产前检查对妊娠结局和围生儿状况的影响

目的：探讨产前检查对产妇妊娠结局和围生儿状况的影响,为妇幼保健工作提供一定理论依据。方法：通过分析过去1年内在我院分娩的1010例产妇的临床资料,比较接受产检组与未接受产检组的产妇妊娠结局和围生儿状况有无差异。结果：接受过正规产检的产妇发生宫内感染（P=0．003）、前置胎盘（P=0．009）、胎盘早剥（χ2=5．958,P-0．015）、产后出血（P=-0．006）及妊娠高血压综合征（χ2=4．678,P=O．031）的比例均低于未接受产检组。同时,接受产检组低体重儿（P=0．004）、早产儿（χ2=4．409,P=0．036）、新生儿窒息（χ2=13．092,P=0）、新生儿颅内出血（χ2=14．162,P=0）的发生率也都低于未接受产检组。结论：通过产前检查能够对妊娠中的异常状况做到早发现、早诊断、早处理,最大程度地减少了不良妊娠结局的发生,有效地保障了母婴健康。     

Term abdominal pregnancy with healthy newborn: a case report

Abdominal pregnancy is a rare form of ectopic pregnancy with very high morbidity and mortality for both the mother and the foetus. Diagnosis and management can pose some difficulties especially in low-resource centres. High index of suspicion is vital in making prompt diagnosis in such situations. A case of abdominal pregnancy that resulted in a live healthy newborn at a Regional Hospital in Ghana is presented.     

Successful pregnancy outcome following laparoscopic myomectomy: case report

Laparoscopic myomectomy is now widely used as an alternative to laparotomy in the management of symptomatic uterine fibroids. The advantages of this minimal access approach outweigh those of the open techniques. The pregnancy outcomes between the two methods have been studied and are comparable, but there still exists a lot of scepticism locally concerning this. It is against this background that we present a 31 year old nulliparous lady who had a two year history of primary infertility secondary to multiple uterine fibroids, the largest being fundal and measuring 6.6cm. She underwent a successful laparoscopic myomectomy in November, 2006 and conceived spontaneously in February 2007. Her antenatal follow up was uneventful. She delivered a live male, 2,650 grams by Caesarean section in October, 2007 and had an unremarkable peuperium. With the availability of proper equipment, instruments, and adequately developing skills, laparoscopic myomectomy is feasible locally and with proper patient selection could result in favourable outcome as it is elsewhere.     

Insignificant blunt maternal trauma with lethal fetal outcome: a case report.

We report a case of a twenty-nine-week breech fetus with skull fracture, intracranial bleeding, and liver laceration sustained in a vehicular accident. This case describes insignificant maternal trauma with poor fetal outcome.     

Cesarean scar pregnancy: a case report

Ranking among the rare forms of ectopic pregnancy,Cesarean scar pregnancy is a dangerous condition that can potentially lead to uterine rupture and severe hemorrhaging, or even a secondary abdominal pregnancy.Its early diagnosis can be challenging, and the optimal treatment has not been determined. This case report will     

原发性腹主动脉瘤十二指肠瘘1例

腹主动脉瘤消化道瘘是腹主动脉瘤少见但极为严重的并发症,是消化道出血的少见病因。本文报道1例原发性腹主动脉
瘤十二指肠瘘患者,以腹痛、便血、呕血为主要症状,经电子结肠镜、腹部增强CT及血管三维重建等检查确诊,及时行手术等治
疗,病人痊愈。
     

早发型重度子痫前期终止妊娠时机与围生结局分析

目的探讨早发型重度子痫前期终止妊娠时机与围产结局的关系;进一步研究早发型重度子痫前期的期待保守治疗的临床意义。方法回顾分析2001年1月至2007年6月的91例早发型重度子痫前期患者,分为两组A组积极治疗组、B组期待治疗组（入院期待治疗48h后终止妊娠）,比较两组围生结局。结果A组41例终止妊娠孕周数31w±6．7d,围生儿病死率68．5％,B组50例终止妊娠孕周数32w±9．2d,围生儿病死率14％,B组的围生儿病死率、新生儿窒息率和NICU住院率均低于A组（P〈0．05）,B组的新生儿体质量明显大于积极治疗组（P〈0．01）。结论选择合适的早发型重度子痫前期孕妇进行期待治疗,可以明显改善围生儿结局,对孕产妇也是安全和可行的。     

