Selective Cesarean Section Research Articles

Prediction of Expected Fetal Weight From Fetal Limb Soft Tissue Measurements [ID 2683393

INTRODUCTION: This study was to investigate a combination of new formulas that predict birth weight in full-term pregnancy by measuring the thickness of the humerus soft tissue and femur soft tissue in fetuses using three-dimensional (3D) ultrasound. METHODS: There were a total of 110 mothers and newborns who were hospitalized with selective cesarean section, induced delivery, or natural delivery between April 2019 and August 2021. We retrospectively investigated fetal biometric parameters (BPD, HC, AC, FL, partial arm volume [Avol], and partial thigh volume [Tvol]), as measured by 4D View 9.0 and GE Healthcare Ultrasound while the mother was admitted to the delivery ward before delivery. The study was approved by the ethics board of the National Medical Center (NMC-2022-03-026). RESULTS: Among the several combinations that showed the expected weight, the weight predicted by AC/BPD/Tvol gave the strongest correlation (0.780) with the actual weight of the newborn, with an error rate of 6.4%. In boys, among the several combinations indicating the predicted body weight, AC/Avol/BPD had the highest correlation coefficient with the actual body weight (0.791), with an error rate of 5.0%. In girls, among several combinations, AC/Tvol/BPD had the highest correlation coefficient with actual body weight (0.878), with an error rate of 5.3%. CONCLUSION: The fetal weight predicted using Tvol and Avol measured using 3D ultrasound as parameters had a lower error rate for birth weight than the predicted weight measured by conventional 2D ultrasound. The parameters highly correlated with birth weight; however, differences were seen between the sexes.

Relationship between traditional Chinese medicine constitution and pregnancy outcome in elderly primiparae

Purpose: To investigate the correlation between traditional Chinese medicine (TCM) constitution and pregnancy outcomes in elderly primiparae.Methods: A cross-sectional case-control study was conducted on 113 elderly primiparae who were delivered in Jinshan Hospital of Fudan University, Shanghai, China from January 2019 to December 2019. The elderly primiparae was the study group. Using a random ratio of 1:3, 393 primiparous women of suitable age who were delivered in the hospital at the same period were selected as the control group. A traditional Chinese medicine (TCM) questionnaire was used to collect clinical data, and differences between the two groups were compared.Results: The incidence of gestational diabetes mellitus was significantly higher in the study group (elderl y primiparae) with phlegm dampness constitution and qi stagnation constitution than in control group (appropriate-age primiparae) (p < 0.05). The incidence of hypertension was significantly higher in the study group with yin deficiency constitution and special constitution than in control group (p < 0.05). The frequency of selective cesarean section in study group with a biased qi-deficiency constitution, yang-deficiency constitution, and yin-deficiency constitution were significantly higher than control group (p < 0.05).Conclusion: There is a correlation between pregnancy outcomes in old age and TCM constitution. Individualized diet and exercise programs may be formulated in early pregnancy (based on the type of physique) to improve pregnancy outcomes in elderly primiparae.

An Evaluation of Antibacterial Effects of Human Amniotic Fluid on Pathogenic and Probiotic Bacteria In Vitro.

Amniotic fluid in the uterus is beneficial for the fetus growth and protection due to its nutritional elements as well as its antibacterial and anti-inflammatory properties. Today, body membranes are increasingly being used in multiple fields. The purpose of the current study was evaluation of the antibacterial effects of amniotic fluid and comparison of its effects on pathogenic and probiotic bacteria. This experimental study was conducted on amniotic fluid obtained from 43 healthy mothers who gave birth by selective cesarean section. Then, antibacterial effects of amniotic fluids were investigated on 8 standard bacterial strains, including Bacillus cereus, Escherichia coli, Staphylococcus aureus, Shigella flexneri, Pseudomonas aeruginosa, Klebsiella pneumoniae, Bacillus cereus, and Lactobacillus plantarum by agar well-diffusion method. Data analysis was performed by SPSS software, vs. 22 (IBM, US). Amniotic fluid revealed an inhibitory effect on the growth of bacterial strains. Staphylococcus aureus and Streptococcus pyogenes strains showed growth inhibition in 39% and 17% of samples, respectively. In other bacterial strains, there was growth inhibition in less than 5% of the samples. Also, the zone of growth inhibition for Staphylococcus aureus and Streptococcus pyogenes was significantly higher than the other strains. Amniotic fluid samples had an antibacterial effect on all pathogen strains in general, but not on the Lactobacillus plantarum probiotic strain. Our findings suggest that the antibacterial effect of amniotic fluid on pathogenic bacteria is significantly higher than the Lactobacillus plantarum as a probiotic one. Overall, the findings support the use of natural substances as alternative therapeutic agents to combat antibiotic resistance.

