淄博市不同孕期女性尿碘水平及甲状腺功能状况调查

目的:研究淄博市孕期女性碘营养状况、不同妊娠阶段甲状腺功能变化及妊娠期甲状腺疾病种类分布,制定淄博地区孕期女性特异的血清甲状腺功能指标参考值,为孕期实施碘营养监测及甲状腺功能筛查提供理论依据。方法:选取2013年3月至2014年2月在淄博市妇幼保健院门诊行产检的1268例孕妇。采用化学发光法测定妊娠早、中、晚期孕妇的血清促甲状腺素(TSH)、游离甲状腺素(FT4)、甲状腺过氧化物酶抗体(即TPOAb)。采用酸消化砷一铈接触法测定尿碘水平。结果:1268例孕妇中,孕早、中、晚期尿碘中位数分别为100.3、110.5、105.2,孕早期尿碘水平最低,孕中期尿碘中位数高于孕晚期。孕期FT4参考值范围设定:孕早期12.50~25.10pmmol/L,孕中期12.10~23.10pmmol/L,孕晚期11.20~20.16pmmol/L;孕期TSH参考值范围设定:孕早期0.15~3.20m IU/L,孕中期0.40~3.90m IU/L,孕晚期0.50~4.12m IU/L。正常尿碘组、低尿碘组及高尿碘组的FT4、TSH均在正常范围,高尿碘组、低尿碘组的FT4均低于正常尿碘组(P0.05),3组的TSH值比较差异均无统计学意义(P0.05)。1268例孕妇中,甲状腺功能异常者368例(29.02%),孕早期的甲状腺功能异常发生率高于孕中期及孕晚期,甲状腺功能异常以亚临床型甲减为主,其次为单纯TPOAb阳性。结论:淄博市孕期女性碘营养缺乏严重,需定期监测尿碘水平。随着孕周的增加,FT4值逐渐下降,而TSH值则呈上升趋势;尿碘异常早期可引起FT4的改变,对TSH影响不大。建议在妊娠早期对有甲状腺疾病危险因素的女性积极筛查甲状腺功能。     

孕妇尿碘及甲状腺功能监测

目的　探讨不同孕周、不同碘营养状况下孕妇尿碘水平及孕妇、新生儿甲状腺功能 ,分析孕妇碘营养状况及药物治疗的必要性。方法　于 1997年 7月～ 2 0 0 3年 3月期间 ,收集在我院就诊及分娩的孕产妇尿标本 185 2 8例次 ,按照是否补充“金典”分为A组 (未补碘 )及B组 (补碘 ) ,按照孕周分为 :孕早期 1组 ,孕中期 2组 ,孕晚期 3组 ;另随机抽取 2 4 6例孕产妇 ,并分组 :早孕未补充“金典”者 81例为JA1组 ,孕足月未补充“金典”者 86例为JA3组 ,孕足月补充“金典”者 79例为JB3组 ,对该组孕妇其及分娩的新生儿脐带血进行甲状腺功能的检测。结果　①本组孕产妇尿碘中位数为 2 31μg L ,尿碘值 <5 0 μg L、 <10 0 μg L、 <2 0 0 μg L的发生率分别为 2 4 %、 13 9%及 4 3 4 % ;②孕早、中、晚期未补充“金典” (及补充“金典”)组尿碘值中位数分别为 :16 2 μg L (377μg L)、 193μg L (2 86 μg L)、 2 6 0 μg L (382 μg L) ,前者尿碘值均低于后者 ,其差异有显著性 (P =0 0 0 0 ) ;随着孕周的增加 ,未补充“金典”组尿碘值依次升高 ,差异有显著性 (P =0 0 0 0 ) ;③三组孕妇甲状腺功能检测值的中位数均在正常范围内 ,除TG一项外 ,FT3、FT4 、TSH、TM等几项差异均有统计学意义(P =0 0 0 0 ) ;④足月     

