Pub Date : 2019-12-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.12.003
Peng Tu, Xiao-Mei Gu, Xiaohang Zhang, Hongmei Dong, Xue-mei Zhang, Yun Lin, Yihua He, S. Ran
Objective To analyze the feasibility of prenatal ultrasound quantitative measurement of the angles between trachea and bilateral bronchi as a new diagnostic tool for fetuses with heterotaxy syndrome. Methods The angles between trachea and bilateral bronchi were measured at 18-34+6 gestational weeks for 200 fetuses with normal ultrasound findings (normal group) and 41 fetuses with heterotaxy syndrome [35 right atrial isomerisms (right group) and six left atrial isomerisms (left group)] diagnosed by ultrasound and confirmed after abortion or induction (case group) in Chongqing Health Center for Women and Children from October 2015 to December 2018. Scatter plots of left/right bronchus angle (α/β) ratios were drawn. Differences in bilateral bronchus angles between the three groups were statistically analyzed using one-way analysis of variance and paired t-test. Results In the normal group, scatter plots showed the α/β ratios were relatively constant at 0.8-1.0 with larger β than α (t=-33.14, P 0.05] and presented as bilateral right bronchial angle; in the left group, the β value decreased and was close to the α value [(147.38±3.16)° vs (148.82±5.56)°, t=-1.18, P>0.05] and presented as bilateral left bronchial angle. There were significant differences in the α and β values among the normal group, the right and left groups (all P<0.05), and the bronchial angles of the right group were both greater than those of the left group (all P<0.05). Conclusions Prenatal ultrasound measurement of the angles between trachea and bilateral bronchi can be used as an indirect indicator for the diagnosis of heterotaxy syndrome. Key words: Heterotaxy syndrome; Ultrasonography, prenatal; Trachea; Bronchi
{"title":"Feasibility of quantitative measurement of fetal trachea and bilateral bronchial angles by ultrasound to diagnose heterotaxy syndrome in middle and late pregnancy","authors":"Peng Tu, Xiao-Mei Gu, Xiaohang Zhang, Hongmei Dong, Xue-mei Zhang, Yun Lin, Yihua He, S. Ran","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.12.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.12.003","url":null,"abstract":"Objective \u0000To analyze the feasibility of prenatal ultrasound quantitative measurement of the angles between trachea and bilateral bronchi as a new diagnostic tool for fetuses with heterotaxy syndrome. \u0000 \u0000 \u0000Methods \u0000The angles between trachea and bilateral bronchi were measured at 18-34+6 gestational weeks for 200 fetuses with normal ultrasound findings (normal group) and 41 fetuses with heterotaxy syndrome [35 right atrial isomerisms (right group) and six left atrial isomerisms (left group)] diagnosed by ultrasound and confirmed after abortion or induction (case group) in Chongqing Health Center for Women and Children from October 2015 to December 2018. Scatter plots of left/right bronchus angle (α/β) ratios were drawn. Differences in bilateral bronchus angles between the three groups were statistically analyzed using one-way analysis of variance and paired t-test. \u0000 \u0000 \u0000Results \u0000In the normal group, scatter plots showed the α/β ratios were relatively constant at 0.8-1.0 with larger β than α (t=-33.14, P 0.05] and presented as bilateral right bronchial angle; in the left group, the β value decreased and was close to the α value [(147.38±3.16)° vs (148.82±5.56)°, t=-1.18, P>0.05] and presented as bilateral left bronchial angle. There were significant differences in the α and β values among the normal group, the right and left groups (all P<0.05), and the bronchial angles of the right group were both greater than those of the left group (all P<0.05). \u0000 \u0000 \u0000Conclusions \u0000Prenatal ultrasound measurement of the angles between trachea and bilateral bronchi can be used as an indirect indicator for the diagnosis of heterotaxy syndrome. \u0000 \u0000 \u0000Key words: \u0000Heterotaxy syndrome; Ultrasonography, prenatal; Trachea; Bronchi","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"844-848"},"PeriodicalIF":0.0,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47268492","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 : 2019-12-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.12.012
Siwei Luo
Large population-based cohort studies conducted in the industrialized countries in different eras revealed that the use of antenatal corticosteroids for extremely preterm births (EPT, <28 gestational weeks) reached 60% or higher in the mid-1990s, accompanying by steadily declined perinatal mortality to 13%-22% in EPT with gestational age ≥25 weeks in developed countries. Notably, the survival rate of EPT with 23-24 weeks of gestation was over 50% in Sweden since 2005. There's a link between the increment of antenatal corticosteroids use and steady decline of mortality in EPT in the past three decades. High-quality evidence is needed to demonstrate the impact of antenatal corticosteroids on EPT perinatal outcomes under the current healthcare background in China. This review, focusing on the progression of antenatal corticosteroid treatment for EPT, may facilitate the quality improvement of maternal-fetal and infant healthcare in China. Key words: Glucocorticoids; Infant, extremely premature; Peripartum period; Prognosis
