糖尿病妊娠分娩期的观察护理

目的通过对妊娠期糖尿病的孕妇进行孕期、分娩期、产褥期的护理,以观察妊娠结局。方法对21例在我院产科门诊检查的高危孕妇进行筛查,诊断为妊娠期糖尿病（GDM）后收入院治疗。结果经过系统的治疗和护理,妊娠结局良好。21例产妇阴道分娩8例,剖宫产13例,巨大儿4例,均健康成活。结论积极的孕期干预可以提高妊娠期糖尿病患者的健康水平,有效控制血糖,降低母婴并发症。     

糖尿病妊娠分娩期的观察护理

目的 通过对妊娠期糖尿病的孕妇进行孕期、分娩期、产褥期的护理,以观察妊娠结局.方法 对21例在我院产科门诊检查的高危孕妇进行筛查,诊断为妊娠期糖尿病(GDM)后收入院治疗.结果 经过系统的治疗和护理,妊娠结局良好.21例产妇阴道分娩8例,剖宫产13例,巨大儿4例,均健康成活.结论 积极的孕期干预可以提高妊娠期糖尿病患者的健康水平,有效控制血糖,降低母婴并发症.     

妊娠期糖尿病孕妇糖化血红蛋白水平与不良母婴结局的相关性

目的:通过分析妊娠期糖尿病(gestational diabetes mellitus,GDM)孕妇分娩前糖化血红蛋白(glycosylated hemoglobin,HbAlc)水平与不良母婴结局的关系,探讨HbAlc在血糖监测及预判母婴结局中的价值.方法:回顾性分析2019年1月至6月在安徽医科大学附属妇幼保健院住...     

影响妊娠糖尿病妊娠结局的临床分析

目的探讨不同诊疗经过对妊娠期糖尿病妊娠结局的影响。方法采用回顾性分析方法对2000年1月至2006年12月在驻马店市中心医院确诊、住院分娩资料完整的妊娠期糖尿病患者共83例的资料进行分析。结果妊娠期糖尿病发生率为1.93%。母体并发症以妊娠期高血压疾病(30.12%)为主。有32例(38.6%)未经治疗即终止妊娠,经过孕期单纯饮食控制或饮食控制加胰岛素治疗51例。治疗组母体并发症、新生儿发病率明显低于未治疗组(P<0.05=。结论控制血糖使血糖维持在正常水平是治疗妊娠期糖尿病的关键,是降低母体并发症和减少围生儿患病率和死亡率的主要因素。剖宫产和早产并不影响妊娠结局。     

艾塞那肽联合甘精胰岛素对肥胖2型糖尿病效果观察

目的：对艾塞那肽联合甘精胰岛素在2型糖尿病患者中的治疗效果进行观察。方法选取我院2012年4月~2014年4月68例2型肥胖糖尿病患者,将所有患者分成两组,每组34例,1组作为对照组进行胰岛素治疗,2组作为实验组进行艾塞那肽联合甘精胰岛素治疗。治疗后对两组患者的空腹血糖、餐后2h血糖、血脂等情况进行比较。结果实验组平均空腹血糖为(5.83±0.71)mmol/L,餐后2h血糖为(7.32±1.05)mmol/L,糖化血红蛋白水平为(6.15±0.72)%;对照组患者空腹血糖水平为(11.26±1.34)mmol/L,餐后2h血糖为(14.31±2.06)mmol/L,糖化血红蛋白水平(9.93±1.51)%,P<0.05。两组患者胆固醇、甘油三酯、低密度脂蛋白水平存在明显差异,但高密度脂蛋白水平差异不大。结论：艾塞那肽联合甘精胰岛素在2型糖尿病患者中的治疗效果较为显著,能够有效的对患者血糖进行控制,降低患者发病率。     

妊娠期糖尿病规范化管理对妊娠结局的影响

目的探讨妊娠期糖尿病（GDM）的规范化管理对妊娠结局的影响。方法选择我院采用旧标准漏诊GDM而采用新标准确诊的GDM孕妇共200例,随机分入研究组1（GDM管理组）和研究组2（GDM不管理组）,每组各100例。对研究组1给予医学营养、运动和药物治疗,进行规范化管理;选取同期120例正常妊娠孕妇作为对照组。观察GDM患者治疗前后血糖水平[空腹血糖（FPG）、餐后2h血糖（2hPG）、餐后最高血糖）]变化情况,同时观察和比较3组孕产妇并发症（妊高症、羊水过多、胎膜早破、产后出血）、分娩方式（阴道分娩、剖宫产）、围生儿结局（早产、巨大儿、新生儿窒息、新生儿呼吸窘迫综合征）。结果与治疗前相比,GDM患者治疗后FPG、2hPG、餐后最高血糖水平均显著降低（P〈0.05）;与对照组相比,研究组1患者在并发症、阴道分娩率、剖宫产率,以及围生儿结局等方面,差异均无统计学意义（P〉0.05）,而研究组2患者与对照组相比各妊娠结局发生率显著不同。结论对于GDM患者进行规范化管理能够达到正常妊娠结局。     

