Adult ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; diagnosis ; drug therapy ; Prurigo ; diagnosis ; drug therapy ; Recurrence

INTRODUCTIONPregnancies in women with thrombophilia are associated with a higher risk of obstetric complications. We systematically reviewed the findings of relevant randomised controlled trials (RCTs) with the aim of investigating the effectiveness of low-molecular-weight heparins (LMWHs) in pregnant women with inherited thrombophilic disorders and its effect on the incidence of live births in these patients.

METHODSThe MEDLINE-PubMed and Cochrane CENTRAL databases from 2000 to 2010 were searched using a combination of keywords, including low-molecular-weight heparin, enoxaparin, pregnancy, live birth and thrombophilia. Studies were included if they were RCTs assessing the effect of anticoagulant treatment on live birth rates in women with a history of miscarriage without apparent causes other than thrombophilic disorder. Interventions included LMWH, with or without aspirin, aspirin alone or placebo controlled for the prevention of adverse pregnancy outcome.

RESULTS43 articles with seven RCTs were retrieved following the initial search, of which four studies had to be excluded as they assessed thromboembolic events as the final outcome (n = 1), focused on idiopathic recurrent miscarriages (n = 1), compared efficacy and safety of two doses of enoxaparin (n = 1), and examined patients with or without thrombophilic disorder (n = 1). Pooled data from the remaining three RCTs showed no significant difference in the improvement of live birth rates following LMWH interventions (p = 0.15).

CONCLUSIONAt present, the use of LMWH in women with inherited thrombophilia with recurrent pregnancy loss is not indicated. Large randomised placebo-controlled trials are further needed to prove the effectiveness of LMWH in these patients.

Female ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Pregnancy ; Pregnancy Complications, Hematologic ; drug therapy ; Pregnancy Outcome ; Thrombophilia ; complications ; drug therapy ; Treatment Outcome

Antiviral Agents ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; virology

Antiviral Agents ; therapeutic use ; Female ; Hepatitis B, Chronic ; drug therapy ; Humans ; Pregnancy ; Pregnancy Complications, Infectious ; drug therapy ; virology

Antiviral Agents ; therapeutic use ; Female ; Hepatitis B virus ; Hepatitis B, Chronic ; drug therapy ; Humans ; Pregnancy ; Pregnancy Complications ; drug therapy ; virology

OBJECTIVETo evaluate the relationship between the incidence of abnormal thyroid function of newborns and maternal hyperthyroidism with antithyroid drug therapy.

METHODThe clinical data of 35 neonates born to mothers with hyperthyroidism from 1983 to 2003 in Peking Union Medical College Hospital were retrospectively analyzed. According to the maternal thyroid function and the antithyroid drugs taken during pregnancy, subjects were divided into different groups.

RESULTSThe proportion of abnormal thyroid function in newborn was 48.6% (17/35). The prevalences of primary hypothyroidism, subclinical hypothyroidism, hypothyroxinemia, and central hypothyroidism were 29.4%, 29.4%, 35.3%, and 5.9%, respectively. The incidence of abnormal thyroid function of neonates whose mothers did not take the antithyroid drugs (ATDs) until the third trimester of pregnancy was significantly higher than those without and with ATDs during the first or second trimester (P < 0.01). The incidence of abnormal thyroid function significantly increased in premature neonates, neonates whose mothers with modest or heavy pregnant hypertension, or neonates whose core serum thyroid-stimulating hormone or serum anti-thyroid peroxidase antibodies levels were abnormal.

CONCLUSIONThe risk of abnormal thyroid function of infants whose hyperthyroid mothers did not take ATDs until the third trimester of pregnancy may be increased. Prompt diagnosis and appropriate treatment of hyperthyroidism in pregnant women are essential for the prevention of neonatal thyroid functional abnormality.

Adult ; Antithyroid Agents ; adverse effects ; Female ; Humans ; Hyperthyroidism ; complications ; drug therapy ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Complications ; drug therapy ; Retrospective Studies ; Thyroid Diseases ; congenital ; epidemiology ; etiology ; Time Factors

OBJECTIVETo evaluate the therapeutic effect of Yinchenghao decoction (YCHD) and S-adenosy-L-methionine (SAM) in treating intrahepatic cholestasis of pregnancy (ICP) and improving prognosis of perinatal newborn babies.

METHODSSixty in-patients of ICP were randomly divided into two groups, the group A treated with YCHD and the group B treated with SAM. The symptom of itching and serum biochemical indexes, including glycocholic acid, bilirubin and transaminase, were observed after 3 weeks treatment, and the prognosis of perinatal newborn babies between the two groups was compared after delivery.

RESULTSAfter treatment, the symptom of itching, serum levels of glycocholic acid, bilirubin and transaminase improved significantly (P < 0.05) in both groups, and the prognosis of newborn in the two groups was similar (P > 0.05).

