Reference Interval of Thyroidal Function of Women in the Early,Middle and Late Pregnancy in Jingzhou City,Hubei Province

[Objectives]To study the reference value of thyroid function in healthy women of childbearing age during different pregnancies(early,middle and late pregnancy)in Jingzhou City.[Methods]362 healthy women of childbearing age during different pregnancies(early,middle and late pregnancy)were selected as the study group,and 360 non-pregnant women were selected as the control group.Serum thyroid hormone levels in the two groups were detected,and the reference value was expressed as the median(M)and 95%confidence interval(CI).On this basis,the chart of changing trend of thyroid hormone in the early,middle and late pregnancy were plotted.[Results]Compared with the control group,FT3,TT4,TT3,FT4and TSH in the early,middle and late pregnancy were significantly different in the study group(P<0.05).In the study group,there were significant differences in the early,middle and late pregnancy(P<0.05).[Conclusions]This trend chart has certain reference value in the screening,diagnosis and treatment of thyroid diseases in healthy women of childbearing age during different pregnancies(early,middle and late pregnancy)in Jingzhou City of Hubei Province.

Comparative Study on Clinical Characteristics and Outcomes of Overt Diabetes Mellitus and Gestational Diabetes Mellitus in Late Pregnancy

Background: With the rising prevalence in recent years, gestational diabetes mellitus has become one of the leading causes of maternal and child mortality and morbidity worldwide and has raised health concern. It is seriously detrimental to both the women and fetuses. However, there are limited evidences of two types of gestational diabetes mellitus on clinical characteristics and outcomes. Therefore, this study was aimed to explore the clinical characteristics and outcomes of patients with overt diabetes mellitus (ODM) and gestational diabetes mellitus (GDM) at the late pregnancy. Methods: From January 2015 to August 2016, totally 63 gestational diabetes mellitus from the Department of Clinical Nutrition in Beijing Anzhen Hospital were enrolled in the study. Patients were classified into two groups. 31 patients with gestational overt diabetes mellitus were grouped into ODM group and 32 patients with gestational diabetes mellitus were grouped into GDM group. Clinical characteristics and outcomes were compared between ODM and GDM. We collected records of the age, gestational week, family history, past history, pregnancy complications, insulin use, blood pressure, clinical nutrition indexes, blood pressure. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), total protein (TP), albumin (ALB), prealbumin (PALB), hemoglobin (HGB), urea nitrogen (BUN), serum creatinine (CREA), and dynamic blood glucose monitoring were measured. And we recorded the changes of blood glucose and the test data. We statistically analyzed the data of two groups. Results: In the ODM group, HbA1c, FBG, average blood glucose, two-hour postprandial blood glucose (2hPBG) after breakfast, 2hPBG after dinner, the number of hyperglycemic events and high blood glucose time ratio are significantly higher than those of GDM and two groups compared with statistical significance (P < 0.05). The number of patients treated with insulin (10/31) in ODM is significantly more than that in GDM (1/32) (P < 0.05). 45% (14/31) of ODM have a family history of diabetes patients. The ratio is significantly higher than 13% (4/32) of GDM (P < 0.05). There was significant difference in urinary ketone positive rate between the two groups (P < 0.05), but there was no significant difference in urinary microalbumin abnormal rate between them (P > 0.05). The number of preeclampsia in ODM (8/31) is significantly higher than that of GDM (P < 0.05). The level of HGB in ODM is lower than that of GDM (P < 0.05). There was no difference in the pregnancy outcomes between the two groups. Conclusion: Late pregnancy women with ODM have obvious family history, higher HbA1c, higher FBG, higher glucose levels of two-hours after breakfast and dinner, higher average blood glucose, longer hypoglycemia time, higher probability of hyperglycemic events and greater opportunity to use insulin in the treatment of symptomatic patients, higher risk of preeclampsia, lower HGB level than GDM, while GDM has higher positive rate of urine ketone than ODM.

Clinical Study on the Relationship between the HCG Levels during the Late Pregnancy and the Delivery Mechanism

Objective： The relationship between the HCG levels during the late pregnancy and the delivery mechanism was discussed. Method： If the HCG levels during the late pregnancy were related to the delivery mechanism was studied by using the β -HCG changes of 100 women pregnant for 36 weeks, 37 weeks, 38 weeks, 39 weeks, 40 weeks, and 41 weeks, and also the [3 -HCG changes when their uterine orifice was opened for 3cm near the time of labor as the clinical data. All these cases were found to suffer no clinical complications. Result： The difference in HCG changes during the late pregnancy was of no statistical significance （P〉0.05）. Conclusion： The β-HCG levels change during the late pregnancy is not significantly correlated with the labor onset time, and the labor onset time is unpredictable with the monitoring of the HCG levels change during the late pregnancy.

