产前不同时期三维超声筛查胎儿唇裂的效果比较

目的 探讨产前不同时期三维超声筛查胎儿唇裂畸形的效果。方法 选择2007年8月至2014年6月在衡阳市第一人民医院进行产前检查并确诊胎儿为唇裂的孕妇31例,对其二维图像及三维成像进行对比,研究三维成像对胎儿唇裂的显示率及最佳显示时间。结果 31例唇裂中,孕14～19周5例,面部三维成像满意者3例,唇部结构清晰显示者2例（唇裂的三维超声显示率40．0％）;孕20～27周17例,面部三维成像满意或基本满意者15例,唇部结构清晰显示者15例（三维超声显示率88．2％）;孕28～34周6例,面部三维成像满意或基本满意者3例,唇部结构清晰显示者2例（三维超声显示率33．3％）;孕35周～39周3例,仅1例羊水过多患者面部三维成像满意,唇部结构显示清晰（三维超声显示率33．3％）。孕20～27周胎儿唇裂三维成像显示率明显高于孕14～19周（χ^2=5．119,P＝0．024）、28～34周（χ^2=6．933,P＝0．008）和35～39周（χ^2=4．804,P＝0．028）,差异均有统计学意义。三维成像满意显示的唇裂中Ⅰ度唇裂3例（15．0％）,Ⅱ度唇裂4例（20．0％）,Ⅲ度唇裂7例（35．0％）,唇裂合并上牙槽突裂3例（15．0％）,唇裂合并腭裂3例（15．0％）。结论 三维超声诊断胎儿唇裂存在明显的时限性,最佳时间为孕20～27周。     

孕11～13^＋6周超声检查胎儿颈项透明层厚度的临床研究

目的 探讨孕11～13^＋6周超声检查胎儿颈项透明层厚度（NT）诊断胎儿畸形的临床价值。方法 对2286例单胎妊娠孕妇于孕11～13^＋6周进行腹部超声检查,测量胎儿NT值,并对所有胎儿进行随访。结果 共36例胎儿发育异常,31例NT值≥3 mm,其中染色体核型异常6例,25例染色体核型正常胎儿均为结构异常;36例发育异常胎儿中5例NT值〈3mm,其中4例为结构异常,1例为染色体核型异常。正常胎儿NT值随孕周增大而增大,不同孕周NT值比较差异有统计学意义（F=5.638,P=0.004）;不同年龄孕妇的正常胎儿NT值比较差异无统计学意义（F=0.162,P=0.736）,所有2 286例孕妇中,NT值≥3 mm共63例,其中31例胎儿存在结构异常,6例存在染色体核型异常,平均检出时间为孕12^＋4周,孕妇年龄平均为34.1岁。25例胎儿染色体核型正常,结构异常平均检出时间为孕12^＋6周,孕妇年龄平均为32.8岁。结论 胎儿NT厚度与发育异常存在密切联系,孕11～13＋6周超声检测NT厚度可作为胎儿畸形筛查的重要指标。     

妊娠20周前体重增长与妊娠期高血压关系的研究

目的：探讨妊娠20周前的体重增长与妊娠期高血压发生风险的关系。方法对自2013年1月至2013年4月在北京妇产医院进行常规产前检查并在本院分娩的1263例孕妇进行前瞻性巢式病例对照研究,病例组为发生妊娠期高血压的孕妇,对照组为血压正常的孕妇。收集年龄、身高、孕前体重、分娩前体重、妊娠期体重记录、高血压家族史、孕次、产次等资料,统计学方法采用t检验、χ2检验及多因素logistic回归分析。结果病例组的孕期总增重（17．94．5kg）高于对照组（16．44．4kg）,t＝2．54,P＝0．01;病例组的妊娠20周前体重增长（6．12．8 kg）也高于对照组（5．03．1kg）,t＝2．72, P＝0．01。按孕前体质量指数（BMI）分组后,对于BMI＜24 kg／m2的孕妇,病例组的孕期总增重和妊娠20周前的体重增长仍明显高于对照组（P＜0．05）;对于BMI≥24 kg／m2的孕妇,病例组的孕期总增重明显高于对照组（P＜0．05）,而妊娠20周前的体重增长与对照组相比虽然有增高趋势,但差异无统计学意义（P＞0．05）。控制年龄、孕前BMI、孕次、产次、高血压家族史、测量体重时的孕周等混杂因素后,妊娠20周前的体重增长每增加1kg,发生妊娠期高血压的风险增加12．5％（95％可信区间为1．038～1．220,P＝0．004）。结论妊娠20周前的体重增长是妊娠期高血压的危险因素,控制妊娠20周前的体重增长对于预防妊娠期高血压可能具有重要意义,尤其是对于孕前BMI＜24 kg／m2的孕妇。     