{"title":"Advances in antenatal corticosteroids for improving perinatal outcomes of extremely preterm infants","authors":"Siwei Luo","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.12.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.12.012","url":null,"abstract":"Large population-based cohort studies conducted in the industrialized countries in different eras revealed that the use of antenatal corticosteroids for extremely preterm births (EPT, <28 gestational weeks) reached 60% or higher in the mid-1990s, accompanying by steadily declined perinatal mortality to 13%-22% in EPT with gestational age ≥25 weeks in developed countries. Notably, the survival rate of EPT with 23-24 weeks of gestation was over 50% in Sweden since 2005. There's a link between the increment of antenatal corticosteroids use and steady decline of mortality in EPT in the past three decades. High-quality evidence is needed to demonstrate the impact of antenatal corticosteroids on EPT perinatal outcomes under the current healthcare background in China. This review, focusing on the progression of antenatal corticosteroid treatment for EPT, may facilitate the quality improvement of maternal-fetal and infant healthcare in China. \u0000 \u0000 \u0000Key words: \u0000Glucocorticoids; Infant, extremely premature; Peripartum period; Prognosis","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"899-903"},"PeriodicalIF":0.0,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41949131","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 : 2019-12-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.12.007
Qiu-lan Yang, Min Song, Qian Sun, Xiang Wang, Aiqin Han
Objective To analyze the clinical characteristics of streptococcal toxic shock syndrome (STSS) caused by Streptococcus pyogenes (S. pyogenes) in the third trimester to improve clinical awareness of this disease. Methods A retrospective study was conducted to analyze the clinical data of two patients with STSS caused by S. pyogenes in Jinan Maternal and Child Health Care Hospital and nine reported cases of healthy pregnant women infected with S. pyogenes at 28-42 gestational weeks with detailed data retrieved from Chinese National Knowledge Infrastructure and PubMed database from January 1997 to December 2018. Results The two cases admitted to our hospital were both multiparas, with onset in winter and no specific symptoms in early stage. Disseminated intravascular coagulation (DIC) was developed in both cases on admission. In one case, the fetal heart rate was reduced and disappeared soon after admission. The other patient was diagnosed as stillbirth on admission. Both patients died and blood culture revealed infection of group A streptococcus. Nine previous cases were reported in one Chinese and five English articles. No high-risk pregnancy or premature rupture of membranes was reported in these 11 cases. Among the 11 cases, ten were positive for S. pyogenes indicated by blood or tissue culture and one was positive for streptococcal toxin. Ten cases had high fever and three presented with respiratory symptoms in early stage. Abdominal pain and watery diarrhea were common symptoms and all patients developed multiple organ dysfunction and DIC. Cases occurred in winter or spring were more common. Nine women died within 36 h after the onset of fulminant symptoms. Only two survived and hospitalized for 90 d and 25 d, respectively, after emergent cesarean section indicated by reduced fetal heart rate. Unfortunately, both neonates died after birth. For the babies, there were seven intrauterine fetal deaths, one stillbirth and three live births, but only one survived (whose mother developed respiratory cardiac arrest 90 min after delivery). Conclusions STSS caused by S. pyogenes in pregnant women exacerbates rapidly with a high mortality. Early identification of clinical manifestations and rapid progress of the disease are crucial for early diagnosis and treatment, which may help improve maternal and fetal outcomes. Key words: Shock, septic; Streptococcal infections; Streptococcus pyogenes; Pregnancy trimester, third
{"title":"Streptococcal toxic shock syndrome in third trimester: a report of two cases and literature review","authors":"Qiu-lan Yang, Min Song, Qian Sun, Xiang Wang, Aiqin Han","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.12.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.12.007","url":null,"abstract":"Objective \u0000To analyze the clinical characteristics of streptococcal toxic shock syndrome (STSS) caused by Streptococcus pyogenes (S. pyogenes) in the third trimester to improve clinical awareness of this disease. