Effects of medical abortion assisted by traditional Chinese medicine: A network meta-analysis of randomized controlled trials.

BACKGROUND: To what extent traditional Chinese medicine (TCM) combined with mifepristone and misoprostol is beneficial for improving the complete abortion rate and duration of vaginal bleeding has been a subject of debate in the field of medical abortion. OBJECTIVE: To assess the evidence regarding the complete abortion rate and duration of vaginal bleeding of medical abortion assisted by different kinds of TCM. SEARCH STRATEGY: We searched electronic databases such as PubMed, Web of Science and Cochrane Library database, China National Knowledge Internet, Wan fang Database, VIP Database, and China Biology Medicine disc from 2000 to February 15, 2023. SELECTION CRITERIA: The control group was medical abortion with mifepristone and misoprostol, and the experimental group was medical abortion assisted by TCM. DATA COLLECTION AND ANALYSIS: Major data extraction included sample size, age, medicine used for abortion, outcome measures. RevMan 5.3 and Stata 15.1 software were used to assess the literature quality and perform network meta-analysis, respectively. MAIN RESULTS: A total of 73 randomized controlled trials (RCTs) with 11 683 patients and nine kinds of TCM were included in this study. Compared with mifepristone and misoprostol, eight kinds of TCM had statistical significance in improving the complete abortion rate. The effect value of Sancao decoction was 5.86 (95% confidence interval [CI] 2.53-13.58). Seven kinds of TCM shortened the duration of vaginal bleeding. The effect value of comfrey and trichosanthin decoction was -8.75 (95% CI -10.86 to -6.64). CONCLUSIONS: This network meta-analysis showed that Lenge Zhumo decoction and Sancao decoction could have a large beneficial effect on complete abortion rate in medical abortion during early pregnancy, and comfrey and trichosanthin decoction could be the best TCM for shortening the duration of vaginal bleeding.

Predictive value of abdominal wall scar score for pelvic floor function rehabilitation, vaginal microecology and complications after cesarean section.

Objective: To explore the predictive value of the abdominal wall scar score for pelvic floor function rehabilitation, vaginal microecology and complications after cesarean section. Methods: A total of 120 pregnant women who underwent cesarean section in our hospital from January to December 2022 were selected. The patients were divided into observation group (score ≥ 60, n = 52) and control group (score < 60, n = 68) according to the preoperative score of abdominal wall scar and whether the score exceeded 60. The pelvic floor function rehabilitation, vaginal microecology and complications were compared between the two groups, and the score of abdominal wall scar was evaluated by receiver operating characteristic (ROC) curve. The predictive value of pelvic floor function rehabilitation, vaginal microecology and complications after cesarean section was evaluated. Results: There were significant differences between the two groups in postpartum class I and class II muscle fiber strength and pelvic floor muscle potential (P < 0.05). ROC curve showed that the AUC of abdominal scar score in predicting pelvic floor function rehabilitation was 0.806 (95% CI [0.684-0.927]), the specificity was 80.17%, and the sensitivity was 79.76%. There was significant difference in the abnormal rate of leukocte estrase (LE) and Acetylaminoglucosidase (NAG) between the two groups (P < 0.05). ROC curve showed that the AUC of abdominal scar score in predicting vaginal microecology was 0.871 (95% CI [0.776-0.966]), the specificity was 85.09%, and the sensitivity was 82.36%. There was significant difference in the incidence of postpartum complications between the two groups (P < 0.05). ROC curve showed that the AUC of abdominal scar score in predicting complications was 0.844 (95% CI [0.735-0.953]), the specificity was 82.27%, and the sensitivity was 81.15%. Conclusion: The abdominal scar score has a certain effect on predicting the recovery of pelvic floor function, vaginal microecology and complications after cesarean section. Therefore, it can help the medical staff to adjust the treatment measures in time, which can be used as a means of preoperative auxiliary examination.

Interactions between Benzo(a)pyrene exposure and genetic polymorphisms of AhR signaling pathway on missed abortion.

