Extrauterine Pregnancy: A Nine-Year Review of Incidence, Seasonality and Management at a Tertiary Hospital in Southern Ghana

Introduction: Most cases of extrauterine pregnancies present in the ruptured state in low-resource settings and patients with haemodynamic instability risk mortality without swift intervention. An idea of when ectopic gestations are likely to present may be useful for logistic planning and facility readiness for case management. The study sought to assess the incidence of extrauterine gestation, mode of management and any link with seasonal and/or sociocultural events within the Cape Coast metropolis of Ghana over a 9-year review period.?Methods: A retrospective review of all cases of extrauterine pregnancies managed at the Cape Coast Teaching Hospital (CCTH) from January 2010 to December 2018 was conducted. Data on patient age, parity, month of presentation, site and laterality of ectopic gestation, number of abortions and deliveries were retrieved from hospital records and analysed. Yearly and monthly aggregated incidence of extrauterine pregnancies were computed.?Result: A total of 480 ectopic pregnancies out of 26,850 total pregnancies were seen over the period, giving an overall occurence of 17.9/1000 pregnancies and almost all were managed surgically. Half of all the cases occurred in the 20?-?29 years age group while the extremes of age recorded the lowest. An average of about 53 cases per year was recorded for the period under review. The peak months of occurrence were October and November. About 83% were ruptured with the ampulla region being the commonest site. Conclusion: The data suggests increased ectopic gestation occurrence in the Cape Coast metropolis about two months after the major traditional festivals and this may have implications for instituting mitigating measures, logistic management and facility preparedness for case management.

Hypoglycaemia in screening oral glucose tolerance test in pregnancy with low birth weight fetus

Maternal hypoglycemia,a condition characterized by lower than normal blood glucose levels in pregnant women,has been increasingly associated with adverse pregnancy outcomes,including low birth weight(LBW)in neonates.LBW,defined as a birth weight of less than 2500 g,can result from various factors,including maternal nutrition,health status,and metabolic conditions like hypoglycemia.Maternal hypoglycemia may affect fetal growth by altering the supply of essential nutrients and oxygen to the fetus,leading to restricted fetal development and growth.This condition poses significant risks not only during pregnancy but also for the long-term health of the child,increasing the likelihood of developmental delays,health issues,and chronic conditions later in life.Research in this area has focused on understanding the mechanisms through which maternal hypoglycemia influences fetal development,with studies suggesting that alterations in placental blood flow and nutrient transport,as well as direct effects on fetal insulin levels and metabolism,may play a role.Given the potential impact of maternal hypoglycemia on neonatal health outcomes,early detection and management are crucial to minimize risks for LBW and its associated complications.Further investigations are needed to fully elucidate the complex interactions between maternal glucose levels and fetal growth,as well as to develop targeted interventions to support the health of both mother and child.Understanding these relationships is vital for improving prenatal care and outcomes for pregnancies complicated by hypoglycemia.

Effects of Health Education with Problem-Based Learning Approaches on the Knowledge, Attitude, Practice and Coping Skills of Women with High-Risk Pregnancies in Plateau Areas

Objective: Given the unique cultural background, way of life, and physical environment of the Tibetan Plateau, this study aims to investigate the effects of health education using problem-based learning (PBL) approaches on the knowledge, attitude, practice, and coping skills of women with high-risk pregnancies in this region. Methods: 76 high-risk pregnancy cases were enrolled at Tibet’s Linzhi People’s Hospital between September 2023 and April 2024. 30 patients admitted between September 2023 and December 2023 were selected as the control group and were performed with regular patient education. 46 patients admitted between January 2024 and April 2024 were selected as the observation group and were performed regular patient education with problem-based learning approaches. Two groups’ performance on their health knowledge, attitude, practice and coping skills before and after interventions were evaluated, and patient satisfaction were measured at the end of the study. Results: There was no statistical significance (P P P Conclusions: Health education with problem-based learning approaches is worth promoting as it can help high-risk pregnant women in plateau areas develop better health knowledge, attitude and practice and healthier coping skills. Also, it can improve patient sanctification.

