Pub Date : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.011
Qi Xu, Yi Zhou, D. Huang, Yanjun Chen, Lin-fen Huang
Objective To investigate the value of first-trimester ultrasound parameters in predicting complicated monochorionic diamniotic (MCDA) twins. Methods In this retrospective study, pregnant women diagnosed as MCDA twins by ultrasound in the First Affiliated Hospital of Sun Yat-sen University from January 2013 to January 2018 were recruited and divided into the following four groups: non-complicated MCDA twins group, twin-twin transfusion syndrome (TTTS) group, selective intrauterine growth restriction (sIUGR) group and twin anemia-polycythemia sequence (TAPS) group. Thickness of nuchal translucency (NT), crown-rump length (CRL), umbilical cord insertion (UCI) and ductus venosus (DV) flow at 11-14 weeks of gestation were recorded. The predictive value for complicated MCDA twins was analyzed using t-test, Chi-square (or Fisher's exact) test, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve. Results (1) A total of 430 MCDA twin pregnancies were included in this study with 152 in the TTTS group, 142 in the sIUGR group, seven in the TAPS group and 129 in the normal MCDA twins group. No further analysis was performed on the TAPS group due to the small sample size. (2) NT discordance in twins of the TTTS group was significantly greater than that in the normal MCDA twins group[(21.5±16.0)% vs (14.6±13.5)%, t=-3.533, P<0.001]. The area under ROC curve (AUC) of TTTS predicted by NT discordance was 0.649. Stratified analysis showed that TTTS was best predicted when NT discordance was 20% with the sensitivity of 57.9% and specificity of 70.6%. (3) The sIUGR group had greater discordance in CRL and NT and higher UCI discordance than the normal MCDA twins group [NT: (27.8±21.3)% vs (14.6±13.5)%, t=-5.556, P<0.001; CRL: (8.6±6.9)% vs (5.4±4.4)%, t=-3.144, P=0.002; UCI: 47.9% (68/142) vs 13.9% (18/129), χ2=35.929, P<0.001]. The AUC of sIUGR was 0.675 predicted by NT discordance and 0.649 by CRL discordance. Stratified analysis showed that NT discordance of 20% and CRL discordance of 10% were the best prediction for sIUGR with the sensitivity of 53.1% and 34.7% and specificity of 72.1% and 83.8%, respectively. Multivariate logistic regression analysis suggested that UCI discordance was the risk factor for sIUGR (OR=7.165, 95%CI: 2.637-19.472). Conclusions MCDA twins with NT discordance greater than 20% during early pregnancy are at increased risk for TTTS. CRL discordance greater than 10%, NT discordance greater than 20% and abnormal UCI are risk factors for sIUGR. Key words: Twins, monozygotic; Pregnancy trimester, first; Ultrasonography, prenatal; Nuchal translucency measurement; Fetofetal transfusion; Fetal growth retardation; Forecasting
{"title":"Predictive value of first-trimester ultrasound markers for complicated monochorionic diamniotic twins","authors":"Qi Xu, Yi Zhou, D. Huang, Yanjun Chen, Lin-fen Huang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.011","url":null,"abstract":"Objective \u0000To investigate the value of first-trimester ultrasound parameters in predicting complicated monochorionic diamniotic (MCDA) twins. \u0000 \u0000 \u0000Methods \u0000In this retrospective study, pregnant women diagnosed as MCDA twins by ultrasound in the First Affiliated Hospital of Sun Yat-sen University from January 2013 to January 2018 were recruited and divided into the following four groups: non-complicated MCDA twins group, twin-twin transfusion syndrome (TTTS) group, selective intrauterine growth restriction (sIUGR) group and twin anemia-polycythemia sequence (TAPS) group. Thickness of nuchal translucency (NT), crown-rump length (CRL), umbilical cord insertion (UCI) and ductus venosus (DV) flow at 11-14 weeks of gestation were recorded. The predictive value for complicated MCDA twins was analyzed using t-test, Chi-square (or Fisher's exact) test, multivariate logistic regression analysis and receiver operating characteristic (ROC) curve. \u0000 \u0000 \u0000Results \u0000(1) A total of 430 MCDA twin pregnancies were included in this study with 152 in the TTTS group, 142 in the sIUGR group, seven in the TAPS group and 129 in the normal MCDA twins group. No further analysis was performed on the TAPS group due to the small sample size. (2) NT discordance in twins of the TTTS group was significantly greater than that in the normal MCDA twins group[(21.5±16.0)% vs (14.6±13.5)%, t=-3.533, P<0.001]. The area under ROC curve (AUC) of TTTS predicted by NT discordance was 0.649. Stratified analysis showed that TTTS was best predicted when NT discordance was 20% with the sensitivity of 57.9% and specificity of 70.6%. (3) The sIUGR group had greater discordance in CRL and NT and higher UCI discordance than the normal MCDA twins group [NT: (27.8±21.3)% vs (14.6±13.5)%, t=-5.556, P<0.001; CRL: (8.6±6.9)% vs (5.4±4.4)%, t=-3.144, P=0.002; UCI: 47.9% (68/142) vs 13.9% (18/129), χ2=35.929, P<0.001]. The AUC of sIUGR was 0.675 predicted by NT discordance and 0.649 by CRL discordance. Stratified analysis showed that NT discordance of 20% and CRL discordance of 10% were the best prediction for sIUGR with the sensitivity of 53.1% and 34.7% and specificity of 72.1% and 83.8%, respectively. Multivariate logistic regression analysis suggested that UCI discordance was the risk factor for sIUGR (OR=7.165, 95%CI: 2.637-19.472). \u0000 \u0000 \u0000Conclusions \u0000MCDA twins with NT discordance greater than 20% during early pregnancy are at increased risk for TTTS. CRL discordance greater than 10%, NT discordance greater than 20% and abnormal UCI are risk factors for sIUGR. \u0000 \u0000 \u0000Key words: \u0000Twins, monozygotic; Pregnancy trimester, first; Ultrasonography, prenatal; Nuchal translucency measurement; Fetofetal transfusion; Fetal growth retardation; Forecasting","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"744-750"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48831032","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 : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.012
