Evaluation of process management of postpartum hemorrhage due to uterine atony

Objective: To evaluate the management process and the guidelines for management of postpartum hemorrhage due to uterine atony at the General Hospital Vienna, Medical University Vienna. Material and Methods: A retrospective analysis was carried out on all 24 cases of postpartum hemorrhage due to uterine atony with an estimated blood loss of more than 800 mL, in which standardized guidelines were obtained. We included all women who gave birth at the General Hospital of Vienna, the Medical University Vienna, during the period from January 1st 2003 and December 31st 2009 and who suffered blood loss 800 mL at minimum due to uterine atony. Results: The guidelines were in use for 14% - 71%. The average blood loss of the 24 cases with uterine atony was 1342 mL. Conclusion: The management process of postpartum hemorrhage due to uterine atony deviates from the hospital’s guidelines in many cases.

The Active Management of Postpartum Uterine Atony—A Checklist Based Approach

Uterine atony remains the major cause of postpartum hemorrhage, and of death from postpartum hemorrhage in the United States. While existing guidelines outlining a general approach to postpartum hemorrhage are useful, recent data suggest that greater specificity may be necessary to significantly impact mortality. We present a highly specific and methodical approach to the management of uterine atony, which addresses what we believe to be the most common cause of preventable maternal hemorrhagic death in the US—lack of an intensive, focused approach to atony and perseverance with therapies that are not working. This protocol should result in cessation of hemorrhage by medical or surgical means within 1 hour of diagnosis. We then apply this protocol to a number of illustrative cases of maternal death due to atony. An approach involving the active management of uterine atony may assist clinicians in avoiding severe morbidity and mortality from uterine atony.

Uterine Artery Embolization for Management of Primary Postpartum Hemorrhage Associated with Placenta Accreta

Objective To evaluate the efficacy and safety of uterine artery embolization(UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women(mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization. The complications, control of hemorrhage and recurrent bleeding of the placenta left inside the uterus were retrospectively collected for assessment. Results All patients underwent transcatheter embolization of bilateral uterine arteries. The technical success rate of embolization was 100%. Bleeding was controlled in 17 of 18 patients(94%) during follow-up period(median 18 months, 3-31months) without further bleeding recurred. One patient with placenta percreta undertook an emergent hysterectomy along with surgical bladder repair after UAE because of persistent uterine bleeding. Eight patients had postembolization syndrome and no other complications occurred. Conclusion Uterine artery embolization is an effective and safe treatment for the management of primary postpartum massive hemorrhage associated with placenta accreta.

Efficacy of Uterine Artery Embolization for Patients with Postpartum Hemorrhage

Purpose: To investigate the efficacy of uterine arterial embolization (UAE) in patients with post-partum hemorrhage (PPH). Materials and Methods: The subjects were 40 women (mean age, 33 years;age range, 21 - 42 years) who underwent UAE for PPH at two institutes from June 2001 to May 2011. The rates of clinical success (avoidance of hysterectomy) and complications were calculated. Differences in related factors between primary PPH and secondary PPH and between caesarean section and vaginal delivery were examined. The risk factors associated with hysterectomy were also examined. Results: The overall clinical success rate was 90% (93% of primary PPH, 77% of secondary PPH, and 87.5% of PPH with cesarean section), and the overall complication rate was 10%. There were significant differences in time to PPH (P < 0.0001) and in blood infusion after UAE (P = 0.0158) between subtypes of primary and secondary PPH and in blood infusion before UAE (P = 0.0052) between delivery methods. The significant factors associated with hysterectomy were cesarean section (P = 0.02), severe PPH (>1000 mL bleeding, P = 0.03), and embolization of non-uterine arteries (P = 0.02).

Observation on the effect of carbetocin in preventing postpartum hemorrhage caused by uterine inertia

