Objective This study aimed to assess the feasibility and usefulness of transabdominal color Doppler flow imaging(CDFI)technology and the high-definition flow imaging(HDFI)technique in detecting fetal pulmonary veins(P...Objective This study aimed to assess the feasibility and usefulness of transabdominal color Doppler flow imaging(CDFI)technology and the high-definition flow imaging(HDFI)technique in detecting fetal pulmonary veins(PVs)in the first trimester(11–13^(+6)weeks).Methods From December 2018 to October 2019,328 pregnant women with 328 normal singleton fetuses(crown-rump length:45–84 mm)who had undergone CDFI and HDFI scans for fetal heart and vessel examination were enrolled in this study.The cases were divided into three groups according to the gestational age:group A,11^(+0)−11^(+6)weeks;group B,12^(+0)−12^(+6)weeks;and group C,13^(+0)−13^(+6)weeks.Baseline sonograms and CDFI and HDFI images were analyzed by two senior radiologists independently and blindly.The abilities of CDFI and HDFI to display PVs were compared.Results Successful PV display rates via CDFI and HDFI were 2.3%and 68.2%(P<0.01),22.4%and 82.4%(P<0.01),41.5%and 91.2%(P<0.01)for group A,group B,and group C,respectively.The total successful display rates for the two methods were 28.9%(CDFI)and 84.8%(HDFI)(P<0.01).Conclusions The HDFI technique is more valuable than CDFI for detecting PVs in early pregnancy(11–13^(+6)weeks).HDFI can detect at least one PV in all cases and may be used to detect pulmonary venous anomalies early.展开更多
Objectives To understand the changes on sexual and contraceptive behaviours of unmarried induced abortion（IA） youth by intervention in Sichuan, China; and to find a way to improve sexual and contraceptive behaviours...Objectives To understand the changes on sexual and contraceptive behaviours of unmarried induced abortion（IA） youth by intervention in Sichuan, China; and to find a way to improve sexual and contraceptive behaviours of unmarried IA youth. Methods Intervention epidemiological surveys （baseline and evaluation） plus qualitative interview were used. During July 2002 and July 2003, 2 484 unmarried female volunteers who aged 15-29 years and come to clinics seeking abortion were recruited by cluster random sampling from the four selected regions of Sichuan, 48 volunteers were interviewed for 8 focusgroup discussions （FGDs） and 16 in-depth interviews equally for each survey. Information, education anol communication（IEC） materials, education sessions, trainings and counseling were given to subjects and service providers during the project implementation. Questionnaires for surveys and guidelines for qualitative interviews were used. Results Comparison of the after with the before intervention. 1） the proportion of respondents having knowledge about sexuality was increased by 13%. Among them, the proportion of respondents got part and most of the knowledge was increased by 43%. Maximum number of sex partners the respondents have decreased from 9 to 4. Respondents＇partnerships have gradually changed from more acquaintances/school mates/boyfriends to fianés mainly; 2） respondents＇ contraceptive use rate was increased by 20%. Among them, the condom use rate increased rapidly to 80%. Purposes of condom use were changed from only for contraception to for prevention of HIV/AIDS/STDs and pregnancy. And most of respondents stabilised their method use - condoms. Most of respondents suggested condoms was the method most suitable for unmarried IA youth, this proportion was increased by 44%; 3） proportion of respondents knowing more about consequences of induced abortion was increased by 24%; and 4） proportions of respondents having depression and anxiety symptoms were decreased by 66% and by 61%, respectively. Conclusion The intervention including IEC materials, education, training and counseling was effective in improving sexual and contraceptive behaviours of unmarried IA youth.展开更多
Objective : To find a simple and rapid way far the prenatal diagnosis of phenyUce-tonuria (PKU) during the first trimester in order to prevent inborn PKU patients as early as possible. Methods :DNA was extracted respe...Objective : To find a simple and rapid way far the prenatal diagnosis of phenyUce-tonuria (PKU) during the first trimester in order to prevent inborn PKU patients as early as possible. Methods :DNA was extracted respectively from the Mood sampleps of 9 families' members and chori-onic tissues of 9 embryoes by cliorionic vittus sampling (CVS). The independent short tandem repeat (STR) alleles of members in 9 families with classic form of PKU were analyzed and prenatal diagnosis were conducted using polymerase chain reaction (PCR) together with denaturing gradient gel elec-trophoresis(DGGE)and silver dyeing. Results-.We identified 1 embryo with PKU, 2 normal individuals and 5 carriers among 9 subjects. Conclusion: Prenatal diagnosis for PKU by STR is available in the first trimester. This procedure was promising and would be widely used in Chinese population.展开更多