妊娠期碘营养状况及其与甲状腺功能关系研究

目的探讨广州地区孕妇碘营养状况及其与甲状腺功能的关系。方法选择2012年3月至2014年2月在中山大学孙逸仙纪念医院产检的孕妇815为研究对象,进行甲状腺功能、抗甲状腺过氧化物酶抗体(TPO-Ab)和尿碘的检测,结果异常者定期复查,密切监测母胎情况,追踪至妊娠终止。结果 815例无甲状腺疾病史孕妇尿碘中位数(median urinary iodine,MUI)为197.0μg/L;其中碘缺乏者39.6%(323/815);碘适宜者20.9%(170/815);碘超足量者27.4%(223/815);碘过量者12.1%(99/815)。早中晚孕期MUI分别为208、182.5、174.5μg/L。不同碘营养状况下甲状腺功能、甲状腺疾病的患病率及TPO-Ab阳性率的差异无统计学意义,均P0.05。结论孕妇碘营养状态为碘适宜,但个体间差异较大。不同碘营养状况下甲状腺疾病的患病率无明显差异,即轻度碘缺乏或碘过量不增加甲状腺疾病的患病率。随着孕周的增加,尿碘值逐渐下降,但都在碘适宜的范围内。     

子痫前期可溶性CD105的表达及变化意义

目的探讨子痫前期患者可溶性CD105(sCD105)表达的变化和意义,探索妊娠中期测定血清sCD105值预测子痫前期的可能性。方法选择2007年1月至2008年2月间绍兴市妇幼保健院子痫前期患者40例(子痫前期组),其中轻度子痫前期12例,重度子痫前期28例。选择同期在该院年龄、孕龄匹配且有正常妊娠结局的40例正常孕妇为对照组。两组孕妇在孕15～20周曾行产前筛查,保留有血液标本。采用酶联免疫吸附分析法(ELISA)测定各组血清sCD105水平。结果对照组和子痫前期组血清妊娠晚期sCD105水平的中位数分别为10.35μg/L和35.15μg/L,差异有统计学意义(P0.001)。轻度子痫前期组和重度子痫前期组血清妊娠晚期sCD105水平的中位数分别为20.99μg/L和51.68μg/L,差异有统计学意义(P=0.001)。对照组和子痫前期组妊娠中期sCD105水平的中位数分别为5.20μg/L和5.90μg/L,差异有统计学意义(P=0.032)。选择sCD1055.23μg/L为界限值,预测子痫前期的灵敏度为67.5%,特异度为52.5%,阳性预测值为58.7%,阴性预测值为61.8%。结论子痫前期患者sCD105水平显著增高,发生子痫前期的妊娠中期孕妇sCD105也显著增高,而且这种增高与疾病的严重程度呈正相关。     

泉州地区妊娠中期单纯性低甲状腺素血症危险因素分析

目的探讨泉州地区妊娠中期单纯性低甲状腺素血症的危险因素。方法选取563例妊娠中期妇女,检测尿碘浓度、FT、FT4、TSH和生化指标等。分别以孕中期特异性甲状腺激素参考值(地区范围)和非孕期甲状腺激素参考值(试剂范围)诊断单纯性低甲状腺素(低T4)血症,比较两种情况下低T4血症患者临床资料的差异。以Pearson相关分析及多元线性回归分析探讨低T4血症发病的危险因素。结果 (1)入组孕妇中位数尿碘132.6μg/L。碘缺乏327例(58.1%),碘充足161例(28.6%),碘超足量58例(10.3%),碘过量17例(3.0%);(2)两种参考范围诊断的低T4血症患病率比较有统计学差异(1.95%vs 12.08%, P 0.01);(3)多元线性逐步回归分析表明,BMI、FT3、TSH、TG、LDL-C、年龄与FT4有独立的相关关系(均P 0.01)。结论孕妇碘缺乏在食盐加碘的沿海城市泉州很常见;高龄、高BMI、高TG、高LDL-C水平增加孕中期低T4血症风险。     