Siyu Wang, X. Gu, Jiancheng Han, Ying Zhao, Xiaowei Liu, Ye Zhang, Lin Sun, Yong Guo
Objective To analyze the echocardiographic features and prognosis of fetal pulmonary artery sling (PAS). Methods In this retrospective study, clinical information of 13 PAS cases diagnosed by fetal echocardiography in Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2018 were collected. Echocardiographic characteristics and complications of intracardiac and extracardiac malformations were summarized. Their outcomes were also analyzed. Results (1) Two out of the 13 pregnant women continued their pregnancies until delivery, while the other 11 terminated the pregnancies. One neonate received surgery in another hospital after birth and was followed up to one year old with normal growth and development. The other infant was lost to follow up after birth. (2) Among the 13 cases, 12 were complete PAS and one (case 13) was partial PAS. Nine cases were complicated by other intracardiac malformations and five by extracardiac malformations. (3) Pulmonary artery development: Echocardiographic data of ten cases (the other three cases were excluded due to absence of detailed echocardiographic information) revealed that one fetus had tetralogy of Fallot with the diameter of pulmonary valve under normal value, while the pulmonary valve diameters of the other nine cases were all within the normal range. The inner diameter of the left and the right pulmonary artery that below the normal values were observed in four and two cases, respectively. One case showed absent distal end of right pulmonary artery with right pulmonary dysplasia, but the normal inner diameter at the beginning of right pulmonary artery. Conclusions Fetal PAS is more likely to be complicated by persistent left superior vena cava (PLSVC) and ventricular septal defect (VSD) as well as left and right pulmonary artery stenosis. The prognosis of PAS may be improved if operation is performed after birth, but further studies are needed. Key words: Pulmonary artery; Congenital abnormalities; Ultrasonography, prenatal; Echocardiography; Prognosis
{"title":"Prenatal echocardiographic characteristics and prognosis of fetal pulmonary artery sling: analysis of 13 cases","authors":"Siyu Wang, X. Gu, Jiancheng Han, Ying Zhao, Xiaowei Liu, Ye Zhang, Lin Sun, Yong Guo","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.012","url":null,"abstract":"Objective \u0000To analyze the echocardiographic features and prognosis of fetal pulmonary artery sling (PAS). \u0000 \u0000 \u0000Methods \u0000In this retrospective study, clinical information of 13 PAS cases diagnosed by fetal echocardiography in Beijing Anzhen Hospital Affiliated to Capital Medical University from January 2016 to December 2018 were collected. Echocardiographic characteristics and complications of intracardiac and extracardiac malformations were summarized. Their outcomes were also analyzed. \u0000 \u0000 \u0000Results \u0000(1) Two out of the 13 pregnant women continued their pregnancies until delivery, while the other 11 terminated the pregnancies. One neonate received surgery in another hospital after birth and was followed up to one year old with normal growth and development. The other infant was lost to follow up after birth. (2) Among the 13 cases, 12 were complete PAS and one (case 13) was partial PAS. Nine cases were complicated by other intracardiac malformations and five by extracardiac malformations. (3) Pulmonary artery development: Echocardiographic data of ten cases (the other three cases were excluded due to absence of detailed echocardiographic information) revealed that one fetus had tetralogy of Fallot with the diameter of pulmonary valve under normal value, while the pulmonary valve diameters of the other nine cases were all within the normal range. The inner diameter of the left and the right pulmonary artery that below the normal values were observed in four and two cases, respectively. One case showed absent distal end of right pulmonary artery with right pulmonary dysplasia, but the normal inner diameter at the beginning of right pulmonary artery. \u0000 \u0000 \u0000Conclusions \u0000Fetal PAS is more likely to be complicated by persistent left superior vena cava (PLSVC) and ventricular septal defect (VSD) as well as left and right pulmonary artery stenosis. The prognosis of PAS may be improved if operation is performed after birth, but further studies are needed. \u0000 \u0000 \u0000Key words: \u0000Pulmonary artery; Congenital abnormalities; Ultrasonography, prenatal; Echocardiography; Prognosis","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"751-756"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43579409","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 : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.010
Jing Liu, R. Qiu
Pulmonary hemorrhage is a common critical disease in neonates, with high mortality. Early and accurate diagnosis is the key to successful treatment. Recently, lung ultrasound has been successfully used to diagnose neonatal pulmonary hemorrhage. Main ultrasonographic manifestations of neonatal pulmonary hemorrhage are described in this article, including shred sign, lung consolidation with air bronchogram, pleural effusion, lung edema, pleural line abnormality and A-line disappearance. Key words: Lung diseases; Hemorrhage; Infant, newborn; Ultrasonography