Effects of Different Delivery Modes on Pelvic Floor Function in Parturients 6-8 Weeks after Delivery Using Transperineal Four-Dimensional Ultrasound.

Objective To evaluate the effects of different delivery modes on pelvic floor function in parturients 6–8 weeks after delivery using transperineal four-dimensional ultrasound. Methods Pelvic floor function 6–8 weeks after delivery in 40 vaginal delivery parturients between November 2018 and December 2020 was assessed by four-dimensional ultrasound, with 40 selective cesarean section delivery parturients as a control group. The imaging results of the two groups were compared. Results The levels of clinical indexes such as UVJ-M, Ar, Av, θ, Dr, Dv, and ARJ-VDv in the selective cesarean section group were significantly lower than those in the vaginal delivery group 6–8 weeks after delivery (P < 0.05). However, no significant difference in CV-VD was observed under Valsalva action and at rest between the two groups (P > 0.05). No significant difference in ARJ-VD was found at rest between the two groups (P > 0.05). The incidence of pelvic organ prolapse in the selective cesarean section group (40.0%) was significantly lower than that in the vaginal delivery group (62.5%) (P < 0.05). No significant difference in the parameters of pelvic diaphragm hiatus at rest was observed between the two groups (P > 0.05). The parameters of pelvic diaphragm hiatus under maximum Valsalva action in the vaginal delivery group were significantly higher than those in the selective cesarean section group (P < 0.05). Whether the patient was complicated with diabetes had no significant effect on the functional injury of pelvic floor muscle (P > 0.05). Conclusion The pelvic floor function 6–8 weeks after delivery was significantly more affected in vaginal delivery than in selective cesarean section. Selective cesarean section had certain but limited protective effect on maternal pelvic floor tissue.

Systematic review and meta-analysis of evaluation of selective cesarean section in postpartum pelvic floor function recovery under perineal ultrasound.

Different delivery modes can affect the early pelvic floor function of puerpera, but there are no reports on the systematic evaluation of the effects of selective cesarean section delivery (CSD) and vaginal delivery (VD) on the pelvic floor function of puerpera. We searched for clinical controlled studies on the evaluation of pelvic floor function and performance after CSD and VD, published between 1 January 2010 and 1 August 2021, in the databases of PubMed, Embase, The Cochrane Library, and Web of Science. Literature was screened according to the inclusion and exclusion criteria. The quality of trials included in the studies was evaluated using the Cochrane Working Manual (5.3). Meta-analysis of the extracted data from the eligible articles was performed using Review Manager 5.3 software. The heterogeneity was assessed by chi-square, and P<0.05 was considered statistically significant among groups. A total of 3,704 parturient women were included in 10 articles, including 1,072 cases in the CSD group and 2,632 cases in the VD group. Meta-analysis showed that pelvic floor muscle strength {mean difference (MD) [95% confidence interval (CI)]: -12.51 (-17.10 to -7.91); Z=5.34; P<0.00001} and bladder neck strength decreases in the CSD group [standardized mean difference (SMD) (95% CI): 1.01 (0.73 to 1.29); Z=7.08; P<0.00001] were higher than those in the VD group. In addition, the maximum urine flow [MD (95% CI): -6.86 (-9.32 to -4.39); Z=5.46; P<0.00001], bladder angle [MD (95% CI): -3.82 (-4.54 to -3.11); Z=10.46; P<0.00001], stress urinary incontinence (SUI) rate [relative risk (RR) (95% CI): 0.56 (0.35 to 0.88); Z=2.52; P=0.01], and pelvic floor organ prolapse rate [odds ratio (OR) (95% CI): 0.29 (0.09 to 0.89); Z=2.17; P=0.03] were lower than VD group, and the differences were significant (P<0.05). Selective CSD can reduce the injury of pelvic floor muscle during delivery to a certain extent, and reduce the incidence of SUI and pelvic floor organ prolapse in early puerpera; however, such impacts cannot be completely avoided.

