The monitoring of pregnant women is very important. It plays an important role in reducing fetal mortality, ensuring the safety of perinatal mother and fetus, preventing premature delivery and pregnancy accidents. At present, regular examination is the mainstream method for pregnant women's monitoring, but the means of examination out of hospital is scarce, and the equipment of hospital monitoring is expensive and the operation is complex. Using intelligent information technology (such as machine learning algorithm) can analyze the physiological signals of pregnant women, so as to realize the early detection and accident warning for mother and fetus, and achieve the purpose of high-quality monitoring out of hospital. However, at present, there are not enough public research reports related to the intelligent processing methods of out-of-hospital monitoring for pregnant women, so this paper takes the out-of-hospital monitoring for pregnant women as the research background, summarizes the public research reports of intelligent processing methods, analyzes the advantages and disadvantages of the existing research methods, points out the possible problems, and expounds the future development trend, which could provide reference for future related researches.
ObjectiveTo evaluate liver perfusion in pregnant women with hepatitis between 13 and 41 weeks of gestation by three-dimensional color power Doppler angiography (3D-CPA) vascular indexes. MethodsThis study involved 73 pregnant women with hepatitis and 44 healthy pregnant women who had the pregnancy examination between February 2012 and June 2013. We sampled in the area which was near the right lobe of the pregnant women liver's portal vein branch, and obtained the vascularization index (VI), flow index (FI) and vascularization flow index (VFI) via the virtual organ computer-aided analysis (VOCAL) method. Then, we compared the liver perfusion differences between the pregnant women with hepatitis and healthy pregnant women. ResultsThe hepatic flow indexes obtained by 3D-CPA were significantly different between the HBV-DNA viral load and the control groups. The cutoff values of the three vascular indexes of patients with hepatitis with HBV-DNA viral load and the healthy pregnant women were respectively VI=8.760 (P<3×10-4); FI=22.180 (P<6×10-7); and VFI=1.575 (P<3×10-5). ConclusionApplication of the 3D-CPA on liver perfusion may differentiate pregnant women with hepatitis B from normal ones, thus offer a support for clinical prevention and treatment for pregnant women with hepatitis B.
Intravitreal anti-VEGF injection have been widely used in retinal vascular diseases and achieved good efficacy. Early pregnancy is an important period for fetal organ formation and vascular development. Studies have proved that VEGF plays an important role in maintaining the fetal and placental vascular system, and its loss or decline will affect embryonic development and lead to abortion. The use of intravitreal anti-VEGF during pregnancy is controversial, which may cause systemic side effects to the mother and fetus. This paper summarizes the literature of 23 cases on the use of anti-VEGF during pregnancy. Three cases reported loss of pregnancy with concomitant exposure to intravitreal bevacizumab, which suggested that we should be careful about the use of anti-VEGF during pregnancy and explain the possibility of ocular and systemic side effects to patients in detail. When deciding whether to use anti-VEGF, we should consider the relationship between exposure time and the critical period of vascular development and the systemic exposure of different drugs. Currently, there is a lack of large sample size studies on the use of anti-VEGF in pregnancy, and its safety needs to be further observed.
Objective To compare the central foveal thickness (CFT) and subfoveal choroidal thickness (SFCT) in healthy pregnant women and patients with pre-eclampsia. Methods A prospective control study. Twenty normal subjects, 20 healthy pregnant women and 20 patients with pre-eclampsia were included. The difference of gestational weeks between healthy pregnant women and patients with pre-eclampsia was not significant (χ2=0.012, P=0.913). The differences of age and spherical equivalent among normal subjects, healthy pregnant women and patients with pre-eclampsia were not significant (χ2=1.760, 0.087; P=0.413, 0.957). All eyes underwent optical coherence tomography examination to measure the CFT and SFCT. Results The mean CFT of normal subjects, healthy pregnant women and patients with pre-eclampsia were (194.40±16.17), (201.2±17.33), (199.00±15.46) μm, there was no significant difference among the three groups (χ2=0.888, P=0.641). The mean SFCT of normal subjects, healthy pregnant women and patients with pre-eclampsia were (263.45±69.66), (330.00±49.20), (373.40±52.00) μm, there was significant difference among the three groups (χ2=22.818, P=0.000). The mean SFCT of healthy pregnant women was increased than that of normal subjects (Z=−2.991, P=0.002). The mean SFCT of patients with pre-eclampsia was increased than that of healthy pregnant women (Z=−2.638, P=0.007). Conclusion The mean SFCT of patients with pre-eclampsia is increased than healthy pregnant women.