{"title":"Lung ultrasound for diagnosis of neonatal pulmonary hemorrhage","authors":"Jing Liu, R. Qiu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.010","url":null,"abstract":"Pulmonary hemorrhage is a common critical disease in neonates, with high mortality. Early and accurate diagnosis is the key to successful treatment. Recently, lung ultrasound has been successfully used to diagnose neonatal pulmonary hemorrhage. Main ultrasonographic manifestations of neonatal pulmonary hemorrhage are described in this article, including shred sign, lung consolidation with air bronchogram, pleural effusion, lung edema, pleural line abnormality and A-line disappearance. \u0000 \u0000 \u0000Key words: \u0000Lung diseases; Hemorrhage; Infant, newborn; Ultrasonography","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"740-743"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48567724","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 : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.007
Meng-zhou He, Jing Jia, Jing-yi Zhang, Xuan Zhou
Objective To explore whether the pro-inflammatory effect of endoplasmic reticulum stress in placental tissues involves in the genesis of gestational diabetes mellitus (GDM). Methods Forty gravidas who underwent regular prenatal examinations and delivered at Tongji Hospital were recruited from January to December, 2016. Among them, 20 were GDM women (GDM group), and the remaining twenty were served as the control, which were selected from those without GDM and matched for age and gestational weeks to the GDM group. Placental tissues were collected from the two groups. The ultrastructure of endoplasmic reticulum in trophoblast cells was observed under transmission electron microscope. The expression of glucose-regulated protein-78 (GRP-78), a marker protein for endoplasmic reticulum stress, and C/EBP homologous protein (CHOP) were detected using Western blotting. Five placental tissue samples were collected from normal gravidas for explant culture. Three subgroups were set up according to different culturing methods including culturing with IL-1β (5 ng/ml) for 20 h (IL-1β model group), 30 μmol/L thapsigargin (TG, an endoplasmic reticulum stress agonist) for 2 h after treating with IL-1β (5 ng/ml) for 18 h (IL-1β+TG intervention group) or with no stimulation (blank control group). Western blotting was used to detect the expressions of GRP-78, CHOP and glucose transporter 4 (GLUT4) in placenta explants. The mRNA expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were determined by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Statistical analysis was performed using one-way analysis of variance, LSD and t test. Results (1) In the GDM group, increased number and size of endoplasmic reticulum cisternae were observed in trophoblast cells. Moreover, obviously dilated endoplasmic reticulum and different size of fragments and vesicles were also seen under electron microscope. While the endoplasmic reticulum in the placental tissues of the control group showed no obvious swelling. (2) The expression of GRP-78 and CHOP protein in the GDM group were higher than those in the control group (0.90±0.17 vs 0.48±0.08, t=2.24; 0.85±0.13 vs 0.46±0.12, t=2.10; both P<0.05). (3) Compared with the blank control group, the expression of GRP-78 and CHOP protein in the IL-1β model group increased significantly (0.87±0.18 vs 0.36±0.07, t=2.67; 1.14±0.09 vs 0.78±0.06, t=3.20; both P<0.05); but the expression of GLUT4 protein significantly decreased (1.00±0.14 vs 2.21±0.49, t=2.40, P<0.05); the expressions of IL-6 and TNF-α mRNA significantly increased (0.89±0.23 vs 0.30±0.06, t=2.31; 0.62±0.16 vs 0.17±0.09, t=2.29; both P<0.05). Compared with the IL-1β model group, the expression of GRP-78 and CHOP protein significantly increased in IL-1β+TG group (2.02±0.32 vs 0.87±0.18, t=3.11; 2.18±0.31 vs 1.14±0.09, t=3.16; both P<0.05); the expression of GLUT4 protein significantly decreased (0.39±0.19 vs 1.00±0.14, t=2.66, P<0
目的探讨胎盘组织内质网应激的促炎作用是否参与妊娠期糖尿病的发生。方法选取2016年1 - 12月在同济医院进行常规产前检查的产妇40例。其中，GDM妇女20例(GDM组)，其余20例作为对照，从未患GDM的妇女中选择年龄、胎周与GDM组相匹配的妇女。取两组胎盘组织。透射电镜下观察了滋养细胞内质网的超微结构。Western blotting检测内质网应激标记蛋白葡萄糖调节蛋白-78 (GRP-78)和C/EBP同源蛋白(CHOP)的表达。从正常妊娠中采集5个胎盘组织样本进行外植体培养。按不同的培养方法分为3个亚组:IL-1β (5 ng/ml)培养20 h (IL-1β模型组)，IL-1β (5 ng/ml)治疗18 h (IL-1β+TG干预组)后30 μmol/L thapsigargin (TG，内质网应激激动剂)培养2 h(空白对照组)。Western blotting检测胎盘外植体中GRP-78、CHOP和GLUT4的表达。采用实时荧光定量聚合酶链式反应(RT-PCR)检测白细胞介素-6 (IL-6)和肿瘤坏死因子-α (TNF-α) mRNA表达。统计学分析采用单因素方差分析、LSD和t检验。结果(1)GDM组滋养细胞内质网池池数量增多，池池大小增大。电镜下可见内质网明显扩张，碎片和囊泡大小不一。对照组胎盘组织内质网未见明显肿胀。(2) GDM组GRP-78、CHOP蛋白表达高于对照组(0.90±0.17 vs 0.48±0.08,t=2.24;0.85±0.13 vs 0.46±0.12,t=2.10;P < 0.05)。(3)与空白对照组比较，IL-1β模型组GRP-78、CHOP蛋白表达显著升高(0.87±0.18 vs 0.36±0.07,t=2.67;1.14±0.09 vs 0.78±0.06,t=3.20;均P < 0.05);GLUT4蛋白表达显著降低(1.00±0.14 vs 2.21±0.49,t=2.40, P<0.05);IL-6、TNF-α mRNA表达量显著升高(0.89±0.23 vs 0.30±0.06,t=2.31);0.62±0.16 vs 0.17±0.09,t=2.29;P < 0.05)。与IL-1β模型组比较，IL-1β+TG组GRP-78、CHOP蛋白表达显著升高(2.02±0.32 vs 0.87±0.18,t=3.11;2.18±0.31 vs 1.14±0.09,t=3.16;均P < 0.05);GLUT4蛋白表达量显著降低(0.39±0.19 vs 1.00±0.14,t=2.66, P<0.05);IL-6、TNF-α mRNA表达显著升高(1.67±0.25 vs 0.89±0.23,t=2.26);1.42±0.27 vs 0.62±0.16,t=2.51;P < 0.05)。结论内质网应激可能与部分GDM妇女胎盘组织促炎细胞因子释放增加有关，参与了GDM的发生和发展。关键词:糖尿病;妊娠期;内质网应力;胎盘;细胞因子;炎症
