Pub Date : 2019-07-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.07.013
Xiaoli Wang, H. Mei
Neonatal acute respiratory distress syndrome (NARDS), featured by dyspnea and hypoxemia, is a serious life-threatening acute and diffuse lung injury caused by many influencing factors. microRNAs (miRNAs), a type of endogenous small non-coding RNA molecules that post-transcriptionally regulate gene expression, are involved in the development of NARDS. In recent years, an increasing number of studies on miRNA and NARDS have been conducted. It is widely acknowledged that miRNAs do not only promote the pathogenesis of NARDS, but also play a protective role as different miRNAs have different functions with different underlying mechanisms. Although numerous studies on the correlation between miRNA and NARDS have emerged, specific pathogenesis and regulatory mechanisms are not fully understood. This article reviewed the latest progress in the research of correlation between miRNAs and NARDS and the related molecular mechanisms to provide information for clinical practice. Key words: microRNAs; Respiratory distress syndrome, newborn
{"title":"Progress on microRNAs and neonatal acute respiratory distress syndrome","authors":"Xiaoli Wang, H. Mei","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.013","url":null,"abstract":"Neonatal acute respiratory distress syndrome (NARDS), featured by dyspnea and hypoxemia, is a serious life-threatening acute and diffuse lung injury caused by many influencing factors. microRNAs (miRNAs), a type of endogenous small non-coding RNA molecules that post-transcriptionally regulate gene expression, are involved in the development of NARDS. In recent years, an increasing number of studies on miRNA and NARDS have been conducted. It is widely acknowledged that miRNAs do not only promote the pathogenesis of NARDS, but also play a protective role as different miRNAs have different functions with different underlying mechanisms. Although numerous studies on the correlation between miRNA and NARDS have emerged, specific pathogenesis and regulatory mechanisms are not fully understood. This article reviewed the latest progress in the research of correlation between miRNAs and NARDS and the related molecular mechanisms to provide information for clinical practice. \u0000 \u0000 \u0000Key words: \u0000microRNAs; Respiratory distress syndrome, newborn","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"495-499"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41631309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.07.002
Chenyu Xu, Tingmei Chen, Yihua Zhou
Breast milk is the best food for infants. However, worrying about the transmission of pathogens to their offspring, mothers who have ongoing infections are usually hesitated on breastfeeding, or even unwillingly give up breastfeeding. This article summarized some basic knowledge and evidence on breastfeeding when maternal infections occur and emphasized that there is no risk of hepatitis virus transmission during breastfeeding. After taking appropriate measures, mothers with transmittable diseases through breastfeeding can still breastfeed their babies. This review provides reasonable medical advice on whether to breastfeed when maternal infection occurs in order to increase breastfeeding rate. Key words: Mothers; Communicable diseases; Breast feeding
{"title":"Maternal infection and breastfeeding","authors":"Chenyu Xu, Tingmei Chen, Yihua Zhou","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.002","url":null,"abstract":"Breast milk is the best food for infants. However, worrying about the transmission of pathogens to their offspring, mothers who have ongoing infections are usually hesitated on breastfeeding, or even unwillingly give up breastfeeding. This article summarized some basic knowledge and evidence on breastfeeding when maternal infections occur and emphasized that there is no risk of hepatitis virus transmission during breastfeeding. After taking appropriate measures, mothers with transmittable diseases through breastfeeding can still breastfeed their babies. This review provides reasonable medical advice on whether to breastfeed when maternal infection occurs in order to increase breastfeeding rate. \u0000 \u0000 \u0000Key words: \u0000Mothers; Communicable diseases; Breast feeding","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"436-440"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47469012","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective Human milk of mothers with positive hepatitis B surface antigen (HBsAg) contains hepatitis B virus (HBV). However, breastfeeding does not increase the risk of mother-to-infant transmission of HBV. Previous investigations demonstrated that breast milk has a property of binding with HBsAg. This study aimed to identify the component in human milk that can bind to HBsAg. Methods This study was performed in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, from June 2015 to February 2017. Human milk samples from two postpartum women with negative HBV markers and two control samples of cow milk and goat milk were analyzed by Far-Western blot, in which highly purified recombinant yeast HBsAg was used to bind with whey proteins. Based