目的 描述孕妇配偶在妊娠期的焦虑和社会支持现状，并探讨孕妇配偶获得社会支持对其焦虑情绪的影响。 方法 2010年11月－2011年4月，采用焦虑自评量表（SAS）和社会支持评定量表（SSRS） 对105例（回收99例）孕妇配偶进行问卷调查。 结果 孕妇配偶的SAS条目中焦虑及乏力、尿频、多汗等躯体症状得分依次为（1.56 ± 0.58）、（1.62 ± 0.74）、（1.49 ± 0.75）、（2.48 ± 1.18）分，高于国内常模，差异有统计学意义（P＜0.05）；其客观支持、主观支持及社会支持总分依次为（9.48 ± 2.84）、（22.40 ± 3.83）、（7.48 ± 1.83）分，低于国内常模，且差异有统计学意义（P＜0.05）；同时，SAS与客观支持、主观支持、对支持的利用度及社会支持总分呈负相关，r值依次为−0.260、−0.244、−0.094、−0.347，其中SAS与客观支持、主观支持和社会支持总分的相关性有统计学意义（P＜0.05）。 结论 孕妇配偶所获得的社会支持越少，其焦虑程度及出现的躯体化症状越高，作为医务人员，应正确认识孕妇配偶在特殊人生时期存在的心理问题，及时的提供指导，鼓励其表达自己内心的感受，学会利用各种方法来调整自己的心态，并主动扩大其支持系统。同时更应该向家庭、社会提出呼吁，改变传统观念，关注孕妇的同时也要关注孕妇配偶的情感状况。
Objective To investigate the methodological characteristics of observational studies on the correlation between drug exposure during pregnancy and birth defects. Methods The PubMed database was searched from January 1, 2020 to December 31, 2020 to identify observational studies investigating the correlation between drug use during pregnancy and birth defects. Literature screening and data extraction were conducted by two researchers and statistical analysis was performed using R 3.6.1 software. Results A total of 40 relevant articles were identified, of which 8 (20.0%) were published in the four major medical journals and their sub-journals, 21 (42.5%) were conducted in Europe and the United States, and 4 were conducted (10.0%) in China. Cohort studies (30, 75.0%) and case-control studies (10, 25%) were the most commonly used study designs. Sixteen studies (40.0%) did not specify how the databases were linked. Sixteen studies (40.0%) did not report a clear definition of exposure, while 17 studies (42.5%) defined exposure as prescribing a drug that could not be guaranteed to have been taken by the pregnant women, possibly resulting in misclassification bias. Six studies (15.0%) did not report the diagnostic criteria for birth defects and 18 studies (45.0%) did not report the types of birth defects. In addition, 33 studies (82.5%) did not control for confounding factors in the study design, while only 19 studies (47.5%) considered live birth bias. Conclusion Improvements are imperative in reporting and conducting observational studies on the correlation between drug use during pregnancy and birth defects. This includes the methods for linking data sources, definition of exposure and outcomes, and control of confounding factors. Methodological criteria are needed to improve the quality of these studies to provide higher quality evidence for policymakers and researchers.
ObjectiveTo determine teratogenicity of beta-blockers in early pregnancy. MethodsWe searched PubMed, EMbase, Cochrane Clinical Trials, clinicaltrials.gov, CBM, Wanfang database, and CNKI from establishment of each database to December 2014. We evaluated the quality of included literature. Statistical analysis was conducted in RevMan5.3 software. ResultsFifteen population-based case-control or cohort studies were identified. The score of included studies changed from 5-7 points. Based on meta-analysis, first trimester oral beta-blocker use showed no increased odds of all or major congenital anomalies. While in analysis examining organ-specific malformations, statistically increased odds of cardiovascular (CV) defects with OR 2.21 and 95% CI 1.63 to 3.01, cleft lip/palate (CL/P) with OR 3.11 and 95% CI 1.78 to 9.89, and neural tube (NT) defects with OR 3.56 and 95% CI 1.19 to 10.67 were observed. ConclusionCausality is difficult to interpret given small number of heterogeneous studies and possibility of biases. Given the frequency of this exposure in pregnancy, further research is needed.
Objective To investigate the incidence of full-term prelabor rupture of membranes (FPROM) and risk factors for FPROM. Methods A prospective nested case-control study was performed on pregnant women in early pregnancy and their spouses, who underwent prenatal examination for the first time in Zhuhai Center for Maternal and Child Health Care from May 2021 to December 2022. Pregnant women with a clear diagnosis of FPROM were included in the case group, and pregnant women without FPROM were randomly selected at a 1∶3 ratio for inclusion in the control group. A questionnaire survey was performed to collect exposure information possibly related to FPROM. The hospital's medical record system was used for information verification and to record the pregnancy outcomes. A multivariate logistic regression analysis was used to investigate the risk factors for FPROM. Results The incidence of FPROM in this study was 24.27%. The multivariate logistic regression analysis showed that obesity pregnant women, smoking, drinking, unbalanced diet, high-intensity physical activity during pregnancy, eating areca nut before pregnancy, using glucocorticoids during pregnancy, older at the time of first pregnancy, a history of adverse pregnancy outcomes, a history of pregnancy complications, a history of diabetes, a history of scar uterus, no folate supplementation during pregnancy, repeated intrauterine operations, polyembryony, polyhydramnios, transverse fetus and fetal cephalopelvic disproportion as the way of conception were risk factors for FPROM (P<0.05). Additionally, the pregnant women whose spouses were obese or smoked or drinking had an increased risk of FPROM (P<0.05). Lower gravidity and lower parity were protective factors against FPROM (P<0.05). Conclusion There are many risk factors for FPROM. Special attention should be given to the life behaviors of pregnant women during pregnancy, and health education should be strengthened for pregnant women and their spouses to help them develop good living habits and reduce the incidence of FPROM.