{"title":"Pro-inflammatory effect induced by endoplasmic reticulum stress in placental trophoblast cells participates in genesis of gestational diabetes mellitus","authors":"Meng-zhou He, Jing Jia, Jing-yi Zhang, Xuan Zhou","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.007","url":null,"abstract":"Objective \u0000To explore whether the pro-inflammatory effect of endoplasmic reticulum stress in placental tissues involves in the genesis of gestational diabetes mellitus (GDM). \u0000 \u0000 \u0000Methods \u0000Forty gravidas who underwent regular prenatal examinations and delivered at Tongji Hospital were recruited from January to December, 2016. Among them, 20 were GDM women (GDM group), and the remaining twenty were served as the control, which were selected from those without GDM and matched for age and gestational weeks to the GDM group. Placental tissues were collected from the two groups. The ultrastructure of endoplasmic reticulum in trophoblast cells was observed under transmission electron microscope. The expression of glucose-regulated protein-78 (GRP-78), a marker protein for endoplasmic reticulum stress, and C/EBP homologous protein (CHOP) were detected using Western blotting. Five placental tissue samples were collected from normal gravidas for explant culture. Three subgroups were set up according to different culturing methods including culturing with IL-1β (5 ng/ml) for 20 h (IL-1β model group), 30 μmol/L thapsigargin (TG, an endoplasmic reticulum stress agonist) for 2 h after treating with IL-1β (5 ng/ml) for 18 h (IL-1β+TG intervention group) or with no stimulation (blank control group). Western blotting was used to detect the expressions of GRP-78, CHOP and glucose transporter 4 (GLUT4) in placenta explants. The mRNA expressions of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) were determined by real-time fluorescence quantitative polymerase chain reaction (RT-PCR). Statistical analysis was performed using one-way analysis of variance, LSD and t test. \u0000 \u0000 \u0000Results \u0000(1) In the GDM group, increased number and size of endoplasmic reticulum cisternae were observed in trophoblast cells. Moreover, obviously dilated endoplasmic reticulum and different size of fragments and vesicles were also seen under electron microscope. While the endoplasmic reticulum in the placental tissues of the control group showed no obvious swelling. (2) The expression of GRP-78 and CHOP protein in the GDM group were higher than those in the control group (0.90±0.17 vs 0.48±0.08, t=2.24; 0.85±0.13 vs 0.46±0.12, t=2.10; both P<0.05). (3) Compared with the blank control group, the expression of GRP-78 and CHOP protein in the IL-1β model group increased significantly (0.87±0.18 vs 0.36±0.07, t=2.67; 1.14±0.09 vs 0.78±0.06, t=3.20; both P<0.05); but the expression of GLUT4 protein significantly decreased (1.00±0.14 vs 2.21±0.49, t=2.40, P<0.05); the expressions of IL-6 and TNF-α mRNA significantly increased (0.89±0.23 vs 0.30±0.06, t=2.31; 0.62±0.16 vs 0.17±0.09, t=2.29; both P<0.05). Compared with the IL-1β model group, the expression of GRP-78 and CHOP protein significantly increased in IL-1β+TG group (2.02±0.32 vs 0.87±0.18, t=3.11; 2.18±0.31 vs 1.14±0.09, t=3.16; both P<0.05); the expression of GLUT4 protein significantly decreased (0.39±0.19 vs 1.00±0.14, t=2.66, P<0","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"722-728"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47054874","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 : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.005
Cheng Tan, M. Fan, Wentong Jia, Yeling Ma, Dunjin Chen, Rong Li, Yan-Ling Wang
Objective To investigate the regulatory effect of CLEC2D-CD161 interaction on killing capacity of decidual natural killer (dNK) cells during early pregnancy and its association with the incidence of recurrent spontaneous abortion (RSA). Methods Decidua tissues were collected from normal pregnancies (n=16) and RSA cases (n=6) at 6-10 gestational weeks in the Department of Obstetrics and Gynecology of Peking University Third Hospital from October 2018 to May 2019. (1) Expressions of CLEC2D and CD161 in decidua from early pregnancy were detected using immunofluorescence. (2) Primary dNK cells were isolated from decidua from early pregnancy. dNK cells pre-treated with CD161 antibody (blocking CD161, B-CD161) were co-cultured with JEG-3 cells which were knocked-down by CLEC2D small interfering RNA (siCLEC2D), followed by killing capacity assessment of dNK cells by cytotoxicity assay and determination of expressions of related molecules by quantitive real-time polymerase chain reaction. (3) Western blot and flow cytometry were used to detect the expression of CLEC2D and CD161 in decidua tissues. Cytotoxicity assay was performed to analyze the killing capacity of dNK cells. T test was used for statistical analysis between normal and RSA cases. Results (1) CLEC2D was mainly expressed in extravillous trophoblast (EVT) cells and CD161 was mainly detected in dNK cells. CD161-positive dNK cells and CLEC2D-positive EVT cells were adjacently located in decidua tissues allowing their interaction. (2) Cytotoxicity assay suggested that CD161 blocking in dNK cells or CLEC2D knockdown in JEG-3 cells could enhance the cytotoxicity of dNK cells. The target cell lysis rates at the effector-target ratios of 40∶1, 20∶1, 10∶1 and 5∶1 in B-CD161 group were (59.12±4.56)%, (25.96±5.44)%, (13.60±8.94)% and (12.53±8.94)%, and in IgG control group were (20.01±1.96)%, (8.51±1.32)%, (3.24±0.75)% and (3.82±1.92)%, respectively. There were significant differences between the two groups at the effector-target ratios of 40∶1 (t=13.922, P 0.05). The target cell lysis rates at the effector-target ratios of 40∶1, 20∶1, 10∶1 and 5∶1 in si-CLEC2D group were (43.37±2.01)%, (32.99±2.08)%, (23.47±1.36)% and (11.48±0.37)%, and in the negative control (NC) group were (15.54±1.46)%, (13.84±1.68)%, (9.94±3.01) and (5.50±0.99)%, respectively. Differences between the two groups at all effector-target ratios were statistically significant (t=19.402, 12.400, 7.093 and 9.842, all P<0.01). Moreover, the expression of dNK killing-related factor granzyme B in the siCLEC2D group was higher than that in the NC group. (3) Compared with the normal pregnancy group, the RSA group showed decreased CD161 expression and increased killing capacity of dNK cells, but no significant difference in CLEC2D expression. Conclusions At early pregnancy, CLEC2D on EVT cells can interact with CD161 on dNK cells, which inhibits the cytotoxicity of dNK cells and induces immune tolerance at the fetal-materna