解整合素-金属蛋白酶12作为子(癇)前期筛查标志物的初步研究

目的 初步评价孕中期血清解整合素-金属蛋白酶12(a disintegrin and metalloprotease 12,ADAM 12)可否作为子癇前期筛查的一种标志物. 方法 通过病例-对照研究,采用初步建立的间接竞争法ELISA检测100例子癇前期患者与200例正常妊娠妇女孕14～18周血清标本中的ADAM 12水平,将其转换成MoM值后比较其有无明显差异. 结果 正常孕妇孕14～18周血清ADAM 12中位数分别为680/μg/L、738 μg/L、801 μg/L、849μg/L和900/μg/L,子癇前期患者孕14～18周血清ADAM 12中位数分别为598μg/L、664 μg/L、729/μg/L、791 μg/L和839μg/L.子癇前期组患者血清ADAM 12 LogMoM平均值-0.05242,明显低于正常孕妇组血清ADAM 12 LogMoM平均值-0.003 68(P＜0.01). 结论 子癇前期组患者孕14～18周血清ADAM 12水平明显低于正常孕妇,孕中期血清ADAM 12可能作为子癇前期筛查的一种标志物.     

我国部分地区孕妇和哺乳妇女适宜的尿碘参考值范围的制定

目的:对我国部分地区正常孕妇和哺乳妇女的尿碘值进行测定,以期对尿碘值范围提供一定的参考.方法:收集我国6个地区孕妇和哺乳妇女的尿碘和甲状腺功能数据,对甲状腺功能正常的141例孕妇和170例哺乳妇女的尿碘值进行统计分析.结果:我国部分地区孕妇和哺乳妇女适宜的尿碘值范围分别为90～500 μg/L和70～450μg/L.结论:本研究为孕妇和哺乳妇女碘营养状况的个体诊断提供了一种思考方法.     

北京1151例孕妇铅暴露水平流行病学调查

目的　了解目前北京城区孕妇血铅水平、脐带血铅水平及产妇乳汁铅水平 ,探讨三者之间的关系 ,并分析孕妇铅暴露的影响因素。　方法　将孕妇按不同孕周分为早孕、中孕和晚孕三组 ,收集孕妇静脉血 ,于胎儿娩出时收集脐带血 ,于产后 3d收集产妇乳汁。所有样本采用石墨炉原子吸收法进行铅含量的测定。采用自行编制的问卷对调查对象进行有关环境、生活方式、膳食情况的调查以分析孕妇铅暴露的影响因素。　结果　共收集孕产妇静脉血 115 1例 ,孕期血铅中位数为 4 3.4 0μg/L。孕期血铅呈动态变化 ,孕中期最低为 37.4 0 μg/L ,孕早、晚期较高 ,分别为 4 4 .5 0 μg/L和4 5 .10μg/L ,差异有显著性 ,P <0 .0 0 1。文化程度、家用燃料、乳制品摄入量这三个因素对血铅的影响具有统计学意义。收集脐带血 4 34例 ,铅中位数为 2 6 .4 0 μg/L ,与母体血铅呈正相关 ,r =0 .36 5 ,P <0 .0 0 1。收集乳汁 2 76例 ,铅水平 4 .4 8μg/L ,与母血铅无明显相关性。　 结论　目前北京城区孕妇血铅水平处于可接受范围。铅易于通过胎盘进入胎儿体内 ,但产妇早期乳汁中铅含量很低。另外 ,加强健康教育 ,大力治理环境 ,适当增加饮食中乳制品比例 ,采用天然气为家用燃料 ,是减少铅暴露的有效措施。     

尿β-HCG结合平均动脉压预测妊高征

目的　测定孕中期尿 β HCG水平结合平均动脉压 (mABP)预测妊高征的发生 ,寻求一种简便、易行并具有临床实用价值的预测方法。方法　采用放射免疫方法测定尿、血 β HCG值 ,同时测量平均动脉压进行前瞻性研究。结果　发现妊高征孕妇 16～ 2 0周尿 β HCG值 [(43 3 5 8± 40 78) μg/L]明显高于未发生妊高征者[(2 18 46± 2 4 5 8) μg/L],统计学上有显著差异 (P <0 0 5 ) ;尿 β HCG值 >43 3 5 8μg/L时 ,妊高征发生率明显增加 ;以尿 β HCG值 >43 3 5 8μg/L ,血 β HCG >43 81μg/L ,mABP≥ 12kPa为临界值 ,其阳性预测值和灵敏度分别为 42 9%和 60 0 %。结论　孕中期尿 β HCG水平结合平均动脉压可预测妊高征的发生 ,预测价值高于单项预测指标     