Objective:To explore the effect of carbetocin in preventing postpartum hemorrhage caused by uterine inertia.Methods: A total of 256 puerpera with single full-term delivery who were admitted in our hospital from May, 2015 to May, 2016 were included in the study and divided into the vaginal delivery group and cesarean section group with 128 cases in each group according to the delivery ways. According to the medication, each group was divided into the carbetocin group and oxytocin group with 64 cases in each group. After fetus delivery, the puerpera in the carbetocin group were given intravenous injection of carbetocin (100μg), while the puerpera in the oxytocin group were given intravenous injection of oxytocin (10 U)+0.9% NaCl (500 mL) for 2 h. The amount of bleeding at delivery, 2 h and 24 h after delivery in each group was observed. A volume of 5 mL elbow venous blood before delivery and 24 h after delivery was extracted. The automatic blood cell analyzer was used to detect the decreased value of 24 h hemoglobin in each group. The coagulation detector was used to detect PT, APTT, and FIB before delivery and 24 h after delivery. The blood pressure and heart rate before and after medication in each group were observed.Results: The amount of bleeding at delivery, 2 h and 24 h after delivery in the carbetocin group was signiifcantly less than that in the oxytocin group (P<0.05). The decreased value of 24 h hemoglobin after delivery in the carbetocin group was signiifcantly less than that in the oxytocin group (P<0.05). The indicators of coagulation function 24 h after delivery in each group were not signiifcantly changed (P>0.05). The heart rate and blood pressure after medication in each group were not significantly changed when compared with before medication (P>0.05).Conclusions:Carbetocin can effectively prevent the postpartum hemorrhage caused by uterine inertia, and is safe and effective in application of vaginal delivery and cesarean section;therefore, it deserves to be widely recommended in the clinic.

Correlation of large conductance Ca2+ activated K+ channelα andβ subunit expression in uterine smooth muscle with the postpartum hemorrhage induced by uterine inertia

Objective:To study the correlation of large conductance Ca2+ activated K+ channel (BKCa)α andβ subunit expression in uterine smooth muscle with the postpartum hemorrhage induced by uterine inertia.Methods: The puerperae who underwent cesarean section and had postpartum hemorrhage induced by uterine inertia in Panzhihua Women and Children Health Hospital between March 2015 and May 2017 were selected as the hemorrhage group of the study, and the puerperae who underwent cesarean section and were without postpartum hemorrhage in Panzhihua Women and Children Health Hospital during the same period were selected as the control group. Proper amount of uterine muscle tissue was collected during the cesarean section to measure the expression of BKCaα andβ subunits and the levels of contraction-related proteins in uterine muscle as well as the contraction characteristic parameters of the uterine muscle.Results: The mRNA expression and protein expression of BKCaα andβ subunits in uterine muscle tissue of hemorrhage group were significantly higher than those of control group;the contraction amplitude, contraction frequency and contraction activity of uterine muscle tissue as well as the OTR, COX2, CX43 and HSP27 levels in uterine muscle tissue of hemorrhage group were significantly lower than those of control group;the BKCaα andβ subunit expression in uterine muscle tissue of hemorrhage group were negatively correlated with the contraction amplitude, contraction frequency and contraction activity as well as the OTR, COX2, CX43 and HSP27 levels.Conclusion: The high expression of BKCa in uterine smooth muscle can reduce the uterine muscle contractility and decrease the levels of contraction-related proteins, and it is closely related to the occurrence of postpartum hemorrhage induced by uterine inertia.

Effect of uterine water bag + gauze packing on coagulation function and stress response of patients with postpartum hemorrhage

Objective:To study the effect of uterine water bag + gauze packing on coagulation function and stress response of patients with postpartum hemorrhage.Methods: Patients who gave birth and had postpartum hemorrhage in the hospital between June 2014 and May 2017 were chosen as the research subjects and divided into the combined group who received uterine water bag + gauze packing hemostasis, the control group 1 who received uterine water bag hemostasis and the control group 2 who received gauze packing hemostasis. The overall clinical efficacy was observed, and the serum levels of blood coagulation function indexes and stress response indexes were determined before treatment and after hemostatic treatment.Results: The intraoperative blood loss, postoperative blood loss and the change of hemoglobin before treatment and after hemostatic treatment of combined group were less than those of control group 1 and control group 2;compared with those of same group before treatment, serum APTT and PT levels as well as FDP, ET-1, ANG-II, ALD, NE, E, TNF-α, IL-6, ICAM1 and VCAM1 contents after hemostatic treatment were significantly lower whereas PAI-1 and AT-III contents were significantly higher, and serum APTT and PT levels as well as FDP, ET-1, ANG-II, ALD, NE, E, TNF-α, IL-6, ICAM1 and VCAM1 contents of combined group after hemostatic treatment were significantly lower than those of control group 1 and control group 2 whereas PAI-1 and AT-III contents were significantly higher than those of control group 1 and control group 2.Conclusion: uterine water bag + gauze packing treatment of postpartum hemorrhage can achieve better efficacy than monotherapy and improve the coagulation function and stress response.

