1078例孕妇TORCH血清学检测结果分析

1971年Nahmias将可造成胎儿垂直感染的几种病原体称为“TORCH”,包括弓形虫(Toxoplasma,TOX),风疹病毒(Rubella Virus,RV),单纯疱疹病毒(Herpes Si mplexVirus,HSV),巨细胞病毒(Cytomaglovirus,CMV)及其它微生物(Others),这些病原体可通过胎盘屏障传播给胎儿,导致流产、早产、胎儿中枢神经发育迟缓、畸形及死胎等,在围产医学中称为“TORCH综合征”。为了解武汉地区孕妇中TORCH的感染情况,以便在孕前和孕期向孕妇提出正确的建议,保证母婴健康,我们对本地区1078例孕妇进行了TORCH抗体水平测定,结果报道如下。1资料与方法1.1研…     

1816例孕妇孕期HBeAg、HCV、HIV、梅毒抗体筛查检测结果分析

目的孕妇孕期感染乙型肝炎、丙型肝炎、艾滋病、梅毒均可引起母婴垂直传播,其危害可伴随终生,尤其是孕期感染梅毒并在活动期还可引起早产、死胎等。方法为了解本地区孕妇上述疾病的感染情况,我们对2010年1月至12月间在我院正常孕期体检的1816例孕妇（检测组）及同期健康体检的1500例育龄妇女（对照组）的HBVM,抗HCV抗体;抗HIV抗体;梅毒抗体进行筛查检测。结果检测组与对照组乙肝HBsAg阳性（2.64%;3.53%）、抗HCV抗体阳性率（0.06%;0）、抗HIV抗体阳性率（0.11%;0）之间无统计学意义（P〉0.05）;而梅毒抗体检测结果分别为1.9%与0.27%,统计学有显著性差异（P〈0.05）。结论孕妇孕期四项感染性疾病的筛查可及时发现孕妇的感染情况并可采取相应的措施,对降低新生儿感染、减少和避免医务人员职业暴露风险有重要意义。     

6401例孕产妇产前梅毒筛查结果分析

目的了解本地区妊娠梅毒的流行情况,为采取有针对性的预防干预措施提供依据。方法对2009年1月至12月间来我院的孕产妇进行梅毒血清学检测分析。结果在6401例标本中检出梅毒患者57例,检出率为0.89%。结论对孕产妇进行梅毒血清学检测及规范治疗是杜绝先天梅毒,控制母婴传播的有效方法和措施.     

TPPA和TRUST联合检测对孕妇梅毒的诊断和监控意义

目的探讨TPPA和TRUST联合检测对孕妇梅毒的诊断和监控意义。方法用TPPA和TRUST法同时对6240例孕妇进行检测。结果6240例孕妇TPPA阳性为45例,阳性率为7.2‰,TRUST阳性为24例,阳性率为3.8‰,(其中单纯TRUST阳性为2例)。讨论对初检患者,尤其是孕妇,宜选用检测TPPA,以提高初检结果的检出率和可靠性,其阳性结果再查TRUST,以随访观察疗效、复发及再感染,做到早发现,早诊断,早治疗,确保优生优育,减少先天梅毒儿的产生。     

2297例产妇梅毒血清学试验结果分析

本文对2297例产妇进行了梅毒血清学试验分析,现报告如下。 1材料和方法 1.1临床资料选取2009年12月～2010年12月间产科住院产妇共2297例,常规进行了快速血清反应素试验（RPR）、梅毒螺旋体抗体（TP-Ab）检测,阳性者再行梅毒螺旋体颗粒凝集试验（TPPA）血清学试验确证。年龄（18～42）岁,平均29岁。     

20例梅毒孕妇胎盘功能的临床分析

梅毒感染是一个较为古老的性传播疾病，对胎儿造成的损害也是明确的，本文结合本院近年来收住确诊的20例梅毒孕妇，经正规治疗者共12例，未治疗或非正规治疗8例，两组胎盘功能及妊娠结局有明显差异，现报告如下。     

