The authors studied retrospectively clinical data of seventy cases with breast cancer during pregnancy and lactation.They were treated and diagnosed by operation and pathology.Primary factors influencing prognosis were analyzed.It was demonstrated that 5year survival rate of the patients were significantly influenced by clinical stage , month of pregnancy and lactation, time of symptoms, type of operation, type of pathology, histological grade of malignancy, recurrence and metastasis, and estrogen receptor status (Ｐ＜0.05).Age and termination of pregnancy had no beneficial effect on survival (Ｐ＞0.05).The prognosis of pregnant and lactating breast cancer was poorer than ordinary breast cancer.Their 5year survival rate were 55.7% and 74.3%, respectively. After they were matched for stage and for age, no difference in survival was found.Early diagnosis and radical operation combined with radiotherapy, chemotherapy and hormonal therapy have better prognosis.The method can shorten time of treatment and improve survival rate.Termination of pregnancy has not been shown to improve survival and shall not be advised routinely.Future pregnancy may be detrimental and shall be discouraged.
ObjectiveTo investigate the effect of behavior intervention through diets and exercises on blood glucose controlling in patients with gestational diabetes mellitus (GDM), and to provide the basis for GDM therapy. MethodsA total of 116 patients with GDM diagnosed and treated in the Sixth Affiliated Hospital of Sun Yat-sen University between March 2011 and December 2012 were taken as our study objects, including 72 patients in the study group and 44 patients in the control group, based on their will. For patients in the study group, we carried out behavior interventions through diets and exercises, including dietary guidance, giving pamphlet and formulating exercise plan, while for patients in the control group, we only gave them oral guidance and publicity materials. The same questionnaire was used to collect all the patients' information. Follow-up was done once in every 3 days, and rechecking was performed 2 weeks later. The results of oral glucose tolerance test and the rate of pathoglycemia were compared in these groups before and after intervention. ResultsThe fasting blood glucose, 1- and 2-hour blood glucose were lowered after the behavior intervention in the study group (P<0.05), which were also significantly lower than the control group (P<0.05). Fasting blood glucose, 1- and 2-hour pathoglycemia was significantly lower in the study group than that in the control group and that before intervention (P<0.05). ConclusionCombination of diets and exercises can control levels of blood glucose in GDM patients, and is an important therapy for GDM.
Inflammatory bowel disease (IBD) is a group of chronic, recurrent, and non-specific intestinal inflammatory diseases. It usually occurs between 20 and 40 years old, overlapping with the patient’s childbearing age. Active IBD may lead to decreased fertility and adverse pregnancy outcomes, and pregnancy may also lead to recurrence of IBD. Through studying domestic and foreign related literature on pregnancy and IBD, this article elaborates on the guidance and management of IBD before pregnancy, the disease management of IBD during pregnancy, the disease management of IBD during lactation, and the current status and prospects of traditional Chinese medicine treatment. It aims to provide references for patients and clinicians to have a more scientific understanding of pregnancy with IBD.
ObjectiveTo establish a normal reference value range of specific thyroid function in pregnant women corresponding to Beckman reagent in Chengdu.MethodsWe randomly selected 120 non-pregnant women and 445 pregnant women who underwent routine examinations at the First Affiliated Hospital of Chengdu Medical College from November 2016 to June 2017; tested for free triiodothyronine (FT3), free thyroxine (FT4), and thyroid stimulating hormone (TSH) in serum; used SPSS 24.0 to calculate the bilateral limit of each index (Section 2.5, 97. 5 Quot); established the normal range of Beckman reagent.ResultsThe reference ranges of FT3, FT4, and TSH in the first, second, and third trimester of pregnancy were 4.41–6.33, 4.17–6.12, and 3.86–6.39 pmol/L; 7.64–14.63, 6.62–13.69, and 6.62–12.51 pmol/L; 0.21–3.62, 0.16–4.35, and 0.89–4.88 mU/L; respectively. There was no significant difference in serum TSH between the first and second trimester (P>0.05), and neither between the first and second trimesters and the controls in serum FT3 (P>0.05). The differences in serum FT3, FT4, and TSH among the rest of trimesters, and between each trimester and the normal control group were statistically significant (P<0.05). There was a significant correlation between TSH and FT4 in the early and middle stages of pregnancy (r=–0.277, –0.392, P<0.01).ConclusionThe reference value of FT3, FT4, and TSH in pregnant women with Beckman reagent was significantly different from that in non-pregnant women.