Oxytocin and Uterine Atony during Cesarean Section

In our medical practice, in particular obstetrics, it is difficult to change certain consolidated dogmas, but the necessity and the current situation of our obstetrical exercise pushed us to find new technical supports, to make the exercise of our specialty as stripped of pitfalls as possible. Our work is summarized in a prospective comparative study, aimed at evaluating the existence or not of a difference between the administration of oxytocin just before the hysterotomy in a cesarean section and its administration after fetal extraction. We used a set of criteria to include patients in our study. This study took place over a period of one year (2020) in the Mother and Child regional center, in Meknes Imperial city, Morocco, involving a total number of 364 patients. With a group A comprising 176 patients 48% (176/364) who received oxytocin just before the hysterotomy and a group B of 188 patients 52% (188/364) who received it classically after fetal extraction. The difference was very significant as detailed in the article. Conclusion: the very convincing results of our study and the difference between the two groups, allowed us to demonstrate the effectiveness of our process and to endorse its use in our routine practice, with the perspective of conducting a prospective randomized study on a larger series.

Effect of uterine arterial embolization on the ovarian function in puerpera with postpartum hemorrhage

Objective:To observe the hemostatic effect of uterine arterial embolization in the treatment of postpartum hemorrhage and the effect on menstruation, sex hormone level, ovarian function, and pelvic floor function.Methods:A total of 45 patients with postpartum hemorrhage who were admitted in the Department of Obstetrics of our hospital from January, 2014 to June, 2016 for uterine arterial embolization were included in the study and served as the treatment group. The postoperative menstruation recovery was recorded. The hormone levels, ovarian function, and pelvic floor function before and after treatment were recorded. A total of 42 normal puerpera were served as the control group. The menstrual status of the two groups after menstruation was compared.Results: Rapid and effective hemostasis could be obtained from patients in the treatment group after treatment with hemostasis success rate of 100%. The comparison of menstruation cycle and menstruation days after treatment between the two groups was not statistically significant. The levels of E2, P, FSH, LH and PRL, ovarian function index RI and PI, pelvic floor muscle fatigue and vaginal dynamic pressure before and after 3 and 6 months had no significant difference, and there was no significant difference between the 2 groups.Conclusions: Uterine arterial embolization in the treatment of postpartum hemorrhage is effective, and has no influence on the patient's menstrual conditions, sex hormone levels, ovarian and pelvic floor functions;therefore, it is worthy of clinical application.

Oxytocin Abuse and Postpartum Hemorrhage

Among the most consolidated dogmas in obstetrics, we have the essential role of oxytocin during: labor by regulating, consolidating uterine contractions, by supporting the expulsive efforts of the patient during childbirth and after childbirth by preventing postpartum hemorrhage. But what challenged us to conduct our study is the large and increasing number of surgical operations for postpartum hemorrhage in patients who received oxytocin during labor. We assumed that the generalization use of oxytocin in all patients during labor is probably responsible of this increasing rate of incidents. To verify this assumption, we carried out a prospective randomized comparative study, involving 3990 pregnant patients admitted at the start of labor at term, with no contraindication for giving birth by normal ways, during a period of 10 months (January-October 2022). The patients have been divided into 2 groups. The first group comprises 1991 patients who were placed on admission on a glucose serum infusion with 4 ampoules of a non-anticholinergic musculotropic antispasmodic: “Hydrated phloroglucinol + trimethylphloroglucinol” (Each ampoule contains 40 mg of hydrated phloroglucinol and 0.04 mg of trimethylphloroglucinol) instead of receiving oxytocin during the active phase of their labor and a second group consisting of 1999 patients who received oxytocin during the active phase of their labor. The results were very surprising and contrary to the already consolidated evidence in our specialty. Indeed, the rate of postpartum hemorrhages was 10 patients (0.5%) in the 1st group vs 30 patients (1.5%) in the 2nd group, 9 patients (0.4%) presented fetal heart rate abnormalities in the 1st group vs 90 (4.5%) in the 2nd group, 8 cases (0.4%) of dynamic dystocia in the 1st group vs 132 cases (6.6%) in the 2nd group and 99 caesareans (5%) in the 1st group vs 299 (15%) in the 2nd group. Against all expectations the results were very surprising, with more details in the article.