Correlations of Serum 1,25-Hydroxy Vitamin D3 level with Severity and Prognosis of Neonatal Respiratory Distress Syndrome.

This study was done to explore the correlations of serum 1,25-hydroxy vitamin D3 [1,25-(OH)2-VitD3] level with severity and prognosis of neonatal respiratory distress syndrome (NRDS). The clinical data of 145 NRDS children admitted between April 2019 and June 2020 were retrospectively analyzed. The subjects were comprised of 76 boys and 69 girls. Based on NRDS severity, they were assigned into mild group (n = 82) and severe group (n = 63), and their general data were compared. The independent factors affecting NRDS severity were evaluated by multivariate logistic regression analysis. The correlations of serum 1,25-(OH)2-VitD3 level in NRDS children with NRDS severity and other related blood test indices were analyzed using Spearman's and Pearson's methods. On the basis of multivariate analysis results, a prediction model was established using R3.6.0 software, which was validated by the receiver operating characteristic (ROC) curve and consistency index. The association between serum 1,25-(OH)2-VitD3 level and prognosis was evaluated through Kaplan-Meier curve. The severe group had higher groups of children with a gestational age < 39 weeks, spontaneous delivery, selective cesarean section, intrauterine distress, intrauterine infection, maternal hypertension, maternal dyslipidemia, and older maternal age than the mild group (p < 0.05). Procalcitonin, C-reactive protein, activin-A, Clara cell protein-16, interleukin-18, and IL-10 were significantly higher in the severe group than those in the mild group (p < 0.05), while serum bicarbonate, 1,25-(OH)2-VitD3, vitamin A, and IL-8 were significantly lower in the severe group than those in the mild group (p < 0.05). Multivariate logistic regression analysis results exhibited that gestational age < 39 weeks, lower 1,25-(OH)2-VitD3 and vitamin A levels, higher activin-A and CC-16 were independent risk factors for severe NRDS (p < 0.05). ROC curve analysis revealed that the area under the ROC curve of the model was 0.785, and the prediction accuracy was 88.08%. Serum 1,25-(OH)2-VitD3 level was significantly negatively correlated with NRDS severity (r = -0.287, p < 0.001), activin-A (r = -0.073, p < 0.001), and CC-16 (r = -0.098, p < 0.001), but positively correlated with vitamin A (r = 0.009, p < 0.001). Kaplan-Meier curve revealed that the survival rate of NRDS children with a high 1,25-(OH)2-VitD3 level was significantly higher than that of children with a low 1,25-(OH)2-VitD3 level (p < 0.001). 1,25-(OH)2-VitD3 is an independent influencing factor for the severity of NRDS and may affect the prognosis of NRDS children.

Propofol as Inducing Agent of Elective Cesarean

Propofol as an inducing agent in selective caesarean section is considered one of the most effective methods to carry out the surgical procedure without any type of complication, however, studies have shown that anesthetics such as Thiopental produce similar effects, therefore A bibliographic review and a brief comparison with this drug are carried out in order to determine the effectiveness and efficacy of both, and their effects on the mother and the newborn.

