264例先天性畸形围产儿尸检病理分析

目的 探讨高原地区围产儿先天性畸形的临床病理特点及发病原因。方法 通过对264例先天性畸形死亡围产儿进行尸体解剖及病理诊断，确诊各种先天性畸形。结果 发现单纯内脏畸形114例，单纯体表畸形85例，体表合并内脏畸形65例。各系统发生畸形的构成比例依次为心血管系统、中枢神经系统、消化系统、呼吸系统及泌尿生殖系统。结论 围产儿先天性畸形发生率高与地处高原有关。     

围产儿死亡与胎儿畸形关系探讨

目的：探讨胎儿畸形与围产儿死亡的关系。方法：回顾分析328例围产儿死亡与胎儿畸形的相关关系。结果：328例围产儿死亡病例有114例畸形儿,畸形累计252畸形,以心血管系统畸形占首位,致死性畸形76例。结论：胎儿畸形是围产儿死亡的主要原因,应重视胎儿畸形发生的原因,提高早期诊断水平及处理水平,降低围产儿死亡率。     

219例围产儿先天畸形临床分析

目的了解先天性畸形发病情况,探讨胎儿畸形的发病原因和预防措施。方法对2006年1月至2010年12月在我院出生的8928例围生儿中有出生缺陷的219例畸形儿的发病情况进行回顾性分析。结果 219例围生儿畸形中骨骼系统与神经系统畸形发生率较其它系统发生率高（构成比分别为15.98%与15.52%）,其次为颌面五官系统唇腭裂、附耳（构成比分别为12.32%和11.42%）,呼吸系统和消化系统畸形发生率较其它系统发生率低（P〈0.05）;B超诊断率在2006年最低（45.16%）,2009年最高（63.83%）,两年的诊断率差异无统计学意义（P〉0.05）,其余各年的B超诊断差异也无统计学意义（P〉0.05）;219例中〈28周发现的仅占14.61%,28～37周及〉37周发现分别为42.21%及40.18%,明显高于〈28周;发现畸形人数2006年活产率最低（29.03%）,2008年活产率最高（57.14%）,差异有统计学意义（P〈0.05）。结论通过诊断技术和治疗手段的提高,预防和宣传措施的加强,促进优生优育工作,有效预防和减少胎儿畸形的发生。     

72例围产儿颅内出血临床与尸解对比分析

本文总结了７２例ＩＣＨ病儿的尸解和临床资料。提示本病以早产儿和低出生体重儿多见，缺氧、窒息是其发病的主要原因；产伤是足月儿发病的常见原因，尤其是使用胎头吸引器助产时。本病易与新生儿败血症、吸入性肺炎及化脓性脑膜炎相混淆而造成误诊、漏诊，提醒临床工作者注意。     

胎儿畸形518例分析

随着人们生活健康水平的提高，流行病、感染性疾病、营养不良等疾病已逐渐得到控制。胎儿畸形即出生缺陷成为我国围产儿死亡的主要原因之一。其中神经管畸形仍为我国出生儿缺陷之首。我院自1994年至2002年11月超声诊断出518例胎儿畸形，现分析报告如下     

胎儿泌尿系统畸形尸检1例讨论

对我院收治的胎儿泌尿系统畸形1例分析如下。     

围产儿尸检226例临床死因分析

1979年3月～1991年12月,我院对围产期Ⅱ226例死婴进行尸检,通过尸检对围产儿的致死原因进行分析报道如下:226例中死胎死产20例,余均为活产儿死亡。男151例,女75例,男:女=2:1。 1 结果 1.1 围产儿主要死因:肺部疾病118例,占48.3。其中吸入性肺炎52例,肺出血33例,肺透明膜病31例,肺不张2例。畸形48例,占19.7。其中感染性     

超声诊断妊娠中期胎儿先天性畸形21例分析

随着超声技术的不断进展,产科是超声诊断应用最广泛的领域之一,其特点是检出率高、直观性能好、无创伤,可进行动态观察反复检查,对胎儿无影响.超声应用价值优于其他影像学检查,已成为产前检查和发现胎儿畸形的首选.胎儿畸形是围产儿死亡的重要原因之一,畸形患儿的出生会给家庭和社会带来巨大的压力和负担.因此产前准确检查和发现胎儿畸形十分重要,对优生优育和提高人口素质,促进社会发展是十分重要的.     

