Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the presen...Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the present study is to highlight the prevalence of physical coercion leading to pregnancy and the associated maternal-fetal complications. Methodology: This was a comparative descriptive and analytical cross-sectional study of complications associated with post-rape pregnancy by physical restraint among minors who were treated at the General Reference Hospital of Panzi over a two-year period from June 2020 to June 2022. A total of 140 minor survivors of violence with pregnancy were included in the study. Data were collected using a questionnaire, coded and analyzed in Excel and XLSTAT version 2014. Results: The prevalence of physical constraints was 65%. After mulltivariate analyses, denial of pregnancy (ORa: 9.64 95% CI: 1.1 - 81.2;p-value: 0.0370), attempted abortion (ORa: 56.1 95% CI: 1.5 - 2027.6;p-value: 0.0278) and agitation during delivery (ORa: 88.7 95% CI: 4.5 - 1715;p-value: 0.0030) were the complications associated with pregnancy in minors who experienced physical restraint rape. In addition, BMI was a factor in reducing the risk of physical restraint rape at the ORa of 0.5054 [0.3;0.8];p 0.006). Conclusion: Pregnancy among minors is a reality and occurs in a situation of physical coercion in the eastern Democratic Republic of Congo. These pregnancies are often associated with complications that require an intensive management system since they can jeopardize the maternal-fetal prognosis of minors.展开更多
As maternal deaths have decreased worldwide, increasing attention has been placed on the study of severe obstetric complications, such as hemorrhage, eclampsia, and obstructed labor, to identify where improvements can...As maternal deaths have decreased worldwide, increasing attention has been placed on the study of severe obstetric complications, such as hemorrhage, eclampsia, and obstructed labor, to identify where improvements can be made in maternal health. The objective of this study was to determine pregnancy complications and prenatal care among women aged 15 - 49 in Oğuzeli, Turkey, and to provide data for prevention in the field. This descriptive, cross-sectional study was conducted between February and May 2013 in Oğuzeli distinct, Turkey. The total women registered to family doctors in Oğuzeli was listed and, 470 women were selected using a stratified and simple random sampling technique. Pregnancy complications were asked for the last pregnancy of each women. Of the women, 23.9% (n = 109) declared that they experienced pregnancy complications during their pregnancies. The most frequent problems were anemia (11.1%) hypertension (3.7%) and diabetes mellitus (2.4%) respectively. Women having chronic diseases before their pregnancy were more likely to have pregnancy complications compared to healthy women (p = 0.005). The mean number of prenatal care among women having pregnancy complications was 5.47 ± 3.57, while it was 3.84 ± 3.00 among healthy women (p = 0.000). Women having chronic diseases should be handled carefully and, pregnancy should be delayed until the chronic disease’s remission. Family planning in primary care is the key measure to archive this. Early diagnosis of hypertension among young women is highly important for the women’s and infants’s health during pregnancy, and for the women’s future heath. During prenatal care, women should be trained about correct eating habits and activity.展开更多
Objective Uterine leiomyoma is not a rare pathological condition in pregnant women;thus the aim of the study was to evaluate the recent progress in the treatment of these pregnant women on the basis of the association...Objective Uterine leiomyoma is not a rare pathological condition in pregnant women;thus the aim of the study was to evaluate the recent progress in the treatment of these pregnant women on the basis of the association of leiomyoma in pregnancy (LP) with pregnancy complications and birth outcomes including structural birth defects, i.e. congenital abnormalities (CA) in the offspring. Design Cases with CA and matched controls without CA in the population-based Hungarian Case-Control Surveillan- ce System of Congenital Abnormalities (HCC SCA) were evaluated. Only women with prospectively and medically recorded LP in prenatal maternity logbook and medically recorded birth outcomes (gestational age, birth weight, CA) were included to the study. Setting the HCCSCA, 1980-1996 contained 22,843 cases with CA and 38,151 matched controls without CA. Population Hungarian pregnant women and their informative offspring: live births, stillbirths and prenatally diagnosed malformed fetuses. Methods Comparison of birth outcomes of ca- ses with matched controls and pregnancy com- plications of pregnant women with or without LP. Main outcome measures Pregnancy complications, mean gestational age at delivery and birth weight, rate of preterm birth, low birthweight, CA. Results A total of 34 (0.15%) cases had mothers with LP compared to 71 (0.19%) controls. There was a higher incidence of threatened abortion, placental disorders, mainly abruption placentae and anaemia in mothers with LP. There was no significantly higher rate of preterm birth in the newborns of women with LP but their mean birth weight was higher and it associated with a higher rate of large birthweight newborns. A higher risk of total CA was not found in cases born to mothers with LP (adjusted OR with 95% CI = 0.7, 0.5-1.1), the spe- cified groups of CAs were also assessed versus controls, but a higher occurrence of women with LP was not revealed in any CA group. Con- clusions Women with LP have a higher risk of threatened abortion, placental disorders and anaemia, but a higher rate of adverse birth outcomes including CAs was not found in their offspring.展开更多
