Perimortem caesarean section: A case report of an out-of-hospital arrest pregnant woman

Dear editor, In July 2015, a 39-year-old gravida 2, para 0 lady at 35 weeks＇ gestation was found collapsed at home and sent to the emergency department （ED） by ambulance. She had a background of chronic hypertension on anti- hypertensives and aspirin, but repeatedly refused in- patient treatment for her uncontrolled hypertension. She had received pre-hospital cardiopulmonary resuscitation （CPR） for 17 minutes en route to the ED.

Hemorrhagic Valsalva Retinopathy in a Pregnant Woman

Valsalva retinopathy is caused by a sudden increase in intra-thoracic or abdominal pressure, following forced expiration, with mouth and nose closed (Valsalva maneuver). We report a case of Valsalva retinopathy in a pregnant woman. A 36 years old patient, pregnant at 24 weeks of amenorrhea, who consulted for sudden visual acuity decrease of the left eye, evolving since 24 hours after Valsalva maneuvers to calm down her panic and control her breathing. The refraction has demonstrated a decrease of visual acuity in the left eye to “can see a hand moving”, while the visual acuity remained normal in the right eye. Spontaneous evolution was marked by a fast and progressive reduction of hemorrhage and progressive recovery of vision in the left eye. Valsava retinopathy was first described in 1972 by Thomas Duane. Physical activity is usually found before it occurs. Many situations are usually associated to this occurrence among which: pregnancy, vomiting, weightlifting or trauma. Regression of this hemorrhage without sequelae is usual. But sometimes, we need a Nd:Yag laser treatment or surgery to evacuate the blood.

Circadian Rhythms of Physiological Functions of the Pregnant Woman and the Fetus and the Biological Solemnity Thereof

The basic rhythms of nature that left their imprint on the existence of all living organism on the Earth, arose under the influence of the Earth’s rotation relative to the Sun, the Moon and other planets and stars of the Universe. This periodicity gave rise to the rhythm that has become essential for their life. Life is a continual chemical process of building up and breaking down of organic substances, which results from the substance exchange between an organism and the environment. This makes it impossible for a living organism to exist without the external environment. Since 1978-1979 we have been carrying out a task-oriented research with the aim to approximate the moment when we are able to answer all these questions. Daily fluctuations of cardiac and motor activity of the fetus have been studied (uninterrupted daily recording of fetal ECG);polysomnography of nocturnal sleep was recorded;daily fluctuations of endocrine system activity in the pregnant were studied. A correlation was made between the functional state of maternal sleep-wakefulness biological rhythm, biological clock of the human fetus and the “light-darkness” cycle of a 24-hour solar day. In the process of the study we have developed an original method of day-to-day analysis of maternal and fetal ECGs. It has been established that a healthy fetus has distinct, diurnal variations of physiological functions. The fetal biorhythms coordinate with the status of the maternal organism being, however, in an opposite phase. The curve of the dynamics of fetal physiological system functioning shows a biphasic nature (one-phase in adults). “Active” and “quiet” (sleep-like) periods have been singled out in the human fetus. No reaction is observed in “quiet” periods. However, the “zero”-type fetal reaction recorded by us within the period from 2 p.m. to 9 p.m. does not indicate unsatisfactory condition of the fetus but rather is suggestive of a definite reduction of functional levels of the fetal physiological systems, which is necessary for vital activity. Although conventionally recognized as an indicator of poor state of the fetus, this type only calls for precise attention when recorded in fetal “active” hours. The present study has been the first in the world’s medicine and biorhythmology to detect and establish the daily rhythms of cardiac and motor activity in the human fetus.

Retroperitoneal Extraskeletal Osteosarcoma in a Pregnant Woman Incidentally Found on Cesarean Section

Extraskeletal osteosarcoma (ESO) is a rare malignant mesenchymal neoplasm accounting for 1% - 2% of all soft tissue sarcomas that produce osteoid, bone, and/or chondroid material. Here we report the first case of a retroperitoneal ESO in a 35-year-old pregnant woman. A retroperitoneal ESO was incidentally found at cesarean section. Despite treatment, she rapidly died from wide spread dissemination. We focus on histological characteristics including immunohistochemical results and differential diagnosis of ESO.