Influence of oligohydramnios on late pregnancy outcome

Oligohydramnios of late pregnancy is an extremely important signal of a life threatening to the fetus, which severely affect the prognosis of perinatal and makes perinatal mortality rate 5 times higher. [1].As one of the conditions that should be prevented in late pregnany, timely discovery and treatment of oligohydramnios can significantly reduce the perinatal mortality rate and improve the quality ofperinatal [2] We will make a summary on the influence of oligohydramnios in late pregnancy outcome in this article. Normally, amniotic fluid volume increases with the passes of gestational week and the volumes increases to about 800ml during late pregnancy to full-term pregnancy.We call it oligohydramnios when if the volume is less than 300m1.[3].

Effect and Safety of Iron Supplementation on Mild Thalassemia Complicated by Iron Deficiency in Late Pregnancy

Aim:To study the clinical effect and safety of iron supplementation in the treatment of mild thalassemia complicated by iron deficiency in late pregnancy.Methods:376 patients with mild thalassemia complicated by iron deficiency in late pregnancy treated in our hospital from July 2019 to June 2021 were selected and recruited in the research group,and 200 normal pregnant women treated in the same period were selected and recruited in the control group.Hemoglobin(Hb),reticulocyte blood,red blood protein(RET he)level,ferritin(SF)level,soluble transferrin receptor(sTfR)level,adverse maternal and infant outcomes,etc.were analyzed.Results:There was no significant difference in the levels of SF,Hb,RET he and sTfR between the two groups before treatment.After treatment,the levels of SF,Hb,RET he and sTfR in the research group were significantly improved,which was statistically significant compared with the control group.The frequencies of intrapartum hemorrhage,premature delivery,stillbirth,hemorrhagic shock,and neonatal asphyxia in the research group were 289±47.88,36(9.57%),0(0.00%),25(6.65%),and 6(1.26%),respectively.The frequencies of intrapartum hemorrhage,premature delivery,stillbirth,hemorrhagic shock,and neonatal asphyxia in the control group were 284±46.99,7(3.50%),0(0.00%),6(3.00%),and 0(0.00%),respectively.There were significant differences in preterm delivery and hemorrhagic shock,and there was no significant difference in other delivery outcomes.Conclusions:Under the premise of strictly controlling the iron reserve in pregnant women,continuous medication until the end of delivery may be conducive to the control of maternal thalassemia complicated by iron deficiency and the improvement of pregnancy outcome.

Effect of hormonal status and metabolic changes of restricted ewes during late pregnancy on their fetal growth and development

This study investigated the effects of hormonal status; metabolic changes of restricted ewes during late pregnancy on the ovine fetus growth; development. One hundred Mongolian ewes, synchronized for oestrus; mated, were divided into three groups; offered 0.175 MJME·kgw[0.75]·d[1] (Restricted Group 1, RG1), 0.33 MJME·kgw[0.75]·d[1] (Restricted Group 2, RG2); ad libitum access to feed (Control Group, CG) during their late pregnancy respectively. The results suggested that with the supply of exogenous energy decreasing during late pregnancy, maternal body weight; net body weight loss in RG2; RG1 were lower than those of CG (Ps0.01). The insulin; IGF-1 concentrations of ewes in RG2; RG1 tended to be lower than those of CG (P】0.05), but the GH concentrations in RG2; RG1 were enhanced; there was significant difference between RG1; CG on d 120 of gestation (P【0.05). The glucose concentration of ewes in RG2; RG1 was decreased throughout the feed restriction period,; the differences were observed between RG1; CG on d 120 of gestation (P【0.05). In addition, the nonesterified fatty acid (NEFA); total amino acid (TAA) concentrations of ewes in RG2 tended to increase, but there was no significant difference (P】0.05). However, the NEFA; FAA concentrations of ewes in RG1 were reduced from d 90 to d 120 of gestation, then enhanced from d 120 to d 140 of gestation. During the late pregnancy, with the supply of nutrition decreasing, the negatively physiological; biochemical maternal reactions to restriction became worse, which significantly reduced the average lamb birth weight; daily growth rate of fetus in RG2 (P【0.05); RG1 (P【0.01).

Effect of maternal lipid profile,C-peptide,insulin,and HBA1c levels during late pregnancy on large-for-gestational age newborns

Background:Large-for-gestational age(LGA)newborns can increase the risk of metabolic syndrome.Previous studies have shown that the levels of maternal blood lipids,connecting peptide(C-peptide),insulin and glycosylated hemoglobin(HbA_(1c))were significantly different between LGA and appropriate-for-gestational age(AGA)newborns.This study aimed to determine the effect of the levels of maternal lipids,C-peptide,insulin,and HbA_(1c) during late pregnancy on LGA newborns.Methods:This study comprised 2790 non-diabetic women in late pregnancy.Among their newborns,2236(80.1%)newborns were AGA,and 554(19.9%)newborns were LGA.Maternal and neonatal characteristics were obtained from questionnaires and their case records.The levels of maternal fasting serum apolipoprotein A1(ApoA1),triglyceride(TG),total cholesterol(TC),high-density lipoprotein cholesterol(HDL-C),low-density lipoprotein cholesterol(LDL-C),C-peptide,insulin and blood HbA_(1c) were measured.The chi-square and Mann-Whitney U test were used to analyze categorical variables and continuous variables between the AGA and LGA groups,respectively.Binary logistic regression analysis was made to determine the independent risk factors for LGA newborns.Results:Maternal TG,C-peptide,insulin and HbA_(1c) levels were signifi cantly higher in the LGA group than in the AGA group(P<0.05).The LGA group had signifi cantly lower levels of maternal TC,HDL-C and LDL-C than the AGA group(P<0.05).After adjustment for confounding variables,including maternal age,pre-pregnancy body mass index,education,smoking,annual household income,amniotic fluid volume,gestational hypertension,newborn gender and gestational age at blood collection,high maternal TG levels remained signifi cantly associated with LGA newborns(P<0.05).Conclusion:High maternal TG level during late pregnancy is signifi cantly associated with LGA newborns.

Relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine fetal distress

BACKGROUND By comprehensively analyzing the blood flow parameters of the umbilical and middle cerebral arteries,doctors can more accurately identify fetal intrauterine distress,as well as assess its severity,so that timely interventions can be implemented to safeguard the health and safety of the fetus.AIM To identify the relationship between ultrasound parameters of the umbilical and middle cerebral arteries and intrauterine distress.METHODS Clinical data of pregnant women admitted between January 2021 and January 2023 were collected and divided into the observation and control groups(n=50 each),according to the presence or absence of intrauterine distress.The ultrasound hemodynamic parameters of the uterine artery(UtA),fetal middle cerebral artery(MCA),and umbilical artery(UmA)were compared with neonatal outcomes and occurrence of intrauterine distress in the two groups.RESULTS Comparison of ultrasonic hemodynamic parameters,resistance index(RI),pulsatility index(PI),and systolic maximal blood flow velocity of UmA compared to diastolic blood flow velocity(S/D),revealed higher values of fetal MCA,PI,and S/D of UmA in pregnant women with UtA compared to controls(P<0.05),while there was no difference between the two groups in terms of RI(P<0.05)The incidence of a neonatal Apgar score of 8-10 points was lower in the observation group(66.7%)than in the control group(90.0%),and neonatal weight(2675.5±27.6 g)was lower than in the control group(3117.5±31.2 g).Further,cesarean section rate was higher in the observation group(70.0%)than in the control group(11.7%),and preterm labor rate was higher in the observation group(40.0%)than in the control group(10.0%).The incidence of fetal distress,neonatal growth restriction and neonatal asphyxia were also higher in the observation group(all P<0.05).CONCLUSION Fetal MCA,UmA,and maternal UtA hemodynamic abnormalities all develop in pregnant women with intrauterine distress during late pregnancy,which suggests that clinical attention should be paid to them,and monitoring should be strengthened to provide guidance for clinical intervention.

研究凝血四项和血小板相关指标检测在妊娠期高血压妊娠晚期的临床应用价值

目的探讨凝血四项和血小板相关指标的检测水平变化在妊娠期高血压(GH)妊娠晚期的应用价值。方法选择我院2014年3月~2016年3月收治的78例GH孕妇(GH组)和75例正常妊娠孕妇(正常对照组)作为研究对象,均为妊娠晚期(孕期30~40周),检测并比较两组孕妇凝血四项指标:血浆凝血酶原时间(PT)﹑活化部分凝血活酶时间(aPTT)﹑凝血酶时间(TT)及纤维蛋白原(Fbg)和血小板相关指标:血小板计数(PLT)、平均血小板体积(MPV)和血小板分布宽度(PDW)。结果 GH组孕妇的PT、aPTT和TT检测水平均明显低于正常对照组,差异有统计学意义(P<0.05),Fbg检测水平高于正常对照组(P<0.05);GH组孕妇MPV检测水平明显高于正常对照组,差异有统计学意义(P<0.05),PLT和PDW检测水平比较,差异无统计学意义(P>0.05)。结论 GH妊娠晚期孕妇机体处于明显高凝状态,应加强其凝血功能和血小板相关指标的常规检测,有利于GH的病情评估,对防治血栓等并发症具有参考意义。

Perioperative nursing of multidisciplinary emergency surgery for a late-term pregnancy with acute Stanford type A aortic dissection

To summarize a case of late pregnancy complicated with acute Stanford type A aortic dissection who underwent multidisciplinary treatment perioperative nursing experience in emergency surgery. The patient was 37weeks of intrauterine pregnancy and suffered from sudden chest pain. The emergency admission was diagnosed with aortic dissection(Stanford A type), and the condition was dangerous and life-threatening. After preoperative multidisciplinary combined systematic comprehensive disease assessment and comprehensive surgical emergency plan was formulated, do a good job of effective psychological counseling and operation cooperation education,nursing cooperation during intraoperative anesthesia and nursing focus of multidisciplinary combined surgical treatment, postoperative prevention of massive bleeding, puerperium infection and a series of effective nursing measures, no perioperative period occurred nursing complications. The newborn survived, the patient recovered and was discharged from the hospital, and returned to the hospital for re-examination with normal indicators and good physical condition.