BACKGROUND Nickel(Ni)may accumulate in the human body and has biological toxicity and carcinogenicity.Ni has an extensive impact on the health of pregnant women and fetuses during gestation.AIM To evaluate Ni exposure...BACKGROUND Nickel(Ni)may accumulate in the human body and has biological toxicity and carcinogenicity.Ni has an extensive impact on the health of pregnant women and fetuses during gestation.AIM To evaluate Ni exposure in pregnant women in Kunming,Yunnan Province,China;to describe the distribution of Ni in the maternal-fetal system and placental barrier function;and to investigate the effect of Ni exposure on fetal health in mothers with pregnancy complications.METHODS Seventy-two pregnant women were selected using a case-control design.The women were divided into two groups:The control group(no disease;n=29)and the disease group[gestational diabetes(GDM),hypertensive disorder complicating pregnancy(HDCP),or both;n=43].The pregnant women in the disease group were further divided as follows:14 cases with GDM(GDM group),13 cases with HDCP(HDCP group)and 16 cases with both GDM and HDCP(disease combination group).Basic information on the pregnant women was collected by questionnaire survey.Maternal blood,placenta blood and cord blood were collected immediately after delivery.The Ni content in paired samples was determined using inductively coupled plasma mass spectrometry.RESULTS Compared to the control group,age was higher and body mass index was greater in pregnant women in the disease groups(28.14±2.54 vs 28.42±13.89,P<0.05;25.90±3.86 vs 31.49±5.30,P<0.05).The birth weights of newborns in the HDCP group and the control group were significantly different(2.52±0.74 vs 3.18±0.41,P<0.05).The content of Ni in umbilical cord blood in the entire disease group was higher than that in the control group(0.10±0.16 vs 0.05±0.07,P<0.05).CONCLUSION In the maternal-fetal system of women with pregnancy complications,the barrier effect of the placenta against Ni is weakened,thus affecting healthy growth of the fetus in the uterus.展开更多
Objective:Some pregnancy complications are associated with respiratory problems in infants.Early identification and implementation of respiratory support are needed for these infants.This study aimed to(1)use lung ult...Objective:Some pregnancy complications are associated with respiratory problems in infants.Early identification and implementation of respiratory support are needed for these infants.This study aimed to(1)use lung ultrasound(LU)for predicting the respiratory support requirements of infants and(2)simplify the examination method to facilitate its clinical application.Methods:Neonates underwent LU examinations within 1 hour of birth.The infants were divided into a pregnancy complication(PC)group and a control group according to their mothers'clinical data.The primary outcome measure was the need for respiratory support.Predictive models were established based on the differences in LU patterns between the two groups.The predictive value of the models was compared with that of the LU score(LUS)system,which has been widely used in other studies.Simplified models were established by analyzing the predictive effects of LU patterns in different parts of the lungs.Predictive reliability was tested using the receiver operating characteristic curve analysis.Results:PC and control groups had 29 and 117 neonates,respectively;a total of 22 neonates required respiratory support.The PC and control groups showed differences in respiratory support requirements,A-lines,and coalesced B-lines.The percentages of A-lines and coalesced B-lines were associated with respiratory support requirements.The optimal cutoff values for the percentages of the A-lines and coalesced B-lines were 55.7%and 24.5%,respectively.Similar effects were obtained by calculating the percentage of coalesced B-lines in four areas(R3,R4,L3,and L4).These methods were judged as more visual and convenient than LUS assessment.conclusion:The percentages of A-line and coalesced B-lines on LU images can be used to predict the respiratory support needs of neonates whose mothers had pregnancy complications.Only four areas(R3,R4,L3,and L4)had similar predictive values.展开更多
