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A pathomorphological analysis of the endometrial stromal tumors of uterus

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(2):111-112.

Objective To furthur recognize the pathomorphological features of the endometrial stromal tumors.MethodsThe clinicopathological analysis was made for 19 cases of endometrial stromal tumors of uterus, including 1 of nodule, 15 of low-grade sarcomas and 3 of high-grade sarcomas. ResultsThe location of neoplasm predominated in submucosal in 4 cases, 4 cases of sarcomas recurred after operation. 4 cases showed extrauterine tumors. Sex-cord-like differentiation presented in 6 tumors. Smooth muscle differentiation was found in 7 cases. ConclusionLow-grade endometrial stromal sarcomas is the commonest histopathological pattern in the endometrial stromal tumors. Sex-cord-like differentiation and smooth muscle differentiation are not rare in endometrial stromal tumors.

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Effects of angiogenesis on the development of endometrial carcinoma

Jinquan CUI ; Liju SUN ; Nan MA

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(2):109-110.

ObjectiveTo study the effects of angiogenesis on the development of endometrial carcinoma. Methods Hysterectomy specimens were stained immunohistochemically by the marker of factor Ⅷ-related antigen for endothelium vessels in normal controls, patients with endometrial hyperplasia and with endometrial carcinoma. Results The microvascular density(MVD) in tumour increased gradually from normal endometrium to endometrial hyperplasia and to endometrial carcinoma(P<0.01). MVD correlated with the mvometrial invasion, histologic grades and the stages.ConclusionMYD in endometrial hyperplasia increases. MVD can be used as a prognostic factor.

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Effects of optional cesarean section on the level of plasma motilin and serum gastrin in neonatal umbilical blood

Zhijun XIA ; Shulan ZHANG ; Zhuo ZHOU

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(2):107-108.

ObjectiveTo explore the effects of optional cesarean section on the level of plasma motilin and serum gastrin in umbilical blood and their relationship with gastroenteric symptoms of neonates. MethodsWe measured the concentrations of plasma motilin and serum gastrin in umbilical blood from neonates undergoing optional cesarean operation, emergency cesarean section and vaginal delivery by radioimmunoassay(RIA). ResultsFull-term deliveries undergoing optional cesarean section were with significant gastrointestinal symptoms. Plasma motilin and serum gastrin were significantly lower in neonates undergoing cesarean operation without birth initiate group(optional cesarean section)than that in cesarean section with birth initiate group and vaginal delivery group (P<0.05). ConclusionCesarean operation without birth initiate influences neonatal gastroenteric symptoms.Breast feeding which begins as early as possible will help to relieve those symptoms.

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Relationship between range of operative and postoperative ovary function in 55 endometriosis

Jun PAN ; Wen DI ; Defu CHEN

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(2):102-104.

ObjectiveTo study the relationship between the range of operations and the incidence of climacteric syndrom,the time of episode, degree and estrogen level in endometriosis after operations. MethodsThesexual hormone level was measured and climacteric syndrome was followed up after operation in 55 endometriosis. ResultsThe incidence of climacteric syndrom in oophorectomy was more frequent and earlier than partial oophorectomy. Meanwhile, the syndrome was much severe and the level of E2 was lower in the former group than those in the later one. ConclusionSo we should retain the ovary tissue and blood supply as much as possible. 6 months postoperation is suggested to be suitable to begin hormone replacement therapy. The dosage should be adviced to remain the blood hormone level just like one ovary does.

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Clinical study of influence of Doula delivery on cesarean section morbidity

Ping WANG ; Jianhua LIU

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(2):99-101.

Objective To discuss the influence of Doula delivery and non -Doula delivery on cesarean section(CS)morbidity. Methods796 cases with Doula delivery and 800 cases with non-Doula delivery were compared in CS morbidity, CS causes, dystocia morbidity in vaginal delivery and neonatal distress. ResultsThe main causes of CS in both groups were fetal distress, fetal malposition and cephalopelvic disproportion and uterine inertia (problems of"power"), The CS morbidity in Doula delivery group(24.37%) was significantly lower than that in non-Doula group(38.25%) (P<0.01). In Doula delivery, CS due to uterine inertia was significantly less than that in non-Doula delivery (P<0.05). However, CS rate due to fetal distress was higher in the former group (P<0.05). In the vaginal delivery cases of the two groups, dystocia morbidity in Doula delivery group(6.00%) was statistically lower than that in non-Doula delivery group(9.72%) (P<0.05). The rates of neonatal distress in the two groups were not significantly different (P>0.05). ConclusionDoula delivery can decrease the CS morbidity without increasing the rate of neonatal distress. Therefore, Doula delivery is worth administering in clinical practice.

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Discussion of interrupted circular suture dming caesarean section with placenta previa

Miao ZHANG ; Yanzhi JIN ; Zijie ZHOU

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(2):93-94.

