A rare case of fundal intramural ectopic pregnancy associated with previous B-Lynch sutures.

BACKGROUND: Intramural ectopic pregnancy is a rare form of ectopic pregnancy that occurs within the myometrium. It is challenging to diagnose it early because of its nonspecific clinical presentation, and there is no consensus or guideline on the optimal management among gynecologists. CASE PRESENTATION: We report a case of a 34-year-old woman who developed fundal intramural ectopic pregnancy after a previous caesarean section with B-Lynch suture. The B-Lynch suture was performed at 38 weeks of gestation for postpartum hemorrhage caused by refractory uterine atony about 8 years ago. Since then, the patient had oligomenorrhea. The diagnosis of intramural ectopic pregnancy was not confirmed by magnetic resonance imaging or ultrasound. An exploratory laparoscopy and hysteroscopy was performed to remove the gestational sac without significant bleeding. The surgery was successful and the patient recovered well. The patient was advised to monitor her ß-HCG levels regularly until they returned to normal, and a follow-up pelvic ultrasound showed no complications. However, she has not been able to conceive or have an ectopic pregnancy so far. CONCLUSIONS: This case illustrates the difficulty of diagnosing intramural ectopic pregnancy, especially when it is associated with previous uterine surgery and B-Lynch suture. It also demonstrates the feasibility and safety of laparoscopic surgery for treating complete IUP, especially when the gestational sac is located close to the uterine serosa. However, the risk of uterine rupture and hemorrhage should be considered, and the patient should be informed of the possible complications and alternatives. Gynecologists should be familiar with various management strategies and customize the treatment plan according to the patient's clinical situation and preferences.

Chromosome analysis of foetal tissue from 1903 spontaneous abortion patients in 5 regions of China: a retrospective multicentre study.

BACKGROUND: Abnormal foetal tissue chromosome karyotypes are one of the important pathogenic factors for spontaneous abortion (SA). To investigate the age and abnormal foetal karyotypes of 1903 couples who experienced SA. METHODS: A retrospective multicentre study collected age and foetal tissue karyotypes CNV-seq data of 1903 SA couples from 6 hospitals in 5 regions from January 2017 to March 2022. The distribution and correlation of abnormal foetal tissue karyotypes were evaluated by using regions and age. RESULTS: In our study, 1140 couples (60.5% of the total) had abnormal foetal tissue chromosome karyotypes in all regions. We found that there were differences in the number of abnormal foetal tissue chromosome karyotypes, of which the incidence of trisomy was higher. At the same time, the populations situated in the eastern region had a more triploid (15.5%) distribution, trisomy (58.1%) in the southern region, mosaicism (14.8%) and microduplication (31.7%) in the southwestern region, microdeletion (16.7%) in the northern region. There are variances across areas, and it is more common in the north. The incidence risk of prenatal chromosomal abnormalities varied according to age group. CONCLUSION: The findings of this study suggest that the karyotypes of patients with abnormal foetal tissue chromosome abortion in different regions were different. Meanwhile, patients ≥ 35 years old had a higher risk of abnormal foetal tissue chromosome abortion.

The effects of metabolic indicators and immune biomarkers on pregnancy outcomes in women with recurrent spontaneous abortion: a retrospective study.