汉中市南郑县9643例新生儿出生体重分析

目的探讨单胎活产新生儿体重分布及相关因素对新生儿体重的影响。方法对2003年1月1日至2012年12月31日在汉中市南郑县人民医院产科孕妇分娩的单胎新生儿体重进行分析,记录新生儿体重及孕妇年龄、孕周、职业、居住地理位置,以及不同年度对新生儿体重的影响,并进行统计分析。结果10年收住孕32＋2～43＋6周孕妇9643例,新生儿体重分布在600～5100g,平均体重（3218．69±415．02）g,体重随孕周而增加（F＝147．444,P＜0．001）。26～35岁组孕妇分娩的新生儿体重较重,各年龄组比较差异有统计学意义（F＝21．542,P＜0．001）。男性新生儿体重明显重于女性（F＝13．985）,平川丘陵居住的孕妇新生儿体重较山区重（F＝12．387）,2～3产次出生的新生儿较1、4产次重（F＝32．868）,均P＜0．001,农民与职工孕妇的新生儿体重相近（ P＞0．05）。孕32＋2～43＋6周、孕36～41＋6周、孕38～41＋6周的新生儿出生体重10年内各年度的差异有统计学意义（ F值分别为2．966、3．323、3．225,均P＜0．05）。结论新生儿体重与性别、孕妇居住地理位置、产次、孕周、年龄有关,与职业无关,新生儿体重有逐年增加趋势。     

孕期妇女全血5种微量元素的测定

摘要:目的　了解不同孕期妇女外周血铜、锌、钙、镁、铁元素水平的变化。方法　选取2012年7月-2014年6月在我院进行孕前、妊娠及产后体检的20～35岁健康女性为研究对象,选择孕前样本100例,妊娠样本900例（4周为一孕期,每孕期100例）,产后样本收集69例,以原子吸收光谱法测定外周血5种元素含量。结果　血铜水平与孕期正相关（r＝0.388,P＜0.01）,产后下降接近孕前。孕前、孕4～8周及产后血铜水平显著低于其他孕期（-462.09＜H＜-257.67,P＜0.001）。血锌水平孕20周前与孕期负相关（r＝-0.218,P＜0.01）,孕20周后与孕期正相关（r＝0.106,P＜0.01）;血锌水平在产后显著高于孕前～孕32周各期（-373.42＜H＜-193.76,P值介于0.000～0.003）,在孕37～40周显著高于孕4～24周各期（-278.45＜H＜-155.18,P值介于0.000～0.021）,在孕33～36周显著高于孕9～24周各期（-226.90＜H＜-149.10,P值介于0.000～0.035）,在孕前（H分别为160.68,155.39,P值分别为0.013,0.020）及孕29～32周（H分别为-179.66,-174.37,P值分别为0.002, 0.004）高于孕13～20周各期。血镁水平与孕期负相关（r＝-0.165,P＜0.01）,产后恢复至孕前。血镁水平在孕前（156.69＜H＜181.90,P值介于0.002～0.018）、孕4～8周（151.22＜H＜176.43,P值介于0.003～0.029）及产后-211.75＜H＜-186.54,P值介于0.001～0.006）高于孕37～40周及孕17～32周各期,在产后高于孕33～36周（H＝-167.22,P＝0.03）。血铁水平与孕期负相关（r＝-0.264,P＜0.01）,孕33周后逐步恢复。血铁水平在孕前高于孕9～40周各期（163.42＜H＜322.71,P值介于0.000～0.010）,在孕4～8周高于孕17～40周各期（170.15＜H＜228.42,P值介于0.000～0.005）,在孕9～12周高于孕21～28周各期（148.96＜H＜159.29,P值介于0.036～0.015）,在产后分别高于孕21～28周（-187.16＜H＜-176.83,P值介于0.006～0.014＜0.05）及孕33～36周（H＝-166.03,P＝0.032）。不同孕期妇女血钙水平无统计学差异（P＝0.098）。结论　血铜在孕期增高,血镁水平在孕17～32周达到最低,血铁在21～36周达到最低,血锌在孕20周达到最低。妊娠期微量元素的补充应根据该元素在孕期的变化规律有所侧重。     