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted to analyze the clinical data of two patients with STSS caused by S. pyogenes in Jinan Maternal and Child Health Care Hospital and nine reported cases of healthy pregnant women infected with S. pyogenes at 28-42 gestational weeks with detailed data retrieved from Chinese National Knowledge Infrastructure and PubMed database from January 1997 to December 2018. \u0000 \u0000 \u0000Results \u0000The two cases admitted to our hospital were both multiparas, with onset in winter and no specific symptoms in early stage. Disseminated intravascular coagulation (DIC) was developed in both cases on admission. In one case, the fetal heart rate was reduced and disappeared soon after admission. The other patient was diagnosed as stillbirth on admission. Both patients died and blood culture revealed infection of group A streptococcus. Nine previous cases were reported in one Chinese and five English articles. No high-risk pregnancy or premature rupture of membranes was reported in these 11 cases. Among the 11 cases, ten were positive for S. pyogenes indicated by blood or tissue culture and one was positive for streptococcal toxin. Ten cases had high fever and three presented with respiratory symptoms in early stage. Abdominal pain and watery diarrhea were common symptoms and all patients developed multiple organ dysfunction and DIC. Cases occurred in winter or spring were more common. Nine women died within 36 h after the onset of fulminant symptoms. Only two survived and hospitalized for 90 d and 25 d, respectively, after emergent cesarean section indicated by reduced fetal heart rate. Unfortunately, both neonates died after birth. For the babies, there were seven intrauterine fetal deaths, one stillbirth and three live births, but only one survived (whose mother developed respiratory cardiac arrest 90 min after delivery). \u0000 \u0000 \u0000Conclusions \u0000STSS caused by S. pyogenes in pregnant women exacerbates rapidly with a high mortality. Early identification of clinical manifestations and rapid progress of the disease are crucial for early diagnosis and treatment, which may help improve maternal and fetal outcomes. \u0000 \u0000 \u0000Key words: \u0000Shock, septic; Streptococcal infections; Streptococcus pyogenes; Pregnancy trimester, third","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"872-877"},"PeriodicalIF":0.0,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47925398","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 : 2019-12-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.12.006
Ling-ying Kong, Huixia Yang
Objective To investigate the changes of coagulation indexes in normal pregnant women in early and late pregnancy. Methods The coagulation indexes in early and late pregnancy including activated partial thromboplastin time (APTT), APTT ratio, prothrombin time (PT), PT ratio, prothrombin activity, international normalized ratio, fibrinogen (Fib) and thrombin time (TT) were retrospectively collected from 196 normal pregnant women delivered in Peking University First Hospital from August 2013 to September 2014. Differences in these indexes before and after the seventh gestational week of early pregnancy and in early and late pregnancy were compared. In addition, the normal reference values were calculated. Paired t test and sum-rank test were used for statistical analysis. The reference values were presented with P2.5-P97.5. Results In early pregnancy, some coagulation indexes after the seventh weeks were shorter than those before, such as APTT [30.3 (26.1-35.5) vs 32.1 (27.9-36.8) s, Z=25.850, P<0.001] and TT [13.8 (12.2-16.0) vs 14.5 (12.3-16.4) s, Z=16.720, P<0.001], but Fib [3.3 (2.5-4.3) vs 2.9 (2.2-3.8) g/L, Z=43.180, P<0.001] became higher. APTT [(27.5±1.6) vs (31.4±2.4) s, t=24.736, P<0.001], PT [(9.7±0.5) vs (11.0±0.8) s, t=18.647, P<0.001] and TT [(13.3±0.8) vs (14.2±1.0) s, t=9.255, P<0.001] were significantly shorter, while Fib [(4.4±0.5) vs (3.1±0.4) g/L, t=-29.152, P<0.001] was higher in late pregnancy than in early pregnancy. The reference values of APTT, PT, Fib and TT in early pregnancy were 26.5-36.0 s, 9.4-12.4 s, 2.4-4.0 g/L and 12.3-16.4 s, and those in late pregnancy were 25.0-31.2 s, 8.8-10.6 s, 3.4-5.4 g/L and 12.0-14.9 s, respectively. Conclusions The coagulation indexes of pregnant women change significantly since the beginning of early pregnancy. APTT, PT and TT are shorter, while Fib is higher in late pregnancy than in early pregnancy. Key words: Partial thromboplastin time; Prothrombin time; Thrombin time; Fibrinogen; Pregnancy trimester, first; Pregnancy trimester, third
{"title":"Variations of coagulation biochemical markers in normal pregnant women in early and late pregnancy","authors":"Ling-ying Kong, Huixia Yang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.12.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.12.006","url":null,"abstract":"Objective \u0000To investigate the changes of coagulation indexes in normal pregnant women in early and late pregnancy. \u0000 \u0000 \u0000Methods \u0000The coagulation indexes in early and late pregnancy including activated partial thromboplastin time (APTT), APTT ratio, prothrombin time (PT), PT ratio, prothrombin activity, international normalized ratio, fibrinogen (Fib) and thrombin time (TT) were retrospectively collected from 196 normal pregnant women delivered in Peking University First Hospital from August 2013 to September 2014. Differences in these indexes before and after the seventh gestational week of early pregnancy and in early and late pregnancy were compared. In addition, the normal reference values were calculated. Paired t test and sum-rank test