Feasibility study of first-year medical students identifying cardiac anatomy using ultrasound in rural Panama

BACKGROUND: There are over 15 million children who have cardiac anomalies around the world, resulting in a significant morbidity and mortality. Early recognition and treatment can improve the outcomes and lengthen life-expectancy of these patients. The NIH and WHO have promoted guidelines for screening for congenital cardiac anomalies using ultrasound in rural environments.METHODS: Our study took place in Bocas Del Toro, Panama where a mobile clinic was established for community healthcare screening and ultrasonographic evaluation by medical student volunteers and volunteer clinical faculty. This was a non-blinded, investigational study utilizing a convenience sample of pediatric patients presenting for voluntary evaluation. Seven first-year medical students were recruited for the study. These students underwent a training program for advanced cardiac ultrasound instruction, termed "Pediatric Echocardiography Cardiac Screening(PECS)".RESULTS: Ten patients were enrolled in the study. Nine patients had adequate images as defined by the PECS criteria and were all classified as normal cardiac pathology by the medical students, resulting in a sensitivity and specificity of 100%. A single patient was identified by medical students as having a pathologic pulmonic stenosis. This was confirmed as correct by a blinded ultrasonographer.CONCLUSIONS: In this pilot study, the first-year medical students were able to correctly identify pediatric cardiac anatomy and pathology in rural Panama after undergoing a 12-hour ultrasound PECS training session. We believe that with this knowledge, minimally trained practitioners can be used to screen for cardiac anomalies in rural Panama using ultrasound.     

Assessment of clinical dehydration using point of care ultrasound for pediatric patients in rural Panama

BACKGROUND: Dehydration and its associated symptoms are among the most common chief complaints of children in rural Panama. Previous studies have shown that intravascular volume correlates to the ratio of the diameters of the inferior vena cava (IVC) to the aorta (Ao). Our study aims to determine if medical students can detect pediatric dehydration using ultrasound on patients in rural Panama. METHODS: This was a prospective, observational study conducted in the Bocas del Toro region of rural Panama. Children between the ages of 1 to 15 years presenting with diarrhea, vomiting, or parasitic infection were enrolled in the study. Ultrasound measurements of the diameters of the IVC and abdominal aorta were taken to assess for dehydration. RESULTS: A total of 59 patients were enrolled in this study. Twenty-four patients were clinically diagnosed with dehydration and 35 were classified to have normal hydration status. Of the 24 patients with dehydration, half (n=12) of these patients had an IVC/Ao ratio below the American threshold of 0.8. Of the remaining asymptomatic subjects, about half (n=18) of these subjects also had an IVC/Ao ratio below the American threshold of 0.8. CONCLUSION: Our study did not support previous literature showing that the IVC/Ao ratio is lower in children with dehydration. It is possible that the American standard for evaluating clinical dehydration is not compatible with the rural pediatric populations of Panama.     

Ultrasound curriculum taught by first-year medical students: A four-year experience in Tanzania

BACKGROUND: Diagnostic imaging is an integral aspect of care that is often insufficient, if not altogether absent, in rural and remote regions of low to middle income countries (LMICs) such as Tanzania. The introduction of ultrasound can significantly impact treatment in these countries due to its portability, low cost, safety, and usefulness in various medical assessments. This study reviews the implementation of a four-week ultrasound course administered annually from 2013-2016 in a healthcare professional school in Mwanza, Tanzania by first-year allopathic US medical students.METHODS: Participants (n=582, over 4 years) were recruited from the Tandabui Institute of Health Sciences and Technology to take the ultrasound course. Subjects were predominantly clinical officer students, but other participants included other healthcare professional students, practicing healthcare professionals, and school employees. Data collected includes pre-course examination scores, post-course examination scores, course quiz scores, demographic surveys, and post-course feedback surveys. Data was analyzed using two-tailed t-tests and the single factor analysis of variance (ANOVA).RESULTS: For all participants who completed both the pre- and post-course examinations (n=229, 39.1% of the total recruited), there was a significant mean improvement in their ultrasound knowledge of 42.5%, P<0.01.CONCLUSION: Our data suggests that trained first-year medical students can effectively teach a point of care ultrasound course to healthcare professional students within four weeks in Tanzania. Future investigation into the level of long-term knowledge retention, impact of ultrasound training on knowledge of human anatomy and diagnostic capabilities, and how expansion of an ultrasound curriculum has impacted access to care in rural Tanzania is warranted.     