BACKGROUND Around 1 million cases of medical termination of pregnancy(MTP)take place yearly in the United States of America with around 2 percent of this population developing complications.The cardiovascular(CVD)comp...BACKGROUND Around 1 million cases of medical termination of pregnancy(MTP)take place yearly in the United States of America with around 2 percent of this population developing complications.The cardiovascular(CVD)complications occurring post MTP or after stillbirth is not very well described.AIM To help the reader better understand,prepare,and manage these complications by reviewing various cardiac comorbidities seen after MTP.METHODS We performed a literature search in PubMed,Medline,RCA,and google scholar,using the search terms“abortions”or“medical/legal termination of pregnancy”and“cardiac complications”or“cardiovascular complications”.RESULTS The most common complications described in the literature following MTP were infective endocarditis(IE)(n=16),takotsubo cardiomyopathy(TTC)(n=7),arrhythmias(n=5),and sudden coronary artery dissection(SCAD)(n=4).The most common valve involved in IE was the tricuspid valve in 69%(n=10).The most observed causative organism was group B Streptococcus in 81%(n=12).The most common type of TTC was apical type in 57%(n=4).Out of five patients de veloping arrhythmia,bradycardia was the most common and was seen in 60%(3/5)of the patients.All four cases of SCAD-P type presented as acute coronary syndrome 10-14 d post termination of pregnancy with predominant involvement of the right coronary artery.Mortality was only reported following IE in 6.25%.Clinical recovery was reported consistently after optimal medical management following all these complications.CONCLUSION In conclusion,the occurrence of CVD complications following pregnancy termination is infrequently documented in the existing literature.In this review,the most common CVD complication following MTP was noted to be IE and TTC.展开更多
Pregnancy requires several changes in the body of the mother to successfully carry and deliver a child.Multiple alterations occur,including changes in cardiovascular system to meet the increased demands of the mother ...Pregnancy requires several changes in the body of the mother to successfully carry and deliver a child.Multiple alterations occur,including changes in cardiovascular system to meet the increased demands of the mother and placenta,the tilting of the hypercoagulable status to a more pro-coagulable state to prevent excessive blood loss post-delivery,and immunologic manipulations to protect the mother and fetus and decreasing the risk of a fatal immunologic response to the allogeneic fetus.These alterations are physiologically normal and expected,but can become pathologic when thresholds are crossed.Pregnancy may cause or exacerbate underlying retinal vascular diseases,a class of disorders compromised predominantly of retinal vein occlusion(RVO),retinal artery occlusion(RAO),central serous retinopathy(CSR),diabetic retinopathy,and hypertensive-related retinopathy,which includes pre-eclampsia,eclampsia,and hemolysis,elevated liver enzymes,and low platelets(HELLP)syndrome.The majority of the literature on retinal changes associated with pregnancy has focused on diabetic retinopathy,while the knowledge regarding the pathogenesis and treatment options of other pregnancy-related vascular diseases remains scarce.Understanding the implications pregnancy has on these rare,but severe,retinal vascular complications can help guide clinical management and potential treatment modalities.This paper aims to serve as a review of the retinal manifestations of diseases outside of diabetic retinopathy.展开更多
Decidualization is the differentiation of endometrial stromal cells into secretory decidual stromal cells.Human decidualization involves some amount of signaling molecules and pathways as well as genetic reprogramming...Decidualization is the differentiation of endometrial stromal cells into secretory decidual stromal cells.Human decidualization involves some amount of signaling molecules and pathways as well as genetic reprogramming,which is driven by the postovulatory rise in progesterone levels and local cyclic adenosine monophosphate production.Decidualization extends from the primary decidual zone to the secondary decidual zone,and then exits through apoptosis.Evidences support that decidual fibroblasts function as the pool of decidual stromal cells during pregnancy.Decidualization undergoes an acute inflammatory phase,an anti-inflammatory secretory phase to the final recession phase.The decidualization of the inner layer of endometrium,termed decidua,is the most critical determinant of pregnancy success,which can promote placenta formation,modulate immune tolerance,foster resistance to oxidative stress,sense embryo quality,and control labor.Failure to adequate decidualization in terms of hormones,biochemistry,and immunology leads to adverse pregnancy outcomes,including diseases such as preeclampsia,miscarriage,premature labor,repeated implantation failures,and some age-related decline in reproductive capacity.The development of animal models and in vitro culture systems combined with emerging technologies provides a powerful system to explore the mechanism of decidualization.However,decidualization is a dynamic,multi-step process,and translating of current research progress into disease predictions and interventions for pregnancy complications remains to be achieved.The study of periodic regeneration and spontaneous decidualization of the endometrium will be beneficial to the diagnosis and treatment of pregnancy diseases.展开更多
In recent years,immune checkpoint molecules have made breakthroughs in the fields of inducing graft tolerance,tumor immune escape and preventing autoimmunity.These immunoregulatory factors,when combined with ligand,ca...In recent years,immune checkpoint molecules have made breakthroughs in the fields of inducing graft tolerance,tumor immune escape and preventing autoimmunity.These immunoregulatory factors,when combined with ligand,can transduce the inhibitory signal into cells to negatively regulate the immune response,which brings new enlightenment for the immune research of pregnancy and pregnancy complications.In this review,we reviewed the immunomodulatory effects of CTLA-4,PD-1 and Tim-3 in pregnancy,in order to evaluate their potential effects in pregnancy,and to provide a new direction for the immunotherapy of pregnancy complications.展开更多