Aims: Hemorrhages in the first trimester of pregnancy constitute a public health problem in developing countries with maternal mortality which is still very high. This is the most common reason for consultation in ear...Aims: Hemorrhages in the first trimester of pregnancy constitute a public health problem in developing countries with maternal mortality which is still very high. This is the most common reason for consultation in early pregnancy. The objectives of this study were to describe the sociodemographic characteristics of the patients, identify the etiologies, describe the management and evaluate the maternal prognosis in patients presenting with hemorrhage in the first trimester of pregnancy. Methods: This was a descriptive-type prospective study lasting 12 months from January 1 to December 31, 2020, carried out at the maternity ward of Ignace Deen National Hospital. Results: During the study period, we recorded 163 cases of hemorrhage in the first trimester of pregnancy out of 5478 deliveries, i.e. a frequency of 2.97%. The main incriminated etiologies were spontaneous abortion (46.62%), ectopic pregnancy (28.22%), hydatidiform mole (16.56%), threatened abortion (5.52%) and pregnancy stopped (3.06%). The socio-demographic profile of the patients was that of a woman in the age group of 26 - 30 years (33.12%), married (79.14%), with secondary level (35.58%), exercising a liberal profession (36.19%) and nulliparous (60.12%). More than half of the patients came directly from home (57.66%) with metrorrhagia (44.78%) and abdominal pain (33.12%) as reasons for consultation. The gestational age between 7-11SA was more represented (82.82%). Manual intrauterine aspiration (58.89%) and salpingectomy (28.22%) were the most practiced therapeutic procedures. We transfused 10.42% of patients and 20.85% received medical treatment. The maternal prognosis was good in 47.87%. The main complications recorded were anemia (38.65%) and the state of shock (10.42%). Conclusion: Hemorrhages in the first trimester of pregnancy represent an important cause of maternal morbidity in developing countries. The improvement of the maternal prognosis would pass by the early consultation in front of any case of pregnancy.展开更多
Preeclampsia(PE),a multisystem disorder in pregnancy,is one of the leading causes of perinatal morbidity and mortality that poses financial and physical burdens worldwide.Preterm PE with delivery at<37 weeks of ges...Preeclampsia(PE),a multisystem disorder in pregnancy,is one of the leading causes of perinatal morbidity and mortality that poses financial and physical burdens worldwide.Preterm PE with delivery at<37 weeks of gestation is associated with a higher risk of adverse maternal and perinatal outcomes than term PE with delivery at≥37 weeks of gestation.A myriad of first trimester screening models have been developed to identifying women at risk of preterm PE.In fact,the Fetal Medicine Foundation(FMF)first trimester prediction model has undergone successful internal and external validation.The FMF triple test enables the estimation of patient-specific risks,using Bayes theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure,uterine artery pulsatility index,and serum placental growth factor.Establishing a quality control process for regular monitoring and to ensure data standardization,reliability,and accuracy is key to maintaining optimal screening performance.The rate of preterm PE can be reduced by 62%by using the FMF prediction model,followed by the administration of low-dose aspirin.Recent evidence has also demonstrated that metformin has the potential for preventing PE in patients at high-risk of the disorder.In this article,we will summarize the existing literature on the different screening methods,different components of risk assessment,therapeutic interventions,and clinical implementation of the first trimester screening and prevention program for PE with specific considerations for Chinese mainland.展开更多