Valvular heart disease in pregnancy: maternal and fetal outcome

The aim of this study was to evaluate the maternal and fetal outcome of pregnancy in Valvular Heart Disease (VHD). A better understanding of the effects of valvular abnormalities on pregnancy outcome is of value for risk assessment and the design of a therapeutic plan from the available information of a series of patient. A multicenter prospective study was carried out over a period of 5 years (2005-2009) involving 60 pregnant patients with valvular heart disease. Thirty eight patients (64%) had single valve involvement and mitral stenosis was the most predominant lesion (50%). Ten patients (16.7%) had undergone interventional and surgical correction prior to the pregnancy. Fourteen (24%) patients were identified as a NYHA class III-IV. Women with VHD had 8.35% pulmonary edema, 15.03% developed different types arrhythmia. The incidence of preterm birth and small for gestational age newborn was 11.69% and 13.36% respectively. There was one (1.67%) maternal death. Pregnancy in women with valvular heart disease is associated with remarkable unfavourable effect on maternal and fetal outcome which are related to severity of disease.     

Abdominal pregnancy: a case report and literature review

We report a rare and unusual case of an Abdominal pregnancy that was delivered successfully at term. It is the first documented case in the local literature in almost 30 years. What makes it even more exceptional is that despite the high mortality associated with the condition, both mother and baby survived the ordeal. She subsequently delivered another child, 2 years later by an elective lower segment caesarean section and had a tubal ligation performed concomitantly. A review of the topic and its management is also presented.     

Unilateral tubal twin pregnancy: a case report

A rare case of unilateral tubal twin pregnancy managed at the Kenyatta National Hospital and confirmed at laparotomy is presented. The difficulty and hence delay in making a diagnosis of ectopic pregnancy is discussed, and the need to seek to exclude it in any woman presenting with suggestive features in her reproductive years is stressed.     

孕期保健对孕产妇妊娠结局的影响

目的 观察孕期保健对孕产妇妊娠结局的影响.方法 将2010年10～ 12月于该院就诊的3 044例孕产妇作为研究对象.根据产前检查是否≥7次将所有孕产妇分为孕期保健组(n＝2 664例)和未实施孕期保健组(n＝380例).对比孕期保健组和未实施孕期保健组的妊娠期高血压疾病、妊娠期糖尿病、产后出血率、分娩方式等方面的情况.结果 孕期保健组的妊娠期高血压疾病和妊娠期糖尿病的发生卒明显低于未实施孕期保健组的妊娠期高血压疾病和妊娠期糖尿病的发生率,两组间比较差异有统计学意义(P＜0.05);孕期保健组的产后出血率明显低于未实施孕期保健组的产后出血率,两组间比较差异有统计学意义(P＜0.05);孕期保健组的自然分娩率明显高于未实施孕期保健组的自然分娩率,两组间比较差异有统计学意义(P＜0.05).结论 规范实施孕期保健,可减少妊娠期高血压疾病、妊娠期糖尿病,减少产后出血率,增加自然分娩率,减少不良妊娠结局发生.     

妊娠期高血压疾病对母婴结局的影响

目的探讨妊娠期高血压疾病对母亲和新生儿的影响。方法对2009年1月至2011年7月在我院分娩的135例妊娠期高血压患者(观察组)与随机抽取的150例同期正常分娩的孕产妇(对照组)进行对比分析。结果 135例妊娠期高血压患者低蛋白血症、早产、胎盘早剥、产后出血、剖宫产率均高于对照组(P<0.05)。围生儿早产、FGR、胎儿窘迫、新生儿窒息率也均高于对照组(P<0.05)。结论妊娠期高血压疾病能增加母婴的不良妊娠结局,必须加强产前保健,早发现、早诊断、早治疗,以改善母婴妊娠结局。