Background: The etiology of recurrent spontaneous abortion (RSA) remains elusive despite specific investigations affirming the association between RSA and thyroid autoimmunity (TAI). This study explores the immunological and metabolic profiles of RSA patients exhibiting positive thyroid antibodies and their connection with the rates of first-trimester miscarriage and live births. The aim is to provide further guidance for clinical interventions. Methods: A retrospective analysis included 478 women with RSA. Thyroid profile, thyroid peroxidase antibodies, and anti-thyroglobulin antibodies were measured in all participants. The clinical characteristics and pregnancy outcomes of RSA women were compared between thyroid autoimmunity (TAI)-positive and TAI-negative patients. Significant factors associated with adverse pregnancy outcomes and risk prediction models were explored in TAI-positive patients. Correlation analysis was used to identify specific metabolic or immune biomarkers associated with thyroid autoantibodies. Results: The prevalence of TAI was 18.6%. Compared with women without TAI, the thyroid-stimulating hormone (TSH) concentration of TAI-positive RSA was significantly higher (2.80 ± 2.98 vs 1.89 ± 1.17, p=0.006). After 28 weeks, the live birth rate of the TAI-positive group was lower than that of the TAI-negative group, with statistical significance (p<0.05). The immune biomarkers that differed between RSA women with live births and those with first-trimester miscarriages were complement C4 and interleukin-6, respectively, in TAI-negative and TAI-positive women. Then, a risk prediction model for first-trimester miscarriage was constructed for TAI-positive women with an AUC of 0.81. Finally, some factors related to thyroid peroxidase antibody (TPO-Ab) levels were explored, and it was found that TPO-Ab levels were positively correlated with free thyroxine and negatively correlated with 25 hydroxyvitamin D, interleukin-4, and fasting blood glucose in RSA patients. Conclusion: TAI-positive RSA patients have higher first-trimester miscarriage rates and a lower live birth rate, which may be related to metabolic immune shifts in TAI-positive RSA patients.

Genetic analysis of ANXA5 haplotype and its effect on recurrent pregnancy loss.

Recurrent pregnancy loss (RPL) is often associated with dysregulated Annexin A5 (ANXA5) expression. Moreover, the variants of Anxa5, a protein that is enriched in the placenta to prevent coagulation, have been reported to affect RPL risks. The haplotypes M1 [including single nucleotide polymorphisms (SNPs) 1A/C and 27T/C] and M2 (including SNPs 19G/A, 1A/C, 27T/C and 76G/A) of ANXA5 were also reported to affect RPL risks. The present study aimed to investigate the association between the haplotype located in the promoter region of ANXA5 and the risk of RPL. Patients with RPL (n=235) or intrauterine fetus death (IUFD; n=154), as well as healthy control subjects (n=375) were enrolled in the current research. Their haplotypes of ANXA5 were determined using genotyping, and the association between ANXA5 haplotypes and the risk of RPL was accordingly analyzed. A luciferase assay was conducted to investigate the haplotype responsible for ANXA5 activity. Reverse transcription­quantitative PCR, western blot analysis, immunohistochemistry and ELISA were performed to assess the expression level and activity of ANXA5 in patients with RPL. Consequently, the majority (n=214) of patients with RPL had a history of early RPL, whereas 31 patients with RPL had a history of both early and late RPL episodes. A significant difference was found between cases and controls in terms of gravidity and parity, whereas no significant differences were found in terms of age. The percentage of patients with RPL carrying the M2 haplotype of ANXA5 was significantly higher compared with that in control subjects, indicating that the M2 haplotype of ANXA5 was an independent risk of RPL as it influenced the transcription efficiency of ANXA5 promoter. In patients with RPL, ANXA5 activity was suppressed and the mRNA and protein expression levels of Anxa5 were decreased. Thus, the ANXA5 M2 haplotype may be an independent risk factor of RPL by affecting Anxa5 activity.

Insignificant Effect of Isolated Hypothyroxinemia on Pregnancy Outcomes During the First and Second Trimester of Pregnancy.

Objective: Adverse maternal outcomes and perinatal complications are associated with overt and subclinical maternal hypothyroidism. It is not clear whether these complications also occur in women with isolated hypothyroxinemia during pregnancy. The aim of this study was to evaluate the effects of isolated hypothyroxinemia on maternal and perinatal outcomes during pregnancy. Methods: This study included data from 2,864 pregnant women in the first trimester (67 women with isolated hypothyroxinemia, 784 euthyroid women) and the second trimester (70 women with isolated hypothyroxinemia, 1,943 euthyroid women) of pregnancy. Maternal serum samples were collected in the first and second trimesters to examine thyroid hormone concentration. Hypothyroxinemia was defined as a normal maternal thyroid-stimulating hormone concentration with a low maternal free thyroxine concentration and negative thyroid autoantibodies. The following maternal outcomes were recorded: gestational hypertension, gestational diabetes mellitus, placenta previa, placental abruption, prelabor rupture of membranes, and premature delivery. Perinatal outcomes, including fetal growth restriction, fetal distress, low birth weight, intrauterine fetal death, and malformation. The incidence of adverse pregnancy outcomes and perinatal complications was compared between women in the first trimester and second trimester with isolated hypothyroxinemia. Results: There were no significant differences in the incidence rates of adverse maternal outcomes and perinatal complications between patients in the first and second trimesters with isolated hypothyroxinemia. Conclusion: The results of this study indicate that isolated hypothyroidism does not increase the incidence of adverse maternal outcomes and perinatal complications.

