Analysis of Perinatal Outcomes of Twin Pregnancy in a Referral Hospital for High Risk

Introduction: The incidence of twin pregnancies has increased significantly in recent decades. These pregnancies require more attention due to their worse outcomes than singleton pregnancies. Objective: To analyze the characteristics and perinatal outcomes of twin pregnancies at the Caxias do Sul General Hospital. Methods: This is a descriptive and retrospective study that included all births related to twin pregnancies between March 1998 and June 2018. Maternal and perinatal variables were analyzed. Descriptive analyses were carried out using measures of central tendency and dispersion for continuous variables (mean and standard deviation or median and interquartile range), according to a prior assessment of distribution using the Shapiro-Wilk test, and absolute (n) and relative (n%) frequencies for categorical variables. Results: 172 pairs of twins/21,972 births (0.8%) were identified. There was a high percentage of interpartum interval of less than 12 months, adherence and prenatal visits, body mass index, and need for neonatal intensive care. Stillbirth and neomortality rates were within acceptable parameters. Conclusion: The sample studied showed a percentage similar to that in the literature, a high rate of maternal and perinatal complications, characterizing it as a high-risk fetal pregnancy.

Effects of High Risk Pregnancy Factors on Pelvic Floor Muscle Weakness and Changes of PG, ACTH and CRP

Objective: To investigate the effects of different delivery modes on perinatal pelvic floor muscle strength, PG, ACTH and CRP of high-risk pregnant women. Methods: 380 high-risk pregnant women who gave birth in our hospital from March 2021 to February 2022 were selected as subjects, including 100 vaginal natural delivery, 156 forceps assisted delivery and 124 cesarean section. Pelvic floor pressure, PG, ACTH, CRP, IL-6, TNF-α and IL-4, IL-10 levels were evaluated and compared. The perinatal occurrence of pelvic floor functional disease (PFD) in high-risk pregnant women in each group was analyzed and evaluated. Results: There were statistical differences in the amount of postpartum blood loss (P 0.0001, F = 99.01), postpartum blood loss 24 h (P = 0.0004, F = 19.54) and hospital stay (P 0.0001, F = 70.81) among the three groups of high-risk women in natural vaginal delivery, forceps delivery and cesarean section. In addition, there were 72, 134 and 70 cases of abnormal pelvic floor fatigue in natural vaginal delivery, forceps assisted delivery and cesarean section (P 0.0001, χ2 = 30.16). There were 36, 79 and 21 cases of muscle injury, respectively (P 0.0001, χ2 = 34.16). There were 49, 98 and 43 cases of dysmuscular contraction, respectively (P 0.0001, χ2 = 21.94). There were 65, 120 and 41 cases with vaginal dynamic pressure 80 cm H2O (P 0.0001, χ2 = 56.86), respectively. The.

Assessment of Cardiovascular Risk Factors During Pregnancy: A Multicenter Study in West Africa, Dakar, Senegal

Context: Non-communicable diseases, including hypertension, are major causes of complications during pregnancy, posing significant risks to maternal and fetal health. Pregnancy increases cardiovascular risks, particularly through the development of gestational hypertension and preeclampsia, requiring early screening and close monitoring to prevent adverse outcomes. Objectives: This study aimed to evaluate the frequency of cardiovascular risk factors in pregnant women in Senegal and identify associated socio-behavioral and economic determinants. Methodology: A descriptive, analytical cross-sectional study with prospective data collection was conducted over three months (April 10 to July 10, 2023). The study included pregnant women aged 15 and older from three public hospital maternity wards in Senegal. We studied sociodemographic aspects, cardiovascular risk factors, and collected information on previous and current pregnancies, including the number of pregnancies, parity, miscarriages, the number of prenatal consultations, and the number of fetuses. Written consent was obtained. A p-value ≤ 0.05 was considered statistically significant. Results: A total of 222 pregnant women were enrolled, representing 28% of prenatal consultations. The average age was 29.18 years (range 15 - 47). Most participants (90%) lived in Dakar suburbs, 74.20% had no medical coverage, 84% worked in the informal sector (p = 0.043), and 18% had no education. Among them, 30.63% were in their first pregnancy, 34% were nulliparous, and 3.15% were grand multiparous. The average number of prenatal visits was 3.5, with about 40% having more than four visits. Risk factors included hypertension (17%), more prevalent in women over 30 (p = 0.043), diabetes (4%), and smoking (2%). Conclusion: The study highlights critical prenatal health needs and socio-economic challenges faced by pregnant women, emphasizing the need for targeted strategies to improve healthcare access and health education.