were used for statistical analysis. The reference values were presented with P2.5-P97.5. \u0000 \u0000 \u0000Results \u0000In early pregnancy, some coagulation indexes after the seventh weeks were shorter than those before, such as APTT [30.3 (26.1-35.5) vs 32.1 (27.9-36.8) s, Z=25.850, P<0.001] and TT [13.8 (12.2-16.0) vs 14.5 (12.3-16.4) s, Z=16.720, P<0.001], but Fib [3.3 (2.5-4.3) vs 2.9 (2.2-3.8) g/L, Z=43.180, P<0.001] became higher. APTT [(27.5±1.6) vs (31.4±2.4) s, t=24.736, P<0.001], PT [(9.7±0.5) vs (11.0±0.8) s, t=18.647, P<0.001] and TT [(13.3±0.8) vs (14.2±1.0) s, t=9.255, P<0.001] were significantly shorter, while Fib [(4.4±0.5) vs (3.1±0.4) g/L, t=-29.152, P<0.001] was higher in late pregnancy than in early pregnancy. The reference values of APTT, PT, Fib and TT in early pregnancy were 26.5-36.0 s, 9.4-12.4 s, 2.4-4.0 g/L and 12.3-16.4 s, and those in late pregnancy were 25.0-31.2 s, 8.8-10.6 s, 3.4-5.4 g/L and 12.0-14.9 s, respectively. \u0000 \u0000 \u0000Conclusions \u0000The coagulation indexes of pregnant women change significantly since the beginning of early pregnancy. APTT, PT and TT are shorter, while Fib is higher in late pregnancy than in early pregnancy. \u0000 \u0000 \u0000Key words: \u0000Partial thromboplastin time; Prothrombin time; Thrombin time; Fibrinogen; Pregnancy trimester, first; Pregnancy trimester, third","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"867-871"},"PeriodicalIF":0.0,"publicationDate":"2019-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45471066","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.007
Xiaoyang Wang, Junge Zhao, Shengling Li, Y. Qiu, Cai-jiang Sun, Qin Liu
Objective To explore the influence of early essential newborn care(EENC) on the development of omphalitis in preterm infants following normal delivery. Methods A total of 184 preterm infants, admitted to General Hospital of Ningxia Medical University from January 2017 to December 2017, were retrospectively collected as EENC group. During the same period, 161 preterm infants who were born in Yinchuan Maternal and Child Health Hospital were included in the control group. Preterm infants in EENC group were managed based on the clinical practice guideline of "Early Essential Newborn Care", while those in the control group underwent routine care after birth. The incidence of omphalitis between the two groups were compared using independent-samples t test and Chi-square test. Influencing factors of omphalitis were analyzed using univariate analysis and multivariate logistic regression analysis. Results The incidence of mild omphalitis was lower [5.4% (10/184) vs 11.8% (19/161), χ2=4.520, P<0.05], and the separation and drying up time of cord stump were both earlier in the EENC group than those in the control group [(5.5±1.5) vs (8.2±1.2) d, t=4.169; (2.6±1.4) vs (3.2±1.4) d, t=4.513; both P<0.05]. Logistic regression analysis showed that gestational age≤34 weeks (OR=1.885, 95%CI: 1.109-6.757, P=0.032), early umbilical cord clamping (OR=3.615, 95%CI: 1.372-9.381, P=0.001) and bandaging of the umbilical stump (OR=1.921, 95%CI: 1.257-11.893, P=0.035) were independent risk factors of omphalitis in preterm infants. Conclusions Umbilical cord treatment based on EENC could reduce the incidence of omphalitis by avoiding its risk factors in preterm infants following normal delivery. Key words: Infant, premature; Umbilicus; Inflammation; Umbilical cord; Constriction; Neonatal nursing
{"title":"Effect of early essential newborn care on omphalitis in vaginally born preterm infants","authors":"Xiaoyang Wang, Junge Zhao, Shengling Li, Y. Qiu, Cai-jiang Sun, Qin Liu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.007","url":null,"abstract":"Objective \u0000To explore the influence of early essential newborn care(EENC) on the development of omphalitis in preterm infants following normal delivery. \u0000 \u0000 \u0000Methods \u0000A total of 184 preterm infants, admitted to General Hospital of Ningxia Medical University from January 2017 to December 2017, were retrospectively collected as EENC group. During the same period, 161 preterm infants who were born in Yinchuan Maternal and Child Health Hospital were included in the control group. Preterm infants in EENC group were managed based on the clinical practice guideline of \"Early Essential Newborn Care\", while those in the control group underwent routine care after birth. The incidence of omphalitis between the two groups were compared using independent-samples t test and Chi-square test. Influencing factors of omphalitis were analyzed using univariate analysis and multivariate logistic regression analysis. \u0000 \u0000 \u0000Results \u0000The incidence of mild omphalitis was lower [5.4% (10/184) vs 11.8% (19/161), χ2=4.520, P<0.05], and the separation and drying up time of cord stump were both earlier in the EENC group than those in the control group [(5.5±1.5) vs (8.2±1.2) d, t=4.169; (2.6±1.4) vs (3.2±1.4) d, t=4.513; both P<0.05]. Logistic regression analysis showed that gestational age≤34 weeks (OR=1.885, 95%CI: 1.109-6.757, P=0.032), early umbilical cord clamping (OR=3.615, 95%CI: 1.372-9.381, P=0.001) and bandaging of the umbilical stump (OR=1.921, 95%CI: 1.257-11.893, P=0.035) were independent risk factors of omphalitis in preterm infants. \u0000 \u0000 \u0000Conclusions \u0000Umbilical cord treatment based on EENC could reduce the incidence of omphalitis by avoiding its risk factors in preterm infants following normal delivery. \u0000 \u0000 \u0000Key words: \u0000Infant, premature; Umbilicus; Inflammation; Umbilical cord; Constriction; Neonatal nursing","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"797-801"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49147473","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.003
