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.     

化学发光微粒子免疫分析在梅毒螺旋体抗体筛查中的应用探讨

目的 评价化学发光微粒子免疫分析法(CMIA)用于梅毒螺旋体抗体(TP-Ab)筛查的价值,并制定合理的TP-Ab血清学筛查方案.方法 收集在我院进行TP-Ab筛查的患者标本,共计30,100例,对于CMIA为阴性者直接报告结果,CMIA阳性者采用梅毒螺旋体明胶凝集试验(TPPA)确认,并同时进行快速血浆反应素环状卡片试验(RPR),分析结果的一致性.结果 在30100例筛查标本中,CMIA阳性者402例(1.3％),样本吸光度与临界质控吸光度比值(S/CO)在1.05～40.56之间.CMIA结果＞10 S/CO的标本共178例,TPPA阳性比例为100％,RPR阳性63例;在6-10 S/CO之间的标本共计50例,RPR阳性8例,TPPA阳性比例92％;在3～6 S/CO之间的标本59例,RPR阳性者5例,TPPA阳性的比例66.1％;在1～3 S/CO之间的标本115例,RPR均为阴性,TPPA阳性的比例仅为20％.结论 CMIA筛查TP-Ab具有较高的灵敏度,但特异性相对较低,采用CMIA进行TP-Ab筛查,并根据其S/CO值确定是否需要进一步采用另外一种高特异性梅毒螺旋体抗体检测试验进行确认,是TP-Ab筛查理想的方案,确认方法可以选择TPPA等试验.确认阳性者,应报告RPR结果,辅助临床区分既往感染和现症感染.     

7574例孕产妇产前筛查结果分析

目的了解孕中期产前筛查对胎儿染色体异常及神经管缺陷的作用。方法应用时间分辨免疫荧光法检测7574例孕中期母血清AFP和Free-HCGβ进行产前筛查，并与B超、羊水、新生儿检查结果对照。结果筛查高风险477例，确诊染色体异常3例，染色体多态4例，神经管畸形3例，无筛查漏检病例。结论在妊娠妇女中进行产前筛查是非常必要的。孕中期产前筛查对降低新生儿出生缺陷有重要作用。     

1050例妊娠期糖尿病筛查分析

目的 通过糖尿病筛查分析妊娠期糖尿病的发病状况,以加强对妊娠期糖尿病孕妇的围生期保健与监护,减少妊娠并发症,降低围生儿死亡率.方法 对2010年1-6月在我院产科门诊建卡并连续进行产前检查的24-28W孕妇进行糖尿病筛查,对筛查阳性者行糖耐量试验(OGTT).结果 共检测1050例,筛查阳性113例,筛查阳性率10.7%.确诊糖尿病23例,占2.19%,糖耐量异常42例,占4%.结论 通过糖尿病筛查和OGTT能对妊娠期糖尿病及早作出诊断,对控制糖尿病病情,减少糖尿病并发症,降低孕产妇和围生儿发病率和死亡率有重要意义.     

先天性梅毒研究进展

近十几年来随着性传播疾病在我国的传播蔓延,先天性梅毒的发病率也随之增加。先天性梅毒又称胎传梅毒,是梅毒螺旋体由母体经过胎盘而发生的胎儿宫内感染。妊娠任何时期都可能发生胎传梅毒。先天性梅毒的发生与母亲妊娠期梅毒是否治疗密切相关。孕母感染后可发生流产、死胎、死产、新生儿死亡和先天性梅毒。对孕妇的早期诊断、系统治疗是预防先天性梅毒的关键。青霉素仍然是治疗梅毒最有效的药物。早期诊断系统治疗先天性梅毒患儿是减少其并发症,提高治愈率的唯一手段。     

广州地区1226507例无偿献血者梅毒筛查结果分析

目的了解广州地区无偿献血者梅毒感染状况,确定梅毒感染低危人群,为安全输血提供有效的预防措施。方法选择广州地区2005—2009年无偿献血者梅毒筛查数据进行分析。梅毒血清学筛查试验采用ELISA试验,梅毒血清学筛查阳性标本采用TPPA试验确认。结果1226507例无偿献血者中梅毒阳性率为0．45％。其中单位员工、大专院校学生、流动人员和其他献血人员（包括无偿机采成分献血者）梅毒抗体阳性率分别为0．44％、0．14％、0．69％、0．29％;年龄在20～39岁梅毒抗体阳性献血者5126例,占梅毒抗体阳性者的93．4％;梅毒阳性率不同年龄和职业分布差异均有统计学意义（P〈0．01）。各年份无偿献血者中梅毒抗体阳性率差异无统计学意义（P〉0．05）。结论广州地区2005—2009年无偿献血人群梅毒感染率保持相对稳定水平,无明显上升趋势。大专院校学生和单位员工为梅毒感染低危人群,可作为主要献血人群,发展献血者队伍。采供血部门应加强对流动人员的无偿献血筛查工作,以保证血液安全。     

