Use of vaginal dinoprostone for women with term prelabor rupture of membranes and an unfavorable cervix within 6 h versus within 6-24 h.

BACKGROUND: Most guidelines propose inducing labor within 24 h following term (37 or more weeks of gestation) prelabor rupture of membranes (PROM). However, the exact timing for initiating induction within the 24 h period remains unknown. This study aims to comparatively assess the efficacy and safety of the use of vaginal dinoprostone within 6 h versus within 6-24 h for singleton pregnancies with PROM and an unfavorable cervix (Bishop score < 6). METHODS: This was a retrospective cohort study including singleton pregnancies with PROM and an unfavorable cervix (Bishop score < 6) in which labor was induced using vaginal dinoprostone. Women were divided into two groups according to the timing of the use of induction (within 6 h versus within 6-24 h after PROM). Baseline maternal data, maternal and neonatal outcomes were recorded for statistical analysis. RESULTS: 450 women were included, 146 (32.4%) of whom were induced within 6 h of PROM and 304 (67.6%) were induced within 6-24 h. Cesarean delivery rate (15.8% versus 29.3%, p = 0.002) and nonreassuring fetal heart rate tracing (4.8% versus 10.5%, p = 0.043) in group with vaginal dinoprostone within 6 h were significantly lower than those in group with vaginal dinoprostone within 6-24 h. There was no significant differences in terms of duration from IOL to vaginal delivery. CONCLUSION: Induction of labor within 6 h with vaginal dinoprostone after PROM for singleton pregnancies with an unfavorable cervix (Bishop score < 6) significantly associated with less cesarean section, less nonreassuring fetal heart rate tracing, compared to induction of labor within 6-24 h after PROM.

Plasma Lnc-UCA1/miR-138 axis as a potential biomarker for gestational diabetes mellitus and neonatal prognosis.

OBJECTIVES: This study aimed to explore the correlations of Lnc-UCA1/miR-138 axis with gestational diabetes mellitus (GDM) risk and neonatal prognosis. MATERIAL AND METHODS: First, the blood samples from sixty GDM patients and 60 healthy pregnant women were collected to detect the change of Lnc-UCA1/miR-138 axis by using real-time polymerase chain reaction (RT-qPCR). The clinical characteristics of GDM patients, healthy controls, and neonates were recorded. Then, the correlation analysis of Lnc-UCA1, miR-138, and Lnc-UCA1/miR-138 axis levels with clinicopathological characteristics was performed to explore the clinical value of Lnc-UCA1/miR-138 axis in GDM. Finally, the specificity and sensitivity of Lnc-UCA1, miR-138, and Lnc-UCA1/miR-138 axis for GDM diagnosis was evaluated using receiver operating characteristic (ROC) curves. RESULTS: Our present study found that, when compared with healthy pregnancies, the expression levels of Lnc-UCA1 and miR-138 were increased and decreased, respectively, and Lnc-UCA1/miR-138 axis profile was elevated. Second, Lnc-UCA1 and Lnc-UCA1/miR-138 axis were positively correlated with fasting glucose, one-hour glucose, and two-hour glucose, while miR-138 showed the opposite trend. Furthermore, the area under the ROC curve (AUC) were 0.8196, 0.8021, and 0.8901 for diagnostic efficiencies of Lnc-UCA1, miR-138, and Lnc-UCA1/miR-138, respectively. In addition, higher profiles of Lnc-UCA1 were correlated with birth asphyxia of neonate. CONCLUSIONS: Circulating Lnc-UCA1/miR-138 axis might be involved in the pathogenesis of GDM and could function as a novel and effective biomarker for GDM risk and neonatal prognosis.

ALDH1A1 is a marker for malignant prostate stem cells and predictor of prostate cancer patients' outcome.

