米非司酮终止中期妊娠时胎盘循环与超微结构的变化

观察３０例妊娠１６～２４周需终止妊娠者服用米非司酮前后子宫动脉和脐动脉血流速度波型的变化，并用电镜观察了５例胎盘微血管的改变。结果：服用米非司酮后，子宫动脉阻力指数（ＲＩ）和Ｓ／Ｄ比值及脐动脉的Ｓ／Ｄ比值较用药前明显增高，胎盘微血管壁有损伤性表现。提示：子宫胎盘循环动力学的变化及胎盘微血管的损伤可能是米非司酮终止妊娠的重要环节。     

妊高征患者淋巴细胞β_2－肾上腺素能受体结合量改变及与新生儿体重关系的研究

应用放射配体结合分析，测定４０例正常晚期妊娠妇女及４０例妊高征妇女外周血淋巴细胞β_２－肾上腺素能受体（β_２－ＡＲ）结合量，并测定两组妇女分娩的新生儿体重。结果为：１．正常晚期妊娠妇女外周淋巴细胞β_２－ＡＲ结合量明显降低，妊高征妇女β_２－ＡＲ结合量降低更显著；２．妊高征孕妇组的新生儿出生体重明显低于正常妊娠组的新生儿体重；３．孕妇β_２－ＡＲ结合量与新生儿出生体重呈明显正相关，提示好高征与机体β_２－ＡＲ结合量下降有关，β_２－ＡＲ改变影响胎儿生长发育。     

Learning in escape/avoidance tasks in female rats does not vary with reproductive condition

To determine whether the development of novel stimulus-response associations by the mother during the periparturient period is attributable to a general facilitation of learning produced by the hormonal milieu during that period, learning ability under various reproductive conditions was assessed in two tasks unrelated to the periparturitional situation. The two tasks, selected because they equalized the various groups for motivation and performance variables, were acquisition of a water-maze escape (including two reversals), and acquisition and retention of an unsignalled shuttlebox shock avoidance. The groups tested in the water maze were a midpregnant group, an immediately prepartum group, and an immediately postpartum group. In the shuttlebox, the same conditions (different rats) were compared, together with a nonpregnant estrus condition, and a nonpregnant diestrus condition. The results of both experiments indicate that although learning occurred, the characteristics of acquisition and retention were not influenced by reproductive condition.     

妊娠前不同体重指数与围产结局的关系研究

目的研究妊娠前不同体重指数对围产结局的影响。方法回顾性分析2005~2007年在我院分娩的单胎妇女238例,按妊娠前体重指数(BMI)分为BMI在19.8~23.9的正常BMI组、BMI 24~27的高BMI组和BMI≥27的肥胖组。新生儿体重≥4000g为巨大儿。比较正常BMI组、高BMI组和肥胖组的围产结局。结果全部资料共有238例,其中正常BMI组182例,高BMI组117例,肥胖组56例,巨大儿的发生率分别为10.4%、19.6%、28.6%,妊娠期高血压病、妊娠期糖尿病、羊水过多的风险随妊娠前BMI增加而上升,早产、剖宫产、新生儿病率的发生率亦随妊娠前BMI增加而升高,差异有显著性。结论妊娠前异常的母亲体重指数高度影响巨大儿的发生率;随妊娠前BMI增加不良围产结局的风险增加。     

Prevalence of hepatitis B virus infection among women at reproductive age at a German university hospital

BACKGROUND: Mother to infant transmission of hepatitis B virus (HBV) represents a major factor in maintaining chronic infection and depends on the degree of maternal infectivity status. OBJECTIVES: To examine the seroprevalence of hepatitis B virus surface antigen (HBsAg) in women at reproductive age admitted to the Department of Gynaecology at a German university hospital. STUDY DESIGN: The seroprevalence of hepatitis B surface antigen (HBsAg) in 5518 women at reproductive age was examined, HBsAg-positive samples were tested for additional HBV markers to verify the infection status. RESULTS: Out of 5518 samples from women at reproductive age, 88 women (1.59%) were positive for HBsAg and 7 of these HBV-positive women (7.95%) were additionally positive for HBeAg. The majority of the study population were German citizens, however most HBV infected persons originated from countries with a high HBV prevalence. The HBV seroprevalence in our study group is about two times higher compared to the average seroprevalence in the German citizen adult population, thus probably resulting in an underestimation of the infection rate in a multinational setting. CONCLUSIONS: Screening for HBsAg during pregnancy is still necessary and important for reduction of perinatal HBV transmission even in countries with low HBV prevalence.     

eNOS基因和MTHFR基因多态性与妊娠高血压综合征发病的相关性研究进展

〔摘要〕 妊娠高血压综合征（妊高征）产科常见的并发症，是引起孕产妇和围产儿死亡的主要原因之一，对其发病原因和机理尚不清楚。一般认为是由环境因素和遗传因素共同作用造成的，目前的研究热点是易感基因与妊高征的关系。本文对内皮型一氧化氮合酶（eNOS）基因和亚甲基四氢叶酸还原酶(MTHFR)基因多态性与妊高征发病的相关性进行了综述。     