Ultrasound Exposure During Gross Anatomy

Background

As medical schools seek to standardize ultrasound training and incorporate clinical correlations into the basic science years, we proposed that ultrasonography should have a greater role in the anatomy curriculum.

Objectives

To describe the introduction of ultrasound into the curriculum of a first-year medical student anatomy course and evaluate the utility of this introduction.

Methods

First-year medical students attended two ultrasound lectures and three small-group hands-on sessions that focused on selected aspects of musculoskeletal, thoracic, abdominal, and neck anatomy. Pre and post surveys were administered to assess student perception of their ability to obtain and interpret ultrasound images and the utility of ultrasound in the anatomy course. Understanding of basic ultrasound techniques and imaging was tested in the practical examinations.

Results

Of the 269 first-year medical students who completed the course, 144 students completed both surveys entirely, with a response rate of 53%. Students' interest and self-perceived experience, comfort, and confidence in ultrasound skills significantly increased (p < 0.001) as a result of this early introduction to ultrasonography. Objective evidence, provided by practical examination scores on ultrasound images, is consistent with this self-perceived confidence reported by students.

Conclusions

Ultrasound can be effectively incorporated into an anatomy course for first-year medical students by utilizing didactics and hands-on exposure. Medical students found the addition of ultrasound training to be valuable, not only in enhancing their understanding of anatomy, but also in increasing their interest and experience in ultrasound imaging.     

孕早期颈项透明层超声联合孕中期彩色多普勒超声可提高产前胎儿畸形检出率

目的探究孕早期颈项透明层（NT）超声联合孕中期彩色多普勒超声在产前胎儿畸形筛查中的应用价值。方法选择2017年8月~2019年12月在我院行胎儿畸形筛查的2417例孕妇作为研究对象,所有孕妇于孕11~14周行NT超声检查,并于孕22~28周行二维、四维彩超检查。以引产或分娩结果为“金标准”,比较畸形胎儿、正常胎儿的NT值及NT异常率,对比NT超声检查、二维联合四维彩超检查结果,并就NT超声、二维及四维彩超及二者联合在诊断胎儿畸形中的诊断率进行比较。结果2417例孕妇最终确诊异常胎儿88例,发病率为3.64%。畸形胎儿的NT值明显高于正常胎儿,NT异常率（93.18%）明显高于正常胎儿（1.33%）,差异比较有统计学意义（P < 0.05）。NT超声检查共检出异常胎儿82例,诊断准确率为93.18%;二维联合四维彩超共检出异常胎儿85例,诊断准确率为96.59%。二维联合四维彩超的诊断准确率略高于NT超声检查,差异无统计学意义（P>0.05）。NT超声联合二维、四维彩超在诊断胎儿畸形中的敏感度、特异度和准确度分别为100.00%、99.57%、99.59%,高于NT超声、二维和四维彩超（分别为93.18%、98.67%、98.47%和96.59%、99.06%、98.97%）,组间比较差异有统计学意义（P < 0.05）。结论孕早期NT超声及孕中期彩色多普勒超声在产前筛查胎儿畸形上各具有优势,均具有较好的诊断价值。二者联合应用能够进一步提升胎儿畸形的检出率,对尽早终止胎儿畸形孕妇继续妊娠,减少畸形胎儿出生具有重要意义。     