Risk Prediction Model for Hypertensive Disorders of Pregnancy Based on Routine Laboratory Indicators and Risk Factors: A Retrospective Analysis

Background: Hypertensive disorder of pregnancy (HDP) is a group of diseases in which pregnancy and elevated blood pressure coexist. There is still a lack of reliable clinical tools to predict the incidence of HDP. The purpose of this study was to establish and validate a nomogram prediction model for assessing the risk of HDP in pregnant women based on laboratory indicators and HDP risk factors. Method: A total of 307 pregnant women who were hospitalized in the obstetrics and gynecology department of our hospital were included in this study, and were randomly divided into a training cohort and validation cohort at a ratio of 7:3. Univariate and multivariate logistic regression analyses were performed to identify independent risk factors for the development of HDP on laboratory indicators as well as risk factors for HDP in the training cohort of patients. The results of the multivariate regression model were visualized by forest plots. A nomogram was constructed based on the results of multivariate logistic regression to predict the risk of HDP in pregnant women. The validity of the risk prediction model was evaluated by the area under the receiver operating characteristic curve (AUC), the consistency index (C-index), the calibration curve and the decision curve analysis (DCA). Results: BMI ≥ 25 Kg/m2, total cholesterol in early pregnancy, uric acid and proteinuria in late pregnancy were independent risk factors for HDP. The AUC and C-index of the nomogram constructed by the above four factors were both 0.848. The calibration curve is closely fitted with the ideal diagonal, showing a good consistency between the nomogram prediction and the actual observation of HDP. The DCA has demonstrated the great clinical utility of nomogram. Internal verification proves the reliability of the predicted nomograms. Conclusion: The BTUP nomogram model based on laboratory indicators and risk factors proposed in this study showed good predictive value for the risk assessment of HDP. It is expected to provide evidence for clinical prediction of the risk of HDP in pregnant women.

The effect of risk perception and COVID‑19 anxiety in pregnancy on decision‑making via the Internet and prenatal care quality:A cross‑sectional multivariate analysis

Background:Risk perception and COVID‑19 anxiety in pregnant women restrict access to health services,cause pregnant women to resort to alternative channels such as the Internet,and affect prenatal care quality(PCQ)negatively.Purpose:The purpose of this study was to examine the effect of risk perception and COVID‑19 anxiety in pregnancy on decision‑making via the Internet(DMI)and PCQ with multivariate analysis.Materials and Methods:This cross‑sectional study was conducted with 406 pregnant women selected using the convenience sampling method in a training and research hospital,in Turkey.The data were collected using the information form,the perception of pregnancy risk questionnaire,the Coronavirus Anxiety Scale,the DMI Scale,and the PCQ Scale.The data obtained were subject to descriptive analysis and the multivariate analysis of variance.Results:Approximately 24.9%of the pregnant women were found to have a high perception of risk and 18%had symptoms of COVID‑19 anxiety.Pregnant women with high COVID‑19 anxiety and a higher perception of risk perceived the Internet as less influential for decision‑making(P<0.05).Pregnant women with a high‑risk perception had lower PCQ(P<0.05).Conclusion:The findings can be used to enhance mental health and resilience in pregnant women and to formulate appropriate intervention strategies.

Maternal and Perinatal Prognosis of Arterial Hypertension and Pregnancy in a Peripheral Health Center in Mali

Introduction: Maternal mortality constitutes a public health problem and its rate is an indicator of a country’s development. Among the causes of maternal and perinatal death, high blood pressure associated with pregnancy occupies a significant part. It represents 5% of direct maternal deaths. Objective: to study the maternal and perinatal prognosis of high blood pressure during pregnancy in the Tenenkou reference health center in Mali. Methodology: This was a descriptive, analytical and retrospective cross-sectional study over a period of twelve months from January 1, 2021 to December 31, 2021 and involving 144 cases of high blood pressure associated with pregnancy. Results: We obtained a frequency of 11.75%. The majority of patients 70.9% were aged between 20 - 35 years. The important risk factor found was young age. During our study, 46.5% of patients had performed at least one CPN and only 13.9% performed 04 CPN. Pre-eclampsia was the most common type of high blood pressure during pregnancy, i.e. 61.1%. Eclampsia and retroplacental hematoma were the most common maternal complications, respectively 27.8% and 11.1%. The most common fetal complications were premature births and fetal distress with 20.9% and 17.4% respectively. Conclusion: Hypertension associated with pregnancy still remains a major cause of maternal-fetal morbidity and mortality in our context where diagnosis is often late. The main clinical form was preeclampsia. Eclampsia and retroplacental hematoma were the most frequent maternal complications. Fetal complications were mainly prematurity and fetal distress.