Y Specific Sequence Gene Analysis of Single Fetal Nucleated Erythroblasts from the Peripheral Blood of Pregnant Women

The single cell isolation technique was used to detect fetal nucleated erythroblasts at a single cell level from the peripheral blood of pregnant women in order to investigate the feasibility of this method for noninvasive prenatal diagnosis. Single fetal nucleated erythroblasts were isolated from the peripheral blood samples from 51 pregnant women by micromanipulation techniques after density gradient centrifugation. Nested polymerase chain reaction method was used to amplify the SRY gene. It was found that the concordance rate of amplification results with real fetal sex was 82.61 %. The sensitivity and specificity were 80 % and 87.50 % respectively. It was suggested that it is feasible and promising in non invasive prenatal diagnosis to detect fetal nucleated erythroblasts at a single cell level by using micromanipulation techniques.

HIV-1 Viral Load and CD4 Assessment in HIV-1 Infected Pregnant Women Supported as Part of PMTCT in N’Djamena, Chad

In Sub-Saharan Africa, HIV affects lots of women of childbearing age;without prevention they can transmit the virus to their child. A cross-sectional study was conducted in the center of Psycho Medico-Social Support (APMS) in N’Djamena, Chad from January 2014 to March 2015. Our sampling concerned HIV-1 infected pregnant women followed up for PMTCT and their newborn. CD4+ lymphocytes and HIV-1 viral load were tested respectively with PIMATM and Abbott m2000 Real Time in mothers. Early infant diagnosis of HIV-1 was done in Children using PCR tool (Abbott m2000 Real Time). Pregnant women included in the study had a median age of 25 years (IQR, 22 - 30 years). Most of them (75.6%) (34/45), were under combination ART (TDF + 3TC or FTC + EFV). The median duration on ART was 4 month (IQR [3 - 5 months]). Nevirapine syrup was administrated to newborns as prophylaxis at least for the first six weeks of life until EID was done. At ART initiation, mothers’ LTCD4+ median was 249 cells/mm3 (IQR: 95 - 674 cells/mm3). After a median duration of 4 months on ART, LTCD4+ median was 530 cells/mm3 (IQR [263 - 1220 cells/mm3]). Viral load assessment in mothers showed that 15.5% (7/45) were undetectable, 75.6% (34/45) were detectable with a VL < 3log copies/ml and 8.8% (4/45) at virologic failure (VL > 3log copies/ ml). Four (11.4%) of 35 children included were tested positive at EID for HIV-1. Antiretroviral treatment management in pregnant women can improve their health and reduce the risk of MTCT. Availability of virologic monitoring in routine is essential for pregnant women in resources limited setting for preventing HIV transmission to their new-born and keep them alive.

Healthy neonate born to a SARS-CoV-2 infected woman:A case report and review of literature

BACKGROUND Severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)is a newly discovered coronavirus that has generated a worldwide outbreak of infections.Many people with coronavirus disease-2019(COVID-19)have developed severe illness,and a significant number have died.However,little is known regarding infection by the novel virus in pregnant women.We herein present a case of COVID-19 confirmed in a woman delivering a neonate who was negative for SARS-CoV-2 and related it to a review of the literature on pregnant women and human coronavirus infections.CASE SUMMARY The patient was a 36-year-old pregnant woman in her third trimester who had developed progressive clinical symptoms when she was confirmed as infected with SARS-CoV-2.Given the potential risks for both the pregnant woman and the fetus,an emergency cesarean section was performed,and the baby and his mother were separately quarantined and cared for.As a result,the baby currently shows no signs of SARS-CoV-2 infection(his lower respiratory tract samples were negative for the virus),while the mother completely recovered from COVID-19.CONCLUSION Although we presented a single case,the successful result is of great significance for pregnant women with SARS-CoV-2 infection and with respect to fully understanding novel coronavirus pneumonia.