<strong>Introduction</strong><strong>: </strong><span style="font-family:""><span style="font-family:Verdana;">Maternal mortality remains a major public hea...<strong>Introduction</strong><strong>: </strong><span style="font-family:""><span style="font-family:Verdana;">Maternal mortality remains a major public health problem in </span><span style="font-family:Verdana;">the world. Complications during pregnancy and childbirth are the main</span><span style="font-family:Verdana;"> causes </span><span style="font-family:Verdana;">of maternal mortality in low-income countries. It is estimated that 15% of</span><span style="font-family:Verdana;"> deaths are related to these complications. Studies have shown that women </span><span style="font-family:Verdana;">have little or no acquaintance on sign danger and complications during</span><span style="font-family:Verdana;"> pregnancy and childbirth. Limited literature exists on women’s knowledge and attitudes about pregnancy and childbirth’s complications as well as the barriers for their management, therefore necessity to carry out this study. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To explore women’s knowledge and attitudes in the community about complications during pregnancy and childbirth. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">A qualitative study was conducted in three prefectures of Guinea. Eighteen focus groups were conducted with women of reproductive age living in urban and rural areas. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Complications during pregnancy and childbirth are common among </span><span style="font-family:Verdana;">pregnant women in Guinea. Many women have knowledge about various</span><span style="font-family:Verdana;"> sorts </span><span style="font-family:Verdana;">of complications related to pregnancy and childbirth. These complications </span><span style="font-family:Verdana;">were mostly vaginal bleeding, abortions and maternal mortality. The use of a health facility in case of complications during pregnancy and childbirth was reported as a major attitude in this study. Accompanying the woman to the </span><span style="font-family:Verdana;">health facility was another attitude identified. Lack of financial means, the</span><span style="font-family:Verdana;"> distance from the health facilities and the lack of means of transport were listed as barriers to the management of complications during pregnancy and childbirth. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This study showed that women’s knowledge and attitudes about obstetric complications are insufficient. To that effect, women counselling during prenatal consultations on the risks of complications and especially the identification of sign danger during pregnancy and childbirth is </span><span style="font-family:Verdana;">essential to reduce maternal and neonatal mortality in our less equipped </span><span style="font-family:Verdana;">countries.</span></span>展开更多
Background: Hypertension is the leading cause of cardiovascular disease worldwide. Hypertensive disorders in pregnancy also constitute a major global health threat. There are different types of hypertension that can o...Background: Hypertension is the leading cause of cardiovascular disease worldwide. Hypertensive disorders in pregnancy also constitute a major global health threat. There are different types of hypertension that can occur during pregnancy;with different mechanisms and consequences for mother and fetus. Objectives: To determine the frequency of hypertension (hypertension) during pregnancy. Document the risk factors for pregnancy-related hypertension. Review the material and fetal complications which determine the prognosis. Methods and Patients: This was a retrospective cross-sectional study from January 1 to June 30, 2022 in the Obstetrics and Gynecology Department of the Brazzaville Hospital and University Center. We noted 72 cases of hypertension among 1188 births admitted during the reference period. Hypertension was defined as blood pressure 40/90mmHg. Results: Hypertension was observed in 6% of those giving birth. The average age of the patients was 28 ± 8 years (range 15 to 39 years). The age group of 15 to 34 years was the most affected, 56 cases (778%). The risk factors were young age (15 - 34 years), late transfer of women in labor, 49 cases (68%). Primiparity, 33 cases (45.8%), absence of prenatal consultation, 7 cases (9.7%), hypertension, 8 cases (11%), twinning, 4 cases (5%), fetal macrosomia, one case (1.3%). Maternal complications recorded were: 21 cases of eclampsia (29%), 6 cases of left ventricular failure (8.3%), 5 cases of anemia (6.9%), 2 cases of retroplacental hematoma (2.8%), 1 case of HELLP syndrome, as much renal failure. Fetal and neonatal complications were 23 cases of prematurity (32%), 10 cases of acute fetal distress (14%), 4 cases of hypotrophy (5.6%). Eleven cases of death (15.3%) were: 3 in utero. B in the neonatal period.展开更多