Clinical Significance of Serum Uric Acid Combined with Cystatin C Detection in Patients with Different Levels of Hypertension with High Risk Degree and Above

Objective: To explore the clinical significance of serum uric acid combined with cystatin C detection in high risk degree of hypertension of different grades. Methods: The patients who were treated in the Department of Cardiovascular Medicine of our hospital from January to December 2022 were selected as the study subjects, and the high risk and extremely high risk groups of grade I, II and III hypertension were selected for comparative analysis to explore their clinical significance. Results: There was a statistically significant difference in the number of patients with extremely high risk of grade II hypertension between men and women (P 0.05), which showed that there was no specificity in the concentration detection of serum uric acid and cystatin C in different grades of hypertension;there was no significant difference in serum uric acid concentration between grade II and grade III of hypertension with high risk grade and cystatin C concentration between grade I and grade III of hypertension with high risk grade (P > 0.05), but there was significant difference in the concentration detection of serum uric acid and cystatin C between the other groups (P < 0.05), which indicates that the detection of serum uric acid and cystatin C has important clinical significance in the high risk degree of hypertension. Conclusion: In the comparison of the detection of blood uric acid and cystatin C in different levels of hypertension with extremely high risk, the difference of cystatin C in grade I and grade III was not statistically significant, and the rest were statistically significant;therefore, the detection of serum uric acid and cystatin C can provide reliable laboratory data for clinical diagnosis and treatment of the extremely high risk degree of different levels of hypertension.

Application Analysis of High Risk HPV Detection Combined with Cervical Cytology, Colposcopy and Pathology in Cervical Lesions of Women in Tiandeng County

Purpose: To understand the application of high-risk HPV detection combined with cervical cytology, colposcopy and pathology in cervical lesions of women in Tiandeng County. Method: Women in the outpatient and inpatient departments of our hospital from January 2021 to October 2022 were collected for high-risk HPV testing, TCT, colposcopy and pathological examination according to their personal wishes, to understand the application of relevant examinations in cervical lesions. Result: In 2021, the number of patients was 5801, among whom 1743 patients had received cervical cancer examination in the past, accounting for 30.05% of the total number of patients, and 5795 who had volunteered for TCT examination this time, accounting for 99.90% of the total;A total of 289 cases of atypical squamous cells with unclear significance (ASC-US) were detected, excluding 11 cases of high-grade squamous intraepithelial lesions (ASC-H), 122 cases of low-grade squamous intraepithelial lesions (LSIL), 16 cases of high-grade squamous intraepithelial lesions (HSIL), 2 cases of squamous cell carcinoma (SCC), and 4 cases of atypical adenocyte (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of people who volunteered for high-risk HPV testing was 4237, and the number of positive cases was 740, accounting for 17.47% of the screening population;Among 740 HPV-positive patients, 488 high-risk HPV-positive patients were selected for TCT examination, and 87 patients were found to be TCT positive;From 401 high-risk HPV-positive and TCT negative patients, 287 patients with possible lesions were screened out for colposcopy;The results showed that 60 patients may have certain cervical lesions and need further pathological examination and the results showed that 28 patients had CTN1 and 18 patients had CIN2 - 3. In 2022, 8840 patients received medical treatment, among which 3188 patients had received cervical cancer examination in the past, accounting for 36.06% of the total number of patients, and 8314 patients voluntarily underwent TCT examination, accounting for 94.05% of the total number of patients. 434 cases of atypical squamous cells with ambiguous meaning (ASC-US) were detected, excluding 13 cases of high-grade squamous intraepithelial lesions (ASC-H), 217 cases of low-grade squamous intraepithelial lesions (LSIL), 35 cases of high-grade squamous intraepithelial lesions (HSIL), 1 case of squamous cell carcinoma, and 4 cases of atypical adenocarcinoma (AGC);Atypical cervical adenocytosis and cervical carcinoma in situ were not detected. The number of volunteers for high-risk HPV testing was 3871 cases, and the number of positive cases was 654 cases, accounting for 16.89% of the screening number. 527 high-risk HPV-positive patients were selected from 654 HPV-positive patients for TCT examination, and the number of TCT-positive patients was found to be 49. From 478 high-risk HPV-positive patients with TCT negative, 276 patients with possible lesions were screened out for colposcopy;The results showed that 66 patients may have certain cervical lesions and need further pathological examination;and then the results showed that 31 cases of CTN1 and 6 cases of CIN2 - 3. Conclusion: Gynecological high-risk HPV examination can provide better etiological sources for cervical cancer screening;Cervical cytology examination has high sensitivity;Colposcopy examination has high specificity;Pathological examination can be used as an effective supplement for cervical cytology examination and colposcopy;So high-risk HPV combined with cytology examination, colposcopy examination and pathological examination has high clinical application value;It is worth popularizing and applying.