Handheld transabdominal ultrasound,after limited training,may confirm first trimester viable intrauterine pregnancy: a prospective cohort study

ObjectivesHandheld point-of-care abdominal ultrasound (POCUS) may be used by primary care physicians while vaginal ultrasound is limited to use in specialist care. We aimed to compare abdominal handheld ultrasound to vaginal ultrasound in determining first trimester viable intrauterine pregnancy and estimate gestational length.DesignProspective cohort study.SettingGynaecologic outpatient clinic; women referred from GPs during early pregnancy. Handheld ultrasound using VscanExtend^® was performed by fourth-year medical students with limited training. Transvaginal ultrasound using high-end devices was performed by ordinary hospital staff.SubjectsWomen in the first trimester of pregnancy referred for termination of pregnancy or with symptoms of early pregnancy complications.Main outcome measuresRate of confirming vital intrauterine pregnancy (visualizing foetal heart beats) and measurement of crown-rump length (CRL) using handheld abdominal versus vaginal ultrasound.ResultsIn all 100 women were included; 86 confirmed as viable intrauterine pregnancies and 14 pathological pregnancies (miscarriages/extrauterine pregnancies). Handheld abdominal ultrasound detected fetal heartbeats in 63/86 (73% sensitivity) of healthy pregnancies and confirmed lack of fetal heartbeats in all pathological pregnancies, total positive predictive value (PPV) 100% and total negative predictive value (NPV) 38%. From gestational week 7, handheld abdominal ultrasound confirmed vitality in 51/54 patients: PPV 100% and NPV 79%. CRL (n = 62) was median 1 mm shorter (95% confidence interval 1–2 mm) measured by handheld abdominal versus vaginal ultrasound.ConclusionHandheld ultrasound has an excellent prediction confirming viable intrauterine pregnancy from gestational week 7. Validation studies are needed to confirm whether the method is suitable in primary care assessing early pregnancy complications.

KEY POINTS

• When early pregnancy vitality needs to be confirmed, women will traditionally be referred to secondary care for transvaginal comprehensive ultrasonography performed with high-end devices by imaging specialists.
• In this study personnel with limited former training (fourth-year medical students) performed transabdominal POCUS using a handheld device, investigating 100 first trimester pregnancies for confirmation of viability.
• Using handheld ultrasound viable pregnancy was confirmed from gestational week 7 with 79% positive and 100% negative predictive value.
• If handheld ultrasound used in primary care confirms vital intrauterine pregnancy, the need for specialist referral could be reduced.

     

A pilot study of comprehensive ultrasound education at the Wayne State University School of Medicine: a pioneer year review.

OBJECTIVE: Ultrasound is a versatile diagnostic modality used in a variety of medical fields. Wayne State University School of Medicine (WSUSOM) is one of the first medical schools in the United States to integrate an ultrasound curriculum through both basic science courses and clinical clerkships. METHODS: In 2006, 25 portable ultrasound units were donated to WSUSOM. First-year medical students were provided an ultrasound curriculum consisting of 6 organ-system sessions that addressed the basics of ultrasound techniques, anatomy, and procedural skills. After the last session, students were administered 2 anonymous and voluntary evaluations. The first assessed their overall experience with the ultrasound curriculum, and the second assessed their technical skills in applying ultrasound techniques. RESULTS: Eighty-three percent of students agreed or strongly agreed that their experience with ultrasound education was positive. On the summative evaluation, nearly 91% of students agreed or strongly agreed that they would benefit from continued ultrasound education throughout their 4 years of medical school. Student performance on the technical assessment was also very positive, with mean class performance of 87%. CONCLUSIONS: As residency programs adopt ultrasound training, medical school faculty should consider incorporating ultrasound education into their curriculum. Portable ultrasound has the potential to be used in many different settings, including rural practice sites and sporting events. The WSUSOM committee's pilot ultrasound curriculum will continue to use student feedback to enhance the ultrasound experience, helping students prepare for challenges that they will face in the future.     

