Electronic fetal monitoring(EFM)during labor is one of means to evaluate the fetal intrauterine state. Category Ⅱ pattern is a suspicious fetal heart rate monitoring pattern, which is common in clinic. Its manifestation is different and atypical. It suggests that the fetus is in suspicious distress in utero. For this kind of pattern, it is necessary to correctly identify, interpret, carry out necessary clinical interventions, such as intrauterine resuscitation, and subsequent reevaluation. This paper mainly introduces various methods of intrauterine resuscitation and the evaluation of various methods of resuscitation.

Intrapartum fetal monitoring is an important method to determine the fetal well-being in order to detect signs of intrapartum hypoxia. However, this technology has not improve perinatal mortality and the incidence of cerebral palsy. Instead, the rates of caesarean section and instrumental deliveries have been continuously increased. There are also specific limitations and underlying deficiencies in the Category Ⅰ-Ⅲ system.

Live failure during pregnancy often evolves critically and carries out high maternal-fetus mortality. Infection of hepatitis B virus and acute fatty liver of pregnancy (AFLP) are the most common causes of liver failure during pregnancy in China. Prognosis can be improved with effective evaluation of illness state and timely termination of pregnancy. The model for end-stage liver disease (MELD) scoring system, Child-Turcotte-Pugh (CTP) scoring system of liver function and Swansea criteria can be used to predicting the prognosis of acute-chronic hepatitis B liver failure and AFLP, but it should be further explored in clinical work.

Postpartum hemorrhage is the most common serious complication of childbirth and is the most preventable cause of maternal mortality. For every patient, risk assessment should be considered at multiple time points during patient care, including antepartum, near the time of labor, during labor and after delivery. Each delivery center should have a detailed management plan for responding to obstetric hemorrhage emergencies, standarding training and drills, and improving the ability and level of clinicians to deal with postpartum hemorrhage.

To evaluate the effects of uterine artery embolization on preventing the pregnancy with complete placenta previa hemorrhage during induced labor in second trimester and its adverse effects.

We retrospectively analyzed 79 cases of labor induction on pregnancy with complete placenta previa during second trimester, who were admitted to the third affiliated hospital of Guangzhou medical university during January 2011 to December 2014. There were divided into embolization group and control group. In embolization group, 29 patients were induced labored by using rivanol and mifepristone. On the same time, they were performed uterine artery embolization (UAE). 18 cases were 20-27^{+ 6} gestational weeks and 11 cases were less than 20 gestational weeks. In control group, 50 patients were induced labored by using rivanol and mifepristone. 20 cases were 20-27^{+ 6} gestational weeks and 30 cases were less than 20 gestational weeks. The timing of labor induction, the number of loss bleeding, the rate of fever, the pain degree and the recovery phase of menstruation were compared between embolization group and control group.

(1) Excepted one performed cesarean section due to fail of induced labor, the timing of induced labor in 20-27^{+ 6} gestational weeks was (49.36±7.80) hour in embolization group and was(41.23±7.59)hour in control group. Under 20 gestational weeks, the timing of induced labors was (49.36±7.80) h and (41.23±13.85) h in embolization group and control group, respectively. Compared in the timing of induced labored between two groups, there was significant difference.(2)Compared in the number of loss bleeding in 20-27^{+ 6} gestational weeks between two groups, 294±60 ml and 356±81 ml were respectively in embolization group and control group, which was significant difference. There war not significant difference in less than 20 gestational weeks. (3)Compared in the pain degree in 20-27^{+ 6} gestational weeks between two groups, the score was respectively 8.70±0.90 and 2.11±0.50 in embolization group and control group, which was significant difference. Compared in the pain degree in less than 20 gestational weeks, the score was 7.27±1.80 and 1.65±0.48 respectively in embolization group and control group, which was significant difference.(4) The rate of fever was 61.11% in 20~27^{+ 6} gestational weeks of embolization group and 5% in control group, which was significant difference. Compared in less than 20 gestational weeks between two groups, there was respectively 63.63% and 6.67%, which also were significantly difference.

(1) UAE played a positive role on preventing hemorrhage due to central placenta previa in more than 20 gestational weeks. But there was not on less than 20 gestational weeks. (2) UAE could prolong the time of labor induction, increase the pain degree and the rate of fever. So we used UAE cautiously. (3) In induced labor with central placenta previa during second trimester, adept skill played a positive role on preventing and decreasing hemorrhage.

