摘要：目的:观察血清糖类抗原(CA153)、可溶性细胞间黏附分子-1(sICAM-1)在妊娠中期孕妇中的表达,分析二者与胎盘早剥(AP)的关系。方法:回顾性分析2018年1月—2020年3月南阳市第一人民医院完成分娩的61例AP产妇资料,设为AP组。另收集同期60例于医院完成分娩的非AP产妇资料,设为非AP组。设计基线资料填写表,仔细查阅产妇相关资料并记录研究所需基线资料情况,重点比较产妇妊娠中期血清CA153、sICAM-1水平,分析二者表达与AP的关系。结果:AP组血清妊娠相关蛋白A(PAPP-A)、胎盘生长因子(PLGF)水平均低于非AP组,sICAM-1、CA153水平均高于非AP组,差异有统计学意义(t=17.430、11.050,u=7.877、8.139,P1,P0,P0.80,且当二者的cut-off值分别取88.97 U/mL、800.20μg/L时,可获得最佳预测价值。结论:妊娠中期孕妇血清sICAM-1、CA153表达与AP发生有一定关系,二者过表达可能提示AP高风险,尽早监测孕妇血清sICAM-1、CA153水平,可用于预测AP风险,并指导早期预防。

摘要：目的探讨妊娠中期孕妇血清铁蛋白(SF)水平与甲状腺功能的相关性。方法纳入2016年12月~2017年7月在我院产科门诊常规产检的妊娠中期孕妇1484例,根据是否存在ID(SF0.05)。相关性分析结果显示,妊娠中期孕妇SF与TSH水平呈负相关(r=-0.120,P<0.001),与FT 4呈正相关(r=0.205,P<0.001)。logistic回归分析结果显示,SF水平降低是TSH水平升高和FT 4水平降低的危险因素(β=-0.002,P=0.022;β=0.005,P=0.003)。结论SF水平降低是妊娠中期孕妇出现甲状腺功能异常的危险因素。

摘要：目的探讨妊娠中期妇女血清尿酸水平与25羟维生素D3[25(OH)VD3]的关系。方法选取妊娠中期妇女221例,收集其年龄、妊娠周期等一般资料,检测其肝、肾功能、空腹血糖(FPG)、甲状腺功能及25(OH)VD3水平,并根据25(OH)VD3水平将其分为维生素D缺乏组[25(OH)VD3<50nmo/L]和维生素D适宜组[25(OH)VD3≥50nmol/L],比较两组患者的临床资料,并对影响25(OH)VD3水平的因素进行分析。结果221例妊娠中期妇女中,147例(67%)存在维生素D缺乏,74例(33%)维生素D适宜。维生素D缺乏组妊娠周期、血清尿酸、促甲状腺激素(TSH)水平均低于维生素D适宜组,游离甲状腺素(FT4)、FPG和总胆红素(TBIL)水平均高于维生素D适宜组,差异有统计学意义(P<0.05)。相关性分析结果显示,妊娠中期妇女25(OH)VD3水平与妊娠周期、血清尿酸、TSH呈正相关,与FT4、TBIL呈负相关(P<0.05)。Logistic回归分析结果显示,妊娠中期妇女血清尿酸水平降低是25(OH)VD3缺乏的危险因素(OR=1.008,P=0.024)。结论维生素D缺乏在妊娠中期妇女中较为常见,妊娠周期、血清尿酸、FT4、TSH及TBIL与妊娠中期妇女的25(OH)VD3相关,其中血清尿酸水平降低是25(OH)VD3缺乏的主要危险因素。

摘要：Objective: The purpose of this study was to evaluate the relationship between serum concentrations of relaxin and soluble CD163 with cervical length and preterm delivery in women with previous spontaneous preterm delivery. Study design: Sixty-one of 69 pregnant women with a previous spontaneous preterm had serum relaxin and soluble CD163 measured at week 16(range, 12-25 weeks). End points were cervical length and gestational age at delivery. Results: Of the 61 women, 26%had > 1 previous spontaneous preterm delivery; 84%were black; 87%were unmarried; 13%were smokers, and 39%were delivered before 37 weeks of gestation. Neither relaxin(median, 368 ng/L; range, 83-1493 ng/L) nor soluble CD163(2.4 mg/L; range, 0.86-6.85 mg/L) correlated with cervical length or gestational age at delivery. Black women had higher relaxin levels(436 vs 205 ng/L; P=.002), but soluble CD163 levels were similar among racial groups. Conclusion: Relaxin and soluble CD163 measured at 16 weeks of gestation are not clinically useful predictors of short cervical length or preterm delivery in women with a previous spontaneous preterm delivery.

