Objective:To explore the correlation between the distribution of 14bp polymorphism in exon 8 of human leukocyte antigen-G(HLA-G)gene in Hainan Li nationality and susceptibility to severe preeclampsia.Methods:100 cases...Objective:To explore the correlation between the distribution of 14bp polymorphism in exon 8 of human leukocyte antigen-G(HLA-G)gene in Hainan Li nationality and susceptibility to severe preeclampsia.Methods:100 cases of severe preeclampsia inpatients(experimental group)admitted to our hospital from June 2018 to September 2019 were selected.Among them,50 were Li and 50 were Han,and 100 were admitted to our hospital during the same period Normal pregnant women were the control group,including 50 cases of Li nationality and 50 cases of Han nationality.Venous blood was collected to detect the 14bp polymorphism in HLA-G gene exon 8,and the correlation between the 14bp polymorphism in HLA-G gene exon 8 and susceptibility to severe preeclampsia was analyzed.Results:There was a statistically significant difference in the 14-bp genotyping and allele frequency in HLA-G exon 8 of the Li ethnic group in the control group and the experimental group(P<0.05).The SBP and DBP of the Li 14-14/14bp typing,+14bp/-14bp typing,and allele-14bp typing were lower in the experimental group than in the Han group in the experimental group(P<0.05),and the SBP of+14bp/-14bp typing DBP was higher than that of Han patients in the experimental group(P<0.05).Binary Logistic Regression Analysis+14bp/-14bp was associated with the incidence of severe preeclampsia in Li women in Hainan region(P<0.05).The-14bp/-14bp classification was a protective factor for severe preeclampsia in Li women in Hainan region(P<0.05).Conclusion:The HLA-G gene exon 8 carrying a 14bp deletion polymorphism in the Hainan Li nationality is associated with preeclampsia susceptibility and progression.展开更多
Severe pre<span>e</span><span>clampsia is a challenging issue facing both intensivist and anesthetic team carrying both maternal and fetal morbidity and mortality. Termination of pregnancy after bloo...Severe pre<span>e</span><span>clampsia is a challenging issue facing both intensivist and anesthetic team carrying both maternal and fetal morbidity and mortality. Termination of pregnancy after blood pressure control is the golden key in management. Cerebral complications due to diffuse cerebral vasospasm are most common and serious. Intrathecal midazolam with its gamma amino butyric action may antidote glutamate mediated sympathetic surge and decreasing cerebral vasospasm. Temporal view transcranial Doppler imaging maternal middle cerebral artery is used to examine blood flow indices namely pulsat</span><span>i</span><span>lity index and resistiv</span><span>e</span><span> index. One hundred ladies with severe pre</span><span>e</span><span>clampsia scheduled for urgent caesarian section were recruited in 2 groups, both received 10</span><span> </span><span>mg bupivacaine 0.5%, Midazolam group received 1</span><span> </span><span>mg midazolam and the other group received 0.2</span><span> </span><span>ml sterile saline 0.9% NaCl. All vascular indices were significantly better in midazolam group, less ICU stay.</span>展开更多
This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients ...This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients with severe preeclampsia (PE group) and 20 normal pregnant women (control group) to prepare monocytes which were then treated with LXA 4 at different concentrations of 0,10,100 nmol/L respectively.IL-1β level in the supernatant of monocytes was detected by enzyme linked immunoassay.The [Ca 2+ ] i of monocytes was measured by laser scanning confocal microscopy.The results showed that the IL-1β level and the [Ca 2+ ] i of monocytes in the PE group were significantly higher than those in the control group.LXA 4 significantly decreased the generation of IL-1β in a dose-dependent manner in the PE group.After treatment with 100-nmol/L LXA 4,in the PE group,the [Ca 2+ ] i concentration of monocytes was significantly reduced.It was concluded that LXA 4 may inhibit the IL-1β production of monocytes from severe preeclampsia women by inhibiting extracellular calcium influx.展开更多
Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesa...Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesarean deliveries in patients with severe preeclampsia. Methods: It was a case-control study carried out over 6 months, from December 1st, 2015 to May 31st, 2016 at the Yaoundé Central and the Yaoundé Gynaeco-Obstetric and Paediatric Hospitals. We evaluated 159 women undergoing a caesarean delivery to assess the risk of maternal and foetal postoperative complications in patients with severe preeclampsia. Significance level was set at 0.05. Results: The incidence of postoperative complications stood at 26.4%. Maternal and foetal complications were more frequent in preeclamptic women at 54.5% versus 11.5% (p < 0.05) and 47.3% versus 27.9% (p < 0.05) respectively. The incidence of adverse events was greater in women with preeclampsia: pruritus and limb pain (RR = 2.96;p < 0.001), the persistence of high blood pressure (RR = 4.51, p < 0.001), maternal death (RR = 2.93, p < 0.001), postpartum convulsions (RR = 3, p < 0.001) headaches resistant to first-line analgesics (RR = 3, p < 0.001), Disseminated Intravascular Coagulation (DIC) (RR = 2.92, p < 0.001), a cute pulmonary oedema (RR = 2.92, p < 0.001), prematurity (RR = 4.43, p < 0.001), neonatal asphyxia (RR = 2.93, p < 0.001), and hyaline membrane disease (RR = 2.93, p Conclusion: Severe preeclampsia is associated with an increased risk of postoperative complications.展开更多
Objective: To compare the levels of p38 mitogen-activated protein kinase (MAPK), soluble endoglin and endothelin-1 in the serum of patients with severe preeclampsia, hemolysis, elevated liver enzymes, and low platelet...Objective: To compare the levels of p38 mitogen-activated protein kinase (MAPK), soluble endoglin and endothelin-1 in the serum of patients with severe preeclampsia, hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and normal pregnancies. Methods: This study was an observational analytic cross-sectional study performed at Wahidin Sudirohusodo Hospital, Makassar, Indonesia, in the period of 5th February 2016 to 20th January 2017. P38 MAPK, soluble endoglin and endothelin-1 levels of patients with normal pregnancies, severe preeclampsia and HELLP syndrome were measured by enzyme-linked immunoabsorbentassay technique, using kits of human soluble endoglin, endothelin-1 and p38 MAPK, Quantikine immunoassay: R&D System Inc. Results: Level of serum p38 MAPK in HELLP syndrome group was higher than in severe preeclampsia and normal pregnancy groups. Soluble endoglin and endothelin-1 levels in pregnancies with severe preeclampsia and HELLP syndrome were higher than normal pregnancy but there was no significant difference between these two groups (P>0.05). Levels of p38 MAPK, soluble endoglin and endothelin-1 also had a positive linear correlation with systolic and diastolic blood pressures (P<0.05). Conclusions: P38 MAPK in serum may be a marker for evidence of the severe hypoxia and its application may be considered for the diagnosis of HELLP syndrome.展开更多
Objective: The aim of this study was to determine maternal and perinatal complications of pregnancies complicated by severe preeclampsia in three tertiary care centers in Cameroon. Methods: We carried out a descriptiv...Objective: The aim of this study was to determine maternal and perinatal complications of pregnancies complicated by severe preeclampsia in three tertiary care centers in Cameroon. Methods: We carried out a descriptive cross sectional study from the 1st of June 2012 to the 31th of June 2014, among pregnant women with severe preeclampsia followed up in three tertiary level hospitals in Yaoundé, Cameroon: the Yaoundé General Hospital, the Yaoundé Central Hospital, and the Yaoundé University Hospital. Statistical analysis was performed using EPI 3.5.5. Data were described as means ± standard deviation, percentages and numbers. Chi-square and Fisher exact tests were used where appropriate. Results: Of the 2500 deliveries registered during the study period, 111 cases (8.49%) were managed as severe preeclampsia. Four patients refused to participate and were excluded from the study. Most of these patients were non workers (58.0%), pauciparous (61.7%) and young (median age of 27.47 years ± 6.46). Eclampsia (12.14%), abruptio placentae (11.21%) and hypertensive retinopathy (7.47%) were the most frequent maternal complications. Two cases (1.86%) of maternal deaths occurred in patients who had eclampsia. Prematurity (48.6%), intra uterine fetal death (13.1%) and oligoamnios (11.2%) were the most frequent fetal complications. All four neonatal deaths occurred in women in whom the diagnosis of severe preeclampsia was done between 28 and 33 weeks of gestation. Conclusion: Pregnancies complicated by severe preeclampsia had significantly high maternal and perinatal morbidity and mortality in Cameroon. The complications of severe preeclampsia can be prevented by more widespread use of antenatal care, education of primary medical care personnel, prompt diagnosis of high-risk patients and timely referral to tertiary medical centers.展开更多