r Objective To discuss the diagnosis of and conservative management for lower uterine segment pregnancy with placenta increta complicating first trimester abortion. Methods Four patients with previous caesarean sec...r Objective To discuss the diagnosis of and conservative management for lower uterine segment pregnancy with placenta increta complicating first trimester abortion. Methods Four patients with previous caesarean section and severe hemorrhage in induced abortion in the first trimester were studied. Uterine artery embolization (UAE) was used to control bleeding and preserve the uterus. Results UAE controlled heavy uterine bleeding satisfactorily. One of the four patients asked for a hysterectomy after UAE, and her pathology report confirmed “lower uterine segment pregnancy with placenta increta”. Conclusion Previous caesarean section is a risk factor for lower uterine segment pregnancy with placenta increta. UAE is one of the best conservative management methods for heavy hemorrhage, especially for women who desire future fertility.展开更多
Objective To identify and determine the optimal method to screening for fetal Down＇s syndrome （DS）. Methods Three large cohorts with 17 118, 39 903, 16 646 subjects were enrolled for the first trimester double mark...Objective To identify and determine the optimal method to screening for fetal Down＇s syndrome （DS）. Methods Three large cohorts with 17 118, 39 903, 16 646 subjects were enrolled for the first trimester double marker （pregnancy-associated plasma protein A and free [B-human chorionic gonadotropin） screening （FTDMS）, second trimester double marker （c{-fetoprotein and free B-human chorionic gonadotropin） screening （STDMS）, and second trimester triple marker （a-fetoprotein, free 13-human chorionic gonadotropin and unconjugated estriol 3） screening （STTMS）, respectively. The sensitivity, specificity, false positive rate （FPR）, false negative rate （FNR） and the areas under ROC curves （AUCs） were estimated in order to determine the optimal screening method in women under or above 35 years old. Results For women under 35 years old, STTMS was the best method with a detection rate of 68.8% and FPR of 4.3% followed by the STDMS with a detection rate （sensitivity） of 66.7% and FPR of 4.9%. The FTDMS had a lower detection rate of 61.1% and FPR of 6.3%. For women above 35 years old, the detection rate of all the methods was similar, but STTMS method had a lowest FPR of 15.9%. For women under 35 years old AUCs were 0.77 （95% CI, 0.64 to 0.91）, 0.81 （95% CI, 0.71 to 0.91）, and 0.82 （95% CI, 0.69 to 0.96） for FTDMS, STDMS, and STTMS methods, respectively; for those above 35 years old, AUCs were 0.70 （95% CI, 0.56 to 0.83）, 0.70 （95% CI, 0.59 to 0.82）, 0.78 （95% Cl, 0.58 to 0.97） for FTDMS, STDMS and SITMS, respectively. Conclusion Findings from our study revealed that STDMS is optimal for the detection of fetal DS in pregnant women aged under 35. For individual women, if economic condition permits, STFMS is the best choice, while for women aged above 35, STTMS is the best choice in this regard.展开更多
In China, ultrasound screening of fetal abnormalities is usually performed at 20 to 24 weeks of gestation.Recent data suggest that many fetal abnormalities can be detected as early as 11 to 14 weeks of gestation.l In ...In China, ultrasound screening of fetal abnormalities is usually performed at 20 to 24 weeks of gestation.Recent data suggest that many fetal abnormalities can be detected as early as 11 to 14 weeks of gestation.l In this study, we applied standard ultrasound views to screen for fetal structural abnormalities during the first trimester and investigated the effectiveness of the standard ultrasound views in the detection of fetal abnormalities.展开更多
TWO protein hormones, which are dominantly produced by the gonads, are termed inhibin and aetivin since they can inhibit and stimulate the secretion of follicle-stimulating hormone (FSH) by anterior pituitary gland. T...TWO protein hormones, which are dominantly produced by the gonads, are termed inhibin and aetivin since they can inhibit and stimulate the secretion of follicle-stimulating hormone (FSH) by anterior pituitary gland. They are also found in human placenta, and may regulate the placental hormonal secretion. However, control of inhibin subunit expression is not yet reported in human first trimester placenta. Here, using solution hybridization/nuclease protect assay, we determine expression of inhibin a and βA subunits in serum-free cultured trophoblast tissue from human first trimester placenta (6-9 week).展开更多
Emergency physicians are often the first providersto encounter patients with complications in earlypregnancy. Point-of-care （POC） pelvic ultrasound isbeing increasingly used in the evaluation of emergencydepartment ...Emergency physicians are often the first providersto encounter patients with complications in earlypregnancy. Point-of-care （POC） pelvic ultrasound isbeing increasingly used in the evaluation of emergencydepartment （ED） patients with first trimester symptoms.[1]While the initial aim of POC ultrasound in this settingis to confirm an intrauterine pregnancy, a secondarygoal is to differentiate between a normal and abnormalpregnancy. There exist a number of sonographic featuresto suggest a pregnancy is non-viable.展开更多