Liver stiffness in pregnant women with intrahepatic cholestasis of pregnancy:A case control study

BACKGROUND Intrahepatic cholestasis of pregnancy(ICP)is a rare but severe complication for both the mother and the unborn child.The diagnosis is primarily based on elevated serum levels of bile acids.In a large ICP cohort,we here study in detail liver stiffness(LS)using transient elastography(TE),now widely used to noninvasively screen for liver cirrhosis within minutes.AIM To specifically explore LS in a large cohort of women with ICP compared to a control group with uncomplicated pregnancy.METHODS LS and hepatic steatosis marker controlled attenuation parameter(CAP)were measured in 100 pregnant women with ICP using TE(Fibroscan,Echosens,Paris,France)between 2010 and 2020.In 17 cases,LS could be measured postpartum.450 women before and 38 women after delivery with uncomplicated pregnancy served as control group.Routine laboratory,levels of bile acids and apoptosis marker caspase-cleaved cytokeratin 18 fragment(M30)were also measured.RESULTS Women with ICP had significantly elevated transaminases but normal gammaglutamyl transferase(GGT).Mean LS was significantly increased at 7.3±3.0 kPa compared to the control group at 6.2±2.3 kPa(P<0.0001).Postpartum LS decreased significantly in both groups but was still higher in ICP(5.8±1.7 kPa vs 4.2±0.9 kPa,P<0.0001),respectively.In ICP,LS was highly significantly correlated with levels of bile acids and M30 but not transaminases.No correlation was seen with GGT that even increased significantly after delivery in the ICP group.Bile acids were mostly correlated with the liver apoptosis marker M30,LS and levels of alanine aminotransferase,aspartate aminotransferase,and bilirubin.In multivariate analysis,LS remained the sole parameter that was independently associated with elevated bile acids.CONCLUSION In conclusion,LS is significantly elevated in ICP which is most likely due to toxic bile acid accumulation and hepatocyte apoptosis.In association with conventional laboratory markers,LS provides additional non-invasive information to rapidly identify women at risk for ICP.

Risk Factors and Pregnancy Outcomes： Complete versus Incomplete Placenta Previa in Mid-pregnancy

This prospective study was conducted to compare risk factors and pregnancy outcomes between women with complete placenta previa and those with incomplete placenta previa diagnosed in mid-pregnancy. The study was carried out from April 2014 to December 2015, during which 70 patients with complete previa and 113 with incomplete previa between 20＋0 weeks and 25＋6 weeks of gestation were included. Maternal demographics and pregnancy outcomes were compared between the two groups. Comparisons between categorical variables were tested by chi-squared test and those between continuous variables by Student t test. Resolution ofprevia occurred in 87.43% of the studied women. The mean gestational age at resolution was 32.1＋4.4 weeks. Incidence of maternal age ≥35 years and incidence of prior uterine operation 〉3 were high in women with complete previa （28.6% vs. 8.8%, P=0.003; 28.6% vs. 8.8%, P=0.003）. Resolution ofprevia occurred less often in complete previa group （74.3% vs. 95.6%, P=0.001）. Women with complete previa admitted earlier （37.3±2.0 weeks vs. 38.1±1.4 weeks, P=0.011） and delivered earlier （37.7±1.2 weeks vs. 38.3±1.4 weeks, P=0.025）. Maternal age ≥35 years and prior uterine operation 〉3 increase the risk of complete previa in mid-pregnancy. Placenta previa is more likely to persist in women with complete previa than those with incomplete previa diagnosed in mid- pregnancy. What is more, women with complete previa in mid-pregnancy delivers earlier.