The Association Between Prolactin and Metabolic Parameters in PCOS Women: A Retrospective Analysis.

Background: The aim of this retrospective study was to analyze the association between prolactin (PRL) and metabolic parameters in infertile patients with polycystic ovary syndrome (PCOS). Methods: A total of 2,052 patients with PCOS and 9,696 patients with tubal infertility (non-PCOS) undergoing in vitro fertilization and embryo transfer (IVF-ET) at the reproductive medicine center of the first affiliated hospital of Wenzhou Medical University from January 2007 to July 2017 were enrolled in this study. Serum PRL, basic endocrine hormones, fasting plasma lipid, fasting plasma glucose (FPG), liver function, thyroid hormone and other parameters were measured and analyzed. Result: PRL levels were significantly lower in PCOS patients than controls over all age groups (p < 0.05). In the PCOS patients, serum PRL was significantly and positively correlated with FPG, serum TSH and serum FT4, and significantly and negatively correlated with LH, LH/FSH, TC, TG, LDL-C, AST, ALT, γ-GGT, FT3, and FT3/FT4 (p < 0.05 or 0.01). After adjusted for age and body mass index (BMI), serum PRL was positively correlated with FPG, TSH, and FT4, and negatively correlated with LH and LH/FSH. Conclusion: Low serum PRL may be an important cause of metabolic risk in infertile patients with PCOS.

Cation size mismatch and charge interactions drive dopant segregation at the surfaces of manganite perovskites.

Cation segregation on perovskite oxide surfaces affects vastly the oxygen reduction activity and stability of solid oxide fuel cell (SOFC) cathodes. A unified theory that explains the physical origins of this phenomenon is therefore needed for designing cathode materials with optimal surface chemistry. We quantitatively assessed the elastic and electrostatic interactions of the dopant with the surrounding lattice as the key driving forces for segregation on model perovskite compounds, LnMnO3 (host cation Ln = La, Sm). Our approach combines surface chemical analysis with X-ray photoelectron and Auger electron spectroscopy on model dense thin films and computational analysis with density functional theory (DFT) calculations and analytical models. Elastic energy differences were systematically induced in the system by varying the radius of the selected dopants (Ca, Sr, Ba) with respect to the host cations (La, Sm) while retaining the same charge state. Electrostatic energy differences were introduced by varying the distribution of charged oxygen and cation vacancies in our models. Varying the oxygen chemical potential in our experiments induced changes in both the elastic energy and electrostatic interactions. Our results quantitatively demonstrate that the mechanism of dopant segregation on perovskite oxides includes both the elastic and electrostatic energy contributions. A smaller size mismatch between the host and dopant cations and a chemically expanded lattice were found to reduce the segregation level of the dopant and to enable more stable cathode surfaces. Ca-doped LaMnO3 was found to have the most stable surface composition with the least cation segregation among the compositions surveyed. The diffusion kinetics of the larger dopants, Ba and Sr, was found to be slower and can kinetically trap the segregation at reduced temperatures despite the larger elastic energy driving force. Lastly, scanning probe image contrast showed that the surface chemical heterogeneities made of dopant oxides upon segregation were electronically insulating. The consistency between the results obtained from experiments, DFT calculations, and analytical theory in this work provides a predictive capability to tailor the cathode surface compositions for high-performance SOFCs.

Tensile lattice strain accelerates oxygen surface exchange and diffusion in La1-xSrxCoO3-δ thin films.