文摘Introduction: Pregnancy resulting from rape is a public health and sexual and reproductive health issue, especially among minors. Rape can be perpetrated with or without physical restraint. The objective of the present study is to highlight the prevalence of physical coercion leading to pregnancy and the associated maternal-fetal complications. Methodology: This was a comparative descriptive and analytical cross-sectional study of complications associated with post-rape pregnancy by physical restraint among minors who were treated at the General Reference Hospital of Panzi over a two-year period from June 2020 to June 2022. A total of 140 minor survivors of violence with pregnancy were included in the study. Data were collected using a questionnaire, coded and analyzed in Excel and XLSTAT version 2014. Results: The prevalence of physical constraints was 65%. After mulltivariate analyses, denial of pregnancy (ORa: 9.64 95% CI: 1.1 - 81.2;p-value: 0.0370), attempted abortion (ORa: 56.1 95% CI: 1.5 - 2027.6;p-value: 0.0278) and agitation during delivery (ORa: 88.7 95% CI: 4.5 - 1715;p-value: 0.0030) were the complications associated with pregnancy in minors who experienced physical restraint rape. In addition, BMI was a factor in reducing the risk of physical restraint rape at the ORa of 0.5054 [0.3;0.8];p 0.006). Conclusion: Pregnancy among minors is a reality and occurs in a situation of physical coercion in the eastern Democratic Republic of Congo. These pregnancies are often associated with complications that require an intensive management system since they can jeopardize the maternal-fetal prognosis of minors.
文摘As maternal deaths have decreased worldwide, increasing attention has been placed on the study of severe obstetric complications, such as hemorrhage, eclampsia, and obstructed labor, to identify where improvements can be made in maternal health. The objective of this study was to determine pregnancy complications and prenatal care among women aged 15 - 49 in Oğuzeli, Turkey, and to provide data for prevention in the field. This descriptive, cross-sectional study was conducted between February and May 2013 in Oğuzeli distinct, Turkey. The total women registered to family doctors in Oğuzeli was listed and, 470 women were selected using a stratified and simple random sampling technique. Pregnancy complications were asked for the last pregnancy of each women. Of the women, 23.9% (n = 109) declared that they experienced pregnancy complications during their pregnancies. The most frequent problems were anemia (11.1%) hypertension (3.7%) and diabetes mellitus (2.4%) respectively. Women having chronic diseases before their pregnancy were more likely to have pregnancy complications compared to healthy women (p = 0.005). The mean number of prenatal care among women having pregnancy complications was 5.47 ± 3.57, while it was 3.84 ± 3.00 among healthy women (p = 0.000). Women having chronic diseases should be handled carefully and, pregnancy should be delayed until the chronic disease’s remission. Family planning in primary care is the key measure to archive this. Early diagnosis of hypertension among young women is highly important for the women’s and infants’s health during pregnancy, and for the women’s future heath. During prenatal care, women should be trained about correct eating habits and activity.
文摘Objective Uterine leiomyoma is not a rare pathological condition in pregnant women;thus the aim of the study was to evaluate the recent progress in the treatment of these pregnant women on the basis of the association of leiomyoma in pregnancy (LP) with pregnancy complications and birth outcomes including structural birth defects, i.e. congenital abnormalities (CA) in the offspring. Design Cases with CA and matched controls without CA in the population-based Hungarian Case-Control Surveillan- ce System of Congenital Abnormalities (HCC SCA) were evaluated. Only women with prospectively and medically recorded LP in prenatal maternity logbook and medically recorded birth outcomes (gestational age, birth weight, CA) were included to the study. Setting the HCCSCA, 1980-1996 contained 22,843 cases with CA and 38,151 matched controls without CA. Population Hungarian pregnant women and their informative offspring: live births, stillbirths and prenatally diagnosed malformed fetuses. Methods Comparison of birth outcomes of ca- ses with matched controls and pregnancy com- plications of pregnant women with or without LP. Main outcome measures Pregnancy complications, mean gestational age at delivery and birth weight, rate of preterm birth, low birthweight, CA. Results A total of 34 (0.15%) cases had mothers with LP compared to 71 (0.19%) controls. There was a higher incidence of threatened abortion, placental disorders, mainly abruption placentae and anaemia in mothers with LP. There was no significantly higher rate of preterm birth in the newborns of women with LP but their mean birth weight was higher and it associated with a higher rate of large birthweight newborns. A higher risk of total CA was not found in cases born to mothers with LP (adjusted OR with 95% CI = 0.7, 0.5-1.1), the spe- cified groups of CAs were also assessed versus controls, but a higher occurrence of women with LP was not revealed in any CA group. Con- clusions Women with LP have a higher risk of threatened abortion, placental disorders and anaemia, but a higher rate of adverse birth outcomes including CAs was not found in their offspring.