The Ultrasound Challenge

Undergraduate ultrasound education is becoming increasingly important to medical student development; as a result, innovative training methods are being designed and implemented. The Ultrasound Challenge was created to help students learn core ultrasound techniques and apply them in a friendly competition where they showcase their abilities. The Ultrasound Challenge consisted of 6 events: focused assessment with sonography for trauma, cardiac ultrasound, aortic ultrasound, pelvic ultrasound, vascular access, and musculoskeletal ultrasound. Thirty‐three students from all 4 years of medical school participated. Medical center residents and faculty served as judges. The Ultrasound Challenge successfully provided medical students with ultrasound experience for future clinical endeavors.     

孕早期妇女体力活动现状及影响因素分析

目的 了解我国孕早期妇女体力活动现状及影响因素。方法 2017年7月—2018年7月采用方便取样法在全国15个省的24所医院共选取7 976名孕早期的妇女,采用一般情况调查问卷及国际体力活动短问卷对其进行调查。结果 清楚并有效填写国际体力活动短问卷的4 837名孕早期妇女中,体力活动不足的孕妇占68.5%,Logistic回归分析结果显示,年龄、孕妇文化程度、孕妇职业性质是孕早期妇女体力活动不足的影响因素（P<0.05）。 结论 孕早期妇女体力活动不足,体力活动水平需进一步提高。医护人员应加强对孕早期妇女尤其是年龄较低、低文化程度和无业孕妇关于孕期体力活动的健康教育,使孕妇养成良好的活动习惯。     

超声检查习惯性流产患者早孕期胎心率在妊娠结局中的预测价值

目的探讨超声检查习惯性流产（RSA）患者早孕期胎心率变化在妊娠结局预测中的作用。方法收集行超声检查的妊娠42~69 d的孕妇,其中,有RSA病史孕妇255例,无RSA病史孕妇201例。根据妊娠42~196 d（即6~28周）期间妊娠结局分为3组：RSA异常妊娠组（有RSA病史孕妇本次妊娠期间发生自然流产）;RSA正常妊娠组（有RSA病史孕妇本次妊娠至28周以上）;非RSA正常妊娠组（无RSA病史孕妇本次妊娠至28周以上）。孕妇经腹或经阴道超声测量孕囊大小及胚芽、胎儿头臀长,启用M取样并放大模式测量胎心率,连续测量3次,取均值,记录孕囊大小、头臀长及胎心率,追踪随访至妊娠28周,比较各组间资料。结果255例RSA孕妇中,83.0%的胚胎停育发生在55 d前,胎心率越低,胚胎停育发生率越高。超声检查与胚胎停育时间相隔越短,胎心率缓慢发生率越高。RSA正常妊娠组与非RSA正常妊娠组各孕龄平均胎心率的差异无统计学意义（P > 0.05）。RSA异常妊娠组与非RSA正常妊娠组孕49~62 d平均胎心率差异有统计学意义（P < 0.05）,孕42~48 d和孕63~69 d平均胎心率之间差异无统计学意义（P > 0.05）。用胎心率为检验变量,妊娠结局为金标准,预测胎心率诊断的价值,曲线面积为0.831,结果具有统计学意义（P < 0.05）。结论超声检查发现RSA患者早孕期胎心率缓慢对不良妊娠结局有一定的预测价值。     

Accuracy of abdominal ultrasound for the diagnosis of small bowel obstruction in the emergency department

BACKGROUND: Emergency physicians frequently encounter patients with acute small bowel obstructions (SBO). Although computed tomography (CT) imaging is the current gold standard in the assessment of patients with suspected SBO in the emergency department, a few studies have examined the use of ultrasound as an alternative imaging technique.METHODS: We evaluated the accuracy of ultrasound performed in the ED by a variety of providers (physicians with various levels of training, physician assistants) compared to CT imaging in 47 patients with suspected SBOs.RESULTS: Our data demonstrated a sensitivity of 93.8% and a specificity of 93.3% when compared to abdominal CT, and a sensitivity of 94.3% and specificity of 95.2% using a composite endpoint of abdominal CT and discharge diagnosis.CONCLUSION: Ultrasound can play an important role in the identification of small bowel obstructions in ED patients.     