孕妇血清 Fol、VB12和 Hcy水平与胎儿 CHD相关性研究

目的 比较胎儿先天性心脏病（ CHD）的孕妇和正常孕妇血清叶酸（ Fol）、维生素B12（ VB12）和同型半胱氨酸（ Hcy）水平,以了解3种物质的代谢水平与胎儿CHD的关系。方法 根据有无胎儿CHD将研究对象分为病例组（ n＝46）和对照组（n＝43）。病例组为经B超诊断为孕CHD胎儿确诊的孕妇,对照组为经B超诊断胎儿发育正常的孕妇。检测89例研究对象血清标本Fol、VB12和Hcy水平,比较病例组和对照组血清Fol、VB12和Hcy水平差异。结果 病例组的Fol水平高于对照组,差异有统计学意义（t＝2．426,P＝0．017）;病例组Hcy水平高低于对照组,但差异无统计学意义（P＞0．05）。血清Fol≥44．5nmol／L的孕妇与＜38．6nmol／L的孕妇相比,胎儿CHD发生率降低36倍;Hcy的OR＝1．036（95％CI：0．807～1．329）,但并未增加胎儿CHD发生的危险性（P＞0．05）;VB12的OR＝1．007（95％CI：1．001～1．013）,增加胎儿CHD发生的危险性（P＝0．015）。 Fol和VB12对CHD的发生都有关联,差异均有统计学意义（P＝0．046,P＝0．020）,但是曲线下的面积都＜70％,用这两个指标单独进行诊断无很大价值。结论 孕妇高水平Fol是妊娠胎儿CHD的保护因素,VB12是妊娠胎儿CHD的危险因素,血清Fol和VB12联合检测对胎儿CHD的发生更有预测价值。     

低剂量阿司匹林对高危孕妇子痫前期的预防效果

目的：评价低剂量阿司匹林（ LDA）在预防高危孕妇子痫前期（ PE）的作用及疗效。方法采用随机、对照、双盲实验将480名12周及20周孕妇分为12个组别,分别给予50mg／d、100mg／d及150mg／d剂量的LAD和安慰剂,比较各组间的子痫发生情况、分娩孕周、孕妇产后出血量、早产及胎儿生长受限、新生儿出血性疾病发生、新生儿死亡率等情况。观察合适的服用LDA的时间和剂量。结果12周与20周孕妇不同剂量LDA组结果均显示,服用LDA的子痫发生率均低于服用安慰剂组,而且以100mg／d组别子痫发生率最低,差异具有统计学意义（χ2＝29．838,P＜0．05）;12周结果显示早产发生、新生儿出血性疾病发生情况方面,服用LDA与服用安慰剂均无统计学差异（χ2值分别为1．441、1．034,均P＞0．05）;但是服用LDA组发生胎儿生长受限及新生儿死亡情况显著低于服用安慰剂组,且差异有统计学意义（χ2值分别为13．317、15．984,均P＜0．05）。20周结果显示在早产发生、胎儿生长受限、新生儿出血性疾病发生情况方面,服用LDA与服用安慰剂并无统计学差异（χ2值分别为1．441、6．117、0．835,均P＞0．05）;但是服用LDA组发生新生儿死亡情况显著低于服用安慰剂组,且差异有统计学意义（χ2＝15．984,P＜0．05）;12孕周服用LDA各组较20孕周服用LDA各组的子痫发生率低显著降低（χ2＝11．663,P＜0．05）。结论12周服用LDA100mg／d可以有效降低PE的发生,具有预防效果。     

