1.Clinical characteristics and influencing factors of acute colonic pseudo-obstruction after emergency cesarean section
Ruizhi HE ; Chongxin TONG ; Hongya YIN ; Qing SHANG ; Junxia LI
Journal of Navy Medicine 2024;45(8):832-836
Objective To explore the clinical characteristics and influencing factors of acute colonic pseudo-obstruction(ACPO)after emergency cesarean section.Methods A total of 22 parturients with ACPO after emergency cesarean section who were admitted to Hebei Children's Hospital from January 2019 to June 2023 were retrospectively selected and assigned to the ACPO group,and 110 parturients without ACPO after emergency cesarean section during the same period were selected as the non-ACPO group,according the ratio of 5∶1.The clinical characteristics of the ACPO group were observed.The clinical data of the two groups were collected and compared.Multivariate logistic regression methods were used to analyze the risk factors of ACPO after emergency cesarean section.Results All the patients with ACPO after emergency cesarean section presented with progressive abdominal dull pain,nausea and vomiting,abdominal distension,cessation of defecation and exhaust or a small amount of defecation and exhaust.Physical examination showed abdominal bulge,especially in the upper and right abdomen,with mild tenderness and with no rebounding pain.Univariate analysis showed that there were no significant differences in the maternal age,gestational weeks,embryo number,gravidity,parity,prenatal body mass index(BMI),cause of emergency cesarean section,pregnant complications,general anesthesia,preoperative albumin level or postoperative analgesia between the two groups(all P>0.05);the proportions of operation time≥60 min,blood loss≥800 ml,history of abdominal surgery,cocurrent chronic pelvic inflammatory disease,and intraoperative removal of uterine fibroids in the ACPO group were significantly higher than those in the non-ACPO group(all P<0.05).Multivariate logistic regression analysis showed that operation time≥60 min(OR=5.761),concurrent chronic pelvic inflammatory disease(OR=3.241),and intraoperative removal of uterine fibroids(OR=4.319)were the risk factors of ACPO after emergency cesarean section(all P<0.05).Conclusion Operation time≥60 min,concurrent chronic pelvic inflammatory disease,and intraoperative removal of uterine fibroids are the risk factors of ACPO after emergency cesarean section.More attention should be paid to the parturients with the above-mentioned risk factors after emergency cesarean section,and preventive measures should be taken in advance to effectively reduce the risk of postoperative ACPO.
2.The clinical effect of low molecular heparin calcium on early onset severe pre-eclampsia
Chongxin TONG ; Shuwei HAO ; Xiaofen XING ; Shuhua QIAO ; Lin LIU ; Zhanping DING
Clinical Medicine of China 2012;28(2):146-148
Objective To analyze the clinical effects of low molecular heparin calcium on early onset severe pre-eclampsia.Methods Sixty patients with early onset severe pre-eclampsia at 26-34 weeks of gestational age were divided into treatment group(28 cases)and control group(32 cases).The conventional treatment was delivered in control group and low molecalar heparin calcium(LMWHC)was used in treatment group additionally.The time of prolonged gestational age,umbilical arterial S/D ratio,amniotic fluid index,placenta weight,neonatal weight and Apgar score were measured in two groups.Results The time of prolonged gestational age was 10.19 ±4.57days in treatment group and 6.14 ±3.56 days in control group,which were significantly different(P < 0.01).Umbilical arterial S/D ratio,amniotic fluid index,placenta weight and neonatal weight were all significantly different between the two groups(P < 0.05).Neonatal Apgar score in treatment group was remarkably improved(P < 0.01).Conclusion LMWHC treatment in the patients with early onset severe pre-eclampsia could extend gestational age,increase neonatal weight and improve perinatal outcomes.
3.Comparison of the clinical effects of three artificial abortion methods in mid-term pregnancy
Xiaofen XING ; Chongxin TONG ; Suqing LIU
Clinical Medicine of China 2009;25(11):1221-1223
Objective To compare the effects of three artificial abortion methods, Mifepriston with Misopro-fil,Rivanol with Mifepristone and Rivanol,in mid-term pregnancy. Methods 235 women who were pregnant for 12 to 28 weeks and volunteered to abort with drugs were selected and observed. The total subjects were randomly divided into three groups,study group Ⅰ (n=80),study group Ⅱ (n=78),and control group (n=77). In study group Ⅰ, each was given Mifepristone 50 mg, po, bid, for 3 days. On the fourth day, Misoprofil 200-1000 μg was administered though vagina. In study group Ⅱ, Rivanol(70-100 mg) was injected into amniotic cavity and at the same tame, Mife-pfistone,75 mg was given bid,po,for each case for 1 day. In study group Ⅲ,each case was injected with Rivanol (70-100 nag) only into amniotic cavity. Results The complete abortion rate in study group Ⅰ, Ⅱ and Ⅲ was 88.75% (71/80), 65.38% (51/78), 38.96% (30/77) respectively. The success rate was 98.75% (79/80), 71.79% (56/78),76.62% (59/77) respectively. The mean time from the initial uterine contraction to the expulsion of the fetus and placenta was (6.85±3.68) h, (8.87±3.58) h, (14.67±3.50) h respectively. The volume of in-trapartum and postpartum vaginal hemorrhage within 2 hours was (80.86±40.28) ml, (94.70±42.35) ml, (120. 68±43.30)ml respectively. The complete abortion rate and success rate in study group Ⅰ was significantly greater than that in study group Ⅱ and study group Ⅲ. In addition, the birth process was shorter and the vaginal hemorrhage was less significantly in study group Ⅰ than those in the other two groups (P<0.01). The complete abortion rate in study group Ⅱ was significantly greater than that in study group Ⅲ (P<0.01). Conclusions Mffepristone admin-istered with Misoprpfil has many advantages usages, such as high complete abortion rate and success rate, short birth process, and less volume of vaginal hemorrhage, when used for artificial abortion in mid-term pregnancy. They are es-pecially suitable for the mid-term artificial abortion under 20-week pregnancy. Rivanol administered with Mifepristone can raise complete abortion rate,shorten labor process and decrease vaginal hemorrhage when they are used in artifi-cial abortion. They are suitable for the mid-term artificial abortion above 16-week pregnancy. The stage of labor lasts long when using only Rivanol for artificial abortion. The pain is relatively heavier and the rate of incomplete abortion is higher.

Result Analysis
Print
Save
E-mail