Introduction: A novel three dimensional approach for aneuploidy screening in the first trimester of pregnancy was developed in which risk assessment derives directly from comparing the plotted data of nuchal transluce...Introduction: A novel three dimensional approach for aneuploidy screening in the first trimester of pregnancy was developed in which risk assessment derives directly from comparing the plotted data of nuchal translucency, pregnancy associated plasma protein A (PAPP-A), and free β-human chorionic gonadotropin (fβ-hCG) of an examined fetus with similar coordinates of fetuses with already known health status. Under this approach, it is possible to utilize either a ‘box’ or a ‘sphere’ model. In either case, optimal volume sizes and the benefits of adopting a ‘minimum number of required fetuses’ (MNR) have not yet been investigated;and for the box model, two modifications, called ‘empty box results positive’ (EB+) and ‘simulation’ (SIM), provide additional options. It was the aim of this study to analyze which of the two models and their variants provides the best test performance. Methods: The study cohort was divided into a reference collective (n = 10,954) and a test collective (n = 4239). The test collective was examined repeatedly, with another model and modification used on each occasion. Test performances were compared by the area under curve (AUC) of receiver operating characteristics (ROC) curves. Results: The sphere model was inferior to the box model when optimal volumes were used with the latter and combined with the modifications EB+ and Sim. EB+ increased the number of assessable fetuses while Sim improved the test performance. MNR improved neither the box nor the sphere model. Conclusion: A new, optimized model in line with the obtained results should be developed and tested in further studies.展开更多
Preeclampsia(PE)is a multisystem disorder of pregnancy classically characterized by hypertension with significant proteinuria after 20 weeks'gestation.This disorder is one of the leading causes of maternal and per...Preeclampsia(PE)is a multisystem disorder of pregnancy classically characterized by hypertension with significant proteinuria after 20 weeks'gestation.This disorder is one of the leading causes of maternal and perinatal morbidity and mortality.PE can be subdivided into preterm PE(with delivery at<37 weeks'gestation)and term PE(with delivery at≥37 weeks'gestation).Preterm PE is associated with a higher risk of adverse maternal and perinatal outcomes than term PE.Traditional method of screening as recommended by professional guidelines has limited predictive performance and therefore should be updated to reflect recent scientific evidence that the target of screening should be preterm PE,the best way to identify the high-risk group is the Bayes-based method that combines maternal risk factors and biomarkers,the threshold should be set at screen positive rate of 10%,aspirin should be started before 16 weeks'gestation,and the daily dose should be higher than 100mg.展开更多
基金the Clinical Research Foundation of the Seventh Affiliated Hospital of Sun Yat-sen University(No.ZSQYLCKYJJ202010)the General Program of Science and Technology Project of Shenzhen(No.JCYJ20190814170205768)the Foundation of the Key Program of Social Science and Technology Development Project of Dongguan(No.202050715041216).
文摘Objective This study aimed to assess the feasibility and usefulness of transabdominal color Doppler flow imaging(CDFI)technology and the high-definition flow imaging(HDFI)technique in detecting fetal pulmonary veins(PVs)in the first trimester(11–13^(+6)weeks).Methods From December 2018 to October 2019,328 pregnant women with 328 normal singleton fetuses(crown-rump length:45–84 mm)who had undergone CDFI and HDFI scans for fetal heart and vessel examination were enrolled in this study.The cases were divided into three groups according to the gestational age:group A,11^(+0)−11^(+6)weeks;group B,12^(+0)−12^(+6)weeks;and group C,13^(+0)−13^(+6)weeks.Baseline sonograms and CDFI and HDFI images were analyzed by two senior radiologists independently and blindly.The abilities of CDFI and HDFI to display PVs were compared.Results Successful PV display rates via CDFI and HDFI were 2.3%and 68.2%(P<0.01),22.4%and 82.4%(P<0.01),41.5%and 91.2%(P<0.01)for group A,group B,and group C,respectively.The total successful display rates for the two methods were 28.9%(CDFI)and 84.8%(HDFI)(P<0.01).Conclusions The HDFI technique is more valuable than CDFI for detecting PVs in early pregnancy(11–13^(+6)weeks).HDFI can detect at least one PV in all cases and may be used to detect pulmonary venous anomalies early.