摘要：目的 探讨妊娠中期妇女运动状态及特点,为指导妊娠中期妇女进行合理运动提供依据.方法 采用便利抽样法,对2012年8月至2013年3月在我院产科门诊建卡的650名妊娠中期孕妇进行调查.采用自行设计的《妊娠中期妇女运动行为调查表》,对其一般资料、主要运动方式、频率、时间、强度等进行评价,并运用SPSS21.0统计学软件进行统计分析.结果 本组问卷共发放650份,回收619份,有效回收率为95％.其中95.1％（589/619）的孕妇认为妊娠中期可以适当运动,将近一半孕妇需要运动方面知识的指导.本次受调查的妊娠中期孕妇主要运动方式为散步,占94.3％（584/619）.妊娠中期妇女进行静息型体力活动时间较多,与进行其他强度体力活动的时间相比差异有统计学意义,F=3.38,P＜0.01.结论 成都市孕妇妊娠中期运动形式单一,运动知识缺乏,需加强对孕妇健康指导,纠正其不良运动习惯.

摘要：Objective: The purpose of this study was to evaluate the antenatal umbilical cord coiling index obtained during the fetal anatomic survey in the second trimester as a predictor of adverse pregnancy outcome. Study design: Four hundred twenty-five consecutive women who had a fetal anatomic survey between 18 to 23 weeks of gestation were evaluated for umbilical cord coiling. The antenatal umbilical cord coiling index was calculated as a reciprocal value of the distance between a pair of coils (antenatal umbilical cord coiling index = 1/distance in cm) and was correlated with the following adverse pregnancy outcomes: (1) small for gestational age, (2) mode of delivery, (3) presence of meconium-stained amniotic fluid, (4) presence of nonreassuring fetal status in labor, and (5) Apgar scores at 1 and 5 minutes. Results: A total of 294 patients had adequate ultrasound images and all antenatal and labor data to meet the study inclusion criteria. Abnormal coiling was associated significantly with small for gestational age neonates at birth (P = .043) and nonreassuring fetal status in labor (P = .007). Nine of 58 neonates (15.5% ) with abnormal umbilical coiling were small for gestational age infants compared with 15 of 236 small for gestational age neonates (6.4% ) who had normal cord coiling. A nonreassuring fetal status in labor was observed in 25.7% of fetuses (15/58 fetuses) with abnormal umbilical coiling compared with 11.0% of fetuses (26/236 fetuses) with normal cord coiling. In contrast, no statistical difference for Apgar scores at 1 and 5 minutes or higher prevalence of interventional deliveries and meconium-stained amniotic fluid in labor between the groups with normal and abnormal umbilical cord coiling was observed. Conclusion: Abnormal umbilical cord coiling that is detected at the fetal ultrasound anatomic survey in the second trimester is associated with a higher prevalence of small for gestational age neonates and nonreassuring fetal status in labor. This ob

