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Low-dose aspirin in the prevention of pre-eclampsia in China: postpartum hemorrhage in subgroups of women according to their characteristics and potential bleeding risk

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Chinese Medical Journal 2023年第5期136卷 550-555页

作者： Jiahui Chen Jing Huai Li Lin Boya Li Yuchun Zhu Huixia Yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China beijing key laboratory of maternal fetal medicine of gestational diabetes mellitus Beijing 100034China.

Background:The APPEC study is a large-population randomized controlled trial in China evaluating the role of low-dose aspirin prophylactic treatment for *** was no statistically significant difference in postpartum hemorrhage(PPH)incidence between the aspirin and control *** study aimed to evaluate the potential bleeding risk of 100 mg aspirin in high-risk pregnant women and the difference in the incidence of PPH according to maternal ***:This is a secondary data analysis of the APPEC *** counts and coagulation test results were collected at five follow-up *** defined by maternal age(gestational age at enrollment,and medical history,including pre-eclampsia,chronic hypertension,and diabetes mellitus,were *** regression analysis was used to determine the statistical significance of the difference in the incidence of PPH after aspirin administration in pregnant women in each *** using multiple logistic regression models followed these *** logistic regression was used to determine the relationship between pre-BMI and ***:There was no significant difference between the aspirin and control groups in bleeding risk(3.4%[16/464]vs.3.0%[13/434],T=0.147,P=0.701).No significant difference was found in the incidence of PPH in total(relative risk=1.220,95%confidence interval[CI]=0.720–2.067,P=0.459;aspirin group *** group,6.5%[30/464]vs.5.3%[23/434],P=0.459)or in subgroup analysis.A significant correlation between pre-BMI and PPH was found in the aspirin group,while in the control group there was no significant correlation(aspirin group,odds ratio[OR]=1.086,95%CI=1.004–1.175,P=0.040;control group,OR=1.060,95%CI=0.968–1.161,P=0.209).Conclusions:A dosage of 100 mg of aspirin per day,initiated from 12 to 20 gestational weeks until 34 weeks of gestation,did not increa

关键词： APPEC study Aspirin Postpartum hemorrhage Body mass index Pre-eclampsia

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maternal circulating biomarkers associated with placenta accreta spectrum disorders

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Chinese Medical Journal 2023年第8期136卷 995-997页

作者： Zhirong Guo Huixia Yang Jingmei Ma Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China beijing key laboratory of maternal fetal medicine of gestational diabetes mellitus Beijing 100034China

To the Editor:Placenta accreta spectrum(PAS)disorders refer to a spectrum of abnormal *** subtypes include placenta accreta(creta or adherenta,PA),placenta increta(PI),and placenta percreta(PP).The incidence of PAS has dramatically increased over the past four decades.A study using a nationally representative sample in the United States showed that the prevalence of PAS was 0.29%among women who underwent cesarean delivery with live birth.[1]Women with PAS are at a considerably higher risk of concurrent hemorrhage,bladder and urinary tract injury,and hysterectomy during delivery.[1]

关键词： bladder disorders spectrum

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Exercise intervention during pregnancy induces DNA methylation alterations in maternal blood and cord blood

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Chinese Medical Journal 2023年第13期136卷 1624-1626页

作者： Jie Yan Chen Wang Yumei Wei Huixia Yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China beijing key laboratory of maternal fetal medicine of gestational diabetes mellitus Beijing 100034China

To the Editor:Obesity characterized with excess accumulation of white adipose tissue increases the prevalence of gestational diabetes mellitus(GDM).Exposure to intrauterine hyperglycemia increases the long-term sequelae including cardiovascular abnormalities and metabolic syndrome in adult offspring.[1]As early as two decades ago,*** Barker provided evidence that nutritional exposures in utero has a lasting impact on offspring’s health status in adulthood.[2]This emphasizes the critical role of early intrauterine environmental exposures and highlights the potential origins of adult metabolic diseases.

关键词： alterations cardiovascular pregnancy

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Interpretation of Chinese expert consensus on diagnosis and management of amniotic fluid embolism

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Chinese Medical Journal 2020年第14期133卷 1719-1721页

作者： Ye Feng Hui-Xia Yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China beijing key laboratory of maternal fetal medicine of gestational diabetes mellitus Peking University First HospitalBeijing 100034China

Amniotic fluid embolism(AFE)is a rare but potentially lethal condition characterized by an abrupt onset,unpredictability,and high fatality *** Society formaternal-fetalmedicine(SMFM)published clinical guideline No.9“Amniotic fluid embolism:diagnosis and management”in 2016.[1]Based on this guideline and other relevant studies,the Obstetrics Group of the Chinese Society of Obstetrics and Gynecology,Chinese Medical Association,developed a consensus on the diagnosis and treatment of AFE in December 2018,aiming to standardize its diagnosis and management,and to improve maternal and perinatal outcomes.

