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简介：Objective:Toexplorethecharacteristicsofclosedabdominalinjuryinpregnancywomenanditstreatment.Methods:Theclinicaldataof37pregnancypatientswithclosedabdominalinjurytreatedinourhospitalfromJune1993toJune2003werecollectedandanalyzed.Results:Allthe37patientsweretreatedwithoperation.Amongthem2earlypregnancypatientswithintestinalruptureand1patientwithretroperitonealhematomaweretreatedunderlaparoscope;inother34pregnancypatientslaparotomywasperformed.Ofthe34patients8usedcesareansectionbecauseprematureseparationofplacentaandenlargedwombinterruptedthemanagementofintra-abdominalorganinjury.Inthe37patients33(89.1%)werecured,4(10.8%)die,postoperativecomplicationratewas16.2%(6/37).Twopatients(5.4%)sufferedfromabdominalcavityinfection,3(8.1%)frompulmonaryinfection,and1(2.7%)hadmulti-organfailure.Conclusions:Forpregnancypatientswithclosedabdominalinjury,besidesobstericdiseasesintra-abdominalinjuryshouldbegivenmuchattention.Accuratediagnosisandtimelytreatmentcangainthetimetosavethelifeofbothmotherandfetus.

简介：AIM:Toinvestigatechoroidalthicknessinpregnantwomenandcomparethemeasurementswiththoseofnormalnonpregnantwomen.METHODS:Usingenhanceddepthimagingopticalcoherencetomography(EDI-OCT),choroidalthicknesswasmeasuredatthefoveaandat1mmand3mmsuperior,inferior,temporal,andnasaltothefoveainbothhealthypregnantwomenandnonpregnantwomen.Pearsoncorrelationanalysiswasperformedtoevaluatetherelationshipsbetweensubfovealchoroidalthickness(SFCT)andthedemographicandocularparameters.Pooledoddsratio(OR)and95%confidenceinterval(CI)werecalculatedusingfixed-effectsmodelwhenMeta-analyseswereconducted.RESULTS:Comparisonofchoroidalthicknessbetweenthegroupsshowedthatitwassignificantlygreaterinhealthypregnantwomen’seyesthaninnormalnonpregnantwomen’seyesatalllocationsexceptat3mmsuperiorand3mmtemporalfromthefovea(P<0.05).ThemeanSFCTwas344.13±50.94μminhealthypregnantwomen’seyesand315.03±60.57μminnormalnonpregnantwomen’seyes,withastatisticallysignificantdifference(P=0.008).PearsoncorrelationanalysisshowedthatageandaxiallengthweresignificantlyrelatedtoSFCTinhealthypregnantwomen,normalnonpregnantwomen,andallsubjects.Theresultsofourcross-sectionalstudywereconsistentwiththeresultsofthefurtherMeta-analysis,withapooledweightedmeandifference(WMD)of33.66μm(95%CI:26.16to41.15)forSFCT.CONCLUSION:Ourresults,alongwiththecomprehensiveMeta-analysis,suggestthatchoroidalthicknessinhealthypregnantwomenisgreaterthanthatinnormalnonpregnantwomen.

简介：BackgroundPregnancycomplicatingpulmonaryarterialhypertension(PAH)isalife-threateningobstetricalcomplication.FewstudieshavereportedtheclinicalcharacteristicsandoutcomesofpregnantwomenwithPAH.MethodsRetrospectivelyanalysiswasconductedon86casesofpregnantwomenwithPAHattheDepartmentofObstetricinGuangdongGeneralHospitalbetween2009and2014.Dataincludedpatients'age,theetiologiesofPAH,clinicalclassificationoftheNewYorkHeartAssociation(NYHA),gestationalweeks,deliverymode,maternalandfetaloutcomes.Results1Therewere2casesofidiopathicpulmonaryarterialhypertension(IPAH)and84casesofsecondarypulmonaryarterialhypertension.Thelatterwascomposedby40(47.61%)casesofcongenitalheartdisease(CHD),38(45.23%)casesofrheumaticheartdisease(RHD),3(3.57%)casesofsystemiclupuserythematosus(SLE)and1(1.19%)caseofpartialhydatidiformmole.ThenumberofpatientsclassifiedinNYHAI~IVwere8(9.30%),41(47.67%),26(30.23%)and11(12.7%),respectively.Andthemortalitywas3.48%(3/86).2Amongthe86patients,31(36.04%)womengavebirthattermand36(41.86%)hadprematuredelivery.Inaddition,16(18.6%)womenhadanabortionlessthan28weeks.Therewereatotalof65(75.58%)livebirths,61(93.84%)ofwhomweredeliveredviacesareansection,whiletheother4(6.15%)werevaginaldeliveries.3Patientsweredividedinto3groups,12ofmild(<40mmHg),35ofmoderate(40~70mmHg)and39ofsevere(≥70mmHg)regardingthepulmonaryarterysystolicpressure(sPAP)measuredbyultrasound.WedefinedtheformertwoasgroupAandthelatterasgroupB.Thesignificancewasseenstatisticallyingestationalweeks(32.86±8.86gvs28.76±9.84),therateoftransferringtoICU(19.14%vs53.84%),neonatalbirth-weight(2725.69±467.43vs2044.82±665.75g),APGARscoring(9.97±0.16vs8.68±2.08),maternalstatusofheartfunctionandadversepregnantoutcomes,whencomparedgroupAwithB.AlltheP-valuesmentionedabovew