Gastric cancer incidence and mortality in Zhuanghe,China,between 2005 and 2010

AIM： To investigate the incidence and mortality of gastric cancer （GC） in Zhuanghe region, northeast China and the influencing factors for their changing trends.METHODS： All new cancer cases and deaths registered from 2005 to 2010 in Zhuanghe County were reviewed. The annual GC cases, constituent ratio, crude rates,age-standardized rates, their sex and age distribution and temporal trends were assessed. The method of annual percentage change （APC） was used to estimate the trends of GC.RESULTS： Altogether 2634 new cases of GC and 1722 related deaths were registered, which accounted for 21.04% and 19.13% of all cancer-related incidence and deaths, respectively. The age-standardized incidence rate steadily decreased from 57.48 in 2005 to 44.53 in 2010 per 10^5 males, and from 18.13 to 14.70 per 10s females, resulting in a APC of -5.81% for males and -2.89% for females over the entire period. The magnitude of APC in GC mortality amounted to -11.09% and -15.23%, respectively, as the agestandardized mortality rate steadily decreased from 42.08 in 2005 to 23.71 in 2010 per 10^5 males, and from 23.86 to 10.78 per 10^5 females. Females had a significantly lower incidence （a male/female ratio 2.80, P 〈 0.001） and mortality （a male/female ratio 2.30, P 〈 0.001）. In both genders, the peak incidence and mortality occurred in the 80-84 years age group. The age-standardized mortality/incidence ratio also decreased from the peak of 0.73 in 2005 to 0.53 in 2010 for males, and from 1.32 to 0.73 for females.CONCLUSION： Encouraging declines of incidence and mortality of GC were observed in Zhuanghe region between 2005 and 2010, possibly due to the economic development and efficient GC control strategies.

Incidence and mortality rate of esophageal cancer has decreased during past 40 years in Hebei Province,China

Background： Hebei province is located in North of China with of approximately 6% of whole national population. It is known as a high-risk area for esophageal cancer in China and worldwide. The aim of our study was to estimate the esophageal cancer burden and trend in Hebei Province. Methods： Eight cancer registries in Hebei Province submitted cancer registry data to the Hebei Provincial Cancer Registry Center. All data were qualified and compiled for cancer statistics in 2011. The pooled data were stratified by gender and age group （0, 1-4, 5-9, 10-14...80＋）. Incidence and mortality rates were age-standardized to World Segi＇s population standard and expressed per 100,000 persons. In addition, proportions and cumulative incidence/mortality rates for esophageal cancer were calculated. Esophageal cancer mortality data during the periods 1973-1975, 1990-1992, and 2004-2005 were extracted from the national death surveys. Mortality and incidence rate data from Cixian and Shexian were obtained from population-based cancer registries in each county. Results： The estimated number of newly diagnosed esophageal cancer cases and deaths in 2011 in Hebei Province was 24,318 and 18,226, respectively. The crude incidence rate of esophageal cancer was 33.37/100,000 （males, 42.18/100,000 and females, 24.31/100,000）. The age-standardized rate by world standard population （ASRW） was 28.09/100,000, ranking third among all cancers. The esophageal cancer mortality rate was 25.01/100,000 （males, 31.40/100,000 and females, 18.45/100,000）, ranking third in deaths among all cancers. The mortality rates of esophageal cancer displayed a significant decreasing trend in Hebei Province from 1973-1975 （ASRW =48.69/100,000） to 2004-2005 （ASRW =28.02/100,000）, with a decreased rate of 42.45%. In Cixian, the incidence of esophageal cancer decreased from 250.76/100,000 to 106.74/100,000 in males and from 153.86/100,000 to 75.41/100,000 in females, with annual percentage changes （APC） of 2.13 and 2.16, while the mortality rates declined with an APC of 2.46 for males and 3.10 for females from 1988 to 2011. In Shexian, the incidence rate decreased from 116.90/100,000 to 74.12/100,000 in males and from 46.98/100,000 to 40.64/100,000 in females, while the mortality rates declined, with an APC of 4.89 in males from 2003 to 2011. Conclusions： Although the incidence and mortality rates of esophageal cancer remain high, an obvious decreasing trend has been observed in Hebei Province, as well as in high-risk regions, such as Cixian and Shexian, over the past 40 years.