on the results of mass-spectrum analysis, competition inhibition test was used to confirm the functioning component. Results Far-Western blot showed remarkable protein bands at the relative molecular weight of about 80 000 in both lanes of human milk, but none in the lane of cow or goat milk. Mass-spectrum analysis of the protein band indicated there were proteins sharing 28.4%-93.4% homology in amino acid sequences with five proteins with the highest homology to lactoferrin (93.4%). Further Far-Western blot with purified recombinant lactoferrin showed that lactoferrin could bind to the recombinant HBsAg. Competition inhibition test suggested that the purified recombinant lactoferrin inhibited the binding of HBsAg to its antibody in a dose-dependent manner. Conclusions This study confirms the capability of lactoferrin in human milk to combine with HBsAg, suggesting that lactoferrin can bind to HBV. Further study on whether lactoferrin can inhibit the infectivity of HBV would be valuable to clarify the reason for not increasing the risk of mother-to-infant transmission of HBV by breastfeeding. Key words: Milk, human; Lactoferrin; Hepatitis B surface antigens
{"title":"Screening and identification of hepatitis B surface antigen binding to lactoferrin in human milk","authors":"Zhao-hua Zhang, Jingli Liu, Jing Feng, Y. Dai, Yali Hu, Yihua Zhou","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.006","url":null,"abstract":"Objective \u0000Human milk of mothers with positive hepatitis B surface antigen (HBsAg) contains hepatitis B virus (HBV). However, breastfeeding does not increase the risk of mother-to-infant transmission of HBV. Previous investigations demonstrated that breast milk has a property of binding with HBsAg. This study aimed to identify the component in human milk that can bind to HBsAg. \u0000 \u0000 \u0000Methods \u0000This study was performed in Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, from June 2015 to February 2017. Human milk samples from two postpartum women with negative HBV markers and two control samples of cow milk and goat milk were analyzed by Far-Western blot, in which highly purified recombinant yeast HBsAg was used to bind with whey proteins. Based on the results of mass-spectrum analysis, competition inhibition test was used to confirm the functioning component. \u0000 \u0000 \u0000Results \u0000Far-Western blot showed remarkable protein bands at the relative molecular weight of about 80 000 in both lanes of human milk, but none in the lane of cow or goat milk. Mass-spectrum analysis of the protein band indicated there were proteins sharing 28.4%-93.4% homology in amino acid sequences with five proteins with the highest homology to lactoferrin (93.4%). Further Far-Western blot with purified recombinant lactoferrin showed that lactoferrin could bind to the recombinant HBsAg. Competition inhibition test suggested that the purified recombinant lactoferrin inhibited the binding of HBsAg to its antibody in a dose-dependent manner. \u0000 \u0000 \u0000Conclusions \u0000This study confirms the capability of lactoferrin in human milk to combine with HBsAg, suggesting that lactoferrin can bind to HBV. Further study on whether lactoferrin can inhibit the infectivity of HBV would be valuable to clarify the reason for not increasing the risk of mother-to-infant transmission of HBV by breastfeeding. \u0000 \u0000 \u0000Key words: \u0000Milk, human; Lactoferrin; Hepatitis B surface antigens","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"457-460"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48795754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.07.009
K. Wei, Heng Guo, Huawen Xin
Pregnant and breastfeeding women are perhaps "the last true therapeutic orphans". Due to dearth of adequate research on certain medications and healthcare providers' poor knowledge of lactational pharmacology, nursing mothers are often ill-advised to give up breastfeeding or unlikely to receive appropriate treatment. Accumulating evidence-based data have shown that most medications are safe for nursing mothers. Besides safety concerns, infant's condition and maternal attitude should also be considered when making treatment decisions. Clear understanding of lactational pharmacology and risk assessment tools in breastfed infants would be beneficial to meet the medical needs of nursing mothers and promote breastfeeding. Key words: Breast feeding; Drug therapy; Risk assessment
{"title":"Rational use of medications and risk assessment during lactation","authors":"K. Wei, Heng Guo, Huawen Xin","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.009","url":null,"abstract":"Pregnant and breastfeeding women are perhaps \"the last true therapeutic orphans\". Due to dearth of adequate research on certain medications and healthcare providers' poor knowledge of lactational pharmacology, nursing mothers are often ill-advised to give up breastfeeding or unlikely to receive appropriate treatment. Accumulating evidence-based data have shown that most medications are safe for nursing mothers. Besides safety concerns, infant's condition and maternal attitude should also be considered when making treatment decisions. Clear understanding of lactational pharmacology and risk assessment tools in breastfed infants would be beneficial to meet the medical needs of nursing mothers and promote breastfeeding. \u0000 \u0000 \u0000Key words: \u0000Breast feeding; Drug therapy; Risk assessment","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"472-478"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49108309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.07.007