Prostate cancer (PCa) contains a small population of cancer stem cells (CSCs) that contribute to its initiation and progression. The development of specific markers for identification of the CSCs may lead to new diagnostic strategies of PCa. Increased aldehyde dehydrogenase 1A1 (ALDH1A1) activity has been found in the stem cell populations of leukemia and some solid tumors. The aim of the study was to investigate the stem-cell-related function and clinical significance of the ALDH1A1 in human PCa. ALDEFLUOR assay was used to isolate ALDH1A1(+) cells from PCa cell lines. Stem cell characteristics of the ALDH1A1(+) cells were then investigated by in vitro and in vivo approaches. The ALDH1A1 expression was also analyzed by immunohistochemistry in 18 normal prostate and 163 PCa tissues. The ALDH1A1(+) PCa cells showed high clonogenic and tumorigenic capacities, and serially reinitiated transplantable tumors that resembled histopathologic characteristics and heterogeneity of the parental PCa cells in mice. Immunohistochemical analysis of human prostate tissues showed that ALDH1A1(+) cells were sparse and limited to the basal component in normal prostates. However, in tumor specimens, increased ALDH1A1 immunopositivity was found not only in secretory type cancer epithelial cells but also in neuroendocrine tumor populations. Furthermore, the high ALDH1A1 expression in PCa was positively correlated with Gleason score (P=0.01) and pathologic stage (P=0.01), and inversely associated with overall survival and cancer-specific survival of the patients (P=0.00093 and 0.00017, respectively). ALDH1A1 could be a prostate CSC-related marker. Measuring its expression might provide a potential approach to study tumorigenesis of PCa and predict outcome of the disease.

Impact of Wuhan lockdown on the indications of cesarean delivery and newborn weights during the epidemic period of COVID-19.

OBJECTIVE: To prevent the rapid spread of COVID-19, the Chinese government implemented a strict lockdown in Wuhan starting on 23 January, 2020, which inevitably led to the changes in indications for the mode of delivery. In this retrospective study, we present the changes in the indications for cesarean delivery (CD) and the birth weights of newborns after the lockdown in Wuhan. METHODS: A total of 3,432 pregnant women in the third trimester of their pregnancies who gave birth in our hospital from 23 January 2019 to 24 March 2020 were selected as the observation group, while 7,159 pregnant women who gave birth from 1 January 2019 to 22 January 2020 were selected as the control group; control group was matched using propensity score matching (PSM). A comparative analysis of the two groups was performed with the chi-square test, t test and rank sum test. RESULTS: The difference in the overall rate of CD between the two groups was not statistically significant (p<0.05). Among the indications for CD, CD on maternal request (CDMR) and fetal distress were also significantly more common in the observation group (p<0.05) than the control group. Furthermore, we found that the weight of newborns was significantly heavier in the observation group than in the control group when considering full-term or close-to-full-term births (p<0.05). CONCLUSIONS: The results may provide useful information to management practices regarding pregnancy and childbirth after lockdown in other cities or countries, enabling better control of the rate of CD due to CDMR, reducing fetal distress, and controlling newborn weight. We recommend that pregnant women pay more attention to controlling the weight of newborns through diet and exercise.

Association between delivery mode and pelvic organ prolapse: A meta-analysis of observational studies.

Pelvic organ prolapse (POP) is a common disease in aged women with negative physical and psychological influences. The long-term impact of delivery mode on POP remains uncertain. To evaluate the relationship between delivery mode and POP, a meta-analysis was carried out in this study. PubMed, Web of Science and CENTRAL were combined to search for relevant studies. Data were extracted by two investigators independently. Odd ratios (ORs) and 95% confidence intervals (95% CIs) were calculated by a random-effects model. Sensitivity analysis was performed to explore the potential source of heterogeneity. Moreover, Begg's and Egger's tests were conducted to assess the publication bias of included studies. In total, 13 eligible studies were included in our meta-analysis. Among them, six studies using objective standards for POP definition were included in Group 1, 5 studies addressing the women's own perception of POP were included Group 2, and the remaining 2 studies with both objective and subjective measures for POP assessment were included in both group 1 and group 2. Pooled estimates in our study demonstrated increased risk of POP after any vaginal delivery vs. cesarean section (Group 1: OR = 7.69; 95% CI = 4.89, 12.07; heterogeneity: P = 0.00, I2 = 85.8%. Group 2: OR = 2.22; 95% CI = 1.72, 2.87; heterogeneity: P = 0.10, I2 = 43.5%). Similar results were found in the comparison of spontaneous vaginal births only vs. cesarean sections (Group 1: OR = 7.76; 95% CI = 4.43, 13.60; Group 2: OR = 2.08; 95% CI = 1.50, 2.89). There was no significant difference in POP between assisted vaginal delivery (including vacuum and forceps) and spontaneous vaginal births. Compared with cesarean sections, vaginal delivery (including women delivering only by spontaneous vaginal births and women with both vaginal and cesarean deliveries) is associated with an increased risk of long-term POP.