Study on risk factors of respiratory distress syndrome in term neonates: a retrospective case-control study

Background: Respiratory distress syndrome (RDS) is one of the most common causes of neonatal respiratory failure and neonatal death. It is more common in preterm neonates but also been found in term and late preterm neonates. This study aims at studying the risk factors for developing RDS in term neonates. Objectives was to study the maternal and perinatal risk factors for RDS in term neonates.Methods: This is a retrospective case control study conducted in neonatal intensive care unit of tertiary care centre. A total of 100 term neonates with RDS were taken as cases and 150 normal term neonates were taken as control. Data were collected from the hospital NICU records, maternal and neonatal history was taken. The χ2 tests or Fisher’s exact text were used for one-way risk factor analysis. The effects of multiple factors on term neonatal RDS were analyzed using logistic regression analysis.Results: In our study RDS in term neonates was significantly associated with following risk factors like selective cesarean section, male sex, SGA, oligohydramnios, MSAF, severe fetal distress, birth asphyxia, PROM, and maternal-fetal infection. Among the significant risk factors severe birth asphyxia, maternal-fetal infection, PROM, MSAF were showing positive association with RDS in full-term neonates.Conclusions: Several high-risk factors such as severe birth asphyxia, maternal-fetal infection, PROM, and MSAF were closely correlated with full-term neonatal RDS. Hence these could provide a significant reference for the diagnosis and treatment of term neonatal RDS.

Спокуса кесаревим розтином (Основні NB! модифікованої методики)

Obstetrics has changed in an era of «selective caesarean section». In a few decades, a rather rare operation, designed to save the lives of the mother and the baby, has become a frequent and even casual way of giving birth. The modified cesarean section technique, performed simultaneously by two surgeons, is an advanced surgical intervention. The peculiarities of its implementation indicate that the risks associated with this surgery are decreased. Key words: cesarean section, modification, surgical technique, perfection, safety.

The Effect of Group Counseling with Cognitive-Behavioral Approach on Self-Efficacy of Pregnant Women’s Choice of Vaginal Delivery

Background: Cognitive-behavioral approach has been used to overcome many problems among pregnant women such as fear and anxiety, self-efficacy improvement, depression during pregnancy and after childbirth, traumatic childbirth, as well as stress management. Objectives: The aim of this study was to determine the effect of cognitive-behavioral group counseling approach on self-efficacy on the choice of a normal vaginal delivery. Methods: In this randomized clinical trial study, 60 nulliparous pregnant women who had not chosen their method of delivery were randomly assigned into two intervention and control groups. The intervention group received three two-hour sessions of cognitive-behavioral group counseling between the 29 and 34 weeks of pregnancy, with weekly intervals. The control group received routine care provided in the health system. Before the intervention, immediately after the end of counseling and in the last month of pregnancy, self-efficacy questionnaire, with two dimensions of expected outcomes, as well as expected self-efficacy and sources of self-efficacy (outcome of past experiences of mastering a specific situation, vicarious experience provided by others, social persuasion and physiological and affective state (fear and anxiety)) were completed with the help of a collaborating midwife. The collected data were analyzed using a mixed analysis of variance. Results: The results showed that after the intervention, 76.6% of mothers in the intervention group chose a normal vaginal delivery, however, there was no firm choice in the control group. There was a significant difference between the mean scores of expected outcome and expected self-efficacy of two groups immediately after and in the last month of the pregnancy; the difference increased with the passage of time. Conclusions: Cognitive-behavioral group counseling during prenatal care can reduce fear and anxiety and increase self-efficacy of nulliparous pregnant women in choosing normal vaginal delivery, which can ultimately reduce the amount of selective caesarean section. Copyright © 2018, Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/) which permits copy and redistribute the material just in noncommercial usages, provided the original work is properly cited.