Objectives: To better understand the etiologic factors that can influence preeclampsia, we inves- tigated hereditary factors for thrombosis, FV Leiden, F II 20210A mutation and the polymorphism C677T of the MTHFR, as ...Objectives: To better understand the etiologic factors that can influence preeclampsia, we inves- tigated hereditary factors for thrombosis, FV Leiden, F II 20210A mutation and the polymorphism C677T of the MTHFR, as singly and as in association, in a group of women from Ceará state-Northeast Brazil with severe preeclampsia. Material and Methods: We conducted a case-control study. 101 cases of severe preeclampsia were recruited from School Maternity Assis Chateaubriand, a reference Maternity of State of Ceará, Brazil, from December 2009 to December 2010. For clinical correlations, women were interrogated about fetal low weight (less than2500 grams) and fetal loss in previous pregnancies. Low weight, fetal loss and necessity of neonatal intensive care unit (neonatal ICU) related to current pregnancy were registered. 245 healthy voluntary women were recruited from the blood bank donors to verify the frequency of FV Leiden, FII and MTHFR as a control group. The study was approved by the Committee on Ethics in Human Research of Maternidade Escola Assis Chateubriand and all individuals gave their informed consent to participate in the study. Standard veinipuncture, with EDTA as anticoagulant, was used to collect blood samples. Genomic DNA was extracted, soon after, using a salting out method. Agarose gel electrophoresis with ethidium bromide staining was performed to ensure the quality of DNA extraction. Results: The frequencies of FV Leiden and FII mutation carrier were 0.99% (1/101) for both factors in the preeclampsia patients and 1.86% (4/214) and 0.93% (2/214), respectively, in control group. All mutates were heterozygous and concomitance of both mutations was not found. The genotype distribution of the MTHFR C677T in the patients and controls frequencies was in Hardy-Weinberg equilibrium (p ≤ 0.05). No statistical difference was observed between cases and controls in MTHFR genotypes or alleles. Conclusions: The FV Leiden, FII G20210A mutation and MTHFR C677T were not risks for preeclampsia development. FV Leiden and FII G20210A mutations had low frequency in the population studied, which may justify the absence of association.展开更多
The classic picture of a hydatiform mole is made of recurrent metrorrhagia, exaggeration of sympathetic signs, increase of uterine volume compared to gestational age and marked elevation of serum β-hCG. The occurrenc...The classic picture of a hydatiform mole is made of recurrent metrorrhagia, exaggeration of sympathetic signs, increase of uterine volume compared to gestational age and marked elevation of serum β-hCG. The occurrence of preeclampsia is less common and its mechanism is less well known. In this case, the authors report an atypical presentation of the complete hydatiform mole alarmed by chronic hypertension with preeclampsia added to a pregnant woman of 39 years. The management involved stopping the pregnancy and normalization of the blood pressure figures was spectacular after uterine aspiration.展开更多
<strong>Objective:</strong> <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">To study</span><...<strong>Objective:</strong> <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">To study</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> effect</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">on fetal MCA and UA blood flow changes</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">using Doppler ultrasound</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">in cases of severe PET and eclampsia. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">A total of 40 patients with severe PET admitted to El-Shatby Maternity University Hospital, Alexandria (Egypt) were examined before and after administration of MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> using Doppler study to measure fetal MCA</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">and UA blood flow changes. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">After administration</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">of MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;">, the mean</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">RI of UA, PI of UA showed a statistically significant decrease (P < 0.001) also the systolic-diastolic ratio (p = 0.001). Mean resistivity index (RI) cerebral showed a statistically significant increasing (P = 0.001), pulsatility index (PI)-cerebral and the systolic-diastolic ratio showed a statistically significant increasing (P < 0.001).</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">C/U (cerebroumblical) ratio increased after the treatment (P < 0.001). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">Infusion of MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> significantly decreases the fetal RI, PI, SDR umbilical and increases the fetal RI, PI, SDR MCA and increases cerebroumblical ratio indices obtained by Doppler</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">examinations.</span></span></span>展开更多
Severe preeclampsia (SPE) is associated with fetal complications including intrauterine growth retardation (IUGR), prematurity and in utero fetal death. Its treatment remains child birth that often is planned before t...Severe preeclampsia (SPE) is associated with fetal complications including intrauterine growth retardation (IUGR), prematurity and in utero fetal death. Its treatment remains child birth that often is planned before term. However, this attitude can lead to fetal complications related to prematurity. Several studies on preeclampsia have already been studied in the DRC and several aspects have already been realized, but to date, the neonatal outcome has not yet been addressed. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is cross-sectional study performed in four public hospitals in Kinshasa (Democratic Republic of Congo). We included 400 cases of induced prematurity (IP) for SPE;the analysis compared pregnant women who gave birth before 34 weeks of amenorrhea (WA) and those after 34 WA. The comparison of the proportions was made by the Chi</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">square test and the calculation of Means by the Student’s test. The significance level was set at P < 0.05. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To determine the frequency of induced prematurity for severe preeclampsia (SPE), to identify the indications and to evaluate neonatal outcome. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The IP frequency for SPE was 46.2%. The retro placental hematoma was the most indication in pregnancies before 34 WA 24.9%, while high blood pressure 54.5% in the after 34 WA group. </span><i><span style="font-family:Verdana;">In</span></i> <i><span style="font-family:Verdana;">utero</span></i><span style="font-family:Verdana;"> death was more common in pregnant women who gave birth before 34 weeks 25.4%;chronic fetal distress was elevated in the after 34 WA group 19.5%. Neonatal infection was more common in the group after 34 WA </span><span style="font-family:Verdana;">49.4%, while respiratory distress 39.6%, intra and periventricular hemorrhage 19.5% and neonatal death 39.6% were more in group before 34</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">WA. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Prematurity induced for SPE is related to a poor neonatal</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> prognosis.展开更多
