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简介：AbstractWe present an unusual and, until now, unreported case of vesicoallantoic cyst associated with multiple malformations in a fetus. A differential diagnosis is discussed, including the hypothesis of a genetic disorder.

简介：AbstractObjective:To investigate the safety and efficacy of internal electronic fetal heart rate (FHR) monitoring during labor.Methods:This was a retrospective case-control study, which was an analysis of monitoring FHR with a fetal scalp electrode or a Doppler probe (94 pregnant women per group). In the internal monitoring group, when the opening of the uterine orifice was ≥3 cm, the fetal scalp electrode was placed after natural or artificial rupture of the membrane. FHR was simultaneously monitored using a Doppler probe. In the external monitoring group, continuous FHR monitoring was performed using an ultrasound Doppler transducer fixed on the maternal abdomen. The toco transducer was used to record uterine contractions. Pathological examination of the placenta was performed prospectively in 49 and 48 cases in the internal electronic FHR monitoring group and control group, respectively. Maternal-infant outcomes (e.g. fever, puerperal infection, puerperal morbidity, delivery mode, Apgar score, and scalp injury) were recorded. Umbilical artery blood was extracted for blood gas analysis. Differences between the two groups were compared using the paired t-test, χ2 test, Yates corrected χ2 test or Fisher exact test.Results:Non-statistically significant differences between the internal and external monitoring groups were observed in the incidence of neonatal acidosis (1/94 (1.06%) vs. 3/94 (3.19%), respectively; χ2= 0.255, P= 0.613), cesarean section/operative vaginal delivery (8/94 (8.51%) vs. 15/94 (15.96%), respectively; χ2 = 2.427, P= 0.181), fever during labor (18/94 (19.15%) vs. 15/94 (15.96%), respectively; χ2=0.331, P= 0.565), puerperal morbidity (2/94 (2.13%) vs. 3/94 (3.19%), respectively; χ2= 0.000, P= 1.000), chorioamnionitis (9/49 (18.37%) vs. 7/48(14.58%), respectively; χ2= 0.252, P= 0.616), and neonatal asphyxia (0/94 (0.00%) vs. 1/94 (1.06%), respectively; χ2= 0.000, P= 1.000). There were no puerperal infections, neonatal scalp injuries, or scalp abscesses found in either group. Using the internal monitoring value as reference, the incidence of FHR false deceleration in external FHR monitoring was 20.21% (19/94 women).Conclusion:Internal FHR monitoring during labor does not increase the incidence of adverse perinatal outcomes. External monitoring was associated with FHR false decelerations.

简介：AbstractSelective fetal growth restriction (sFGR) is a severe condition that complicates 10% to 15% of all monochorionic diamniotic (MCDA) twin pregnancies. Pregnancies complicated with sFGR are at high risk of intrauterine demise or adverse perinatal outcome for the twins. Three clinical types have been described according to the umbilical artery (UA) Doppler pattern observed in the smaller twin: type I, when the UA Doppler is normal; type II, when there is persistent absent or reversed end-diastolic blood flow in the UA Doppler; and type III, when there is intermittent absent and/or reversed end-diastolic blood flow in the UA Doppler. Clinical evolution and management options mainly depend on the type of sFGR. Type I is usually associated with a good prognosis and is managed conservatively. There is no consensus on the management of types II and III, but in earlier and more severe presentations, fetal interventions such as selective laser photocoagulation of placental anastomoses or selective fetal cord occlusion of the smaller twin may be considered. This review aims to provide updated information about the diagnosis, evaluation, follow-up, and management of sFGR in MCDA twin pregnancies.

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简介：AbstractDuring the past decades, early fetal ultrasound and diagnosis have increasingly gained attention in pregnancy care with the development of high-frequency transducers, which make it possible to obtain detailed images of the early fetus and its organs, and thus move part of the anatomy and anomaly scan from the second to the first-trimester. By transabdominal sonography or transvaginal sonography, or a combination of both approaches, it is now able to diagnose a wide variety of fetal abnormalities at 11-13+6 weeks.

简介：ToexploretheactionmechanismofmoxibustiononZusanli(ST36)intreatingmalnutrition.MethodsInfantileSDratsweredividedintonormalgroup,modelgroup,comparisongroupandtreatmentgroup.Ganjimodelsofratweremadebyfeedinghighfatandhighcaloriefood.Thentheyweretreatedwithmoxibustionon“Housali”.ResultsAfterthemodelsbeingmade,theappetite,weight,GASandMTLweredecreased.Aftertwoperiodsoftreatment,theywereallincreasedandwerenearlyturnedtobenormallevel.ConclusionMoxibustiononZusanli(ST36)canimprovetheappetite,weight,GASandMTLinGanjimodelsofratandregulatetheirdigestivefunction.