Hereditary Angioedema in Pregnancy and Management without Recombinant Human C1-INH

A pregnant woman diagnosed with type 1 angioedema seeks care at a public hospital for planning the delivery. This report presents ways to prevent and manage an acute HAE crisis during childbirth and early postpartum without the availability of first-line medications, such as plasma-derived human C1-INH concentrate.

Effect of antioxidants on amelioration of high-risk factors inducing hypertensive disorders in pregnancy

Background This is a prospective clinical study based on a large sample gathered from multiple centers in China, subordinating to 10th Five-Year Plan of National Science ＆ Technology Progression. We analyzed the high-risk factors inducing hypertensive disorders in pregnancy （HDP） and estimated the potential effect of anti-oxidants administration, including vitamin C （VC）, vitamin E （VE） and Salvia Miltiorrhiza L （SML）, a Chinese herb medicine, in amelioration of the high-risk factors in pregnancy. Methods From April 2005 to July 2006, 4814 pregnant women from 24 national wide cooperative hospitals were involved in this prospective research. The participants were randomly divided into two groups： 1607 cases were in anti-oxidants group with administration of vitamins and SML; 3207 cases were in control group without any medicine given. Every participant was under monitoring for the morbidity of HDP and the high-risk factors were investigated in HDP cases in each group. Results （1）The morbidity of HDP was 3.55% in anti-oxidants group vs. 4.18% in control group. No statistical difference existed between the two groups （P〉0.05）. （2） In anti-oxidants group, the HDP morbidities among three subgroups： VC ＋ VE ＋ SML, VC ＋ VE and SML only, were 5.51%, 3.05% and 5% respectively. It showed no statistical difference among three remedies （P 〉0.05）. （3） The related index of factors affecting HDP showed in intensity sequence as follows： family HDP history 〉 profession 〉 education level 〉 age 〉 body weight. The incidence of HDP in normal population was 3.51%, and the incidence of HDP in high-risk pregnant women （family HDP history, heavy physical labor, low education level （middle school and below）, age 〉40, body mass index 〉24） was 5.84%, which was obviously higher than that in normal population （P 〈0.01）. In anti-oxidants group, the probability of HDP in women with high-risk factors was 3.81%, which was obviously lower than that in control group with high-risk factors at 7.14% （P〈0.01）. （4） In control group, the morbidity of HDP in women with family HDP history （especially with sisters＇）, heavy physical labor, middle school and below, age 〉35 was： 50.00%, 15.22%, 6.33%, 26.28% and 5.75%, respectively, and that in anti-oxidants group was 0, 7.69%, 3.74%, 9.27% and 2.67%, respectively, which was obviously lower than that in control group. Conclusions The high-risk factors prone to induce HDP included： family history of HDP, heavy physical labor, low education level, aging and obesity. No impressive effect of anti-oxidants application was found in preventing HDP in general population but the remedy demonstrated positive effect on preventing HDP in pregnant women with high-risk factors.