关键词： diagnosis fluid embolism

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Incidence and Clinical Risk Factors for Preeclampsia and Its Subtypes:A Population-Based Study in beijing,China

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maternal-fetal medicine 2021年第2期3卷 91-99页

作者： Li Lin Jing Huai Rina Su Chen Wang Boya Li Huixia Yang Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China beijing key laboratory of maternal fetal medicine of gestational diabetes mellitus Beijing 100034China

Objective:This study aimed to evaluate the incidence and associated clinical risk factors for preeclampsia(PE)and its subtypes in a large multicentre retrospective study of beijing,***:This study was conducted as a secondary analysis from the gestational diabetes mellitus Prevalence Survey(GPS),a multicentre retrospective cohort study,which included 15 hospitals in beijing,*** analysis included 15,003 pregnant women who delivered in beijing from June 20th to November 30th,*** incidence of PE was *** factors for PE,including maternal age,pre-gestational body mass index(BMI),parity,chronic hypertension,pre-existing diabetes,and gestational diabetes mellitus,were *** was defined as early-or late-onset PE based on clinical manifestations during the week of delivery,and mild or severe PE based on the severity of the *** regression analysis was used to quantify the association with the risk factors,and data were displayed as odds risks(OR)and 95%confidence interval(CI).Results:The overall incidence of PE was 2.65%(397/15,003).The prevalence of early-onset and late-onset PE was 0.36%(54/15,003)and 2.29%(343/15,003),*** prevalence of mild and severe PE was 0.91%(137/15,003)and 1.73%(260/15,003),*** factors including high BMI considered overweight(adjusted odds risk(aOR):1.48;95%CI:1.06-2.05;P=0.02)and obesity(aOR:2.15;95%CI:1.50-3.08;P<0.001),nulliparity(aOR:1.73;95%CI:1.32-2.25;P<0.001),multiple gestation(aOR:4.58;95%CI:2.86-7.32;P<0.001),and chronic hypertension(aOR:34.95;95%CI:26.60-45.93;P<0.001),were associated with increased risk for *** chronic hypertension(aOR:13.75;95%CI:4.78-39.58;P<0.001)was a significant risk factors for early-onset PE,whereas high BMI considered both overweight(aOR:1.54;95%CI:1.09-2.18;P=0.01)and obesity(aOR:2.23;95%CI:1.53-3.27;P<0.001),nulliparity(aOR:2.00;95%CI:1.49-2.68;P<0.001),multiple gestation(aOR:4.11;95%CI:2.40-7.05;P<0.001),and chronic hypertension(

关键词： Pre-eclampsia Early-onset preeclampsia Late-onset preeclampsia Mild preeclampsia Severe preeclampsia Prevalence Risk factor

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METTL3 regulates glucose transporter expression in placenta exposed to hyperglycemia through the mTOR signaling pathway

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Chinese Medical Journal 2024年第13期137卷 1563-1575页

作者： Jie Ning Jing Huai Shuxian Wang Jie Yan Rina Su Muqiu Zhang Mengtong Liu Huixia Yang Department of Obstetrics and Gynaecology Peking University First HospitalBeijing 100034China beijing key laboratory of maternal Foetal medicine of gestational diabetes mellitus Beijing 100034China Peking University Beijing 100034China

Background:Alterations in the placental expression of glucose transporters(GLUTs),the crucial maternal-fetal nutrient transporters,have been found in women with hyperglycemia in pregnancy(HIP).However,there is still uncertainty about the underlying effect of the high-glucose environment on placental GLUTs expression in ***:We quantitatively evaluated the activity of mammalian target of rapamycin(mTOR)and expression of GLUTs(GLUT1,GLUT3,and GLUT4)in the placenta of women with normal pregnancies(CTRL,n=12)and pregnant women complicated with poorly controlled type 2 diabetes mellitus(T2DM,n=12)by *** addition,BeWo cells were treated with different glucose concentrations to verify the regulation of ***,changes in the expression of GLUTs following the activation or suppression of the mTOR pathway were also assessed using MHY1485/rapamycin(RAPA)treatment or small interfering RNA(siRNA)-mediated silencing ***,we further explored the alteration and potential upstream regulatory role of methyltransferase-like 3(METTL3)when exposed to ***:mTOR,phosphorylated mTOR(p-mTOR),and GLUT1 protein levels were upregulated in the placenta of women with T2DM compared with those *** BeWo cells,mTOR activity increased with increasing glucose concentration,and the expression of GLUT1,GLUT3,and GLUT4 as well as GLUT1 cell membrane translocation were upregulated by hyperglycemia to varying *** the drug-mediated and genetic depletion of mTOR signaling in BeWo cells suppressed GLUTs expression,whereas MHY1485-induced mTOR activation upregulated GLUTs ***,high glucose levels upregulated METTL3 expression and nuclear translocation,and decreasing METTL3 levels suppressed GLUTs expression and mTOR activity and vice ***,in METTL3 knockdown BeWo cells,the inhibitory effect on GLUTs expression was eliminated by activating the mTOR signaling pathway using ***:High-g

关键词： Glucose transporters Hyperglycemia Type 2 diabetes mellitus Pregnancy Mammalian target of rapamycin Methyltransferase-like 3

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A Brief Overview of a Round Table Discussion About Venous Thromboembolism in Pregnancy During the First International Forum on Chinese maternal-fetal medicine

