Objective To explore the influencing factors of early postpartum pelvic organ prolapse(POP)after vaginal delivery in advanced maternal age primipara.Methods Clinical data of 153 postpartum women were collected from Beijing Tongren Hospital Mentougou Campus,Capital Medical University,from June 2015 to May 2024.According to whether pelvic organ prolapse occurred during the 6-week postpartum reexamination of the primiparas,the parturients were divided into two groups:non-POP group(91 cases)and POP group(62 cases).Univariate and multivariate Logistic regression analyses were conducted to identify the independent factors influencing early postpartum POP.Subgroup analysis was also performed to assess the relationship between family history of POP and early postpartum POP after adjusting for confounding factors.Results Multivariate Logistic regression analysis revealed that neonatal birth weight,maternal pre-pregnancy body mass index(BMI),use of delivery balls,and family history of POP were independent factors associated with early postpartum POP occurrence(P＜0.05).Among the parturients who did not use of delivery balls,before and after using Logistic regression to adjust for birth weight,pre-pregnancy BMI and perineal laceration,the impact of family history of POP on the occurrence of POP was statistically significant(P＜0.05).However,among the parturients who used the delivery balls,regardless of whether the adjustment was made or not,the impact of family history of POP on the occurrence of POP was not statistically significant(P＞0.05).Conclusion Neonatal birth weight,maternal pre-pregnancy BMI,and family history of POP are risk factors for early postpartum POP,while the use of delivery balls is a protective factor.Women with a family history of POP are advised to use delivery balls to reduce the risk of early postpartum POP.

Objective To explore the influencing factors of early postpartum pelvic organ prolapse(POP)after vaginal delivery in advanced maternal age primipara.Methods Clinical data of 153 postpartum women were collected from Beijing Tongren Hospital Mentougou Campus,Capital Medical University,from June 2015 to May 2024.According to whether pelvic organ prolapse occurred during the 6-week postpartum reexamination of the primiparas,the parturients were divided into two groups:non-POP group(91 cases)and POP group(62 cases).Univariate and multivariate Logistic regression analyses were conducted to identify the independent factors influencing early postpartum POP.Subgroup analysis was also performed to assess the relationship between family history of POP and early postpartum POP after adjusting for confounding factors.Results Multivariate Logistic regression analysis revealed that neonatal birth weight,maternal pre-pregnancy body mass index(BMI),use of delivery balls,and family history of POP were independent factors associated with early postpartum POP occurrence(P＜0.05).Among the parturients who did not use of delivery balls,before and after using Logistic regression to adjust for birth weight,pre-pregnancy BMI and perineal laceration,the impact of family history of POP on the occurrence of POP was statistically significant(P＜0.05).However,among the parturients who used the delivery balls,regardless of whether the adjustment was made or not,the impact of family history of POP on the occurrence of POP was not statistically significant(P＞0.05).Conclusion Neonatal birth weight,maternal pre-pregnancy BMI,and family history of POP are risk factors for early postpartum POP,while the use of delivery balls is a protective factor.Women with a family history of POP are advised to use delivery balls to reduce the risk of early postpartum POP.

Objective:To investigate the value of the venous-to-arterial CO 2 gap (Δ CO 2 gap) before and after the fluid challenge (FC) in determining the fluid responsivenessin septic shock patients. Methods:A total of 104 septic shock patients admitted to the Medical Intensive Care Unit (MICU) of Peking Union Medical College Hospital were included in the retrospective study. All patients were monitored by Swan Ganz floating catheter during the FC. Hemodynamics and blood gas indices were collected before FC (T0) and immediately (T1), 10 min (T2), 30 min (T3) and 60 min (T4) after FC. Responders were defined as patients with a > 10% increase in cardiac output (CO) after FC. Spearman correlation analysis was used to evaluate the correlation between CO 2 gap and CO. The value of ΔCO2 gap were calculated by the area under the receiver operating characteristic (AUROC) curve in the whole population. Results:Among 104 patients, the effective rates of FC at T1, T2, T3 and T4 were 59% (61/104), 72% (75/104), 73% (76/104), and 77% (80/104), respectively. CO of patients in the reactive group was lower than that in the non-reactive group at T2 [6.0 (4.7, 7.5) vs. 7.2 (6.4, 8.5) L/min, P=0.019], and there was no significant difference in CO 2 gap between the two groups before FC. Spearman correlation analysis showed that CO 2 gap was negatively correlated with CO, and the correlations between CO 2 content gap and CO was -0.34, and -0.33 of CO 2 pressure gap and CO, respectively (both P <0.05). ROC curve analysis showed that the ΔCO 2 gap at T1 could weakly judge the reactivity at T2, T3 and T4, but could not judge the reactivity at T1. The AUROC at T2 was 0.669 of ΔCO 2 content gap and 0.684 of ΔCO 2 pressure gap (both P <0.05). Conclusions:The evaluate time judging the effect of FC should be appropriately extended. The change value of CO 2 gap before and immediately after volume expansion in septic shock patients can judge the fluid responsiveness within 10 min after FC.