文摘Objectives To understand the changes on sexual and contraceptive behaviours of unmarried induced abortion（IA） youth by intervention in Sichuan, China; and to find a way to improve sexual and contraceptive behaviours of unmarried IA youth. Methods Intervention epidemiological surveys （baseline and evaluation） plus qualitative interview were used. During July 2002 and July 2003, 2 484 unmarried female volunteers who aged 15-29 years and come to clinics seeking abortion were recruited by cluster random sampling from the four selected regions of Sichuan, 48 volunteers were interviewed for 8 focusgroup discussions （FGDs） and 16 in-depth interviews equally for each survey. Information, education anol communication（IEC） materials, education sessions, trainings and counseling were given to subjects and service providers during the project implementation. Questionnaires for surveys and guidelines for qualitative interviews were used. Results Comparison of the after with the before intervention. 1） the proportion of respondents having knowledge about sexuality was increased by 13%. Among them, the proportion of respondents got part and most of the knowledge was increased by 43%. Maximum number of sex partners the respondents have decreased from 9 to 4. Respondents＇partnerships have gradually changed from more acquaintances/school mates/boyfriends to fianés mainly; 2） respondents＇ contraceptive use rate was increased by 20%. Among them, the condom use rate increased rapidly to 80%. Purposes of condom use were changed from only for contraception to for prevention of HIV/AIDS/STDs and pregnancy. And most of respondents stabilised their method use - condoms. Most of respondents suggested condoms was the method most suitable for unmarried IA youth, this proportion was increased by 44%; 3） proportion of respondents knowing more about consequences of induced abortion was increased by 24%; and 4） proportions of respondents having depression and anxiety symptoms were decreased by 66% and by 61%, respectively. Conclusion The intervention including IEC materials, education, training and counseling was effective in improving sexual and contraceptive behaviours of unmarried IA youth.
文摘Objective : To find a simple and rapid way far the prenatal diagnosis of phenyUce-tonuria (PKU) during the first trimester in order to prevent inborn PKU patients as early as possible. Methods :DNA was extracted respectively from the Mood sampleps of 9 families' members and chori-onic tissues of 9 embryoes by cliorionic vittus sampling (CVS). The independent short tandem repeat (STR) alleles of members in 9 families with classic form of PKU were analyzed and prenatal diagnosis were conducted using polymerase chain reaction (PCR) together with denaturing gradient gel elec-trophoresis(DGGE)and silver dyeing. Results-.We identified 1 embryo with PKU, 2 normal individuals and 5 carriers among 9 subjects. Conclusion: Prenatal diagnosis for PKU by STR is available in the first trimester. This procedure was promising and would be widely used in Chinese population.
文摘Aims: Hemorrhages in the first trimester of pregnancy constitute a public health problem in developing countries with maternal mortality which is still very high. This is the most common reason for consultation in early pregnancy. The objectives of this study were to describe the sociodemographic characteristics of the patients, identify the etiologies, describe the management and evaluate the maternal prognosis in patients presenting with hemorrhage in the first trimester of pregnancy. Methods: This was a descriptive-type prospective study lasting 12 months from January 1 to December 31, 2020, carried out at the maternity ward of Ignace Deen National Hospital. Results: During the study period, we recorded 163 cases of hemorrhage in the first trimester of pregnancy out of 5478 deliveries, i.e. a frequency of 2.97%. The main incriminated etiologies were spontaneous abortion (46.62%), ectopic pregnancy (28.22%), hydatidiform mole (16.56%), threatened abortion (5.52%) and pregnancy stopped (3.06%). The socio-demographic profile of the patients was that of a woman in the age group of 26 - 30 years (33.12%), married (79.14%), with secondary level (35.58%), exercising a liberal profession (36.19%) and nulliparous (60.12%). More than half of the patients came directly from home (57.66%) with metrorrhagia (44.78%) and abdominal pain (33.12%) as reasons for consultation. The gestational age between 7-11SA was more represented (82.82%). Manual intrauterine aspiration (58.89%) and salpingectomy (28.22%) were the most practiced therapeutic procedures. We transfused 10.42% of patients and 20.85% received medical treatment. The maternal prognosis was good in 47.87%. The main complications recorded were anemia (38.65%) and the state of shock (10.42%). Conclusion: Hemorrhages in the first trimester of pregnancy represent an important cause of maternal morbidity in developing countries. The improvement of the maternal prognosis would pass by the early consultation in front of any case of pregnancy.