简介：有绗维素酶的帮助的chitosan(72.05%的DD)的降级在45的条件下面被执行，pH5.0并且1:15(chitosan/enzyme)的比率。结果证明绗维素酶能降级chitosan高效地。chitosan的粘性很快速被减少，减少释放的糖在降级期间与时间被增加。由使用膜，水解作用混合的分离被学习。蛋白质的拒绝能被到达是low-molecular-weightchitosans的99.74%.65.9%是不到2kDa。chitosan被发现比chitosan和发射度好的low-molecular-weight的溶解度能到达是在pH的全部范围的超过95%113。

简介：AbstractCholedochal cysts is a rare congenital cystic dilatation of common biliary duct. The most common prenatal diagnosed form type- I (85%-90%), consists of fusiform dilation of the common bile duct. There is communication between the bile duct and the cyst. In antenatal period diagnosis may be made by the presence of a cyst in the upper right side of the fetal abdomen on ultrasound. To differentiate it with other cystic lesions prenatal ultrasonography (USG), three-dimensional USG and magnetic resonance imaging may be helpful. By early diagnosis and prompt removal of cyst in postnatal period long term complications like development of biliary cirrhosis, portal hypertension, calculi formation or adenocarcinoma can be avoided in later life. The operative mortality is about 10%. We are reporting a case of antenatal diagnosis type I congenital choledochal cysts at 21 weeks, its follow up and successful postnatal management.

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简介：AbstractViral infections during pregnancy are associated with adverse pregnancy outcomes, including maternal and fetal mortality, pregnancy loss, premature labor, and congenital anomalies. Mammalian gestation encounters an immunological paradox wherein the placenta balances the tolerance of an allogeneic fetus with protection against pathogens. Viruses cannot easily transmit from mother to fetus due to physical and immunological barriers at the maternal-fetal interface posing a restricted threat to the fetus and newborns. Despite this, the unknown strategies utilized by certain viruses could weaken the placental barrier to trigger severe maternal and fetal health issues especially through vertical transmission, which was not fully understood until now. In this review, we summarize diverse aspects of the major viral infections relevant to pregnancy, including the characteristics of pathogenesis, related maternal-fetal complications, and the underlying molecular and cellular mechanisms of vertical transmission. We highlight the fundamental signatures of complex placental defense mechanisms, which will prepare us to fight the next emerging and re-emerging infectious disease in the pregnancy population.

简介：AbstractFetal growth restriction (FGR) is a common complication of pregnancy associated with higher rates of perinatal mortality and morbidity, as well as a variety of long-term adverse outcomes. To standardize the clinical practice for the management of FGR in China, Fetal Medicine Subgroup, Chinese Society of Perinatal Medicine, Chinese Medical Association and Maternal-Fetal Medicine Committee, Chinese Society of Obstetrics and Gynecology,Chinese Medical Association organized an expert committee to provide official consensus-based recommendations on FGR. We evaluated the evidence provided by relevant high-quality literature, performed a three-round Delphi study and organized face-to-face meetings with experts from multidisciplinary backgrounds. The consensus includes the definition, prenatal screening, prevention, diagnosis, monitoring and management of FGR.

简介：AbstractBackground:The fetal growth charts in widest use in China were published by Hadlock >35 years ago and were established on data from several hundred of American pregnant women. After that, >100 fetal growth charts were published around the world. We attempted to assess the impact of applying the long-standing Hadlock charts and other charts in a Chinese population and to compare their ability to predict newborn small for gestational age (SGA).Methods:For this retrospective observational study, we reviewed all pregnant women (n = 106,455) who booked prenatal care with ultrasound measurements for fetal biometry at the Shenzhen Maternity and Child Healthcare Hospital between 2012 and 2019. A fractional polynomial regression model was applied to generate Shenzhen fetal growth chart ranges for head circumference (HC), biparietal diameter (BPD), abdominal circumference (AC), and femur length (FL). The differences between Shenzhen charts and published charts were quantified by calculating the Z-score. The impact of applying these published charts was quantified by calculating the proportions of fetuses with biometric measurements below the 3rd centile of these charts. The sensitivity and area under the receiver operating characteristic curves of published charts to predict neonatal SGA (birthweight <10th centile) were assessed.Results:Following selection, 169,980 scans of fetal biometry contributed by 41,032 pregnancies with reliable gestational age were analyzed. When using Hadlock references (<3rd centile), the proportions of small heads and short femurs were as high as 8.9% and 6.6% in late gestation, respectively. The INTERGROWTH-21st standards matched those of our observed curves better than other charts, in particular for fat-free biometry (HC and FL). When using AC<10th centile, all of these references were poor at predicting neonatal SGA.Conclusions:Applying long-standing Hadlock references could misclassify a large proportion of fetuses as SGA. INTERGROWTH-21st standard appears to be a safe option in China. For fat-based biometry, AC, a reference based on the Chinese population is needed. In addition, when applying published charts, particular care should be taken due to the discrepancy of measurement methods.

