Objective:To investigate the factors for adverse pregnancy outcomes and the value of throm-boelastography(TEG)in patients with prethrombotic state(PTS)during pregnancy.Methods:A total of 183 preg-nant women with PTS treated at the Department of Obstetrics,Xiangya Third Hospital,Central South University,from January 2020 to September 2023 were retrospectively analyzed.These women were divided into two groups based on pregnancy outcomes:the favorable pregnancy outcome group(97 cases)and the adverse pregnancy outcome group(86 cases).The risk factors for adverse pregnancy outcomes were evaluated by univariate and multivariate analyses,and the diagnostic value of TEG was assessed using the receiver operating characteristic(ROC)curve and Kaplan-Meier method.Results:The results of univariate analysis indicated that,compared to-the favorable pregnancy outcome group,the positive rates of antinuclear antibody(ANA),anticardiolipin antibody(ACA),and anti-beta2 glycoprotein antibody 1(β2-GP1)were higher in the adverse pregnancy outcome group(P<0.05),and lower utilization rates of hydroxychloroquine and low-molecular heparin(P<0.05),and shorter clotting reaction time in the thromboelastography(TEG-R)(P<0.05).Multivariate Logistic regression analyses revealed that TEG-R,ANA,β2-GP1 and gestational age at treatment initiation were all independent risk factors for adverse pregnancy outcome in pregnant women with PTS during pregnancy(P<0.05).ROC curve analysis showed the area under the curve for TEG-R was 0.632(95%Cl 0.551-0.741).At a TEG-R value of 4.65 min,the specificity was 0.948 and the sensitivity was 0.302.Kaplan-Meier survival curve analysis revealed that the gesta-tional weeks of pregnant women with an TEG-R>4.65 min were significantly longer than those with an TEG-R≤4.65 min.These results were statistically significant(P<0.01).Conclusions:ANA,ACA,β2-GP1,and TEG are valuable for predicting and evaluating adverse pregnancy outcomes in PTS patients.The TEG-R value≤4.65 min may serve as a critical threshold to guid anticoagulant therapy during pregnancy.

Objective:To investigate the factors for adverse pregnancy outcomes and the value of throm-boelastography(TEG)in patients with prethrombotic state(PTS)during pregnancy.Methods:A total of 183 preg-nant women with PTS treated at the Department of Obstetrics,Xiangya Third Hospital,Central South University,from January 2020 to September 2023 were retrospectively analyzed.These women were divided into two groups based on pregnancy outcomes:the favorable pregnancy outcome group(97 cases)and the adverse pregnancy outcome group(86 cases).The risk factors for adverse pregnancy outcomes were evaluated by univariate and multivariate analyses,and the diagnostic value of TEG was assessed using the receiver operating characteristic(ROC)curve and Kaplan-Meier method.Results:The results of univariate analysis indicated that,compared to-the favorable pregnancy outcome group,the positive rates of antinuclear antibody(ANA),anticardiolipin antibody(ACA),and anti-beta2 glycoprotein antibody 1(β2-GP1)were higher in the adverse pregnancy outcome group(P<0.05),and lower utilization rates of hydroxychloroquine and low-molecular heparin(P<0.05),and shorter clotting reaction time in the thromboelastography(TEG-R)(P<0.05).Multivariate Logistic regression analyses revealed that TEG-R,ANA,β2-GP1 and gestational age at treatment initiation were all independent risk factors for adverse pregnancy outcome in pregnant women with PTS during pregnancy(P<0.05).ROC curve analysis showed the area under the curve for TEG-R was 0.632(95%Cl 0.551-0.741).At a TEG-R value of 4.65 min,the specificity was 0.948 and the sensitivity was 0.302.Kaplan-Meier survival curve analysis revealed that the gesta-tional weeks of pregnant women with an TEG-R>4.65 min were significantly longer than those with an TEG-R≤4.65 min.These results were statistically significant(P<0.01).Conclusions:ANA,ACA,β2-GP1,and TEG are valuable for predicting and evaluating adverse pregnancy outcomes in PTS patients.The TEG-R value≤4.65 min may serve as a critical threshold to guid anticoagulant therapy during pregnancy.

