深圳市南山区未婚女青年非意愿妊娠现状分析

目的:了解未婚女青年非意愿妊娠的现状,为探讨如何开展有效的青少年健康教育、减少青少年非意愿妊娠的发生提供理论依据。方法:对2006年1～12月到深圳市南山区六家计划生育服务机构自愿要求终止妊娠,年龄≤24岁的3200例未婚女青年的临床资料进行回顾性分析。结果:2004～2006年3年间未婚女青年流产比例呈逐年上升趋势,2006年未婚女青年流产比例达53.7%。本次调查3200例青少年中≤l9岁占40.5%,≥3次妊娠者占22.8%,半年内有妊娠史者占18.6%。有15.8%的人每次性交时采取了避孕措施,38.5%的人偶尔采用避孕措施,45.7%的人从未采取任何避孕措施。结论:未婚女青年非意愿妊娠发生率高,有效避孕措施使用率低,高危流产率高,及早进行青少年健康教育与避孕指导是减少青少年非意愿妊娠的主要手段。     

深圳市南山区684例妊娠梅毒患者随访率影响因素分析

目的:明确深圳市南山区妊娠梅毒患者抗梅毒治疗后随访率的影响因素。方法:对684例规则治疗后的妊娠梅毒患者进行健康宣教和发放随访通知卡。结果:一年内规则随访率为74.56%。年龄、职业、文化程度、血清学滴度、妊娠结局与随访率相关,具有统计学意义(均P0.0001)。结论:梅毒患者随访率的影响因素包括年龄、职业、文化程度、妊娠结局、血清学滴度。     

稽留流产的原因分析以及早期诊断

目的:通过统计学方法探讨Ct、Uu、TORCH感染与稽留流产的相关性以及妊娠相关血浆蛋白-A(PAPP-A)、孕激素(Progesterone,P)水平在稽留流产早期诊断中的价值。方法:选取2014年7月到12月宝鸡市妇幼保健院稽留流产病例107人以及门诊同期正常妊娠病例150人,通过免疫法和培养法对孕妇宫颈分泌物进行感染(Ct、Uu和TORCH)检测,统计感染所占稽留流产病例的比例从而确定感染与稽留流产的相关性;同时通过用酶联免疫吸附法检测稽留流产患者和同期门诊正常妊娠病例血清孕酮和妊娠相关蛋白含量。结果:稽留流产患者Ct或/和Uu的感染率为56%,正常妊娠孕妇感染率为6.6%;稽留流产患者的TORCH感染率为17.8%,正常妊娠孕妇感染率为5.3%;稽留流产患者血清P和PAPP-A含量分别为(23.37±5.89)nmol/L和(59.58±8.32)U/L;而对应正常妊娠病例的含量分别为(75.47±17.63)nmol/L和(168.07±2.57)U/L。结论:感染和稽留流产有很高的相关性,是造成稽留流产病因之一;早期检测P和PAPP-A含量有利于稽留流产的早期诊断。     

传统药物流产联合清宫术在妊娠早期终止妊娠中临床效果分析

目的:探讨传统药物流产联合清宫术在妊娠早期终止妊娠中的临床效果,为临床提供参考。方法:将2015年1月至2015年12月入本院治疗的120例孕妇随机分为两组,对照组孕妇实行传统药物流产的方法,对治疗组孕妇实行传统药物流产协同清宫术的方法。对比分析两组患者的临床疗效以及日后生育质量。结果:对照组完全流产率为20.34%,治疗组为98.36%,两组比较差异有统计学意义(P0.05);治疗组孕妇临床疗效优于对照组,治疗组患者平均出血量明显低于对照组,平均出血时间明显短于对照组,两组比较差异具有统计学意义(P0.05)。治疗组患者满意度高于对照组。结论:传统药物流产联合清宫术在妊娠早期终止妊娠中临床效果显著优于单独采用传统药物,可在临床推广使用。     

宫内妊娠误诊为异位妊娠的原因及对策

目的：探讨宫内妊娠误诊为异位妊娠的原因及对策。方法：对两家医院1998年1月-2008年12月,10年间宫内妊娠误诊为异位妊娠218例及同期确诊为异位妊娠218例采用病例对照方法进行回顾性分析。结果：症状：宫内妊娠组停经史例数及平均停经天数与异位妊娠组均无显著差异（P〉0．05）;阴道流血例数两组有显著差异（P〈0．01）;腹痛例数两组无显著差异（P〉0．05）。体征：宫内妊娠组腹部压痛、宫颈举痛和附件区压痛例数显著低于异位妊娠组。B超检查：宫内膜增厚例数两组之间差异无统计学意义（P〉0．05）。宫内妊娠组附件包块例数少于异位妊娠组（P〈0．05）。宫内妊娠组盆腔积液例数显著少于异位妊娠组（P〈0．01）。β—HCG值：两组入院时血β—HCG平均值差异无统计学意义（P〉0．05）。结论：医师的诊治思维,过分依赖辅助检查等是误诊的主要原因。对有疑问的病例,在患者生命体征平稳的情况下,加强动态观察和期待疗法是必要的。     

