Obstetrics in China

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Roberta Speyer: Hello, it is Roberta Speyer reporting for OBGYN.net. I am in Beijing and I am talking to two obstetricians, Dr. Lin and Dr. Yang. We are going to discuss today a little bit about the new changes and developments in diagnosis of problems in obstetric cases. What is going on in China today?

Dr. Yang: For the prenatal diagnosis, a lot of change in the recent ten years. You know the first screenings we just do the Down Syndrome screen test for most of the pregnant woman during the first trimester, or the second trimester. If we find a high-risk pregnant woman for the screen test we can do some amniocentesis, and some hospitals can do some CVS. But the bigger problems are in the small village hospitals that cannot do the procedure. The patient maybe should transfer to the big hospitals.

Roberta Speyer: Are you seeing this also? That the transfers are happening more?

Dr. Lin: Yes.

Roberta Speyer: In a lot of cases in the United States if you have this diagnosis there is a termination of the pregnancy. This I assume is also true in China, especially because you have the one child policy, and so of course you are trying to bring a healthy baby to term.

Do you see that in the provinces there is better ability for people to get that care than happened in the past? Is there more of an outreach into the communities to bring them in and get tested earlier?

Dr. Yang: Yes.

Roberta Speyer: How do you see going forward developing? Do you think there will be more use of some of the newer technologies? There are some problems sometimes with amniocentesis because it can cause a spontaneous miscarriage or abortion. What is your opinion of diagnosis using Nuchal translucency?

Dr. Yang: Yes, this is also very common and also very simple tests. By these tests only should ask them information about the babies, you know if the NT is safe, maybe we also need to confirm the test for the babies. Maybe we just follow the babies by ultrasound; sometimes we also should check the babies’ chromosomes. You know for some of the babies with abnormal NT, maybe the baby is abnormal and we should terminate the pregnancy.

Roberta Speyer: Are there any programs that identify the high risks? Who do you consider in China to be at high risk? You know, a more elderly population of mothers, are women waiting longer to have babies; is this causing a greater risk? This is happening in the United States. Women are waiting to have babies until what, they are 90 years old? No! They are waiting until they are in their late 30s. Where do you see that in China with the risk factors? For the age, is it increasing, are people waiting longer?

Dr. Yang: Yes, after marriage some of the women are waiting for a long time to become pregnant because some of the professional women choose to deliver a baby later, especially in the big cities.

Roberta Speyer: This is really also a sociological problem as women leave the role of just being mothers, and having multiple children early on, and they start coming into the workforce, and being more dynamically involved in their careers. This is affecting both Down Syndrome, and also the infertility rates are increasing. So, no lack of work at the hospital!

I appreciate your taking the time, is there anything else you would like to share with us? I would like to hear more about both of your institutions; how they are the same and how they are different.

Dr. Yang: Compare?

Roberta Speyer: Yes, I think our viewers would like to know about the hospitals in China. What is the same, and what is different perhaps, size, or patient population?

Dr. Yang: For both of the hospitals, the general hospitals and also the teaching hospitals maybe we have a lot of the high-risk pregnant women as Dr. Bian mentioned in the (inaudible) hospitals maybe that the delivery number is not so high, but we must check a lot of the high-risk pregnancy women. In my hospital I see a lot of the pregnant women with diabetes, and preeclampsia patients, and other medical complications. You know even the patients in the other cities maybe just transfer to Beijing to some of the hospitals, similar to Dr. Yang’s hospitals.

Roberta Speyer: Yes, preeclampsia causes a lot of problems. Dr. Yang is your facility further away from here?

Dr. Lin: Yes, far away. Also we are the central hospital.

Roberta Speyer: So for your area it is the large centre, you are the magnet the people come to with the high-risk pregnancies.

Drs. Lin & Yang: Yes.

Dr. Lin: So, a lot of (inaudible) genetic matters come.

Roberta Speyer: Well, there are a lot of new things going on and it is interesting to see the same problem of course all over the world, China, United States, Europe, how to bring a healthy baby to full term.

And we appreciate that both of you are working to help that happen and you take the time to talk to us today. Thank you very much doctors.

Drs. Lin & Yang: Thank you.