53528例妇女中妊娠期梅毒的筛查分析

目的了解妊娠期妇女梅毒感染率制定治疗预防措施。方法对来我院产前检查,并建立围产期保健卡的孕妇进行梅毒螺旋体快速血清反应实验（RPR）,阳性者再进行梅毒补体试验确诊（TPPA）。结果53528名围产期孕妇进行RPR筛查试验,58例孕妇确诊梅毒感染,感染率为1．08％,9。结论孕期开展RPR筛查十分必要。     

应用双抗原夹心ELISA法筛查献血员梅毒螺旋体抗体

目的：优选一种适宜于献血员梅毒筛查的试验方法。方法：采用检测梅毒特异性抗体的双抗原夹心ELISA法对献血员进行抗体检测，并与RPR检测结果进行比较，对两种方法检测结果不一致的标本，再用TPHA法进行确证。结果：ELISA法阳性检出率0．36％(41／1271)、RPR法阳性检出率0．26％(29／11271)。ELISA法与TPHA法总符合率97．5％(40／41)、RPR法与TPHA总符合率63．41％(26／41)。结论：ELISA法优于RPR法，具有较高的灵敏度和特异性，适宜于献血员的筛查．有利于控制和减少梅毒的输血传播。     

妊娠期糖尿病筛查3280例结果分析

目的初步了解本地妊娠期糖尿病（GDM）和妊娠期糖耐量受损（GIGT）的患病率;探讨糖筛查试验和空腹血糖两种方法对妊娠期糖尿病筛查的意义。方法对3280例孕24～28周孕妇进行口服50g葡萄糖负荷试验（GCT）,对1h静脉血糖≥7.8mmol/L者做75g口服葡萄糖糖耐量试验（OGTT）。结果本地GDM患病率为2.16%;GIGT的患病率为4.82%;GCT异常率为28.23%;空腹血糖作为筛查方法的漏诊率为22.53%,敏感性差。结论本地GDM和GIGT有一定的患病率,应重视和加强筛查工作。糖筛查试验应作为妊娠期产前检查的常规项目,对临床早期诊断妊娠期糖尿病具有重要意义。     

RPR、TP-ELISA和TPPA在无偿献血者梅毒筛查中的应用评价

评价快速血浆反应素环状卡片试验(RPR)、梅毒酶联免疫吸附试验(TP-ELISA)和梅毒螺旋体明胶凝集试验(TPPA)在无偿献血者梅毒筛查中的应用价值,选择适用于血站血液筛查梅毒的检测方法.选择无偿献血者20200份血液,采用RPR和TP-ELISA方法检测梅毒抗体,经初筛、复检阳性标本再以TPPA法确认.结果表明:R...     

Validity of the Kessler 10 (K-10) in detecting DSM-IV defined mood and anxiety disorders among pregnant women

It has been suggested that women experience depression most commonly in the childbearing years and that reproductive events such as pregnancy and child birth may coincide with the onset of mood and anxiety disorders in women. Therefore, a brief screening tool, with good sensitivity/specificity for psychiatric diagnoses that could be administered to pregnant women would be a valuable and useful proxy measure. We assessed the validity of the K-10, using the SCID as the gold standard, in a sample of 129 healthy pregnant women who presented for care at midwife obstetric units in Cape Town, South Africa. A receiver-operating characteristic curve (ROC) analysis indicated that the K-10 showed agreeable sensitivity and specificity in detecting depression (area under the receiver-operating characteristic curve, 0.66), posttraumatic stress disorder (0.69), panic disorder (0.71), and social phobia (0.76). The K-10 may be a useful screening measure for mood and anxiety disorders in pregnant women.     