Balloon Tamponade in the Management of Postpartum Hemorrhage: Three Years of Experience in a Single Center

Introduction: Postpartum hemorrhage (PPH) is one of the leading causes of maternal death in the world and it is reported to occur in 5% - 8% of pregnancies. Objective: This study aimed to present a single centre’s experience in treating PPH by balloon tamponade. Methods: During the time period between January 2013 and March 2016, 50 patients who had undergone balloon tamponade for postpartum hemorrhage in our clinic were evaluated retrospectively. The patients’ age, parity, type of delivery, birth weight, hemoglobin and platelet values, total blood loss from catheter, balloon’s staying time, blood and platelet transfusion status, the presence of placenta anomalies and the Bakri balloon hemostasis success rate were evaluated. Results: During the study period, there were 27,249 deliveries. The frequency of massive postpartum hemorrhage was 0.61% (n = 168). Among the 168 patients with massive postpartum hemorrhage, there were 50 patients in whom the Bakri balloon catheter was used. Bakri balloons were placed via cesarean section incision in 19 patients and via vagina in 31 patients. The mean staying time of Bakri balloon was 18 hours. In 8 patients, balloon tamponade failed. Two patients underwent hysterectomy;other two patients had surgical ligation of the hypogastric artery. Four cases were referred to a tertiary center. Placental invasion abnormalities were observed in five patients. The overall Bakri balloon hemostasis successful rate was found to be as 84% in all cases. Conclusion: Bakri balloon tamponade is an effective, safe and practical approach in the treatment of postpartum hemorrhage.

An old uterine rupture repaired 2 months postpartum using laparoscopy aided by hysteroscopy: A case report

With an incidence of 0.005%,unscarred uterine rupture is extremely rare.It is difficult to diagnose uterine rupture because of the absence of characteristic clinical symptoms.Here,we report a rare case of a 31-year-old woman with a uterine rupture that was accurately diagnosed and repaired by laparoscopy and hysteroscopy on postpartum day 69.The patient recovered uneventfully and was discharged on postoperative day 4.Three months after surgery,pelvic magnetic resonance imaging was performed,which confirmed wound repair.In women with a stable condition,laparoscopy with hysteroscopy could be an alternative choice for the diagnosis and treatment of suspected uterine rupture;however,more substantial studies are needed to confirm this surgical approach.

马来酸麦角新碱联合卡前列素氨丁三醇对宫缩乏力性产后出血的防治效果

目的探究马来酸麦角新碱联合卡前列素氨丁三醇在宫缩乏力性产后出血防治中的应用效果,以期为临床提供一种更安全有效的治疗方案。方法收集2020年3月至2022年3月在本院就诊的自然分娩产妇82例,采用随机数字表法分组,即对照组、观察组,均41例。对照组予以缩宫素注射液,观察组在对照组的基础上增加马来酸麦角新碱联合卡前列素氨丁三醇。统计两组产妇产后出血情况、宫底情况及不良反应等。结果观察组产妇产后2h、12h、24h出血量、产后出血发生率、宫底高度、恶露持续时间、宫腔积血发生率均低于对照组(P<0.05);两组不良反应发生率比较,P>0.05。结论来酸麦角新碱联合卡前列素氨丁三醇在宫缩乏力性产后出血防治中具有显著的应用优势,能有效降低产后出血发生率和出血量,减少宫底高度和恶露持续时间,且安全性高。

基于循证案例分析的优质护理对宫缩乏力性产后出血的护理效果

目的:探讨基于循证案例分析的优质护理对宫缩乏力性产后出血患者的护理效果。方法:选取104例宫缩乏力性产后出血患者,按照护理方式不同将患者分为对照组和观察组,两组各52例。对照组给予常规护理;观察组在常规护理基础上使用基于循证案例分析的优质护理,对比两组患者的出血情况、临床疗效、凝血及纤溶功能指标水平、并发症发生情况、生活质量。结果:观察组患者产后0.5、2、12及24 h出血量均少于对照组,止血耗时短于对照组(P<0.05);干预后,观察组患者活化部分凝血活酶时间(APTT)、凝血酶原时间(PT)、D-二聚体(D-D)水平均低于对照组,纤维蛋白原(FIB)水平高于对照组(P<0.05);观察组并发症总发生率低于对照组(P<0.05);观察组患者SF-36量表各维度评分均高于对照组(P<0.05)。结论:基于循证案例分析的优质护理可有效降低宫缩乏力性产后出血患者的出血量,缩短止血时间,改善凝血及纤溶功能,减少并发症发生率,提高生活质量。