早孕期超声筛查在胎儿结构畸形诊断中的应用

目的：探究早孕期系统性超声筛查在胎儿结构畸形诊断中的临床应用价值。方法选取聊城市第二人民医院于2013年5月至2015年5月期间接受孕期超声检查的11～13＋6周孕妇64例,行早期超声胎儿筛查;对妊娠至22～24＋6周孕妇行中孕期超声检查（采用连续扫查法）,并对以上最终的结果进行跟踪。结果早孕期畸形胎儿检出率与中孕期畸形胎儿检出率相比,组间无显著性差异（χ2＝1．03,P＞0．05）,早中孕期联合诊断畸形胎儿检出率与单独的早孕期检出率和中孕期检出率相比,组间均存在显著性差异（χ2＝4．53,P＜0．05;χ2＝5．39,P＜0．05）。早孕期超声筛查胎儿结构畸形共36种类型,占前3位的分别为：颈部水囊瘤及NT增厚（33．33％）、颜面部异常（25．00％）、前腹壁异常（11．11％）;中孕期超声筛查胎儿结构畸形共42种类型,占前3位的分别为：心血管异常（30．95％）、颜面部异常（21．43％）、中枢神经系统异常（11．11％）。早孕期与中孕期进行系统性超声筛查结果中,各类畸形结构分布率均存在显著性差异（χ2＝4．55～6．32,P＜0．05）。结论早孕期进行系统性超声筛查,胎儿结构畸形检出率较高,但是不能完全取代中期的超声检查,同时建议早中联合检查可以提高胎儿结构畸形的检出率。     

超声鼻骨测量在胎儿唐氏综合症诊断中的应用研究

目的：讨论鼻骨测量在胎儿产前筛查中的应用价值。方法：对5年内有病理及染色体诊断依据的4l例唐氏综合症（Ds）患者的超声资料进行回顾性诊断分析，对结果采用spss17．0进行统计分析，同时采用线性回归方程描述鼻骨与超声孕周的关系。结果：正常胎儿的鼻骨长度随着孕妇孕周的增加而增加，鼻骨与超声孕周的回归方程为Y=0．238＋0．0246X，F=78．65，胎儿鼻骨长度与孕周均呈直线线性相关，其差异有统计学意义（r=0．801，P〈0．05）。鼻骨短小在相应各孕周与健康对照组比较，11～14周、15-18周及19-22周相比差异显著，具有统计学意义（f=-5．378，t=-2．369，f=-2．195，t=-2．195；P〈0．05）。结论：通过产前筛查扫查胎儿鼻骨，准确把握特异切面，能够发现鼻骨的异常发育，同时鼻骨的发育能够有效反应胎儿的孕周。结合全面的超声筛查，有效诊断胎儿的发育畸形。     

