Ovarian hyperstimulation syndrome following GnRH agonist trigger for final follicular maturation in a patient undergoing random start ovarian stimulation for egg-donation cycle with an inadvertent concomitant early pregnancy

Abstract

We report the first case of OHSS following GnRH agonist trigger for final follicular maturation in random start ovarian stimulation for egg-donation cycles during inadvertent concomitant early pregnancy. As an additional note, the sustained activity exerted by the increasing endogenous hCG production seemed to be responsible for the suboptimal performance in terms of oocyte yield in the current case. OHSS can occur in random-start stimulations protocols even after the use of a GnRH agonist for triggering in case of concomitant unnoticed early pregnancy especially if stimulation is commenced in the periovulatory/luteal phase. The present case report introduces a note of extreme caution when proceeding with this protocol in an otherwise fertile population (egg-donors, elective or oncologic oocyte cryopreservation).     

空间频域成像在皮肤病定量评估中的研究

利用空间频域成像技术搭建的成像系统检测多种皮肤病组织的光学参数和生理参数信息，并对比分析讨论不同类型的皮肤病与光学参数、生理参数之间的关系。实验结果表明，病变皮肤组织与正常皮肤组织之间在光学参数、生理参数上存在较大差异，这将为临床医生对皮肤病诊治提供一种新颖、可靠、科学的评估方法。     

腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠疗效分析

目的 探讨腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠疗效及对内分泌的影响.方法 选择2011年1月至2015年12月剖宫产瘢痕妊娠患者57例,其中A组32例患者给予超声引导下清宫术治疗,B组25例患者给予腹腔镜下子宫双侧动脉阻断术联合清宫术治疗,比较两组患者出血量、住院时间、月经复潮时间、术后人绒毛膜促性腺激素(hCG)降至正常时间,并发症情况及术前(T0)、术后第1d(T1)、第3d(T2)神经内分泌激素水平.结果 ①B组患者出血量低于A组,住院时间、月经复潮时间短于A组,比较差异有统计学意义(t出血量=31.85,k院时间=9.36,t月经复t潮时间=16.37,均P＜0.05);②B组患者并发症发生率为8.00％,低于A组的15.63％,比较差异有统计学意义(x2=9.35,P＜0.05);③B组T1、T2血清COR、β-EP、GLU水平低于A组(CORF交互=17.67,β-EPF交互=132.36,6LUF交互=155.38,均P＜0.05).结论 腹腔镜下子宫双侧动脉阻断术联合清宫术治疗剖宫产瘢痕妊娠微创优势明显,安全性高,对内分泌影响较轻.     

不良妊娠患者抑郁现状及影响因素分析

目的探讨不良妊娠患者发生抑郁现状及影响因素,为不良妊娠患者针对性干预提供参考。方法采用一般资料调查表、Beck抑郁量表、社会支持量表和应对方式问卷对125例不良妊娠患者进行问卷调查。结果不良妊娠患者抑郁发生率为56.0%。社会支持总分42.86±6.70,应对方式6个分量表均分0.46~0.79;Logistic回归分析显示,孕周、解决问题、自责、客观支持4个变量进入回归方程。结论不良妊娠患者抑郁发病率较高,社会支持处于中等水平,孕周、自责应对方式为危险因素,客观支持、解决问题应对方式为保护因素。护理人员可根据患者的个体特征进行干预,防止抑郁的发生。     

Cancer in pregnancy

Cancer is rarely diagnosed during pregnancy, but the incidence of cases is increasing. Diagnosis may be delayed due to an assumption that symptoms are pregnancy-related, or a reluctance to perform investigations. Multidisciplinary discussion is vital, with decision-making involving the obstetrician, patient and family. Many cancers can be treated during pregnancy. Surgery is considered safe and chemotherapy after the first trimester does not increase fetal risks. Timing and mode of delivery will depend on the treatment plans as well as obstetric considerations. The rate of preterm birth is increased, but overall neonatal and paediatric outcomes do not seem to be affected.     

Neonatal herpes infections in The Netherlands in the period 2006–2011

Objective: To monitor the incidence of neonatal herpes in The Netherlands between 2006 and 2011, as well as the adherence to the rather conservative Dutch prevention policy.

Methods: Questionnaires were sent to all virology laboratories (n?=?44), gynaecology and paediatrics departments of all hospitals in The Netherlands (n?=?89). Questionnaires for the laboratories pertained to rates of proven cases of neonatal herpes; for the gynaecologists and paediatricians it pertained to rates of genital herpes during pregnancy and neonatal herpes, and their policy. For gynaecologists this concerned the risk of herpes simplex virus transmission in case of primary genital herpes during pregnancy or labour; for paediatricians it concerned the diagnostic policy in a neonate suspected of neonatal herpes.

Results: For the period 2006–2011 38 cases of neonatal herpes were reported, yielding an incidence of 4.7 per 100?000 births. The estimated annual number of pregnant women with primary or recurrent genital herpes was 278. Of the responding gynaecologists and paediatricians, only 59% and up to 39%, respectively, reported a policy in accordance with the national guideline.

Conclusions: The incidence of neonatal herpes in The Netherlands seems to have increased in the period 2006–2011. Combined with suboptimal guideline adherence this warrants strategies to improve awareness and subsequent adherence.