不同年龄和孕期的健康孕妇血浆D-二聚体的临界值差异性比较

目的:比较不同年龄和孕期的健康孕妇血浆D-二聚体的差异。方法:选择2020年5月至2021年1月在重庆医科大学附属第一医院进行产前检查的健康孕妇1846例,按孕期分为3组：早孕组(孕周≤13⁺⁶周)481例;中孕组(孕14⁺⁰～27⁺⁶周)591例;晚孕组(孕28⁺⁰～40⁺⁶周)774例。采用乳胶免疫比浊法对其血浆D-二聚体进行定量检测,统计学分析不同年龄和孕周的健康孕妇血浆D-二聚体的差异。结果:孕早期、孕中期和孕晚期的D-二聚体值分别是正常人群D-二聚体参考值上限的3.26倍、6.16倍和10.06倍,与孕早期的P₉₅值比较,孕中期和孕晚期D-二聚体的P₉₅值逐渐增高,差异有统计学意义(P<0.05)。孕妇血浆D-二聚体水平与孕妇年龄无差异性。不同孕期的D-二聚体的临界值为孕早期≤1.63 mg/L,孕中期≤3.08 mg/L,孕晚期≤5.03 mg/L。结论:目前推荐用于正常人群血浆D-二聚体水平参考范围(≤0.5 mg...     

妊娠中、晚期血清瘦素、β-hCG及ADAM12水平的变化及其与子痫前期发生的关系

目的：探讨妊娠中、晚期妇女血清瘦素、人绒毛膜促性腺激素β亚单位（β-hCG）及解整合素-金属蛋白酶12（ADAM12）的水平变化及这些指标对子痫前期（PE）发生的预测价值。方法：选择2007年6月—2008年5月在福建省妇幼保健院定期产检和住院分娩的189例妊娠妇女,分别测定妊娠中期（20～24周）和妊娠晚期（30～34周）血清瘦素、β-hCG、ADAM12的浓度,其中25例发展为PE者为病例组,164例正常妊娠者为正常组。根据受试者工作特征（ROC）曲线确定预测界限值。结果：①妊娠中期病例组血清β-hCG、ADAM12浓度显著高于正常组（P＜0.001）。②妊娠晚期病例组血清瘦素、β-hCG、ADAM12浓度明显高于正常组（P＜0.001）。③病例组妊娠晚期血清瘦素、β-hCG及ADAM12水平均较妊娠中期升高（P＜0.05）,正常组妊娠晚期血清瘦素水平较妊娠中期升高（P＜0.001）, 而血清β-hCG与ADAM12水平2组间差异无统计学意义（P＞0.05）。④妊娠中期以血清β-hCG≥32 μg/L、血清ADAM12≥818 μg/L为预测界值,两者联合阳性预测值为82.61%,高于单项阳性预测值（P＜0.05）。两者联合ROC曲线下面积与单项ROC曲线下面积比较差异无统计学意义（P＞0.05）。⑤妊娠晚期以血清瘦素≥23 μg/L、血清β-hCG≥37 μg/L及血清ADAM12≥900 μg/L为预测界值,三者联合阳性预测值达92.31%,高于单项阳性预测值（P＜0.05）。三者联合ROC曲线下面积大于单项β-hCG及瘦素ROC曲线下面积（P＜0.05）,但与单项ADAM12曲线下面积差异无统计学意义（P＜0.05）。⑥联合妊娠中、晚期血清β-hCG预测PE发生的阳性率为81.25%;联合妊娠中、晚期血清ADAM12预测PE发生的阳性率为90.48%,均比单一指标的阳性预测值高。结论：检测妊娠中、晚期妇女血清β-hCG及ADAM12水平可作为PE发生的有效预测指标;联合多项指标并动态监测可进一步提高对PE发生的阳性预测值及准确率。     

