Uterine structural anomalies and arthrogryposis—death of an urban legend

In a review of 2,300 cases of arthrogryposis collected over the last 35 years, 33 cases of maternal uterine structural anomalies were identified (1.3%). These cases of arthrogryposis represent a very heterogeneous group of types of arthrogryposis. Over half of individuals affected with arthrogryposis demonstrated asymmetry and some responded to removal of constraint, 29 of the 33 cases of arthrogryposis whose mother had a uterine structural anomaly could be identified as having a specific recognizable type of arthrogryposis. Only two cases (0.08%) had primarily proximal contractures that returned to almost normal function within 1 year. Craniofacial asymmetry was the most striking finding in these two cases. A quarter of cases had ruptured membranes between 32 and 36 weeks and either oligohydramnios or prematurity. The pregnancy histories of the mothers with uterine structural anomalies were typical in having infertility, multiple miscarriages, and stillbirths. The finding of only two cases which are likely to have multiple congenital contractures on the basis of uterine constraint suggests that it is a very rare primary cause of arthrogryposis. © 2012 Wiley Periodicals, Inc.     

Is pregnancy associated plasma protein-A (PAPP-A) a marker for adverse perinatal outcomes in preterm isolated oligohydramnios cases?

Objective

Isolated oligohydramnios is defined as an amniotic fluid index below five centimeter with no other coexisting condition. There are still controversies about the management and pregnancy outcomes. A marker predicting these is crucial. Low pregnancy associated plasma protein-A levels were reported to be related with adverse pregnancy outcomes. We aimed to determine the role of first trimester pregnancy associated plasma protein-A for poor outcomes in preterm isolated oligohydramnios cases.

足月妊娠羊水偏少200例临床分析

目的：探讨足月妊娠羊水偏少对新生儿结局的影响。方法选择200例足月妊娠羊水偏少患者为观察组,同期154例羊水过少患者及191例羊水量正常孕妇为对照组,比较三组不同分娩方式下新生儿异常情况的发生率。结果羊水偏少组及羊水过少组新生儿异常发生率均高于羊水正常组（χ2＝0．001,P＜0．05）,但羊水偏少组与羊水过少组新生儿异常发生率无统计学差异（χ2＝0．978,P＞0．05）;不同分娩方式羊水偏少组与羊水过少组新生儿异常发生率无统计学差异（χ2值分别为0．103、0．117,均P＞0．05）;羊水偏少组与羊水过少组发生羊水污染者不同分娩方式新生儿异常情况无统计学差异（χ2值分别为0．804、0．151,均P＞0．05）。结论足月妊娠羊水偏少不容忽视,同样易导致围产儿异常,阴道试产时应密切观察产程进展。     

延期妊娠并发羊水过少妊娠结局临床分析

目的探讨延期妊娠并发羊水过少对母婴的影响。方法采用回顾性分析方法,对延期妊娠分娩的产妇羊水过少组98例及羊水正常组343例进行对比分析。结果羊水过少组中羊水Ⅱ度以上粪染、胎盘成熟度Ⅲ+级及胎盘钙化、胎儿窘迫、新生儿窒息率、引产率、产后出血率及剖宫产率均显著高于羊水正常组,差异有统计学意义(P<0.05)。结论羊水过少是胎儿宫内慢性缺氧敏感的特异性指标,不论是延期妊娠还是过期妊娠,一经确诊应积极处理,估计短时间内不能分娩者,宜剖宫产结束妊娠。     

晚期妊娠羊水过少与围产儿缺氧现象临床观察

目的探讨羊水过少与围产儿缺氧现象的关系,并寻找正确的处理方法,以降低围产儿病死率。方法回顾性分析我院2004年1月至12月115例临床羊水过少病例(样本组)。羊水过少诊断标准:临床估算实际羊水量<300m l;超声波检查羊水指数AFI≤5 cm,超声波检查结果与临床有异时以临床为准。结果样本组围产儿死亡、窒息及难产婴儿率均高于同期羊水正常组。所以羊水过少确诊后,严密监测产程,适时及合理方式终止妊娠,提高围产儿出生质量。     

ICP、FGR及羊水过少患者血清中铜、锌、镁含量的变化

目的探讨妊娠期肝内胆汁淤积症(ICP)、胎儿生长受限(FGR)及羊水过少患者血清中铜、锌、镁含量的变化。方法以原子吸收分光光度法分别测定35名ICP患者、11例FGR患者、25例羊水过少患者及20例正常妊娠女性血清锌、铜、镁浓度。结果ICP患者血清锌较对照组明显降低(P0.05),铜及镁较对照组无显著性差异(P0.05);FGR组铜较对照组明显升高,锌、镁较对照组明显降低,均有显著性差异(P0.05);羊水过少组铜含量较对照组无显著性差异,锌含量较对照组降低而镁含量较对照组升高,差异有显著性(P0.05)。铜、锌、镁含量在ICP、FGR及羊水过少3组之间相比无显著性差异(P0.05)。结论ICP、FGR及羊水过少患者血清铜、锌、镁含量较正常孕妇有所变化,针对这些变化进行饮食调整对孕期健康有重要意义。