基金Yunnan Provincial Health Committee Senior Talent Project,No.L-2018006 and No.H-2018045International Science and Technology Cooperation Special Key Research and Development Plan,No.2017IB004and Academician Expert Workstation of Yunnan Province,No.202005AF150033.
文摘BACKGROUND Nickel(Ni)may accumulate in the human body and has biological toxicity and carcinogenicity.Ni has an extensive impact on the health of pregnant women and fetuses during gestation.AIM To evaluate Ni exposure in pregnant women in Kunming,Yunnan Province,China;to describe the distribution of Ni in the maternal-fetal system and placental barrier function;and to investigate the effect of Ni exposure on fetal health in mothers with pregnancy complications.METHODS Seventy-two pregnant women were selected using a case-control design.The women were divided into two groups:The control group(no disease;n=29)and the disease group[gestational diabetes(GDM),hypertensive disorder complicating pregnancy(HDCP),or both;n=43].The pregnant women in the disease group were further divided as follows:14 cases with GDM(GDM group),13 cases with HDCP(HDCP group)and 16 cases with both GDM and HDCP(disease combination group).Basic information on the pregnant women was collected by questionnaire survey.Maternal blood,placenta blood and cord blood were collected immediately after delivery.The Ni content in paired samples was determined using inductively coupled plasma mass spectrometry.RESULTS Compared to the control group,age was higher and body mass index was greater in pregnant women in the disease groups(28.14±2.54 vs 28.42±13.89,P<0.05;25.90±3.86 vs 31.49±5.30,P<0.05).The birth weights of newborns in the HDCP group and the control group were significantly different(2.52±0.74 vs 3.18±0.41,P<0.05).The content of Ni in umbilical cord blood in the entire disease group was higher than that in the control group(0.10±0.16 vs 0.05±0.07,P<0.05).CONCLUSION In the maternal-fetal system of women with pregnancy complications,the barrier effect of the placenta against Ni is weakened,thus affecting healthy growth of the fetus in the uterus.
基金supported by the Shanghai Municipal Health Commission(202040402)。
文摘Objective:Some pregnancy complications are associated with respiratory problems in infants.Early identification and implementation of respiratory support are needed for these infants.This study aimed to(1)use lung ultrasound(LU)for predicting the respiratory support requirements of infants and(2)simplify the examination method to facilitate its clinical application.Methods:Neonates underwent LU examinations within 1 hour of birth.The infants were divided into a pregnancy complication(PC)group and a control group according to their mothers'clinical data.The primary outcome measure was the need for respiratory support.Predictive models were established based on the differences in LU patterns between the two groups.The predictive value of the models was compared with that of the LU score(LUS)system,which has been widely used in other studies.Simplified models were established by analyzing the predictive effects of LU patterns in different parts of the lungs.Predictive reliability was tested using the receiver operating characteristic curve analysis.Results:PC and control groups had 29 and 117 neonates,respectively;a total of 22 neonates required respiratory support.The PC and control groups showed differences in respiratory support requirements,A-lines,and coalesced B-lines.The percentages of A-lines and coalesced B-lines were associated with respiratory support requirements.The optimal cutoff values for the percentages of the A-lines and coalesced B-lines were 55.7%and 24.5%,respectively.Similar effects were obtained by calculating the percentage of coalesced B-lines in four areas(R3,R4,L3,and L4).These methods were judged as more visual and convenient than LUS assessment.conclusion:The percentages of A-line and coalesced B-lines on LU images can be used to predict the respiratory support needs of neonates whose mothers had pregnancy complications.Only four areas(R3,R4,L3,and L4)had similar predictive values.