Background: Abdominal pregnancy is a rare ectopic pregnancy in which the baby grows up in the peritoneal cavity exclusive of tubal, ovarian, or intraligamentary implantations. Abdominal pregnancy has very high materna...Background: Abdominal pregnancy is a rare ectopic pregnancy in which the baby grows up in the peritoneal cavity exclusive of tubal, ovarian, or intraligamentary implantations. Abdominal pregnancy has very high maternal and fetal morbidity and mortality. Therefore, early recognition and prompt management remain challenges for the treating physician. A thorough examination of the newborn is critical to rule out congenital anomalies. We reported a 24-year-old woman primigravida 40 weeks post-date with spontaneous conception who was admitted to the hospital with complaints of diffuse abdominal pain, symptoms, and signs of severe preeclampsia (headache, vomiting, high blood pressure, blurred vision, and swelling of the feet, ankles, face, and hands). Moreover, she had recurrent vaginal spotting, nausea, loss of appetite, and occasional vomiting. She was diagnosed with a progressive abdominal pregnancy later. A live male fetus stained with meconium was removed from the abdominal cavity, and the placenta was completely removed without significant blood loss. Conclusion: Abdominal pregnancy is a rare ectopic pregnancy requiring high clinical suspicion, early identification, and prompt management to avoid maternal morbidity and mortality. Abdominal pregnancy can be prevented by avoiding miscarriage and treating adhesions and chronic inflammatory diseases.展开更多
Objective:To study the influence of human albumin combined with low-dose heparin on disease condition, serology and placental blood flow of severe preeclampsia patients. Methods:A total of 78 patients with severe pree...Objective:To study the influence of human albumin combined with low-dose heparin on disease condition, serology and placental blood flow of severe preeclampsia patients. Methods:A total of 78 patients with severe preeclampsia in our hospital between May 2011 and February 2017 were chosen as study subjects, treatment methods were reviewed and all patients were divided into control group (n=37) who underwent low-dose heparin plus conventional treatment and observation group (n=41) who underwent human albumin combined with low-dose heparin plus conventional treatment, both lasting for 7 d. Before and after treatment, mean arterial pressure (MAP) and 24 h urinary protein were measured, serum markers of disease were measured by enzyme-linked immunosorbent assay (ELISA), and umbilical artery hemodynamics were detected by color Doppler ultrasound.Results:Before treatment, there was no significant difference between the two groups in MAP, 24 h urine protein, serum disease-related indexes or umbilical artery hemodynamic indexes. 7 d after treatment, MAP and 24 h urine protein levels in observation group were lower than those in control group;serum disease-related indexes TGF-β1 and VEGF contents in observation group were higher than those in control group whereas VCAM-1 and sFlt-1 contents were lower than those in control group;umbilical artery hemodynamic indexes PI, RI and S/D levels in observation group were lower than those in control group.Conclusion: Human albumin combined with low-dose heparin can optimize the disease condition, promote the angiogenesis of placenta and increase the blood supply of placenta in patients with severe preeclampsia.展开更多
Objective: To investigate the effect of magnesium sulfate combined with labetalol on the apoptosis and invasion molecule expression in placenta as well as maternal endothelial function of patients with severe preeclam...Objective: To investigate the effect of magnesium sulfate combined with labetalol on the apoptosis and invasion molecule expression in placenta as well as maternal endothelial function of patients with severe preeclampsia. Methods: A total of 68 patients with severe preeclampsia who were treated in the hospital between October 2015 and August 2017 were chosen as the research subjects and divided into study group (n=34) and control group (n=34) by random number table method. Control group received magnesium sulfate therapy on the basis of conventional therapy, and study group received magnesium sulfate combined with labetalol therapy on the basis of conventional therapy. The differences in the expression of apoptosis and invasion molecules in placenta tissue as well as the levels of maternal endothelial function indexes were compared between the two groups. Results: Fas, Bax and Caspase-3 mRNA expression in the placenta tissues of study group were lower than those of control group whereas Bcl-2 mRNA expression was higher than that of control group;GPR30, LAMA4 and MEST mRNA expression in placenta tissues were lower than those of control group whereas CDKN1C mRNA expression was higher than that of control group;24 h before delivery, maternal serum ET-1 and vWF levels of study group were lower than those of control group whereas NO level was higher than that of control group (P<0.05). Conclusion: Magnesium sulfate combined with labetalol therapy can effectively inhibit the apoptosis of placental trophoblast cells and enhance their invasion ability, and also improve the maternal endothelial function in patients with severe preeclampsia.展开更多
Hypertensive disorders are the most common medical complications of pregnancy (7.15%). Doppler analysis of umbilical artery S/D ratio PI and RI, absent or reversal of EDV were evaluated and follow up results studied i...Hypertensive disorders are the most common medical complications of pregnancy (7.15%). Doppler analysis of umbilical artery S/D ratio PI and RI, absent or reversal of EDV were evaluated and follow up results studied in severe preeclampsia women between 26 to 40 weeks. Doppler analysis of Uterine Artery and Middle Cerebral Artery is also studied. Doppler study guides in decision making and follows up in severe preeclampsia and guides in reducing perinatal morbidity and mortality. Period of Study: This is a prospective randomised study conducted at Niloufer Hospital for Women and Children Red Hills Hyderabad from September 2011 to June 2014. Material and Methods: 100 pregnant women with severe preeclampsia who attended Antenatal Out-Patient Department and got admitted in Emergency ward underwent Umbilical artery velocimetry by means of a Colour doppler vision (6000 Toshiba corp Tokyo Japan) using 3.5_5 MHZ Trasabdominal traducer. Results: Total number of 100 women were studied. In this 60 women had foetuses with abnormal umbilical artery flow velocimetry and 40 had normal umbilical artery flow velocimetry. The average birth weight and diagnosis to delivery interval were lower in foetuses with abnormal umbilical artery doppler. Admission to neonatal intensive care unit is high. The APGAR score at 1 minute is <7 in 20 women with abnormal umbilical artery doppler compared to 17 women with normal umbilical artery doppler. Compared to 32 women with normal umbilical artery doppler, the APGAR score is more than 7 in 31 women with abnormal umbilical artery Doppler. P = 0.639647 and chi-square statistic = 0.2192, the result is statistically not significant at p-value < 0.05, implying that APGAR scores are not dependent on doppler findings alone. Conclusion: Doppler study guides obstetrician to assess the physiological status of the foetus and it helps in identifying the changes in the foetal circulation. This study suggests that doppler assessment of foe to placental circulation including umbilical artery is a better prognostic indicator in severe PE and helps in timely intervention. The foetuses with normal artery flow velocimetry area at a lower risk of having poor APGAR score than those with abnormal velocimetry and NICU admissions are less with normal umbilical artery flow velocimetry. The average birth weight of neonates with abnormal umbilical artery was lower compared to neonates with normal umbilical artery velocimetry.展开更多