阴道超声、腹部超声联合β人绒毛膜促性腺激素、孕酮诊断宫外孕的临床价值

目的  研究阴道超声、腹部超声与β人绒毛膜促性腺激素(β-HCG)、孕酮在诊断宫外孕中的价值。方法  开展回顾性分析,将医院妇产科2019年1月~2022年10月收治的63例宫外孕患者纳为宫外孕组,同期60例妊娠时间相似的正常孕早期妇女作为对照组。比较两组阴道超声及腹部超声检查资料及β-HCG、孕酮水平,分析阴道超声、腹部超声、β-HCG及孕酮水平在诊断宫外孕中的价值。结果  宫外孕组患者外周血β-HCG、孕酮水平及子宫内膜厚度均低于对照组,差异有统计学意义(P < 0.05)。阴道超声附件区包块检出率高于腹部超声,差异有统计学意义(P < 0.05),两组胎芽、胎心搏动、盆腔积液、同侧卵巢显示及对侧卵巢显示率比较,差异无统计学意义(P > 0.05)。β-HCG、孕酮及子宫内膜厚度单独应用时在诊断宫外孕中的效能分别为AUC= 0.732,95% CI：0.642~0.823;AUC=0.719,95% CI：0.626~0.812;AUC=0.803,95% CI：0.720~0.885,三指标联合应用在诊断宫外孕中的价值最高(AUC=0.862,95% CI：0.790~0.934)。结论  阴道超声、经腹超声及β-HCG、孕酮联合应用可有效提高宫外孕诊断效果。     

阴道超声联合超声造影对早孕期瘢痕妊娠的诊断价值

目的  探究阴道超声联合超声造影测定子宫瘢痕厚度对瘢痕妊娠的诊断价值。方法  选取我院2019年12月~2021年12月收治的92例疑似瘢痕妊娠患者为研究对象,采用阴道超声与超声造影对患者进行孕早期子宫瘢痕厚度测定,比较两种检查方式相关图像表现结果与病理检查结果,采用ROC曲线判断其厚度对瘢痕妊娠的诊断效能。结果  阴道超声测量结果为7.03± 0.17 mm,超声造影结果为7.25±0.14 mm,病理检查结果为7.42±0.15 mm,超声造影检查的厚度高于经阴道超声（P < 0.05）,两种方式检查结果均低于病理检查结果（P < 0.05）。对两种检查方式的图像进行比较,阴道超声检查诊断为92例患者均无法排除瘢痕妊娠,其中83例患者明确观察到妊娠物着床于瘢痕处,确诊为瘢痕妊娠,另9例患者无法确定其着床位置,无法排除瘢痕妊娠。进行超声造影后发现,有86例患者诊断为瘢痕妊娠,其中孕囊型57例,包块型29例,6例组织物植入肌层。病理检查结果显示,瘢痕妊娠88例,非瘢痕处峡部妊娠2例,妊娠着床位置过低2例。经阴道超声诊断准确度为92.39%,敏感度为94.31%,特异性为50.00%,超声造影诊断准确度、敏感度以及特异性分别为96.74%、97.73%、75.00%。经ROC曲线分析可得,阴道超声和超声造影诊断瘢痕妊娠的曲线下面积分别为0.722、0.864,超声造影诊断整体效能高于经阴道超声。结论  与经阴道超声相比,超声造影对子宫瘢痕厚度测量更加接近病理检查结果,能更为清晰地观察妊娠物着床部位,显示其与子宫肌层的关系,对瘢痕妊娠的诊断准确性、敏感度和特异性更高。     

