Objective To estimate the maternal.neonatal morbidity associated with induction deliveries compared with spontaneous deliveries in 41 gestational weeks uncomplicated primiparae.Methods Three hundred and seventy.four uncomplicated primiparous deliveries at 41 gestational weeks at Peking Union Medical College Hospital from Sept 2002 to Apr 2007 were reviewed.including 225 women undergoing induced labor and 149 women undergoing spontaneous labor.The induction methods included drug induction (173),rupture of membrane induction(5)and combined drug with rupture of membrane induction(47).The maternal morbidity,delivery method,matemal cost on hospital stay and neonatal asphyxia associated with induction deliveries or spantaneous deliveries were retrospectively analyzed.Results (1)There was no maternal death.The caesarean section rate in the induction group(44.0%,99/225)was significantly higher than that of spontaneous group(18.1%,27/149;P<0.05).(2)No statistically significantdifference(P>0.05)was observed between induction group and spontaneous group in the following puerperal complications:postpartum hemorrhage(2.7%,6/225 and 1. 3%,2/149 respectively),puerperal morbidity(0.9%,2/225 and 0.7%,1/149 respectively),severe amniotie fluid contamination (11.6%,26/225 and 13.4%,20/149 respectively),wound infection(0.9%,2/225 and 0.7%.1/149 respectively),urinary retention(4.4%,10/225 and 3.4%,5/149 respectively),traumata(0.4%,1/225and 0 respectively)and neonatal asphyxia(1.3%,3/225 and 2.0%,3/149 respectively).(3)The average duration of first stage of labor in the induction group(413 min)Was not significantly different from tllat of spontaneous group(461 min;P>0.05).In the induction group,more women had precipitate lahore(P

Objective To investigate the effect of pregnancy and spontaneous delivery on the morphologic characteristics of the levator ani muscle and innervation of the vaginal mucosa. Methods Eight nullipara without pelvic floor dysfunction (PFD) and 64 normal primipara undergoing spontaneous delivery were enrolled in this study during July to December 2006 in Peking Union Medical College Hospital. Biopsy specimens of levator ani muscle (LAM) and anterior and posterior vaginal walls were obtained from the puerpera as well as from the 8 nullipara undergoing vaginal operation. The structures of LAM were examined with histological techniques. Vaginal mucosa specimens were examined using immunohistochemistry staining for protein gene product 9. 5 ( PGP 9. 5), vasoactive intestinal poptide (VIP) and ne uropeptide Y ( NPY),and the positive stained nerve fibers were calculated respectively. Results The LAMs of the puerpera undergoing spontaneous delivery presented myogenetic and neurogenetic changes, both acute and chronic.Type Ⅰ muscular fibers were predominant(79% )with both types increasing in diameters [ (86±9)μm and (79±15) μm]. Significantly different ( P < 0. 05 ) innervation of PGP 9. 5, VIP, and NPY nerve fiberswas observed between epithelial lamina of anterior vaginal wall(5.9±3. 3, 7. 6±3. 1 and 8. 2±3. 2, respectively) and that of posterior vaginal wall (3. 8±2. 9, 5.9±3. 1 and 6. 0±3.0, respectively), with the nerve fibers being more in epithelial lamina of anterior vaginal wall, while no difference in the innervation of nerve fibers was observed in the lamina propria. Significantly different( P <0. 05 ) innervation of PGP 9. 5 and VIP nerve fibers was observed in the lamina propria of the anterior vaginal wall in puerperal undergoing vaginal delivery (6.9±3.2 and 4.9±2. 1) compared with those in nullipara (3.9±3.6 and 3. 1±1.2). Conclusions Pathologic changes occur in LAMs and pelvic floor nerves during labor and delivery. LAM fibers become hypertrophy to adapt to the physiological changes during pregnancy. Richer innervation of PGP 9. 5 and VIP nerve fibers in the lamina propria of the anterior vaginal wall in puerpera undergoing spontaneous delivery is beneficial for dilation of the blood vessels and smooth muscles and makes preparation for delivery.

Objective:To evaluate the impact of self-crosslinked hyaluronic acid (SCH) gel on endometrium recovery after artificial abortion.Methods:A multicenter, prospective randomized controlled trial was conducted across 18 hospitals from December 2021 to February 2023, involving 382 women who underwent artificial abortion. Participants were randomly allocated to receive either treatment with SCH gel (SCH group) or no treatment (control group) in a 1∶1 ratio. The primary outcome was endometrium thickness in 14 to 18 days after the first postoperative menstruation. Secondary outcomes included changes in menstrual volume during the first postoperative menstruation, menstruation resumption within 6 postoperative weeks, time to menstruation resumption, duration of the first postoperative menstruation, and incidence of dysmenorrhea.Results:Baseline characteristics of participants were comparable between the two groups (all P>0.05), with 95.3% (182/191) in SCH group and 92.7% (177/191) in the control group completed the study. The postoperative endometrial thickness in SCH group was significantly greater than that in the control group [(9.78±3.15) vs (8.95±2.32) mm; P=0.005]. SCH group also had significantly fewer participants with reduced menstrual volume [23 cases (12.6%, 23/182) vs 31 cases (17.5%, 31/177); P=0.038]. Although SCH group experienced less dysmenorrhea during the first postoperative menstrual period, this difference was not statistically significant [28.5% (51/179) vs 37.1% (65/175); P=0.083]. Outcomes were similar between SCH group and the control group regarding the proportion of participants who resumed menstruation within 6 weeks postoperatively, time to menstruation resumption, and duration of the first postoperative menstruation ( P=0.792, 0.485, and 0.254, respectively). No serious adverse events were observed during the study period, and no adverse events were attributed to SCH gel treatment. Conclusion:The application of SCH gel after artificial abortion is safe and might aid in the recovery of the endometrium.