妊娠期妇女生殖道假丝酵母菌病与妊娠不良结局分析

目的探讨妊娠期妇女生殖道假丝酵母菌病对妊娠不良结局的影响。方法回顾性分析2011年1月-2014年2月在我院住院孕产妇共2500例,进行阴道分泌物细菌培养,对白色念珠菌培养阳性组与正常对照组的妊娠结局进行分析,以探讨妊娠合并生殖道假丝酵母菌病与围产期并发症的关系。结果在2500例围产期妇女中,无致病菌组（对照组）为1300例,假丝酵母菌培养阳性组（感染组）为350例,总患病率为14%,其中有症状组200例（57.14%）,无症状组为150例（42.86%）。有症状感染组、无症状感染组、对照组的胎膜早破的发生率分别为22.5%、9.33%、8.15%,早产率分别为9.5%、4%、3%,绒毛膜羊膜炎率分别为23%、8.67%、7.38%,产褥感染率分别为7.5%、4%、3.54%,新生儿黄疸的发生率分别为21%、10.67%、11.54%,新生儿窒息率分别为2%、2.67%、2.31%,低体重儿的发生率分别为1.5%、1.33%、1.92%。有症状的妊娠期妇女生殖道假丝酵母菌病与无症状组及对照组相比较,胎膜早破、早产、绒毛膜羊膜炎、产褥感染、新生儿黄疸的发生率均有显著升高,新生儿窒息率及低体重儿的发生率无显著性差异。结论孕期对有症状的生殖道假丝酵母菌病的治疗是有重要意义的。     

5875例孕早期孕妇梅毒血清学检测结果分析

目的了解妊娠早期孕妇梅毒感染情况及影响因素,探讨产前梅毒血清学检测必要性。方法回顾2008年～2010年我院报告的妊娠梅毒病例进行感染状况及影响因素分析。结果 5875例孕妇中确诊妊娠梅毒59例,感染率为1.00%,2008年～2010年三年感染率分别为0.91%、0.96%和1.14%。89.84%的患者为潜伏梅毒。作过婚前或孕前检查的孕妇感染率为0.46%,未作过的感染率2.07%,明显增高。结论孕早期孕妇梅毒感染不容忽视,加强孕早期孕妇梅毒检测,可及早采取防治措施,保证优生优育。     

孕期产前检查质量与妊娠结局分析

目的分析孕妇产前检查状况与妊娠不良结局的关系。方法对2009年在复旦大学附属金山医院住院分娩的孕妇1747例临床资料进行回顾性分析。结果①研究对象中总体产前检查率为69.3%,而流动户口人员产前检查率明显低于与本地户口人员产前检查率,差异有显著性(P<0.05)。②进行规范的产前检查可以降低子痫前期、过期妊娠、早产、FGR、羊水异常及新生儿窒息的发生率(P<0.05)。结论产前检查可改善妊娠结局,目前我国仍然存在部分孕妇没有进行规范的产前检查,应该加产前检查措施的落实。     

Periodontitis-associated risk factors in pregnant women

OBJECTIVE:

The main objective of this study was to investigate the risk factors associated with periodontitis in pregnant women.

METHODS:

This study was conducted in two stages. In Stage 1, a cross-sectional study was conducted to determine the prevalence of periodontitis among 810 women treated at the maternity ward of a university hospital. In Stage 2, the factors associated with periodontitis were investigated in two groups of pregnant women: 90 with periodontitis and 720 without. A hierarchized approach to the evaluation of the risk factors was used in the analysis, and the independent variables related to periodontitis were grouped into two levels: 1) socio-demographic variables; 2a) variables related to nutritional status, smoking, and number of pregnancies; and 2b) variables related to oral hygiene. Periodontitis was defined as a probing depth ≥4 mm and an attachment loss ≥3 mm at the same site in four or more teeth. A logistic regression analysis was also performed.

RESULTS:

The prevalence of periodontitis in this sample was 11%. The variables that remained in the final multivariate model with the hierarchized approach were schooling, family income, smoking, body mass index, and bacterial plaque.

CONCLUSION:

The factors identified underscore the social nature of the disease, as periodontitis was associated with socioeconomic, demographic status, and poor oral hygiene.     

Environmental odor intolerance in pregnant women

Previous findings indicating that pregnant women experience a shift in odor sensitivity and hedonics raise the question of whether these changes evoke adverse reactions to odorous and pungent environmental substances in daily activities, to a larger extent in pregnant than in nonpregnant women. Forty-four women in pregnancy weeks 21-23 and 44 nonpregnant women were therefore compared with respect to affective reactions to and behavioral disruptions by odorous/pungent daily environments by means of the questionnaire-based, 21-item Chemical Sensitivity Scale (CSS). This scale refers to neurasthenic and sensory/somatic symptoms and includes the 11 items of the Chemical Sensitivity Scale for Sensory Hyperreactivity (CSS-SHR). This latter scale refers predominantly to sensory/somatic symptoms. To investigate whether there is a general environmental hypersensitivity during pregnancy, the Noise Sensitivity Scale (NSS) was used that is analogous to the CSS (including 11 NSS items corresponding to those of the CSS-SHR; "NSS-SHR"). Results show that the two groups were similar with respect to scores on both the CSS and NSS, whereas the pregnant women had higher scores than the nonpregnant women on the CSS-SHR, but not on the "NSS-SHR". These results suggest that pregnant women to a larger extent than nonpregnant women manifest an odor intolerance that affects their daily activities, with predominantly sensory/somatic symptoms, which appears not to be due to a general environmental hypersensitivity. This behavior may have embryo- and maternal-protective functions.     

