of conservative treatment and greatly improves the outcome of patients. Individual therapy is strongly recommended.
文摘The antiphospholipid syndrome(APS)is a multi-systemic disease being characterized by the presence of antiphospholipid antibodies that involves both arterial and venous systems resulting in arterial or venous thrombosis,fetal loss,thrombocytopenia,leg ulcers,livedo reticularis,chorea,and migraine.We document a previously unreported case of a 37-year-old female in whom APS was first manifested by infarction and cecal perforation following cesarean section.At laparotomy the underlying cause of colonic perforation was not clear and after resection of the affected bowel an ileo-colostomy was performed.The diagnosis of APS was established during post-operative hospital stay and the patient was commenced on warfarin.Eventually,she made a full recovery and had her stoma reversed after 4 mo.Pregnancy poses an increased risk of complications in women with APS and requires a more aggressive approach to the obstetric care.This should include full anticoagulation in the puerperium and frequent doppler ultrasound monitoring of uterine and umbilical arteries to detect complications such as preeclampsia and placental insufficiency.
文摘目的：探讨产前预测新生儿出生体重的方法，为降低产时并发症（产后出血、软产道裂伤、生殖道瘘、肩难产、新生儿窒息）提供科学依据。方法：根据孕前体重指数（Body Mass Index，BMI）将研究对象分为高体重组、标准体重组、低体重组。孕期增重〉18kg，定为高增重组；孕期增重9—18kg，定为标准增重组；孕期增重〈9kg，定为低增重组。分别计算各组新生儿平均体重、巨大儿发生率、低体重儿发生率。应用超声测量胎儿腹围（Fetal Abdominal Circumference，FAC），分析胎儿腹围与新生儿出生体重的关系。结果：各组新生儿平均体重、巨大儿发生率、低体重儿发生率均有差异，差异有统计学意义。FAC≥36cm时，巨大儿发生率83．33％，明显高于非巨大儿发生率，差异有统计学意义。多因素逐步回归分析新生儿出生体重与孕前BMI最相关，与孕期增重、FAC也相关，得出预测新生儿体重的回归方程式：新生儿出生体重=106．204＋90．999X孕前BMI＋31．756X孕期增重＋27．613×FAC。预测巨大JI,I~H性率91．84％，剖宫产率77．55％。556例孕妇中无1例产时并发症。结论：联合应用超声测量、孕妇孕前体重指数（BMI）及孕期增重预测新生儿出生体重的方法值得推广应用。
文摘Objective: To explore the characteristics of closed abdominal injury in pregnancy women and its treatment.Methods: The clinical data of 37 pregnancy patients with closed abdominal injury treated in our hospital from June 1993 to June 2003 were collected and analyzed.Results: All the 37 patients were treated with operation. Among them 2 early pregnancy patients with intestinal rupture and 1 patient with retroperitoneal hematoma were treated under laparoscope; in other 34 pregnancy patients laparotomy was performed. Of the 34 patients 8 used cesarean section because premature separation of placenta and enlarged womb interrupted the management of intra-abdominal organ injury. In the 37 patients 33 ( 89.1%) were cured, 4 ( 10.8%) die, postoperative complication rate was 16.2% (6/37). Two patients ( 5.4%) suffered from abdominal cavity infection, 3 ( 8.1%) from pulmonary infection, and 1 ( 2.7%) had multi-organ failure.Conclusions: For pregnancy patients with closed abdominal injury, besides obsteric diseases intra-abdominal injury should be given much attention. Accurate diagnosis and timely treatment can gain the time to save the life of both mother and fetus.