围产儿出生缺陷检测资料6822例分析

目的通过对出生缺陷发生情况、类型的分析，为今后的预防工作提供科学依据。方法对2001～2005年出生的6822例围产儿出生缺陷进行检测（包括死胎、死产），观察缺陷动态变化及其相关因素。结果缺陷发生率为16.86‰。常见出生缺陷中，先天性心脏病发生率为5.57‰，多指（趾）发生率为2.64‰，唇腭裂为1.76‰，发生缺陷的胎儿性别差异无显著性（P〉0.05）。结论出生缺陷先天性心脏病居首位，有逐年上升趋势。提高产前诊断技术，适时终止妊娠，进行优生优育宣传指导，为孕妇创造优良环境及合理均衡饮食，可有效降低出生缺陷发生率。     

胎婴儿成红细胞增多症4例尸检分析

目的 观察成红细胞增多症胎婴儿的临床病理特点,并对其发生机制进行分析.方法 对4例成红细胞增多症胎婴儿的临床表现、外形、内脏结构以及胎盘形态进行观察分析.结果 4例成红细胞增多症均伴有胎儿水肿和腹腔积液,胎婴儿肝、脾、肺或肾中可见有核红细胞,胎盘绒毛肿大和水肿,胎盘血管中可见幼稚红细胞.结论 胎婴儿成红细胞增多症的主要病理改变为全身脏器血管内可见大小不一、幼稚不成熟的有核红细胞,其发生与母婴血型不合有密切关系.     

Kinematic analysis of kicking movements in preterm infants with very low birth weight and full-term infants

BACKGROUND AND PURPOSE: Study of kicking development provides important information to understand how early spontaneous movements change in infants as they acquire voluntary control. Researchers have investigated the kicking movements of preterm infants; however, the movement patterns that they have described were inconsistent. The purpose of this study, therefore, was to examine the development of kicking movements with kinematic analysis in preterm infants with very low birth weight (VLBW) and full-term infants. SUBJECTS AND METHODS: Twenty-two infants with VLBW who were divided into low gestational age (gestational age of <30 weeks, n=9) and high gestational age (gestational age of >or=30 weeks, n=13) classes and 22 full-term infants were evaluated during kicking movements using 4 synchronized cameras and 3-dimensional kinematic analysis when the infants were 2 and 4 months of corrected age. RESULTS: The infants with VLBW and a high gestational age showed similar kicking movements compared with the full-term infants. In contrast, the infants with VLBW and a low gestational age exhibited a higher kick frequency and a shorter flexion phase at 4 months of corrected age. They also exhibited a higher hip-knee correlation and lower variability in the interlimb coordination pattern at 2 and 4 months of corrected age. DISCUSSION AND CONCLUSION: The findings indicate that infants with VLBW, particularly those with a low gestational age, have age-related differences in movement organization and coordination of kicking compared with full-term infants.     

小儿危重症院前急救转运684例患儿疾病谱的研究

急诊医学的工作核心是提高急危重症及创伤患者的救治成功率及改善其存在质量。因此,需要建立完善的急诊医疗服务体系,院前急救转运是急诊医疗服务体系的一部分。本文通过对小儿危重症院前急救转运患儿疾病谱的研究,为完善儿科院前急救体系,提高院前急救转运质量提供依据。为此,本文对我院小儿危重症院前急救转运684例患儿的疾病谱进行了分析,现报告如下。     

Prevention of birth defects: folic acid

Neural tube defects (NTDs) comprise an important category contributing to infant mortality. While some NTDs may be due to identifiable inherited or specific environmental factors, most are multifactorial, with genetic and environmental factors contributing to their occurrence. Folic acid has been found to have a protective effect against the recurrence and occurrence of NTDs. In addition to natural dietary sources, in the United States, all enriched grain products now are fortified with folic acid. In addition, all women who could become pregnant are recommended to consume 0.4 mg of folic acid daily. Despite these measures, not all women of childbearing age have added sufficient folic acid to their diets or take a vitamin supplement. Challenges remain regarding educating women of childbearing age about the potential health benefits of adequate folic acid consumption.     

A comparative study of prenatal diagnosis and perinatal autopsy.

The objective of this study was to assess the accuracy of prenatal ultrasonography and to identify patterns of fetal malformations. All fetal and neonatal autopsies over a 3 year period were compared to prenatal sonographic findings and comparisons were made between the results of the two examinations. We identified 133 fetuses and neonates who had both a complete autopsy and a perinatal autopsy. Approximately 87% of autopsy-demonstrated major abnormalities had been detected by prenatal ultrasonography, with 61% of all malformations detected. Some limitations in accuracy of prenatal diagnosis are unavoidable, but strict attention to a thorough fetal examination should improve accuracy. Autopsy examination remains an important component of the evaluation of perinatal losses, especially if dysmorphology is known or suspected.     

胎儿肺静脉共同腔闭锁3例尸体解剖分析

目的 探讨胎儿肺静脉共同腔闭锁的尸体解剖学特点.方法 回顾超声心动检查发现的胎儿先天性心脏畸形3例,引产后进行尸体病理解剖,心、血管畸形按心脏节段分析方法进行分析.结果 例1为完全性肺静脉共同腔闭锁,例2、3为不完全性肺静脉共同腔闭锁,均合并完全性肺静脉异位引流;3例均伴有复杂的先天性心脏畸形,同时合并内脏反位及无脾症;与婴幼儿不同,不伴有肺淋巴管扩张.结论 肺静脉共同腔闭锁为少见的先天性心血管畸形,胎儿肺静脉共同腔闭锁不伴有肺淋巴管扩张,诊断更困难.