Clinical significance of the detection of Rh blood group antigens and irregular antibodies in pregnant women with a second pregnancy

Objective:To investigate the phenotype distribution of five antigens of Rh blood group system and the specificity of Rh blood group irregular antibodies in pregnant women with second child.To analyze the relationship between Rh blood group antibody and hemolytic disease of the newborn(HDN)in second-child pregnant women,and to provide laboratory basis for the diagnosis and treatment of hemolytic disease of the newborn(Rh-HDN).Methods:500 pregnant women with second child were collected as the study group and 500 pregnant women with first pregnancy as the control group(all pregnant women underwent obstetric examination in the integrated obsteric clinic of our hospital from January 2020 to January 2021).To detectethe Rh blood group antigens(D,C,c,E,e)of the two groups of samples,screene the irregular antibodies,identify the specificity of irregular antibodies,determine the titer and record the hemolytic disease of the newborn of pregnant women with positive Rh blood group antibodies.Results:There were 11 Rh phenotypes in the pregnant women with second child in the study group:CCDee(152cases,30.4%),CcDEe(136cases,27.2%)CcDee(84cases,16.8%),ccDEE(30cases,6%),ccDee(31cases,6.2%),CCDEe(14cases,2.8%),ccDEe(9cases,1.8%),cc dee(18cases,3.6%),CCDEE(2cases,0.4%),CcdEe(12cases,2.4%),Ccdee(6cases,1.2%),CCd ee(6cases,1.2%).A total of 42 cases(8.4%)in the pregnant women with second child were negative for RhD.There were 10 Rh phenotypes in the pregnant women with first pregnancy in the control group:CCDee(144cases,28.8%),CcDEe(138cases,27.6%),CcDee(90cases,18%),ccDEE(42cases,8.4%),ccDee(28cases,5.6%),CCDEe(10cases,2%),ccDEe(8cases,1.6%),cc dee(19cases,3.8%),CCDEE(1cases,0.2%),CcdEe(11cases,2.2%),Ccdee(9cases,1.8%).A total of 39 cases(7.8%)in the pregnant women with first pregnancy were negative for RhD.In the pregnant women with second child in the study group,the positive rate of irregular antibody screening was 4.0%(20/500),and the specificity of Rh blood group antibodies was found as follows:anti-E 1.8%(9/500),anti-D 1.4%(7/500),anti-C 0.4%(2/500)and anti-Ec 0.4%(2/500).The positive rate of irregular antibody screening in the pregnant women with first pregnancy in the control group was 0,and the difference between the two groups was statistically significant(P<0.05).Rh-HDN was found in 10 newborns(2%)of the 20 women with positive irregular antibodies in the pregnant women with second child,and the antibody titer during pregnancy was more than 32.No Rh-HDN occurred in newborns in the pregnant women with first pregnancy,and the difference between the two groups was statistically significant(P<0.05).Conclusion:Pregnancy stimulation can increase the probability of irregular antibodies in pregnant women,and irregular antibodies in Rh blood group can easily cause Rh-HDN,so attention should be paid to routine detection of five antigens of Rh blood group and irregular antibody screening during prenatal examination.It is helpful for the early detection of Rh-blood irregular antibodies and the assessment of fetal or neonatal risk of Rh-HDN.