Jing Wang, Pingyang Chen, Kaiju Luo, Mingfeng He
Objective To study the effects of human milk on feeding intolerance, infant growth and development, complications during hospitalization and length of hospital stay in very/extremely low birth weight (VLBW/ELBW) preterm infants. Methods VLBW/ELBW preterm infants admitted to the Division of Neonatology, Children's Medical Center of the Second Xiangya Hospital from May 2015 to April 2018 were enrolled in this retrospective study and were assigned into two groups: human milk group (human milk accounted for at least 50% of total enteral feeding during hospitalization) and formula group (exclusive formula feeding due to breastfeeding contraindication or insufficient human milk supply). Feeding intolerance, neonatal growth, complications and length of hospital stay were compared between the two groups using independent sample t-test, Mann-Whitney U test and Chi-square test (or Fisher's exact probability test). Results A total of 113 VLBW/ELBW infants were enrolled consisting of 52 in the human milk group and 61 in the formula group. The starting time of enteral feeding, duration of minimal enteral feeding and incidence of feeding intolerance were similar between the two groups (all P>0.05). The increasing rate of milk volume was (8.4±1.6) ml/(kg·d) in the human milk group and (7.6±1.4) ml/(kg·d) in the formula group (t=2.853, P 0.05). The incidence of neonatal necrotizing enterocolitis (NEC) in the human milk group was lower than that of the formula group [1.9% (1/52) vs 11.5% (7/61), χ2=3.894, P 0.05). There were 14 cases (26.9%) of BPD in the human milk group, of which eight were mild and six moderate. While in the formula group, 24 cases (39.3%) had BPD and among them, four, 18 and two infants were mild, moderate and severe BPD, respectively. BPD cases in the human milk group were less severe than those in the formula group (U=-2.645, P<0.05). The length of hospital stay of the human milk group was shorter than that of the formula group [(47.5±14.8) vs (53.9±16.3) d, t=-2.129, P<0.05)]. Conclusions Human milk for VLBW/ELBW infants may shorten the time to full enteral feeding and the length of hospital stay, reduce the incidence of NEC, decrease the severity of BPD. VLBW/ELBW infants fed with fortified human milk have similar growth rate as those fed with formula milk. Key words: Breast feeding; Infant, very low birth weight; Infant, extremely low birth weight; Infant, premature; Prognosis
{"title":"Effects of human milk on short-term outcomes of very/extremely low birth weight preterm infants","authors":"Jing Wang, Pingyang Chen, Kaiju Luo, Mingfeng He","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.007","url":null,"abstract":"Objective \u0000To study the effects of human milk on feeding intolerance, infant growth and development, complications during hospitalization and length of hospital stay in very/extremely low birth weight (VLBW/ELBW) preterm infants. \u0000 \u0000 \u0000Methods \u0000VLBW/ELBW preterm infants admitted to the Division of Neonatology, Children's Medical Center of the Second Xiangya Hospital from May 2015 to April 2018 were enrolled in this retrospective study and were assigned into two groups: human milk group (human milk accounted for at least 50% of total enteral feeding during hospitalization) and formula group (exclusive formula feeding due to breastfeeding contraindication or insufficient human milk supply). Feeding intolerance, neonatal growth, complications and length of hospital stay were compared between the two groups using independent sample t-test, Mann-Whitney U test and Chi-square test (or Fisher's exact probability test). \u0000 \u0000 \u0000Results \u0000A total of 113 VLBW/ELBW infants were enrolled consisting of 52 in the human milk group and 61 in the formula group. The starting time of enteral feeding, duration of minimal enteral feeding and incidence of feeding intolerance were similar between the two groups (all P>0.05). The increasing rate of milk volume was (8.4±1.6) ml/(kg·d) in the human milk group and (7.6±1.4) ml/(kg·d) in the formula group (t=2.853, P 0.05). The incidence of neonatal necrotizing enterocolitis (NEC) in the human milk group was lower than that of the formula group [1.9% (1/52) vs 11.5% (7/61), χ2=3.894, P 0.05). There were 14 cases (26.9%) of BPD in the human milk group, of which eight were mild and six moderate. While in the formula group, 24 cases (39.3%) had BPD and among them, four, 18 and two infants were mild, moderate and severe BPD, respectively. BPD cases in the human milk group were less severe than those in the formula group (U=-2.645, P<0.05). The length of hospital stay of the human milk group was shorter than that of the formula group [(47.5±14.8) vs (53.9±16.3) d, t=-2.129, P<0.05)]. \u0000 \u0000 \u0000Conclusions \u0000Human milk for VLBW/ELBW infants may shorten the time to full enteral feeding and the length of hospital stay, reduce the incidence of NEC, decrease the severity of BPD. VLBW/ELBW infants fed with fortified human milk have similar growth rate as those fed with formula milk. \u0000 \u0000 \u0000Key words: \u0000Breast feeding; Infant, very low birth weight; Infant, extremely low birth weight; Infant, premature; Prognosis","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"461-466"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43345186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.07.003