荣昌县农村妇女孕产期保健服务利用现状及影响因素分析

目的了解荣吕县农村妇女孕产期保健服务利用现状,分析其影响因素,探讨进一步改善孕产期保健服务利用的措施。方法采用分层整群抽样的方法抽取700名2008年4～12月分娩的农村妇女,运用SAS8．2对资料进行统计分析。结果产前检查覆盖率为95．0％,孕早期检查率为75．4％,5次及以上产检率为69．3％,住院分娩率为98．3％,3次及以上产后访视率为26．3％,孕产妇系统管理率为16．7％。影响孕产妇系统管理率的因素主要是怀孕前一年家庭收入、是否参加新型农村合作医疗和母亲怀孕次数。结论该县孕产妇系统管理率尚待提高,必须加强宣教,改善产前检查和产后访视状况,引导更多妇女参加新型农村合作医疗。     

子宫动脉频谱形态异常可预测系统性红斑狼疮患者的妊娠结局

目的探讨子宫动脉多普勒在预测系统性红斑狼疮（SLE)合并妊娠母胎结局中的应用价值。方法回顾性选取45例系统性红斑狼疮合并妊娠孕妇,分析两组患者的临床情况及新生儿结局,并根据子宫动脉多普勒频谱是否出现切迹、搏动指数（PI)值增高,将患者分为正常组（n=31)及异常组（n=14),比较两组间的差异。结果45例孕妇中,15例（33%)出现子痫前期、狼疮性肾炎及抗磷脂综合征,胎儿出现不良结局共9例（20%)。子宫动脉频谱正常组31例（69%),5例（11%)孕妇发生子痫前期,1例（2%)胎儿发生小于胎龄儿。子宫动脉频谱异常组14例（31%),10例（22%)孕妇出现并发症,包括子痫前期、狼疮性肾炎,抗磷脂抗体（+)及抗磷脂综合征;8例（18%)胎儿发生不良结局：包括小于胎龄儿、胎儿生长受限及胎儿丢失。3例（7%)妊娠期新发SLE患者,孕妇子宫动脉波形均出现异常（波形出现切迹、PI值增高),3例胎儿均于围生期死亡。子宫动脉波形异常组母体并发症及胎儿不良结局的发生率均高于波形正常组,组间差异有统计学意义（P < 0.01)。结论孕妇子宫动脉频谱形态异常是预测妊娠期SLE加重及胎儿发生不良结局的敏感指标。     

妊娠期女性身体活动指南的质量评价及内容分析

目的 对国外妊娠期女性身体活动指南进行质量评价及内容分析,以期为我国妊娠期女性身体活动推荐意见、指导方案及指南的形成提供借鉴。方法 检索指南网站及数据库发布的妊娠期女性身体活动相关指南。2名研究者独立进行资料提取,2名评价者独立对指南进行评价。使用内容分析法汇总指南推荐意见。结果 共纳入10部指南,其中3部专家共识,7部循证指南。循证指南中A级3部,B级4部,AGREEⅡ的6个领域平均标准化得分依次为：范围和目的（92%）、清晰性（81%）、参与人员（81%）、独立性（73%）、应用性（68%）、严谨性（61%）。评价者间ICC得分均>0.75。内容分析总结出适用对象、禁忌证、活动处方、活动举例、活动警告信号、活动注意事项及特殊孕妇活动策略7方面的内容。结论 妊娠期女性身体活动相关指南质量较高,内容丰富,指导性强,可为我国妊娠期女性身体活动相关推荐意见、指导方案及指南的形成提供一定的借鉴。但在借鉴国外指南的内容时,需根据我国妊娠期女性身体素质、文化背景、社会环境等对推荐的内容进行具体分析。     