70岁以上住院患者梅毒螺旋体血清学检测的结果分析

为了控制梅毒的院内感染,现已规定凡行手术、输血、各种创伤性检查的患者均须进行梅毒螺旋体的相关血清学检验。由于梅毒对健康和生命造成危害以及患病后对患者个人、家庭以及社会影响较大,因此相关检测结果的正确与否一直是十分敏感的医学和社会问题。国内多位学者[1-4]的研究结果显示,TP-ELISA和TPPA在老年人中有较高的假阳性率,我们在日常的工作中也发现     

265例孕妇肾功能检测结果分析

目的：研究分析孕妇肾功能检测的不同结果。方法择取2013年06月~2014年06月在我院接受检查的265例孕妇,根据其年龄、孕期进行分组,并探析各组间孕妇的尿素氮(英简BUN)、血清肌酐(英简Cr)水平比较。结果不同年龄组孕妇的BUN、Cr水平之间比较,差异>0.05不具统计学意义。不同孕期组孕妇的BUN水平没有显著差异性,但Cr水平存在明显差异,<0.05有统计学意义。结论不同年龄孕妇的肾功能状况没有显著差异,只是在孕中晚期孕妇肾功能会发生一定变化。     

老年人梅毒阳性检测结果的分析

梅毒的病原体为梅毒螺旋体即苍白螺旋体的苍白亚种,是一种性传播疾病,由梅毒螺旋体通过破损的皮肤与黏膜由感染者传染给患者,可侵犯全身各器官,产生各种临床症状和体征。目前为了控制梅毒的医院感染,现已规定凡是手术、输血(供、受血者)及各种创伤性检查的患者,均进行梅毒螺旋体的相关血清学检查。常规检验中发现老年患者梅毒血清学试验结果阳性率偏高,但临床上却没有任何症状,病人也诉无发病史和疾病接触史,老年人逐渐丧失性能力,通     

济南地区426例早期妊娠妇女尿碘水平测定

目的研究济南市早期妊娠妇女碘营养状况。方法采用酸消化-砷铈接触法测定426例早期妊娠妇女尿碘。结果孕妇尿碘中位数为173.2μg/L,尿碘均数为218.51±171.8μg/L,尿碘值>150μg/L者252例,占59.15%尿碘值<100μg/L者86例占20.19%,<50μg/L者12例,占2.82%。结论部分孕早期妇女存在碘摄入不足,有必要进行早期妊娠尿碘筛查,预防碘缺乏的发生。     

孕妇传染病感染标志物的检测及临床意义

目的了解孕妇乙肝、丙肝、梅毒及艾滋病的感染状况,探讨检测的临床意义。方法对我院2002年1月~2004年12月住院孕妇进行乙肝病毒血清标志物(HBV-M)、抗-HCV、-TP及-H IV检测,共2782例。结果HBsAg阳性率为12.80%,三年来乙肝阳性率变化不大,各年阳性率相互间比较无显著性差异(P>0.05);丙肝、梅毒阳性率分别为0.32%和1.40%,阳性率显逐年上升趋势,2004年与2002年梅毒阳性率比较,差异具有显著性意义(χ2=4.07,P<0.05);抗-H IV全为阴性。结论对孕妇进行4种传染病感染标志物检测是及早发现传染病和防止传染病母婴垂直传播的有效防治措施之一。     

