Malnutrition in Middle-class Pregnant Women

ABSTRACT: Using three case histories, a review of malnutrition caused by calorie and salt restriction and diuretics is made, with special note of the relationship between these factors and toxemia, low birth weight and other obstetric complications. A survey of women entering prenatal classes in four geographic areas of the US is reported. We found that between 24 percent and 79 percent of women entering prenatal classes are actually dieting to hold the line at their seventh month weight gains. Up to 66 percent of women were told nothing as to an ideal weight gain by their doctors, and as many as 10% thought the weight gain given was too high. We found that about half of all women surveyed reached whatever they thought was the maximum weight gain by the seventh month of pregnancy, and then dieted to hold the line; up to 7 percent were trying to lose weight. Sodium restriction is still being prescribed for between 12 and 49 percent of women in the communities surveyed. Diuretics for late pregnancy edema are seldom prescribed. The physiology of protein-calorie restriction and salt depletion are reviewed, with recommendations for action on the part of childbirth educators.     

妊娠合并细菌性阴道病的研究

目的：确定妊娠合并细菌性阴道病（ＢＶ）的发病情况，探讨妊娠合并ＢＶ与不良妊娠结局的关系。方法：根据临床表现和阴道革兰染色涂片镜检，对不同孕期的３８０名健康孕妇进行ＢＶ发病情况调查，并对其妊娠结局进行随诊。结果：妊娠合并ＢＶ的检出率为６．８％（２６／３８０）。妊娠合并ＢＶ孕妇的产褥感染、新生儿感染及新生儿黄疸的发生率，依次为１４．３％（３／２１）、９．５％（２／２１）及２３．８％（５／２１），高于无合并ＢＶ者（分别为２．２％、１．３％及５．４％，Ｐ＜０．０５，Ｐ＜０．０５，Ｐ＜０．００５）。结论：妊娠合并ＢＶ与母儿感染有关，有必要对妊娠合并ＢＶ孕妇进行治疗。     

Bioimpedance in Pregnant Women with Preeclampsia

To analyze the direct (resistance and reactance) and indirect (intra and extracellular total body water) BIA parameters in preeclamptic women, 51 healthy pregnant women and 65 preeclamptic women were submmited to bioeletric impedance on the thrid trimester of gestation. The significance value adopted was 5%. Preeclamptic women showed lower values for R (448 Ω vs. 542 Ω), Rc (40 Ω vs. 53 Ω) and ICW (49.45% vs. 51%) when compared to control group. They also showed higher values for TBW (49% vs. 47%), TBWcor (41.6% vs. 34%) and ECW (50% vs. 47%). Biolectric impedance allowed differentiating preeclamptic women from health pregnant women, indicating that preeclampsia changes body compartments during pregnancy. This method can help understand the mechanisms involved in preeclampsia and to be a prediction away of preeclampsia.     

高龄产妇围生期妊娠结局分析

目的:探讨高龄产妇分娩对妊娠结局的影响.方法:采用回顾性对照研究,对3216例单活胎产妇的临床资料进行分析,比较高龄组(≥35岁,n=155)和非高龄产妇组(<35岁,n=3061)分娩方式、妊娠期合并症、并发症以及新生儿结局的差异.结果:高龄组初产妇及经产妇的剖宫产率91.8%、42.55%都明显高于非高龄组的63.09%、26.26%(P<0.05);高龄组妊娠期高血压疾病、妊娠期糖尿病、前置胎盘、早产、产后出血、胎膜早破、贫血的发病率均高于非高龄组(P<0.05),高龄组新生儿体重降低(P<0.05).结论:高龄产妇妊娠期合并症、并发症增多,剖宫产率增加,高龄妊娠应加强围生期保健.     

Influenza Vaccine Requirements in Pregnant Women

Objective

To explore the importance of administering influenza vaccine during pregnancy.

Materials and Methods

An internet search for data, study and position papers was done. Medline and Pubmed were the frequently used search engines besides search for WHO and CDC position statements. The keywords used included, influenza vaccine, pregnancy, outcome, safety and trimesters.