基金the National Key Research and Development Program of China(No.2021YFC2701600 and 2021YFC2701604).
文摘Preeclampsia(PE),a multisystem disorder in pregnancy,is one of the leading causes of perinatal morbidity and mortality that poses financial and physical burdens worldwide.Preterm PE with delivery at<37 weeks of gestation is associated with a higher risk of adverse maternal and perinatal outcomes than term PE with delivery at≥37 weeks of gestation.A myriad of first trimester screening models have been developed to identifying women at risk of preterm PE.In fact,the Fetal Medicine Foundation(FMF)first trimester prediction model has undergone successful internal and external validation.The FMF triple test enables the estimation of patient-specific risks,using Bayes theorem to combine maternal characteristics and medical history together with measurements of mean arterial pressure,uterine artery pulsatility index,and serum placental growth factor.Establishing a quality control process for regular monitoring and to ensure data standardization,reliability,and accuracy is key to maintaining optimal screening performance.The rate of preterm PE can be reduced by 62%by using the FMF prediction model,followed by the administration of low-dose aspirin.Recent evidence has also demonstrated that metformin has the potential for preventing PE in patients at high-risk of the disorder.In this article,we will summarize the existing literature on the different screening methods,different components of risk assessment,therapeutic interventions,and clinical implementation of the first trimester screening and prevention program for PE with specific considerations for Chinese mainland.
文摘r Objective To discuss the diagnosis of and conservative management for lower uterine segment pregnancy with placenta increta complicating first trimester abortion. Methods Four patients with previous caesarean section and severe hemorrhage in induced abortion in the first trimester were studied. Uterine artery embolization (UAE) was used to control bleeding and preserve the uterus. Results UAE controlled heavy uterine bleeding satisfactorily. One of the four patients asked for a hysterectomy after UAE, and her pathology report confirmed “lower uterine segment pregnancy with placenta increta”. Conclusion Previous caesarean section is a risk factor for lower uterine segment pregnancy with placenta increta. UAE is one of the best conservative management methods for heavy hemorrhage, especially for women who desire future fertility.
基金supported by the National Natural Science Foundation of China (81101655)the grant from the China Postdoctoral Science Foundation (2011M501282)the grant from Hunan Provincial Science & Tecnology Departemnt(2009SK3048)
文摘Objective To identify and determine the optimal method to screening for fetal Down＇s syndrome （DS）. Methods Three large cohorts with 17 118, 39 903, 16 646 subjects were enrolled for the first trimester double marker （pregnancy-associated plasma protein A and free [B-human chorionic gonadotropin） screening （FTDMS）, second trimester double marker （c{-fetoprotein and free B-human chorionic gonadotropin） screening （STDMS）, and second trimester triple marker （a-fetoprotein, free 13-human chorionic gonadotropin and unconjugated estriol 3） screening （STTMS）, respectively. The sensitivity, specificity, false positive rate （FPR）, false negative rate （FNR） and the areas under ROC curves （AUCs） were estimated in order to determine the optimal screening method in women under or above 35 years old. Results For women under 35 years old, STTMS was the best method with a detection rate of 68.8% and FPR of 4.3% followed by the STDMS with a detection rate （sensitivity） of 66.7% and FPR of 4.9%. The FTDMS had a lower detection rate of 61.1% and FPR of 6.3%. For women above 35 years old, the detection rate of all the methods was similar, but STTMS method had a lowest FPR of 15.9%. For women under 35 years old AUCs were 0.77 （95% CI, 0.64 to 0.91）, 0.81 （95% CI, 0.71 to 0.91）, and 0.82 （95% CI, 0.69 to 0.96） for FTDMS, STDMS, and STTMS methods, respectively; for those above 35 years old, AUCs were 0.70 （95% CI, 0.56 to 0.83）, 0.70 （95% CI, 0.59 to 0.82）, 0.78 （95% Cl, 0.58 to 0.97） for FTDMS, STDMS and SITMS, respectively. Conclusion Findings from our study revealed that STDMS is optimal for the detection of fetal DS in pregnant women aged under 35. For individual women, if economic condition permits, STFMS is the best choice, while for women aged above 35, STTMS is the best choice in this regard.