The influence of lattice strain on the oxygen exchange kinetics and diffusion in oxides was investigated on (100) epitaxial La1-xSrxCoO3-δ (LSC) thin films grown by pulsed laser deposition. Planar tensile and compressively strained LSC films were obtained on single-crystalline SrTiO3 and LaAlO3. 18O isotope exchange depth profiling with ToF-SIMS was employed to simultaneously measure the tracer surface exchange coefficient k* and the tracer diffusion coefficient D* in the temperature range 280-475 °C. In accordance with recent theoretical findings, much faster surface exchange (∼4 times) and diffusion (∼10 times) were observed for the tensile strained films compared to the compressively strained films in the entire temperature range. The same strain effect--tensile strain leading to higher k* and D*--was found for different LSC compositions (x=0.2 and x=0.4) and for surface-etched films. The temperature dependence of k* and D* is discussed with respect to the contributions of strain states, formation enthalpy of oxygen vacancies, and vacancy mobility at different temperatures. Our findings point toward the control of oxygen surface exchange and diffusion kinetics by means of lattice strain in existing mixed conducting oxides for energy conversion applications.

The value of laparoscopy alone or combined with hysteroscopy in the treatment of interstitial pregnancy: analysis of 22 cases.

OBJECTIVE: The purpose of this study was to investigate the value of laparoscopy alone or combined with hysteroscopy in treating clinically stable interstitial pregnancy. STUDY DESIGN: Clinically stable women with interstitial pregnancy were enrolled in the study. They were treated either with laparoscopy or with a combination of laparoscopy and hysteroscopy and suction. RESULTS: Of 22 cases, 15 were treated with laparoscopy. Five out of seven cases were successfully treated with hysteroscopy and suction using an 8 F pediatric catheter. Two cases converted to a resection of the uterine cornua and salpingectomy with laparoscopy and laparotomy, respectively, secondary to cornual uterine perforation. CONCLUSION: Laparoscopy alone or combined with hysteroscopy can treat clinically stable interstitial pregnancy successfully. Transcervical suction using an 8 F pediatric catheter placed through the cornual end under laparoscopic and hysteroscopic guidance, preserving the uterus and fallopian tube, is an effective option for management of interstitial pregnancy in selected patients.

Surface electronic structure transitions at high temperature on perovskite oxides: the case of strained La0.8Sr0.2CoO3 thin films.

In-depth probing of the surface electronic structure on solid oxide fuel cell (SOFC) cathodes, considering the effects of high temperature, oxygen pressure, and material strain state, is essential toward advancing our understanding of the oxygen reduction activity on them. Here, we report the surface structure, chemical state, and electronic structure of a model transition metal perovskite oxide system, strained La(0.8)Sr(0.2)CoO(3) (LSC) thin films, as a function of temperature up to 450 °C in oxygen partial pressure of 10(-3) mbar. Both the tensile and the compressively strained LSC film surfaces transition from a semiconducting state with an energy gap of 0.8-1.5 eV at room temperature to a metallic-like state with no energy gap at 200-300 °C, as identified by in situ scanning tunneling spectroscopy. The tensile strained LSC surface exhibits a more enhanced electronic density of states (DOS) near the Fermi level following this transition, indicating a more highly active surface for electron transfer in oxygen reduction. The transition to the metallic-like state and the relatively more enhanced DOS on the tensile strained LSC at elevated temperatures result from the formation of oxygen vacancy defects, as supported by both our X-ray photoelectron spectroscopy measurements and density functional theory calculations. The reversibility of the semiconducting-to-metallic transitions of the electronic structure discovered here, coupled to the strain state and temperature, underscores the necessity of in situ investigations on SOFC cathode material surfaces.

Dynamically stabilized growth of polar oxides: the case of MgO(111).

By using MgO(111) as a model system for polar oxide film growth, we show by first-principles calculations that H acts as a surfactant, i.e., the H changes its position and bonding during the growth process, remaining in the surface region. Continuous presence of H during the growth of MgO(111) film efficiently removes the microscopic dipole moment, thus enabling the growth of perfect fcc-ordered MgO(111) films. These theoretical predictions are confirmed experimentally by molecular beam epitaxy single crystal growth of MgO(111) on SiC(0001).