2019-2023年无锡市梁溪区高危妊娠孕产妇流行病学特征分析

目的:了解2019—2023年无锡市梁溪区高危妊娠孕产妇的流行病学特征,为规范高危孕产妇管理提供参考的依据。方法:依托江苏省妇幼健康信息系统,收集2019—2023年无锡市梁溪区高危妊娠孕产妇人群特征和妊娠风险信息,分析高危妊娠发生率、妊娠风险等级、人群特征、妊娠风险因素特征的变化趋势。结果:2019—2023年梁溪区高危孕产妇发生率逐年上升,平均为75.428%;妊娠风险以黄色为主,橙色和红色风险比例逐年上升。2021年起高龄、剖宫产的高危孕产妇增多趋势发生逆转,2023年才明显回升;低龄高危孕产妇比例自2020年起一直保持在低位。5年来13周内初次产检、产检次数超过10次以上的高危孕产妇占比逐年提升;妊娠风险因素前10种类变化不大,2023年前三顺位为体质量指数异常、贫血、糖尿病。结论:2019—2023年梁溪区高危妊娠孕产妇的发生率逐年升高,妊娠风险等级倾向于复杂化,人群年龄和分娩方式特征、主要妊娠风险因素特征均发生变化,高危孕产妇的健康管理逐渐规范。梁溪区应依据现状调整高危妊娠管理方向,针对难点、弱点采取对应的干预措施。

孕产妇产前免疫学检验项目的应用价值评估

目的全面分析免疫学检验项目的具体内容,探究孕产妇产前的应用效果。方法研究对象筛选后,具体构成为:孕产妇,抽取时间方面,开始于2023年1月,结束于2023年12月,经过统计发现,共有90例孕产妇符合条件,而后划分组别,该过程中,临床工作人员可遵循电脑随机法原则,在分组结果中,具体命名为:对照组、实验组;产前阶段,将常规检查为对照组提供,免疫学检验为实验组提供,每个组别中,纳入45例研究样本,比较最终效果,具体内容有:高危妊娠(TORCH感染、乙肝病毒感染、单纯疱疹病毒感染)发生率、不良妊娠结局(自然流产、新生儿感染、死胎)发生率。结果(1)孕产妇产前检查后,常见的高危妊娠现象有:TORCH感染、乙肝病毒感染、单纯疱疹病毒感染,计算发生率后,对照组为17.78%(8/45),实验组为4.44%(2/45),比较结果得出:实验组更低(P<0.05);(2)不良妊娠结局发生率比较,实验组(4.44%,2/45)vs.对照组(20.00%,9/45),计算数据更低(P<0.05)。结论产前检查过程中,免疫学检验项目非常重要,对于孕产妇来说,能够及时发现高危妊娠现象,从而保障母婴分娩结局,在临床上安全价值高,可推行、使用。

1990至2019年中国宫外孕发病的年龄-时期-队列分析

目的:分析1990至2019年中国宫外孕的发病变化,为制定相关预防和治疗提供数据支持。方法:利用Joinpoint回归分析1990至2019年分年龄段中国宫外孕发病的趋势变化,采用年龄-时期-队列模型和内生因子法估计宫外孕发病风险的年龄、时期和队列效应。结果:1990至2019年中国宫外孕发病率和标化发病率分别降低53.0%和46.1%,1990至2019年中国标化发病率的平均年度变化百分比(AAPC)为-1.9%(95%CI为-2.8~-0.9),分年龄段的发病率趋势中10~14岁、15~19岁、20~24岁、25~29岁、30~34岁和35~39岁年龄组呈下降趋势,AAPC分别为-1.9%(95%CI为-2.3~-1.4)、-3.4%(95%CI为-4.3~-2.5)、-4.0%(95%CI为-4.7~-3.4)、-2.0%(95%CI为-2.8~-1.2)和-1.1%(95%CI为-1.7~-0.5),45~49岁和50~54岁年龄组呈上升趋势,AAPC分别为0.8%(95%CI为0.1~1.6)和1.0(95%CI为0.3~1.8)。年龄效应可以看出25~29岁年龄组发病风险最高,相对危险度由10~14岁的0.02升至25~29岁的10.96后降至50~54岁的0.03。时期效应显示1990至2019年间发病的效应系数呈先下降后上升趋势,相对危险度由1990至1994年的1.12降至2000至2004年的0.76后升至2015至2019年的1.53。队列效应显示宫外孕发病率随出生年份的后移呈先上升后下降趋势,在1970至1979年达到高峰,发病的相对危险度为1.62。2019年中国宫外孕的标化发病率在全球范围内处于较低水平,1990至2019年中国宫外孕的变化率在全球范围的下降幅度较高。结论:对宫外孕人群进行更多层次的分析,从而为当地卫生行政部门以及相关的健康从业人员提供有利的科学依据和数据支持,以期降低宫外孕的发病风险。