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简介：Objective:Tofindoutthebasicconditionsofmycosisinfectionoffull-termpregnantwomen.Methods:Fungusisolationandidentificationfromthevaginalsecretionsandoralspecimensfrom208full-termpregnantwomenwerecarriedoutbyfungicultureandidentifiedfollowingstandardbiologicalpractice.Results:Thepositivedetectionrateforvaginalfungiwas51.92%andfororalfungiitwas47.59%.20.19%hadfungiinboththevaginalandoralcavity.ThefungifoundweremainlyofthespeciesCandidaalbicans.Conclusion:Theprevalenceoffungalmycosisinfectioninfull-termpregnantwomenwashigherthanthatusuallyfoundinnon-pregnantwomen.Inordertopreventfurthercomplicationsandmateral-childtransmission,seriousattentionshouldbepaidtothishighprevalencefinding.

简介：Objective:ToinvestigateU.parvum(previouslyUreaplasmaurealyticumbiovar1)andU.urealyticum(previouslyUreaplasmaurealyticumbiovar2)andtheirsubtypesandserovarsinurinespecimensofpregnantwomen.Methods:Aftercollecting151specimensandinoculatingbroth,allbrothculturepositive(ureasepositive)specimenswereamplified,specieswereidentifiedandsubtypedbyusinggeneralprimers,species-specific,andtype-specificprimerstargetingthemultiplebandedantigen(MBA)genesequence.Results:U.parvumwasidentifiedin58of151specimensandU.urealyticumin18(bothwerepresentin5,andneitherwerefoundin6).Serovars3,1,and6werethemostcommonamongU.parvumisolatesandsubtypes1and3werethemostcommonamongU.urealyticum.Multipleserovarsamongclinicalisolateswerefound.Conclusion:ThisPCR-basedtypingsystemcouldfacilitatestudiesoftherelationshipbetweenindividualureaplasmaspeciesorsubtypesandhumandiseases.

简介：ObjectiveThestudyistoidentifythecarrierrateofcommondeafnessmutationinChinesepregnantwomenviadetectingdeafnessgenemutationswithgenechip.MethodsThepregnantwomeninobstetricclinicwithouthearingimpairmentandhearingdisordersfamilyhistorywereselected.Theinformedconsentwassigned.PeripheralbloodwastakentoextractgenomicDNA.Applicationofgeneticdeafnessgenechipfordetecting9mutationalhotspotofthemostcommon4Chinesedeafnessgenes,namelyGJB2(35delG,176del16bp,235delC,299delAT),GJB3(C538T),SLC26A4(IVS72A>G,A2168G)andmitochondrialDNA12SrRNA(A1555G,C1494T).Furthergenetictestingwereprovidedtothespousesandnewbornsofthescreenedcarriers.ResultsPeripheralbloodof430pregnantwomenweredetected,detectionofdeafnessgenemutationcarriersin24cases(4.2%),including13casesoftheGJB2heterozygousmutation,3casesofSLC26A4heterozygousmutation,1casesofGJB3heterozygousmutation,and1caseofmitochondrial12SrRNAmutation.18spousesand17newbornstookfurthergenetictests,and6newbornsinheritedthemutationfromtheirmother.ConclusionThecommondeafnessgenesmutationhasahighcarrierrateinpregnantwomengroup,235delCandIVS7-2A>Gheterozygousmutationsarecommon.