妊娠中、晚期血清瘦素、β-hCG及ADAM12水平的变化及其与子痫前期发生的关系

目的：探讨妊娠中、晚期妇女血清瘦素、人绒毛膜促性腺激素β亚单位（β-hCG）及解整合素-金属蛋白酶12（ADAM12）的水平变化及这些指标对子痫前期（PE）发生的预测价值.方法：选择2007年6月-2008年5月在福建省妇幼保健院定期产检和住院分娩的189例妊娠妇女,分别测定妊娠中期（20～24周）和妊娠晚期（30～34周）血清瘦素、β-hCG、ADAM12的浓度,其中25例发展为PE者为病例组,164例正常妊娠者为正常组.根据受试者工作特征（ROC）曲线确定预测界限值.结果：①妊娠中期病例组血清β-hCG、ADAM12浓度显著高于正常组（P＜0.001）.②妊娠晚期病例组血清瘦素、β-hCG、ADAM12浓度明显高于正常组（P＜0.001）.③病例组妊娠晚期血清瘦素、β-hCG及ADAM12水平均较妊娠中期升高（P＜0.05）,正常组妊娠晚期血清瘦素水平较妊娠中期升高（P＜0.001）,而血清β-hCG与ADAM12水平2组间差异无统计学意义（P＞0.05）.④妊娠中期以血清β-hCG≥32 μg/L、血清ADAM12≥818 μg/L为预测界值,两者联合阳性预测值为82.61%,高于单项阳性预测值（P＜0.05）.两者联合ROC曲线下面积与单项ROC曲线下面积比较差异无统计学意义（P＞0.05）.⑤妊娠晚期以血清瘦素≥23 μg/L、血清β-hCG≥37 μg/L及血清ADAM12≥900 μg/L为预测界值,三者联合阳性预测值达92.31%,高于单项阳性预测值（P＜0.05）.三者联合ROC曲线下面积大于单项β-hCG及瘦素ROC曲线下面积（P＜0.05）,但与单项ADAM12曲线下面积差异无统计学意义（P＜0.05）.⑥联合妊娠中、晚期血清β-hCG预测PE发生的阳性率为81.25%;联合妊娠中、晚期血清ADAM12预测PE发生的阳性率为90.48%,均比单一指标的阳性预测值高.结论：检测妊娠中、晚期妇女血清β-hCG及ADAM12水平可作为PE发生的有效预测指标;联合多项指标并动态监测可进一步提高对PE发生的阳性预测值及准确率.     

Iodine status of pregnant women in a metropolitan city which proved to be an iodine-sufficient area. Is mandatory salt iodisation enough for pregnant women?

The objective of this study was to assess the iodine status of pregnant women in a metropolitan city which was stated as iodine sufficient area after salt iodination program. This multicenter, cross-sectional study was carried out on 3543 pregnant women. Age, gestational weeks, smoking, consumption of iodized salt, dietary salt restriction, history of stillbirth, abortus and congenital malformations were questioned. Spot urine samples were analyzed for urine iodine concentration (UIC). The outcomes were: (a) median UIC in three trimesters of pregnancy and (b) frequency of ID among pregnant women. The median UIC was 73?µg/L. The median UIC was 77?µg/L (1–324), 73?µg/L (1–600) and 70?µg/L (1–1650) in three trimesters of pregnancy, respectively (p: 0.14). UIC <50?µg/L was observed in 36.6% (n: 1295) and UIC<150?µg/L was observed in 90.7% (n: 3214) of pregnant women. Only 1% (n: 34) of the pregnant women had UIC levels higher than 500?µg/L. This study showed that more than 90% of the pregnant women in this iodine-sufficient city are facing some degree of iodine deficiency during their pregnancy. A salt iodization program might be satisfactory for the non-pregnant population, but it seems to be insufficient for the pregnant population.     