Objective:To study the effect of adjuvant low-molecular-weight heparin therapy on placental hypoxia and cell apoptosis in puerperae with severe preeclampsia.Methods:A total of 94 puerperae with severe preeclampsia who...Objective:To study the effect of adjuvant low-molecular-weight heparin therapy on placental hypoxia and cell apoptosis in puerperae with severe preeclampsia.Methods:A total of 94 puerperae with severe preeclampsia who received treatment and safely gave birth in our hospital between May 2014 and May 2016 were selected as the research subjects and randomly divided into the LMWH group who received low-molecular-weight heparin combined with conventional symptomatic treatment and the control group who received conventional symptomatic treatment. Before and after treatment, serum was collected respectively to determine the levels of placental hypoxia-related cytokines, and after delivery, the placentas were collected to detect oxidative stress indexes and cell apoptosis indexes.Results: After treatment, serum PLGF and PAPP-A levels of both groups were significantly higher than those before treatment while sFlt-1 and sEng levels were significantly lower than those before treatment, and after treatment, serum PLGF and PAPP-A levels of LMWH group were significantly higher than those of control group while sFlt-1 and sEng levels were significantly lower than those of control group;ROS and RNS levels as well as Fas, FasL, caspase-3 and caspase-8 protein expression in placenta tissue of LMWH group were significantly lower than those of control group while GPx-1, SOD-1 and Trx levels as well as Survivin, XIAP and Bcl-2 protein expression were significantly higher than those of control group.Conclusion:Adjuvant low-molecular-weight heparin therapy can relieve the placental hypoxia, improve oxidative stress reaction and inhibit cell apoptosis in puerperae with severe preeclampsia.展开更多
Objective:To study the omentin expression level in neonatal umbilical cord of patients with severe preeclampsia and its correlation with maternal endothelial injury and placental trophoblast invasion.Methods: The subj...Objective:To study the omentin expression level in neonatal umbilical cord of patients with severe preeclampsia and its correlation with maternal endothelial injury and placental trophoblast invasion.Methods: The subjects who were diagnosed with severe preeclampsia and gave birth in Wuhan No.1 Hospital between November 2015 and October 2017 were selected as the PE group, while healthy subjects who gave birth in Wuhan No.1 Hospital during the same period were selected as control group. The omentin expression in neonatal umbilical cord, endothelial injury index contents in maternal blood and invasion gene expression in placenta were determined.Results: The omentin expression in neonatal umbilical cord, VEGF and PLGF contents in maternal blood as well as OPN, MMP2 and MMP9 mRNA expressions in placenta of PE group were significantly lower than those of control group whereas IFI16, ET-1, sEng and sFlt-1 contents in maternal blood as well as Gadd45 and E-cadherin mRNA expressions in placenta were significantly higher than those of control group;IFI16, ET-1, sEng and sFlt-1 contents in maternal blood as well as Gadd45 and E-cadherin mRNA expressions in placenta of patients with high omentin expression were significantly lower than those of patients with low omentin expression whereas VEGF and PLGF contents in maternal blood as well as OPN, MMP2 and MMP9 mRNA expressions in placenta were significantly higher than those of patients with low omentin expression.Conclusion: The low expression of omentin in neonatal umbilical cord of patients with severe preeclampsia is closely related to the maternal endothelial injury and insufficient placental trophoblast invasion.展开更多
Objective:To study the effect of preventive multimodal analgesia (MMA) on maternal stress reaction as well as placental endoplasmic reticulum stress and cell apoptosis in patients with severe preeclampsia after cesare...Objective:To study the effect of preventive multimodal analgesia (MMA) on maternal stress reaction as well as placental endoplasmic reticulum stress and cell apoptosis in patients with severe preeclampsia after cesarean section.Methods: A total of 78 patients with severe preeclampsia who accepted cesarean section in Obstetrics Department of Shijiazhuang Maternal and Child Health Care Hospital between May 2014 and October 2016 were retrospectively analyzed and divided into MMA group and control group according to the different analgesia solutions after cesarean section. Before cesarean section as well as 1 d and 3 d after operation, serum levels of pain mediators and stress hormones were determined;after cesarean section, endoplasmic reticulum stress molecule expression levels in the placenta were determined.Results: 1 d and 3 d after operation,β-EP, SP, PGE2, ACTH, COR, INS and C-P levels in maternal blood circulation of both groups of subjects were significantly higher than those before cesarean section, andβ-EP, SP, PGE2, ACTH, COR, INS and C-P levels in maternal blood circulation of MMA group were significantly lower than those of control group;after childbirth, GRP78, GRP94, ERdj1, IRE1α, CHOP and Caspase-3 protein expression in placenta of MMA group were significantly lower than those of control group while XIAP and Survivin protein expression were significantly higher than those of control group.Conclusion:MMA has significant inhibitory effect on the maternal stress reaction as well as placental endoplasmic reticulum stress and cell apoptosis in patients with severe preeclampsia after cesarean section.展开更多
BACKGROUND Low-molecular-weight heparins(LMWH)are the most commonly used anticoagulants during pregnancy.It is considered to be the drug of choice due to its safety in not crossing placenta.Considering the beneficial ...BACKGROUND Low-molecular-weight heparins(LMWH)are the most commonly used anticoagulants during pregnancy.It is considered to be the drug of choice due to its safety in not crossing placenta.Considering the beneficial effect in the improvement of microcirculation,prophylactic application of LMWH in patients with preeclampsia became a trend.However,the bleeding risk related with LMWH in preeclampsia patients has seldomly been evaluated.This current study aimed to identify the potential risks regarding LMWH application in patients with preeclampsia.CASE SUMMARY Herein we present a case series of three pregnant women diagnosed with preeclampsia on LMWH therapy during pregnancy.All the cases experienced catastrophic hemorrhagic events.After reviewing the twenty-one meta-analyses,the bleeding risk related with LMWH seems ignorable.Only one study analyzed the bleeding risk of LMWH and found a significantly higher risk of developing PPH in women receiving LMWH.Other studies reported minor bleeding risks,none of these were serious enough to stop LMWH treatment.Possibilities of bleeding either from uterus or from intrabdominal organs in preeclampsia patients on LMWH therapy should not be ignored.Intensive management of blood pressure even after delivery and homeostasis suture in surgery are crucial.CONCLUSION Consideration should be given to the balance between benefits and risks of LMWH in patients with preeclampsia.展开更多
The superplastic behavior and associated deformation mechanisms of a fine-grained Mg-10.1 Li-0.8Al-0.6Zn alloy(LAZ1011)with a grain size of 3.2μm,primarily composed of the BCCβphase and a small amount of the HCPαph...The superplastic behavior and associated deformation mechanisms of a fine-grained Mg-10.1 Li-0.8Al-0.6Zn alloy(LAZ1011)with a grain size of 3.2μm,primarily composed of the BCCβphase and a small amount of the HCPαphase,were examined in a temperature range of 473 K to 623 K.The microstructural refinement of this alloy was achieved by employing high-ratio differential speed rolling.The best superplasticity was achieved at 523 K and at strain rates of 10^(-4)-5×10^(-4)s^(-1),where tensile elongations of 550±600%were obtained.During the heating and holding stage of the tensile samples prior to tensile loading,a significant increase in grain size was observed at temperatures above 573 K.Therefore,it was important to consider this effect when analyzing and understanding the superplastic deformation behavior and mechanisms.In the investigated strain rate range,the superplastic flow at low strain rates was governed by lattice diffusion-controlled grain boundary sliding,while at high strain rates,lattice diffusion-controlled dislocation climb creep was the rate-controlling deformation mechanism.It was concluded that solute drag creep is unlikely to occur.During the late stages of deformation at 523 K,it was observed that grain boundary sliding led to the agglomeration of theαphase,resulting in significant strain hardening.Deformation mechanism maps were constructed forβ-Mg-Li alloys in the form of 2D and 3D formats as a function of strain rate,stress,temperature,and grain size,using the constitutive equations for various deformation mechanisms derived based on the data of the current tests.展开更多