Toxoplasma gondii-specific IgG avidity testing in pregnant women

BackgroundThe parasite Toxoplasma gondii can cause congenital toxoplasmosis following primary infection in a pregnant woman. It is therefore important to distinguish between recent and past infection when both T. gondii-specific IgM and IgG are detected in a single serum in pregnant women. Toxoplasma gondii-specific IgG avidity testing is an essential tool to help to date the infection. However, interpretation of its results can be complex.ObjectivesTo review the benefits and limitations of T. gondii-specific avidity testing in pregnant women, to help practitioners to interpret the results and adapt the patient management.SourcesPubMed search with the keywords avidity, toxoplasmosis and Toxoplasma gondii for articles published from 1989 to 2019.ContentToxoplasma gondii-specific IgG avidity testing remains a key tool for dating a T. gondii infection in immunocompetent pregnant women. Several commercial assays are available and display comparable performances. A high avidity result obtained on a first-trimester serum sample is indicative of a past infection, which occurred before pregnancy. To date, a low avidity result must still be considered as non-informative to date the infection, although some authors suggest that very low avidity results are highly suggestive of recent infections depending on the assay. Interpretation of low or grey zone avidity results on a first-trimester serum sample, as well as any avidity result on a second-trimester or third-trimester serum sample, is more complex and requires recourse to expert toxoplasmosis laboratories.ImplicationsAlthough used for about 30 years, T. gondii-specific avidity testing has scarcely evolved. The same difficulties in interpretation have persisted over the years. Some authors have proposed additional thresholds to exclude an infection of <9 months, or in contrast to confirm a recent infection. Such thresholds would be of great interest to adapt management of pregnant women and avoid unnecessary treatment; however, they need confirmation and further studies.     

Acute hepatitis E virus in pregnant women in Israel and in other industrialized countries

Background and objectivesAcute hepatitis E virus (HEV) is the most common etiology of viral hepatitis in adults in developing countries. HEV is rare in industrialized countries but its incidence is rising both in returning travelers and through autochthonous infection. In developing countries HEV is associated with a high rate of fulminant hepatitis and mortality during pregnancy and contributes to poor obstetric and fetal outcomes. There are no reliable data on the outcome of HEV during pregnancy in industrialized countries.Study designA retrospective analysis of acute HEV cases diagnosed in Israel were examined. The clinical course of the disease among pregnant women was retrieved. A systematic review of the literature was performed for cases of HEV and pregnancy, originating or treated in industrialized countriesResultsBetween the years 1993–2013, 68 cases of acute HEV were diagnosed in Israel, including 9 pregnant women (13%). An additional 6 reported cases were found from a literature search. From the 15 women (10 autochthonous cases and 5 imported cases), the outcome was favorable in 10 cases, however, 5 cases (33%) resulted in fulminant hepatitis and two women underwent an urgent liver transplantation. No fatality occurred in the mothers and all babies were born alive and healthy.DiscussionThis is the first case series of acute HEV infection in pregnant women in industrialized countries. Acute HEV infection poses a significant risk in pregnancy, irrespective of patients’ country of origin. In contrast to reports from developing countries, all babies and mothers survived.     

Beliefs about exercise and physical activity among pregnant women

Objective

The objective of this study was to document self-reported beliefs about physical activity and exercise among pregnant women.

Methods

The Pregnancy, Infection, and Nutrition (PIN3) Study asked 1306 pregnant women about beliefs regarding physical activity and exercise at 27–30 weeks’ gestation.

Results

While 78% of women agreed that most women can continue their regular exercise during pregnancy, fewer (68%) agreed that most women who never exercised could begin an exercise program during pregnancy. Most (89%) agreed that regular exercise was better than irregular exercise during pregnancy. While almost all women agreed with the benefits of light activity (98%), fewer agreed that there were benefits with moderate (73%) or vigorous exercise (13%). Differences in beliefs were most notable by educational level, race/ethnicity, and whether they participated in regular exercise during pregnancy.

Conclusion

Future studies can better elucidate the reasons behind the differences in beliefs, to explore whether cultural reasons are contributing to these differences and whether tailored messages would be more effective than general educational approaches.

Practice Implications

This study provides information to create more successful interventions to help women understand concepts regarding the safety and benefits of physical activity during pregnancy.