Demographic and perinatal outcome data of fetuses with SUA/PRUV

Aim: Identify structural anomalies and adverse pregnancy outcomes accompanying single umbilical artery (SUA) and persistent right umbilical vein (PRUV) and to investigate whether SUA and PRUV are associated with chromosomal abnormalities and if these defects warrant invasive antenatal diagnosis. Methods: We retrospectively analyzed pregnancies with an antenatal diagnosis of SUA/PRUV from the International Peace Maternity and Child Health Hospital (IPMCHH) database. Data of structural malformations, fetal karyotyping, and pregnancy outcomes were analyzed. Results: Results revealed that 13.9 and 7% of SUA and PRUV cases, respectively, had malformations. Furthermore, 60% of the malformations accompanying SUA were isolated congenital heart disease (CHD), and 50% of the malformations accompanying PRUV were multiple malformations including CHD. All primarily diagnosed isolated PRUV (iPRUV) cases and 92.6% of primarily diagnosed iSUA cases had normal fetal echocardiography. Cases of iSUA and iPRUV with indications of invasive antenatal diagnosis showed no chromosomal abnormalities. The emergency cesarean section rate did not differ between the study population and the IPMCHH general population (p = .184). Conclusion: Patients of SUA and PRUV diagnosed in secondary hospitals should be referred to tertiary medical center for further ultrasonography. SUA and PRUV are not indicators for invasive antenatal diagnosis and selective cesarean section.

Evaluating the short-term effect of delivery mode on female anterior compartment of pelvic floor

Objective To dynamically observe and evaluate the position and movement of anterior pelvic floor organs in vaginal delivery and selective caesarean section primipara with translabial two-dimensional(2D) ultrasound, and discuss the short-term effect of delivery mode on the anterior compartment of pelvic floor. Methods Translabial 2D ultrasound was performed on selective caesarean section and vaginal delivery primipara in 6-8 weeks. The position of bladder, the existence of bladder neck funneling were observed, and the mobility of bladder neck and the urethral rotation angle were measured during maximum Valsalva maneuver. Results The mobility of bladder neck was larger in vaginal delivery group than selective caesarean section group during maximum Valsalva maneuver. The rates of bladder neck funneling, cystocele and stress urinary incontinence were higher in vaginal delivery group. Conclusions Translabial 2D ultrasound could dynamically observe and evaluate the position and movement of anterior pelvic floor organ, which could be used to assess the effect of delivery mode on anterior compartment of pelvic floor. The short-term effect of vaginal delivery on anterior compartment of pelvic floor is greater than that of selective cesarean delivery. Key words: Translabial ultrasonography; Pelvic floor; Delivery mode; Anterior compartment of pelvic floor

Comparison of Oxidative Stress Markers and Serum Cortisol between Normal Labor and Selective Cesarean Section Born Neonates.

An imbalance between antioxidant and oxidant-generating systems in newborns can cause oxidative damage. The effect of modes of delivery on oxidative stress in neonates is not fully investigated. This study was aimed to examine the effects of modes of delivery on oxidative stress markers and cortisol in newborns. In this study 60 term neonates {30 born via Normal Delivery (ND) and 30 born via elective Caesarean Delivery (CS)} at birth were enrolled. Glutathione Peroxidase (GPx), Catalase (CAT) and Superoxide Dismutase (SOD) activities were determined in umbilical cord blood in all neonates. Moreover serum cortisol, uric acid and Total Antioxidant Capacity (TAC) were measured. GPx and SOD activities in cesarean born neonates were significantly higher than those of control subjects (p<0.05). TAC and CAT were not significantly different between the two groups. Serum cortisol was lower in caesarean born subjects as compared to normal born neonates. On the other hand uric acid concentration was higher in caesarean born neonates. The obtained data indicated that babies born via caesarean section might be predisposed to pathological conditions due to altered antioxidant levels.

Commentary on 'A multicentre randomised controlled trial comparing elective and selective caesarean section for the delivery of the preterm breech infant'.

Commentary on 'A multicentre randomised controlled trial comparing elective and selective caesarean section for the delivery of the preterm breech infant'.