Contamination of Fungi and Mycotoxins in Foodstuffs in High Risk Area of Esophageal Cancer

Fungal and mycotoxin contamination has been found in fordstuffs from Cixian County, an area with a high incidence of esophageal carcinoma (Eca). To set a scientific foundation for the prevention of Eca at the etiological level, fungal and mycotoxin contaminations of local foodstuffs in Cixian County were analyzed using classical fungal culture methods and HPLC. From 1990 to 1994, 220 corn/wheat samples and 34 corn samples were studied. As a control, 26 corn samples collected from a relatively low incidence area of Eca in Zanhuang County were analyzed for mycotoxins in 1990. The results showed that fungal contamination in corn and wheat was severe and that several of the predominant contaminating fungi such as Furasium moniliforme, etc. were carcinogenic. HPLC results showed that the detection rate and mean content of the mycotoxin sterigmatocystin (ST) in the mountainous area (5/8; 9. 14 μg/kg) were significantly higher than those in the hilly (0; 0) and plain areas (1/18; 1. 29 μg/kg) as well as in low risk area control samples (3/26; 0. 76 μg/kg). Detection rates of deoxynivalenol (DON) in mountainous and hilly areas (5/8, 4/8 respectively) were slightly higher than that in plain area (8/18), while the mean content of DON in the plain area was significantly higher (90. 45-170. 22 vs 50. 56 and 46. 45 μg/kg).Among the different aflatoxins, AFB1 was detected in samples from the two villages in the plain area for the subsequent two years. The mean content of AFB1 was 0. 0183μg/kg, and the highest level was 0. 0497 μg/kg. No AFB1 was detected in the samples from mountainous and hilly areas. AFG1 was detected in more than half of all the samples, and its concentration ranged from 8. 77 to 46. 51 ng/kg. No AFG2 was found in the samples. Thus, the results suggest that at present, fungal and mycotoxin contamination of foodstuffs in Cixian County are quite common.

Pregnancy is not a risk factor for gallstone disease: Results of a randomly selected population sample

AIM： To investigate the prevalence, risk factors, and selection of the study population for cholecystolithiasis in an urban population in Germany, in relation to our own findings and to the results in the international literature. METHODS： A total of 2 147 persons （1 111 females, age 42.8 ＋ 12.7 years; 1 036 males, age 42.3 ＋ 13.1 years） participating in an investigation on the prevalence of Echinococcus rnultilocularis were studied for risk factors and prevalence of gallbladder stone disease. Risk factors were assessed by means of a standardized interview and calculation of body mass index （BMI）. A diagnostic ultrasound examination of the gallbladder was performed. Data were analyzed by multiple logistic regression, using the SAS statistical software package. RESULTS： Gallbladder stones were detected in 171 study participants （8.0%, n = 2 147）. Risk factors for the development of gallbladder stone disease included age, sex, BMI, and positive family history. In a separate analysis of female study participants, pregnancy （yes/no） and number of pregnancies did not exert any influence. CONCLUSION： Findings of the present study confirm that age, female sex, BMI, and positive family history are risk factors for the development of gallbladder stone disease. Pregnancy and the number of pregnancies, however, could not be shown to be risk factors. There seem to be no differences in the respective prevalence for gallbladder stone disease in urban and rural populations.

MUTAGENICITY AND CARCINOGENICITY OF FISH SAUCE FROM A COUNTY WITH THE HIGH RISK FOR GASTRIC CANCER IN CHINA

The mutagenicity and carcinogenicity of fish sauce (FS) sample from Changle County, a high gastric cancer mortality (113.20/105) area, were investigated with the biologic short-term tests and laboratory animal experiment. The results showed that the extract of FS was markedly direct mutagenic toward S. typhimurium TA100, induced high sister chromatid exchanges (SCE) and micronucleus (MN) in V79 cells after nitrosation with sodium nitrite. But the non-nitrosated FS did not. The nitrosated fish sauce (NFS) also induced SOS in E. coli PQ37 and alkylation of calfthymus DNA. The potency of NFS to induce unscheduled DNA synthesis (UDS) in human normal gastric mucosal cells was increased about fivefold compared with FS. When the NFS extract was given to newborn rats by gavage, dys-plasia and adenocaroinoma were induced in the glandular stomach in the 4th and 16th experimental week, respectively. N-nitrosamides were also found in NFS, which may account for the mutagenicity and carcinogenicity of NFS. It is indicated that FS, a traditional daily eaten seasoning, may contribute to the causes of the high gastric cancer mortality for the local residents.