Jinjing Zhang, Yajuan Wang
Objective To evaluate the performance of multiplex polymerase chain reaction-based reverse line blot hybridization (mPCR/RLB) in the detection of pathogens causing neonatal bacterial meningitis and associated drug resistance genes. Methods Clinical data and cerebrospinal fluid (CSF) samples were collected retrospectively from 80 cases diagnosed with neonatal bacterial meningitis in Beijing Children's Hospital from January 1, 2012 to December 31, 2018. A total of 100 CSF samples were obtained including 80 samples collected after admission (12 before and 68 after antibiotic treatment) and 20 recollected at follow-up. All CSF samples were analyzed by conventional culture, susceptibility test and mPCR/RLB. Differences in the detection of pathogens and drug resistance genes were analyzed by Chi-square test. Results (1) Among the 80 first-collected CSF samples, mPCR/RLB revealed significantly higher positive rate than conventional culture [26.3% (21/80) vs 7.5% (6/80), χ2=10.025, P=0.002]. No significant difference was showed between the two methods in analyzing the 12 samples collected before antibiotic therapy (9/12 vs 5/12, χ2=1.543, P=0.214), while the positive rate in 68 samples collected after antibiotic intervention detected by mPCR/RLB was obviously higher than that by conventional culture [17.6% (12/68) vs 1.5% (1/68), χ2=13.176, P<0.001]. (2) Conventional culture results of the 20 samples collected during follow-up were all negative, but four were positive using mPCR/RLB, which were also positive previously. Furthermore, the results of both methods in previous detections were identical. (3) According to the conventional culture results, the pathogens were Escherichia coli (three cases), Group B Streptococcus (two cases) and Listeria monocytogenes (one case), while mPCR/RLB detected Escherichia coli (four cases), Group B Streptococcus (five cases), Listeria monocytogenes (four cases), Neisseria meningitidis (four cases), Haemophilus influenzae b (one case), Gram-negative bacteria (one case), Gram-positive bacteria (one case), and Listeria monocytogenes and Haemophilus influenzae b coinfection (one case) in 80 first-collected CSF samples. (4) Antibiotic susceptibility test showed that one Escherichia coli strain produced extended spectrum beta-lactamases. Drug resistance gene detection by mPCR/RLB showed that acrA, acrB, CTX-M (consistent with antibiotic susseptibility test) and TetM genes were positive in three, two, one and one case, respectively. Conclusions mPCR/RLB is of great clinical value due to its higher detection rate and better accuracy compared with bacterial culture and can also detect drug resistance genes. Key words: Meningitis, bacterial; beta-Lactamases; Multiplex polymerase chain reaction; Nucleic acid hybridization; Drug resistance, bacterial; Infant, newborn
{"title":"Multiplex polymerase chain reaction-based reverse line blot hybridization to detect pathogens causing neonatal bacterial meningitis and relevant drug resistance genes","authors":"Jinjing Zhang, Yajuan Wang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.003","url":null,"abstract":"Objective \u0000To evaluate the performance of multiplex polymerase chain reaction-based reverse line blot hybridization (mPCR/RLB) in the detection of pathogens causing neonatal bacterial meningitis and associated drug resistance genes. \u0000 \u0000 \u0000Methods \u0000Clinical data and cerebrospinal fluid (CSF) samples were collected retrospectively from 80 cases diagnosed with neonatal bacterial meningitis in Beijing Children's Hospital from January 1, 2012 to December 31, 2018. A total of 100 CSF samples were obtained including 80 samples collected after admission (12 before and 68 after antibiotic treatment) and 20 recollected at follow-up. All CSF samples were analyzed by conventional culture, susceptibility test and mPCR/RLB. Differences in the detection of pathogens and drug resistance genes were analyzed by Chi-square test. \u0000 \u0000 \u0000Results \u0000(1) Among the 80 first-collected CSF samples, mPCR/RLB revealed significantly higher positive rate than conventional culture [26.3% (21/80) vs 7.5% (6/80), χ2=10.025, P=0.002]. No significant difference was showed between the two methods in analyzing the 12 samples collected before antibiotic therapy (9/12 vs 5/12, χ2=1.543, P=0.214), while the positive rate in 68 samples collected after antibiotic intervention detected by mPCR/RLB was obviously higher than that by conventional culture [17.6% (12/68) vs 1.5% (1/68), χ2=13.176, P<0.001]. (2) Conventional culture results of the 20 samples collected during follow-up were all negative, but four were positive using mPCR/RLB, which were also