The implementation of WHO guidelines has significantly reduced hospital mortality due to severe malnutrition. Nevertheless, severe acute malnutrition in children under five remains a major public health problem in all...The implementation of WHO guidelines has significantly reduced hospital mortality due to severe malnutrition. Nevertheless, severe acute malnutrition in children under five remains a major public health problem in all low-income countries and is little studied. The study aimed to assess the nutritional status and quality of management of severe acute malnutrition in children aged 06 to 59 months hospitalized in the pediatric ward of Kayanza Hospital. This is a prospective study with descriptive and analytical aims over 6 months from February 10 to July 9, 2023. All children aged 6 to 59 months admitted for severe acute malnutrition are included in this study. The results show that the most affected age group is 12 to 23 months (42.55%). Marasmus is the most common clinical form, at 70.2%. Housewives and mothers from rural areas are the most affected, with rates ranging from 69.14% to 91.49%. The study shows that the reasons for consultation are respectively: edema (29.78%), diarrhea (26.59%), vomiting (19.14%), and fever (14.89%). Dehydration and hypothermia were the main complications observed in 45.74% and 22.34% respectively. Medical treatment was provided by antibiotics (44.68%), artesunate (31.91%), and resomal (21.27%). Nutritional treatment consisted of F75 100% milk and F100 100% milk. Pathologies observed were: anemia 38.29%, malaria 37.23%, urinary tract infection 12.7%, measles 11.7%. The national protocol for integrated management of acute malnutrition (PCIMA) was followed. This study shows that 72.3% of children were successfully treated, with 9.5% dropping out and dying, and 8.5% not responding. We found that malnutrition remains a public health problem, affecting mostly children aged 12 to 24 months. The main complications or pathologies associated with malnutrition are diarrhea, malaria, and fever, and the majority of children suffer from marasmus.展开更多
基金Medical and health research project of Hainan Provincial(1901031027A2001)
文摘Objective:To explore the correlation between the distribution of 14bp polymorphism in exon 8 of human leukocyte antigen-G(HLA-G)gene in Hainan Li nationality and susceptibility to severe preeclampsia.Methods:100 cases of severe preeclampsia inpatients(experimental group)admitted to our hospital from June 2018 to September 2019 were selected.Among them,50 were Li and 50 were Han,and 100 were admitted to our hospital during the same period Normal pregnant women were the control group,including 50 cases of Li nationality and 50 cases of Han nationality.Venous blood was collected to detect the 14bp polymorphism in HLA-G gene exon 8,and the correlation between the 14bp polymorphism in HLA-G gene exon 8 and susceptibility to severe preeclampsia was analyzed.Results:There was a statistically significant difference in the 14-bp genotyping and allele frequency in HLA-G exon 8 of the Li ethnic group in the control group and the experimental group(P<0.05).The SBP and DBP of the Li 14-14/14bp typing,+14bp/-14bp typing,and allele-14bp typing were lower in the experimental group than in the Han group in the experimental group(P<0.05),and the SBP of+14bp/-14bp typing DBP was higher than that of Han patients in the experimental group(P<0.05).Binary Logistic Regression Analysis+14bp/-14bp was associated with the incidence of severe preeclampsia in Li women in Hainan region(P<0.05).The-14bp/-14bp classification was a protective factor for severe preeclampsia in Li women in Hainan region(P<0.05).Conclusion:The HLA-G gene exon 8 carrying a 14bp deletion polymorphism in the Hainan Li nationality is associated with preeclampsia susceptibility and progression.
文摘Severe pre<span>e</span><span>clampsia is a challenging issue facing both intensivist and anesthetic team carrying both maternal and fetal morbidity and mortality. Termination of pregnancy after blood pressure control is the golden key in management. Cerebral complications due to diffuse cerebral vasospasm are most common and serious. Intrathecal midazolam with its gamma amino butyric action may antidote glutamate mediated sympathetic surge and decreasing cerebral vasospasm. Temporal view transcranial Doppler imaging maternal middle cerebral artery is used to examine blood flow indices namely pulsat</span><span>i</span><span>lity index and resistiv</span><span>e</span><span> index. One hundred ladies with severe pre</span><span>e</span><span>clampsia scheduled for urgent caesarian section were recruited in 2 groups, both received 10</span><span> </span><span>mg bupivacaine 0.5%, Midazolam group received 1</span><span> </span><span>mg midazolam and the other group received 0.2</span><span> </span><span>ml sterile saline 0.9% NaCl. All vascular indices were significantly better in midazolam group, less ICU stay.</span>
文摘This study examined in vitro effect of lipoxin A 4 (LXA 4) on interleukin-1β (IL-1β) production of monocytes and its possible mechanism in severe preeclampsia (PE).Peripheral venous blood was drawn from 15 patients with severe preeclampsia (PE group) and 20 normal pregnant women (control group) to prepare monocytes which were then treated with LXA 4 at different concentrations of 0,10,100 nmol/L respectively.IL-1β level in the supernatant of monocytes was detected by enzyme linked immunoassay.The [Ca 2+ ] i of monocytes was measured by laser scanning confocal microscopy.The results showed that the IL-1β level and the [Ca 2+ ] i of monocytes in the PE group were significantly higher than those in the control group.LXA 4 significantly decreased the generation of IL-1β in a dose-dependent manner in the PE group.After treatment with 100-nmol/L LXA 4,in the PE group,the [Ca 2+ ] i concentration of monocytes was significantly reduced.It was concluded that LXA 4 may inhibit the IL-1β production of monocytes from severe preeclampsia women by inhibiting extracellular calcium influx.
文摘Introduction: Severe preeclampsia is a frequent cause of maternal death, and also a frequent indication for caesarean deliveries when faced with the need to expedite delivery. We sought complications specific to caesarean deliveries in patients with severe preeclampsia. Methods: It was a case-control study carried out over 6 months, from December 1st, 2015 to May 31st, 2016 at the Yaoundé Central and the Yaoundé Gynaeco-Obstetric and Paediatric Hospitals. We evaluated 159 women undergoing a caesarean delivery to assess the risk of maternal and foetal postoperative complications in patients with severe preeclampsia. Significance level was set at 0.05. Results: The incidence of postoperative complications stood at 26.4%. Maternal and foetal complications were more frequent in preeclamptic women at 54.5% versus 11.5% (p < 0.05) and 47.3% versus 27.9% (p < 0.05) respectively. The incidence of adverse events was greater in women with preeclampsia: pruritus and limb pain (RR = 2.96;p < 0.001), the persistence of high blood pressure (RR = 4.51, p < 0.001), maternal death (RR = 2.93, p < 0.001), postpartum convulsions (RR = 3, p < 0.001) headaches resistant to first-line analgesics (RR = 3, p < 0.001), Disseminated Intravascular Coagulation (DIC) (RR = 2.92, p < 0.001), a cute pulmonary oedema (RR = 2.92, p < 0.001), prematurity (RR = 4.43, p < 0.001), neonatal asphyxia (RR = 2.93, p < 0.001), and hyaline membrane disease (RR = 2.93, p Conclusion: Severe preeclampsia is associated with an increased risk of postoperative complications.
文摘Objective: To compare the levels of p38 mitogen-activated protein kinase (MAPK), soluble endoglin and endothelin-1 in the serum of patients with severe preeclampsia, hemolysis, elevated liver enzymes, and low platelets (HELLP) syndrome and normal pregnancies. Methods: This study was an observational analytic cross-sectional study performed at Wahidin Sudirohusodo Hospital, Makassar, Indonesia, in the period of 5th February 2016 to 20th January 2017. P38 MAPK, soluble endoglin and endothelin-1 levels of patients with normal pregnancies, severe preeclampsia and HELLP syndrome were measured by enzyme-linked immunoabsorbentassay technique, using kits of human soluble endoglin, endothelin-1 and p38 MAPK, Quantikine immunoassay: R&D System Inc. Results: Level of serum p38 MAPK in HELLP syndrome group was higher than in severe preeclampsia and normal pregnancy groups. Soluble endoglin and endothelin-1 levels in pregnancies with severe preeclampsia and HELLP syndrome were higher than normal pregnancy but there was no significant difference between these two groups (P>0.05). Levels of p38 MAPK, soluble endoglin and endothelin-1 also had a positive linear correlation with systolic and diastolic blood pressures (P<0.05). Conclusions: P38 MAPK in serum may be a marker for evidence of the severe hypoxia and its application may be considered for the diagnosis of HELLP syndrome.