Prediction of Gestational Diabetes Mellitus in Early Pregnancy: Is Abdominal Skin Fold Thickness 20 mm or More an Independent Risk Predictor?

Background: Gestational Diabetes Mellitus (GDM) is associated with several maternal and perinatal complications. Early detection and treatment can improve pregnancy outcomes. Objectives: To determine the prevalence, risk factors and predictors of GDM in early pregnancy at the University of Port Harcourt Teaching Hospital, (UPTH), Port Harcourt Nigeria. Methods: A cohort of 235 mothers who registered for antenatal care between 15 - 18 weeks of gestation at UPTH was prospectively studied. Their socio-demographic data, examination findings, anthropometric measurements, fasting blood sugar at booking and OGTT results at 28 weeks gestation were collated and entered into PC with SPSS for windows version 21.0 which was also used for the analysis. Variables were expressed as absolute numbers, percentages or means with standard deviations and significant differences determined using chi square test or the student “t” test as appropriate. The level of significance was set at P < 0.05. Results: Of the 235 participants, 35 (14.9%) developed GDM. Women who had GDM were significantly older (P = 0.001), had higher weight (t = 2.95, P = 0.01), BMI (t = 2.29, P = 0.02), abdominal skin fold thickness (t = 4.15, P = 0.001), blood pressure (t = 3.38, P = 0.001) compared to women who did not. Previous history of GDM was significantly different between two groups as χ2 = 93.56 and P = 0.001. Abdominal skin fold thickness and prior GDM history were found to be independent predictors of GDM on application of multiple logistic regression analysis. Conclusion: The prevalence of GDM in Port Harcourt is 14.9% and major risk factors are obesity, previous GDM history, advanced age and hypertension. Abdominal skin fold thickness ≥ 20 mm is an independent predictor. The risk of developing GDM can be predicted in early second trimester using algorithm incorporating risk factor screening and anterior abdominal wall skin fold thickness estimation.

Managing high risk glaucoma with the Ahmed valve implant:20 years of experience

AIM： To estimate the efficacy and safety of the Ahmed implant in patients with high risk for failure after glaucoma surgery.METHODS： In 342 eyes of 342 patients with refractory glaucoma, even with application of medical treatment, the Ahmed valve was introduced for intraocular pressure（IOP） control, in the period of the last 20y. The nature of glaucoma was neovascular in 162 eyes, pseudophakic or aphakic in 49 eyes, inflammatory in 29 eyes and non working previous antiglaucomatic surgical interventions in 102 eyes. RESULTS： Follow-up ranged from 18 to 120m o with a mean follow-up of 63.2m o. IOP before the operation decreased from 31.6±10.4 mmHg to 18.3±5.4 mm Hg（no systemic treatment） at the end of follow up period. When we compared the IOP values before the operation using ANOVA showed statistically significant difference（P〈0.001）. The success rate was 85.2% during the first semester, 76.8% at 12 mo and 50.3% at the end of follow up period（18 to 120 mo after implantation）. Success rate was 25.7% in neovascular glaucoma, 63.2% in aphakic glaucoma and 73.8% in non working previous antiglaucomatic surgical interventions. Complications due to the implant were： serous choroidal detachment in 14.8%, blockage of the tube in 2.8%, malposition of the tube in 4.9%, suprachoroidal hemorrhage in 2.1%, cataract progression in 39.6%（phakic eyes）, shallow anterior chamber in 9.2%, hyphaema in 28.9%, exposure of valve in 2.6%, exposure of tube in 9.3%, hypotony in 4.9% and conjunctival fibrosis in 41.5%.CONCLUSION： Despite the fact that Ahmed valve implant had suchlike results as other implants concerning the IOP control, complications rate due to hypotony or over filtration in the first days after the intervention are not that frequent as with other valve implants.