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maternal-fetal medicine 2020年第3期2卷 129-130页

作者： Wang Chen Yang Hui-Xia Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China beijing key laboratory of maternal fetal medicine of gestational diabetes mellitus Beijing 100034China

Venous thromboembolism(VTE)is a leading cause of maternal morbidity and mortality though with low *** to non-pregnant women of comparable age,women during pregnancy have five-to ten-fold increased risk of VTE,additional risk factors for VTE during pregnancy include a personal history of thrombosis,the presence of a thrombophilia,cesarean delivery,obesity,hypertension,preeclampsia,autoimmune disease,heart disease,sickle cell disease and multiple ***,early clinical evaluation,preferably in peri-conceptional period,is crucial for VTE risk detection and,thus,for prophylaxis decision *** thromboprophylaxis brought significant advantages in pregnancy outcomes and maternal *** pharmacological and mechanical forms of thromboprophylaxis includes heparin compounds,anti-embolic stockings and intermittent pneumatic compression ***-molecular-weight heparin as first line *** guidelines or expert opinions on VTE treatment or prophylaxis during pregnancy diverge *** quality research in this area is still needed,and China needs to develop its own VTE ***,absolute risks and potential benefits of VTE thromboprophylaxis should be evaluated to make the best decisions on VTE screening,prevention,and treatment.

关键词： Venous thromboembolism Pregnancy Prophylaxis Risk factor

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Metformin in Pregnancy with diabetes—Opinions from Several Latest Guidelines

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maternal-fetal medicine 2020年第1期2卷 10-11页

Pregnancy complicated with diabetes is associated with adverse maternal and fetal *** control of glucose level during pregnancy contributes to improve maternal and fetal outcomes and break the vicious cycle of"diabetes begetting diabetes".The first line antidiabetic drug in pregnancy is insulin,which is expensive and inconvenient to *** of clinical trials and meta-analyses have constantly confirmed the safety and efficacy of metformin in *** guidelines across the world have been discussing metformin as an alternative to insulin in *** article summarizes the opinions about metformin from several latest guidelines.

关键词： diabetes,gestational Type 2 diabetes mellitus Pregnancy Metformin Guidelines

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A Summary of Chinese Guidelines on Diagnosis and Management of Hyperglycemia in Pregnancy(2022)

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maternal-fetal medicine 2023年第1期5卷 4-8页

作者： maternal-fetal medicine Committee,Chinese Society of Obstetrics and Gynecology,Chinese Medical Association Chinese Society of Perinatal medicine,Chinese Medical Association Professional Committee of gestational diabetes mellitus,Chinese maternal and Child Health Association Chen Wang Juan Juan Huixia Yang 不详 Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China beijing key laboratory of maternal fetal medicineof gestational diabetes mellitus Beijing 100034China

Hyperglycemia is one of the most common complications women encounter during pregnancy,and is associated with a higher incidence of short-and long-term health risks for both the mother and *** 2022,the maternal-fetal medicine Committee of the Chinese Society of Obstetrics and Gynecology,Chinese medicine Association,worked with the Chinese Society of Perinatal medicine and the Professional Committee of gestational diabetes mellitus of the Chinese maternal and Child Health Association to update the Guidelines for the diagnosis and management of hyperglycemia in pregnancy in *** aim was to further standardize the management of hyperglycemia in pregnancy from the aspects of screening,diagnosis,monitoring,treatment,and prevention of gestational diabetes mellitus,and consequently to further improve the health of mother and child.

关键词： Hyperglycemia Pregnancy diabetes gestational Guideline

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Cervical Length at 28-32 Weeks of Gestation Predicts Preterm Birth

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maternal-fetal medicine 2021年第3期3卷 185-189页

作者： Mengying Zhang Xiaoxiao Zhang Huixia Yang Chunyan Shi Department of Obstetrics and Gynecology Peking University First HospitalBeijing 100034China beijing key laboratory of maternal fetal medicine of gestational diabetes mellitus Beijing 100034China

Objective:To evaluate the ability of cervical length(CL)at 28-32 weeks of gestation to predict spontaneous preterm delivery and preterm premature rupture of membranes(PPROM).Methods:It was a retrospective cohort study that vaginal ultrasonography at approximately 28-32 weeks of gestation was performed in 14,953 women between 17-49 years old with singleton pregnancies who delivered after 28 weeks of gestation at the Peking University First Hospital from June 2008 to December *** pregnancy outcomes were followed and the relationship between the CL and preterm delivery or PPROM was *** relative risk was calculated to assess group differences in the likelihood of an event ***:The overall prevalence of preterm delivery was 5.7%(858/14,953);the incidence for therapeutic preterm delivery was 2.1%(318/14,953),for spontaneous preterm delivery was 0.9%(133/14,953),and for PPROM was 2.7%(407/14,953).Excluding the 318 women who had therapeutic preterm delivery,the relative risk of preterm delivery for women with a CL between 25 mm and25 mm(80.6%,328/407,P<0.05).Conclusion:CL at 28-32 weeks of gestation can predict spontaneous preterm delivery,and is val

关键词： Cervical length measurement Preterm delivery Pregnancy trimester,third Forecasting

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