Risk factor for interstitial pregnancy following ipsilateral salpingectomy? A retrospective matched case control study.

BACKGROUND: Interstitial pregnancy may still happen even after ipsilateral salpingectomy, resulting in massive hemorrhage. Therefore, the purpose of the study is to identify risk factors associated with interstitial pregnancy following ipsilateral salpingectomy and discuss possible prevention. METHODS: We conducted a retrospective cohort study in a single, large, university-affiliated hospital. Data of 29 patients diagnosed with interstitial pregnancy following ipsilateral salpingectomy from January 2011 to November 2020 were assigned into the case group (IP group). Whereas there were 6151 patients with intrauterine pregnancy after unilateral salpingectomy in the same period. A sample size of 87 control patients was calculated to achieve statistical power (99.9%) and an α of 0.05. The age, BMI and previous salpingectomy side between the two group were adjusted with PSM at a ratio of 1:3. After PSM, 87 intrauterine pregnancy patients were successfully matched to 29 IP patients. RESULTS: After PSM, parous women were more common and intrauterine operation was more frequent in the IP group compared with control group (P<0.05). There was only one patient undergoing IVF-ET in the IP group as compared with 29 cases in the control group (3.4% vs. 33.3%, P<0.05). Salpingectomy was performed on 5 patients in the IP group and 4 patients in the control group due to hydrosalpinx (P<0.05). Logistic regression indicated that hydrosalpinx was the high risk factor of interstitial pregnancy following ipsilateral salpingectomy (OR = 8.175). CONCLUSIONS: Hydrosalpinx appears to be an independent factor contributing to interstitial pregnancy following ipsilateral salpingectomy in subsequent pregnancy.

Postoperative reproductive results of infertile patients with intrauterine adhesions: A retrospective analysis.

OBJECTIVE: To explore the reproductive outcomes after hysteroscopic separation of intrauterine adhesions (IUA) in infertile patients due to IUA. METHODS: This retrospective study enrolled patients with fertility requirements and infertility due to IUA. Data were collected from the hospital medical records and by follow-up by telephone. The impact on pregnancy and pregnancy outcome of preoperative adhesion, menstrual conditions before and after surgery and postoperative re-adhesion was analysed. RESULTS: A total of 106 patients (median age, 28 years) were enrolled in the study. There was a significant correlation between preoperative menstrual patterns and pregnancy rate. There were 56 pregnancies (pregnancy rate 52.83%) after the operation. Patients with improved menstruation after the operation had a significantly higher pregnancy rate (pregnancy rate 56.25%; 45 of 80 patients) compared with the patients that did not experience any improvement in their postoperative menstrual status (pregnancy rate 21.43%; three of 14 patients). Of the 56 pregnancies, 40 (71.43%) resulted in live births and six (10.71%) patients had miscarriages. A total of 54 of 56 patients (96.43%) became pregnant within 2 years. CONCLUSION: Pregnancy after intrauterine adhesion separation has a high rate of miscarriage and obstetric complications, so close monitoring of the patient is required.

Effects of fine particulate matter (PM2.5) on ovarian function and embryo quality in mice.

Fine particulate matter (PM2.5) has an adverse effect on reproductive function, in particular causing reduced male reproductive function, but relatively few studies have directly targeted its effects on female reproduction. To investigate the effects of PM2.5 exposure on female reproduction, we exposed female mice to PM2.5 by intratracheal instillation for 28 days, and evaluated apoptosis of ovarian granulosa cells and oocytes and the quality embryos after insemination. Our results showed increased numbers of apoptotic granulosa cells and oocytes after exposure to elevated concentrations of PM2.5, which had adverse effects on female fertility via compromising embryo development and quality. We conclude that PM2.5 induced apoptosis of ovarian granulosa cells and oocytes leading to disrupted embryo development and female fertility in mice.

Effects of Prenatal PM10 Exposure on Fetal Cardiovascular Malformations in Fuzhou, China: A Retrospective Case-Control Study.

BACKGROUND: Maternal exposure to ambient air pollution has been associated with an increased risk of congenital heart defects in offspring; however, the results are inconsistent. OBJECTIVES: We investigated whether there is an association between prenatal exposure to particulate matter with diameter ≤10µm (PM10) during early pregnancy and fetal cardiovascular malformations. METHODS: The gravidae from a hospital-based case­control study in Fuzhou, China, during 2007­2013 were assigned 10-d or 1-mo averages of daily PM10 using an air monitor­based inverse distance weighting method during early pregnancy. A total of 662 live-birth or selectively terminated cases and 3,972 live-birth controls were enrolled. The exposure was considered as a categorical variable. A multivariable logistic regression model was constructed to quantify the adjusted odds ratios (aORs) of the exposure to PM10 and the risks of fetal cardiovascular malformations. RESULTS: PM10 levels were positively associated with the risks of atrial septal defect (aORs ranging from 1.29 to 2.17), patent ductus arteriosus [aORs = 1.54, 1.63; 95% confidence intervals (CIs): 1.17, 2.23; 1.06, 3.24], overall fetal cardiovascular malformations (aOR = 1.28; 95% CI: 1.03, 1.61), ventricular septal defect (aOR = 1.19; 95% CI: 1.00, 1.43), and tetralogy of Fallot (aOR = 1.44; 95% CI: 1.01, 2.19) in the various observed periods scaled by 10 d or 1 mo in the first and second gestation months. The strongest associations were observed for exposure to PM10 in the second quartile, whereas the associations were attenuated when higher concentrations of PM10 in the third and fourth quartiles of the exposure were evaluated. No correlations of PM10 levels with these cardiovascular malformations in the other time periods of gestation were observed. CONCLUSIONS: Our findings suggest some positive associations between maternal exposure to ambient PM10 during the first two months of pregnancy and fetal cardiovascular malformations. https://doi.org/10.1289/EHP289.