卡前列素氨丁三醇与麦角新碱预防剖宫产产妇出血及对子宫复旧的作用

目的观察卡前列素氨丁三醇与麦角新碱预防剖宫产产妇出血及对子宫复旧的作用。方法该项目为回顾性研究,选取2019年3月至2024年1月在合肥市第一人民医院行剖宫产术的产妇118例,根据产后药物干预方案分为A组(n=48,采用麦角新碱治疗)、B组(n=33,采用卡前列素氨丁三醇治疗)和C组(n=37,采用卡前列素氨丁三醇联合麦角新碱治疗)。收集3组患者临床资料,比较3组患者产后出血量、恶露持续时间、住院时间、产后出血发生率及子宫复旧情况,评估3组产妇药品不良反应。结果A组和B组产后2 h及24 h出血量、恶露持续时间和住院时间分别为[A:(343.58±49.32)mL,(426.35±68.65)mL,(18.25±3.21)d,(5.26±0.25)d;B:(341.63±54.27)mL,(431.25±63.59)mL,(17.98±2.66)d,(5.34±0.32)d]比较,差异无统计学意义(t=0.168,0.325,0.398,1.261,P=0.867,0.746,0.692,0.211)(P>0.05);C组产后2 h及24 h出血量,恶露持续时间和住院时间分别为(215.65±42.36)mL,(301.36±50.35)mL,(14.21±2.14)d,(4.21±0.43)d,均少于A组和B组(C vs A:t=16.968,13.030,9.465,20.289,均P<0.001;C vs B:t=15.267,12.372,8.070,19.950,均P<0.001)。3组产后出血发生率分别为4.17%,30.3%,0,差异无统计学意义(P=0.624)。A组和B组产后3 d、5 d的子宫下降程度分别为[A:(2.09±0.18)cm,(4.03±0.25)cm;B:(2.16±0.39)cm,(4.15±0.34)cm],均差异无统计学意义(t=1.088,1.831,P=0.280,0.071),C组以上指标分别为(2.94±0.23)cm,(4.89±0.29)cm,均大于A组和B组(C vs A:t=20.460,17.154,均P<0.001;C vs B:t=19.177,15.077,均P<0.001)。A,B,C组患者总不良反应发生率分别为14.58%,9.09%,24.32%,差异无统计学意义(χ^(2)=3.134,P=0.209)。结论卡前列素氨丁三醇与麦角新碱均可有效促进子宫收缩,预防产后出血,促进子宫复旧,两者联合可能具有协同作用,可更进一步的提高临床效果。

子宫动脉栓塞术对产后出血患者并发症及再次妊娠围生期妊娠结局的影响

目的探讨子宫动脉栓塞术(UAE)对产后出血(PPH)患者并发症及再次妊娠围生期妊娠结局的影响。方法选择2015年1月至2019年12月唐山市妇幼保健院妇接收的79例UAE治疗的PPH患者作为UAE组,选择同期在我院接受子宫动脉结扎术(UAL)治疗的78例PPH患者作为UAL组。比较两组术中及术后恢复情况、卵巢功能指标水平、术后近远期并发症发生率及再次妊娠围生期妊娠结局。通过logistic回归分析确定产后出血治疗后远期并发症发生的影响因素。结果UAE组术中失血量[(959.70±203.15)mL]、止血时间[(30.59±5.81)min]、住院时间[(7.33±1.58)d]、产后月经恢复时间[(72.14±16.42)d]均少于UAL组,产后首次月经量/妊娠前平均月经量(1.13±0.35)多于UAL组,差异均有统计学意义(P<0.05);UAL组术后抗缪勒氏管激素(AMH)、雌二醇(E_(2))水平较术前降低(P<0.05),卵泡刺激素(FSH)水平较术前增高(P<0.05),两组术前后AMH、E_(2)、FSH的差值比较,差异有统计学意义(P<0.05);UAE组近期、远期并发症发生率分别为3.80%和5.06%,均低于UAL组(P<0.05);logistic回归分析显示,治疗方式是产后出血治疗后远期并发症发生的影响因素;两组再次妊娠者瘢痕部位妊娠、自然流产、前置胎盘等围产期妊娠结局发生率比较,差异无统计学意义(P>0.05)。结论与UAL相比,UAE对PPH患者的止血更迅速,月经恢复时间更短,对卵巢功能的影响更小,近、远期并发症发生率更低。在再次妊娠者围生期妊娠结局方面,两种止血方式未见差异。