基于互联网平台的5A护理模式在妊娠糖尿病患者中的应用效果

目的探究基于互联网平台的5A护理模式在妊娠糖尿病(GDM)患者中的应用效果。方法选取2019年7月至2022年2月在滨州市中心医院进行产检的115例GDM患者进行前瞻性研究,采用随机数字表法将其分为对照组和研究组。对照组58例,年龄22~33岁,予以临床常规护理干预;研究组57例,年龄22~35岁,予以常规护理增加基于互联网平台的5A护理模式干预。比较两组患者血糖[空腹血糖(FBG)、糖化血红蛋白(HbA1c)]控制情况、自我效能感[糖尿病管理自我效能量表(DMSES)、一般自我效能感量表(GSES)]、心理状态[妊娠相关焦虑量表(PAQ)、焦虑自评量表(SAS)、抑郁自评量表(SDS)]、自我管理能力[改良版糖尿病自我管理行为量表(SDSCA)]及妊娠结局情况。统计学方法采用t检验、χ^(2)检验。结果护理后,研究组FBG、HbA1c水平均低于对照组[(5.11±1.02)mmol/L比(5.62±1.12)mmol/L、(5.21±1.04)%比(5.74±1.15)%],差异均有统计学意义(t=2.55、2.59,均P<0.05);研究组DMSES、GSES评分均高于对照组[(168.47±18.72)分比(154.32±17.15)分、(35.27±3.92)分比(31.48±3.51)分],差异均有统计学意义(t=4.23、5.46,均P<0.05);研究组PAQ、SAS、SDS评分均低于对照组[(18.51±3.70)分比(21.42±4.28)分、(41.32±6.88)分比(45.51±7.58)分、(42.33±7.05)分比(45.62±7.61)分],差异均有统计学意义(t=3.90、3.10、2.40,均P<0.05);研究组SDSCA中饮食、运动、血糖监测、足部护理评分均高于对照组[(22.15±3.69)分比(20.41±3.40)分、(10.87±2.17)分比(9.43±1.89)分、(11.12±2.22)分比(10.21±2.04)分、(11.45±2.29)分比(10.31±2.06)分],差异均有统计学意义(t=2.63、3.80、2.29、2.81,均P<0.05)。研究组羊水过多、巨大儿发生率均低于对照组[5.26%(3/57)比18.97%(11/58)、7.02%(4/57)比24.13%(14/58)],差异均有统计学意义(χ^(2)=5.05、6.38,均P<0.05)。结论对GDM患者应用基于互联网平台的5A护理模式干预,孕期血糖水平得到明显控制,且自我效能感、心理状态及自我管理能力均有改善,有较好妊娠结局。

济宁地区孕产妇人体寄生虫病防治知识的调查与分析

目的 了解济宁地区孕产妇对相关人体寄生虫病防控知识的知晓情况,加强健康教育促进优生优育。方法 针对2023年7—10月来济宁医学院附属医院就诊的20岁以上孕/产妇发放统一设计的调查问卷,采用Excel 2019软件建立数据库,分别计算1胎孕/产妇、2胎孕/产妇、3胎孕/产妇对问卷的知晓情况;采用SPSS 26.0软件对来自不同地区、年龄段、文化程度以及职业的孕产妇进行统计分析,差异采用χ^(2)检验进行比较。结果 参与调查的有效孕产妇人数为630人,总体正确率为74.79%,各类孕产妇的综合正确率由高到低分别为3胎孕/产妇(83.22%)、2胎孕/产妇(76.57%)、1胎孕产妇(74.69%),不同地区、年龄段、文化程度以及职业等变量的差异具有统计学意义(χ^(2)=19.791,16.455,40.040,42.074,P均<0.01)。结论 济宁地区孕产妇对人体寄生虫病防治知识的知晓率欠佳,且不同人群变量之间差异较大,今后应加强济宁地区孕产妇对人体寄生虫病健康意识,普及优生优育防治知识。

羊膜腔穿刺介入性产前诊断孕妇决策前体验的质性研究

目的 探讨羊膜腔穿刺(amniocentesis, AC)介入性产前诊断孕妇决策前的真实体验,为制订针对性的干预措施提供依据。方法 2022年3-8月,采用目的抽样法对13例AC孕妇进行半结构式访谈,采用Colaizzi 7步分析法进行归纳、提炼主题。结果 AC孕妇决策前的体验可归纳为4个主题,即:术前的心理反应;迫切寻求信息支持;手术决择前面临困扰和社会支持发挥重要作用。结论 医护人员应关注AC孕妇决策前的体验和需求,探索有效的干预措施,促进其做出理性决策。