Results

Search provided studies that had been conducted in developing nations like Bangladesh as well as developed nations like Norway and England. The WHO and CDC status reports were also accessed and studied.

Conclusion

Administration of influenza vaccine is recommended in any trimester of pregnancy, to protect the pregnant woman as well as the newborn child below the age of 6 months from the deleterious effects of influenza. The vaccine is safe and free from side effects.     

Antiretroviral Therapy in HIV-infected Pregnant Women

The use of antiretroviral therapy in pregnancy has changed dramatically in the past five years. This article reviews these developments. The use of zidovudine monotherapy in pregnancy, during delivery and given post-natally to the infant for the reduction of maternal-infant transmission has been evaluated. In a placebo-controlled double-blinded method, a significant reduction in maternal-infant transmission, from 25 to eight percent, was found. Triple antiretrovirals with newer agents from different drug families are now recommended as the optimal therapy for adults. Therapy is directed by the adults HIV viral load and by their CD4 count as measures of viral activity and immune compromise, respectively. Given these changes in adult therapy, treatment of the pregnant woman is undergoing re-evaluation. It is now considered to be in the best interest of the mother to consider full triple antiretroviral therapy during pregnancy or to continue antiretroviral therapy if pregnancy occurs while a woman is taking this treatment. It is of great concern that there is minimal information about the safety of these drugs used during pregnancy. A review of each of the currently available antiretroviral drugs in pregnancy is presented here. It is strongly recommended that any health care provider caring for an HIV-infected pregnant woman, or an HIV-infected woman who could become pregnant, be aware of the issues and concerns around combination antiretrovirals in pregnancy. Consultation with experts in this area is recommended.     

兰州地区孕妇弓形虫感染情况的调查

目的：调查孕妇弓形虫感染的情况。方法：采用间接血凝试验，对兰州地区１２５０例孕妇及普通妇科患者１３２７例进行弓形虫感染的检测。结果：（１）孕妇的弓形虫感染率为７．２８％（９１／１２５０），普通妇科患者感染率为８．１４％（１０８／１３２７）。孕妇与普通妇科患者的弓形虫感染率，经统计学处理，差异无显著性（Ｐ＞０．０５）。（２）不同年龄孕妇的弓形虫感染，经统计学处理，差异无显著性（Ｐ＞０．０５）。（３）不同孕期孕妇之间弓形虫感染，经统计学处理，差异无显著性（Ｐ＞０．０５）。（４）新近感染和活动性感染的孕妇所占的比重大（４１／９１）。结论：孕妇不因妊娠而增加感染弓形虫的机会。     

Blood Pressure Assessments in Different Subtypes of Hypertensive Pregnant Women: Office Versus Home Patient- or Nurse-Measured Blood Pressure

Objective:?To explore the difference between distinct methods of assessing blood pressure (BP) in pregnant women with different hypertensive disorders.?Methods:?We compared office BP to home patient- and nurse-measured diastolic BP in pregnant women with essential chronic hypertension (CH), preeclampsia (PE) and isolated hypertension (IOH).?Results:?Office BP was lower or similar to home patient- and nurse-measured BP in women with CH. Office BP was higher than home patient-measured BP in women with PE and in women with IOH (p < 0.0001). Nurse-measured BP was higher than patient-measured BP in women with PE (p < 0.01).?Conclusions:?BP assessments in women with PE are significantly influenced by the environment, which should be considered in managing these women.     

Breast Cancer in Pregnant and Postpartum Women

Breast cancer is reported to occur in from I in 3000 to I in 10 000 pregnancies worldwide. In the United States, 10% to 20% of breast cancers occur in women of childbearing age. Diagnosis and treatment of breast cancer during pregnancy present many additional challenges.     