巨大儿高危因素临床分析

目的探讨巨大儿发生的高危因素。方法回顾性分析246例分娩巨大儿孕妇及200例分娩正常体重胎儿孕妇的年龄、孕周、孕产次、身高、宫高、腹围、胎儿双项径及妊娠合并症。结果2005年10月至2009年10月间巨大儿发生率有逐年上升的趋势,但各组闯比较无统计学意义。研究组平均年龄（28．32±3．12）岁;对照组平均年龄（28．53±2．87）岁。两组平均年龄相比无统计学意义（P〉O．05）。研究组年龄〉35岁患者明显高于对照组（P〈0．01）。研究组孕次平均为（2．21±1．13）次,对照组平均孕次为（1．52±0．93）次,两组相比有统计学意义（P〈0．05）。孕40周后巨大儿的发生比率升高,与对照组相比有统计学意义（P〈0．01）。研究组孕妇身高、宫高＋腹围及胎儿双顶径均明显高于对照组,两组相比有显著差异（P〈0．01）。研究组中糖尿病或GDM患者明显高于对照组,且血糖控制不良者明显高于对照组（P〈0．05）。结论巨大儿的发生与孕妇年龄、孕周、孕次产、身高、宫高、腹围、胎儿双顶径及糖尿病均有关系,掌握好巨大儿的高危因素和巨大儿的预测方法,对产前准确判断巨大儿具有重要作用。     

Tei指数在胎儿宫内生长受限心脏功能检测中的价值

目的：探讨Tei指数在孕晚期胎儿宫内生长受限心脏功能监测中的应用价值。方法：选择在孕晚期发现的宫内生长受限胎儿40例，同时选取正常胎儿40例，在28~32周，33~38周，38周以上3个孕周时段多次测量左、右室Tei指数，进行统计学分析。结果：宫内生长受限胎儿Tei指数测值随孕周而增加，在28~32周、33~38周、38周以上3个时间段左、右心室Tei指数测值均高于正常胎儿组，比较差异有统计学意义（P〈0.01）。结论：Tei指数在孕晚期胎儿宫内生长受限心脏功能监测中有较大价值。     

胎儿胼胝体发育的超声监测

目的:探讨胎儿胼胝体生长发育规律。方法:对622例孕16～39周胎儿进行胼胝体超声检查,测量胼胝体前后径,并分析其与孕周的关系。结果:胎儿胼胝体前后径与孕周呈正相关(r=0.932,P<0.001),回归方程为:胼胝体前后径(mm)=-9.567+1.495×胎龄(周)。结论:胼胝体随孕周发育的变化规律及其正常测量数据为进一步判断病变提供了参照标准。     

Role of structural birth defects in preterm delivery

The proportion of preterm births associated with structural birth defects has not been adequately quantified. We explored the proportion of preterm infants with structural birth defects diagnosed in the first year of life, as well as the specific phenotypes of birth defects occurring among preterm infants. The data used were from the California Birth Defects Monitoring Program, a population-based registry, as well as data from California vital records corresponding to births and fetal deaths in the period 1984-96. The prevalence of structural birth defects exceeded 8% among deliveries with gestational ages < or = 30 weeks, and prevalence decreased to 2% as gestational age increased to > or = 37 weeks gestation. The decreasing prevalence pattern with increasing gestational age was observed for a variety of anatomically defined birth defect groups suggesting that certain birth defects were not the sole contributors to the elevated prevalences among preterm births. Decreasing prevalence with increasing gestational age was also observed across strata of maternal race/ethnicities, ages, infant's sex and each year studied. These data indicate that structural birth defects may contribute significantly to the proportion of infants who are delivered before 37 weeks gestation.     

Maternal and fetal plasma vitamin E to total lipid ratio and fetal RBC antioxidant function during gestational development

