Objective To study the advances in research of breast cancer during pregnancy. Methods The literatures in recent years were reviewed. Results A lot of evidences suggested that the diagnosis may be delayed easily. The diagnosis was primarily made by needle aspiration cytology and biopsy. The treatment of pregnant breast cancer was not different from ordinary breast cancer, however the factor of foetus should be taken into account. Termination of pregnancy did not improve survival. Conclusion Pregnant breast cancer is mostly at later stage at the time of diagnosis and has poorer prognosis than ordinary breast cancer. The patients with breast cancer during pregnancy usually have an equivalent survival rate when compared with age and stagematched ordinary group. Future pregnancy may be allowed after two years of treatment in patients with early breast cancer.
ObjectivesUsing systematic literature review to analyze the effects of levetiracetam (LEV) on neonatal safety during early pregnancy.MethodsThe scope of the literature must be English literature, published from 1997 to 2018. Meta-analysis was performed by random effects models.ResultsSeven literatures were included. A total of 672 cases exposed to LEV in treatment group and 772 234 cases in control groups were selected for meta-analysis. There was no significant difference in neonatal malignancy between treatment group and control group［OR=1.05, 95% CI (0.54, 2.02), P=0.37］. Further, we evaluated the effect of LEV monotherapy and polytherapy on neonatal safety, a total of 464 monotherapy cases and 632 polytherapy cases respectively were selected for meta-analysis. The results showed that there was no significant difference between these two therapies in neonatal malignancy ［OR=0.54, 95% CI(0.31, 0.96), P=0.32］.ConclusionsAs the papers we included, levetiracetam in the treatment of epilepsy during pregnancy is relatively safe for newborn.
Objective To formulate an evidence-based treatment plan for a patient with gestational diabetes mellitus. Methods Based on the clinical questions raised from a real-life patient of gestational diabetes mellitus, we searched ACP Journal Club (1991 to Dec. 2006), The Cochrane Library (Issue 4, 2006), MEDLINE (1966 to Dec. 2006) and Chinese Biological Medical Database (1980 to Dec. 2006) for systematic reviews, randomized controlled trials, cohort and case-control studies. We used the following keywords: gestational diabetes, metformin, and pregnancy complication. The quality of the included studies was assessed.Results One meta-analysis (from MEDLINE) and two randomized controlled trials (from the Cochrane Central Register of Controlled Trials) were included. These studies concluded that there was no clear evidence on the benefits of metformin for gestational diabetes. Based on the current evidence, integrated with clinical expertise and the patient’s values, metformin was not used for this patient. Instead, intensive dietary control, blood glucose control, and appropriate exercise were administered. After this individual treatment, the patient gave birth to a healthy baby in 39+4 Weeks. Conclusion The appropriate management for gestational diabetes mellitus has been formulated with the approach of evidence-based medicine. Large-scale, methodologically-sound trials are required.
