Objective Identifying organizational factors affecting venous thromboembolism (VTE) incidence and variations between hospitals. Methods From a 2019 survey of VTE and live births in 113 hospitals, organizational factors: (hospital type, characteristics, live birth number), resource availability: (D-dimer, B-scan ultrasonography of lower extremity veins, computed tomographic pulmonary angiography [CTPA], and competency: [risk assessment, use of anticoagulants and patient education], data were collected and the associations, weighted by live birth number, analyzed. Results Of 113 hospitals in China, 770,828 live births and 526 cases of VTE (68.2 per 100,000 live births) were reported. Nine hospitals lacked B-scan ultrasonography of lower extremity veins and 22 lacked CTPA. Prevalence rates of VTE rates were higher in general hospitals (Odds ratio [OR] = 4.251, 95% CI: 3.373-5.357), hospitals with live births < 10,000 (OR = 1.650-2.193), and hospitals without B-scan ultrasonography (OR = 1.661, 95% CI: 1.096-2.518). Hospitals implementing patient education, had a lower risk of VTE (OR = 0.296-0.374), and VTE rate decreased with the annual increase in live births. Conclusions Improved hospital resource availability and competency, especially patient education, is vital for reducing VTE-related maternal mortality and morbidity risk.

Preconception care has emerged as a developing field in maternal and child healthcare worldwide. This care type provides couples of reproductive age with the opportunity for early detection and management of biomedical, behavioral, and social health problems. In 2010, the Chinese government launched a nationwide preconception care program as a welfare project. During the past decade, this project has received international attention, and experiences from the project have been published in the literature. In this review, we summarize the history, implementation, and evaluation of preconception care services in China, and its related maternal and children's health service initiatives, to thereby provide knowledge for policymakers and clinicians in other countries.

Background: To investigate the effect of extracorporeal magnetic wave pelvic floor therapy combined with pelvic floor muscle training (PFMT) on pelvic floor muscle strength and the degree of pelvic organ prolapse in patients with postpartum pelvic floor dysfunction. Methods: A total of 100 patients with postpartum pelvic floor dysfunction (PFD) who were treated in Lishui People’s Hospital from January 2020 to May 2022 were selected as the research objects. According to the random number table method, they were divided into a control group of 50 cases and an observation group of 50 cases. The control group received pelvic floor muscle training, and the observation group received extracorporeal magnetic wave pelvic floor therapy combined with PFMT on its basis, and the two groups received continuous treatment for 8 weeks. The clinical efficacy; Pelvic floor muscle strength classification; Pelvic organ prolapse quantitative scale (POP-Q) score Ap and C index points; Pelvic floor dysfunction questionnaire (PFDI-20) and Pelvic floor dysfunction questionnaire (PFIQ-7) score were compared between the two groups. Results: Compared with the control group (70.00%), the total clinical effective rate (96.00%) of the observation group was significantly increased (p < 0.05); compared with before treatment, the proportion of pelvic floor muscle strength of grade 0 in the observation group was significantly decreased, and the proportion of grade Ⅳ was significantly increased after treatment, and the proportion of pelvic floor muscle strength of grade 0 in the observation group was significantly lower than that in the control group, and the proportion of grade Ⅳ was significantly higher than that in the control group (p < 0.05); Compared with before treatment, the POP-Q scores Ap and C index points in the two groups were significantly decreased after treatment, and the POP-Q scores Ap and C index points in the observation group were significantly lower than those in the control group (p < 0.05); Compared with before treatment, the PFDI-20 scores and PFIQ-7 scores in the two groups after treatment were significantly decreased, and the PFDI-20 scores and PFIQ-7 scores in the observation group were significantly lower than those in the control group (p < 0.05). Conclusions: Extracorporeal magnetic wave pelvic floor therapy combined with PFMT can effectively improve the clinical efficacy of PFD patients, improve pelvic floor muscle strength, reduce the degree of pelvic organ prolapse, and improve the quality of life of patients, which has a high clinical reference value. Clinical Trial Registration: The study was registered at https://www.chictr.org.cn (registration number ChiCTR1900024783).

BackgroundThe use of low-dose aspirin for women with twin pregnancies remains controversial. This study was to describe the frequency of preeclampsia and aspirin use in twin pregnancies in real practice.MethodsThis retrospective cohort study based on real-world data was conducted in the Obstetrics and Gynecology Hospital of Fudan University between 2013 and 2020. Women with twin pregnancies who received prenatal care before 20 weeks of gestational age were included. They were divided into those using low-dose aspirin (LDA group) and those not using aspirin group (N-LDA group). The primary outcome was the frequency of preeclampsia, and secondary outcomes included early-onset and preterm mild and severe preeclampsia.ResultsA total of 2,946 women had twin pregnancies, and 241 were excluded due to missing information. Of 2,705 eligible women, 291 (10.75%) were administered aspirin and the other 2,414 (89.25%) did not. The patients in the LDA group were significantly more likely to be older, have a higher rate of use of ART, have a previous history of hypertension, and have gestational diabetes (p &lt; 0.05). In the LDA group, aspirin compliance ≥50% was relatively low (14.43%, 42/291). Preeclampsia occurred in 106 of 291 participants (36.43%) in the LDA group, as compared to 449 of 2,411 (18.62%) in the N-LDA group (OR: 2.15, 95% CI: 1.62–2.82; p &lt; 0.01). The association was confirmed (OR: 1.74, 95% CI: 1.26–2.4; p &lt; 0.01) in the 1:2 case-matched analysis. Higher odds of ratio in the LDA group were demonstrated (aORs &gt; 1, p &lt; 0.01), except for early-onset and preterm mild preeclampsia (p &gt; 0.05). This association was confirmed in a subgroup analysis of methods of conception (aORs ≥ 1, p &gt; 0.05).ConclusionAspirin prescription of 75 to 100 mg in twin pregnancies was associated with no significant reduction of preeclampsia, which may be due to poor compliance with the aspirin used. Further randomized controlled or prospective cohort studies are required.

Background Despite international clinical guideline recommendations, implementation of Bayes-theorem based preeclampsia risk prediction model in first trimester among Chinese women is limited. The aim of this study is to examine the effectiveness of this risk predictive strategy in reducing the risk of preeclampsia. Methods The study will be a randomized, stepped-wedge controlled trial conducted in eighteen hospitals in China. Stepped implementation of Bayes-theorem based risk prediction model will be delivered to hospitals in a random order to support the introduction of this prediction model of preeclampsia. A staged process will be undertaken to develop the risk prediction strategies, which comprise of: combined risk evaluation by maternal risk factors, medium arterial pressure, uterine artery pulse index and placenta growth factor during 11–13+6 gestational weeks, monthly follow up (including blood pressure, newly onset complications, adherence to aspirin). Repeated cross-sectional outcome data will be gathered weekly across all hospitals for the study duration. The primary outcome measures are the incidence of preeclampsia within 42 days postpartum. Data on resources expended during intervention development and implementation will be collected. The incidence of pregnancy related complications will be measured as secondary outcomes. Discussion This will be the first randomized controlled trial to evaluate the effectiveness of the Bayes-theorem based preeclampsia risk prediction strategies in first trimester by competing risk model validation. If positive changes in clinical practice are found, this evidence will support health service adoption of this risk prediction model to reduce the risk of preeclampsia among Chinese pregnant women. Trial registration Chinese Clinical Trials Registry, No. ChiCTR2100043520 (date registered:21/2/2021).