A bibliometric and social network analysis of pelvic organ prolapse during 2007-2016.

BACKGROUND: Pelvic organ prolapse (POP) seriously affects the life quality of old females. In the present work, we described the knowledge structure of POP in a macroscopic view, and summarized the recent research focus. METHODS: Candidates were identified through reading and screening publications from PubMed database with a MeSH term of "pelvic organ prolapse" during 2007-2016. Relevant journals and journal-affiliated countries were extracted, and essential information, such as the number of publication of each year, first authors and MeSH/subheading words, was analyzed with BICOMB. In addition, highly-frequent MeSH/subheading words were determined and classified, and co-occurrence matrices were produced accordingly. Finally, social network was utilized to analyze the knowledge structure. RESULTS: A total of 3294 publications of POP were retrieved from 364 journals. The publication of POP had a significant downward trend since the beginning of 2015. POP articles published in American and British journals were significantly more compared with other countries. The co-occurrence matrices of 37 × 37 and 55 × 55 were produced by the highly-frequent MeSH/subheading words, and then the social network analysis was performed based on them. CONCLUSION: These publications on POP were mainly from the developed countries. Surgical treatment of POP was a hot topic of POP research in recent 10 years.

Circulating Cell Free DNA as the Diagnostic Marker for Ovarian Cancer: A Systematic Review and Meta-Analysis.

BACKGROUND: Quantitative analyses of circulating cell-free DNA (cfDNA) are potential methods for the detection of ovarian cancer. Many studies have evaluated these approaches, but the results were too inconsistent to be conclusive. This study is the first to systematically evaluate the accuracy of circulating cfDNA for the diagnosis of ovarian cancer by conducting meta-analysis. METHODS: We searched PubMed, Embase, Cochrane Library and the Chinese National Knowledge Infrastructure (CNKI) databases systematically for relevant literatures up to December 10, 2015. All analyses were conducted using Meta-DiSc1.4 and Stata 12.0 software. Sensitivity, specificity and other measures of accuracy of circulating cfDNA for the diagnosis of ovarian cancer were pooled. Meta-regression was performed to identify the sources of heterogeneity. RESULTS: This meta-analysis included a total of 9 studies, including 462 ovarian cancer patients and 407 controls. The summary estimates for quantitative analysis of circulating cfDNA in ovarian cancer screen were as follows: sensitivity, 0.70 (95% confidence interval (CI), 0.65-0.74); specificity, 0.90 (95% CI, 0.87-0.93); positive likelihood ratio, 6.60 (95% CI, 3.90-11.17); negative likelihood ratio, 0.34 (95% CI, 0.25-0.47); diagnostic odds ratio, 26.05 (95% CI, 14.67-46.26); and area under the curve, 0.89 (95% CI, 0.83-0.95), respectively. There was no statistical significance for the evaluation of publication bias. CONCLUSIONS: Current evidence suggests that quantitative analysis of cfDNA has unsatisfactory sensitivity but acceptable specificity for the diagnosis of ovarian cancer. Further large-scale prospective studies are required to validate the potential applicability of using circulating cfDNA alone or in combination with conventional markers as diagnostic biomarker for ovarian cancer and explore potential factors that may influence the accuracy of ovarian cancer diagnosis.