2010-2015年成都市孕产妇艾滋病哨点监测结果分析

目的 了解成都市孕产期妇女人类免疫缺陷病毒(HIV)、丙型肝炎病毒(HCV)和梅毒的感染现状、艾滋病防治知识知晓情况及其影响因素,为当地防控策略制定和干预效果评估提供科学依据.方法 严格按照《全国艾滋病哨点监测实施方案操作手册》标准,于2010-2015年对符合监测条件的孕产妇开展行为学问卷调查和血清学检测.结果 2010-2015年间共监测孕产妇2400名,未发现HIV抗体阳性者,梅毒阳性检出率及HCV阳性检出率均为0.13％;艾滋病防治知识知晓率70.52％,呈逐年上升趋势(X2=75.68,P＜0.001),且文化水平越高、年龄越小、怀孕生育次数越少,其防治知识知晓率越高.结论 成都市孕产妇人群HIV、梅毒、HCV感染率均处于低于全国较低水平,但该人群艾滋病防治知识知晓率仍有待提升,今后应开展针对性的孕期健康教育及行为干预,预防艾滋病母婴传播的发生.     

早中期孕妇贫血及铁储存状况的分析

目的探讨早中期孕妇贫血发生情况与铁储存情况的关系,为临床提供妊娠贫血的实验室资料。方法测定孕早期和孕中期432名孕妇的贫血相关指标RBC、Hb、HCT、MCV、MCH、MCHC,同时检测血清铁蛋白（SF）,血清可溶性转铁蛋白受体（STfR）。结果 163名早期孕妇患者贫血患病率为19.52%,269名中期孕妇贫血患病率为38.31%。孕早期组和孕中期组铁减少患病率分别为14.02%和32.18%。孕中期与孕早期组相比SF显著降低,STfR显著增高。结论孕中期妊娠贫血发生率及铁减少患病率显著高于孕早期组,差异均有统计学意义（P〈0.05）;与孕早期组相比,孕中期Hb、SF显著降低,STfR显著增高（P〈0.05）。     

乙肝孕妇早孕期甲状腺激素水平的观察

目的研究乙肝孕妇早孕期甲状腺激素分泌特点。方法应用化学发光微粒子免疫分析方法检测104例研究对象的早孕期甲状腺激素,104例研究对象分为对照组20例,为非乙肝孕妇,轻度慢性乙型肝炎组22例、中重度慢性乙型肝炎组22例、非活动性HBsAg携带组20例、慢性HBV携带组20例（HBV-DNA大于等于107拷贝／m1）。应用SPSSl7.0统计软件对结果进行统计学分析。结果中重度慢性乙型肝炎组T3（1.59±O．35）、T4（10.80±1．45）、FT3（3.33±0.45）高于对照组T3（1.37±0.21）、T4（9.72±1.47）、FT3（3.08±0.21）,差异有显著性意义,中重度慢性乙型肝炎组TSH（1.11±1.03）及慢性HBV携带组TSH（0.90±0.48）低于对照组TSH（2.01±1.35）,差异有显著性意义,其余各组甲状腺激素与对照组相比均无显著性差异。结论中重度慢性乙型肝炎孕妇早孕期甲状腺激素水平不同于非乙肝孕妇,增强对乙肝孕妇甲状腺激素分布特点的认识,有助于更准确地诊治乙肝孕妇甲状腺功能疾病。     

北京市朝阳区孕妇流感疫苗接种知识、态度、行为调查

目的 了解孕妇对孕期接种流感疫苗知识了解程度,并分析其态度及行为情况,为促进北京孕妇流感疫苗接种工作的开展,制定有针对性的孕妇健康教育方案提供参考.方法 采用整群抽样的方法,对朝阳区妇儿医院建档孕妇开展问卷调查.结果 445名参与调查的孕妇中70.3％认为孕妇是流感易感人群,孕期感染流感的严重后果(增加孕妇死亡、早产、死产、新生儿死亡风险)知晓率分别为35.5％、65.8％、51.2％和53.7％.38.4％的研究对象认为孕期接种流感疫苗是安全的,接种有效性知晓率分别为69.0％、47.4％.对流感接种政策中对孕妇的推荐接种情况知晓率(北京市、中国和世界卫生组织)分别为17.8％、16.9％、14.8％.15.3％的孕妇表示愿意在孕期接种流感疫苗,愿意接种和不愿接种孕妇在知晓水平上存在统计学差异.孕妇最主要和最信赖的信息获取渠道分别为妇产科医生(31.2％)、孕妇课堂(16.1％)、卫生行政部门(13.9％)和疾控中心(12.2％).结论 孕妇低估接种必要性,不信任疫苗接种安全性及有效性,孕期接种流感疫苗的意愿低.建议将孕妇纳入北京地区流感疫苗接种的推荐人群,同时对孕妇开展有针对性的健康教育工作,重点对孕期流感严重后果、孕期接种的安全性及有效性进行宣传.通过妇产科医生宣传、孕妇课堂提高孕期孕妇接种率.     