子宫动脉栓塞介入治疗产后出血中全面性护理的效果

目的:明确全面性护理在子宫动脉栓塞介入治疗产后出血中的应用效果。方法:在本院2018年1月至2022年12月时间段内接受子宫动脉栓塞介入治疗的产后出血患者中抽取50例作为研究对象,随机分为对照组和观察组,均纳入25个病例;基础护理方案用于对照组患者的护理,全面性护理方案用于观察组患者的护理;比较两组临床观察指标、护理满意度和护理效果情况。结果:观察组止血时间、手术时间、下床活动时间和住院时间短于对照组,术后出血量少于对照组,差异明显(P<0.05);观察组护理满意度高于对照组,差异明显(P<0.05);观察组一次性栓塞成功率高于对照组,并发症发生率低于对照组,差异明显(P<0.05)。结论:产后出血患者子宫动脉栓塞介入治疗中给予全面性护理服务,应用效果较好,推广应用价值高。

子宫背带缝合术联合子宫动脉上行支结扎术治疗难治性产后出血的临床效果

目的探究难治性产后出血联合应用子宫背带缝合术、子宫动脉上行支结扎术的临床效果。方法选取本院妇产科300例难治性产后出血患者为研究对象,根据抽签法分为两组,各150例。试验组行子宫背带缝合术辅助子宫动脉上行支结扎术,对照组单纯行子宫动脉上行支结扎术,比较两组手术疗效。结果试验组手术各指标、术后卵巢血流动力学指标优于对照组,并发症总发生率低于对照组(P<0.05)。结论难治性产后出血患者应用子宫背带式缝合术结合子宫动脉上行支结扎术可行性高,能缩短术后康复时间,并发症发生率低,还可减轻对卵巢组织的刺激,建议推广。

子宫动脉栓塞治疗急性产后出血疗效的影响因素分析

目的探讨子宫动脉栓塞(UAE)治疗产后出血疗效的影响因素。方法收集2017年6月至2021年12月于合肥市第三人民医院就诊的95例产后出血患者的临床资料,分析可能影响UAE疗效的因素。结果95例产后出血患者经介入治疗后,成功83例,失败12例,有效率为87.3%。失败组患者瘢痕子宫、盆腔手术、妊娠期并发症、术前总失血量、宫腔球囊填塞情况与成功组患者比较,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,盆腔手术史、瘢痕子宫史、妊娠期并发症及术前总失血量﹥1800 ml均是UAE治疗产后出血疗效的影响因素(P﹤0.05)。结论盆腔手术史、瘢痕子宫史、妊娠期并发症及术前总失血量﹥1800 ml均是影响UAE治疗产后出血临床疗效的独立危险因素,临床医师应全面识别并监测产妇危险因素,降低产后出血发生率,提高产妇围产期身体健康水平,促进胎儿顺利娩出。

bFGF通过NF-κB信号通路抑制人子宫平滑肌收缩

目的:探讨外源性碱性成纤维细胞生长因子(bFGF)对人子宫平滑肌原代细胞(HUt SMCs)收缩功能的影响及其可能机制。方法:用不同浓度外源性bFGF对子宫平滑肌细胞进行干预,qRT-PCR法检测缝隙连接蛋白(CX43)、催产素受体(OXTR)mRNA水平,Western blot法检测CX43、OXTR蛋白表达;胶原收缩实验研究外源性bFGF对HUt SMCs收缩能力的影响;激光共聚焦显微镜观察细胞内Ca 2+水平。用外源性bFGF和JSH-23(NF-κB转录活性抑制剂)处理人子宫平滑肌原代细胞,Western blot法检测CX43和NF-κB p65蛋白表达;酶联免疫吸附实验(ELISA)检测HUt SMCs分泌的IL-6、IL-8水平。结果:bFGF可抑制HUt SMCs收缩相关分子(CX43、OXTR)mRNA和蛋白表达。bFGF可抑制HUt SMCs收缩能力并使细胞内Ca 2+水平降低。bFGF上调人子宫平滑肌细胞NF-κB蛋白表达并下调CX43蛋白表达,促进其分泌IL-8,这种效应被JSH-23所逆转。结论:bFGF通过激活NF-κB通路发挥促炎作用并调控CX43表达,从而参与调节HUt SMCs的收缩能力。