ObjectiveTo discuss the value of interrupted circular suture in hemostasis of placenta previa during cesarean section. Methods We summarized 54 caesarean section patients with placenta previa. Results The hemostasis was succeeded in all of the 9 patients and uterus was retained without postpartum complications. The duration of operation was obviously shorter than that of hysterectomy( P＜0.05). Bleeding and blood transfusion were less than that of hysterectomy, but without statistical difference (P＞0.05). ConclusionInterrupted circular suture is one of the efficient methods in controlling postpartum bleeding during caesarean section with placenta previa.

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Retrospective analysis of clinical outcomes in 89 gravidas with placenta praevia

Yajun XIA ; Xiangmei YUAN ; Li TENG

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(2):90-92.

ObjectiveTo investigate relationship between the degree of placenta praevia, vaginal bleeding and clinical outcomes. MethodsRecords of 89 patients with placenta praevia(mild praevia group 43; severe praevia group 46) were reviewed retrospectively, and outcomes were compared. ResultsThe gestational age at the first bleeding and diagnosis was significantly smaller in severe group than that in mild one (P<0.05). The incidence of antepartum haemorrhage, the times of bleeding and the episodes of heavy bleeding in two groups showed no significant differences(P>0.05). The gestational age at diagnosis and delivery and birthweight were significantly smaller in women with antepartum bleeding than in those without( P<0.01 ). The number of deliveries by emergency caesarean section in women with antepartum bleeding was significantly higher than that in those without (P<0.01). ConclusionThe clinical outcomes of placenta praevia are highly variable. There are no obvious clinical features that are typical in predicting the clinical outcomes. The number of bleeding episodes and the degree of praevia are not associated with outcomes, so they can't be the proof to determine the treatment plan ahead of time.

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Clinical research of section choice in caesarean section for placenta praevia

Guang SHI ; Peng YANG ; Tianyi YAO

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(2):87-89.

ObjectiveTo investigate the influence of transverse and longitudinal lower segment caesarean section on the outcome of newborn, postpartum haemorrhage and ratio of complications in placenta previa. MethodsPlacenta previa with lower segment transverse caesarean section( 117 cases) were taken as control group, meanwhile, the lower segment with longitudinal section (142 cases ) as experimental group. Their operational complications, amount of bleeding during and after operation and outcome of the perinatal period were analysed.Results No significant difference in age, parities, gestational weeks, the types of the placenta praevia and the locus of placenta between the two groups were found( P>0.05), while there were significant difference in the amount of bleeding during and after operation, the need of using gauze ribbon to stop bleeding, section splitting and rate of hysterectomy after caesarean section(P<0.01). ConelusionLower segment longitudinal caesarean section in placenta praevia not only shows less bleeding during operation and lower rate of postpartum haemorrhage, but also avoids using gauzes to stop bleeding and causes lower rate of hysterectomy after caesarean section, so it can be the first choice when determining the style of section in placenta praevia.

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Hysterectomy in obstetric problems

Shuiqing MA ; Xuming BIAN ; Jinghe LANG

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(1):39-41.

Objective To compare and analyse the elective and emergency hysterectomies in obstetric practice. Meth odsA retrospective study was performed to compare elective versus emergency cesarean hysterectomies in PUMC Hos pital from January 1969 to December 1998.ResultsObstetric hysterectomies were performed on 36 patients over 30 years out of 33207 deliveries. 26 emergency cesarean hysterectomies and 10 elective hysterectomies had been done. Pla cental disorder was the main indication of emergency hysterectomy. The perinatal mortality of newborn was 179.5‰. ConclusionObstetric hysterectomy has been proved to be one of the most useful life- saving procedure for patients with postpartum hemorrhage, especially at the time of cesarean section, particularly for patients with a history of benign or malignant gynecologic tumor or irregular vaginal bleeding before pregnancy.

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Combination use of MTX and mifepristone in treating the unruptured tubal pregnancy

Xinqiang JI

Chinese Journal of Practical Gynecology and Obstetrics.2001;17(5):299-300.

Objective　To investigate the effect of combining use of methotrexate and mifepristone on treating unruptured tubal pregnancy.Methods　Treatment consisted of 300mg of mifepristone administered orally one time and 20mg of methotrexate injected intravenously consecutively for 5 days.The previous cases who received only 20mg methotrexate injected intravenously were selected as control group.Results　The success rate of the combination group was 87.5% which was significantly higher than that of the control group.The effect of treatment was related to serum β-hcG levels and whether there was embryos with cardiac activity or not.Conclusion　The treatment of unruptured tubal pregnancy with the combination of methotrexate and mifepristone is safe and effective.It is suitable for the unruptured tubal pregnancy with stable vital signs,but without acute abdominal pain or embryonic cardiac activity and β-hCG＜30μg/L.

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