简介：AbstractBackground:TheNnewlyreportedcasesofcongenitalsyphilishavebeenincreasedingsubstantiallyoverthepastfewyears.Tocontroltheepidemic,amunicipalprogramaimedatpreventingmother-to-childtransmissionofsyphiliswasintroducedinJuly,2001,whichwasdesignedaimedtoscreenallpregnantwomenforsyphilisattheirfirstvisittoantenatalclinicsoratadmissiontohospitalsinShenzhen.Objectives:TheaimofthestudyistTodeterminetheprevalenceofsyphilisamongwomenattendingantenatalclinicsandothermedicalinstitutionsinShenzhenandidentifiesitspatternsofinfection.Methods:Upongivinginformedconsent,wWomenwhoattendedantenatalcarecentersinShenzhenfromJanuarytoDecember2003wereincludedinthisstudysubjecttoobtaininginformedconsent.AbloodsamplewasharvestedforsyphilisscreenedforsyphUisingbyusingrapidplasmareagenttest(RPR)andconfirmedbyTPHAforthosewhowereRPRpositive.Thewomenwithpregnantsyphilispositiveserologyweresystematicallyinterviewedtoobtain.Duringtheinterview,theirdemographicdetailsinformation,patternsofriskbehaviorsandotherdata.Datawerecollectedandwereanalyzedretrospectively.Results:AmongOf118,235pregnantwomensurveyed,555pregnantwomenwereconfirmedtohavesyphilis(prevalenceof4.69%),withaincidenceof4.69‰123womenwereexcludedfromtheanalysisbecauseofincompletemedicalrecords.Of432infectedsubjectswithcompletemedicalrecords,theaverageagewas26.8,witharangeof19to41.7.41%(32/432)ofthemsufferedfromprimarysyphilis,3.24%(14/432)wereofhadsecondarysyphilis,and89.35%(386/432)hadlatentsyphilis,withoutanyconspicuousclinicalsignsandsymptoms.Conclusions:Theprevalenceofsyphilisamongthepregnantwomeninourserieswashighandmostofthemwereasymptomatic.ScreeningforsyphilisamongpregnantwomeninShenzhenisofimportantceforthepreventionofmother-to-childtransmissionofsyphilis.

简介：AbstractTrauma during pregnancy deserves special attention because of its management objectives, i.e. wellbeing of both pregnant woman and foetus. Maxillofacial trauma directly affects the nutrition of foetus by interfering with the normal functions in a pregnant woman such as mouth opening, mastication and breathing. Hence early restitution of form and function of maxillofacial skeleton is essential. However, the gravid status is associated with numerous anatomical and physiological changes which present with clinical dilemma related to imaging and treatment. A careful scrutiny of the patient's systemic and gestational status is absolutely essential before, during and after instituting any interventional procedures. We present a case of bilateral condyle fracture in a 30-year-old pregnant woman in the third trimester (32 weeks). She was treated with inter maxillary fixation using orthodontic brackets & elastics. After successful restitution of occlusion, the patient was advised aggressive physiotherapy which ensured normal mouth opening. Two weeks later, the patient delivered uneventfully. The patient was followed up at one month and 3 month and demonstrated restitution of normal occlusion, mouth opening and lower facial height. This article aims at analyzing the contemporary principles in management of maxillofacial trauma in a pregnant woman and clarifying the common misconceptions.

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简介：AbstractBackground:It is still unclear if and to what extent antenatal or infant or childhood vitamin D supplementation would affect the development of allergy diseases later in life. This study aimed to review the efficacy of vitamin D supplementation in pregnant women, infants, or children for the prevention of allergies.Methods:MEDLINE (PubMed), EMBASE (OVID), and the Cochrane Central Register of Controlled Trials were searched up to March 1, 2020. We included only randomized controlled trials (RCTs). We performed a systematic review and meta-analysis for vitamin D supplementation in primary allergy prevention. These trials were assessed for risk of bias using the Cochrane Collaboration domains and the consensus was reached via discussion with the full study group. We descriptively summarized and quantitatively synthesized original data to evaluate vitamin D supplementation in primary allergy prevention by using Review Manager software for meta-analysis.Results:The search yielded 1251 studies. Seven RCTs were included in this analysis. A meta-analysis revealed that vitamin D supplementation for pregnant women or infants may not decrease the risk of developing allergic diseases, such as asthma or wheezing (supplementation for pregnant women, risk ratio [RR]: 1.01, 95% confidence interval [CI]: 0.81-1.26, P = 0.90, I2 = 47%; supplementation for infants, RR: 1.00, 95% CI: 0.70-1.43, P = 0.99, I2 = 0%; supplementation for pregnant women and infants, RR: 0.35, 95% CI: 0.10-1.25, P= 0.11), eczema (supplementation for pregnant women, RR: 0.95, 95% CI: 0.80-1.13, P= 0.77, I2= 0%; supplementation for infants, RR: 0.84, 95% CI: 0.64-1.11, P= 0.19, I2= 42%), allergic rhinitis (supplementation for pregnant women, RR: 0.93, 95% CI: 0.78-1.11, P = 0.15, I2 = 47%), lower respiratory tract infection (LRTI) (supplementation for pregnant women, RR: 0.97, 95% CI: 0.85-1.11, P = 0.59, I2 = 0%), or food allergy.Conclusions:Supplementation of vitamin D in pregnant women or infants does not have an effect on the primary prevention of allergic diseases.Systematic Review Registration:PROSPERO (CRD42020167747)