{"title":"Regulatory effect of CLEC2D-CD161 interaction on killing capacity of decidual natural killer cells","authors":"Cheng Tan, M. Fan, Wentong Jia, Yeling Ma, Dunjin Chen, Rong Li, Yan-Ling Wang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.005","url":null,"abstract":"Objective \u0000To investigate the regulatory effect of CLEC2D-CD161 interaction on killing capacity of decidual natural killer (dNK) cells during early pregnancy and its association with the incidence of recurrent spontaneous abortion (RSA). \u0000 \u0000 \u0000Methods \u0000Decidua tissues were collected from normal pregnancies (n=16) and RSA cases (n=6) at 6-10 gestational weeks in the Department of Obstetrics and Gynecology of Peking University Third Hospital from October 2018 to May 2019. (1) Expressions of CLEC2D and CD161 in decidua from early pregnancy were detected using immunofluorescence. (2) Primary dNK cells were isolated from decidua from early pregnancy. dNK cells pre-treated with CD161 antibody (blocking CD161, B-CD161) were co-cultured with JEG-3 cells which were knocked-down by CLEC2D small interfering RNA (siCLEC2D), followed by killing capacity assessment of dNK cells by cytotoxicity assay and determination of expressions of related molecules by quantitive real-time polymerase chain reaction. (3) Western blot and flow cytometry were used to detect the expression of CLEC2D and CD161 in decidua tissues. Cytotoxicity assay was performed to analyze the killing capacity of dNK cells. T test was used for statistical analysis between normal and RSA cases. \u0000 \u0000 \u0000Results \u0000(1) CLEC2D was mainly expressed in extravillous trophoblast (EVT) cells and CD161 was mainly detected in dNK cells. CD161-positive dNK cells and CLEC2D-positive EVT cells were adjacently located in decidua tissues allowing their interaction. (2) Cytotoxicity assay suggested that CD161 blocking in dNK cells or CLEC2D knockdown in JEG-3 cells could enhance the cytotoxicity of dNK cells. The target cell lysis rates at the effector-target ratios of 40∶1, 20∶1, 10∶1 and 5∶1 in B-CD161 group were (59.12±4.56)%, (25.96±5.44)%, (13.60±8.94)% and (12.53±8.94)%, and in IgG control group were (20.01±1.96)%, (8.51±1.32)%, (3.24±0.75)% and (3.82±1.92)%, respectively. There were significant differences between the two groups at the effector-target ratios of 40∶1 (t=13.922, P 0.05). The target cell lysis rates at the effector-target ratios of 40∶1, 20∶1, 10∶1 and 5∶1 in si-CLEC2D group were (43.37±2.01)%, (32.99±2.08)%, (23.47±1.36)% and (11.48±0.37)%, and in the negative control (NC) group were (15.54±1.46)%, (13.84±1.68)%, (9.94±3.01) and (5.50±0.99)%, respectively. Differences between the two groups at all effector-target ratios were statistically significant (t=19.402, 12.400, 7.093 and 9.842, all P<0.01). Moreover, the expression of dNK killing-related factor granzyme B in the siCLEC2D group was higher than that in the NC group. (3) Compared with the normal pregnancy group, the RSA group showed decreased CD161 expression and increased killing capacity of dNK cells, but no significant difference in CLEC2D expression. \u0000 \u0000 \u0000Conclusions \u0000At early pregnancy, CLEC2D on EVT cells can interact with CD161 on dNK cells, which inhibits the cytotoxicity of dNK cells and induces immune tolerance at the fetal-materna","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"704-711"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42593493","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 : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.013
Nan Chen, Zhe Liu
This study reported the outcome of a case of fetal hemolytic disease after multiple intrauterine transfusions due to Rh incompatibility between the mother and fetus. The pregnant women had a history of termination for fetal edema at 29 weeks of gestation due to undecided reason as no relevant tests were conducted. Fetal edema was found and hemolytic disease (severe anemia) was diagnosed at 24 gestational weeks in the index pregnancy. After five intrauterine transfusions, fetal edema and anemia were improved. The baby who was born by cesarean section at 33 gestational weeks, was diagnosed with hemolytic disease and transferred to the neonatology department. After one month of treatment, the baby was improved and discharged. Whereafter he was followed up to one year of age without any abnormality in physical or mental development. Key words: Erythroblastosis, fetal; Rh-Hr blood-group system; Blood group incompatibility; Blood transfusion, intrauterine
{"title":"Multiple intrauterine transfusions for fetal Rh hemolytic disease: a case report","authors":"Nan Chen, Zhe Liu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.013","url":null,"abstract":"This study reported the outcome of a case of fetal hemolytic disease after multiple intrauterine transfusions due to Rh incompatibility between the mother and fetus. The pregnant women had a history of termination for fetal edema at 29 weeks of gestation due to undecided reason as no relevant tests were conducted. Fetal edema was found and hemolytic disease (severe anemia) was diagnosed at 24 gestational weeks in the index pregnancy. After five intrauterine transfusions, fetal edema and anemia were improved. The baby who was born by cesarean section at 33 gestational weeks, was diagnosed with hemolytic disease and transferred to the neonatology department. After one month of treatment, the baby was improved and discharged. Whereafter he was followed up to one year of age without any abnormality in physical or mental development. Key words: Erythroblastosis, fetal; Rh-Hr blood-group system; Blood group incompatibility; Blood transfusion, intrauterine","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"757-760"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47252903","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 : 2019-10-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.10.003