58789名孕妇中孕期血清学产前筛查结果与不良妊娠结局关系分析

目的:对58789名中孕期血清学产前筛查结果呈不同风险孕妇的不良妊娠结局进行分析,探讨中孕期血清学筛查结果与不良妊娠结局的相关性。方法:回顾性分析2022年在合肥市妇女儿童保健中心接受中孕期血清学产前筛查的58789名单胎孕妇的筛查结果,并对其妊娠结局、羊水穿刺和超声检查结果进行随访,比较21-三体综合征和18-三体综合征不同风险组孕妇不良妊娠结局发生率。结果:21-三体综合征、18-三体综合征高风险组、临界风险组、低风险组孕妇其他染色体异常、超声结构异常、自然流产发生率比较,差异有统计学意义(21-三体:χ^(2)值分别为388.117、9.285、10.279,18-三体:χ^(2)值分别为39.908、24.536、67.047,P值均<0.05),其中21-三体综合征、18-三体综合征各风险组孕妇其他染色体异常、超声结构异常、自然流产发生率均为高风险组最高。18-三体综合征高风险组、临界风险组其他染色体异常发生率高于21-三体综合征临界风险组,差异有统计学意义(χ^(2)值分别为5.472、7.126,P值均<0.05);18-三体综合征高风险组超声结构异常发生率高于21-三体综合征高风险组和临界风险组,差异有统计学意义(χ^(2)值分别为6.094、8.042,P值均<0.05)。结论:中孕期母血清学三联筛查除了能够筛查出目标疾病,对不良妊娠结局也有一定的预测作用,联合产前诊断和超声检测可以降低出生缺陷的发生率。

Exploring Experiences with "321" Model Management for High-Risk Pregnancy: A Qualitative Study

To editor:In recent years,obstetricians have needed to managemore complex pregnancies involving acute and chronicmedical disorders,and a greater number of pregnancieseach year are now delivered by critical care services.1Datafrom the United States show that poorly controlled maternal medical conditions can have an adverse impact on preg-nancy outcomes.

孕早期检测NLR、氧化应激指标对妊娠期糖尿病的预测价值

目的探讨孕早期检测中性粒细胞/淋巴细胞(NLR)、氧化应激指标对妊娠期糖尿病的预测价值。方法选取本院33例妊娠期糖尿病孕妇(探讨组)和33例正常孕妇(对照组)为研究对象,比较两组的血化验指标、氧化应激指标及不良妊娠结局发生率。结果探讨组活性氧水平高于对照组,核转录因子E_(2)相关因子水平低于对照组,差异有统计学意义(P<0.05);探讨组的不良妊娠结局发生率为33.33%,高于对照组的12.12%,差异有统计学意义(P<0.05);探讨组白细胞计数、NLR、丙氨酸转氨酶水平高于对照组,差异有统计学意义(P<0.05)。结论孕早期检测NLR、氧化应激指标对妊娠期糖尿病有一定的预测价值,能尽早分析疾病,从而尽早开始治疗。