盐酸利托君联合硫酸镁对高龄二胎先兆流产患者免疫调节功能、性激素水平及母婴结局的影响

目的探讨盐酸利托君联合硫酸镁对高龄二胎产妇先兆流产的治疗效果,并分析其可能的作用机制。方法选取2020年3月至2021年12月河北省邯郸市妇幼保健院产三科就诊的100例高龄二胎先兆流产患者,按照随机数字表法均分为对照组和观察组,每组50例。对照组在一般干预措施(卧床休息,给予间歇性吸氧、营养摄入及心理护理等)基础上采用硫酸镁治疗;观察组在一般干预措施基础上采用盐酸利托君联合硫酸镁治疗。比较2组治疗效果,治疗前后免疫调节功能指标[血清封闭抗体(BA)和抗心磷脂抗体(ACA)]、性激素[孕酮(P)、雌二醇(E2)、β-人绒毛膜促性腺激素(β-h CG)]、相关细胞因子[妊娠相关蛋白A(PAPP-A)、人类白细胞抗原G(HLA-G)、白细胞介素-10(IL-10)]水平、母婴结局及不良反应。结果观察组总有效率高于对照组(96%vs.80%,P<0.05)。与治疗前比较,2组治疗后血清BA阳性率显著升高,ACA阳性率显著下降(均P<0.05);而治疗后观察组血清BA阳性率高于对照组,ACA阳性率低于对照组(均P<0.05)。与治疗前比较,2组治疗结束时、治疗后2周血清P、E2、β-hCG、PAPP-A、HLA-G、IL-10水平均显著升高;治疗结束和治疗后2周性激素和相关细胞因子水平观察组均高于对照组(均P<0.05)。观察组保胎成功、足月分娩、自然分娩比例均高于对照组;而流产、早产、剖宫产、新生儿不良结局发生率均低于对照组(均P<0.05)。2组不良反应发生率比较差异无统计学意义(P<0.05)。结论盐酸利托君联合硫酸镁治疗高龄二胎产妇先兆流产效果显著,能改善母体免疫调节功能,调节性激素及PAPP-A、HLA-G、IL-10水平,减少不良母婴结局且不增加不良反应。

孕妇子宫动脉及胎儿大脑中动脉、肾动脉血流参数预测高龄孕妇胎儿宫内窘迫的价值

目的探讨孕妇子宫动脉(UtA)及胎儿大脑中动脉(MAC)、肾动脉(RA)血流参数预测高龄孕妇胎儿宫内窘迫的价值。方法选取2021年3月至2023年6月在河北北方学院附属第一医院建档、产检并住院分娩的高龄孕妇163例作为研究对象,其中符合胎儿宫内窘迫的孕妇43例为研究组,正常分娩的孕妇120例为对照组,应用脉冲多普勒技术获取孕妇UtA、胎儿MAC、胎儿RA频谱图,测量血流参数:收缩期峰值血流速度/舒张末期血流速度(S/D)、搏动指数(PI)、阻力指数(RI),比较2组上述动脉各血流参数。结果2组间孕妇年龄、孕周差异无统计学意义(P>0.05)。与对照组比较,研究组孕妇UtA的S/D、PI、RI均增高(P<0.05);研究组胎儿MAC的S/D、PI、RI均减低(P<0.05);研究组胎儿RA的S/D、PI、RI均增高(P<0.05);研究组胎儿RA和胎儿MAC的S/D、PI、RI比值均增高(P<0.05)。研究组胎儿RA和胎儿MAC的S/D、PI、RI比值与孕妇UtA的S/D、PI、RI均呈正相关(P<0.05)。结论孕妇UtA、胎儿MAC、胎儿RA血流参数相互补充,可以作为预测高龄孕妇胎儿宫内窘迫发生与否的重要监测指标。