High-risk Factors of Respiratory Distress Syndrome in Term Neonates: A Retrospective Case-control Study

Respiratory distress syndrome (RDS) is a common critical disease in term neonates, but reasons for the occurrence of RDS remains unclear. This study aimed to investigate the cause of RDS in full-term neonates by a retrospective case-control study. Case-control study. Among the patients admitted to Bayi Children's Hospital between January 2008 and December 2010, a total of 205 full-term neonates with RDS were assigned to the study group, and 410 full-term neonates without RDS were assigned to the control group. Clinical information, including the presence or absence of premature rupture of membranes (PROM), gender of the neonates, mode of delivery, birth weight, and any conditions suffered by the neonates were recorded. THE RESULTS OF LOGISTIC REGRESSION ANALYSIS SHOWED THAT THE FOLLOWING CAUSES WERE CLOSELY CORRELATED WITH TERM NEONATAL RDS: selective cesarean section (OR: 8.737; 95% CI: 5.232-14.588), severe birth asphyxia (OR: 6.988; 95% CI: 2.990-16.333), small gestational age (OR: 6.222; 95% CI: 2.001-8.993), maternal-fetal infection (OR: 5.337; 95% CI: 1.999-8.233), PROM (OR: 3.380; 95% CI: 1.986-5.754), male sex (OR: 2.641; 95% CI: 1.721-4.053), gestational glucose intolerance or diabetes (OR: 2.415; 95% CI:1.721-4.053), and low birth weight (OR: 2.323; 95% CI: 1.329-4.060). Several high-risk factors, such as selective cesarean section, severe birth asphyxia, maternal-fetal infection, PROM, and male sex are closely correlated with full-term neonatal RDS. These could provide a significant reference for the diagnosis and treatment of term neonatal RDS.

Diagnosis and treatment of respiratory distress syndrome in full-term newborns

To explore the pathogenesis, clinical characteristics and management strategies of respiratory distress syndrome (RDS) in full-term neonates. A total of 316 full-term infants with RDS were enrolled. The main characteristics of term ineonatal RDS are as following: Term neonatal RDS was more common in boys than in girls. 70.9% of the patients had an onset within 3 hours after birth, 90.2% of them within 6 hours after birth and 99.4% of them within 12 hours after birth. The main causes of ARDS was selective cesarean section, followed by males; while severe infection was the most common cause of secondary RDS, followed by severe birth asphyxia and meconium aspiration syndrome. Illness state was more severe and evolved more rapidly. And it was more likely to develop into persistent pulmonary hypertension of newborn (PPHN) and multiple organ system failure (MOSF), especially myocardial injuries and acute renal failure. Most patients required prolonged mechanical ventilation. The mortality was relatively higher and the major mortality cause was severe infection with MOSF. But their prognosis improved after comprehensive treatment measures including early mechanical ventilation and broad spectrum antibiotics were implemented. Key words: Respiratory distress syndrome, newborn; Signs and symptoms

I111 SURGICAL OUTCOMES AND THE CLIENTS' SATISFACTION FOR RECONSTRUCTIVE SURGERY FOR FEMALE GENITAL MUTILATION

Results: The clients reported that they were accepted of the issue of reconstructive surgery. The majority were very satisfied (86%), the rest (14%) of the group were satisfied with the results of the surgery in regards the healing & its duration, shape of the vulva, disappearance of vaginal discharge and the regaining or starting of the sexual activity and the interest. Conclusion: This study confirmed that the reconstructive surgery for the female genital mutilation victims (RCFGM) can be performed to restore some of the genital anatomy with a high degree of clients’ acceptance and satisfaction. Lucky enough the study proves the clients’ refusal to perform FGM for their girls in the future, which gives an excellent chance for the health promotion and education initiative to stand against FGM. I112 CURRENT MANAGEMENT OF PERINEAL TRAUMA AFTER VAGINAL DELIVERY R. Fernando Over 60% of women suffer perineal trauma caused either by perineal tear or episiotomy following vaginal delivery. Perineal trauma sustained during childbirth is a major aetiological factor in the development of perineal pain, sexual dysfunction, pelvic organ prolapse, urinary and faecal incontinence. Preferential use of the vacuum extractor, restricting the use of episiotomy, perineal repair with continuous non locking polyglactin sutures, repair of anal sphincter injury by a trained doctor and selective caesarean section in these women has been shown to be beneficial in preventing complications. More focused training of midwives and doctors in perineal and anal sphincter anatomy and repair technique has also been shown to minimize the morbidity associated with inadequate repair and missed tears. At present there is limited evidence available to predict and prevent perineal trauma and how to manage subsequent pregnancy following anal sphincter injuries and further research need to be focused in these areas. I113