Objective:To analyze the differences in adverse maternal-fetal outcomes among different types of edema in patients with pre-eclampsia(PE),and to explore the relationship between serous effusion and hypopro-teinemia in PE.Methods:We retrospectively collected clinical data of 120 patients with pre-eclampsia who were treated in the Third Xiangya Hospital of Central South University from January 2018 to November 2023.The pa-tients were divided into four groups based on the manifestation of edema:no edema(Type A),pure interstitial e-dema(Type B),pure cavity edema(pure serosal effusion,Type C),and mixed edema(both interstitial and cavity edema,Type D).Clinical and laboratory indicators as well as adverse maternal-fetal outcomes were analyzed a-mong these groups.Subsequently,the patients were further divided into three groups according to the amount of serous cavity effusion:PE without effusion,PE with mild effusion,and PE with moderate to severe effusion.Ad-verse maternal-fetal outcomes were compared among these three groups.Results:Patients in Type B had the highest proportion of hypoalbuminemia(P＜0.05).No statistically significant differences were found in serum albu-min levels,24-hour urinary protein quantification,blood pressure,or the proportion of hypoalbuminemia between patients in Type C and those in other edema types(P＞0.05).The incidence of adverse maternal-fetal outcomes was highest in Type D patients(P＜0.05),with HELLP syndrome and therapeutic premature delivery being the most common.When grouped by the amount of cavity effusion,PE patients with mild effusion had a higher inci-dence of adverse pregnancy outcomes than those without effusion(P＜0.05).Conclusions:Patients with serous cavity effusion,regardless of the effusion volume,have poor maternal-fetal outcomes and require clinical atten-tion.

Objective:To analyze the differences in adverse maternal-fetal outcomes among different types of edema in patients with pre-eclampsia(PE),and to explore the relationship between serous effusion and hypopro-teinemia in PE.Methods:We retrospectively collected clinical data of 120 patients with pre-eclampsia who were treated in the Third Xiangya Hospital of Central South University from January 2018 to November 2023.The pa-tients were divided into four groups based on the manifestation of edema:no edema(Type A),pure interstitial e-dema(Type B),pure cavity edema(pure serosal effusion,Type C),and mixed edema(both interstitial and cavity edema,Type D).Clinical and laboratory indicators as well as adverse maternal-fetal outcomes were analyzed a-mong these groups.Subsequently,the patients were further divided into three groups according to the amount of serous cavity effusion:PE without effusion,PE with mild effusion,and PE with moderate to severe effusion.Ad-verse maternal-fetal outcomes were compared among these three groups.Results:Patients in Type B had the highest proportion of hypoalbuminemia(P＜0.05).No statistically significant differences were found in serum albu-min levels,24-hour urinary protein quantification,blood pressure,or the proportion of hypoalbuminemia between patients in Type C and those in other edema types(P＞0.05).The incidence of adverse maternal-fetal outcomes was highest in Type D patients(P＜0.05),with HELLP syndrome and therapeutic premature delivery being the most common.When grouped by the amount of cavity effusion,PE patients with mild effusion had a higher inci-dence of adverse pregnancy outcomes than those without effusion(P＜0.05).Conclusions:Patients with serous cavity effusion,regardless of the effusion volume,have poor maternal-fetal outcomes and require clinical atten-tion.

Objective To evaluate the impact of aderent perirenal fat (APF) on retroperitoneal laparoscopic partial nephrectomy (RLPN). Methods Clinical data of 52 patients who underwent RLPN for a small renal tumor from October 2013 to December 2015 was analyzed retrospectively. All the patients were divided into two groups according to the presence of APF by preoperative computed tomography imaging. Clinical data was collected including patients' age, gender, BMI, history of hypertension, history of diabetes, American Society of Anesthesiologists score (ASA), intra-abdominal fat (IAF), tumor size, RENAL Nephrometry score (RNS), operative time, warm ischaemia time (WIT), estimated blood loss (EBL), and length of hospital stay. Results Between the two groups, the BMI, tumor size, WIT, length of hospital stay were similar [(26.70 ± 3.33) kg/m2 vs (25.65 ± 4.01) kg/m2, (3.53 ± 1.21) cm vs (3.64 ± 1.05) cm, (27.17 ± 7.55) min vs (25.21 ± 5.64) min, (12.54 ± 4.06) d vs (10.61 ± 3.70) d, P > 0.05)], as well as the ASA and RNS. APF patients were older [(59.25 ± 11.03) y vs (49.71 ± 11.86) y, P = 0.004]. There were a high proportion of men (75.0% vs 46.4%, P = 0.036), patients with hypertension (62.5% vs 28.6%, P = 0.014), and patients with diabetes (41.7% vs 14.3%, P = 0.026). In the APF group, IAF was more [(2.02 ± 0.47) cm vs (1.35 ± 0.66) cm, P = 0.000], operative time was longer [(146.08 ± 45.45) min vs (119.32 ± 28.83) min, P = 0.017], and EBL was higher [(82.92 ± 45.73) ml vs (51.79 ± 25.10) ml, P = 0.005]. Conclusion The adherent preirenal fat sticking renal results in a longer operative time and a higher EBL, but has no influences on the WIT and length of hospital stay. APF makes it difficult to expose the tumor, not to remove it.