According to the theories of institutional economics and development economics,the positive and negative externality of rural labor force flowing from central and western regions and into eastern regions of China were...According to the theories of institutional economics and development economics,the positive and negative externality of rural labor force flowing from central and western regions and into eastern regions of China were analyzed,and then it was proposed that it is necessary to positive externality,rather than take"household register"measures to solve the problem simply.展开更多
Any non-cephalic presentation in a fetus is regarded as malpresentation.The most common malpresentation,breech,contributes to 3%-5%of term pregnancies and is a leading indication for cesarean delivery.Identification o...Any non-cephalic presentation in a fetus is regarded as malpresentation.The most common malpresentation,breech,contributes to 3%-5%of term pregnancies and is a leading indication for cesarean delivery.Identification of risk factors and a proper physical examination are beneficial;however,ultrasound is the gold standard for the diagnosis of malpresentations.External cephalic version(ECV)refers to a procedure aimed to convert a non-cephalic presenting fetus to cephalic presentation.This procedure is performed manually through the mother’s abdomen by a trained health care provider,to reduce the likelihood of a cesarean section.Studies have reported a version success rate of above 50%by ECV.The main objective of this review is to present a broad perspective on fetal malpresentation,ECV,and delivery of a breech fetus.The focus is to elaborate all clinical scenarios of breech and to provide an evidence-based clinical approach for them.After discussing breech prevalence,risk factors,diagnosis,and management,an updated review of ECV is presented.Moreover,ECV indications/contraindications,alternatives,clinical techniques on how to perform ECV and breech vaginal delivery,and obstetrical considerations for the delivery of malpresentations are thoroughly discussed.展开更多
Preterm labor(before 37 weeks’gestation)is the leading cause of neonatal mortality and morbidity,which can be divided into iatrogenic preterm labor,infectious preterm labor,and spontaneous preterm labor(sPTL).Up to n...Preterm labor(before 37 weeks’gestation)is the leading cause of neonatal mortality and morbidity,which can be divided into iatrogenic preterm labor,infectious preterm labor,and spontaneous preterm labor(sPTL).Up to now,there continue to be great difficulties in prediction and prevention of sPTL,owing to multiple risk factors,pathogenesis,and pathologic processes contributing to the event,which have not been fully clarified.Pregnancy maintenance and parturition is a complicated process with continuous maternal-fetal dialogue,in which both maternal and fetal factors participate and affect the outcome of pregnancy,including sPTL.Besides,external factors can also participate in sPTL,individually or through the interaction with internal factors.In this article,we summarize recent studies regarding sPTL from our and other groups,and discuss the risk factors and pathogenesis of preterm birth from both external and internal(maternal and fetal)aspects,so as to provide theoretical evidences for the diagnosis,prevention,and treatment of sPTL in the future.展开更多
文摘According to the theories of institutional economics and development economics,the positive and negative externality of rural labor force flowing from central and western regions and into eastern regions of China were analyzed,and then it was proposed that it is necessary to positive externality,rather than take"household register"measures to solve the problem simply.
文摘Any non-cephalic presentation in a fetus is regarded as malpresentation.The most common malpresentation,breech,contributes to 3%-5%of term pregnancies and is a leading indication for cesarean delivery.Identification of risk factors and a proper physical examination are beneficial;however,ultrasound is the gold standard for the diagnosis of malpresentations.External cephalic version(ECV)refers to a procedure aimed to convert a non-cephalic presenting fetus to cephalic presentation.This procedure is performed manually through the mother’s abdomen by a trained health care provider,to reduce the likelihood of a cesarean section.Studies have reported a version success rate of above 50%by ECV.The main objective of this review is to present a broad perspective on fetal malpresentation,ECV,and delivery of a breech fetus.The focus is to elaborate all clinical scenarios of breech and to provide an evidence-based clinical approach for them.After discussing breech prevalence,risk factors,diagnosis,and management,an updated review of ECV is presented.Moreover,ECV indications/contraindications,alternatives,clinical techniques on how to perform ECV and breech vaginal delivery,and obstetrical considerations for the delivery of malpresentations are thoroughly discussed.
基金supported by National Key Research and Development Project No.2019YFC1005203National Natural Science Foundation of China No.81771608 and 82120108011+2 种基金Major Project of Shanghai Municipal Education Commission’s Scientific Research and Innovation Plan No.2021-01-07-00-07-E00144“Dawn”Program of Shanghai Education Commission No.17SG36The Program for Professor of Special Appointment(Eastern Scholar)at Shanghai Institutions of Higher Learning.
文摘Preterm labor(before 37 weeks’gestation)is the leading cause of neonatal mortality and morbidity,which can be divided into iatrogenic preterm labor,infectious preterm labor,and spontaneous preterm labor(sPTL).Up to now,there continue to be great difficulties in prediction and prevention of sPTL,owing to multiple risk factors,pathogenesis,and pathologic processes contributing to the event,which have not been fully clarified.Pregnancy maintenance and parturition is a complicated process with continuous maternal-fetal dialogue,in which both maternal and fetal factors participate and affect the outcome of pregnancy,including sPTL.Besides,external factors can also participate in sPTL,individually or through the interaction with internal factors.In this article,we summarize recent studies regarding sPTL from our and other groups,and discuss the risk factors and pathogenesis of preterm birth from both external and internal(maternal and fetal)aspects,so as to provide theoretical evidences for the diagnosis,prevention,and treatment of sPTL in the future.