产后护理管理对妊娠期糖尿病患者血糖控制及疾病认知水平的影响

研究产后护理管理对妊娠期糖尿病患者血糖控制及疾病认知水平的影响效果。方法 选择2015年2月~2017年2月我院收治的1500例妊娠期糖尿病患者,随机分为对照组和观察组。两组患者均采用降糖药物治疗,对照组行常规护理管理,观察组行产后护理管理。对比其两组患者血糖控制及疾病认知水平。结果 观察组患者空腹血糖水平为（5.02±1.13）mmol/L、餐后2 h血糖（8.02±1.24）mmol/L、糖化血红蛋白（7.12±1.03）%,对照组患者空腹血糖水平为（6.89±1.54）mmol/L、餐后2 h血糖（10.67±1.85）mmol/L、糖化血红蛋白（8.85±1.57）%,组间比较,差异有统计学意义（P＜0.05）;观察组患者疾病认知、临床诊断、疾病处理方式、疾病代谢特点得分情况均高于对照组,差异有统计学意义（P＜0.05）。结论 产后护理管理对妊娠期糖尿病患者血糖控制具有重要作用,同时能够提高患者疾病认知水平。     

妊娠糖尿病患者血清泌乳素的临床意义

目的探讨血清泌乳素与妊娠糖尿病（GDM）糖代谢紊乱的临床关系。方法将60例妊娠糖尿病患者按糖化血红蛋白水平分为甲乙两组,同时30例健康孕期妇女作为正常对照组,分别测定这3组的泌乳素（PRL）、血糖及HbA1c。结果血糖控制不理想患者血清泌乳素明显高于血糖稳定、并发症少的患者,而后者血清泌乳素与对照组相比无明显差异。结论本研究提示糖尿病时的高泌乳素血症可能是机体对长期糖代谢紊乱及其慢性并发症所产生的一种应激反应。对血糖控制不良的妊娠糖尿病人,并发症者行血清泌乳素测定具有一定的临床意义,它可以作为反映妊娠糖尿病病情的一项间接指标。     

妊娠糖尿病对母婴影响的分析

目的探讨妊娠糖尿病（GDM）对母婴影响。方法观察妊娠糖尿病患者36例及健康孕妇36例,分析其妊娠结局。结果GDM组妊娠期高血压疾病、早产、巨大儿及剖宫产发生率分别为41.7%、27.7%、25%及58.3%,明显高于对照组16.7%、8.3%、5.5%及27.7%,差异有显著性（P〈0.05）。结论GDM是危害孕产妇和围产儿的妊娠并发症,早期诊断GDM及控制血糖是减少母婴并发症的关键。     

糖化血红蛋白测定在妊娠糖尿病诊断中的价值

目的探讨糖化血红蛋白测定与妊娠糖尿病的关系及临床意义。方法对正常妊娠组、妊娠糖尿病组（GDM）和糖耐量受损组进行空腹血糖（FPG）、口服葡萄糖耐量实验（OGTF）和免疫比浊法进行糖化血红蛋白（HbAlc）测定,并对结果进行分析。结果妊娠糖尿病组HbAlc,FPG,OGTY与正常妊娠组及糖耐量受损组比较有显著性差异（P〈0．05）,在妊娠糖尿OGTT,HbAlc,FPG阳性率分别为81．4％,76．7％,46．5％。HbAlc有较高的阳性率,与OGTT最终诊断结果差异无统计学意义（P〉0．05）。结论糖化血红蛋白测定是妊娠糖尿病筛查及监测的简便、可靠的方法,有着重要的临床意义。     

Autoimmune disease during pregnancy and the microchimerism legacy of pregnancy

Pregnancy has both short-term effects and long-term consequences on the maternal immune system. For women who have an autoimmune disease and subsequently become pregnant, pregnancy can induce amelioration of the mother's disease, such as in rheumatoid arthritis, while exacerbating or having no effect on other autoimmune diseases like systemic lupus erythematosus. That pregnancy also leaves a long-term legacy has recently become apparent by the discovery that bi-directional cell trafficking results in persistence of fetal cells in the mother and of maternal cells in her offspring for decades after birth. The long-term persistence of a small number of cells (or DNA) from a genetically disparate individual is referred to as microchimerism. While microchimerism is common in healthy individuals and is likely to have health benefits, microchimerism has been implicated in some autoimmune diseases such as systemic sclerosis. In this paper, we will first discuss short-term effects of pregnancy on women with autoimmune disease. Pregnancy-associated changes will be reviewed for selected autoimmune diseases including rheumatoid arthritis, systemic lupus erythematosus and autoimmune thyroid disease. The pregnancy-induced amelioration of rheumatoid arthritis presents a window of opportunity for insights into both immunological mechanisms of fetal-maternal tolerance and pathogenic mechanisms in autoimmunity. A mechanistic hypothesis for the pregnancy-induced amelioration of rheumatoid arthritis will be described. We will then discuss the legacy of maternal-fetal cell transfer from the perspective of autoimmune diseases. Fetal and maternal microchimerism will be reviewed with a focus on systemic sclerosis (scleroderma), autoimmune thyroid disease, neonatal lupus and type I diabetes mellitus.     