Xuan Shao
Successful pregnancy and delivery of a healthy offspring largely rely on a well-developed placenta. Defects in placental development may lead to various pregnancy complications. However, placenta has been one of the least understood organs. The mechanism of its development and function, as well as the molecular association between placental disorders and pregnancy complications remain unclear, thus become the least known area in the exploration of pregnancy and life. Along with the advances in modern techniques, the understanding of the placenta has been deepened from tissue structure to cellular and molecular level, and gradually toward the omics and systematic biology. In recent years, a number of groundbreaking achievements have been made in the field of placental development, which were summarized in this article. Some relevant international funding programs and future prospects in this area were also discussed. Key words: Placentation; Health planning support; Pregnancy complications
{"title":"Placental development research: breakthrough and prospect","authors":"Xuan Shao","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.10.003","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.10.003","url":null,"abstract":"Successful pregnancy and delivery of a healthy offspring largely rely on a well-developed placenta. Defects in placental development may lead to various pregnancy complications. However, placenta has been one of the least understood organs. The mechanism of its development and function, as well as the molecular association between placental disorders and pregnancy complications remain unclear, thus become the least known area in the exploration of pregnancy and life. Along with the advances in modern techniques, the understanding of the placenta has been deepened from tissue structure to cellular and molecular level, and gradually toward the omics and systematic biology. In recent years, a number of groundbreaking achievements have been made in the field of placental development, which were summarized in this article. Some relevant international funding programs and future prospects in this area were also discussed. \u0000 \u0000 \u0000Key words: \u0000Placentation; Health planning support; Pregnancy complications","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"694-697"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47678387","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 : 2019-09-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.09.012
Chen Li, Junya Chen, L. Fan
Objective To investigate the diagnosis, clinical outcomes and factors influencing the prognosis of fetal periventricular pseudocysts (PVPC). Methods A retrospective analysis was performed on the results of fetal neurosonography (NSG), cranial magnetic resonance imaging (MRI), chromosome karyotype and neonatal cranial ultrasound of 76 PVPC cases detected by prenatal ultrasound in Peking University First Hospital from May 2014 to October 2018. The accuracy of NSG and cranial MRI in PVPC diagnosis was assessed. Prognosis of PVPC and the influencing factors were evaluated. Statistical analysis was performed using Chi-square test or Fisher's exact test. Results (1) This study involved 51 cases (67.1%) of isolated PVPC and 25 cases (32.9%) of non-isolated PVPC. Among the 25 non-isolated PVPC cases, 15 were complicated by one abnormality and 10 by multiple abnormalities. There were 20 cases with intracranial abnormalities, two with extracranial abnormalities, and three with both intracranial and extracranial abnormalities. (2) Eight out of the 76 pregnancies (10.5%) were terminated and among them, two were isolated PVPC cases, five complicated by determined abnormalities (one case of PVPC complicated with pachygyria and bilateral mild fetal ventriculomegaly, one case of PVPC complicated with pachygyria or agyria and agenesis of corpus callosum, one case of PVPC complicated with arachnoid cyst and vermis dysplasia, one case of PVPC complicated with cortical dysplasia, one case of PVPC complicated with intestinal dilatation) and one by abnormalities of undertermined prognosis (PVPC combined with mild fetal ventriculomegaly and polyhydramnios). A total of 61 neonates (80.3%, 61/76) were born alive and followed up. Seven cases (9.2%, 7/76) were lost to follow-up. (3) As of February 2019, among the 61 followed-up infants, 44 with isolated PVPC and 15 with unclear abnormalities developed well. The other two with determined intracranial abnormalities were diagnosed as having cystic lesions in the brain parenchyma. One of them died of respiratory failure two days after birth and the other suffered from chromosomal disease (13.23 Mb deletion in region q24.3q31.2 of chromosome 2) with mental retardation and delayed growth and development. (4) A total of 44 (57.9%, 44/76) neonates received cranial ultrasound after birth and confirmed the diagnosis of PVPC, among which 11 (25.0%, 11/44) were missed or misdiagnosed in prenatal MRI. Conclusions PVPC may have many comorbidities, particularly intracranial abnormalities, which are closely related to the prognosis. A thorough prenatal ultrasound examination is necessary for fetal PVPC, especially NSG. Isolated PVPC usually has a good outcome. However, PVPC complicated by cystic lesions in the brain parenchyma may be associated with chromosomal abnormalities, hence fetal chromosome examination is required. Key words: Lateral ventricles; Central nervous system cysts; Ultrasonography, prenatal; Prog