The most common cause of postpartum hemorrhage is uterine inertia, thus it is critical to use effective uterine contraction drugs as early as possible for the postpartum hemorrhage patients. Uterine contraction drugs can be divided into 8 categories, and oxytocin is the first-line drug, and carboprost tromethamine is the preferred second-line drug.

Pregnancy with liver disease is a quite serious complication. Hepatic protection drugs play an important role in the treatment of liver disease, such as reducing liver enzyme, accelerating detoxification and energy metabolism, improving microcirculation and optimizing immune response, etc. This article mainly summarized 8 kinds of hepatic protection drugs and the rational use in pregnancy.

To establish a prediction system for preeclampsia and eclampsia patients according to pregnancy physiological and pathological changes.

A retrospective study was conducted in 437 preeclampsia and eclampsia patients, who were admitted to the intensive care unit of the Third Affiliated Hospital of Guangzhou Medical University from October 1999 to March 2007. Then we analyzed the relationship between scores and the maternal organ dysfunction, and established the prediction scoring system for preeclampsia and eclampsia. The data were analyzed by using Chi-square test and the mortality prediction equation by using logistic regression model.

The prediction system involved 20 clinical indexes, including body temperature, pressure, respiratory rate, heart rate, arterial partial pressure of oxygen, PaO₂/FiO₂, arterial pH value, serum sodium, serum potassium, serum creatinine, ALT, blood platelets count, serum total bilirubin, serum albumin, fibrinogen, white blood count, hematocrit, blood uric acid, age and scores of nervous system. The number of organ dysfunction was increaring with the scores up. The prediction equation for the mortality risk was log eY/(1-Y)=-6.56+ 0.927×scores of nervous system+ 0.149×(total scores-scores of nervous system).

Establishing a prediction system for the preeclampsia and eclampsia patients can evaluate the illness severity better.

To establish a prediction system for the critically ill obstetric patients.

A retrospective study was conducted in 311 critically ill obstetric patients, who were admitted to the ICU of the Third Affiliated Hospital of Guangzhou Medical University from January 2000 to July 2008. The patients were divided into dead group(72 patients) and survival group (239 patients). Assigned the clinical indexes related to the mortality and established a prediction system for the critically ill obstetric patients. The clinical indexes were analyzed by using t test and the mortality prediction equation by using logistic regression model.

The prediction system involved 18 clinical indexes, including body temperature, mean artery pressure, respiratory rate, heart rate, PaO₂/FiO₂, arterial pH, serum sodium, serum potassium, blood glucose, serum creatinine, serum total bilirubin, serum albumin, ALT, blood platelet count, fibrinogen, white blood count, hematocrit and scores of nervous system. The prediction equation for the mortality risk: log eY/(1-Y)=-7.275+ 0.245×total scores.

Establishing a prediction system for the critically ill obstetric patients not only improves the diagnostic level but also has an scientific and objective basis in improving medical quality and utilizing the medical resources.

To provide guideline for the clinical management of postpartum hemorrhage, and to build up a scoring system for the prediction of severe postartum hemorrhage.

This study reviewed 375 pregnant women with severe postpartum hemorrhage, who were treated on the Third Affiliated Hospital of Guangzhou Medical University from January 2000 to June 2008. Then we analyzed the relationship between scores and the maternal outcomes, which included organ dysfunction, hysterectomy and death, and established the prediction scoring system for postpartum hemorrhage. The data were analyzed using χ² test, Fisher exact probability test, linear association and logistic regression.

log eY / (1-Y) = -7.274 + 0.858 × prenatal score + 0.821 × postpartum score was the formula of prediction for sever postapartume hemorrhage. The score was 4 which suggested the incresing risk of organ dysfunction (χ²=13.23, P<0.01), and 12 scores suggested the incresing risk of three or more organs dysfunction (χ²=54.21, P<0.01). Over 8 scores suggested the risk of hysterectomy was increased significantly(χ²=20.65, P<0.01). There were significantly difference of serve postpartum hemorrhage between score 6 group and score 1-5 group(χ²=10.85, P<0.01). And sever postpartum hemorrhage also had significant difference between score 8 group and 6-7 group(χ²=4.68, P<0.05), score 12 group and score 8-11 group(χ²=10.53, P<0.01).

The prediction scoring system can be used to predict effectively the risk of severe postpartum hemorrhage and evaluate the serious degree of situation. In the further, we need a research on a large scale.