从循证医学角度探讨妊娠期头颈部癌症的治疗策略

虽然妊娠期合并恶性肿瘤较为罕见,但随着女性妊娠期年龄的增大、头颈部癌症(head and neck cancer,HNC)患者的年轻化,妊娠期合并HNC的发病率略有增加。然而,目前临床尚缺乏关于妊娠期HNC的规范化诊疗标准。本研究通过系统检索PubMed数据库,评估孕妇(含围产期)患HNC的频率、肿瘤类型、相关因素和特异性生物标志物,并依据循证医学证据,对妊娠期合并HNC的研究进行综述,以期为临床工作提供指导。

关键节点追踪干预对唐筛临界、高风险孕妇实施进一步检测依从性的影响

目的:探讨关键节点追踪干预对唐氏综合征血清学筛查临界、高风险孕妇出生缺陷二级预防措施实施依从性和对产前门诊服务质量满意度的影响。方法:采用便利抽样历史对照的方法,将某医院2020年1月至2020年12月接受检测的173例孕妇设为对照组,将2021年1月至2021年12月接受检测的165例孕妇设为干预组。对照组孕妇接受常规管理方法,干预组接受关键节点追踪干预方法。比较两组孕妇实施产前筛查与诊断技术依从性情况和对产前门诊服务质量满意度情况。结果:两组孕妇检测依从性比较,干预组的临界、高风险孕妇检测实施依从性均高于对照组(χ^(2)=14.449,P<0.001;χ^(2)=4.696,P<0.05);干预组对产前门诊服务质量的满意度高于对照组(χ^(2)=12.736,P<0.05)。结论:关键节点追踪干预可以有效提高唐氏综合征血清学筛查临界、高风险孕妇进一步检测实施依从性和提高孕妇对产前门诊服务质量的满意度。

SWE定量评估孕妇胆汁淤积综合征的临床价值

目的 探讨实时剪切波弹性成像(SWE)定量评估孕妇胆汁淤积综合征(CS)的临床价值。方法 选择本院就诊的CS孕妇121例(CS组)及正常孕妇115例(对照组)。比较两组一般资料及胆汁酸、谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素水平;ROC分析SWE对孕妇胆汁淤积综合征的诊断效能。结果 CS组孕周、肝脏弹性值、胆汁酸、谷丙转氨酶、谷草转氨酶、总胆红素、直接胆红素均高于对照组(P<0.05)。控制了年龄、孕周、谷丙转氨酶、谷草转氨酶、总胆红素及直接胆红素之后,肝脏弹性值每增大1 kPa,CS风险增加7.966倍。肝脏弹性值诊断CS的ROC下面积为0.910(0.873,0.946),最佳分界点为肝脏弹性值6.44 kPa,此时的灵敏度和特异度分别为75.7%和96.7%,约登指数为0.724。结论 实时剪切波弹性成像能够在早期准确、无创评估孕妇胆汁淤积综合征的肝脏情况,对CS的早期诊断、治疗和干预有较高的临床价值。

孕妇身体活动影响因素问卷的编制及信度效度检验

目的 :编制基于社会生态学模型的孕妇身体活动影响因素问卷,并检验该问卷的信度和效度,以期促进孕妇身体活动。方法 :以社会生态学模型为理论指导,通过文献回顾、半结构化访谈、专家函询、预调查等形成问卷初稿。分别于2022年8月—9月、10月—12月采用便利抽样法分别选取广州市某三级甲等医院产科门诊的250名和300名孕妇作为调查对象,对问卷进行探索性和验证性因子分析。结果 :孕妇身体活动影响因素问卷共包括3个维度、31个条目。2轮专家函询的积极系数为100.0%,权威系数为0.895,肯德尔和谐系数为0.117~0.496(P<0.05)。探索性因子分析的结果共提取3个公因子,累计方差贡献率为61.4%;验证性因子分析的结果显示,构建的孕妇身体活动影响因素的因子结构模型拟合良好。总问卷的Cronbach’s α系数为0.932,折半信度为0.667,重测信度为0.886,问卷条目内容效度为0.87~1.00,问卷平均内容效度为0.99。结论 :本研究编制的孕妇身体活动影响因素问卷信度、效度良好,是评估孕妇身体活动影响因素的可靠工具。