positive previously. Furthermore, the results of both methods in previous detections were identical. (3) According to the conventional culture results, the pathogens were Escherichia coli (three cases), Group B Streptococcus (two cases) and Listeria monocytogenes (one case), while mPCR/RLB detected Escherichia coli (four cases), Group B Streptococcus (five cases), Listeria monocytogenes (four cases), Neisseria meningitidis (four cases), Haemophilus influenzae b (one case), Gram-negative bacteria (one case), Gram-positive bacteria (one case), and Listeria monocytogenes and Haemophilus influenzae b coinfection (one case) in 80 first-collected CSF samples. (4) Antibiotic susceptibility test showed that one Escherichia coli strain produced extended spectrum beta-lactamases. Drug resistance gene detection by mPCR/RLB showed that acrA, acrB, CTX-M (consistent with antibiotic susseptibility test) and TetM genes were positive in three, two, one and one case, respectively. \u0000 \u0000 \u0000Conclusions \u0000mPCR/RLB is of great clinical value due to its higher detection rate and better accuracy compared with bacterial culture and can also detect drug resistance genes. \u0000 \u0000 \u0000Key words: \u0000Meningitis, bacterial; beta-Lactamases; Multiplex polymerase chain reaction; Nucleic acid hybridization; Drug resistance, bacterial; Infant, newborn","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"774-780"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43830408","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.008
Qu Xiaoxing, Y. Meizhen, Zhang Yun, Z. Jia, X. Ya, Zhou Fenhe, Sun Luming
We hereby reported a fetus with abnormal head shape, ventricular septal defect, gallbladder enlargement, low-set ears and local umbilical cord glial edema at 22 and 25 weeks of gestation ultrasound scan. A 15.318 Mb heterozygous microdeletion on chromosome 1p32.1p31.1, arr[GRCh37]1p32.1p31.1(61,279,239-76,597,189)×1, was indentified by chromosomal microarray analysis. The chromosome karyotype of the fetus was 46,XY,del(1)(p32.1p31.1). Therefore, this case was diagnosed as 1p32p31 microdeletion syndrome and proved to be a de novo variation based on routine G-banding analysis and chromosomal microarray analysis of the normal parents. This syndrome might present with abnormalities in the head shape, kidney, bladder and central nervous system. The couple decided to terminate the pregnancy after genetic counseling concerning the possible poor outcomes of the fetus. Key words: Chromosome deletion; Chromosomes, human, pair 1; Prenatal diagnosis
{"title":"Prenatal diagnosis of fetal 1p32p31 microdeletion syndrome: a case report","authors":"Qu Xiaoxing, Y. Meizhen, Zhang Yun, Z. Jia, X. Ya, Zhou Fenhe, Sun Luming","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.008","url":null,"abstract":"We hereby reported a fetus with abnormal head shape, ventricular septal defect, gallbladder enlargement, low-set ears and local umbilical cord glial edema at 22 and 25 weeks of gestation ultrasound scan. A 15.318 Mb heterozygous microdeletion on chromosome 1p32.1p31.1, arr[GRCh37]1p32.1p31.1(61,279,239-76,597,189)×1, was indentified by chromosomal microarray analysis. The chromosome karyotype of the fetus was 46,XY,del(1)(p32.1p31.1). Therefore, this case was diagnosed as 1p32p31 microdeletion syndrome and proved to be a de novo variation based on routine G-banding analysis and chromosomal microarray analysis of the normal parents. This syndrome might present with abnormalities in the head shape, kidney, bladder and central nervous system. The couple decided to terminate the pregnancy after genetic counseling concerning the possible poor outcomes of the fetus. \u0000 \u0000 \u0000Key words: \u0000Chromosome deletion; Chromosomes, human, pair 1; Prenatal diagnosis","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"802-807"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45003455","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 To investigate the value of karyotype analysis, bacterial artificial chromosomes-on-beads (BoBs), chromosome microarray analysis (CMA) and fluorescence in situ hybridization (FISH) in the diagnosis of sex chromosome numerical and structural abnormalities. Methods Conventional G-banding staining technique was used to analyze the karyotypes of amniotic fluid cells and parental peripheral blood cells in two pregnancies with prenatal diagnosis indications. Sex chromosome numerical and structural abnormalities were analyzed based on the results of G-banding, BoBs, CMA and FISH. Results The results of G-banding karyotype analysis showed that there were mosaics in amniotic fluid cells collected from both cases. Karyotype of Case A was 45,X[25]/46,X,idic(Y)(q11.2?)[6], and Case B was 45,X[39]/46,X,psu idic(X)(q21.32?)[44]. Parental peripheral blood karyotypes of both families were normal. Prenatal BoBs indicated copy number abnormalities in sex chromosomes (Y chromosome in Case A and X chromosome in Case B). CMA results suggested a 20.1 Mb duplication in Yp11.32q11.222, and a 7.7 Mb deletion in Yq11.222q11.23 in fetus A with possible karyotype of 46,X,idic(Y)(q11.222); for fetus B, a 92.0 Mb duplication in Xp22.33q21.32, and a 63.0 Mb deletion in Xq21.32q28 were detected, and the karyotype might be 46,X,psu idic(X)(q21.32). The mid-term FISH test of amniotic fluid cells showed that 90% of the amniotic cells from Case A were 45,X, and 10% were 46,X,idic(Y)(q11.2); about 38% were 45,X, and 62% were 46,X,psu dic(X)(q21.3) from Case B. Conclusions Numerical and structural abnormalities of sex chromosomes could be accurately diagnosed by combination of several methods including G-banding karyotype analysis, prenatal BoBs, CMA and FISH, which would help to effectively reduce birth defects. Key words: Sex chromosomes; Chimerism; Sex chromosome aberrations; Karyotyping; Chromosomes, artificial, bacterial; Microarray analysis; In situ hybridization, fluorescence