简介：AbstractThe management of preterm prelabor rupture of membranes (PPROM) before 34 weeks of gestation is intractable, due to pulmonary immaturity, many complications, poor pregnancy outcomes. In particular, the pre-viable PPROM (<23 weeks of gestation) is much more difficult to be treated. The clinical recommendation is to terminate the pregnancy as soon as possible. The pregnancy outcomes of PPROM in the early second-trimester of two twin pregnant women in our hospital were reported to explore the treatment protocols. The pregnancies of the two women developed PROM at 12 and 16 weeks of gestation, respectively. After expectant treatment, they were deliveried successfully at 34+6 and 34+4 weeks of gestation, respectively. The assessment of growth and development of infants was normal during the following six months after birth. Therefore, if PPROM occurs in the early second-trimester of pregnancy, the management of PPROM should be individualized, it’s a long process which should include comprehensive communication between patients and families regarding alternative treatment options (including expectant management) and risks and benefits of the procedure. In the absence of spontaneous labor or occurrence of complications that would prompt delivery (intra-amniotic infection, abruptio placenta, cord prolapse), and fetal status is normal, the patients should proceed with expectant treatment, induction of labor is commonly performed in pregnancies with PPROM ≥34 weeks of gestation.

简介：AbstractObjective:To determine the pregnancy and neonatal outcomes of women who recovered from coronavirus disease 2019 (COVID-19) that developed in early pregnancy.Methods:This case series analyzed five pregnant women (26-33 years) whom recovered from COVID-19 which were developed in early pregnancy (6-27 weeks) and admitted at the Wuhan Union Hospital from January 15, 2020 to April 30, 2020. The clinical manifestation, laboratory examinations, treatment, pregnancy outcomes, maternal and neonatal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) throat swab reverse transcription polymerase chain reaction test results, and SARS-CoV-2 antibody test results in neonates were reviewed. The placental pathology, placental angiotensin-converting enzyme 2 expression were studied by hematoxylin-eosin and immunohistochemistry staining, SARS-CoV-2 presence was examined by QT-PCR. We also followed up the infants at 3-6 months.Results:Three pregnant women were diagnosed with COVID-19 in early pregnancy (Cases 1-3), and two were serum immunoglobulin G positive asymptomatic cases (Cases 4 and 5). Cases 1-3 showed complete recovery after severe COVID-19. Case 3 was infected at 6 weeks of gestation during the first trimester and had induced medical abortion at 12 weeks of gestation. All neonates had no pneumonia, SARS-CoV-2 mRNA reverse transcription polymerase chain reaction and serum immunoglobulin M were negative, and immunoglobulin G were positive. All placental samples were negative for SARS-CoV-2 in the nucleic acid test. Placental pathology showed chronic ischemia changes. ACE-2 expressed in both placenta and decidua. The follow-up showed that the infants were healthy and asymptomatic at 3-6 months.Conclusion:No adverse outcomes was observed in our case series. However, systemic inflammatory responses to SARS-CoV-2 infection may cause placental injury. At the time of delivery after recovery from COVID-19, no SARS-CoV-2 positive results was found in the placenta in this case series.