Placental transfer of vitamin E was investigated from 19 to 35 weeks of gestation by analysis of fetal and maternal blood samples for total tocopherol, total lipids, and fetal red blood cell antioxidant reserves. Fifty-two fetal blood samples were obtained under ultrasonographic guide by percutaneous umbilical blood sampling. Thirteen were from fetuses with gestational age less than or equal to 22 weeks (x serum vitamin E = 0.4 +/- 0.14 mg/dl), 12 were from fetuses at 23-27 weeks gestation (x serum vitamin E = 0.4 +/- 0.21 mg/dl), and 27 were from fetuses with gestational age 28-38 weeks (x serum level = 0.37 +/- 0.18). Total lipid levels ranged from 140 to 216 mg/dl. Maternal plasma vitamin E concentrations correlated significantly with concurrent values in the fetus. There were no significant differences in serum vitamin E levels or vitamin E to total lipid ratio in samples from early, mid, or late gestation in either the mother or fetus. Red blood cell antioxidant reserve on samples from 18 fetuses were grossly abnormal by three different functional assays. On the basis of these data, placental transfer of vitamin E appears to be relatively constant through advancing gestation. Red blood cell antioxidant reserve is uniformly low.     

Maternal and fetal plasma vitamin E to total lipid ratio and fetal RBC antioxidant function during gestational development.

Placental transfer of vitamin E was investigated from 19 to 35 weeks of gestation by analysis of fetal and maternal blood samples for total tocopherol, total lipids, and fetal red blood cell antioxidant reserves. Fifty-two fetal blood samples were obtained under ultrasonographic guide by percutaneous umbilical blood sampling. Thirteen were from fetuses with gestational age less than or equal to 22 weeks (x serum vitamin E = 0.4 +/? 0.14 mg/dl), 12 were from fetuses at 23-27 weeks gestation (x serum vitamin E = 0.4 +/? 0.21 mg/dl), and 27 were from fetuses with gestational age 28-38 weeks (x serum level = 0.37 +/? 0.18). Total lipid levels ranged from 140 to 216 mg/dl. Maternal plasma vitamin E concentrations correlated significantly with concurrent values in the fetus. There were no significant differences in serum vitamin E levels or vitamin E to total lipid ratio in samples from early, mid, or late gestation in either the mother or fetus. Red blood cell antioxidant reserve on samples from 18 fetuses were grossly abnormal by three different functional assays. On the basis of these data, placental transfer of vitamin E appears to be relatively constant through advancing gestation. Red blood cell antioxidant reserve is uniformly low.     

Variations in the reporting of gestational age at induced termination of pregnancy.

Utilizing the 1980 Induced Abortion File maintained by the National Center for Health Statistics, we compared gestational age from date of last normal menses and the physician-based estimate of gestational age. An average .51 week difference between the two methods was observed. Beyond seven weeks gestation, the date of last normal menses value was underestimated by the physician-based estimate with a markedly greater divergence after 20 weeks. A relatively greater underestimation of the date of last normal menses interval by the physician estimate was apparent for Whites after 13 weeks. The data of last normal menses value for non-state residents was overestimated across the entire range of the date of last normal menses gestational age distribution until 21 weeks.     

Influence of prenatal diagnosis and pregnancy termination of fetuses with birth defects on the perinatal mortality rate in Victoria, Australia

Historical data show that in Victoria birth defects have accounted for approximately 25% of all perinatal deaths. Terminations of pregnancies (TOPs) for birth defects occurring at > or =20 weeks gestation are included in the population-based perinatal data collection. These are classified as stillbirths or neonatal deaths. Some would have survived the perinatal period if no termination had taken place, and as a result they have the effect of increasing the perinatal mortality rate (PMR). Conversely, TOPs <20 weeks gestation, of fetuses with lethal birth defects that would have resulted in a perinatal death, are not included in the statistics and therefore reduce the PMR. The aim of this study was to examine the effect on the PMR of TOPs following the prenatal detection of birth defects, taking into account the severity or 'lethality' of the birth defects. Data on live births, stillbirths, neonatal deaths and TOPs carried out because of a birth defect were collected from the Victorian Birth Defects Register (BDR) for 1989-2000. Birth defects were categorised into three groups, according to the estimated likelihood of a baby with that condition dying in the perinatal period: a 'lethal' birth defect was one where there was >50% likelihood of death, 'possibly lethal' 15-50% and 'non-lethal' less than 15%. Based on these 'lethality' groups and associated assumptions about average survival rates beyond the neonatal period, the PMR was recalculated. TOPs for 'non-lethal' birth defects at > or =20 weeks gestation increased the PMR by 3.8%. TOPs for 'lethal' birth defects <20 weeks decreased the PMR by 14.4%. The net effect on the overall PMR from TOPs for birth defects was a 10.6% decrease.     

