Objective:To investigate the safety of selective feticide by radiofrequency ablation (RFA) in dichorionic triamniotic (DCTA) triplets and factors related to the clinical outcome.Methods:A retrospective cohort study was designed to review the clinical records and pregnancy outcome of DCTA triplets patients who underwent RFA for selective feticide performed at the First Affiliated Hospital of Southern University of Science and Technology, Shenzhen People's Hospital from January 1,2016 to January 1,2020. Placentas were collected after delivery for gross examination and perfusion study with the mixture of vinylidene chloride and self-curing denture acrylic.Results:A total of 12 DCTA cases were recruited. Selective feticide by RFA were performed at a mean gestational age of 15.6 weeks, and cases delivered at a mean gestational age of 36.9 weeks (34 +4-38 +2 weeks). Eight of the cases undertook invasive prenatal diagnosis weeks after RFA. The interval between RFA to delivery and gestational ages at delivery were similar between women undertook prenatal diagnosis and those who did not ( P>0.05). Six of the 23 newborns (26%) were small for gestational age. The average birth weight of either monochorionic singleton fetus or the remained co-twin of the monochorionic diamniotic (MCDA) twin as lower than that of singleton pregnancy ( P<0.001). One case of DCTA (8.3%) underwent intrauterine fetal death of the MCDA co-twin 4 h after RFA. Fetal tachycardia and cessation of fetal movement of the co-twin were observed before death. By the time of delivery, placental examination revealed the pale anemia look of the placental part of the co-twin and the reddish appearance of the part of the reduced fetus, which suggested a hypovolemic shock after an uncompleted RFA as the cause of co-twin death. A total of 10 MCDA placentas from cases with a living MCDA co-twins were collected. Various degree of placental perfusion on the reduced fetal side of placenta was noticed in nine cases. The co-twin with the placenta which did not have such kind of perfusion had a birth weight at the lowest percentile. Conclusion:Selective feticide by RFA is a safe procedure for DCTA triplet, and prenatal diagnosis has no adverse impact on pregnancy outcome. Ultrasound monitoring of fetal heart rate and fetal movement of the MCDA co-twin after RFA is helpful for predicting clinical outcome. Postnatal placental examination provides clues for adverse outcome, and the growth potential of the MCDA co-twin might be related to the type of anastomosis between the two fetuses.

Objective:To investigate the safety of selective feticide by radiofrequency ablation (RFA) in dichorionic triamniotic (DCTA) triplets and factors related to the clinical outcome.Methods:A retrospective cohort study was designed to review the clinical records and pregnancy outcome of DCTA triplets patients who underwent RFA for selective feticide performed at the First Affiliated Hospital of Southern University of Science and Technology, Shenzhen People's Hospital from January 1,2016 to January 1,2020. Placentas were collected after delivery for gross examination and perfusion study with the mixture of vinylidene chloride and self-curing denture acrylic.Results:A total of 12 DCTA cases were recruited. Selective feticide by RFA were performed at a mean gestational age of 15.6 weeks, and cases delivered at a mean gestational age of 36.9 weeks (34 +4-38 +2 weeks). Eight of the cases undertook invasive prenatal diagnosis weeks after RFA. The interval between RFA to delivery and gestational ages at delivery were similar between women undertook prenatal diagnosis and those who did not ( P>0.05). Six of the 23 newborns (26%) were small for gestational age. The average birth weight of either monochorionic singleton fetus or the remained co-twin of the monochorionic diamniotic (MCDA) twin as lower than that of singleton pregnancy ( P<0.001). One case of DCTA (8.3%) underwent intrauterine fetal death of the MCDA co-twin 4 h after RFA. Fetal tachycardia and cessation of fetal movement of the co-twin were observed before death. By the time of delivery, placental examination revealed the pale anemia look of the placental part of the co-twin and the reddish appearance of the part of the reduced fetus, which suggested a hypovolemic shock after an uncompleted RFA as the cause of co-twin death. A total of 10 MCDA placentas from cases with a living MCDA co-twins were collected. Various degree of placental perfusion on the reduced fetal side of placenta was noticed in nine cases. The co-twin with the placenta which did not have such kind of perfusion had a birth weight at the lowest percentile. Conclusion:Selective feticide by RFA is a safe procedure for DCTA triplet, and prenatal diagnosis has no adverse impact on pregnancy outcome. Ultrasound monitoring of fetal heart rate and fetal movement of the MCDA co-twin after RFA is helpful for predicting clinical outcome. Postnatal placental examination provides clues for adverse outcome, and the growth potential of the MCDA co-twin might be related to the type of anastomosis between the two fetuses.

BACKGROUND:Placental mesenchymal stem cel s with rich sources are similar to bone marrow mesenchymal stem cel s in terms of morphology, surface markers and differentiation potential, which are one of ideal mesenchymal stem cel s in human body. However, there are few studies addressing the ultrastructure and phagocytotic function of human placental mesenchymal stem cel s and its physiological role in the the placenta has been little explored. OBJECTIVE:To investigate the ultrastrcture and phagocytotic function of placental mesenchymal stem cel s. METHODS:Placental mesenchymal stem cel s obtained from five placentae of normal pregnancy were cultured in vitro and observed for ultrastructure under transmission electron microscope. The fluorescent beads were added in the supernatant for 3 hours, and then the phagocytosis of placental mesenchymal stem cel s was evaluated by flow cytometry. RESULTS AND CONCLUSION:Under the transmission electron microscope, placental mesenchymal stem cel s had large nuclei with prominent nucleoli. In the cytoplasm, a plenty of rough endoplasmic reticula was seen, dilated or stacked. The cytoplasm was also rich in Golgi apparatus and lysosomes. The cel surfaces were covered by microvil i. The intercel ular junctions could be seen occasional y. A part of cel s from these five samples could phagocytose fluorescence beads, which ranged from 49.6%to 18.4%. The ultrastructural characteristics of placental mesenchymal stem cel s suggested these cel s were active to synthesize and secrete proteins and had phagocytotic function, indicating placental mesenchymal stem cel s may play a role in keeping the balance of micro-environments and clean the foreign substances in the placenta.

Objective To investigate the sexual problems during early postpartum period and the awareness of postpartum sexual health. Methods A questionnaire survey was carried out in 109 women who received routine postpartum check-up in our outpatient department between October and November 2010 to identify postpartum sexual problems and the awareness of postpartum sexual health. Results The first postpartum check-up was received 6 to 12 weeks after the delivery. Of 109 participants,6 (5.5%), 17(15.6%) and 46 (42.2%) resumed sexual activity within 6,6 to 8,and 12 weeks after the delivery,respectively. Postpartum sexual problems included dyspareunia (35/46,76. 09% ), vaginal dryness (29/46,63.04% ), hypoactive sexual desire (25/46,54. 35% ) and lack of orgasm ( 11/46,23.91% ). 10. 87% (5/46)took contraceptive measures,21.10% (23/109) understood the appropriate time to resume sexual activity, 12. 84% (14/109) was aware of the possible postpartum sexual problems, 13.76% (15/109) knew how to avoid pregnant,6.42% (7/109) would visit a doctor in case of the sexual disorders,and 9. 17%(10/109) hoped that their husband know about sexual health. Conclusion Postpartum sexual problems may be common and maternal awareness of postpartum sexual health could be low.