简介：【摘要】目的：探究无创DNA产前检测（non-invasive prenatal testing，NIPT)在高龄孕妇胎儿非整倍体染色体疾病产前诊断中的临床应用价值，为高龄孕妇进行无创DNA临床应用提供依据。方法：收集2018年1月至2022年10月在我院自愿进行无创DNA产前检测的单胎高龄孕妇1183例，按年龄将孕妇分为35-39岁组(n=1100)与年龄≥40岁组(n=83)。采用NIPT高通量测序检测孕妇外周血中胎儿游离DNA。检测结果提示染色体高风险者行羊膜腔穿刺抽取羊水进行胎儿染色体核型分析。对检测结果提示低风险者通过电话随访进行验证。观察其胎儿染色体非整倍体疾病诊断。结果：1183例受检者NIPT检测结果提示，胎儿非整倍体染色体异常者12例，其中，21-三体5例，18-三体2例，13-三体1例，性染色体异常4例（2例47，XXX/XXY；1例47，XYY；1例45，XO）。NIPT检测在高龄孕妇中阳性率为1.01%(12/1183)。12例高风险孕妇其中自然流产1例，其余11例均做羊水穿刺，5例21-三体高风险均经羊水穿刺确诊，21-三体在高龄孕妇中的阳性预测值达到100%(5/5)，18-三体在高龄孕妇中的阳性预测值为50%(1/2)，1例13-三体经羊水穿刺排除，性染色体阳性预测值为50%(2/4)。35～39岁年龄组染色体异常高风险发生率为0.73%(8/1100)，年龄≥40岁组染色体异常高风险发生率为4.82%（4/83），两组比较，差异有统计学意义(P＜0.05﹚。结论：NIPT检测对高龄孕妇胎儿 21-三体、18-三体及性染色体符合率较高，可明显减少高龄孕妇介入性产前诊断，但对 13- 三体和性染色体数目减少的符合率偏低，NIPT检测异常的孕妇仍需行羊水穿刺确诊，避免不必要的流产。

简介：AbstractObjective:This study aimed at investigating the expression of nuclear factor kappa B (NF-κB) and mammalian target of rapamycin (mTOR) related signal pathways in liver tissues of intrahepatic cholestasis of pregnancy animal models.Methods:Estrogen (EE)-induced cholestasis and a placental ischemia-reperfusion (IR) model were established in pregnant rats. All pregnant rats were divided into four groups by random number table: EE-IR group (n= 6), EE-sham group (n = 6), control-IR group (n= 6) and control-sham group (n= 6). Liver expression of mTOR, its upstream regulator DNA damage response-1 (REDD1), and downstream factor glucose transporter type-1 (GLUT1), accompanied by NF-κB (p65 is the most important component), its activator toll-like receptor 4 (TLR4), and inhibitor IκBα, were detected by western blot analysis and real-time polymerase chain reaction. The intergroup comparisons were performed with a one-way analysis of variance, the comparisons among groups were analyzed with the nonparametric Kruskal-Wallis test.Results:Giving pregnant rats EE alone reduced the hepatic expression of IκBα (0.72 ± 0.20 vs. 1.01 ± 0.07, P= 0.008). Meanwhile, giving pregnant rats placental IR alone increased liver levels of REDD1 (3.24 ± 0.98 vs. 1.06 ± 0.24, P= 0.025), GLUT1 (2.37 ± 0.82 vs. 1.09 ± 0.10, P= 0.039), TLR4 (2.12 ± 0.29 vs. 1.20 ± 0.28, P= 0.010), and p65 (2.09 ± 0.85 vs. 1.04 ± 0.06, P= 0.023), and decreased hepatic mTOR (0.50 ± 0.07 vs. 1.01 ± 0.03, P= 0.001) and IκBα (0.61 ± 0.08 vs. 1.01 ± 0.07, P= 0.014) expression. Subjecting EE-treated rats to placental IR did not further alter liver levels of GLUT1 (2.02 ± 0.45 vs. 1.79 ± 0.39, P= 0.240), TLR4 (2.10 ± 0.74 vs. 1.60 ± 0.36, P= 0.129), or p65 (2.41 ± 0.83 vs. 1.65 ± 0.46, P= 0.145), whereas it did decrease hepatic mTOR (0.42 ± 0.09 vs. 0.90 ± 0.14, P= 0.008) and IκBα (0.43 ± 0.09 vs. 0.72 ± 0.20, P= 0.004) expression and enhance REDD1 expression (4.46 ± 0.65 vs. 2.05 ± 0.47, P= 0.009). Placental IR stress did impact the hepatic expression of REDD1-mTOR-GLUT1 and TLR4/NF-κB/IκBα in pregnant rats.Conclusion:Placental IR-induced hepatic GLUT1, TLR4, and p65 alternation, which responded efficiently in control rats, were impaired in EE-induced ICP rats.