CONCLUSIONBoth YCHD and SAM could effectively treat ICP. The former is rather cheaper, so it is more feasible for spreading.

Adult ; Cholestasis, Intrahepatic ; drug therapy ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Phytotherapy ; Pregnancy ; Pregnancy Complications ; drug therapy ; Pregnancy Outcome ; S-Adenosylmethionine ; therapeutic use

OBJECTIVETo study the relationship between thrombocytopenia in pregnancy associated with various causes and neonatal outcomes.

METHODSMedical records of 140 pregnant women with thrombocytopenia in pregnancy and the neonatal outcomes from January 2009 to December 2010 were reviewed retrospectively. The pregnant women were classified into four groups according to the causes of thrombocytopenia: gestational thrombocytopenia (GT; n=94), pregnancy with immune thrombocytopenic purpura (ITP; n=30), pregnancy with other hematological disease (aplastic anemia or myelodysplastic syndrome; n=12), and other causes (n=4): pregnancy induced hypertension syndrome, pregnancy with systemic lupus erythematosus, and pregnancy with alcoholic cirrhosis. The neonatal outcomes in the four groups were compared.

RESULTSThe premature birth rates in the GT and the ITP groups were 11.3% and 16.7%, respectively. There was no significant difference between the two groups. The premature birth rate in the other hematological disease group was 53.8%, which was significantly higher than that in the GT (P<0.01) and the ITP groups (P<0.05). Congenital passive immune thrombocytopenia was found in 2 neonates (2%) in the GT group and in 4 neonates (13%) in the ITP group (P<0.05). In addition, other diseases were also observed in neonates in the ITP group, including 1 case (3%) of ITP and 1 case (3%) of Evans syndrome. Intracranial hemorrhage occurred in one neonate (8%) in the other hematological disease group. Neonatal lupus syndrome was found in 1 case (25%) in the other causes group.

CONCLUSIONSThrombocytopenia in pregnancy associated with different causes may result in different neonatal outcomes.

Adult ; Female ; Humans ; Infant, Newborn ; Pregnancy ; Pregnancy Complications, Hematologic ; Pregnancy Outcome ; Premature Birth ; epidemiology ; Prognosis ; Retrospective Studies ; Thrombocytopenia ; complications ; drug therapy

With rapid social development rhythm, the incidence of gynecological diseases gradually rise. Traditional Chinese medicine has made irreplaceable position in the treatment of gynecological disease. Due to the characteristics of gynecological diseases, the syndrome differentiation and treatment has unique characteristics. In this paper, according to menstrual disease, leukorrheal diseases, pregnancy diseases, puerperal diseases and miscellaneous diseases in order, combining documents discussion and old doctors of traditional Chinese medicine treatment of gynecological disease experiences, illustrate the key points of drug selection in the treatment process. We can get a revelation that appropriate choice of tradition Chinese medicine is an indispensable part for healing effects. Through the analysis of characteristics of drugs, we can understand the feature of each period in disease of department of gynecology, increase the ability of usinig traditional Chinese medicine and improve the level of clinical treatment.
Female ; Genital Diseases, Female ; drug therapy ; Humans ; Leukorrhea ; drug therapy ; Medicine, Chinese Traditional ; methods ; Menstruation Disturbances ; drug therapy ; Practice Patterns, Physicians' ; Pregnancy ; Pregnancy Complications ; drug therapy ; Puerperal Disorders ; drug therapy ; Treatment Outcome

AIMTo describe the reproductive outcome following intracytoplasmic sperm injection (ICSI) for male factor infertility associated with Crohn's disease and 6-mercaptopurine (6-MP) chemotherapy.

METHODSThe male partner of a couple suffered from severe Crohn's disease and received a 3-month course of 6-MP for this condition. Two spontaneous conceptions were established before 6-MP, although post-chemotherapy semen analysis found the sperm concentration to be 8,000/mL. In vitro fertilization (IVF) with ICSI and embryo transfer was performed.

RESULTSThe woman underwent an uncomplicated controlled ovarian hyperstimulation sequence using a combined rec-FSH+hMG protocol, following late luteal phase pituitary downregulation. This culminated in the retrieval of 18 oocytes, 11 of which were fertilized with ICSI. She later delivered a normal male infant without urogenital anomaly. Four nontransferred blastocysts were cryopreserved.

CONCLUSIONThis report describes the first successful birth after ICSI for severe oligozoospermia associated with Crohn's disease and 6-MP therapy. We outline salient features of Crohn's disease, 6-MP pharmacology, and their relevance to human fertility.

Adult ; Crohn Disease ; complications ; drug therapy ; Female ; Humans ; Immunosuppressive Agents ; administration & dosage ; Male ; Mercaptopurine ; administration & dosage ; Oligospermia ; complications ; therapy ; Pregnancy ; Pregnancy Outcome ; Sperm Injections, Intracytoplasmic