Transcervical suction of interstitial pregnancy under laparoscopic and hysteroscopic guidance.

Interstitial pregnancy is a rare but life-threatening condition. It is usually treated using cornual resection at operative laparoscopy or laparotomy; however, this may adversely affect future fertility and pregnancy. Transcervical suction using an 8F pediatric catheter placed through the cornua under laparoscopic and hysteroscopic guidance may be possible in some patients if the pregnancy is accessible vaginally. We describe a case of interstitial pregnancy treated with transcervical suction using an 8F pediatric catheter placed through the cornua under laparoscopic and hysteroscopic guidance with preservation of the uterine cornua and fallopian tube. The procedure was quick, bleeding was minimal, and there were no complications. Removal was complete, and serum beta-human chorionic gonadotropin quickly became undetectable. Three months after the operation, salpingography yielded normal findings, and the patient was pregnant again 8 months after the surgery.

Enhanced Néel temperature in Mn ferrite nanoparticles linked to growth-rate-induced cation inversion.

Mn ferrite (MnFe(2)O(4)) nanoparticles, having diameters from 4 to 50 nm, were synthesized using a modified co-precipitation technique in which mixed metal chloride solutions were added to different concentrations of boiling NaOH solutions to control particle growth rate. Thermomagnetization measurements indicated an increase in Néel temperature corresponding to increased particle growth rate and particle size. The Néel temperature is also found to increase inversely proportionally to the cation inversion parameter, delta, appearing in the formula (Mn(1-delta)Fe(delta))(tet)[Mn(delta)Fe(2-delta)](oct)O(4). These results contradict previously published reports of trends between Néel temperature and particle size, and demonstrate the dominance of cation inversion in determining the strength of superexchange interactions and subsequently Néel temperature in ferrite systems. The particle surface chemistry, structure, and magnetic spin configuration play secondary roles.

[Effects of lianhuang decoction in treating fetomaternal ABO blood group incompatibility].

OBJECTIVE: To investigate the clinical curative effect of Lianhuang Decoction (LHD) in treating fetomaternal ABO blood group incompatibility (FM-ABOI). METHODS: Sixty pregnancy women diagnosed as FM-ABOI were randomly assigned to two groups, Group A treated with LHD and Group B treated with Western medicine. The therapeutic efficacy in the two groups was observed. RESULTS: The antibody titer decreased after treatment in both groups to different extent; the effective rate was 90.0% in Group A and 56.7% in Group B. The bilirubin level in cord blood of Group A was lower than that in Group B significantly (P<0.01). No statistically significant difference was found between the two groups new-bom in terms of 5-minute Apgar score, body weight and hemoglobin content in cord blood (P>0.05). CONCLUSION: LHD has good clinical curative effect in treating FM-ABOI, could decrease the serum antibody titer, and prevent the occurrence of postpartum hemolytic disease in newborns.

[Changes of serum epithelial neutrophil-activating peptide-78 in patients with endometriosis].

OBJECTIVE: To investigate the role of serum epithelial neutrophil-activating peptide-78 (ENA-78) in the pathogenesis of endometriosis. METHODS: Serum concentrations of ENA-78 were measured by means of enzyme-linked immunosorbent assay (ELISA) in 42 patients with endometriosis (20 in stages I and II and 22 in stages III and IV) in comparison with 25 women without endometriosis (control group). RESULTS: Serum concentrations of ENA-78 were significantly higher in endometriosis group than in the control group (2.97+/-1.91 ng/ml vs 0.72+/-0.24 ng/ml, P>0.001), and ENA-78 levels in stages III and IV were significantly higher than those in stages I and II (4.48+/-1.25 ng/ml vs 1.30+/-0.74 ng/ml, P>0.001). Significant difference in ENA-78 levels between follicular phase and luteal phase was found in neither of the groups. CONCLUSION: Patients with endometriosis have elevated serum ENA-78 levels, which might be a pathogenic factor of endometriosis.