目的研究正常阴道分娩和选择性剖宫产对女性下尿路解剖和控尿功能的近期影响.方法选择2003年1~12月在我院作产前检查的24例孕妇为研究组,再进一步均分为正常阴道分娩亚组和选择性剖宫产亚组,以20名非妊娠健康女性为对照组.研究组于孕38...目的研究正常阴道分娩和选择性剖宫产对女性下尿路解剖和控尿功能的近期影响.方法选择2003年1~12月在我院作产前检查的24例孕妇为研究组,再进一步均分为正常阴道分娩亚组和选择性剖宫产亚组,以20名非妊娠健康女性为对照组.研究组于孕38~40周和产后6~8周、对照组于排卵期分别进行前庭超声和尿动力检查,分析尿道膀胱连接部移动度(UVJ-M)、静态最大尿道关闭压(MUCP)、功能性尿道长度(FL)和腹压漏尿点压(VLPP)在分娩前、后的变化以及与非妊娠女性的差异.结果各组VLPP均>90 cm H2O.分娩前、后的UVI-M均较非妊娠女性明显增加(P<0.01),分娩后均较分娩前轻度下降(P>0.05),两种分娩方式分娩后UVJ-M的差异无显著性(P>0.05).分娩后MUCP均较分娩前及非妊娠女性显著增加(P<0.01),两种分娩方式分娩后MUCP的差异无显著性(P>0.05).分娩前FL较非妊娠女性明显增加(P<0.01),两种分娩方式分娩后FL的差异无显著性(P>0.05),且与非妊娠女性的差异亦无显著性(P>0.05).结论正常阴道分娩和选择性剖宫产近期内不降低女性下尿路的控尿功能,但是妊娠末期膀胱颈活动度明显增加,并持续到分娩后,是压力性尿失禁的危险因素之一,这种改变是否会随着时间而加重有待长期随访.展开更多
Objective: The mechanisms underlying increased cardio vascular risk among women with a history of pre-eclampsia remain unclear. Imp aired endothelial function has been observed in both pre-eclampsia and atherosc leros...Objective: The mechanisms underlying increased cardio vascular risk among women with a history of pre-eclampsia remain unclear. Imp aired endothelial function has been observed in both pre-eclampsia and atherosc lerosis, and provides a plausible link between the two conditions. We studied en dothelial function and arterial compliance in non-pregnant, previously pre-ecl amptic women. Design: A study of 30 women with a history of pre-eclampsia and 2 1 women with a previous normotensive, uncomplicated pregnancy was carried out. M ethods: Changes in brachial artery blood flow, induced by intra-arterial infusi ons of an endothelium-independent(sodium nitroprusside) and an endothelium-dep endent(acetylcholine) vasodilator,were measured by venous occlusion plethysmogra phy. Arterial stiffness was assessed by pulse wave analysis. Results: Vasodilata tion was impaired in women with previous pre-eclampsia; at low and high concent rations of endothelium-independent(P=0.004 and P=0.057, respectively) and endot helium-dependent(P=0.045 and P=0.02) vasodilators, respectively. There was no d ifference in arterial stiffness between the groups(P=0.45). In multiple regressi on analyses both endothelium-independent and endothelium-dependent vasodilatat ions were independently associated with a history of pre-eclampsia and parity. There was no correlation with blood pressure, body mass index(BMI), smoking or a ge. Conclusions: The finding of impaired vascular dilatation several years after a pre-eclam-ptic pregnancy could contribute to the higher risk of cardiovascu lar disease in these women.展开更多
文摘目的研究正常阴道分娩和选择性剖宫产对女性下尿路解剖和控尿功能的近期影响.方法选择2003年1~12月在我院作产前检查的24例孕妇为研究组,再进一步均分为正常阴道分娩亚组和选择性剖宫产亚组,以20名非妊娠健康女性为对照组.研究组于孕38~40周和产后6~8周、对照组于排卵期分别进行前庭超声和尿动力检查,分析尿道膀胱连接部移动度(UVJ-M)、静态最大尿道关闭压(MUCP)、功能性尿道长度(FL)和腹压漏尿点压(VLPP)在分娩前、后的变化以及与非妊娠女性的差异.结果各组VLPP均>90 cm H2O.分娩前、后的UVI-M均较非妊娠女性明显增加(P<0.01),分娩后均较分娩前轻度下降(P>0.05),两种分娩方式分娩后UVJ-M的差异无显著性(P>0.05).分娩后MUCP均较分娩前及非妊娠女性显著增加(P<0.01),两种分娩方式分娩后MUCP的差异无显著性(P>0.05).分娩前FL较非妊娠女性明显增加(P<0.01),两种分娩方式分娩后FL的差异无显著性(P>0.05),且与非妊娠女性的差异亦无显著性(P>0.05).结论正常阴道分娩和选择性剖宫产近期内不降低女性下尿路的控尿功能,但是妊娠末期膀胱颈活动度明显增加,并持续到分娩后,是压力性尿失禁的危险因素之一,这种改变是否会随着时间而加重有待长期随访.
文摘Objective: The mechanisms underlying increased cardio vascular risk among women with a history of pre-eclampsia remain unclear. Imp aired endothelial function has been observed in both pre-eclampsia and atherosc lerosis, and provides a plausible link between the two conditions. We studied en dothelial function and arterial compliance in non-pregnant, previously pre-ecl amptic women. Design: A study of 30 women with a history of pre-eclampsia and 2 1 women with a previous normotensive, uncomplicated pregnancy was carried out. M ethods: Changes in brachial artery blood flow, induced by intra-arterial infusi ons of an endothelium-independent(sodium nitroprusside) and an endothelium-dep endent(acetylcholine) vasodilator,were measured by venous occlusion plethysmogra phy. Arterial stiffness was assessed by pulse wave analysis. Results: Vasodilata tion was impaired in women with previous pre-eclampsia; at low and high concent rations of endothelium-independent(P=0.004 and P=0.057, respectively) and endot helium-dependent(P=0.045 and P=0.02) vasodilators, respectively. There was no d ifference in arterial stiffness between the groups(P=0.45). In multiple regressi on analyses both endothelium-independent and endothelium-dependent vasodilatat ions were independently associated with a history of pre-eclampsia and parity. There was no correlation with blood pressure, body mass index(BMI), smoking or a ge. Conclusions: The finding of impaired vascular dilatation several years after a pre-eclam-ptic pregnancy could contribute to the higher risk of cardiovascu lar disease in these women.