Objective: Recurrent spontaneous abortion (RSA) refers to two or more consecutive spontaneous abortions, and its morbidity is about 1%-1.8% of fertile women. It was to study the role of MAPK/ERK signal pathway in the recurrent miscarriage patients by case-control analysis; Methods: It collected 46 RSA patients, without growing of early embryos, which were constituted in patients group. Matched gestational time and women age, it used the normal Pregnant woman at same period as control group. The mRNA expression of were detected by RT-PCR, the protein expression of were detected by western blot. Calculated its value and found that difference; Result: It could be found the average ERK1/2 expression in tissues of VCT, EVCT and DSC were lower in the RAS patients than that of the control group (P<0.05). The expression of protein ERK and P-ERK was consistent with RNA testing results, under western blot testing. ERK and PERK were at lower expression in villi and deciduas, which suggested it had relationship with recurrent miscarriage; Conclusion: The expression of ERK1/2 mRNA and the relative protein expression of ERK in RSA pathway were lower than normal pregnancy, which indicated MAPK/ERK signal pathway participated in the maintenance of normal pregnancy; the decreased expression of ERK is closely related to RSA disease.

Objective:To discuss the occurrence and treatment of the perioperative bleeding and serious complications of scar uterus complicated with central placenta previa;and introduce the effect of a new technology of aortic balloon occusion to control intra-operative hemorrhage. Methods:Between Jan. 2005 to Nov. 2013,97 patients of scar uterus complicated with central placenta previa delivered in our hospital,which were divided into 3 groups accord-ing to the placenta attachment:placenta increta group ( 39 cases ) , placenta accreta group ( 18 cases) ,and normal group(40 cases) . 5 patients in placenta increta group accept aortic balloon occlusion during operation to control blood lost. The rate of prenatal bleeding,volume of blood lost intra/peri-operation and transfusion of RBC, serious complications, maternal and neonatal prognosis was analyzed. Results:(1)The rate of prenatal bleeding was 43. 6% in placenta in-creta group,lower than placenta accreta group(67. 7%,P<0. 05)and normal group(75. 5%,P<0 . 05 ) . There was no significance between the late two groups ( P>0 . 05 ) . The average intra-operative blood lost was (1990±1226)ml in placenta increta group,(950±300)ml in placenta accreta group and (625±383)ml in normal group. There was statistically different among each groups (P<0. 01 ). The average peri-operative blood loss was (2208±1409)ml in placenta in-creta group,(1189±822) ml in placenta accreta group,(773±554) ml in normal group. There was statistically different among each groups(P<0. 01). 37 cases(94. 9%) in placenta increta group,16cases(88. 7%) in placenta accrete group and 23 cases(57. 5%) in normal group need blood transfusion. The average volume of RBC transfusion in placneta increta group was (2005±1198)ml,significantly higher than accreta group[(963±393)ml,P<0. 01)]and normal group[(1091±833) ml,P<0. 01]. There was no statistical difference between the later two groups(P>0. 05). (2)The blood lost of the 5 cases in placenta increta group who accept aortic balloon occlusion was much less than the other 34 cases who refused aortic balloon occlusion (media 1000ml vs 2000ml,P<0. 01). (3)26 cases(66. 7%)in placenta increta group and 1 case in accreta group had hysterectomy. ( 4 ) No maternal death. 1 patient in placenta increta group who lost 6000ml blood intra-operation, and underwent cardiac arrest, was successfully saved. 1 serious asphyxia neonate (29 weeks of gestational age) died,all other newborns were healthy. Conclusions:Patients of scar uterus complicated with central placenta previa, have a high rate of placenta increta. The rate of massive blood loss intra/peri operation and hysterecto-my is high. Large volume blood transfusion should be prepared before operation. Aortic balloon occusion is an effective measure to contorl blood lost intra-operation.