Prevention of iodine deficiency diseases in pregnant and lactating women

The objective of this work was to evaluate results of control epidemiological studies of iodine-deficiency condition in pregnant and breast-feeding women; the secondary objective was to develop standard prophylactic iodine dose schedule for these patients. The study included two groups of pregnant women treated either with a daily dose of 200 mcg potassium iodide (group 1, n=52) or with 300 mcg Kl/day (group 2, n=69). In all of them, blood TSH, free thyroxin and antithyroid peroxidase antibody levels were measured along with iodine excretion in urine. Thyroid volume was determined by ultrasound. Initially, median urinary iodine excretion in all the patients was 62.7 mcg/l. Three months after onset of the treatment with potassium iodide it significantly increased to 83.5 mcg/l and 1120.8 mcg/l in groups 1 and 2 respectively (p = 0.006 and 0.001). However, the desired level of >150 mcg/l was not achieved. Treatment with KI in the period of lactation within 2 months after delivery resulted in median urinary iodine excretion of = >100 mcg/l in 10.5% of the women in group 1. None of the patients in group 2 showed the required iodine concentration in the urine. It means that the minimal daily prophylactic dose of iodine for pregnant and lactating women should be 300 mg.     

妊娠及哺乳期妇女血清nesfatin-1水平的检测

nesfatin-1是日本学者Oh-1等[1]于2006年在大鼠下丘脑的弓状核、室旁核和视上核等部位发现的一种由82个氨基酸组成的神经肽.动物实验表明,侧脑室或腹腔内注射nesfatin-1可使大鼠摄食量明显减少,且摄食抑制效应呈剂量依赖性[1-2].     

Addressing concerns of pregnant and lactating women after the 2005 hurricanes: the OTIS response

Natural disasters are devastating for anyone affected, but pregnant and breastfeeding women often have specific concerns about the effects of certain exposures (such as infections, chemicals, medications, and stress) on their fetus or breastfed child. For this reason, the Organization of Teratology Information Specialists (OTIS) and the National Center on Birth Defects and Developmental Disabilities at the Centers for Disease Control and Prevention partnered to provide information for women and healthcare professionals about the effects of exposures on pregnancy and breastfeeding after the hurricanes of 2005. This service expanded on OTIS's existing telephone counseling and fact sheets. Through this project, fact sheets were created to address specific potential concerns regarding exposures after the hurricanes. The OTIS national toll-free telephone number also was modified to accommodate questions regarding hurricane-related exposures, and several strategies were used to publicize this number as a resource for obtaining hurricane-related exposure information related to pregnancy and breastfeeding. This article describes OTIS's response after the 2005 hurricanes, the challenges encountered in implementing the response, and lessons learned that might be useful to improve the response to the unique needs of this special population after any disaster or public health emergency.     

Pancreatitis in pregnant women

Regardless of the fact, that pancreatitis during pregnancy is rare; this disease is characterized by high indices of maternal and perinatal mortality. Among variety of etiological and pathogenetic aspects of pregnant women's acute pancreatitis, leading role in its development belongs to bile-excreting system diseases, conditioned by physiological processes in women's organism during gestational period. Also there is a genetic theory of acute pancreatitis genesis in pregnant women, based on dislipoproteinemia development caused by lipoprotein lipase insufficiency, when severity of pancreatitis course is correlated with morphotype of this enzyme gene mutation. Chronic pancreatitis is conditioned by the same causes and can develop and recur during pregnancy and right after parturition. Diagnostics of pregnant women's pancreatitis is complicated because of limitation of the use of some methods (radiation and endoscopic). Pancreatitis clinical course does not differ from the one in nonpregnant women and is manifested by pain abdominal and dyspeptic syndromes, and also by syndromes of exocrine and endocrine pancreatic insufficiency. The main clinical feature of pregnant women's pancreatitis is high occurrence of painless forms. Approaches to treatment include pain relief disintoxication, use of pancreatic secretion blockers, multienzyme complexes, glycemia correction.     

Stroke in pregnant and postpartum women

Ischemic infarcts and hemorrhages are uncommon but dangerous complications of pregnancy. Their etiology is related to physiological changes during pregnancy. The majority of strokes are seen in the third trimester and postpartum and are etiologically related to three conditions: reversible cerebral vasoconstriction syndrome, preeclampsia/eclampsia and cerebral venous thrombosis. The first two conditions are etiologically connected and can lead to ischemic and hemorrhagic events, whereas cerebral sinus thrombosis is mainly related to hypercoagulation and causes venous infarcts and brain hemorrhages. MRI and CT scans are safe to use for diagnosis of stroke in pregnancy, although use of iodine-based contrast may affect thyroid function of the neonate. Management of stroke in pregnancy is specific to cause and depends on management of blood pressure and delivery in preeclampsia/eclampsia, expected management or calcium channel blockers in reversible cerebral vasoconstriction syndrome, and anticoagulation for cerebral sinus thrombosis.     

Identifying and helping battered pregnant women

This article highlights strategies in identifying and helping battered pregnant women. Studies report that 40-60% of battered women were abused during pregnancy inflicted in the form of blows to the abdomen, injuries to the breasts and genitals, and sexual assault. Because battering during pregnancy has been a prevalent occurrence, assessment during prenatal visits is most critical. This paper outlines several assessment approaches in dealing with battered pregnant women in specific circumstances, giving important consideration to her safety due to the potential risk of homicide. A Danger Assessment tool is utilized in assessing for potential homicide. Intervening with victims of abuse is difficult. The role of the nurse is to assist in the development of problem-solving and decision-making skills while the woman is still in extreme confusion or feeling of conflicting loyalties. Routine assessment for physical and sexual abuse during the prenatal period is recommended in order to prevent further abuse thus promoting maternal-child well being.     

45例妊娠期糖尿病孕妇分娩方式与分娩结局分析

目的为了提高妊娠期糖尿病（GDM）孕妇分娩服务质量及护理经验。方法通过对2004年1月-2005年12月来我院产科住院分娩的45例GDM孕妇及40例健康孕妇的分娩情况进行回顾性分析。结果GDM孕妇病理妊娠、母婴并发症发生率明显增高,因此糖尿病孕妇大多选择剖宫产结束分娩,但由此而导致一系列并发症。结论早期诊断GDM及控制血糖是促进糖尿病孕妇自然分娩,减少母婴并发症的关键。     

45例妊娠期糖尿病孕妇分娩方式与分娩结局分析

目的为了提高妊娠期糖尿病(GDM)孕妇分娩服务质量及护理经验。方法通过对2004年1月-2005年12月来我院产科住院分娩的45例GDM孕妇及40例健康孕妇的分娩情况进行回顾性分析。结果GDM孕妇病理妊娠、母婴并发症发生率明显增高,因此糖尿病孕妇大多选择剖宫产结束分娩,但由此而导致一系列并发症。结论早期诊断GDM及控制血糖是促进糖尿病孕妇自然分娩,减少母婴并发症的关键。     

45例妊娠期糖尿病孕妇分娩方式与分娩结局分析

目的 为了提高妊娠期糖尿病(GDM)孕妇分娩服务质量及护理经验.方法 通过对2004年1月-2005年12月来我院产科住院分娩的45例GDM孕妇及40例健康孕妇的分娩情况进行回顾性分析.结果 GDM孕妇病理妊娠、母婴并发症发生率明显增高,因此糖尿病孕妇大多选择剖宫产结束分娩,但由此而导致一系列并发症.结论 早期诊断GDM及控制血糖是促进糖尿病孕妇自然分娩,减少母婴并发症的关键.