Postpartum quality of life and mental health in women with heart disease: Integrated clinical communication and treatment.

BACKGROUND: Postpartum quality of life (QoL) in women with heart disease has been neglected. AIM: To improve clinical communication and treatment, we integrated medical data and subjective characteristics to study postpartum QoL concerns. METHODS: The study assessed QoL 6 wk after birth using the 12-Item Short-Form Health Survey. The Edinburgh Postnatal Depression Scale, Cardiac Anxiety Questionnaire, European Heart Failure Self-Care Behavior Scale, and a self-designed questionnaire based on earlier research were also used to assess patient characteristics. Patient data were collected. Prediction models were created using multiple linear regression. RESULTS: This retrospective study examined postpartum QoL in 105 cardiac patients. Postpartum QoL scores were lower (90.69 ± 13.82) than those of women without heart disease, with physical component scores (41.09 ± 9.91) lower than mental component scores (49.60 ± 14.87). Postpartum depression (33.3%), moderate anxiety (37.14%), pregnancy concerns (57.14%), offspring heart problems (57.14%), and life expectancy worries (48.6%) were all prevalent. No previous cardiac surgery, multiparity, higher sadness and cardiac anxiety, and fear of unfavorable pregnancy outcomes were strongly related to lower QoL (R2 = 0.525). CONCLUSION: Postpartum QoL is linked to physical and mental health in women with heart disease. Our study emphasizes the need for healthcare workers to recognize the unique characteristics of these women while developing and implementing comprehensive management approaches during their maternity care.

[Relationship between changes of insulin like growth factor-1 and insulin like growth factor binding protein-1 in maternal serum and placenta and pathogenesis of hypertensive disorder complicating pregnancy].

OBJECTIVE: To investigate the role of insulin like growth factor-1 (IGF-1) and insulin like growth factor binding protein-1 (IGFBP-1) in the pathogenesis of hypertensive disorder complicating pregnancy. METHODS: The levels of IGF-1 and IGFBP-1 in serum and placenta were detected from 60 patients with hypertensive disorder complicating pregnancy (hypertensive disorder complicating pregnancy group) and 18 normal pregnant women (control group) by enzyme linked immunosorbent assay (ELISA) and immunohistochemistry. RESULTS: (1) Serum level of IGF-1 (229 +/- 100) microg/L in hypertensive disorder complicating pregnancy group was significantly lower than that in control group (336 +/- 120) microg/L, (P < 0.01). There were significant differences among gestational hypertension (303 +/- 80) microg/L, mild preeclampsia (233 +/- 77) microg/L and severe preeclampsia groups (155 +/- 73) microg/L, (P < 0.05). (2) The expression of IGF-1 in the placenta of hypertensive disorder complicating pregnancy group (48%, 29/60) was significantly reduced than that in control group (83%, 15/18; P < 0.01). Its expressions in mild and severe preeclampsia patients were lower than that in control group (P < 0.05, P < 0.01). (3) Serum IGFBP-1 from hypertensive disorder complicating pregnancy group (161 +/- 90) microg/L was significantly higher than that in control group (98 +/- 75) microg/L, (P < 0.01). There were significant differences among gestational hypertension (97 +/- 73) microg/L, mild preeclampsia (157 +/- 69) microg/L and severe preeclampsia groups (225 +/- 81) microg/L (P < 0.05). (4) The expression of IGFBP-1 in hypertensive disorder complicating pregnancy group (77%, 46/60) was higher than that in control group (39%, 5/18), (P < 0.01). Its expression in mild and severe preeclampsia patients were higher than that in control group (P < 0.05). (5) The levels of IGF-1 in serum and placenta had a significant negative relationship with that of IGFBP-1 in hypertensive disorder complicating pregnancy group (r = -0.269, P < 0.05; r = -0.369, P < 0.01). Levels of IGFBP-1 in maternal serum were positively related with that of placenta (P < 0.01). CONCLUSION: The changes of levels of IGF-1 and IGFBP-1 are related to the occurrence and development of hypertensive disorder complicating pregnancy.

Surgical high ligation of the ovarian vein and preservation of ovarian function for twisted ovarian tumors.

BACKGROUND: Appendectomy is the traditional surgical procedure for correcting torsion of the adnexa. Although it prevents pulmonary embolism, ovarian necrosis, and secondary infection, it can have critical adverse effects on the ovarian function. METHODS: We performed surgery for adnexal torsion in 12 patients, using high ligation of the ovarian vein, followed by removal of the ovarian tumor. RESULTS: Blood flow in the residual ovary gradually returned to normal within 1 - 3 months, and a dominant follicle could be seen in the residual ovary within 2 - 6 months post-surgery in all the 12 cases. Menstruation recovered in these three cases within 2 - 3 months. Postoperative intrauterine pregnancies occurred in two cases, with a corpus luteum graviditatis in the residual ovary in one case, while the other patient underwent labor after 13 months and a normal ovary on the affected side was seen at cesarean section. CONCLUSIONS: This new surgical technique involving high ligation of the ovarian vein for adnexal torsion allowed successful preservation of the residual ovary and ovarian blood distribution, and can thus be used for the treatment of primary diseases of the ovary. The surgical procedure is simple, safe, and effective, and warrants extensive application in clinical practice.