GDM did not affect the time to delivery, cesarean delivery and other perinatal outcomes in Chinese women underwent dinoprostone-induced labor. However, it may be associated with the lower rates of delivery within different time intervals.
Objective: The aim of this study was to investigate the impacts of late gestational liver dysfunction and its impact on pregnancy outcomes. Materials and Methods: The patients hospitalized for liver dysfunction in their late pregnancy between 2010-2012 were set as the observation group, and the pregnant women with normal liver function at the same period were randomly selected and set as the control group. The impacts towards the pregnancy outcomes were compared between these two groups and the impacts of differentdegree transaminase increasing towards the pregnancy outcome were analyzed. Results: The incidence rates of cesarean section, postpartum hemorrhage, fetal distress, premature birth, premature rupture of membranes (PROM) of the observation group and the transaminase-severely-increased group (the severe group) were higher, and the differences were statistically significant (p < 0.01 or < 0.05); while only the cesarean rate of the mild and moderate group was significantly different from the control group (p < 0.01 or < 0.05). The ratios of intrahepatic cholestasis in pregnancy (ICP), gestational hypertension + HELLP syndrome, acute fatty liver in pregnancy (AFLP) of the severe group were higher than the mild and moderate group, and the differences were statistically significant; the nonalcoholic fatty liver disease (NAFLD) group and the unknown cause group mainly showed a mildly increased transaminase; the distributions of viral hepatitis in pregnancy (VHP), post-viral-hepatitis-B cirrhosis, biliary tract disease, and infected toxic liver dysfunction in different-degree increased transaminase groups had no significant difference. Conclusions: Liver dysfunction in later pregnancy, especially with severe transaminase increase, might significantly increase the risk of adverse maternal events. The major causes of severe liver dysfunction in late pregnancy were ICP, gestational hypertensive disorders, and AFLP.
Aim: Gestational hypertension is a common disorder of pregnancy. This study aims to evaluate the effect of labor induction with dinoprostone vaginal suppositories (Propess) on pregnancy outcomes in pregnant women with gestational hypertension. Methods: The retrospective study included 375 patients with gestational hypertension. All patients were included into three groups according to the characteristics at admission. Women who had initiated labor spontaneously at admission were enrolled in Spontaneous labor group. According to Bishop score, other patients underwent labor induction with Propess or oxytocin were enrolled in Propess group or Oxytocin group. Demographic information and perinatal outcome data were collected. Results: The vaginal delivery rate of the women with gestational hypertension was respectively 93.5% (Spontaneous labor group), 77.0% (Propess group), and 52.5% (Oxytocin group) in three groups with significant difference (P < 0.001). The duration of labor was 8.29 AE 3.70 h (Spontaneous labor group), 8.45 AE 5.21 h (Propess group) and 12.37 AE 11.47 h (Oxytocin group) in three groups, respectively. No differences were found in the intrapartum fever (P = 0.588), intrapartum hemorrhage (P = 0.953), intrapartum maximum blood pressure (P = 0.301 and P = 0.535) and post-partum hemorrhage (P = 0.075) among three groups. Neonatal outcomes were similar among three groups (Neonatal hospitalization rate, P = 0.437; 1-min Apgar score, P = 0.304; 5-min Apgar score, P = 0.340; Birth weight, P = 0.089). No poor maternal and neonatal outcomes occurred. Conclusion: Pregnant women with gestational hypertension could have favorable pregnancy outcomes. Using Propess as a mode of labor induction in gestational hypertension is safe and effective, without increasing intrapartum blood pressure and inducing poor pregnancy outcomes.*P < 0.05 comparison between Spontaneous labor group and Oxytocin group.; **P < 0.05 comparison between Spontaneous labor group and Propess group.; ***P < 0.05 comparison between Oxytocin group and Propess group.; P value, comparison between three group by One-way analysis of variance. and DBP, diastolic blood pressure; SBP, systolic blood pressure.
This study aims to investigate the efficacy of insulin in treating severe hypertriglyceridaemia (HTG) during the third trimester of pregnancy. Women with severe HTG (TG ≥ 11.30 mmol/L) in the third trimester of pregnancy who received clinical examination and delivered in Hubei Maternal and Child Health Hospital from 01 January 2017 to 30 September 2021 were recruited. Patients with TG ≥ 11.30 mmol/L at 30–32 weeks of gestation were treated with a low-fat diet and insulin as the insulin treatment group. For the control group, patients with TGs of 5.65–11.30 mmol/L at 30–32 weeks of gestation who developed severe HTG (TG ≥ 11.30 mmol/L) before delivery were treated with a low-fat diet only. General maternal information, delivery, perinatal treatment and laboratory examination information were collected from electronic medical records and compared. We found that in the insulin treatment group, there were higher values of progestational body mass index (BMI) (Z = −2.281, P = 0.023), higher incidence of diabetes (χ2 = 20.618, P < 0.001) and higher incidence of fatty liver (χ2 = 4.333, P = 0.037) than in the control group but also a higher pregnancy weight gain compliance rate (χ2 = 4.061, P = 0.044). Laboratory examination before delivery revealed that compared with the control group, insulin treatment significantly decreased prenatal TG (Z = −10.392, P < 0.001), cholesterol (Z = −8.494, P < 0.001), low-density lipoprotein (Z = −3.918, P < 0.001), apolipoprotein A1 (t = 2.410, P = 0.019), cystatin (Z = −4.195, P < 0.001), incidence of hypocalcaemia (P = 0.036), and absolute number of lymphocytes (Z = −3.426, P = 0.001). Delivery outcomes were also improved in the insulin treatment group compared with the control group, including lower neonatal weight (Z = −2.200, P = 0.028), incidence of macrosomia (χ2 = 4.092, P = 0.043), gestational age (Z = −3.427, P = 0.001), and rate of intensive care unit (ICU) conversion (P = 0.014). In conclusion, insulin therapy for HTG in the third trimester of pregnancy could increase the pregnancy weight gain compliance rate, decrease blood lipid levels and the incidence of severe complications such as HTG acute pancreatitis (HTG-AP), and improve pregnancy outcomes.
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