Predicting Postnatal Depression Among Pregnant Women

ABSTRACT: Background : Depression after the birth of a baby is a common cause of maternal morbidity, and its prevalence in Australia is 10 to 15 percent at 6 to 9 months postpartum. This study assesses the prediction of postnatal depression at 6 weeks postpartum, Method : Women at 24 weeks' gestation or less were invited to complete a Modified Antenatal Screening Questionnaire (MASQ) that identified women more vulnerable to becoming depressed after childbirth. Of these 249 women, 144 (58%) screened more vulnerable, and were randomly allocated to receive either a supportive intervention to reduce postnatal depression or to receive no intervention. At 6 weeks postpartum the women completed the Edinburgh Postnatal Depression Scale (EPDS) to assess their mood after the birth. Results : No difference occurred at 6 weeks postpartum between the MASQ vulneruble group (return rate 64/68) and the MASQ less vulnerable group (return rate 44/51) in the frequency of those who screened as potential candidates for major depression using the EPDS. For major depression the MASQ's sensitivity was 73 percent, specificity 43 percent, positive predictive value 17 percent, and negative predictive value 91 percent; for minor depression its sensitivity was 81, 48, 34, and 89 percent, respectively. The MASQ was able to predict minor depression. More women in the vulnerable group scored at increased risk of minor depression on the EPDS at 6 weeks postpartum. Conclusion : Further studies are needed to extend this work and develop a screening test with higher specificity and greater positive predictive value.     

心动过缓孕妇安装心脏起搏器的临床观察

目的：了解心动过缓孕妇患者安装心脏起搏器的临床效果。方法：回顾分析我院１９８０年至１９９６年，５例因妊娠合并心动过缓而安装起搏器孕妇的资料，其中４例为Ⅲ°房室传导阻滞；１例为窦性心动过缓。心功能Ⅳ级１例；Ⅲ级３例；Ⅱ级１例。５例中１例在孕前安装心脏起搏器，４例在孕期安装起搏器。结果：安装起搏器后心功能得到改善，３例足月剖宫产分娩，母婴安全。２例顺利进行治疗性流产术。结论：Ⅲ°房室传导阻滞是妊娠期的严重合并症，应尽可能在孕前或孕早期安装起搏器；分娩方式以剖宫产为宜。     

Bacterial Vaginosis Screening and Treatment in Pregnant Women

The American College of Obstetricians and Gynecologists, the Centers for Disease Control and Prevention, and the US Preventive Services Task Force recommend against routinely screening asymptomatic pregnant women for bacterial vaginosis (BV). Although asymptomatic BV has been associated with preterm birth, there is insufficient evidence demonstrating that treatment of asymptomatic BV improves outcomes. Conversely, women who have symptomatic BV should be treated to relieve their symptoms. This brief report provides an overview of BV, reviews the evidence regarding screening and treating BV in pregnant women, and summarizes treatment recommendations for pregnant women who have symptomatic BV.     

Axillary Versus Rectal Temperatures in Preterm Infants Under Radiant Warmers

Twenty-five preterm neonates were studied to determine whether monitoring of body temperature may be accomplished by taking axillary instead of rectal temperatures. Both axillary and rectal temperatures were taken simultaneously 12 times over a two-day period. Temperatures were recorded at three, five, eight, and ten minutes. The researchers concluded that an axillary measurement of temperature may be adequately substituted for rectal measurement of temperature.     

妊娠期肥胖妇女的营养治疗

妊娠期肥胖是指妊娠期妇女体内脂肪组织过度蓄积的状态。近年来妊娠期肥胖的发生率呈快速增长趋势,肥胖程度的增加可对孕妇及围生儿造成严重危害,从而对人类健康产生深远影响。只有了解其多方面的影响因素,认识到妊娠期肥胖对母儿的危害,并制定科学有效的治疗和管理方案,才能在保证孕妇及胎儿营养供应的前提下控制孕妇体质量,保障母婴健康。综述妊娠期肥胖妇女的代谢特点,分析肥胖对妊娠并发症、产程及对胎儿的影响,探讨妊娠期肥胖妇女的孕期营养需求及饮食处方,供医务工作者在临床工作中参考。