养阴止咳安胎方治疗妊娠咳嗽的有效性及对其症状体征积分的影响

目的 探究对妊娠咳嗽患者应用养阴止咳安胎方治疗的效果和对其症状体征积分的影响。方法 本次试验选取本院2021年11月—2023年4月收治68例妊娠咳嗽患者,并将其作为数据分析对象,采用随机数表法分为对照组和观察组,每组34例。对照组实施常规头孢拉定胶囊治疗,观察组实施头孢拉定胶囊加养阴止咳安胎方治疗,比较两组临床效果、中医症状体征积分、不良妊娠发生率。结果 两组对比治疗效果,观察组比对照组更高,差异显著有统计学意义(P<0.05)。两组对比中医症状体征积分,观察组日间咳嗽积分、夜间咳嗽积分、总症状体征积分均比对照组更低,差异显著有统计学意义(P<0.05)。两组对比不良妊娠发生率,观察组比对照组更低,差异显著有统计学意义(P<0.05)。结论 在治疗妊娠咳嗽患者时,给予养阴止咳安胎方治疗,效果较为显著,在临床治疗中值得大范围推广与实施。

异位妊娠发病因素分析

目的分析30年来异位妊娠发病率的变化,调查2003年异位妊娠发病相关因素,以期能间接反映该院所属地区发病情况,为进一步临床研究提供资料。方法收集华中科技大学同济医学院附属同济医院1973年、2003年异位妊娠与分娩、妊娠(分娩、引产、人工流产)及妇科住院例数,对异位妊娠发病率的变化进行分析;整理2003年271例异位妊娠临床资料,调查其发病相关因素。结果异位妊娠发病率1973年为0.46%,2003增至6.06%,其发病率有显著性差异(P<0.0001)。相关因素中,≥30岁组、初产妇组异位妊娠发生率较高。发现宫腔手术史、剖宫产术史、前次异位妊娠史、盆腔感染史等因素相关性较强。比较有无避孕措施异位妊娠所占比例,认为IUD等不增加异位妊娠发病几率。分析271例异位妊娠中,急诊占32.10%(87例),危重症占15.13%(41例)。结论异位妊娠严重危害广大青壮年妇女身体健康,影响社会生产力,应重视并加强对异位妊娠的研究。

亚临床甲状腺功能减退对妊娠期糖尿病发病及其妊娠结局的影响

目的:研究亚临床甲状腺功能减退(SCH)对妊娠期糖尿病(GDM)发病及妊娠结局的影响。方法:选取经甲状腺功能筛查诊断为SCH的妊娠妇女342例(SCH组)和正常妊娠妇女2 605例(对照组),根据75 g口服糖耐量试验(OGTT)结果比较2组GDM发病率,每组再分为GDM组及OGTT正常组,比较各组促甲状腺素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(TPOAb)、妊娠结局及新生儿体格参数。结果:SCH组GDM发生率高于对照组(P<0.01)。SCH组TPOAb阳性率、TSH水平和FT4水平与对照组,差异有统计学意义(均P<0.01),而在SCH组和对照组的2个亚组间差异均无统计学意义(P>0.05)。SCH组和对照组的流产、早产率和分娩时间差异均有统计学意义(P<0.01);组间两两比较显示,SCH-GDM组流产、早产率高于SCH-OGTT正常组及对照组,SCH-OGTT正常组高于对照-OGTT正常组,对照-GDM组高于对照-OGTT正常组;SCH组2个亚组间分娩时间差异无统计学意义(P>0.05),但均小于对照组2个亚组(P<0.01)。新生儿体质量、头围和身高等体格参数,各组间差异无统计学意义。结论:SCH会增加GDM发病及妊娠不良结局的风险,SCH合并GDM危害高于单一疾病,应注重对SCH妊娠妇女血糖的监测和控制。

