ObjectiveTo discuss the value of diffusion weighted imaging (DWI) in the diagnosis of placenta increta. MethodsThe clinical data of 42 patients with placenta increta admitted to Sichuan Provincial Hospital for Women and Children between May 2012 and January 2014 were retrospectively analyzed. All the patients were examined by prenatal magnetic resonance scans and DWI scans for subsequent comparison between ADC of the local convex placental region and ADC of the normal placental region and between the results of the two imaging methods. ResultsADC of the implantation area was significantly different from that of the normal placenta, so it could be used as a quantitative index. DWI had a higher sensitivity of diagnosis than conventional MRI. ConclusionCompared with conventional magnetic resonance imaging, DWI is more valuable in the clinical diagnosis of placenta increta, which provides a reliable basis for clinical treatment.
ObjectiveTo investigate the clinical characteristics of epileptics with pregnancy and then provide reference for standardized management of epileptics with pregnancy. MethodsFrom June 2012 to June 2021, epileptics with pregnancy who delivered in Jinan Central Hospital were selected as the research subjects. The clinical data such as the application of Antiseizure medications (ASMs) during pregnancy, seizure frequency, pregnancy outcomes, delivery ways, offspring feeding ways and the incidence of complications were investigated and analyzed. ResultsAmong 36 epileptics with pregnancy, 20 cases (55.56%) were treated with ASMs alone, 5 cases (13.88%) were treated with combined medication, and 11 cases (30.56%) were treated without ASMs during pregnancy. 15 cases (41.67%) adhered to systematic application of ASMs, 17 cases (47.22%) did not adhere to systematic application of ASMs, and 4 cases (11.11%) had unknown medication history. The frequency of seizures increased in 5 cases, decreased in 7 cases and unchanged in 24 cases during pregnancy. Pregnancy outcomes: full-term delivery in 33 cases (91.67%), preterm delivery in 1 case (2.78%) and abortion in 2 cases (5.56%). Delivery mode: cesarean section in 31 cases (91.18%), vaginal delivery in 3 cases (8.82%). After delivery, 4 cases (11.76%) were fed with milk powder and 30 cases (88.24%) were breast-fed. Complications: There were 6 cases complicated with anemia (16.67%), 5 cases complicated with gestational hypertension (13.89%), 3 cases complicated with gestational diabetes (8.33%), 4 cases complicated with premature rupture of membranes (11.11%), 2 cases complicated with fetal growth restriction (5.56%), 2 cases complicated with oligohydramnios (5.56%), 3 cases complicated with fetal distress (8.33%) and 3 cases complicated with neonatal asphyxia (8.33%). ConclusionsThe proportion of epileptics with pregnancy who were systematically treated with ASMs was low and the seizures were poorly controlled. There is a lack of standardized management for such patients in clinical practice.
Objective To study the influence of hyperlipemia on rats with acute pancreatits during pregnancy and its mechanism. Methods Seventy two pregnant Sprague-Dawley rats were randomly divided into the test group and the control group， and then they were fed with high fat diet and balanced diet for 16 days separately. Pregnant rats were given intraperitoneal injection with L-arginine for 2 times (one time is 250 mg/100 g, the other is 200 mg/100 g) at an interval of 1 h. The serum triglyceride (TG), serum amylase (AMS), and lipase (LPS) from blood samples were tested just after injection, and 12 h， 18 h， 24 h， 30 h and 48 h after injection respectively, and wet/dry ratio of pancreas were measured. The histopathological score of pancreatic tissue was evaluated based on microscopic changes, and the expression of TNF-α protein was determined by SP immunohistochemical technique. Results After the last injection, the level of TG in the test group was obviously higher than that in the control group in each time (P＜0.05). The peak values of AMS and LPS in the test group appeared at 24， 18 h respectively, while the peaks appeared at 30， 24 h in the control group, respectively, which were significantly lower than those in the test group (P＜0.05). Compared with the control group, the wet/dry ratio of pancreas in the test group increased at 12, 18 and 24 h after injection (P＜0.05); The pathological changes of pancreas in test group was more serious with higher histopathological score at 0, 12, 18 and 24 h (P＜0.05), and expression of the TNF-α protein was higher at 12, 18 and 24 h (P＜0.05), too. Conclusion Hyperlipemia can make L-arginine-induced-acute-pancreatitis during pregnancy earlier occur and lead to more serious injury in pancreas. This study demonstrates that hyperlipemia may be a high risk factor for acute pancreatitis during pregnancy, making a great amount of free fatty acid released from TG and up-regulated the expression of TNF-α.
Objective To summarize the recent studies on diagnosis and treatment for pregnancy-associated breast cancer （PABC） to provide evidence for diagnosis and treatment for PABC. Methods By PubMed， Medline， and CNKI retrieval system， with “pregnancy-associated breast cancer or PABC， diagnosis of pregnancy-associated breast cancer or PABC， treatment of pregnancy-associated breast cancer or PABC” as key words to retrieval for the recent researches about PABC. All of the publications about studies on diagnosis and treatment for PABC were reviewed and summarized. Results Diagnosis of PABC included ultrasound， mammography， magnetic resonance imaging， needle biopsy， and so on， and the treatment contained surgery， chemotherapy， endocrine therapy， radiation therapy， and targeted therapy. However， when diagnosis and treatment for PABC involved， the impact to patients with pregnancy and fetus must be considered in priority. Conclusions By reviewing the studies of relevant papers about diagnosis and treatment for PABC which can provide a clinical guidance for clinicians. Usage of bevacizumab and lapatinib still needs to further be studied.