{"title":"Diagnosis and prognosis of fetal periventricular pseudocysts","authors":"Chen Li, Junya Chen, L. Fan","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.012","url":null,"abstract":"Objective \u0000To investigate the diagnosis, clinical outcomes and factors influencing the prognosis of fetal periventricular pseudocysts (PVPC). \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was performed on the results of fetal neurosonography (NSG), cranial magnetic resonance imaging (MRI), chromosome karyotype and neonatal cranial ultrasound of 76 PVPC cases detected by prenatal ultrasound in Peking University First Hospital from May 2014 to October 2018. The accuracy of NSG and cranial MRI in PVPC diagnosis was assessed. Prognosis of PVPC and the influencing factors were evaluated. Statistical analysis was performed using Chi-square test or Fisher's exact test. \u0000 \u0000 \u0000Results \u0000(1) This study involved 51 cases (67.1%) of isolated PVPC and 25 cases (32.9%) of non-isolated PVPC. Among the 25 non-isolated PVPC cases, 15 were complicated by one abnormality and 10 by multiple abnormalities. There were 20 cases with intracranial abnormalities, two with extracranial abnormalities, and three with both intracranial and extracranial abnormalities. (2) Eight out of the 76 pregnancies (10.5%) were terminated and among them, two were isolated PVPC cases, five complicated by determined abnormalities (one case of PVPC complicated with pachygyria and bilateral mild fetal ventriculomegaly, one case of PVPC complicated with pachygyria or agyria and agenesis of corpus callosum, one case of PVPC complicated with arachnoid cyst and vermis dysplasia, one case of PVPC complicated with cortical dysplasia, one case of PVPC complicated with intestinal dilatation) and one by abnormalities of undertermined prognosis (PVPC combined with mild fetal ventriculomegaly and polyhydramnios). A total of 61 neonates (80.3%, 61/76) were born alive and followed up. Seven cases (9.2%, 7/76) were lost to follow-up. (3) As of February 2019, among the 61 followed-up infants, 44 with isolated PVPC and 15 with unclear abnormalities developed well. The other two with determined intracranial abnormalities were diagnosed as having cystic lesions in the brain parenchyma. One of them died of respiratory failure two days after birth and the other suffered from chromosomal disease (13.23 Mb deletion in region q24.3q31.2 of chromosome 2) with mental retardation and delayed growth and development. (4) A total of 44 (57.9%, 44/76) neonates received cranial ultrasound after birth and confirmed the diagnosis of PVPC, among which 11 (25.0%, 11/44) were missed or misdiagnosed in prenatal MRI. \u0000 \u0000 \u0000Conclusions \u0000PVPC may have many comorbidities, particularly intracranial abnormalities, which are closely related to the prognosis. A thorough prenatal ultrasound examination is necessary for fetal PVPC, especially NSG. Isolated PVPC usually has a good outcome. However, PVPC complicated by cystic lesions in the brain parenchyma may be associated with chromosomal abnormalities, hence fetal chromosome examination is required. \u0000 \u0000 \u0000Key words: \u0000Lateral ventricles; Central nervous system cysts; Ultrasonography, prenatal; Prog","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"663-668"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45426614","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 effects of neonatal intensive care unit (NICU)-centered regional neonatal transport network (NTN) on the treatment of retinopathy of prematurity (ROP). Methods A retrospective analysis was conducted to analyze the transfer, treatment and outcomes of 406 preterm infants with ROP who were transferred to the Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital via the NTN from July 2008 to December 2014. Independent sample t-test, Chi-square test and Mann-Whitney nonparametric test were used for statistical analysis. Results Among the 406 premature infants who were transferred to our hospital because of ROP, there were 257 males and 149 females with the gestational age of (29.5±1.9) weeks (24+5-36 weeks) and the birth weight of (1 234.8± 268.9) g (580-2 400 g). The age at transfer was (48.9±18.5) d (15-78 d) and the transport distance was (216.5±78.6) km (10-625 km). No death was reported during the transportation. Very preterm births and very low birth weight infants (VLBWI) accounted for 88.7% (360 cases) and 82.5% (335 cases), respectively. Lesions occurred in 1, 2 and 3 zones were detected in 98 (24.1%), 286 (70.4%) and 22 (5.4%) cases, respectively. Lesions of stage 1-5 were observed in 51 (12.6%), 156 (38.4%), 183 (45.1%), 12 (3.0%) and 4 (1.0%) cases. There were 186 cases (45.8%) with Plus lesions. A total of 252 cases (62.1%) underwent surgery which were achieving treatment standards, including 165 (65.5%) undergoing laser therapy, 93 (36.9%) receiving anti-vascular endothelial growth factor (VEGF) therapy, 16 (6.4%) having vitrectomy and two (0.8%) having scleral buckling. Eighteen infants were diagnosed with retinal structural abnormalities, among which 16 had retinal detachment before admission (12 in phase 4 and four in phase 5). Two without retinal detachment on admission developed to phase 4 after surgery. The incidence of retinal structural dysplasia was 0.9% (2/236) in infants receiving laser and/or anti-VEGF therapy in our hospital. Compared with the cured patients (n=234), those with retinal structural dysplasia (n=18) had a late transfer time [80 (38-270) vs 50 (19-150) d, Z=3.387, P<0.001]. Conclusions The NICU-centered and regional transfer-based ROP treatment network provides timely and effective treatment for infants with ROP. Key words: Retinopathy of prematurity; Intensive care units, neonatal; Patient handoff; Treatment outcome