{"title":"Cellular and molecular genetic analysis of sex chromosome chimerism and dicentric isochromosome structural abnormalities: a report of two cases","authors":"Jian Zhang, Yunrong Ma, Xian-ying Lei, Shuang-Yang Zhang, Yuanyuan Liu, Lulu Guo, Shiyu Zheng, Jingjing Pan","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.005","url":null,"abstract":"Objective \u0000To investigate the value of karyotype analysis, bacterial artificial chromosomes-on-beads (BoBs), chromosome microarray analysis (CMA) and fluorescence in situ hybridization (FISH) in the diagnosis of sex chromosome numerical and structural abnormalities. \u0000 \u0000 \u0000Methods \u0000Conventional G-banding staining technique was used to analyze the karyotypes of amniotic fluid cells and parental peripheral blood cells in two pregnancies with prenatal diagnosis indications. Sex chromosome numerical and structural abnormalities were analyzed based on the results of G-banding, BoBs, CMA and FISH. \u0000 \u0000 \u0000Results \u0000The results of G-banding karyotype analysis showed that there were mosaics in amniotic fluid cells collected from both cases. Karyotype of Case A was 45,X[25]/46,X,idic(Y)(q11.2?)[6], and Case B was 45,X[39]/46,X,psu idic(X)(q21.32?)[44]. Parental peripheral blood karyotypes of both families were normal. Prenatal BoBs indicated copy number abnormalities in sex chromosomes (Y chromosome in Case A and X chromosome in Case B). CMA results suggested a 20.1 Mb duplication in Yp11.32q11.222, and a 7.7 Mb deletion in Yq11.222q11.23 in fetus A with possible karyotype of 46,X,idic(Y)(q11.222); for fetus B, a 92.0 Mb duplication in Xp22.33q21.32, and a 63.0 Mb deletion in Xq21.32q28 were detected, and the karyotype might be 46,X,psu idic(X)(q21.32). The mid-term FISH test of amniotic fluid cells showed that 90% of the amniotic cells from Case A were 45,X, and 10% were 46,X,idic(Y)(q11.2); about 38% were 45,X, and 62% were 46,X,psu dic(X)(q21.3) from Case B. \u0000 \u0000 \u0000Conclusions \u0000Numerical and structural abnormalities of sex chromosomes could be accurately diagnosed by combination of several methods including G-banding karyotype analysis, prenatal BoBs, CMA and FISH, which would help to effectively reduce birth defects. \u0000 \u0000 \u0000Key words: \u0000Sex chromosomes; Chimerism; Sex chromosome aberrations; Karyotyping; Chromosomes, artificial, bacterial; Microarray analysis; In situ hybridization, fluorescence","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"787-792"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48781722","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 : 2019-11-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.11.002
Nan Li, Tao Zhang, Y. Qiao, Enqing Liu, Ying Liang, Yue Wang, Hongyan Liu, R. Zheng
Objective To investigate whether rapid weight gain in the first year of life was associated with incidence of overweight and higher blood pressure in small for gestational age (SGA) and appropriate for gestational age (AGA) infants at preschool age. Methods From March 1, 2017 to June 30, 2018, a total of 12 150 children aged six years from 50 municipal kindergartens in Tianjin were enrolled in a cross-sectional survey. Their body weight, height and blood pressure were measured. Body length and weight at birth and one year of age were retrospectively collected. Rapid catch-up growth was defined as the difference of weight-for-height Z-score between one year old and at birth >0.67. The relationship between rapid growth with overweight and blood pressure in SGA and AGA infants at preschool age were analyzed using t test, analysis of variance and Chi-square test. Results At the age of six, children with rapid growth had a higher rate of overweight [28.6% (2 095/7 328) vs 17.5% (842/4 822), t=196.457, P<0.001], and higher systolic blood pressure [(99.4±10.0) vs (98.4±10.1) mmHg (1 mmHg=0.133 kPa), t=29.260, P<0.001] and diastolic blood pressure [(60.0±7.7) vs (59.4±7.8) mmHg, t=16.079, P<0.001] compared with children without rapid growth. SGA children with rapid growth had higher body weight [(21.5±4.4) vs (19.2±3.7) kg, t=3.747, P<0.001], height [(117.4±5.5) vs (114.8±5.4) cm, t=3.557, P<0.001] and systolic blood pressure [(98.4±9.9) vs (95.6±11.2) mmHg, t=2.080, P=0.038] compared with those without. Comparing to AGA children, SGA children had lower overweight rate [17.5% (144/824) vs 24.7% (2 793/11 326), t=21.630, P<0.001] and systolic blood pressure [(98.2±10.0) vs (99.0±10.1) mmHg, t=2.431, P=0.015]. Among the AGA children with rapid growth, 29.8% (1 958/6 564) were overweight. Conclusions Rapid growth in infancy is associated with overweight and higher systolic blood pressure at preschool age. A proper weight gain should be emphasized for both SGA and AGA infants. Key words: Overweight; Blood pressure; Growth; Infant, small for gestational age; Child, preschool