摘要：目的探索孕早中期压力知觉及血浆5-羟色胺水平对产后母乳喂养的影响,为提高纯母乳喂养率提供科学依据。方法基于前瞻性队列研究设计,于2019年4月至2020年3月在南京市鼓楼区妇幼保健所招募建立孕产妇保健手册的孕20周前孕妇,使用压力知觉量表(Perceived Stress Scale,PSS)评估孕妇入组时的压力感知状况,同时检测孕妇血浆5-羟色胺水平,并在产后42 d开展电话随访,调查产妇分娩信息及母乳喂养情况。采用χ^(2)检验、两独立样本t检验、logistic回归分析非纯母乳喂养的危险因素。结果共有366例孕妇入组,353例(96.4%)完成随访纳入分析,根据产后42 d喂养方式分为纯母乳喂养组(n=194)和非纯母乳喂养组(n=159)。单因素分析显示纯母乳喂养组PSS总分[(19.4±6.9)与(21.1±6.9)分,t=-2.25,P=0.026]和高压力孕妇所占比例[23.7%(46/194)与34.0%(54/159),χ^(2)=4.03,P=0.045]均显著低于非纯母乳喂养组。以是否纯母乳喂养为因变量,将单因素分析中P<0.200(PSS总分或PSS分组、血浆5-羟色胺水平、年龄、分娩方式)及临床可能的影响因素(产次、是否足月分娩)为自变量纳入logistic回归分析。结果显示,PSS作为连续型变量时,孕早中期PSS总分为产后非母乳喂养的独立危险因素(OR=1.043,95%CI:1.010~1.077,P=0.011);PSS作为分类变量(PSS分组)时,PSS高压力是非纯母乳喂养的独立危险因素(OR=1.765,95%CI:1.097~2.854,P=0.020)。结论孕早中期压力过大会影响产后母乳喂养,在孕早中期开展心理健康咨询,为孕妇减轻围产期压力可能有利于提高纯母乳喂养率。

摘要：本文探讨了妊娠中期女性不同时间段内由于胸部、腹部等主控部位变化导致体形变化,将女性标准体与妊娠中期体型的12个测量部位进行比较,总结其规律并进行妊娠中期体型划分。为孕妇服装结构制图及设计应用提供一定的理论依据和参考数据。

摘要：Objectives: To describe the natural history of pyelectasis from its detection in the second trimester to delivery, its capability to predict renal pathology and whether prenatal development of pelvic dilatation is correlated to its postnatal evolution. Study design: A retrospective analysis involving 375 fetuses with a complete urological follow- up. Prenatal ultrasound was correlated with the results of postnatal investigation and frequency of postnatal surgery was established. Results: Two- hundred and eighty cases underwent at least two examinations before birth. 73.1% were male fetuses. 57.4% had a bilateral pyelectasis. Prenatal evolution of pelvic dilatation was the following:18.6% of the cases normalized, in 34.6% of the cases the dilatation reduced but did not disappear, in 30.7% it remained unchanged, while it worsened in 16.4% . One case from the first group, three cases from the second, seven cases from the third and 11 cases from the fourth needed surgical treatment. 1.9, 7.2, 18.6, 23.9% of cases respectively worsened after birth in the four groups (trend: P=0.001). Conclusions: Prenatal diagnosis of pyelectasis improves the outcome of these children due to a surgical approach that avoids renal damage. There is a good correlation between prenatal evolution and postnatal outcome, although a postnatal follow- up is opportune in those cases that normalized before birth.

摘要：目的 设计一种基于数字图像视觉特征的超声图像中胎儿双顶径(BPD)、头围(HC),以及股骨骨干长度(FL)的自动测量方法.方法 自动测量方法包括胎儿超声图像增强、连通域提取、目标测量共3个主要步骤.将自动测量结果与人工标注结果进行比较,记录最大误差值.结果 试验测试图像155例,其中头围、双顶径图像75例,股骨图像80例.自动检测方法对头围的定位准确率大于90%,对股骨的定位准确率大于95%.对胎儿头围的测量误差小于5 mm,对双顶径的测量误差小于2 mm,对股骨骨干长度的测量误差小于0.3 mm. t检验概率分别为PHC=0.15,PBPD=0.13,PFL=0.09,α=0.05.试验结果表明利用计算机自动测量技术对双顶径、头围,以及股骨骨干长度的自动评估结果与人工标注结果差异无统计学意义(均P>0.05).结论 采用数字图像视觉特征自动测量具有较高的准确性和计算效率,可以减少人工测量的主观性和随机性,提高超声筛查的准确性,减轻超声医务人员的工作量.