Urine iodine excretion by healthy pregnant women after vitamin and microelement supplementation (Materna) in the first trimester

OBJECTIVES: The aim of the study was the assessment of iodine turnover in healthy pregnant women supplemented by microelement and vitamin preparation Materna. METHODS: To assess iodine supplementation, a modified PAAM method was used for measurement of iodine concentration in morning urine. MATERIALS: 50 pregnant healthy women were tested for Materna supplementation. Urine iodine concentration was measured starting from the I trimester of pregnancy and then after 1, 2 and 3 months of Materna administration. RESULTS: It has been found, that 3 months of supplementation with Materna reduces iodine deficiency in 83% of primiparas, while in the same time urine iodine concentration was normal in only 30% of women in their third and next pregnancy. CONCLUSION: In our opinion iodine urine concentration should be assessed in all multiparas using Materna after 1 month of supplementation in order to correct individual iodine supplementation doses.     

Hemoglobin and erythrocyte indices during normal pregnancy and postpartum in 206 women with and without iron supplementation

BACKGROUND: The aim was to define reference values for hemoglobin, hematocrit and erythrocyte indices, i.e. erythrocyte count, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), in normal pregnancy and after a normal delivery in non-iron-supplemented and iron supplemented women. METHODS: Two hundred and six healthy Danish women included at 9-18 weeks of gestation were allocated to treatment with placebo tablets (n=107) or tablets containing 66 mg iron (n=99). Blood samples were obtained at inclusion, every fourth week during gestation, and 8 weeks postpartum. RESULTS: All hematologic indices were significantly lower in placebo-treated than in iron-treated women. In placebo-treated women, the 5th percentile for hemoglobin was 110 g/L in the 1st trimester; in the 2nd trimester it was 105 g/L in the first and the second, and 103 g/L in the last third; in the 3rd trimester, it was 102 g/L in the first, 100 g/L in the second, and 101 g/L in the last third; postpartum it was 113 g/L. In iron-treated women, the 5th percentile for hemoglobin was 111 g/L in the 1st trimester; in the 2nd trimester it was 109 g/L in the first, 106 g/L in the second, and 103 g/L in the last third; in the 3rd trimester, it was 105 g/L in the first and second, and 110 g/L in the last third; postpartum it was 123 g/L. CONCLUSIONS: Hematologic reference values should be derived from iron replete women.We suggest that the lowest critical hemoglobin value in iron-treated pregnant women should be 110 g/l (6.8 mmol/L) in the 1st trimester, and 105 g/L (6.5 mmol/L) in the 2nd and 3rd trimester.     

Clinical value of urinary kallikrein determination in obstetrics

Whether to determine the urinary kallikrein (UKK) level in the second trimester of pregnancy is valuable or not for the prediction of gestosis, especially of hypertension in the third trimester of pregnancy, was studied on 700 cases of pregnant women including 50 cases of gestosis. The main results obtained were as follows. Sixty cases of 610 non-gestotic women were low in UKK, and 17 of these cases later resulted in gestosis or preterm delivery. When a patient with mild gestosis and/or hypertension was admitted, the UKK level was elevated significantly in general by bed rest and a low-salt diet. The UKK level was more significantly lowered in threatened preterm delivery than in normal pregnant women (p less than 0.001). A close positive correlation was seen between UKK levels and prostaglandin E2 in urine in pregnant women (n = 30, r = 0.528). A relatively close correlation was seen between UKK levels and roll-over test results (n = 30). From these results, the authors reached the conclusion that to determine UKK in the second trimester of pregnancy is quite valuable in predicting not only gestosis and/or hypertension in the third trimester of pregnancy but also preterm delivery.     