基金This study was supported by the grants from the National Natural Science Foundation of China （No. 81071159）, Beijing Municipal Science and Technology Commission Key Project （No. D 101100050010039） and Capital Medicine Development Science Research Foundation （No. 2009-3131）.
文摘In China, ultrasound screening of fetal abnormalities is usually performed at 20 to 24 weeks of gestation.Recent data suggest that many fetal abnormalities can be detected as early as 11 to 14 weeks of gestation.l In this study, we applied standard ultrasound views to screen for fetal structural abnormalities during the first trimester and investigated the effectiveness of the standard ultrasound views in the detection of fetal abnormalities.
文摘TWO protein hormones, which are dominantly produced by the gonads, are termed inhibin and aetivin since they can inhibit and stimulate the secretion of follicle-stimulating hormone (FSH) by anterior pituitary gland. They are also found in human placenta, and may regulate the placental hormonal secretion. However, control of inhibin subunit expression is not yet reported in human first trimester placenta. Here, using solution hybridization/nuclease protect assay, we determine expression of inhibin a and βA subunits in serum-free cultured trophoblast tissue from human first trimester placenta (6-9 week).
文摘Emergency physicians are often the first providersto encounter patients with complications in earlypregnancy. Point-of-care （POC） pelvic ultrasound isbeing increasingly used in the evaluation of emergencydepartment （ED） patients with first trimester symptoms.[1]While the initial aim of POC ultrasound in this settingis to confirm an intrauterine pregnancy, a secondarygoal is to differentiate between a normal and abnormalpregnancy. There exist a number of sonographic featuresto suggest a pregnancy is non-viable.
文摘Introduction: A novel three dimensional approach for aneuploidy screening in the first trimester of pregnancy was developed in which risk assessment derives directly from comparing the plotted data of nuchal translucency, pregnancy associated plasma protein A (PAPP-A), and free β-human chorionic gonadotropin (fβ-hCG) of an examined fetus with similar coordinates of fetuses with already known health status. Under this approach, it is possible to utilize either a ‘box’ or a ‘sphere’ model. In either case, optimal volume sizes and the benefits of adopting a ‘minimum number of required fetuses’ (MNR) have not yet been investigated;and for the box model, two modifications, called ‘empty box results positive’ (EB+) and ‘simulation’ (SIM), provide additional options. It was the aim of this study to analyze which of the two models and their variants provides the best test performance. Methods: The study cohort was divided into a reference collective (n = 10,954) and a test collective (n = 4239). The test collective was examined repeatedly, with another model and modification used on each occasion. Test performances were compared by the area under curve (AUC) of receiver operating characteristics (ROC) curves. Results: The sphere model was inferior to the box model when optimal volumes were used with the latter and combined with the modifications EB+ and Sim. EB+ increased the number of assessable fetuses while Sim improved the test performance. MNR improved neither the box nor the sphere model. Conclusion: A new, optimized model in line with the obtained results should be developed and tested in further studies.
文摘Preeclampsia(PE)is a multisystem disorder of pregnancy classically characterized by hypertension with significant proteinuria after 20 weeks'gestation.This disorder is one of the leading causes of maternal and perinatal morbidity and mortality.PE can be subdivided into preterm PE(with delivery at<37 weeks'gestation)and term PE(with delivery at≥37 weeks'gestation).Preterm PE is associated with a higher risk of adverse maternal and perinatal outcomes than term PE.Traditional method of screening as recommended by professional guidelines has limited predictive performance and therefore should be updated to reflect recent scientific evidence that the target of screening should be preterm PE,the best way to identify the high-risk group is the Bayes-based method that combines maternal risk factors and biomarkers,the threshold should be set at screen positive rate of 10%,aspirin should be started before 16 weeks'gestation,and the daily dose should be higher than 100mg.