The Ultrasound Challenge 2.0

The Ultrasound Challenge was developed at The Ohio State University College of Medicine to introduce focused ultrasound to medical students. The goal was to develop experience in ultrasound through practice and competition. Initially this competition was held between Ohio State University College of Medicine students from years 1 through 4. The Ultrasound Challenge 2.0 was held in 2013. The event expanded on the previous structure by including students from the Wayne State University College of Medicine. The goal of this article is to describe our experiences with expansion of our interinstitutional ultrasound event. The challenge consisted of 6 stations: focused assessment with sonography for trauma, aortic ultrasound, cardiac ultrasound, pelvic ultrasound, musculoskeletal ultrasound, and vascular access. The participants were given a handbook outlining the expectations for each station ahead of time. Vascular access was graded in real time using the Brightness Mode Quality Ultrasound Imaging Examination Technique (B‐QUIET) method. The remainder were timed, saved, and graded after the event by 3 independent faculty members using the B‐QUIET method. The highest score with the fastest time was the winner. The Ultrasound Challenge 2.0 included 40 participants: 31 from The Ohio State University College of Medicine and 9 from the Wayne State University College of Medicine. The makeup of the winners in all categories consisted of 1 first‐year medical student, 7 second‐year medical students, 3 third‐year medical students, and 10 fourth‐year medical students. The Ultrasound Challenge 2.0 was a success for those who participated. It provided the first known interinstitutional medical student ultrasound competition. Students from both institutions were able to practice their image acquisition skills, demonstrate abilities in a competitive environment, and develop collegiality and teamwork.     

经阴道超声检查在早孕期孕妇先兆流产诊断中的应用

目的:探讨经阴道超声检查在早孕期孕妇先兆流产诊断中的应用.方法:选择2017年10月-2019年10月我院收治的60例孕妇,其中30例为正常体检的健康孕妇,设为对照组,30例为早孕期孕妇先兆流产孕妇,设为研究组;对比两组孕妇妊娠情况.结果:研究组宫腔内未出血妊娠较宫腔内出血人数多,但两组数据差异无统计学意义(P＞0.0...     

孕晚期孕妇母胎依恋现状及影响因素分析

目的: 分析孕晚期孕妇母胎依恋现状及其影响因素。方法: 便利取样法,选取2019年8月至12月于天津市某三级甲等医院产科门诊就医的210例孕晚期孕妇为研究对象。采用一般资料调查表、母胎依恋关系量表（MAAS）等研究工具进行调查。采用多重线性逐步回归分析法进行多因素分析。结果: 孕晚期孕妇MAAS得分（75.93±6.03）分。多重线性逐步回归分析结果显示,家庭人均月收入、抑郁、消极应对及领悟社会支持是孕晚期孕妇母胎依恋的影响因素（P<0.01）,解释总变异量的43.3%。结论: 孕晚期孕妇母胎依恋水平处于较高水平,受多种因素影响。医护人员可通过提高其积极应对能力和社会支持水平,改善其母胎依恋质量,从而促进母婴健康。     

产前超声诊断胎儿肾盂分离的意义浅析

目的:浅析产前超声诊断胎儿肾盂分离的意义。方法:抽取75例自2015年12月到2018年12月本院收治的疑似产前胎儿肾盂分离孕妇作为研究对象,回顾75例孕妇临床资料,所有孕妇均行产前超声检查,并以产后检查结果作为标准,对比产前超诊断在胎儿肾盂分离中的诊断效果,即评价产前超声诊断符合率、灵敏度、特异率。结果:75例孕妇经检查发现,有61例胎儿为可复性肾盂分离,APD低于不可复性肾盂分离(14例),P<0.05。产前超声在胎儿肾盂分离诊断中,准确率、灵敏率、特异率分别85.33%、52.94%、94.83%。结论:在胎儿肾盂分离诊断中,产前超声诊断,具有一定的临床应用价值,其可以为早期宫内检查与产后早期治疗提供有利的参考依据,值得临床推广。