Abortion for fetal indications: Timing of prenatal diagnosis and abortion for structural and genetic abnormalities

ObjectiveTo compare diagnoses in patients undergoing abortion for fetal indications at 15–0/7 to 21–6/7 vs. ≥22–0/7 weeks’ gestation.Study designThis retrospective cohort study included women undergoing abortion at ≥15–0/7 weeks’ gestation for fetal indications from 2012 to 2018 at our institution. We compared indications (genetic vs. structural only) between groups by gestational age (15–0/7 to 21–6/7 vs. ≥22–0/7 weeks). We performed statistical analysis using Fisher’s exact and Mann-Whitney U tests.ResultsThe 158 women identified included 97 (61.4%) at 15–0/7 to 21–6/7 and 61 (38.6%) at ≥22–0/7 weeks’ gestation. Women at an earlier gestational age more commonly had an initial diagnosis of a genetic disorder (41 [42.3%)] vs.10 [16.4%], respectively, p < .001). In 69 cases with initial or subsequent diagnosis of a genetic disorder, there were differences in the types of genetic abnormalities, with common chromosomal abnormalities (including Trisomies 13, 18, and 21) the most frequent diagnosis in those who underwent abortion at 15–0/7 to 21–6/7 weeks and microarray abnormalities more common at ≥22–0/7 weeks (22 [44.9%] vs. 4 [18.2%]) and 7 [14.9%] vs. 11 [50.0%], respectively, p = .01). Routine ultrasonography for fetal anomaly surveillance occurred one week earlier in women undergoing abortion for structural anomalies at 15–0/7 to 21–6/7weeks (median 19–2/7 weeks [interquartile range (IQR) 19 0/7 to 19–5/7 weeks]) compared to ≥22–0/7 weeks (median 20–2/7 weeks [IQR 19 6/7 to 20 4/7 weeks]), p < .001.ConclusionAbortions for genetic indications are performed earlier in gestation compared to those performed for structural abnormalities. Timing of fetal anatomy ultrasound examination correlated with gestational age at abortion for structural abnormalities.ImplicationsMany states impose gestational-age based abortion bans, with 20-weeks post-fertilization the most common. However, we may not identify fetal abnormalities until close to 22 weeks gestation (20-weeks post-fertilization). Optimizing timing of prenatal diagnosis might mitigate the impact of gestational-age based abortion bans.     

孕16~20周骨钙素水平对妊娠期糖尿病影响的巢氏病例对照研究

目的 探究孕16~20周骨钙素水平对妊娠期糖尿病的影响,为妊娠期糖尿病的预防提供相应的对策与措施。 方法 本研究采用巢氏病例对照研究,通过孕24周的75 g葡萄糖耐量试验结果选取病例组(妊娠期糖尿病组)和对照组(血糖正常组),回顾性的收集研究对象的基础信息及孕16~20周的血液标本,并进行血清骨钙素的检测。采用非条件logistic回归分析孕16~20周骨钙素水平对妊娠期糖尿病的影响。 结果 妊娠期糖尿病组的16~20周骨钙素水平高于血糖正常组,进一步分析发现,调整了年龄、孕早期体质指数、舒张压等变量后,骨钙素水平第3、4分位(8~9 ng/ml,≥9 ng/ml)均增加妊娠期糖尿病的发生风险,OR(95%CI)分别为3.13(1.20~8.14),4.01(1.42~11.32),且随着骨钙素水平的升高,妊娠期糖尿病发生的危险性逐渐升高(χ²_趋势=8.99,P=0.003)。 结论 孕16~20周骨钙素水平的升高可增加妊娠期糖尿病发生风险。