{"title":"Effects of rapid growth on weight and blood pressure in small and appropriate for gestational age infants during preschool period","authors":"Nan Li, Tao Zhang, Y. Qiao, Enqing Liu, Ying Liang, Yue Wang, Hongyan Liu, R. Zheng","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.002","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.002","url":null,"abstract":"Objective \u0000To investigate whether rapid weight gain in the first year of life was associated with incidence of overweight and higher blood pressure in small for gestational age (SGA) and appropriate for gestational age (AGA) infants at preschool age. \u0000 \u0000 \u0000Methods \u0000From March 1, 2017 to June 30, 2018, a total of 12 150 children aged six years from 50 municipal kindergartens in Tianjin were enrolled in a cross-sectional survey. Their body weight, height and blood pressure were measured. Body length and weight at birth and one year of age were retrospectively collected. Rapid catch-up growth was defined as the difference of weight-for-height Z-score between one year old and at birth >0.67. The relationship between rapid growth with overweight and blood pressure in SGA and AGA infants at preschool age were analyzed using t test, analysis of variance and Chi-square test. \u0000 \u0000 \u0000Results \u0000At the age of six, children with rapid growth had a higher rate of overweight [28.6% (2 095/7 328) vs 17.5% (842/4 822), t=196.457, P<0.001], and higher systolic blood pressure [(99.4±10.0) vs (98.4±10.1) mmHg (1 mmHg=0.133 kPa), t=29.260, P<0.001] and diastolic blood pressure [(60.0±7.7) vs (59.4±7.8) mmHg, t=16.079, P<0.001] compared with children without rapid growth. SGA children with rapid growth had higher body weight [(21.5±4.4) vs (19.2±3.7) kg, t=3.747, P<0.001], height [(117.4±5.5) vs (114.8±5.4) cm, t=3.557, P<0.001] and systolic blood pressure [(98.4±9.9) vs (95.6±11.2) mmHg, t=2.080, P=0.038] compared with those without. Comparing to AGA children, SGA children had lower overweight rate [17.5% (144/824) vs 24.7% (2 793/11 326), t=21.630, P<0.001] and systolic blood pressure [(98.2±10.0) vs (99.0±10.1) mmHg, t=2.431, P=0.015]. Among the AGA children with rapid growth, 29.8% (1 958/6 564) were overweight. \u0000 \u0000 \u0000Conclusions \u0000Rapid growth in infancy is associated with overweight and higher systolic blood pressure at preschool age. A proper weight gain should be emphasized for both SGA and AGA infants. \u0000 \u0000 \u0000Key words: \u0000Overweight; Blood pressure; Growth; Infant, small for gestational age; Child, preschool","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"767-773"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48433670","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}
Preconception cohort studies allow us to conduct in-depth investigations on exposures and heath related factors of couples before pregnancy, and to explore the impact on reproductive health of the couples and on short- and long-term health of the offspring. As a critical window into early life, this area has been gradually gaining much attention worldwide. This paper summarized the characteristics of 21 transnational preconception cohort studies with large samples size, to provide information for relevant researchers in China. Emphasis on international cooperation, application of highly efficient data systems or research tools, and long-term longitudinal survey on parents and their offspring are the direction of further preconception cohort researches. Key words: Preconception care; Cohort studies; Prospective studies
{"title":"Transnational preconception cohort studies: a review","authors":"Changqian Wu, Hong Jiang, Yu Zhang, Xiaoying Ma, X. La, X. Qian","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.11.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.11.012","url":null,"abstract":"Preconception cohort studies allow us to conduct in-depth investigations on exposures and heath related factors of couples before pregnancy, and to explore the impact on reproductive health of the couples and on short- and long-term health of the offspring. As a critical window into early life, this area has been gradually gaining much attention worldwide. This paper summarized the characteristics of 21 transnational preconception cohort studies with large samples size, to provide information for relevant researchers in China. Emphasis on international cooperation, application of highly efficient data systems or research tools, and long-term longitudinal survey on parents and their offspring are the direction of further preconception cohort researches. \u0000 \u0000 \u0000Key words: \u0000Preconception care; Cohort studies; Prospective studies","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"822-828"},"PeriodicalIF":0.0,"publicationDate":"2019-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47443732","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：