Objective To systematically review the association between periodontal disease during pregnancy and the risk of gestational diabetes mellitus (GDM). Methods PubMed, Web of Science, CBM and CNKI databases were electronically searched to collect studies on periodontal disease and GDM from inception to October 23, 2021. Two researchers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed using RevMan 5.4 software. Results A total of 11 studies were included, involving 2 910 pregnant women. The results of meta-analysis showed that pregnant women with periodontal disease during pregnancy reported more GDM than normal pregnant women (OR=1.81, 95%CI 1.31 to 2.50, P=0.000 3). Conclusion The current evidence suggests that there is a positive association between periodontal disease during pregnancy and the risk of GDM. Due to the limited quantity and quality of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explore whether the vaginal environment changes of pregnant women were correlated with pathogenesis of fungal vaginitis. MethodsWe selected 166 women in their early pregnancy in the Obstetrics and Gynaecology Clinic between July 2011 and July 2012 as the study objects (excluding fungal vaginitis patients already confirmed). Two important indicators of changes in pH and the amount of vaginal lactobacilli were chosen to determine changes in the vaginal environment. Using prospective study method, by checking changes in the vaginal environment, the objects were divided into two groups: 96 were in the changing environment group, and 70 were in the normal environment group. Sixty seven of them had a pH value lower or equal to 4.0, and 99 higher than 4.0. Fifty-eight of them had a reduced amount of lactobacillus, and 108 had a normal amount of lactobacillus. The rate of fungal vaginitis in each group was counted. ResultsThe morbidity rate in patients whose pH value was lower than or equal to 4.0 was 17.9% (12/67), while it was 6.1% (6/99) in patients with a pH value higher than 4.0, and the difference was significant (χ2=5.804, P=0.016). The morbidity rate in patients with a reduced amount of lactobacillus was 25.9% (15/58), and it was 2.8% (3/108) in patients with normal lactobacillus, and the difference was also significant (χ2=20.800, P=0.000). The morbidity rate for patients with changing vaginal environment was 16.7% (16/96), and for those with normal environment was 2.9% (2/70), and the difference was significant (χ2=7.985, P=0.005). In those with normal lactobacillus, the reduction of pH value was not correlated with the occurrence of fungal vaginitis (χ2=0.000, P=1.000). ConclusionThe vaginal environment changes during pregnancy (pH value decrease and Lactobacillus decrease) are associated with the incidence of fungal vaginitis, and it can be prevented and treated based on this phenomenon.
目的探讨妊娠期体外循环手术的围术期处理方法及母婴安全性。 方法回顾性分析2006年1月至2014年3月福建省立医院心外科21例妊娠期行体外循环手术患者的临床资料，年龄（26.2±3.4）岁。 结果母亲19例生存，2例死于多器官功能衰竭。婴儿6例引产，2例死亡，生存13例。随访13例存活新生儿8个月至8年，并对4例年龄大于6岁的儿童进行韦氏儿童智力量表第4版（WISC-IV）测试，得分分别为92分、104分、106分、90分，平均98分，与正常儿童无明显差异[（100±15）分]。 结论体外循环下心脏手术对于妊娠期合并严重心脏病患者是可行的，手术的危险性主要取决于手术方式、手术时间、孕周、体外转流时间、是否深低温等，应采取多学科合作，根据患者具体情况制定个体化方案。
ObjectiveTo systematically review the prevalence rate of gestational diabetes mellitus in Chinese population.MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data and VIP databases were electronically searched to collect relevant literature of the prevalence rate of gestational diabetes in Chinese population from inception to October 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using R 3.4.1 software.ResultsA total of 27 studies were included involving 183 338 peoples, of whom 23 834 were diagnosed as gestational diabetes mellitus by oral glucose tolerance test (75g). The prevalence rate was 13% (95%CI 10 to 16). The prevalence rate of gestational diabetes mellitus in north area was 13% (95%CI 9 to 19), central area was 11% (95%CI 2 to 39), east area was 15% (95%CI 12 to 19), south area was 12% (95%CI 11 to 14), northwest area was 5% (95%CI 3 to 8) and southwest area was 4% (95%CI 3 to 4). The prevalence rate of gestational diabetes mellitus during January 2005 to December 2012 was 11% (95%CI 7 to 16), during December 2012 to June 2016 was 17% (95%CI 14 to 20). The prevalence of specialist hospitals was 9% (95%CI 6 to 14), and which of comprehensive hospital was 14% (95%CI 11 to 18). The prevalence of gestational diabetes screening at 24 to 28 weeks gestation remained at 13% (95%CI 10 to 17).ConclusionThe prevalence rate of gestational diabetes mellitus is high in China. The prevalence rate of gestational diabetes mellitus in north China, central China and east China is significantly higher than that in southern China, northwest China and southwest China. The prevalence rate during 2012-2016 is significantly higher than that in 2005 to 2012. Improvement of lifestyle and living standard should be considered be closely related with that. The prevalence of comprehensive hospitals is higher than specialist hospitals. It is related to the China’s economic conditions, medical care situations and the medical habits of patients.