胎盘生长因子在妊娠期高血压疾病胎盘组织中的定位及定量分析

目的探讨胎盘生长因子(placental growth factor,PLGF)在妊娠期高血压疾病胎盘中定位及定量表达。方法选择妊娠期高血压疾病患者46例,其中子痫前期重度23例,子痫1例;慢性高血压并发子痫前期1例,选择同期正常妊娠妇女20例作为对照组。采用免疫组织化学染色法和免疫印迹(Western blot)方法检测两组患者胎盘PLC蛋白定位及定量表达。结果 (1)免疫组织化学染色发现PLGF蛋白在妊娠期高血压疾病组及正常妊娠组胎盘中分布范围基本一致, 主要分布在绒毛合体滋养细胞和间质细胞的胞浆,部分血管合体膜上也有PLGF阳性染色。(2)Western blot方法检测妊娠期高血压疾病组子痫前期轻、重度胎盘绒毛PLGF蛋白表达低于正常妊娠组(0.3±0.4 vs 0．6±0．4、0．2±0．5 vs 0．6± 0．4),差异有统计学意义(P<0．01);妊娠期高血压患者胎盘中PLGF蛋白的表迭为0．5±0．6,与对照组比较,差异无显著性(P>0．05)。结论胎盘PLGF蛋白表达异常在妊娠期高血压疾病发病中可能具有重要的作用。     

Use of antidepressants by pregnant women: Evaluation of perception of risk, efficacy of evidence based counseling and determinants of decision making

Summary Background: The World Health Organization predicts that by 2012, depression will be the number one disease in the world. Thus, many women who become pregnant will require treatment with antidepressants. We are aware that women and their health care providers remain hesitant to prescribe and take these drugs during pregnancy, despite evidence of the relative safety. Objectives: 1) To determine perception of risk of antidepressant drugs by pregnant women with depression, 2) to determine the efficacy of evidence-based counseling, and 3) to identify determinants that influence women in their decision making regarding the continuation/discontinuation of antidepressants during pregnancy. Methods: Women who called The Motherisk Program requesting information about the safety of an antidepressant during pregnancy were compared with two other groups: 1) Women who called about antibiotic use (i.e., non-teratogenic drugs used short-term) and 2) women who called about gastric medications (i.e., non-teratogenic drugs used long-term). Their perception of risk was measured before and after evidenced-based information was given and determinants of decision making was also evaluated. Results: We recruited 100 women taking antidepressants during pregnancy and 100 in each comparison group. Despite receiving evidence-based reassuring information, 15% of antidepressant users, compared to 4% using gastric drugs and 1% using antibiotics, chose to discontinue their medication. The main determinants of decision making were based on: information received prior to calling Motherisk, family and friends advice, the internet, sequence of advice given and if a women was undecided at the time of call. Conclusions: Women continue to fear taking antidepressants during pregnancy, more so than non psychiatric drugs, however, evidence based counseling can lower this fear, although not totally. Deciding whether to continue to take a medication or not during pregnancy, is a complex decision for women and their healthcare providers to make.     

妊娠期血清微量元素的变化

目的探讨妊娠期血清微量元素的变化规律。方法以原子吸收分光光度法分别测定421例孕妇和128例正常对照妇女血清铜(Cu)、锌(Zn)、铁(Fe)等微量元素浓度和血清镁(Mg)、钙(Ca)浓度。结果血清铜(Cu)在整个孕期内无显著性变化,P>0.05;血清锌(Zn)、铁(Fe)、镁(Mg)、钙(Ca)随孕期的增加而降低,P均<0.05。结论孕妇在妊娠期内应根据不同孕期,合理补充微量元素。     

Concentrations of serum total protein and protein fractions during diestrus and pregnancy in Makuii ewes

The aim of this study was to determine the blood protein changes during different stages of pregnancy and to compare with prepregnancy diestrus in ewes. A total of 90 blood samples were taken from ten Makuii ewes (the native sheep breed in Iran) at diestrus and on days 8, 14, 28, 45, 60, 90, 125, and 145 of pregnancy. Serum protein electrophoresis of samples exhibited four fractions: albumin, α, β, and γ fractions in Makuii ewes, which in α- and γ-globulin bands were divided to α1 and α2; and γ1 and γ2, respectively. The mean concentrations (in gram per deciliter) of total serum proteins, albumin, α1-, α2-, β-, γ1-, and γ2-globulin at diestrus period were 7.03, 3.77, 0.18, 0.74, 0.41, 1.56, and 0.41, respectively. Those values fluctuated nonsignificantly throughout gestation until the 125th day of pregnancy. Thereafter, a significant decrease (p < 0.01) in serum protein levels occurred at the 145th day of pregnancy compared to prepregnancy and other gestational time points. It was concluded that blood protein levels declined sharply during late gestation when the nutrient demands of the fetus were maximal.