文摘BACKGROUND Around 1 million cases of medical termination of pregnancy(MTP)take place yearly in the United States of America with around 2 percent of this population developing complications.The cardiovascular(CVD)complications occurring post MTP or after stillbirth is not very well described.AIM To help the reader better understand,prepare,and manage these complications by reviewing various cardiac comorbidities seen after MTP.METHODS We performed a literature search in PubMed,Medline,RCA,and google scholar,using the search terms“abortions”or“medical/legal termination of pregnancy”and“cardiac complications”or“cardiovascular complications”.RESULTS The most common complications described in the literature following MTP were infective endocarditis(IE)(n=16),takotsubo cardiomyopathy(TTC)(n=7),arrhythmias(n=5),and sudden coronary artery dissection(SCAD)(n=4).The most common valve involved in IE was the tricuspid valve in 69%(n=10).The most observed causative organism was group B Streptococcus in 81%(n=12).The most common type of TTC was apical type in 57%(n=4).Out of five patients de veloping arrhythmia,bradycardia was the most common and was seen in 60%(3/5)of the patients.All four cases of SCAD-P type presented as acute coronary syndrome 10-14 d post termination of pregnancy with predominant involvement of the right coronary artery.Mortality was only reported following IE in 6.25%.Clinical recovery was reported consistently after optimal medical management following all these complications.CONCLUSION In conclusion,the occurrence of CVD complications following pregnancy termination is infrequently documented in the existing literature.In this review,the most common CVD complication following MTP was noted to be IE and TTC.
文摘Pregnancy requires several changes in the body of the mother to successfully carry and deliver a child.Multiple alterations occur,including changes in cardiovascular system to meet the increased demands of the mother and placenta,the tilting of the hypercoagulable status to a more pro-coagulable state to prevent excessive blood loss post-delivery,and immunologic manipulations to protect the mother and fetus and decreasing the risk of a fatal immunologic response to the allogeneic fetus.These alterations are physiologically normal and expected,but can become pathologic when thresholds are crossed.Pregnancy may cause or exacerbate underlying retinal vascular diseases,a class of disorders compromised predominantly of retinal vein occlusion(RVO),retinal artery occlusion(RAO),central serous retinopathy(CSR),diabetic retinopathy,and hypertensive-related retinopathy,which includes pre-eclampsia,eclampsia,and hemolysis,elevated liver enzymes,and low platelets(HELLP)syndrome.The majority of the literature on retinal changes associated with pregnancy has focused on diabetic retinopathy,while the knowledge regarding the pathogenesis and treatment options of other pregnancy-related vascular diseases remains scarce.Understanding the implications pregnancy has on these rare,but severe,retinal vascular complications can help guide clinical management and potential treatment modalities.This paper aims to serve as a review of the retinal manifestations of diseases outside of diabetic retinopathy.
基金supported by the National Key R&D Program of China(2019YFA0802600)the National Natural Science Foundation of China(32170863,31871512,and 31671199)to C.Z.Support was also received from grants from the Shanghai Commission of Science and Technology(17DZ2271100)Open Project of Shandong Provincial Key Laboratory of Reproductive Medicine(SDKL2017018).
文摘Decidualization is the differentiation of endometrial stromal cells into secretory decidual stromal cells.Human decidualization involves some amount of signaling molecules and pathways as well as genetic reprogramming,which is driven by the postovulatory rise in progesterone levels and local cyclic adenosine monophosphate production.Decidualization extends from the primary decidual zone to the secondary decidual zone,and then exits through apoptosis.Evidences support that decidual fibroblasts function as the pool of decidual stromal cells during pregnancy.Decidualization undergoes an acute inflammatory phase,an anti-inflammatory secretory phase to the final recession phase.The decidualization of the inner layer of endometrium,termed decidua,is the most critical determinant of pregnancy success,which can promote placenta formation,modulate immune tolerance,foster resistance to oxidative stress,sense embryo quality,and control labor.Failure to adequate decidualization in terms of hormones,biochemistry,and immunology leads to adverse pregnancy outcomes,including diseases such as preeclampsia,miscarriage,premature labor,repeated implantation failures,and some age-related decline in reproductive capacity.The development of animal models and in vitro culture systems combined with emerging technologies provides a powerful system to explore the mechanism of decidualization.However,decidualization is a dynamic,multi-step process,and translating of current research progress into disease predictions and interventions for pregnancy complications remains to be achieved.The study of periodic regeneration and spontaneous decidualization of the endometrium will be beneficial to the diagnosis and treatment of pregnancy diseases.