Currently, cardiac arrest has become a major public health problem, which has a high incidence rate and a high mortality rate in humans. With the continuous advancement of cardiopulmonary resuscitation techniques, the overall prognosis of cardiac arrest victims is gradually improved. However, cardiac arrest events under special circumstances are still serious threats to human health. This article reviews the progress of epidemiology, pathogenesis, treatment characteristics, and key points of cardiopulmonary resuscitation in those special cardiac arrest events associated with trauma, poisoning, drowning and pregnancy.
ObjectiveTo discuss the risk of abortion related to lamotrigine (LTG) and its safety profile during pregnancy. MethodsRetrospectively studied pregnant women in our epilepsy clinics who took LTG from 2011 to 2015 as monotherapy and experienced embryo damage or abortion. Here, we present an extensive review of related literatures regarding possible mechanisms, clinical features and safty of LTG during pregnancy. ResultsIn our study, fourty-five pregnancies were administered monotherapy LTG, and three of these patients suffered embryo damage. ConclusionsAlthough LTG is considered safe for pregnant women and the embryo or fetus,it also has risk of embryo damage or abortion, which should be carefully considered before prescription. Using monotherapy and the lowest effective drug dose, monitoring LTG serum concentrations during pregnancy, supplementing folate administration before and after conception and conducting regular prenatal diagnostic tests might reduce the risk of abortion.
With the opening of the two child policy in China, the number of pregnant women has increased. Pregnancy has a huge impact on the cardiovascular system, and heart disease during pregnancy increases the risk of maternal heart failure and death, intrauterine growth retardation, and the risk of complications such as premature birth. Pregnancy with heart disease ranks first among indirect obstetric deaths in China. Reducing maternal mortality is a global goal of the World Health Organization. Thus, to strengthen the prevention and management of patients with critical heart disease during pregnancy is important. However, clinical decision-making and management of pregnant women with heart disease is still controversial. This article combines relevant literature of pregnancy and heart disease published in recent years and reviews of relevant diagnostic and therapeutic methods, to provide clinical reference for pregnant women with heart disease preventive care and management of the whole strategy.
Inflammatory bowel disease (IBD) is a group of chronic, recurrent, and non-specific intestinal inflammatory diseases. It usually occurs between 20 and 40 years old, overlapping with the patient’s childbearing age. Active IBD may lead to decreased fertility and adverse pregnancy outcomes, and pregnancy may also lead to recurrence of IBD. Through studying domestic and foreign related literature on pregnancy and IBD, this article elaborates on the guidance and management of IBD before pregnancy, the disease management of IBD during pregnancy, the disease management of IBD during lactation, and the current status and prospects of traditional Chinese medicine treatment. It aims to provide references for patients and clinicians to have a more scientific understanding of pregnancy with IBD.
The authors studied retrospectively clinical data of seventy cases with breast cancer during pregnancy and lactation.They were treated and diagnosed by operation and pathology.Primary factors influencing prognosis were analyzed.It was demonstrated that 5year survival rate of the patients were significantly influenced by clinical stage , month of pregnancy and lactation, time of symptoms, type of operation, type of pathology, histological grade of malignancy, recurrence and metastasis, and estrogen receptor status (Ｐ＜0.05).Age and termination of pregnancy had no beneficial effect on survival (Ｐ＞0.05).The prognosis of pregnant and lactating breast cancer was poorer than ordinary breast cancer.Their 5year survival rate were 55.7% and 74.3%, respectively. After they were matched for stage and for age, no difference in survival was found.Early diagnosis and radical operation combined with radiotherapy, chemotherapy and hormonal therapy have better prognosis.The method can shorten time of treatment and improve survival rate.Termination of pregnancy has not been shown to improve survival and shall not be advised routinely.Future pregnancy may be detrimental and shall be discouraged.
ObjectiveTo systematically review the risk of hemorrhage in pregnant cerebral arteriovenous malformation (CAVM) patients. MethodsThe Web of Science, PubMed, Cochrane Library, WanFang Data, VIP and CNKI databases were electronically searched to collect clinical studies related to hemorrhage in pregnant CAVM patients from inception to June, 2023. Two reviewers independently screened literature, extracted data and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 13.1 and R 4.0.4 software. ResultsA total of 13 studies involving 2 273 patients were included. The results of meta-analysis showed that the pooled incidence of hemorrhage in pregnant CAVM patients was 0.18 (95%CI 0.12 to 0.24). The subgroup analyses were carried out based on world regions and the study duration, with the higher pooled incidence of 0.37 (95%CI 0.05 to 0.80) in Europe and 10 to 20 years of study duration of 0.37 (95%CI 0.17 to 0.57). Conclusion Current evidence shows that the incidence of hemorrhage in pregnant CAVM patients is about 18%. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.