伊犁州715例城市孕妇孕期膳食营养摄入状况分析

目的了解新疆伊犁地区孕妇孕期膳食摄入状况和膳食模式,为进一步改善和提高孕妇膳食营养状况提供原始资料。方法采用24 h回顾调查法结合称重法、记账法、收集被调查者连续7 d的膳食摄人情况;然后将调查内容输入由北京医网中心提供的孕期饮食营养分析与指导系统进行评价计算。结果 1.调查对象膳食结构以谷薯类为主,早、中、晚期杂粮各占谷薯类食物4.2%、9.5%、9.1%.奶类、水果类、蔬菜、豆类食物的日平均摄入量均高于全国水平,蛋类日平均摄入量低于全国水平,早、中、晚期肉类食物摄入量均低于全国水平[1],以早期更为明显。谷薯类、奶制品、肉类中中期与早晚期相比较有统计学意义(P<0.05)。2.碳水化合物供能比相对偏低。油脂的摄入量过高,约为推荐摄入量的3倍。碘及叶酸缺乏较为严重,约90%以上的孕妇未及推荐摄入量。中晚期钙、铁、锌、维生素A摄人量未达到AI或者RNI者,所占比例较大。3.三大产能营养素供能及一日三餐能量分配不合理。结论 1应增加伊犁地区城市孕妇在中晚期海产品、水果、瘦肉、豆类的摄入量,提高优质蛋白质、钙、铁、锌、维生素A的含量,适当减少饱和脂肪酸的摄入。     

HTLV infection among foreign pregnant women living in Spain

Background

The overall seroprevalence of HTLV infection among pregnant women in Spain is below 0.02% and accordingly universal antenatal screening is not recommended. However, as the number of immigrants has significantly increased during the last decade, this population might warrant specific considerations.

Objective

To evaluate the seroprevalence of HTLV infection among immigrant pregnant women living in Spain.

Methods

From January 2009 to December 2010 a cross-sectional study was carried out in all foreign pregnant women attended at 14 Spanish clinics. All were tested for HTLV antibodies using a commercial enzyme-immunoassay, being reactive samples confirmed by Western blot or PCR.

Results

A total of 3337 foreign pregnant women were examined. Their origin was as follows: Latin America 1579 (47%), North Africa 507 (16%), East Europe 606 (18%), Sub-Saharan Africa 316 (9%), North America and West Europe 116 (3.5%) and Asia and Australia 163 (5%). A total of 7 samples were confirmed as HTLV positive, of which 6 were HTLV-1 and 1 HTLV-2. HTLV-1 infection was found in 5 women coming from Latin America and 1 from Morocco. The only woman with HTLV-2 came from Ghana. The overall HTLV seroprevalence was 0.2%, being 0.3% among Latin Americans and 0.2% among Africans. It was absent among women coming from other regions.

Conclusions

The seroprevalence of HTLV infection among foreign pregnant women in Spain is 0.2%, being all cases found in immigrants from Latin America and Africa. Given the benefit of preventing vertical transmission, antenatal screening should be recommended in pregnant women coming from these regions.     