简介：摘要Background and objectiveCloser monitoring and treatment is vital for pregnant carbon monoxide (CO) poisoning cases due to fetal poisoning component. Permanent damage can occur in both the mother and the baby. It may cause stillbirth even though no serious clinical symptoms occur in the mother. Hyperbaric oxygen (HBO) treatment is advised for all pregnant patients regardless of their clinical symptoms. Pregnant CO poisoning patients that received HBO treatment and their fetal status were evaluated in this study.MethodsPregnant patients poisoned with CO treated in the same hyperbaric clinic were evaluated. Pregnant patients that received HBO treatment in a multiplace chamber were evaluated in terms of clinical status, demographic structure, laboratory tests, fetal effects and progress of the fetus until birth and 6 months postpartum.ResultsA total number of 32 pregnant cases were treated. COHb values were over 20% (min 6.9- max 40.2) in 23 patients, 11 patients had a history of syncope. All patients took HBO treatment under 2.4 ATA pressure for 120 min. 3 patients received more than 1 session of HBO treatments due to fetal stress; all other cases took 1 session of HBO treatment. No spontaneous abortus occurred in early follow-ups; only 4 babies were born prematurely. 2 of the babies were lost in the early phases after birth, due to causes non-related to CO poisoning complications (cyanotic heart disease, necrotizing enterocolitis). No significant difference were observed in the comparison of laboratory results of patients with syncope and of those who did not have syncope and comparison of patients with COHb value higher than 20% and patients with COHb value lower than 20% (P>0.05)．ConclusionHBO is not advisable for pregnant patients except for CO poisoning. In this study it is observed that HBO treatment under 2.4 ATA pressure for 120 min has no harmful effects on the mother and the fetus. It is observed that continuation of HBO treatment in the cases with fetal distress findings has beneficial effects. COHb levels and syncope were shown to have no significant effect on clinical symptoms and on blood tests.

简介：AbstractObjective:To evaluate the screening performance of noninvasive prenatal testing (NIPT) based on high-throughput massively parallel sequencing technology for the fetal XXY aneuploidies among pregnancies in Beijing of China.Methods:The study enrolled 26 913 consecutive pregnancies, 20-50 years old, who attended the Peking Union Medical College Hospital, Beijing, China, for prenatal screening from January 1, 2016 to December 31, 2019. Cell-free DNA was extracted from maternal peripheral blood to have a high-throughput massively parallel sequencing procedure. Cases with high-risk of fetal XXY were suggested to take invasive prenatal diagnosis (IPD) for confirmation. Maternal DNA sequencing was performed, if necessary, to find other potential factors that may lead to high-risk results of XXY by NIPT.Results:Among a cohort of 26 913 pregnant women, 34 were high-risk for fetal XXY, among which 30 accepted IPD while 4 declined. In those who accepted IPD, 19 cases were confirmed fetal XXY by chromosome karyotyping analysis while 11 were verified as false positive. Among the 19 confirmed fetal XXY cases, 14 elected pregnancy termination. For all the 34 high-risk cases, two were verified maternal sex chromosome aneuploidy. The calculated detection rate, positive predictive value, and false-positive rate of NIPT for fetal XXY in this cohort was 100.00% (19/19), 63.33% (19/30), and 0.04% (11/26 890), respectively. And the percentage of pregnancy termination was 73.68% (14/19).Conclusion:NIPT could be used as a potential method for fetal XXY screening, although the accuracy needs to be improved. As NIPT is not diagnostic, IPD is strongly recommended for those with high-risk results. For cases with discordance between NIPT and fetal karyotyping, maternal DNA sequencing would help to identify the cause of false-positive/false-negative results.

