Comparison on the Perinatal Complications for Newborns between by IVF-ET and Natural Delivery

This study was conducted to compare the perinatal complications for newborns by In vitro fertilization with embryo transfer(IVF-ET)and natural delivery.Respectively 50 cases of the IVF-ET and 50 cases of the natural delivery were selected from Hospital of Chengde Medical University as research subjects.All the recruited cases were selected with the newborns from April,2021 to April,2022.Defining the IVF-ET as the test group,while the natural delivery as the control group to compare and analyze the perinatal situations and the incidences of complications in both the groups.This study showed that the incidences of pregnancy-induced hypertension,diabetes,multiple pregnancy,premature delivery,and cesarean section in the test group were significantly(p<0.05)higher,than the control group.In addition,the incidences of neonatal respiratory distress syndrome(NRDS)and hyperbilirubinemia of newborns in the test group were statistical(p<0.05)higher,compared to the control group.In contrast,there are no statistically significant differences in terms of hypoglycemia,pneumonia,and neonatal asphyxia incidences between the two groups(p>0.05).Interestingly,there is a significant difference(p<0.05)in the incidences of neonatal cardiac anomalies in both groups,however,no significant differences(p>0.05)were observed in terms of birth defects including hypospadias,the cleft lip and palate,polydactyly,anal atresia,and esophageal atresia in both the groups.In summary,the test tube babies of IVF-ET are more susceptible to complications in their perinatal stage compared with natural delivery newborns,therefore,during the clinical development physicians should strengthen clinical attention and take proactive healthcare management,in order to maintain the health and life of the newborns.

Clinical Analysis of Placenta Previa Complicated with Previous Caesarean Section

Objective To investigate the clinical features and treatment of placenta previa complicated with previous caesarean section. Methods The clinical data of 29 patients with placenta previa complicated with a previous caesarean section (RCS group) admitted in Peking Union Medical College Hospital during a period from 2003 to 2011 were retrospectively reviewed and compared with those of 243 patients with placenta previa without a previous caesarean section (FCS group) during the same period. Results There was no difference in the mean age (28.9±3.6 vs. 28.1±4.5 years) and the average gravidity (2.35±1.48 vs. 2.21±1.53) between RCS group and FCS group (all P>0.05). The RCS group had more preterm births (24.1% vs. 13.2%), complete placenta previa (55.2% vs. 4.9%), placenta accreta (34.5% vs. 2.5%), more blood loss during caesarean section (1412±602 vs. 648±265 mL), blood transfusion (51.7% vs. 4.9%), disseminated intravascular coagulation (13.8% vs. 2.1%), and obstetric hysterectomy (13.8% vs. 0.8%) than the FCS group (all P<0.05). The preterm infant rate (30.0% vs. 13.0%), neonatal asphyxia rate (10.0% vs. 4.9%), and perinatal mortality rate (6.7% vs. 0.4%) of the RCS group were higher than those of the FCS group (all P<0.05). Conclusions More patients had complete placenta previa and placenta accreta, postpartum hemorrhage, transfusion, uterine packing, obstetric hysterectomy, and perinatal morbidity in the placenta previa patients with previous caesarean section. The patient should be informed of the risk and unnecessary first cesarean sections should be avoided.

Is There Any Relationship between Maternal Vitamin D Levels and Asymptomatic Bacteriuria? A Preliminary Study

Hypothesis: Vitamin D has been considered to play important roles in maintaining pregnancy. Also, this vitamin is considered to regulate immune response and thus may be important for pregnant women also to maintain no-infection of which preterm delivery is especially important. Since vitamin D regulates maternal anti-infection function and since Asymptomatic bacteriuria (ASB) causes various adverse outcomes in pregnancy, we hypothesized that maternal serum vitamin D level may be related with the presence/absence of ASB. The present study was an effort to determine this. The study included 215 pregnant women, attended the Ondokuz Mayis University Hospital antenatal care polyclinic, Samsun, Turkey, in the summer for initial visits between 6- and 14-weeks’ gestation. Women with symptoms suggestive of urinary tract infection, a history of antibiotic use within the previous two weeks, ongoing antibiotic therapy or urinary system instrumentation, a diagnosis of vitamin D insufficiency or deficiency, and those taking vitamin D supplements were excluded. Demographic data features of the sampled women were analyzed retrospectively. 10 ml maternal peripheral venous blood samples were collected and the concentrations of 25(OH)D3 in the serum were analyzed. Mid-stream morning urine samples were obtained and analyzed at the microbiology laboratory according to established procedures. ASB was reported if bacteria were present at specified quantitative counts (≥105 CFU/ml) in the urine without any sign or symptom. Participants were divided into two groups: ASB (-)—participants without ASB (n = 200) and: ASB (+)—participants with ASB (n = 15). There was no statistically significant relationship between the two groups in terms of demographic features. There was no statistically significant relationship between the distribution of maternal 25(OH)D3 levels in the two groups (p > 0.05). The comparison of maternal median 25(OH)D3 levels between the two groups showed no statistically significant difference (p = 0.576). No statistically significant correlation was found between 25(OH)D3 levels and age, gravida, parity, body weight, or gestation week (p > 0.05). Although there was no significant relationship between maternal vitamin D levels and ASB in this research, further studies in larger groups will increasingly highlight and clarify this topic.

Outcome and risk factors of early onset severe preeclampsia

Background Early onset severe preeclampsia is a specific type of severe preeclampsia, which causes high morbidity and mortality of both mothers and fetus. This study aimed to investigate the clinical definition, features, treatment, outcome and risk factors of early onset severe preeclampsia in Chinese women. Methods Four hundred and thirteen women with severe preeclampsia from June 2006 to June 2009 were divided into three groups according to the gestational age at the onset of preeclampsia as follows： group A （less than 32 weeks, 73 cases）, group B ,（between 32 and 34 weeks, 71 cases）, and group C （greater than 34 weeks, 269 cases）. The demographic characteristics of the subjects, complications, delivery modes and outcome of pregnancy were analyzed retrospectively. Results The systolic blood pressure at admission and the incidence of severe complications were significantly lower in group C than those in groups A and B, prolonged gestational weeks and days of hospitalization were significantly shorter in group C than those in groups A and B. Liver and kidney dysfunction, pleural and peritoneal effusion, placental abruption and postpartum hemorrhage were more likely to occur in group A compared with the other two groups. Twenty-four-hour urine protein levels at admission, intrauterine fetal death and days of hospitalization were risk factors that affected complications of severe preeclampsia. Gestational week at admission and delivery week were also risk factors that affected perinatal outcome. Conclusions Early onset severe preeclampsia should be defined as occurring before 34 weeks, and it is featured by more maternal complications and a worse perinatal prognosis compared with that defined as occurring after 34 weeks. Independent risk factors should be used to tailor the optimized individual treatment plan, to balance both maternal and neonatal safety.