Maternal and fetal blood glucose levels do not correlate with the amount of 2.5 % carbohydrogenated oral rehydration solution taken prior to selective Caesarean section

National Center for Child Health and Development, Department of Anaesthesiology and Intensive Care, Tokyo, Japan

Interleukin 18 messenger RNA and proIL-18 protein expression in chorioamniotic membranes from pregnant women with preterm prelabor rupture of membranes

To quantify the expression of IL-18 mRNA and protein in the chorioamniotic membranes of pregnant women with PPROM and correlate expression with histological chorioamnionitis. A case control study that included 42 pregnant women not in labor in the following groups: PPROM (n=28) and controls with intact membranes submitted to selective cesarean section at term (n=14). Expression of IL-18 mRNA in chorioamniotic membranes was determined by real-time polymerase chain reaction, and IL-18 protein expression was measured by western blot. Histopathological analyses and immunolocalization of IL-18 by immunohistochemistry were also performed. Analyses were performed using the Mann-Whitney or Fisher's exact tests and the group effect was considered significant if the adjusted p-values were <0.05 and the magnitude of change was greater than 2-fold for mRNA expression. IL-18 mRNA was present in 100% of samples and no difference in expression was observed between term vs. PPROM membranes (fold-change 0.12; p=0.88). In the PPROM group, no difference was observed in IL-18 mRNA regarding gestational age (fold-change 0.11; p=0.42) or the presence of histological chorioamnionitis (fold-change 0.26; p=0.15). ProIL-18 was present in all samples. IL-18 was immunolocalized to amnion, chorion and decidua cells, with intense immunohistochemical staining at the choriodecidual junction. Chorioamniotic membranes are sources of IL-18 mRNA and proIL-18, and their expression is unrelated to PPROM or histological chorioamnionitis.

Related factor analysis of prenatal anxiety and its relationship with delivery mode of primiparae

Objective To investigate the prenatal emotional disorder of the primipame and the related factors,and to analyze its influence on the delivery mode.Methods In the prospective cohort study,590 healthy primiparase were asked to complete a self-compiled questionnaires for their general social mental state,state-trait anxiety inventory(STAI)and self-rating depression scale(SDS).Results Questionnaires of 159 patients were selected and these patients were divided into the anxiety group(114 cases)and the control group(455 cases),the depression group(159 cases)and the control group(410 cases).The ratio of selective cesarean section in the anxiety group was significantly higher(45.61%,32.53%,X2=6.85,P＜0.01),while the successful trial of labor were less than that of the control group(19.35%,47.88%,X2=26.30,P＜0.01).The ratio of selective cesarean section in the depression group was significandy higher than that of the control group(46.54%,31.95%,X2=10.21,P＜0.01),while the successful trial of labor were less than that of the control group(31.76%.46.59%,X2=9.13,P＜0.01).Single-factor analysis showed that prenatal anxiety related to the following factors:fear of childbirth,worried about their children,knowledge for childbirth,high economic status,maternal age and their own economic situation.Conclusions Higher incidence and risk factors of anxiety or depression before delivery,such as advanced delivery age,bad economic condition,weak family support,worrying about the safety of babies and themselves,are found in our study.Prenatal emotional disorder would affect the quality of labor and delivery options,and lead the high risk of cesarean section. Key words: Cesarean section; Prenatal anxiety; Primiparae; Delivery mode