Adjustable muscle plication:a new surgical technique for strabismic patients with high risk for anterior segment ischemia

【正】INTRODUCTION Anterior ciliary arteries provide 70%of the vascular supply of the anterior segment.A significant interruption of the vascular flow of these arteries increases the risk for anterior ischemia.Although the frequency of this special condition is low after strabismus surgery(1:13 000)[1],its effects may involve substantial visual problems[2].We report the successful outcome of a new surgical approach for strabismus management in a case of high risk for anterior ischemia.Specifically,we show the correction of the horizontal ocular deviation by means of an adjustable muscle

Pregnancy risk markers in Tourette syndrome: A systematic review

The published literature on the prevalence of pregnancy risk markers in patients with Tourette Syndrome (TS) was reviewed. PubMed was searched for papers describing studies of pregnancy risk markers in TS. All years and languages were searched, and the reference sections of each paper were also reviewed for additional citations. We identified 20 studies reporting on pregnancy risk markers in 1588 subjects with TS. Six studies used comparison populations and two utilized twins for comparisons. Three risk markers (decreased birth weight, father’s age, and number of prior terminations of pregnancy) were identified as possible risk markers for TS. To date, no pregnancy risk marker has been demonstrated to increase risk for development of TS, to increase syndromal severity, rates of comorbidity, or to increase duration of TS.

Cervical Pregnancy in a Primigravida Patient without Risk Factors: A Case Report

Cervical pregnancy is defined as the implantation of the egg below of the internal cervical orifice, and remains a rare clinical entity which affects on average 1 out of 20,000 pregnancies worldwide. Its hemorrhagic complications are life-threatening in case of late diagnosis. It occurs mainly on a history of curettage or caesarian which are the most recognized risk factors. The objective pursued here is to discuss the possibility of the occurrence of this rare clinical entity in a primigravida without risk factors and the different therapeutic possibilities according to the technical platforms. Authors report a case of cervical pregnancy at 6 weeks’ gestation occurring in a primigravida without risk factors who consulted at University clinics of Kinshasa (UCK) for a genital hemorrhage chart. The diagnosis was made using ultrasound and treatment provided by curettage followed by the placement of an intra-cervical foley tube for hemostatic purposes. Given its high mortality, the diagnosis must be early even in pregnant women without obvious risk factors. The diversity of therapeutic means gives practitioners a choice depending on the technical platform.

Impact of Omega-3 Nutritional Protocol on the Occurrence of Preeclampsia among High Risk Pregnant Women

Purpose： to examine the impact of omega-3 nutritional protocol for risky pregnant women on the occurrence of preeclampsia. Topic： Supplementation with omega-3 has been proposed to reduce the risk of preeclampsia, but the effects of this intervention are still uncertain. Method： A RCT （randomized controlled trial） had been conducted on 400 pregnant women between 12 and 16 weeks of gestation. Women were assigned randomly to either the control group or the study group. Achievements： Of the 400 women enrolled, 195 were randomly assigned to the study group and 205 to the control group. There was a significant difference between the study and the control groups in relation to the incidence ofpreeclampsia （0.5% and 5.5% respectively, P 〈 0.05）.

Comprehension of Risk Factors of Malaria during Pregnancy among Pregnant Women Attending Antenatal Care in Malawi

A study was conducted to determine the comprehension of pregnant women on malaria risk factors during pregnancy. Comprehension of Malaria risks is important to ensure compliance to prevention methods and treatment by the pregnant women and hence optimizes the pregnancy outcomes. The study was conducted in 2012 at three health facilities, Queen Elizabeth Central Hospital, Ndirande health Centre and St. Joseph Mission Hospital in Malawi. The study design was descriptive and utilized quantitative data collection and analysis methods on a random sample of 316 antenatal mothers. The study targeted antenatal mothers who were aged between 15 and 49 years, in the gestation period of 28 to 36 weeks and able to converse in English or vernacular language. A structured questionnaire was used to collect data which were analyzed using SPSS version 16.0. Most of the participants (79.4%, n = 251) knew the risk factors of malaria during pregnancy but very few (18.4%, n = 58) knew about intermittent prevention treatment despite taking SP as prescribed. The motivation factors for taking SP were husband support and the desire to protect their babies and themselves from Malaria. Although the comprehension of the intermittent prevention treatment among the women was low, the women were motivated to adhere to the treatment when instructed by the healthcare workers due to the desire for good health for themselves and their unborn babies. Husbands were the most significant other that motivated the pregnant women to adhere to treatment. Results show that there is a need for healthcare workers to facilitate comprehension of intermittent prevention treatment among pregnant mothers.