Morphological and ultrastructural changes in the placenta of the diabetic pregnant Egyptian women

Diabetes mellitus (DM) is a chronic metabolic disease in which the body fails to produce enough insulin or increased tissue resistance to insulin. The diabetes may have profound effects on placental development and function. This study was designed to detect the placental changes in pregnancy associated with DM comparing these changes with normal placenta. The study was carried out on sixty full-term placentae; divided into three equal groups; control group (group I): placentae of normal pregnancy, uncontrolled diabetes (group II): placentae from pregnant women whose blood glucose is poorly controlled during pregnancy. Controlled diabetes (group III): includes placentae from diabetic women whose blood glucose is controlled during pregnancy. The placentae from group II tend to be heavier and exhibited immaturity of villi, villous edema, fibrosis, excessive syncytial knots formation and infarctions. In addition to, fibrinoid necrosis, increased thickness of vasculosyncytial membrane, syncytial basement membrane, microvillous abnormalities and vascular endothelial changes were demonstrated. The syncytial multivesicular knots were present in placentae of group II. The nuclei within these syncytial knots display condensed chromatin, either dispersed throughout the nucleus or in the form of dense peripheral clumps with and numerous cytoplasmic vacuoles. The syncytial basement membrane showed focal areas of increase in its thickness and irregularity. Villous cytotrophoblasts showed increased number and activity in the form of numerous secretory granules, abundant dilated RER, larger distorted mitochondria. Villous vessels showed various degrees of abnormalities in the form of endothelial cell enlargement, folding, thickening and protrusion of their luminal surfaces into vascular lumen making it narrower in caliber. In placentae of group III, most of these abnormalities decreased. In most of placentae of group III, the VSM appeared nearly normal in thickness and showed nearly normal composition of one layer of syncytiotrophoblastic cells, one layer of smooth, regular capillary endothelium and the space between them. Mild microvillous abnormalities were noted in few placentae as they appeared short and blunted with mild decrease in their number per micron. The electron picture of syncytial knots appeared nearly normal containing aggregations of small, condensed hyperchromatic nuclei, minimal vacuoles could be seen in the cytoplasm of syncytial knots. Syncytial basement membrane appeared regular and nearly normal in its thickness and composition coming in direct contact with fetal blood capillaries but mild abnormalities were noted in the basement membrane in few placentae as increased its thickness and deposition of fibers or fibrinoid. Regarding cytotrophoblasts in the terminal villi of placentae with controlled diabetes, these cells appeared nearly normal. They were scattered beneath the syncytium and were active containing mitochondria, rough endoplasmic reticulum, free ribosomes and a large nucleus with fine dispersed chromatin. The vascular ultrastructural pattern in terminal villi of placentae of this group showed no significant abnormalities and was normally distributed in the villous tree. The luminal surface of the vascular endothelium appeared regular smooth in the majority of placentae of this group. The endothelial cells appeared connected to each other with tight junctions. It could be concluded that whether if long-term diabetes is controlled or not, placentae of diabetic mother showed a variety of significant histological structural changes seen more frequently than in the placentae of pregnant women without diabetes.     

5992例孕产妇梅毒筛查与分析

目的 了解妊娠期梅毒的流行情况及对围产结局的影响。方法 对5992例孕产妇进行甲苯胺红不加热血清试验（TRUST）筛查，对TRUST阳性病例再进行梅毒螺旋体血清颗粒凝集试验（TPPA）确诊。并对围产结局进行观察分析。结果 5992例孕产妇，检出梅毒患者43例（0．72％），其中30例经青霉素治疗的患者其新产儿经半年以上随访无1例感染梅毒，在未治疗的13例患者中有10例分娩的新生儿TPPA滴度均≥1：40，其中2例为先天性梅毒。1例为死亡梅毒婴儿。结论 开展妊娠期梅毒血清学的产前筛查，加强对妊娠期梅毒的治疗，对减少先天性梅毒的发生尤为重要。