高龄男性精子质量与不明原因复发性流产相关性分析

目的:探讨高龄男性精子质量与不明原因复发性流产相关性分析。方法:选取2014年1月至2016年6月于我院接受治疗的27例不明原因复发性流产夫妇(女方不明原因自然流产≥2次)高龄男性为观察组研究对象,另选取同时期于我院进行生殖健康体检的138例高龄男性为对照组研究对象,对其进行精液检测。比较两组患者的精液,并分析高龄男性精子质量与不明原因复发性流产相关性。结果:两组在精液量、精子p H值上不存在明显差异,而观察组在精子密度、精子存活率、精子活力包括a级、b级百分率上明显低于对照组(P<0.05)。精子密度、精子存活率、精子活力与不明原因复发性流产有关。结论:精子密度、精子存活率、精子活力等高龄男性精子质量因素与不明原因复发性流产有关。     

人工流产与药物流产对剖宫产术后再次妊娠疗效观察

目的:比较剖宫产术后再次妊娠人工流产与药物流产的治疗效果.方法:回顾性分析2年来剖宫产术后再次妊娠来我院要求终止妊娠的患者100例.随机分为两组,研究组行药物流产者56例,对照组行人工流产者44例,分析两组患者流产后出血量、手术时间、疼痛程度、并发症及随访情况.且术后第一次月经来潮经量明显减少,两组有显著差异(P<0.01).结果:研究组比对照组术中出血少、手术时间短、疼痛程度轻,无并发症发生,两组有显著差异(P<0.01).结论:剖宫产术后再次妊娠行药物流产比人工流产安全、可靠.     

胸腔闭式细管引流意外脱出的原因分析及护理对策

中心静脉导管作为细管,用于胸腔闭式引流操作简单、安全、快速、方便,患者创伤小、易接受,经B超定位后可以有效地引流胸腔积聚的液体和气体,近年来已广泛应用于临床,但是随之带来的护理问题也日益凸显.因此,在护理上应引起足够的重视.     

高原地区淋巴细胞主动免疫治疗原因不明习惯性流产120例临床观察

目的：探讨淋巴细胞主动免疫治疗高原地区原因不明习惯性流产患者的临床疗效。方法：选择120例接受淋巴细胞主动免疫治疗原因不明习惯性流产患者为研究对象,对所有病例进行封闭抗体检测,并分离患者丈夫淋巴细胞,采用前臂皮下注射的方式进行封闭抗体治疗。结果：接受治疗后,120例患者中有103例封闭抗体转为阳性,转阳率为85.8%。阳性妊娠成功88例,成功率85.4%,仍有17例患者为阴性,其中仅5例妊娠成功,成功率29.4%,两组比较差异具有统计学意义（χ^2=6.63,P〈0.05）。全部病例中,有93例妊娠成功,成功率为77.5%。结论：针对高原地区原因不明习惯性流产患者,淋巴细胞免疫治疗的方法简单、廉价、可靠,能取得较高的妊娠成功率,患者容易接受,具有较高的临床应用价值。     

基于GEO数据库筛选不明原因复发性流产的枢纽基因及信号通路

目的 利用生物信息学方法筛选不明原因复发性流产(URSA)相关差异表达基因(DEGs)及信号通路,以期为URSA的诊断和治疗提供新思路。方法 从GEO数据库中筛选数据集,利用R软件DESeq 2包筛选DEGs,应用DAVID数据库对DEGs进行GO和KEGG分析,通过STRING数据库构建DEGs的蛋白质-蛋白质相互作用(PPI)网络,再通过Cytoscape软件筛选出URSA的最显著模块及枢纽(Hub)基因,并对其进行可视化处理。采用GSE26787数据集验证Hub基因的差异表达。结果 经筛选共得到432个DEGs,其中121个DEGs上调,311个DEGs下调。GO富集分析显示,DEGs参与细胞分裂、有丝分裂核分裂、姐妹染色单体的凝聚力和信号转导等生物过程(BP);细胞成分(CC)位于纺锤体、染色体着丝粒点、纺锤体两极、中体;分子功能(MF)与蛋白结合、微管结合、受体活性等相关;KEGG富集分析表明,DEGs富集于自然杀伤(NK)细胞介导的细胞毒性、细胞周期、p53信号通路、抗原加工和呈递、精氨酸和脯氨酸代谢通路。通过PPI网络筛选得到与URSA密切相关的5个Hub基因,分别为CC...     