Jianxing Zhu
Rapid measurements of macronutrients in human milk by infrared spectroscopy, particularly widely used mid-infrared at bed side, is undergoing rapid development in recent years. A recent published systematic review showed that the accurate rate of infrared spectroscopy for protein and fat measurement was only between 60% and 70%, while for carbohydrate/lactose was inconclusive. As for domestic used digital ultrasound techniques, only few studies were published based on small sample size and thus it is difficult to evaluate the results. The storage, temperature and container for milk samples may also affect the results. As individual human milk contents vary during the whole lactation period resulting in the instability of all contents, one single or few samples might not be representative. The proposed individualized fortification based on rapid measurement of human milk has failed to ensure a better growth though it might be true that the analysis made less error in determining the volume of fortifier. We concluded that routine clinical use of bedside or rapid measurement of human milk contents still lack of evidence and should not be recommended. Key words: Milk, human; Proteins; Carbohydrates; Spectrophotometry
{"title":"Limitations in clinical application of rapid measurements of macronutrients in human milk","authors":"Jianxing Zhu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.003","url":null,"abstract":"Rapid measurements of macronutrients in human milk by infrared spectroscopy, particularly widely used mid-infrared at bed side, is undergoing rapid development in recent years. A recent published systematic review showed that the accurate rate of infrared spectroscopy for protein and fat measurement was only between 60% and 70%, while for carbohydrate/lactose was inconclusive. As for domestic used digital ultrasound techniques, only few studies were published based on small sample size and thus it is difficult to evaluate the results. The storage, temperature and container for milk samples may also affect the results. As individual human milk contents vary during the whole lactation period resulting in the instability of all contents, one single or few samples might not be representative. The proposed individualized fortification based on rapid measurement of human milk has failed to ensure a better growth though it might be true that the analysis made less error in determining the volume of fortifier. We concluded that routine clinical use of bedside or rapid measurement of human milk contents still lack of evidence and should not be recommended. \u0000 \u0000 \u0000Key words: \u0000Milk, human; Proteins; Carbohydrates; Spectrophotometry","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"441-444"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43055404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-07-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.07.010
Fang Ye, Hong Lin, Fang Liu, Jie Chen, Kundi Wang, Qi Zhang
Breastfeeding, as the optimal feeding pattern, ensures the physical, neurological and psychological growth and development of infants. Professional evaluation of breastfeeding with assessment tools facilitates identifying critical influencing factors and providing specific guidance and health education. This review summarized the breastfeeding assessment tools at home and abroad to provide reference for clinical practice and research. Key words: Breast feeding; Psychiatric status rating scales
{"title":"A review of breastfeeding assessment tools","authors":"Fang Ye, Hong Lin, Fang Liu, Jie Chen, Kundi Wang, Qi Zhang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.07.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.07.010","url":null,"abstract":"Breastfeeding, as the optimal feeding pattern, ensures the physical, neurological and psychological growth and development of infants. Professional evaluation of breastfeeding with assessment tools facilitates identifying critical influencing factors and providing specific guidance and health education. This review summarized the breastfeeding assessment tools at home and abroad to provide reference for clinical practice and research. \u0000 \u0000 \u0000Key words: \u0000Breast feeding; Psychiatric status rating scales","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"479-484"},"PeriodicalIF":0.0,"publicationDate":"2019-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46585740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.06.006
Boya Li