文摘Objective: The aim of this study was to determine maternal and perinatal complications of pregnancies complicated by severe preeclampsia in three tertiary care centers in Cameroon. Methods: We carried out a descriptive cross sectional study from the 1st of June 2012 to the 31th of June 2014, among pregnant women with severe preeclampsia followed up in three tertiary level hospitals in Yaoundé, Cameroon: the Yaoundé General Hospital, the Yaoundé Central Hospital, and the Yaoundé University Hospital. Statistical analysis was performed using EPI 3.5.5. Data were described as means ± standard deviation, percentages and numbers. Chi-square and Fisher exact tests were used where appropriate. Results: Of the 2500 deliveries registered during the study period, 111 cases (8.49%) were managed as severe preeclampsia. Four patients refused to participate and were excluded from the study. Most of these patients were non workers (58.0%), pauciparous (61.7%) and young (median age of 27.47 years ± 6.46). Eclampsia (12.14%), abruptio placentae (11.21%) and hypertensive retinopathy (7.47%) were the most frequent maternal complications. Two cases (1.86%) of maternal deaths occurred in patients who had eclampsia. Prematurity (48.6%), intra uterine fetal death (13.1%) and oligoamnios (11.2%) were the most frequent fetal complications. All four neonatal deaths occurred in women in whom the diagnosis of severe preeclampsia was done between 28 and 33 weeks of gestation. Conclusion: Pregnancies complicated by severe preeclampsia had significantly high maternal and perinatal morbidity and mortality in Cameroon. The complications of severe preeclampsia can be prevented by more widespread use of antenatal care, education of primary medical care personnel, prompt diagnosis of high-risk patients and timely referral to tertiary medical centers.
文摘Objectives: To better understand the etiologic factors that can influence preeclampsia, we inves- tigated hereditary factors for thrombosis, FV Leiden, F II 20210A mutation and the polymorphism C677T of the MTHFR, as singly and as in association, in a group of women from Ceará state-Northeast Brazil with severe preeclampsia. Material and Methods: We conducted a case-control study. 101 cases of severe preeclampsia were recruited from School Maternity Assis Chateaubriand, a reference Maternity of State of Ceará, Brazil, from December 2009 to December 2010. For clinical correlations, women were interrogated about fetal low weight (less than2500 grams) and fetal loss in previous pregnancies. Low weight, fetal loss and necessity of neonatal intensive care unit (neonatal ICU) related to current pregnancy were registered. 245 healthy voluntary women were recruited from the blood bank donors to verify the frequency of FV Leiden, FII and MTHFR as a control group. The study was approved by the Committee on Ethics in Human Research of Maternidade Escola Assis Chateubriand and all individuals gave their informed consent to participate in the study. Standard veinipuncture, with EDTA as anticoagulant, was used to collect blood samples. Genomic DNA was extracted, soon after, using a salting out method. Agarose gel electrophoresis with ethidium bromide staining was performed to ensure the quality of DNA extraction. Results: The frequencies of FV Leiden and FII mutation carrier were 0.99% (1/101) for both factors in the preeclampsia patients and 1.86% (4/214) and 0.93% (2/214), respectively, in control group. All mutates were heterozygous and concomitance of both mutations was not found. The genotype distribution of the MTHFR C677T in the patients and controls frequencies was in Hardy-Weinberg equilibrium (p ≤ 0.05). No statistical difference was observed between cases and controls in MTHFR genotypes or alleles. Conclusions: The FV Leiden, FII G20210A mutation and MTHFR C677T were not risks for preeclampsia development. FV Leiden and FII G20210A mutations had low frequency in the population studied, which may justify the absence of association.
文摘The classic picture of a hydatiform mole is made of recurrent metrorrhagia, exaggeration of sympathetic signs, increase of uterine volume compared to gestational age and marked elevation of serum β-hCG. The occurrence of preeclampsia is less common and its mechanism is less well known. In this case, the authors report an atypical presentation of the complete hydatiform mole alarmed by chronic hypertension with preeclampsia added to a pregnant woman of 39 years. The management involved stopping the pregnancy and normalization of the blood pressure figures was spectacular after uterine aspiration.
文摘<strong>Objective:</strong> <span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">To study</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> effect</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">on fetal MCA and UA blood flow changes</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">using Doppler ultrasound</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">in cases of severe PET and eclampsia. </span><b><span style="font-family:Verdana;">Materials and Methods: </span></b><span style="font-family:Verdana;">A total of 40 patients with severe PET admitted to El-Shatby Maternity University Hospital, Alexandria (Egypt) were examined before and after administration of MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> using Doppler study to measure fetal MCA</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">and UA blood flow changes. </span><b><span style="font-family:Verdana;">Results: </span></b><span style="font-family:Verdana;">After administration</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">of MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;">, the mean</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">RI of UA, PI of UA showed a statistically significant decrease (P < 0.001) also the systolic-diastolic ratio (p = 0.001). Mean resistivity index (RI) cerebral showed a statistically significant increasing (P = 0.001), pulsatility index (PI)-cerebral and the systolic-diastolic ratio showed a statistically significant increasing (P < 0.001).</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">The</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">C/U (cerebroumblical) ratio increased after the treatment (P < 0.001). </span><b><span style="font-family:Verdana;">Conclusions: </span></b><span style="font-family:Verdana;">Infusion of MgSO</span><sub><span style="font-family:Verdana;">4</span></sub><span style="font-family:Verdana;"> significantly decreases the fetal RI, PI, SDR umbilical and increases the fetal RI, PI, SDR MCA and increases cerebroumblical ratio indices obtained by Doppler</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">examinations.</span></span></span>
文摘Severe preeclampsia (SPE) is associated with fetal complications including intrauterine growth retardation (IUGR), prematurity and in utero fetal death. Its treatment remains child birth that often is planned before term. However, this attitude can lead to fetal complications related to prematurity. Several studies on preeclampsia have already been studied in the DRC and several aspects have already been realized, but to date, the neonatal outcome has not yet been addressed. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This is cross-sectional study performed in four public hospitals in Kinshasa (Democratic Republic of Congo). We included 400 cases of induced prematurity (IP) for SPE;the analysis compared pregnant women who gave birth before 34 weeks of amenorrhea (WA) and those after 34 WA. The comparison of the proportions was made by the Chi</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">square test and the calculation of Means by the Student’s test. The significance level was set at P < 0.05. </span><b><span style="font-family:Verdana;">Objective:</span></b><span style="font-family:Verdana;"> To determine the frequency of induced prematurity for severe preeclampsia (SPE), to identify the indications and to evaluate neonatal outcome. </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The IP frequency for SPE was 46.2%. The retro placental hematoma was the most indication in pregnancies before 34 WA 24.9%, while high blood pressure 54.5% in the after 34 WA group. </span><i><span style="font-family:Verdana;">In</span></i> <i><span style="font-family:Verdana;">utero</span></i><span style="font-family:Verdana;"> death was more common in pregnant women who gave birth before 34 weeks 25.4%;chronic fetal distress was elevated in the after 34 WA group 19.5%. Neonatal infection was more common in the group after 34 WA </span><span style="font-family:Verdana;">49.4%, while respiratory distress 39.6%, intra and periventricular hemorrhage 19.5% and neonatal death 39.6% were more in group before 34</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">WA. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Prematurity induced for SPE is related to a poor neonatal</span></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"> prognosis.