Benzo(a)pyrene (BaP) is an environmental pollutant widely exposed to human beings. While the relationship between BaP and missed abortion is few understood. To explore the association between missed abortion and BaP, genetic polymorphisms of AhR pathway, we recruited 112 cases women with missed abortion and 137 controls women with normal pregnancy from Shanxi, China. The BPDE-DNA adducts level in the case group was higher than that in the control group (P < 0.001). The subjects were categorized according to the tertiles of BPDE-DNA adduct concentrations: T1 (

Narrow linewidth self-injection locked fiber laser based on a crystalline resonator in add-drop configuration.

Strong and narrow spectral feedback plays a key role in self-injection locking (SIL) single-frequency lasers, especially in the stabilization of single longitudinal mode (SLM) operation of a multi-mode laser. Here, we report on a narrow linewidth SIL fiber laser that adopts a fiber add-drop configuration composing of two tapered fibers and a high-Q MgF2 crystalline whispering-gallery-mode resonator. The feedback from the drop port could be controlled and optimized for stable SLM lasing of multi-mode fiber lasers. A stable single-frequency fiber laser with white frequency noise as low as ∼0.4 Hz2/Hz, corresponding to an instantaneous linewidth of ∼1.26 Hz, is demonstrated. Compact, controllable, and all-fiber configuration in this work to achieve an ultra-narrow linewidth laser will attract interest in many applications.

Phthalate levels in urine of pregnant women and their associated missed abortion risk.

Phthalates are one of the most common environmental endocrine disrupting chemicals (EDCs) in human contact. Prenatal phthalates exposure may adversely affect intrauterine growth, however, little is known about their association. This study aimed to explore the impact of phthalates on the risk of missed abortion. A total of 123 women with missed abortion (cases) and 148 normal pregnant women (controls) were simultaneously collected from Taiyuan, China. Four urinary phthalate metabolites were determined by high-performance liquid chromatography (HPLC). Logistic regression model was used to estimate odds ratios (ORs) and 95 % confidence intervals (95 % CI) of missed abortion associated with phthalate metabolite levels. Four phthalate metabolites, including monomethyl phthalate (MMP), monoethyl phthalate (MEP), monobutyl phthalate (MBP), monobenzyl phthalate (MBzP), were detected in at least 78.97 % of all participants, with the highest geometric mean concentration of 147.19 ng/mL for MEP of the urine samples. Both MMP (Z = -3.898, P < 0.001) and MBP (Z = -2.198, P = 0.028) concentrations were higher in cases than in controls. There were no significant differences for MEP (Z = -0.285, P = 0.076) and MBzP (Z = -0.878, P = 0.380) concentrations between cases and controls. Furthermore, Logistic analysis revealed that each one-unit increase in log-transformed MMP (OR = 1.49, 95 % CI = 1.14-1.95) was positively associated with missed abortion. Increasing risks of missed abortion were observed the third quartile (Q3) and the highest quartile (Q4) of MMP(OR = 2.21, 95 % CI = 1.06-4.60; OR = 2.85, 95 % CI = 1.34-6.05) compared to the lowest quartile (Q1) of MMP concentrations. We concluded that prenatal phthalates exposure may contribute to an increased risk of missed abortion.

Clinical manifestation, outcomes in pregnant women with COVID-19 and the possibility of vertical transmission: a systematic review of the current data.

Objectives To assess perinatal outcomes of COVID-19 infections during pregnancy and the possibility of vertical transmission. Methods An analysis was performed using Stata 15.0, and Q-test was used to evaluate the heterogeneity of the included studies. Results The most common symptoms were found to be fever (64.78%), cough (59.81%) and shortness of breath or dyspnea (23.86%). Of this 88.73% patients demonstrated typical COVID-19 signs on chest CT or X-ray. Intubation was carried out in 35.87% of patients, and 4.95% of mothers were admitted to the intensive care unit, where the rate of maternal death was <0.01% and that of premature delivery was 25.32%. The rate of the birth weight being <2,500 g was 30.65% and that of Neonatal intensive care unit (NICU) admission was 24.41%. Positive nasopharynx swabs or sputum from newborns was <0.01%. Conclusions Pregnant patients with COVID-19 most commonly presented with fever, cough, shortness of breath and dyspnea, most of which possessed imaging manifestations. The risk of intubation and admission to intensive care unit were high. The risk of premature delivery was higher, leading to a high risk of NICU admission and low neonatal birthweight. Vertical transmission of SARS-CoV-2 from mother to child was found to be unlikely.