深圳市南山区社区妇女阴道炎患病现状分析

目的:了解深圳市南山区妇女阴道炎患病现状,探索其防治措施.方法:利用计划生育健康普查平台,对2009年3月～2010年9月来中心健康普查的南山区妇女共4182例,年龄21～65岁,提供基本的妇科检查及实验室检测(阴道分泌物清洁度、滴虫、念珠菌、细菌性、混合感染).结果:普查总人数为4182例,收集标本4182人份,阴道炎总患病率为35.44％(1482/4182),其中需氧菌性阴道炎、滴虫性阴道炎、念珠菌性阴道炎、细菌性阴道病、混合性阴道炎患病率分别为14.59％(610/4182)、1.51％(63/4182)、10.14％(424/4182)、7.49％(313/4182)、3.42％(143/4182),其中混合性阴道炎(念珠菌性阴道炎)最常见.结论:南山区基层社区妇女阴道炎患病率很高,多数是无自觉症状,应加强基层社区妇女生殖道感染知识的宣传教育,增强自我保护意识,促进生殖健康发展.     

深圳市某区孕产妇梅毒母婴传播流行病学分析

目的了解南山区孕产妇梅毒流行情况，为梅毒防治决策提供依据。方法对全区孕产妇进行梅毒血清学免费筛查，提取数据资料并进行统计学分析。结果对15662例孕产妇血清学筛查发现梅毒阳性孕产妇57例，阳性检出率为3．64％0。个案调查仅有7例孕产妇承认曾有婚外性接触史和既往梅毒史。暂住和流动人口孕产妇阳性检出率占94．7％。30．36％阳性孕产妇妊娠结局不良。4例未经治疗的产妇娩出先天梅毒患儿。同意检查的22例性伴中仅有9例为RPR和TPPA均为阳性，阳性率40．9l％。隐性梅毒占91．07％，占2003年度女性隐性梅毒报告数的90．32％。结论孕产妇梅毒筛查有利于发现隐性梅毒，应提倡早做孕期保健检查，早期发现和诊治梅毒，阻断先天梅毒的蔓延。     

Knowledge,challenges, and standard of care of young women with ADHD at Swedish youth clinics

ObjectivesSexual risk-taking and its consequences for young women with ADHD(attention deficit hyperactivity disorder) including sexually transmitted diseases, teenage pregnancies and underage parenthood constitute substantial challenges for individuals and midwives. The aim was to investigate current knowledge and specific challenges in reproductive health and contraceptive counselling for women with ADHD at Swedish youth clinics.MethodInductive qualitative interview study of ten midwives at six youth health clinics in Stockholm and Uppsala County. We used a semi-structured interview guide. The interviews were transcribed verbatim and analyzed with the NVivo 12 qualitative data analysis software.ResultsThree main categories were identified: (1) challenges in provision of care of young women with ADHD, (2) standard of care and active adaptations towards women with ADHD and (3) organizational readiness for change;. Several challenges and frustrations, such as difficulties with attention with or without concomitant impulsivity and overactivity, in provision of reproductive health and contraceptive counselling for young women with ADHD were identified. Midwives reported high organizational readiness for improvement of standard of care.ConclusionsInadequate contraceptive counseling or lack of knowledge on specific challenges in the sexual and reproductive health of young women with ADHD may contribute to this group failing to access, inadequately respond to, or act upon counseling at youth clinics. Support for midwives with evidence-based interventions specifically developed for these women are imperative. Development of such tools should be a priority for research.     

Examining the influence of mental health on dual contraceptive method use among college women in the United States

ObjectivesTo examine mental health influences on dual contraceptive method use (i.e., the use of a hormonal contraceptive or intrauterine device with a condom barrier) among college women.Study designData from N = 307 sexually active women who completed the 2014 National College Health Assessment at a large mid-Atlantic university were analyzed. Following chi-square tests of associations, multivariate logistic regressions examined the relation between mental health and sociodemographic factors and dual contraceptive method use.ResultsAmong all women, 27% utilized a dual contraceptive method during last vaginal intercourse. A prior depressive disorder diagnosis was significantly associated with lower odds of dual method use compared to use of other contraceptive methods combined (aOR, 0.39; 95% CI: 0.19–0.79), use of no method (aOR, 0.12; 95% CI: 0.03–0.55), or use of hormonal contraceptives only (aOR, 0.39; 95% CI: 0.18–0.85).ConclusionsMental health is an important contributor to contraceptive method use. Health care providers should consider the role of mental health when counseling women about contraceptive options during routine gynecological visits. Results suggest that mental health screenings may be helpful in identifying those most at risk for not using dual contraceptive methods.     