Conception to ongoing pregnancy: the 'black box' of early pregnancy loss

Even when conditions are optimal, the maximum chance of a clinically recognized pregnancy occurring in a given menstrual cycle is 30-40%. Increasing evidence points to preclinical pregnancy loss rather than failure of conception as the principal cause for the relatively low fecundity observed in humans. While sensitive assays for hCG have provided a glimpse of the events occurring between implantation and the missed menstrual period, new cytogenetic techniques have further opened this 'black box', providing novel insights into the causes of early pregnancy wastage. In this article, the evidence and causes of preclinical or 'occult' pregnancy are reviewed, and the implications for the infertile patient are addressed.     

孕妇血清妊娠相关蛋白A检测及妊娠结局分析

目的探讨妊娠相关蛋白A(PAPP-A)作为血清标记物在孕早期产前筛查中应用的价值.方法用酶联免疫吸附法 (ELISA)测定孕 9～14周孕妇血清中PAPP-A浓度,检测结果低于正常下限值的孕妇视为胎儿染色体异常的高危人群,并对其进一步行羊水染色体检查及B超检查,每例受检的孕妇随访追踪到胎儿出生.结果共检测1380例9～14周单胎妊娠孕妇,筛查出PAPP-A低值的高危孕妇107例 ,确诊染色体异常 3例(2例21-三体,1例47,XXY ) ,高危组不良妊娠结局9例,筛查高危组与筛查低风险组不良妊娠结局比较有显著差异(χ2=39.36,P<0.01).结论 PAPP-A可作为孕早期染色体三体异常筛查的一个指标,对于PAPP-A低值的孕妇提示有不良妊娠结局的可能.     

Trisomic pregnancy and the oocyte pool

BACKGROUND: We tested the hypothesis that trisomy risk is increased for women with fewer oocytes (older ovarian age) than other women of the same chronological age. METHODS: Our study compared three indicators of ovarian age-number of antral follicles, level of dimeric inhibin B, level of FSH-among women who had trisomic pregnancy losses (n = 54) with those among women who had other losses (24 with other chromosomally abnormal loses, 21 with chromosomally normal losses) or who had chromosomally normal births (n = 65). RESULTS: Ovarian age indicators did not differ between women with trisomic spontaneous abortions and the three comparison groups. Compared with live birth controls, adjusting for chronological age, we estimate that, on average, among trisomy cases the geometric means of 1 + follicle count, inhibin B and FSH are about 7.5% higher, 16.6% higher and 5.5% lower, respectively, with all 95% confidence intervals including zero. The sample size was sufficient to detect moderate differences (0.52 standard errors of regression) between trisomy cases and live birth controls. CONCLUSIONS: Although our data do not support our hypothesis, they leave open the possibility that changes in follicular development unrelated to the size of the oocyte pool influence abnormal chromosome segregation.     

Angiosarcoma of the breast complicating pregnancy

A 32-year-old pregnant lady presented with a rapidly enlarging right breast mass. A fine needle aspiration was suggestive of a malignant phylloides tumour. However histopathological examination after mastectomy revealed a moderately differentiated angiosarcoma. The histopathological and cytological features of this rare tumour together with the diagnostic pitfalls are discussed.     

Teenage pregnancy in the Rotunda Hospital

The primary aim of this study was to investigate obstetric outcomes in teenagers delivered in the Rotunda Hospital and to identify whether younger teenagers have a poorer obstetric outcome. Delivery record details were recorded from the years 1992-96. These included the number of teenage mothers, maternal age, parity, gestation, mode of delivery, birth weight and Apgar scores. Teenagers were classified into those aged under 17 years and those aged 17 and over. Overall 2,228 teenage mothers were delivered in the Rotunda hospital, representing 17.2% of the total teenage population delivered in Ireland during the study period. Ten percent of mothers were under 17 years; 10.6% were multiparous with 2.6% of these under 17 years. There was a significant difference in the preterm delivery rate when the teenagers were compared as a whole with matched controls aged 20-24 years (p = 0.0411). However this did not translate into a poorer neonatal outcome as on average only 5% of babies were low birth weight and only 3% had Apgar scores < 3. Overall 70.2% of deliveries were spontaneous, 20.2% were instrumental. Less than 10% of deliveries were by caesarean section. However the rate of caesarean section increased with age from 14 (5.7%) to 19 (13.5%) years and this trend was statistically significant (p = 0.013). In conclusion, this study does not support the view that younger teenage mothers have a poorer obstetric and neonatal outcome. It has also been shown that there has been a large increase in the number of multiparous patients in this teenage population.     

Ectopic pregnancy: the surgical epidemic

Ectopic pregnancy has become a major health problem in terms of its morbidity and its impact on health care resources. In a case-control study involving 40 black patients, the odds ratio of developing ectopic pregnancy in current and former intrauterine device users is 11.7, which is statistically significant. The odds ratio for patients with a history of pelvic inflammatory disease is 4.4, which is statistically insignificant. A review of the current literature indicates Chlamydia salpingitis as the major cause of the ectopic epidemic. Prompt and effective treatment of this venereal disease may curtail health care expenses and prevent suffering of thousands of women each year.