简介：ECGisanimportanttoolfortheprimarydiagnosisofheartdiseases,whichshowstheelectrophysiologyoftheheart.Inourmethod,asinglematernalabdominalECGsignalistakenasaninputsignalandthematernalP-QRS-Tcomplexesoforiginalsignalisaveragedandrepeatedandtakenasareferencesignal.LMSandRLSadaptivefiltersalgorithmsareapplied.TheresultsshowedthatthefetalECGshavebeensuccessfullydetected.TheaccuracyofDaisydatabasewasupto84%ofLMSand88%ofRLSwhilePhysioNetwasupto98%and96%forLMSandRLSrespectively.

简介：瞄准：在首先有教养的人的胎儿的hepatocytes(HFH)调查肝炎B(HBV)的感染和复制。方法：人的胎儿的hepatocytes在没有浆液的中等、HBV积极的浆液是有教养的被增加进媒介学习hepatocytes的危险性到HBV感染。上层清液为ELISA被收集HBsAg和HBeAg的试金，和为HBV-DNA的量的荧光PCR试金日报。白朊和HBcAg，CK8和CK18表情被免疫组织化学在有教养的hepatocytes检测。lactatedehydrogenate(LDH)的内容被测量发现房间膜的正直。结果：一个稳定的hepatocyte文化系统被建立。HBV能感染hepatocytes并且复制，并且HBcAg表示能被免疫组织化学在象hepatocyte一样房间检测。在上层清液的HBV-DNA能从d被检测2到d18并且HBsAg和HBeAg在d3-d上是积极的18在HBV感染以后。在媒介的HBV从d增加了0到d6并且当房间日益增多地正在松开他们的hepatocyte显型，随后减少了。结论：HBV能感染人的胎儿的hepato-cytes并且复制。这个在试管内模型在与人的HBV入口联系进房间和随后的复制的早事件上允许详细研究。

简介：Highlevelsoflowmolecularweight(LMW)IgMincertaindiseasesareassociatedwithclinicalandlaboratoryindiceswhichreflecttheseverityofthedisease.TheseassociationssuggestthatLMWIgMmayplayanimportantroleintheimmunopathogenesisofthesediseases.TofurtherapproachthequestionconcerningthefunctionalactivityofLMWIgMindisease,apanelofLMWIgMandhighmolecularweight(HMW)IgMpreparationswithorwithoutrheumatoidfactor(RF)activitywereusedtoinvestigatetheirantibodybindingactivityandtheireffectorfunction.ItwasfoundthatLMWIgM-RFandHMWIgM-RFhadasimilarbindingcapacitytoFcfragmentastherewasnosignificantdifferenceintheaffinityindexbetweenthem.ItfurthershowedthattherateofactivationandtotalamountofutilizationofcomplementbyLMWIgMandHMWIgMwassimilar,althoughthemeanfluorescenceofC3depositionbyIgM-RFandHMWIgM-RFwasslightlyhigherthanthatofLMWIgM-RFandothercontrolRFantibodies.However,thecurrentstudydemonstratedthatLMWIgMhadstrongneutrophilactivatingpropertieswhencomparedwithHMWIgM.ThesefindingssuggestthatonemechanismofLMWIgMcontributingtotheimmunopathogenesisofRAmaybeduetotheformationofcirculatingimmunecomplex(CIC)byLMWIgMwithsubsequentactivationofneutrophils.WhetherLMWIgMhasotherfunctionalactivityindiseaseisunclearandneedsfurtherinvestigation.

简介：Therehasbeenanappropriatefocus,sincetheturnofthe21stcentury,onsex-andgender-specificcardiovasculardisease(CVD)asincreasingevidencesuggeststhattherearesubstantialdifferencesintheriskfactorprofile,socialandenvironmentalfactors,clinicalpresentation,diagnosis,andtreatmentofischemicheartdiseaseinwomencomparedwithmen.Asaresultofincreasedawareness,detection,andtreatmentofischemicheartdiseaseinwomen,therehasbeensignificantreduction(greaterthan30%)incardiovascularmortality,andin2013,moreUSmenthanUSwomendiedofCVD.Nevertheless,continuedeffortsarerequiredasCVDremainstheleadingcauseofcardiovascularmorbidityanddeathofwomenintheWesternworld,andinwomenyoungerthan55yearstherehasbeenariseincardiovascularmortality.Inthisarticle,wereviewseveralofthecontributingfactorsthatcontinuetocausechallengesinaccurateriskpredictionandriskstratificationinwomen.

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