子痫前期孕妇血清miR-424、miR-31-5p水平与胎儿生长受限的相关性分析

目的探究子痫前期孕妇血清微小RNA-424(miR-424)、微小RNA-31-5p(miR-31-5p)水平与胎儿生长受限(FGR)的相关性。方法选取2019年9月至2022年9月该院收治的122例子痫前期孕妇作为研究对象,根据是否发生FGR分为FGR组(62例)与非FGR组(60例)。采用实时荧光定量聚合酶链反应检测血清miR-424、miR-31-5p的相对表达水平。采用Pearson相关分析子痫前期患者血清miR-424、miR-31-5p表达水平与尿酸、胎儿双顶径、胎儿股骨长度的关系。绘制受试者工作特征(ROC)曲线分析血清miR-424、miR-31-5p单独及联合检测对子痫前期孕妇发生FGR的诊断价值。采用多因素Logistic回归分析子痫前期孕妇发生FGR的影响因素。结果FGR组尿酸水平明显高于非FGR组,胎儿双顶径、胎儿股骨长度均明显低于非FGR组,差异均有统计学意义(P<0.05)。FGR组血清miR-424、miR-31-5p表达水平均明显高于非FGR组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,子痫前期患者血清miR-424、miR-31-5p表达水平与尿酸水平均呈正相关(P<0.05),与胎儿双顶径、胎儿股骨长度均呈负相关(P<0.05)。ROC曲线分析结果显示,血清miR-424、miR-31-5p联合诊断FGR的曲线下面积(AUC)高于各指标单独诊断的AUC(Z_(miR-424 vs.miR-424+miR-31-5p)=2.500,P=0.012;Z_(miR-31-5p vs.miR-424+miR-31-5p)=3.521,P<0.001)。多因素Logistic回归分析结果显示,血清miR-424高表达、miR-31-5p高表达是子痫前期孕妇发生FGR的危险因素(P<0.05)。结论子痫前期发生FGR孕妇血清miR-424、miR-31-5p表达水平明显升高,二者联合诊断FGR发生的效能较单一指标高。

孕妇产时跌倒风险评估单的研制及信效度检验

目的研制孕妇产时跌倒风险评估单,并检验其信效度。方法通过文献回顾收集并建立初级指标条目;通过对孕妇进行认知性访谈深入优化各级指标条目;通过德尔菲专家函询对条目进行筛选、修改和补充,形成孕妇产时跌倒风险评估单;采用便利抽样法对200名产妇进行测评,检验孕妇住院期间跌倒风险评估单的信度和效度。结果孕妇产时跌倒风险评估表的重测信度为0.925,评定者间信度为0.926(>0.7),KMO值为0.801(>0.6)且P<0.05具有统计学意义,均在可以接受的范围内。结论该研究研制的孕妇产时跌倒风险评估单具有较好的信度及效度,能有效筛选出存在跌倒风险的孕妇,并及时采取相对应的预防措施,以期降低孕妇产时跌倒发生率。

益生菌发酵乳对乙肝孕妇孕期常规健康指标的影响

慢性乙型肝炎疾病进展影响母婴健康。探讨摄入益生菌发酵乳对乙肝孕妇孕期便秘、血生化及血、尿常规的影响。纳入24-38岁之间,孕8-12周的志愿者,慢性乙肝孕妇11例为乙肝实验组,健康孕妇10例为健康实验组,10例健康孕妇为对照组进行队列跟踪研究。乙肝实验组和健康实验组志愿者每日摄入一瓶200 mL益生菌发酵乳,对照组志愿者每日摄入一瓶200 mL普通酸奶(不含有益生菌),均持续饮用16周。干预后乙肝组平均血红蛋白浓度水平上升,组间比较差异有统计学意义(P<0.05)。对照组红细胞计数上升,组间比较差异有统计学意义(P<0.05)。乙肝孕妇孕期补充益生菌发酵乳影响常规生化及健康指标,具有改善肝功能的潜在可能,可在临床中进行进一步探究。