Objective To investigate the effect of ultrasound combined with intravenous terbutaline sulfate for external cephalic version and the impact of this therapy on maternal and neonatal complications.Methods 126 singleton pregnant women who were diagnosed by B-ultrasound breech pregnancy at 34-36 weeks in regular antenatal examination from January 2014 to June 2016 were randomly divided into an observation group (n =70)and a control group (n =50).The observation group was treated with intravenous drip of terbutaline sulfate after epidural anesthesia,and then received external cephalic version under B-ultrasound monitoring.The control group received traditional knee-chest position for correcting breech presentation.The success rate of breech correction,breech version rate,cesarean section rate,vaginal delivery rate,adverse reactions,postpartum hemorrhage volume,neonatal asphyxia,and neonatal birth injury were noted and compared between the two groups.Results As compared with the control group,the observation group had a higher success rate of breech correction and a higher rate of vaginal delivery while a lower rate of cesarean section,with a significant difference (x2 =20.210,8.564;P ＜0.05).The rate of postpartum hemorrhage,neonatal asphyxia,or neonatal birth injury did not differ significantly between the two groups (P ＞ 0.05).Conclusions Application of ultrasound combined with intravenous terbutaline sulfate in external cephalic version is easy to operate and has a higher success rate and greater safety,significantly reducing the rate of cesarean section and improve the success rate of vaginal delivery.

BACKGROUND:Despite unrelated cord blood transplantation is expected to become an important method for treating malignant hematological diseases,the manifestation and clinical characteristics of acute graft-versus-host disease in the gastrointestinal tract still require further in-depth investigation. OBJECTIVE:To analyze the clinical characteristics of intestinal acute graft-versus-host disease after unrelated cord blood transplantation. METHODS:A retrospective analysis was conducted on 668 malignant hematological disease patients after unrelated cord blood transplantation who underwent hematopoietic stem cell transplantation subspecialty in the Department of Hematology,First Affiliated Hospital of University of Science and Technology of China from December 2016 to December 2020.Among them,clinical data of 138 patients with intestinal acute graft-versus-host disease were analyzed,including 76 males and 62 females,with a median age of 13(1-62)years.All patients were treated with a myeloablative regimen(without antihuman thymocyte globulin)and cyclosporin A combined with mycophenolate mofetil to prevent graft-versus-host disease. RESULTS AND CONCLUSION:(1)The patients with intestinal acute graft-versus-host disease had diarrhea of varying degrees,most of which were yellow-green,yellow-brown watery stools or mucous stools.53 patients(38.4%)had blood stools,82 patients(57.9%)had skin involvement,18 patients(13.0%)had a secondary intestinal bacterial infection,and 90 patients(65.2%)had cytomegaloviremia.(2)The clinical characteristics of patients(70 cases,50.7%)with grade 1-2 intestinal acute graft-versus-host disease were compared with those(68 cases,49.3%)with grade 3-4 intestinal acute graft-versus-host disease.It was found that the age of grade 3-4 intestinal acute graft-versus-host disease patients was higher than that of grade 1-2 intestinal acute graft-versus-host disease patients(P<0.001),and they were complicated with cytomegaloviremia probably(P=0.035).Diarrhea lasted longer(P=0.00)and the length of hospital stay increased substantially(P<0.001).However,there were no significant differences in recipient gender,pre-transplant disease status,HLA matching,diagnosis,combined skin graft-versus-host disease,and secondary intestinal infection rate in patients of the two groups.(3)These findings conclude that the clinical characteristics of intestinal acute graft-versus-host disease after unrelated cord blood transplantation are complex,which affects the prognosis and quality of life of patients seriously and requires early identification and precise treatment.