文摘Background: Abdominal pregnancy is a rare ectopic pregnancy in which the baby grows up in the peritoneal cavity exclusive of tubal, ovarian, or intraligamentary implantations. Abdominal pregnancy has very high maternal and fetal morbidity and mortality. Therefore, early recognition and prompt management remain challenges for the treating physician. A thorough examination of the newborn is critical to rule out congenital anomalies. We reported a 24-year-old woman primigravida 40 weeks post-date with spontaneous conception who was admitted to the hospital with complaints of diffuse abdominal pain, symptoms, and signs of severe preeclampsia (headache, vomiting, high blood pressure, blurred vision, and swelling of the feet, ankles, face, and hands). Moreover, she had recurrent vaginal spotting, nausea, loss of appetite, and occasional vomiting. She was diagnosed with a progressive abdominal pregnancy later. A live male fetus stained with meconium was removed from the abdominal cavity, and the placenta was completely removed without significant blood loss. Conclusion: Abdominal pregnancy is a rare ectopic pregnancy requiring high clinical suspicion, early identification, and prompt management to avoid maternal morbidity and mortality. Abdominal pregnancy can be prevented by avoiding miscarriage and treating adhesions and chronic inflammatory diseases.
文摘Objective:To study the influence of human albumin combined with low-dose heparin on disease condition, serology and placental blood flow of severe preeclampsia patients. Methods:A total of 78 patients with severe preeclampsia in our hospital between May 2011 and February 2017 were chosen as study subjects, treatment methods were reviewed and all patients were divided into control group (n=37) who underwent low-dose heparin plus conventional treatment and observation group (n=41) who underwent human albumin combined with low-dose heparin plus conventional treatment, both lasting for 7 d. Before and after treatment, mean arterial pressure (MAP) and 24 h urinary protein were measured, serum markers of disease were measured by enzyme-linked immunosorbent assay (ELISA), and umbilical artery hemodynamics were detected by color Doppler ultrasound.Results:Before treatment, there was no significant difference between the two groups in MAP, 24 h urine protein, serum disease-related indexes or umbilical artery hemodynamic indexes. 7 d after treatment, MAP and 24 h urine protein levels in observation group were lower than those in control group;serum disease-related indexes TGF-β1 and VEGF contents in observation group were higher than those in control group whereas VCAM-1 and sFlt-1 contents were lower than those in control group;umbilical artery hemodynamic indexes PI, RI and S/D levels in observation group were lower than those in control group.Conclusion: Human albumin combined with low-dose heparin can optimize the disease condition, promote the angiogenesis of placenta and increase the blood supply of placenta in patients with severe preeclampsia.
文摘Objective: To investigate the effect of magnesium sulfate combined with labetalol on the apoptosis and invasion molecule expression in placenta as well as maternal endothelial function of patients with severe preeclampsia. Methods: A total of 68 patients with severe preeclampsia who were treated in the hospital between October 2015 and August 2017 were chosen as the research subjects and divided into study group (n=34) and control group (n=34) by random number table method. Control group received magnesium sulfate therapy on the basis of conventional therapy, and study group received magnesium sulfate combined with labetalol therapy on the basis of conventional therapy. The differences in the expression of apoptosis and invasion molecules in placenta tissue as well as the levels of maternal endothelial function indexes were compared between the two groups. Results: Fas, Bax and Caspase-3 mRNA expression in the placenta tissues of study group were lower than those of control group whereas Bcl-2 mRNA expression was higher than that of control group;GPR30, LAMA4 and MEST mRNA expression in placenta tissues were lower than those of control group whereas CDKN1C mRNA expression was higher than that of control group;24 h before delivery, maternal serum ET-1 and vWF levels of study group were lower than those of control group whereas NO level was higher than that of control group (P<0.05). Conclusion: Magnesium sulfate combined with labetalol therapy can effectively inhibit the apoptosis of placental trophoblast cells and enhance their invasion ability, and also improve the maternal endothelial function in patients with severe preeclampsia.
文摘Hypertensive disorders are the most common medical complications of pregnancy (7.15%). Doppler analysis of umbilical artery S/D ratio PI and RI, absent or reversal of EDV were evaluated and follow up results studied in severe preeclampsia women between 26 to 40 weeks. Doppler analysis of Uterine Artery and Middle Cerebral Artery is also studied. Doppler study guides in decision making and follows up in severe preeclampsia and guides in reducing perinatal morbidity and mortality. Period of Study: This is a prospective randomised study conducted at Niloufer Hospital for Women and Children Red Hills Hyderabad from September 2011 to June 2014. Material and Methods: 100 pregnant women with severe preeclampsia who attended Antenatal Out-Patient Department and got admitted in Emergency ward underwent Umbilical artery velocimetry by means of a Colour doppler vision (6000 Toshiba corp Tokyo Japan) using 3.5_5 MHZ Trasabdominal traducer. Results: Total number of 100 women were studied. In this 60 women had foetuses with abnormal umbilical artery flow velocimetry and 40 had normal umbilical artery flow velocimetry. The average birth weight and diagnosis to delivery interval were lower in foetuses with abnormal umbilical artery doppler. Admission to neonatal intensive care unit is high. The APGAR score at 1 minute is <7 in 20 women with abnormal umbilical artery doppler compared to 17 women with normal umbilical artery doppler. Compared to 32 women with normal umbilical artery doppler, the APGAR score is more than 7 in 31 women with abnormal umbilical artery Doppler. P = 0.639647 and chi-square statistic = 0.2192, the result is statistically not significant at p-value < 0.05, implying that APGAR scores are not dependent on doppler findings alone. Conclusion: Doppler study guides obstetrician to assess the physiological status of the foetus and it helps in identifying the changes in the foetal circulation. This study suggests that doppler assessment of foe to placental circulation including umbilical artery is a better prognostic indicator in severe PE and helps in timely intervention. The foetuses with normal artery flow velocimetry area at a lower risk of having poor APGAR score than those with abnormal velocimetry and NICU admissions are less with normal umbilical artery flow velocimetry. The average birth weight of neonates with abnormal umbilical artery was lower compared to neonates with normal umbilical artery velocimetry.
文摘Objective:To study the effect of adjuvant low-molecular-weight heparin therapy on placental hypoxia and cell apoptosis in puerperae with severe preeclampsia.Methods:A total of 94 puerperae with severe preeclampsia who received treatment and safely gave birth in our hospital between May 2014 and May 2016 were selected as the research subjects and randomly divided into the LMWH group who received low-molecular-weight heparin combined with conventional symptomatic treatment and the control group who received conventional symptomatic treatment. Before and after treatment, serum was collected respectively to determine the levels of placental hypoxia-related cytokines, and after delivery, the placentas were collected to detect oxidative stress indexes and cell apoptosis indexes.Results: After treatment, serum PLGF and PAPP-A levels of both groups were significantly higher than those before treatment while sFlt-1 and sEng levels were significantly lower than those before treatment, and after treatment, serum PLGF and PAPP-A levels of LMWH group were significantly higher than those of control group while sFlt-1 and sEng levels were significantly lower than those of control group;ROS and RNS levels as well as Fas, FasL, caspase-3 and caspase-8 protein expression in placenta tissue of LMWH group were significantly lower than those of control group while GPx-1, SOD-1 and Trx levels as well as Survivin, XIAP and Bcl-2 protein expression were significantly higher than those of control group.Conclusion:Adjuvant low-molecular-weight heparin therapy can relieve the placental hypoxia, improve oxidative stress reaction and inhibit cell apoptosis in puerperae with severe preeclampsia.