基金National Natural Science Foundation of China(No.81974577)。
文摘In recent years,immune checkpoint molecules have made breakthroughs in the fields of inducing graft tolerance,tumor immune escape and preventing autoimmunity.These immunoregulatory factors,when combined with ligand,can transduce the inhibitory signal into cells to negatively regulate the immune response,which brings new enlightenment for the immune research of pregnancy and pregnancy complications.In this review,we reviewed the immunomodulatory effects of CTLA-4,PD-1 and Tim-3 in pregnancy,in order to evaluate their potential effects in pregnancy,and to provide a new direction for the immunotherapy of pregnancy complications.
文摘<strong>Introduction</strong><strong>: </strong><span style="font-family:""><span style="font-family:Verdana;">Maternal mortality remains a major public health problem in </span><span style="font-family:Verdana;">the world. Complications during pregnancy and childbirth are the main</span><span style="font-family:Verdana;"> causes </span><span style="font-family:Verdana;">of maternal mortality in low-income countries. It is estimated that 15% of</span><span style="font-family:Verdana;"> deaths are related to these complications. Studies have shown that women </span><span style="font-family:Verdana;">have little or no acquaintance on sign danger and complications during</span><span style="font-family:Verdana;"> pregnancy and childbirth. Limited literature exists on women’s knowledge and attitudes about pregnancy and childbirth’s complications as well as the barriers for their management, therefore necessity to carry out this study. </span><b><span style="font-family:Verdana;">Objective: </span></b><span style="font-family:Verdana;">To explore women’s knowledge and attitudes in the community about complications during pregnancy and childbirth. </span><b><span style="font-family:Verdana;">Method: </span></b><span style="font-family:Verdana;">A qualitative study was conducted in three prefectures of Guinea. Eighteen focus groups were conducted with women of reproductive age living in urban and rural areas. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">Complications during pregnancy and childbirth are common among </span><span style="font-family:Verdana;">pregnant women in Guinea. Many women have knowledge about various</span><span style="font-family:Verdana;"> sorts </span><span style="font-family:Verdana;">of complications related to pregnancy and childbirth. These complications </span><span style="font-family:Verdana;">were mostly vaginal bleeding, abortions and maternal mortality. The use of a health facility in case of complications during pregnancy and childbirth was reported as a major attitude in this study. Accompanying the woman to the </span><span style="font-family:Verdana;">health facility was another attitude identified. Lack of financial means, the</span><span style="font-family:Verdana;"> distance from the health facilities and the lack of means of transport were listed as barriers to the management of complications during pregnancy and childbirth. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> This study showed that women’s knowledge and attitudes about obstetric complications are insufficient. To that effect, women counselling during prenatal consultations on the risks of complications and especially the identification of sign danger during pregnancy and childbirth is </span><span style="font-family:Verdana;">essential to reduce maternal and neonatal mortality in our less equipped </span><span style="font-family:Verdana;">countries.</span></span>
文摘Background: Hypertension is the leading cause of cardiovascular disease worldwide. Hypertensive disorders in pregnancy also constitute a major global health threat. There are different types of hypertension that can occur during pregnancy;with different mechanisms and consequences for mother and fetus. Objectives: To determine the frequency of hypertension (hypertension) during pregnancy. Document the risk factors for pregnancy-related hypertension. Review the material and fetal complications which determine the prognosis. Methods and Patients: This was a retrospective cross-sectional study from January 1 to June 30, 2022 in the Obstetrics and Gynecology Department of the Brazzaville Hospital and University Center. We noted 72 cases of hypertension among 1188 births admitted during the reference period. Hypertension was defined as blood pressure 40/90mmHg. Results: Hypertension was observed in 6% of those giving birth. The average age of the patients was 28 ± 8 years (range 15 to 39 years). The age group of 15 to 34 years was the most affected, 56 cases (778%). The risk factors were young age (15 - 34 years), late transfer of women in labor, 49 cases (68%). Primiparity, 33 cases (45.8%), absence of prenatal consultation, 7 cases (9.7%), hypertension, 8 cases (11%), twinning, 4 cases (5%), fetal macrosomia, one case (1.3%). Maternal complications recorded were: 21 cases of eclampsia (29%), 6 cases of left ventricular failure (8.3%), 5 cases of anemia (6.9%), 2 cases of retroplacental hematoma (2.8%), 1 case of HELLP syndrome, as much renal failure. Fetal and neonatal complications were 23 cases of prematurity (32%), 10 cases of acute fetal distress (14%), 4 cases of hypotrophy (5.6%). Eleven cases of death (15.3%) were: 3 in utero. B in the neonatal period.