{"title":"Effects of neonatal intensive care unit-centered regional transport network on treatment of retinopathy of prematurity","authors":"Qiuping Li, Zong-hua Wang, Xiu-mei Yang, Haihua Chen, Hongyi Tang, Zhichun Feng","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.005","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.005","url":null,"abstract":"Objective \u0000To investigate the effects of neonatal intensive care unit (NICU)-centered regional neonatal transport network (NTN) on the treatment of retinopathy of prematurity (ROP). \u0000 \u0000 \u0000Methods \u0000A retrospective analysis was conducted to analyze the transfer, treatment and outcomes of 406 preterm infants with ROP who were transferred to the Bayi Children's Hospital Affiliated to the Seventh Medical Center of PLA General Hospital via the NTN from July 2008 to December 2014. Independent sample t-test, Chi-square test and Mann-Whitney nonparametric test were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000Among the 406 premature infants who were transferred to our hospital because of ROP, there were 257 males and 149 females with the gestational age of (29.5±1.9) weeks (24+5-36 weeks) and the birth weight of (1 234.8± 268.9) g (580-2 400 g). The age at transfer was (48.9±18.5) d (15-78 d) and the transport distance was (216.5±78.6) km (10-625 km). No death was reported during the transportation. Very preterm births and very low birth weight infants (VLBWI) accounted for 88.7% (360 cases) and 82.5% (335 cases), respectively. Lesions occurred in 1, 2 and 3 zones were detected in 98 (24.1%), 286 (70.4%) and 22 (5.4%) cases, respectively. Lesions of stage 1-5 were observed in 51 (12.6%), 156 (38.4%), 183 (45.1%), 12 (3.0%) and 4 (1.0%) cases. There were 186 cases (45.8%) with Plus lesions. A total of 252 cases (62.1%) underwent surgery which were achieving treatment standards, including 165 (65.5%) undergoing laser therapy, 93 (36.9%) receiving anti-vascular endothelial growth factor (VEGF) therapy, 16 (6.4%) having vitrectomy and two (0.8%) having scleral buckling. Eighteen infants were diagnosed with retinal structural abnormalities, among which 16 had retinal detachment before admission (12 in phase 4 and four in phase 5). Two without retinal detachment on admission developed to phase 4 after surgery. The incidence of retinal structural dysplasia was 0.9% (2/236) in infants receiving laser and/or anti-VEGF therapy in our hospital. Compared with the cured patients (n=234), those with retinal structural dysplasia (n=18) had a late transfer time [80 (38-270) vs 50 (19-150) d, Z=3.387, P<0.001]. \u0000 \u0000 \u0000Conclusions \u0000The NICU-centered and regional transfer-based ROP treatment network provides timely and effective treatment for infants with ROP. \u0000 \u0000 \u0000Key words: \u0000Retinopathy of prematurity; Intensive care units, neonatal; Patient handoff; Treatment outcome","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"627-632"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42408013","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 : 2019-09-16DOI: 10.3760/CMA.J.ISSN.1007-9408.2019.09.009
Wei Zhu, Yunfeng Liu, Mei-hua Piao, Jing Wang, Li-jun Wang
This is a case report of preterm female neonate with Raynaud's phenomenon, who was born at 30+3 weeks of gestation. Her right upper limb completely turned pale from wrist to fingers with undetermined cause five days after birth, with weakened radial artery pulsation and lower skin temperature than the other side. After several treatment steps including right upper limb massage, keeping warm, intravenous infusion of Alprostadil and application of tropical mucopolysaccharide polysulfate cream, the affected limb gradually turned to purple and then ruddy. No abnormality was detected in the examinations for secondary Raynaud's phenomenon, therefore a primary Raynaud's phenomenon was considered. No similar symptoms recurred during hospitalization or follow-ups. Though rare, Raynaud's phenomenon should be considered if patients' hands suddenly turn to pale and then purple. The main treatments involve removing the causative factors, keeping warm and massage of the affected limb. Medications can be used to improve peripheral circulation if necessary. Long-term follow-up is needed for neonates suffered from Raynaud's phenomenon. Key words: Raynaud's phenomenon; Infant, premature; Treatment
{"title":"Primary Raynaud's phenomenon in premature infant: a case report","authors":"Wei Zhu, Yunfeng Liu, Mei-hua Piao, Jing Wang, Li-jun Wang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.009","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.009","url":null,"abstract":"This is a case report of preterm female neonate with Raynaud's phenomenon, who was born at 30+3 weeks of gestation. Her right upper limb completely turned pale from wrist to fingers with undetermined cause five days after birth, with weakened radial artery pulsation and lower skin temperature than the other side. After several treatment steps including right upper limb massage, keeping warm, intravenous infusion of Alprostadil and application of tropical mucopolysaccharide polysulfate cream, the affected limb gradually turned to purple and then ruddy. No abnormality was detected in the examinations for secondary Raynaud's phenomenon, therefore a primary Raynaud's phenomenon was considered. No similar symptoms recurred during hospitalization or follow-ups. Though rare, Raynaud's phenomenon should be considered if patients' hands suddenly turn to pale and then purple. The main treatments involve removing the causative factors, keeping warm and massage of the affected limb. Medications can be used to improve peripheral circulation if necessary. Long-term follow-up is needed for neonates suffered from Raynaud's phenomenon. \u0000 \u0000 \u0000Key words: \u0000Raynaud's phenomenon; Infant, premature; Treatment","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"648-651"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46986779","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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