兰州市住院孕产妇不良妊娠结局现况研究

目的：了解兰州市住院孕产妇不良妊娠结局的发生现状，为有针对性地制定降低不良妊娠结局发生率的有效措施提供理论依据。方法：采用整群随机抽样的方法抽取兰州市3所医院2004年1月～2005年12月产科住院孕产妇病历共6825份的相关信息，并对相关因素进行分析。结果：兰州市住院孕产妇不良妊娠结局的发生率为14．65％，各种不良妊娠结局的发生率依次为：自然流产（8．01％）、早产（1．98％）、死胎及死产（1．16％）、新生儿窒息（1．13％）、巨大儿（1．04％）、出生缺陷（0．76％）、葡萄胎（0．57％）；不良妊娠结局在〈20岁和〉40岁年龄段为最高，分别为30．12％和29．99％；农民和无业者不良妊娠结局的发生率高，分别为20．17％和17．65％。结论：兰州市住院孕产妇不良妊娠结局的发生率偏高，〈20岁和〉40岁的育龄妇女是重点防治对象，应加强对农民和无业者等弱势群体的扶持，从而降低不良妊娠结局的发生率。

不同时期异位妊娠发病相关因素的对比研究

目的:探讨不同时期异位妊娠发病相关因素的差异,以探索切实可行的干预措施。方法:对我院1994年1￣12月间(前期组)178例和2004年1￣12月间(后期组)414例异位妊娠患者的发病相关因素进行了回顾性分析,包括发病年龄、婚姻状况、孕产史、职业分布、文化程度、既往病史和治疗情况等。结果:两组患者平均年龄差异无显著性,但后期组20岁以下及20￣25岁年龄段构成比显著增高;未婚女性由1994年的7.87%升高至2004年的28.02%,未育女性由1994年的35.96%升高至2004年的57.01%(P<0.01);职业分布农民的构成比明显下降,学生、个体、待业和干部等逐年升高;既往病史中前期组以安环史为主要病史,占69.67%,后期组中生殖道感染史和前次异位妊娠史显著上升,分别占61.83%和15.22%。结论:10年来异位妊娠的发病相关因素发生了变化,采取针对措施可以降低异位妊娠的发生率。

不同类型早产相关因素对比分析

目的探讨不同类型早产发生率、相关因素及妊娠结局。方法收集首都医科大学宣武医院妇产科2009年1月—2013年12月不同类型早产孕妇和新生儿的临床资料,对不同组别孕产妇(未足月胎膜早破组301例、未足月分娩组234例、医源性早产组193例)并发症发生情况、分娩方式、新生儿资料进行比较。结果 2009—2013年早产率逐年增加,但差异无统计学意义(P>0.05)。医源性早产组产妇年龄、剖宫产率、Apgar评分异常率及并发症明显高于未足月分娩组、未足月胎膜早破组(P<0.05),而孕周、胎儿出生体质量低于未足月分娩组、未足月胎膜早破组(P<0.05);3组早产中经产妇和未进行过产前检查者明显高于初产妇和接受过产检者(P<0.01),医源性早产组经产妇和未进行过产前检查的早产发生率高于未足月胎膜早破组和未足月分娩组(P<0.05)。医源性早产中妊娠期高血压疾病患者高占67.36%(130/193),胎盘因素占15.54%(30/193),胎儿因素占7.77%(15/193),其他占9.33%(18/193)。结论早产率逐年增加,其中医源性早产、未足月胎膜早破是早产发生率增高的重要因素,而减少医源性早产对降低早产的发生率至关重要。

上海妇女妊娠期激素水平与乳腺癌发病率模式的生态学研究

目的 乳腺癌发病率在不同国家间有明显差异 ,而同一国家或地区内则发病率相近。此研究旨在探讨乳腺癌的发病率模式与女性胎儿乳腺组织发育过程中宫内激素环境的关系。方法 采用生态学研究方法 ,在前期对发病率迥异的美国和上海妇女妊娠期激素水平比较的基础上 ,进一步比较上海市区和南汇县孕妇在第 16和 2 7孕周与妊娠有关的各种激素水平。结果 上海市区和南汇县孕妇 16和 2 7周前后雌二醇、雌三醇、孕酮等妊娠期激素差别无显著意义 (P>0 .0 5 )。结论 相对其类似的乳腺癌发病率模式 。