Zhonghua fu chan ke za zhi
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Zhonghua Fu Chan Ke Za Zhi · Nov 2020
[Clinical value of p16INK4a immunocytochemistry in cervical cancer screening].
Objective: To evaluate the value of p16INK4a detected by p16INK4a immunostaining as a new generation of cervical cytology for primary screening and secondary screening in population-based cervical cancer screening, and in improving cytological diagnosis. Methods: Between 2016 and 2018, 5 747 non-pregnant women aged 25-65 years with sexual history were recruited and underwent cervical cancer screening via high-risk (HR)-HPV/liquid-based cytological test (LCT) test in Shenzhen and surrounding areas. All slides were immuno-stained using p16INK4a technology, among them, 902 cases were offered p16INK4a detection during primary screening, and the remaining 4 845 cases were called-back by the virtue of abnormal HR-HPV and LCT results for p16INK4a staining. ⋯ HPV 16/18 to colposcopy and triage other HR-HPV with p16INK4a was equally sensitive (88.2% vs 94.1%; P=0.500) and more specific (88.3% vs 83.0%; P<0.01) than HPV 16/18 to colposcopy and triage other HR-HPV with LCT≥ atypical squamous cells of undetermined significance (ASCUS), and the referral rate decreased (14.0% vs 19.4%; P=0.005). Conclusions: For primary screening, p16INK4a is equally specific to cytology and equally sensitive to HR-HPV screening. p16INK4a alone could be an efficient triage after primary HR-HPV screening. In addition, p16INK4a immunostaining could be used as an ancillary tool to cervical cytological diagnosis, and improves its accuracy in cervical cancer screening.
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Objective: To analyze the effect of pregnancy with adenomyosis on perinatal outcome. Methods: From April 2014 to April 2019, singleton pregnant women complicated with adenomyosis in Peking University Third Hospital was selected and the perinatal outcomes were analyzed retrospectively. Results: The age of patients in the pregnancy with adenomyosis group (study group) was not different from that of the control group (median: 35 vs 34 years old, P>0.05); the body mass index was higher than that of the control group (median: 23.9 vs 21.8 kg/m2, P<0.01); the rate of assisted reproductive technology was significantly higher than that of the control group [25.3% (64/253) vs 3.1% (8/257), P<0.01]. ⋯ There were no significant differences in umbilical artery pH and 1-minute Apgar score between the study group and the control group (all P>0.05). Conclusions: Pregnant women complicated with adenomyosis has low fertility, and most of them need assisted reproductive technology to conceive. The pregnant women with adenomyosis has the poor perinatal outcome, including an increased incedence of preterm birth, preeclampsia, postpartum hemorrhage, cesarean section and SGA, and low newborn weight.
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Zhonghua Fu Chan Ke Za Zhi · Nov 2020
[Clinical analysis of 68 cases of sepsis during pregnancy and the postpartum period].
Objective: To investigate the clinical features, etiology, and prognosis of sepsis during pregnancy and the postpartum period. Methods: Sixty-eight pregnant women with maternal sepsis treated in Peking Union Medical College Hospital from January 1997 to December 2019 were collected, and divided into obstetric infection group (30 cases) and non-obstetric infection group (38 cases) according to different infection sources. Clinical manifestations, types of infection sources, microbiological characteristics, treatment and outcomes were studied and analyzed. ⋯ Conclusions: Sepsis during pregnancy and the postpartum period is a potentially life-threatening disease. Pregnant women with non-obstetric sepsis have more complications, more serious condition and worse prognosis than those with obstetric infection. Timely detection of risk factors, early identification and active treatment are helpful to improve maternal and fetal prognosis.