Labor management is crucial in providing safe delivery care and avoiding the first cesarean section. In 2014, the Obstetrics and Gynecology Branch of Chinese Medical Association updated the guideline on new labor management according to the study results published by Zhang and his colleagues in 2010 based on 62 415 cephalic, singleton pregnant women with spontaneous labor, vaginal delivery and healthy neonatal outcomes. In December 2018, the Labour Progression Study (LaPS), a cluster-randomised controlled trial at 14 obstetric units in Norway, was reported by Bernitz and his colleagues in The Lancet. The primary outcome was the rate of intrapartum caesarean sections (ICSs) in obstetric units using the WHO partograph (control group) or Zhang's partogram (intervention group), which did not show any differences. Here, we discussed the evidence that LaPS provided in reducing the ICSs rate. Key words: Delivery, obstetric; Labor, obstetric
{"title":"Evidence from Labour Progression Study (LaPS) and Zhang's new partogram","authors":"Boya Li","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.06.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.06.006","url":null,"abstract":"Labor management is crucial in providing safe delivery care and avoiding the first cesarean section. In 2014, the Obstetrics and Gynecology Branch of Chinese Medical Association updated the guideline on new labor management according to the study results published by Zhang and his colleagues in 2010 based on 62 415 cephalic, singleton pregnant women with spontaneous labor, vaginal delivery and healthy neonatal outcomes. In December 2018, the Labour Progression Study (LaPS), a cluster-randomised controlled trial at 14 obstetric units in Norway, was reported by Bernitz and his colleagues in The Lancet. The primary outcome was the rate of intrapartum caesarean sections (ICSs) in obstetric units using the WHO partograph (control group) or Zhang's partogram (intervention group), which did not show any differences. Here, we discussed the evidence that LaPS provided in reducing the ICSs rate. \u0000 \u0000 \u0000Key words: \u0000Delivery, obstetric; Labor, obstetric","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"400-402"},"PeriodicalIF":0.0,"publicationDate":"2019-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42625903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.06.010
Wen Jiang, Li-Ping Chen, Lijun Yi, Hong Li, Lin Yang, Bingbing Wu
This paper reported the diagnosis and treatment of two neonates with Kabuki syndrome (KS). Neither of them had typical facial features of KS during the neonatal period, but poor response, abnormal appearance and multiple organ dysplasia were observed in both. Case 1 was lost to follow up after discharge, while typical KS facial features were gradually appeared in Case 2 including eversion of lower lateral eyelids, arched eyebrows, sparse eyebrow arch, flattened nasal tip, prominent ears, during a three-month follow-up after birth. Next-generation sequencing revealed that both neonates were KS caused by lysine methyltransferase 2D (KMT2D) gene mutation, of which case 1 had a heterozygous deletion mutation of c.13895delC (p.P4632HfsTer8) in KMT2D gene, while case 2 had a heterozygous repeat mutation of c.12809dupA (p.T4271Dfs*63) in KMT2D gene. Both cases were defined as de novo mutations and the one carried by case 2 was a newly discovered pathogenic mutation. Key words: Abnormalities, multiple; Face; Hematologic diseases; Vestibular diseases; DNA-binding proteins; Neoplasm proteins; Infant, newborn
{"title":"Neonatal Kabuki syndrome: a report of two cases","authors":"Wen Jiang, Li-Ping Chen, Lijun Yi, Hong Li, Lin Yang, Bingbing Wu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.06.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.06.010","url":null,"abstract":"This paper reported the diagnosis and treatment of two neonates with Kabuki syndrome (KS). Neither of them had typical facial features of KS during the neonatal period, but poor response, abnormal appearance and multiple organ dysplasia were observed in both. Case 1 was lost to follow up after discharge, while typical KS facial features were gradually appeared in Case 2 including eversion of lower lateral eyelids, arched eyebrows, sparse eyebrow arch, flattened nasal tip, prominent ears, during a three-month follow-up after birth. Next-generation sequencing revealed that both neonates were KS caused by lysine methyltransferase 2D (KMT2D) gene mutation, of which case 1 had a heterozygous deletion mutation of c.13895delC (p.P4632HfsTer8) in KMT2D gene, while case 2 had a heterozygous repeat mutation of c.12809dupA (p.T4271Dfs*63) in KMT2D gene. Both cases were defined as de novo mutations and the one carried by case 2 was a newly discovered pathogenic mutation. \u0000 \u0000 \u0000Key words: \u0000Abnormalities, multiple; Face; Hematologic diseases; Vestibular diseases; DNA-binding proteins; Neoplasm proteins; Infant, newborn","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"424-428"},"PeriodicalIF":0.0,"publicationDate":"2019-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47870880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-06-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.06.007
Yan Lyu, Yu-lin Jiang, Xiya Zhou, J. Bai, Ning Li, Mingming Wang, Wei Zhang, H. Meng, Zhong-hui Xu, Y. Ouyang, N. Hao, Juntao Liu, Q. Qi