血清胱抑素C水平与早发型子痫前期发生和不良妊娠结局关系探讨

目的:研究孕妇发生早发型子痫前期及其出现不良妊娠结局与血清胱抑素C(CC)水平变化趋势关系。方法:选取2009年7月至2011年7月在南方医科大学南方医院妇产科住院治疗并分娩的早发型子痫前期患者69例,其中轻度15例(早发轻度组),重度54例(早发重度组),分析血清CC水平和子痫前期发生及母儿结局的关系。并同期选择产前检查正常的妊娠孕妇100例,检测其孕中期和孕晚期血清CC水平作为对照。结果:①正常妊娠孕妇孕中期和孕晚期时血清CC分别为0.81±0.12mmol/L和1.01±0.18mmol/L。早发轻度组血清CC(1.15±0.39mmol/L)和早发重度组血清CC(1.69±0.68mmol/L),分别与正常妊娠孕妇的孕中期和孕晚期比较,差异均有统计学意义(P<0.05)。②早发重度组的血清CC水平高于早发轻度组(P<0.05);早发重度组收缩压、舒张压、尿酸、肌酐和24小时尿蛋白水平均明显高于早发轻度组(P<0.05);早发重度组的羊水过少、胎儿生长受限、胎死宫内、低蛋白血症、胎盘早剥和HEELP综合征等不良妊娠的发生率高于早发轻度组。③早发重度组中出现不良妊娠结局患者中的CC水平高于未出现不良妊娠结局患者(P<0.05)。结论:子痫前期患者在妊娠中期血清CC水平已高于正常妊娠妇女,可能与子痫前期的发生和不良妊娠结局的出现相关。     

Are pregnant women in New Zealand iodine deficient? A cross-sectional survey

Severe iodine deficiency in pregnancy can result in cretinism. There is growing concern that less severe iodine deficiency may also affect fetal growth and development. A handful of prior small New Zealand studies focussed on pregnant women living in Dunedin. This study utilised biochemical, clinical and dietary indices to assess iodine status of 170 women living throughout New Zealand. The median urinary iodine concentration (UIC) of the women was 38 μg/L, well below the 150 μg/L cut-off value that indicates adequate iodine status; 7% of women had goitre. Not surprisingly, iodine intake was also low at 48 μg/day. The majority of women had TSH and FT4 concentrations within pregnant reference ranges, suggesting that despite the low UIC observed in these women, thyroid hormone production appeared unaffected.     

Pericardial effusion in normal pregnant women.

Fifty-two normally pregnant women underwent echocardiography to examine their pericardium in the first, second and third trimester. Pericardial effusion was noted in 15.3% of the women (n = 8) in the first trimester, 19.2% (n = 10) in the second trimester and 44.2% (n = 23) in the third trimester of pregnancy. Pericardial effusion during pregnancy was found to be completely resolved in all patients who underwent an echocardiogram 6 weeks post delivery (n = 11). There was no statistically significant difference in age, hemoglobin, total protein, albumin/globulin ratio or mean blood pressure during pregnancy between those who developed pericardial effusion and those who did not. The frequency of occurrence of pericardial effusion in primigravidas at 69.2% (9/13) was higher than that in multigravidas, with a ratio of 35.9% (14/39), the difference being statistically significant (p less than 0.025). The frequency of occurrence of pericardial effusion in patients who gained more than 12 kg during pregnancy at 67.7% (11/17) was higher than in patients who gained less than 12 kg, with a ratio of 34.3% (12/35), the difference being statistically significant (p less than 0.025).     

Establishing reference intervals for D-dimer to trimesters

Objective: When D-dimer is used to evaluate suspected venous thromboembolism in pregnant patients, the reference interval of common population may cause misinterpretation. The present study aims to determine reference intervals of D-dimer in the three trimesters.

Methods: Four-hundred sixteen pregnant women and 32 non-pregnant women were enrolled in this cross-sectional study. Reference group had comprised 123 pregnant in the first trimester (5–11 week), 164 pregnant in the second trimester (13–20 week) and 126 pregnant women in the third trimester (25–35 week). D-dimer levels were analyzed via immunoturbidimetric assay.

Results: If the threshold of 0.50?mg/L for diagnosis of VTE is used, 4.8% of pregnant women in the second trimester and 23.8% of pregnant women in the third trimester would have D-dimer levels exceeding this cut-off value. Reference intervals of D-dimer were determined as 0.11–0.40?mg/L; 0.14–0.75?mg/L and 0.16–1.3?mg/L in first, second and third trimester, respectively.

Conclusion: The established D-dimer reference intervals for each trimester of pregnancy are different from those used in common population. These reference intervals may assist clinicians in making accurate clinical decisions. Further studies are needed to establish new cut-off values for the D-dimer to rule out VTE in each trimester.