文摘Objective:To study the omentin expression level in neonatal umbilical cord of patients with severe preeclampsia and its correlation with maternal endothelial injury and placental trophoblast invasion.Methods: The subjects who were diagnosed with severe preeclampsia and gave birth in Wuhan No.1 Hospital between November 2015 and October 2017 were selected as the PE group, while healthy subjects who gave birth in Wuhan No.1 Hospital during the same period were selected as control group. The omentin expression in neonatal umbilical cord, endothelial injury index contents in maternal blood and invasion gene expression in placenta were determined.Results: The omentin expression in neonatal umbilical cord, VEGF and PLGF contents in maternal blood as well as OPN, MMP2 and MMP9 mRNA expressions in placenta of PE group were significantly lower than those of control group whereas IFI16, ET-1, sEng and sFlt-1 contents in maternal blood as well as Gadd45 and E-cadherin mRNA expressions in placenta were significantly higher than those of control group;IFI16, ET-1, sEng and sFlt-1 contents in maternal blood as well as Gadd45 and E-cadherin mRNA expressions in placenta of patients with high omentin expression were significantly lower than those of patients with low omentin expression whereas VEGF and PLGF contents in maternal blood as well as OPN, MMP2 and MMP9 mRNA expressions in placenta were significantly higher than those of patients with low omentin expression.Conclusion: The low expression of omentin in neonatal umbilical cord of patients with severe preeclampsia is closely related to the maternal endothelial injury and insufficient placental trophoblast invasion.
文摘Objective:To study the effect of preventive multimodal analgesia (MMA) on maternal stress reaction as well as placental endoplasmic reticulum stress and cell apoptosis in patients with severe preeclampsia after cesarean section.Methods: A total of 78 patients with severe preeclampsia who accepted cesarean section in Obstetrics Department of Shijiazhuang Maternal and Child Health Care Hospital between May 2014 and October 2016 were retrospectively analyzed and divided into MMA group and control group according to the different analgesia solutions after cesarean section. Before cesarean section as well as 1 d and 3 d after operation, serum levels of pain mediators and stress hormones were determined;after cesarean section, endoplasmic reticulum stress molecule expression levels in the placenta were determined.Results: 1 d and 3 d after operation,β-EP, SP, PGE2, ACTH, COR, INS and C-P levels in maternal blood circulation of both groups of subjects were significantly higher than those before cesarean section, andβ-EP, SP, PGE2, ACTH, COR, INS and C-P levels in maternal blood circulation of MMA group were significantly lower than those of control group;after childbirth, GRP78, GRP94, ERdj1, IRE1α, CHOP and Caspase-3 protein expression in placenta of MMA group were significantly lower than those of control group while XIAP and Survivin protein expression were significantly higher than those of control group.Conclusion:MMA has significant inhibitory effect on the maternal stress reaction as well as placental endoplasmic reticulum stress and cell apoptosis in patients with severe preeclampsia after cesarean section.
基金Supported by National Natural Science Foundation of China,No.82301924.
文摘BACKGROUND Low-molecular-weight heparins(LMWH)are the most commonly used anticoagulants during pregnancy.It is considered to be the drug of choice due to its safety in not crossing placenta.Considering the beneficial effect in the improvement of microcirculation,prophylactic application of LMWH in patients with preeclampsia became a trend.However,the bleeding risk related with LMWH in preeclampsia patients has seldomly been evaluated.This current study aimed to identify the potential risks regarding LMWH application in patients with preeclampsia.CASE SUMMARY Herein we present a case series of three pregnant women diagnosed with preeclampsia on LMWH therapy during pregnancy.All the cases experienced catastrophic hemorrhagic events.After reviewing the twenty-one meta-analyses,the bleeding risk related with LMWH seems ignorable.Only one study analyzed the bleeding risk of LMWH and found a significantly higher risk of developing PPH in women receiving LMWH.Other studies reported minor bleeding risks,none of these were serious enough to stop LMWH treatment.Possibilities of bleeding either from uterus or from intrabdominal organs in preeclampsia patients on LMWH therapy should not be ignored.Intensive management of blood pressure even after delivery and homeostasis suture in surgery are crucial.CONCLUSION Consideration should be given to the balance between benefits and risks of LMWH in patients with preeclampsia.
文摘The superplastic behavior and associated deformation mechanisms of a fine-grained Mg-10.1 Li-0.8Al-0.6Zn alloy(LAZ1011)with a grain size of 3.2μm,primarily composed of the BCCβphase and a small amount of the HCPαphase,were examined in a temperature range of 473 K to 623 K.The microstructural refinement of this alloy was achieved by employing high-ratio differential speed rolling.The best superplasticity was achieved at 523 K and at strain rates of 10^(-4)-5×10^(-4)s^(-1),where tensile elongations of 550±600%were obtained.During the heating and holding stage of the tensile samples prior to tensile loading,a significant increase in grain size was observed at temperatures above 573 K.Therefore,it was important to consider this effect when analyzing and understanding the superplastic deformation behavior and mechanisms.In the investigated strain rate range,the superplastic flow at low strain rates was governed by lattice diffusion-controlled grain boundary sliding,while at high strain rates,lattice diffusion-controlled dislocation climb creep was the rate-controlling deformation mechanism.It was concluded that solute drag creep is unlikely to occur.During the late stages of deformation at 523 K,it was observed that grain boundary sliding led to the agglomeration of theαphase,resulting in significant strain hardening.Deformation mechanism maps were constructed forβ-Mg-Li alloys in the form of 2D and 3D formats as a function of strain rate,stress,temperature,and grain size,using the constitutive equations for various deformation mechanisms derived based on the data of the current tests.
文摘The implementation of WHO guidelines has significantly reduced hospital mortality due to severe malnutrition. Nevertheless, severe acute malnutrition in children under five remains a major public health problem in all low-income countries and is little studied. The study aimed to assess the nutritional status and quality of management of severe acute malnutrition in children aged 06 to 59 months hospitalized in the pediatric ward of Kayanza Hospital. This is a prospective study with descriptive and analytical aims over 6 months from February 10 to July 9, 2023. All children aged 6 to 59 months admitted for severe acute malnutrition are included in this study. The results show that the most affected age group is 12 to 23 months (42.55%). Marasmus is the most common clinical form, at 70.2%. Housewives and mothers from rural areas are the most affected, with rates ranging from 69.14% to 91.49%. The study shows that the reasons for consultation are respectively: edema (29.78%), diarrhea (26.59%), vomiting (19.14%), and fever (14.89%). Dehydration and hypothermia were the main complications observed in 45.74% and 22.34% respectively. Medical treatment was provided by antibiotics (44.68%), artesunate (31.91%), and resomal (21.27%). Nutritional treatment consisted of F75 100% milk and F100 100% milk. Pathologies observed were: anemia 38.29%, malaria 37.23%, urinary tract infection 12.7%, measles 11.7%. The national protocol for integrated management of acute malnutrition (PCIMA) was followed. This study shows that 72.3% of children were successfully treated, with 9.5% dropping out and dying, and 8.5% not responding. We found that malnutrition remains a public health problem, affecting mostly children aged 12 to 24 months. The main complications or pathologies associated with malnutrition are diarrhea, malaria, and fever, and the majority of children suffer from marasmus.