Risk factors for syphilis infection among pregnant women: results of a case-control study in Shenzhen, China

BACKGROUND: China has been experiencing a rapidly growing syphilis epidemic since the early 1990s, with the reported incidence of congenital syphilis increasing from 0.01 cases per 100,000 live births in 1991 to 19.7 cases per 100,000 live births in 2005. Detailed studies of risk factors for syphilis in pregnant women are needed to inform new preventive interventions. OBJECTIVE: To investigate factors associated with recent syphilis infection among pregnant women and recommend strategies for improved preventive interventions in the community. METHODS: A case-control study was conducted among women attending antenatal clinics in Shenzhen City, South China. Cases were antenatal clinic women testing positive for early syphilis, based on laboratory results, with those testing negative being controls. All participants completed the same anonymous questionnaire covering demographics, lifestyle, sexual behaviour, and sexual partnerships. RESULTS: 129 cases and 345 controls were recruited. Syphilis was significantly associated with unmarried status, less education, multiple sex partners, travel of sex partner in the past 12 months, a history of induced abortion, and previous sexually transmitted infections. Overall, there were no differences between syphilis-positive and negative women in household registration status (hukou), living district and duration in Shenzhen, monthly income, and age at first sex. CONCLUSIONS: Many demographic and behavioural risk factors are associated with syphilis among pregnant women. In the government congenital syphilis control programme, comprehensive preventive interventions should be provided in all clinical settings in addition to the current procedures for syphilis screening among antenatal women.     

Screening of Herpes simplex virus 2 infection among pregnant women in southern China

The aim was to investigate the prevalence of Herpes simplex virus (HSV)-2 infection among pregnant women in southern China and analyze the relationship between the HSV-2 infection and pregnancy outcome. We examined 1740 sera collected from pregnant women aged 21-39 years, using enzyme-linked immunosorbent assay for the detection of specific antibodies against HSV-2. The overall prevalence of HSV-2 infection was 23.56% (95% confidence interval [CI]=21.53-26.00). The prevalence of HSV-2 infection in the women with abnormal pregnancy was 35.93% (95% CI=26.23-42.44) (83/231), which was much higher than that in women who had been pregnant before but without abnormal pregnancy and that in the primipara group. (P<0.05). The presence of HSV-2 antibodies was also associated with status of education. The prevalence of HSV-2 infection in the 26-30-year age group (27.49%) (95% CI=24.53-30.33) was the highest among all age groups. The prevalence of HSV-2 infection in pregnant women in southern China is quite high. Women with asymptomatic or subclinical genital infection should be identified by examining the HSV-2 antibody, which would be helpful to reduce the abnormal pregnancy outcome.     

深圳市宝安区1999年～2002年孕妇人群梅毒流行病学分析

目的：掌握深圳市宝安区梅毒在孕妇人群中的流行病学特点，为有针对性地开展梅毒的预防与控制及阻断其垂直传播提供科学依据。方法：以患病率和构成比指标对深圳市宝安区5个孕妇人群。梅毒监测点资料进行流行病学分析。结果：四年共检测孕妇21139例，梅毒患病率平均为4．3‰；805患者集中于20岁-29岁的孕妇。学历高中以下占82．6％。夫妻间传播是最重要的传播方式。人口特征以流动人口为主，占51．08％；其次为暂住人口占25％。检出的孕妇梅毒中，隐性感染者占98％。结论：梅毒在该区形成一定的流行势态，已严重危及我区孕妇及新生儿，应切实做好孕妇梅毒血清筛查及追踪随访工作。     

妊娠晚期铁营养状况对孕妇血生化及新生儿血生化的影响

目的探讨妊娠晚期铁营养状况对孕妇血生化及新生儿血生化的影响。方法选取2017年2月至2018年10月在四川省达州市中心医院产科分娩孕妇(孕周≥28周)110例作为研究对象,并于分娩前1周内测定孕妇的血清铁蛋白(SF),根据铁营养状况进行分组,即铁不足组(n=38)、铁正常组(n=42)、铁过量组(n=30)。在分娩后1周内,抽取孕妇空腹静脉血、新生儿(出生1周内)的指尖血,应用自动生化仪检测血清标本中的血生化(CK、TBA、AFU、UA、ALT、GLU、TBIL、CR、LDH、BUN、TP、ALP、ALB)水平,并比较三组之间的差异。结果三组的TP、ALB、TBA、ALP、CR水平之间两两比较,差异具有统计学意义(P<0.05);TBIL、ALT、AFU、CK、LDH、GLU、BUN、UA水平之间两两比较,差异无统计学意义(P>0.05)。结论妊娠晚期铁营养状况对孕妇血生化及新生儿血生化部分指标会产生一定的影响。在临床管理中,监测该类孕妇的铁营养状况,对于降低临床上预防因铁不足或铁过量所致贫血的发生率,具有重要的临床意义。