[Effect of airborne particulate matter exposure on pregnancy and fetal development in female mice].

OBJECTIVE: To investigate subacute exposure of airborne particulate matter (PM) on pregnancy and fetal development in female mice. METHODS: Forty female and forty male ICR adult mice were caged separately by 1:1 to get access to pregnancy. The pregnant mice were randomized into control group (A), small (B), middle (C), large (D) or overdose (E) PM challenge groups (n = 8-11), and were administered with 30 µl of phosphate buffered solution (A) or resuspended standard PM SRM 1649a at 0.09 (B), 0.52 (C), 1.85 (D) or 69.2 (E) µg/µl, once per trid from d 0 till d 19 of pregnancy via instillation onto the base of the tongue. Fetal mice were harvested by cesarean section at the time when spontaneous delivery occurred. Body weight of the pregnant mice, gestational days, intrauterine survival and growth, hepatic and pneumonic histopathological changes of the fetal mice were investigated. Lung/body and liver/body weight ratios were calculated. Expressions of mRNA and protein of CYP1A1 in the fetal lung and CYP1A2 in the fetal liver were assayed. RESULTS: (1) All of the pregnant mice survived pregnancy throughout the entire experiment. Body weight of the pregnant mice was not significantly different among all the groups at gestational d 1 and 7 (P > 0.05), but significantly lower in group E [(41.8 ± 5.8) and (48.9 ± 8.9) g] than in group A [(45.9 ± 1.8) and (56.2 ± 4.9) g] at gestational d 14 and 18 (P < 0.05). The gestational days were significantly decreased in group E [(19.3 ± 1.3) d] when compared with group A [(20.5 ± 0.7) d; P < 0.05] and were not significantly different among groups A, B, C and D (P > 0.05). Lung/body and liver/body weight ratios of the fetal mice were significantly increased in group E [(1.21 ± 0.18) and (4.68 ± 0.21)%] as compared with groups A, B, C and D (P < 0.05). (2) Mortality rates of the fetuses were significantly higher in group E (23.0%) than in groups A (0.8%), B (0.9%), C (1.7%) and D (3.7%) (P < 0.05), but were not significantly different among groups A, B, C and D (P > 0.05) despite of an increasing tendency. (3) Pathological changes in the liver and lung of the fetuses were conspicuous in group E. The fetal liver injury was histopathologically evidenced by deranged tissue structure, degenerated parenchyma of hepatic cells, and mildly stained cytoplasm. Adipose degeneration was represented by clear-boundary intracytoplasmic vacuoles in most of the liver cells, and cell pyknosis with heavily stained cytoplasm was observed in some of the liver cells. Inflammatory cell infiltration and focal necrosis were occasionally found in the hepatic tissue. The fetal lung exhibited bronchiole with narrow lumina, vascular engorgement in the submucosal layer, interstitial and alveolar edema, thickened alveolar septum, granulocyte and lymphocyte infiltrations within the pulmonary alveoli and around the bronchioles. The above pathological changes were lesser in groups C and D, and were not or least found in groups A and B. (4) Protein expressions of CYP1A1 in the fetal lung and CYP1A2 in the fetal liver were significantly increased in group E (1.20 ± 0.40 and 2.55 ± 0.89) when compared with group A (0.77 ± 0.36 and 2.08 ± 0.31) (P < 0.05). mRNA expressions of CYP1A1 in the fetal lung were significantly increased in groups C (0.36 ± 0.12), D (0.41 ± 0.08) and E (0.43 ± 0.11) compared with group A (0.21 ± 0.10), and significantly increased in groups D and E compared with group B (0.28 ± 0.10, P < 0.05). mRNA expressions of CYP1A2 in the fetal liver were significantly increased in groups C (0.37 ± 0.13), D (0.36 ± 0.14) and E (0.43 ± 0.16) compared with group A (0.21 ± 0.03), and significantly increased in group E compared with group B (0.24 ± 0.11, P < 0.05). CONCLUSIONS: PM elicited embryotoxigenicity and resulted in adverse pregnancy outcomes in mice by intrauterine exposure of overdose PM. The expressions of cancer-related genes CYP1A1 and CYP1A2 were up-regulated in organs after the middle- and large-dose subacute exposure of PM, which may have a potential role on the future development.

[Impacts of suspended solids on "tailing" phenomenon in disinfection of sewage with chlorine].

The impacts of suspended solids in secondary effluent on "tailing" phenomenon in disinfection of E. coli with chlorine were investigated using kinetic disinfection curves. Higher SS concentration led to earlier beginning of "tailing" region with lower inactivation level. Comparison between lg-lg regression analyses of disinfection curves demonstrated that the SS concentration correlated with overall inactivation rate, which decreased by 10 times while SS concentration increased from 6 to 85 mg/L. The results of segmental modeling of disinfection curves showed that the SS concentration (at a range of 10-55 mg/L) correlated with the starting time of "tailing" region as well as the log-kill at the starting point of tailing region (R2 > 0.99). The starting time was shortened from 330 min to 55 min, and the log-kill dropped from 5.8 down to 0.8 with SS concentration increasing. Better removal of SS will improve the lg-kill of E. coli at tailing region and the inactivation rate, resulting in lower cost of construction and running. In addition, higher chlorine dosage and lower pH value could slightly enhance the log-kill in the "tailing" region.