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Article in Chinese | WPRIM | ID: wpr-615058


Objective To explore the perinatal outcome of vaginal birth after cesarean (VBAC) in women with advanced age.Methods Totally 2 587 women delivered after one or two prior cesarean sections (gestational age≥28 weeks) in the First Affiliated Hospital of Kunming Medical University from July 2013 to February 2017.909 trial of labor after cesarean(TOLAC) cases of singleton pregnancy with one prior cesarean section were studied retrospectively.According to the age,of the 909 TOLAC cases,237 were the advanced age group,and 672 cases were the low age group.The maternal and neonatal outcomes between the two groups were compared.Results The percentage of TOLAC in women with advanced age was 32.4% (237/731),and VBAC rate was 88.2% (209/237).The percentage of TOLAC in younger women was 36.2% (672/1 856),and VBAC rate was 82.4% (554/672).The difference of the TOLAC rate between the two groups was not significant (P>0.05),and the VBAC rate of the advanced age group was higher than the low age group (P<0.05).In the comparison of the two groups,the proportion of bachelor degree or above(55.7%,132/ 237),the prepregnancy BMI (22.4±3.0) kg/m2,pregnant interval time (68.5±38.3) months,the proportion of gestational hypertension (8.4%,20/237),the proportion of gestational diabetes(34.6%,82/237) and the rate of the neonatal ICU admission (18.1%,43/237) in the advanced age group were higher than those of the low age group (P<0.05),respectively.And there were no significant differences in the rate of postpartum hemorrhage,the rate of postpartum hemorrhage≥1 500 ml,the rate of postpartum transfusion,puerperal morbidity,neonatal birth weight,neonatal 5 min Apgar score<7 score,umbilical artery blood pH<7.0,neonatal tracheal intubation and respiratory distress syndrome (all P>0.05).In all TOLAC cases,the rate of uterine rupture was 0.11%(1/909) and there was no maternal and neonatal death.Conclusion VBAC is a safe and feasible way of delivery for singleton pregnancy after one prior cesarean section in women with advanced age.

Article in Chinese | WPRIM | ID: wpr-404198


To increase the effective rate of treatment of dental injuries. Self-etching adhesives, flat steel wire and resin were used to make adhesive splints and to fix the dislocated teeth. The effect of treatment was excellent.

Article in Chinese | WPRIM | ID: wpr-406075


Objective: To evaluate the treatment efficacy of reverse flaring technique applied by two rotary instruments, Hero 642 and ProTaper, on complicated molar root canal preparation. Methods: 100 molars with curved root canals (maximum curved angle ≥25 degrees) suffered from pulpitis or periapicities were randomly divided into two groups. In experimental group reverse flaring technique was applied by rotary instruments while in control group reverse flaring technique was not adopted. 50 experimental teeth with curved canals were operated with K files, Hero 642 and ProTaper in sequence. Lateral condensation obturation method was utilized in both groups. Root canal preparation and obturation efficiency were evaluated by X-ray, root canal preparation time and complication incidence (1 year follow-up rate was 95%). Results: Reverse flaring technique applied by Hero 642 and ProTaper Ni-Ti rotary instruments on complicated (curved) root canal preparation in group A demonstrated better root canal coning and smoothness, without instrument fractures, while instrument fractures occurred in control group. Significant difference was found in exact root canal obturation rate and not enough full rate, root canal smoothness and postoperative pain between two groups(P<0.05). Conclusion: Reverse flaring technique applied by Hero 642 and ProTaper NI-Ti rotary instruments indicates complementary potencies, demonstrating satisfactory root canal shape and obturation effectiveness, and lower complication incidence. Reverse flaring technique applied by Ni-Ti rotary instruments is apt for medium/severe curved root canal preparation and worthy of clinical application.