Objective To investigate the prenatal diagnosis and genetic counseling of fetal nuchal fold (NF) thickening. Methods This study retrospectively analyzed 17 fetuses with increased NF detected by prenatal ultrasound examination in Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences from December 1, 2016 to December 1, 2017. All cases were divided into isolated (isolated group) or non-isolated increased NF group (non-isolated group) according to whether the fetus had concomitant ultrasonographic abnormalities or not. Karyotype and chromosomal microarray analysis (CMA) were performed on all cases. Clinical data, prenatal genetic testing results and pregnancy outcomes were analyzed. Results Of those twelve cases in the isolated group, two were terminated due to the identification of chromosomal abnormalities and pathogenic copy number variations (CNVs) and the fetal autopsy results were consistent with the prenatal diagnosis. The rest 10 pregnancies were all continued including one fetus carrying a variant of unknown significance, which was proved to be a paternal heredity by CMA, and nine without genetic abnormalities and all-these infants were healthy during follow-up. Among the five non-isolated cases, one was diagnosed as trisomy 21 by karyotyping and CMA, and the other four were found to have structural abnormalities under ultrasound scan, but without genetic abnormalities in karyotyping and CMA. And all the five pregnancies were terminated after genetic counseling and three of them chose whole exome sequencing (WES) for further test. One homozygous mutation in CHRNA1 gene and one de novo mutation in SETD2 gene were found in two cases, respectively, while no abnormality was identified in the other one case. Conclusions Once increased NF were indicated by ultrasound examination, prenatal genetic testing should be offered to the patients, including CMA, regardless of other ultrasonographic abnormalities, and WES should also be offered when necessary. Considering a thickened NF is associated with increased risks of structural defects, a close follow-up with fetal echocardiography and ultrasound is required even the prenatal tests are normal. Key words: Nuchal translucency measurement; Ultrasonography, prenatal; Chromosome aberrations
{"title":"Prenatal diagnosis of fetal nuchal fold thickening: a retrospective study of 17 cases","authors":"Yan Lyu, Yu-lin Jiang, Xiya Zhou, J. Bai, Ning Li, Mingming Wang, Wei Zhang, H. Meng, Zhong-hui Xu, Y. Ouyang, N. Hao, Juntao Liu, Q. Qi","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.06.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.06.007","url":null,"abstract":"Objective \u0000To investigate the prenatal diagnosis and genetic counseling of fetal nuchal fold (NF) thickening. \u0000 \u0000 \u0000Methods \u0000This study retrospectively analyzed 17 fetuses with increased NF detected by prenatal ultrasound examination in Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences from December 1, 2016 to December 1, 2017. All cases were divided into isolated (isolated group) or non-isolated increased NF group (non-isolated group) according to whether the fetus had concomitant ultrasonographic abnormalities or not. Karyotype and chromosomal microarray analysis (CMA) were performed on all cases. Clinical data, prenatal genetic testing results and pregnancy outcomes were analyzed. \u0000 \u0000 \u0000Results \u0000Of those twelve cases in the isolated group, two were terminated due to the identification of chromosomal abnormalities and pathogenic copy number variations (CNVs) and the fetal autopsy results were consistent with the prenatal diagnosis. The rest 10 pregnancies were all continued including one fetus carrying a variant of unknown significance, which was proved to be a paternal heredity by CMA, and nine without genetic abnormalities and all-these infants were healthy during follow-up. Among the five non-isolated cases, one was diagnosed as trisomy 21 by karyotyping and CMA, and the other four were found to have structural abnormalities under ultrasound scan, but without genetic abnormalities in karyotyping and CMA. And all the five pregnancies were terminated after genetic counseling and three of them chose whole exome sequencing (WES) for further test. One homozygous mutation in CHRNA1 gene and one de novo mutation in SETD2 gene were found in two cases, respectively, while no abnormality was identified in the other one case. \u0000 \u0000 \u0000Conclusions \u0000Once increased NF were indicated by ultrasound examination, prenatal genetic testing should be offered to the patients, including CMA, regardless of other ultrasonographic abnormalities, and WES should also be offered when necessary. Considering a thickened NF is associated with increased risks of structural defects, a close follow-up with fetal echocardiography and ultrasound is required even the prenatal tests are normal. \u0000 \u0000 \u0000Key words: \u0000Nuchal translucency measurement; Ultrasonography, prenatal; Chromosome aberrations","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"403-411"},"PeriodicalIF":0.0,"publicationDate":"2019-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49292668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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