ObjectiveTo explore whether the vaginal environment changes of pregnant women were correlated with pathogenesis of fungal vaginitis. MethodsWe selected 166 women in their early pregnancy in the Obstetrics and Gynaecology Clinic between July 2011 and July 2012 as the study objects (excluding fungal vaginitis patients already confirmed). Two important indicators of changes in pH and the amount of vaginal lactobacilli were chosen to determine changes in the vaginal environment. Using prospective study method, by checking changes in the vaginal environment, the objects were divided into two groups: 96 were in the changing environment group, and 70 were in the normal environment group. Sixty seven of them had a pH value lower or equal to 4.0, and 99 higher than 4.0. Fifty-eight of them had a reduced amount of lactobacillus, and 108 had a normal amount of lactobacillus. The rate of fungal vaginitis in each group was counted. ResultsThe morbidity rate in patients whose pH value was lower than or equal to 4.0 was 17.9% (12/67), while it was 6.1% (6/99) in patients with a pH value higher than 4.0, and the difference was significant (χ2=5.804, P=0.016). The morbidity rate in patients with a reduced amount of lactobacillus was 25.9% (15/58), and it was 2.8% (3/108) in patients with normal lactobacillus, and the difference was also significant (χ2=20.800, P=0.000). The morbidity rate for patients with changing vaginal environment was 16.7% (16/96), and for those with normal environment was 2.9% (2/70), and the difference was significant (χ2=7.985, P=0.005). In those with normal lactobacillus, the reduction of pH value was not correlated with the occurrence of fungal vaginitis (χ2=0.000, P=1.000). ConclusionThe vaginal environment changes during pregnancy (pH value decrease and Lactobacillus decrease) are associated with the incidence of fungal vaginitis, and it can be prevented and treated based on this phenomenon.
ObjectiveTo determine teratogenicity of beta-blockers in early pregnancy. MethodsWe searched PubMed, EMbase, Cochrane Clinical Trials, clinicaltrials.gov, CBM, Wanfang database, and CNKI from establishment of each database to December 2014. We evaluated the quality of included literature. Statistical analysis was conducted in RevMan5.3 software. ResultsFifteen population-based case-control or cohort studies were identified. The score of included studies changed from 5-7 points. Based on meta-analysis, first trimester oral beta-blocker use showed no increased odds of all or major congenital anomalies. While in analysis examining organ-specific malformations, statistically increased odds of cardiovascular (CV) defects with OR 2.21 and 95% CI 1.63 to 3.01, cleft lip/palate (CL/P) with OR 3.11 and 95% CI 1.78 to 9.89, and neural tube (NT) defects with OR 3.56 and 95% CI 1.19 to 10.67 were observed. ConclusionCausality is difficult to interpret given small number of heterogeneous studies and possibility of biases. Given the frequency of this exposure in pregnancy, further research is needed.
Objective To analyze the clinical features and outcomes of pregnant women with acute diarrhea. Methods We collected the clinical data of 133 pregnant women with acute diarrhea (group A) admitted into Tangshan Maternal and Child Health Hospital and Kailuan General Hospital between June 2009 and June 2015. Another 100 acute diarrhea patients without pregnancy (group B) and 100 pregnant women without acute diarrhea (group C) were regarded as controls. All the patients’ medical history, symptoms and signs, laboratory examination results, diagnosis and treatment, termination of pregnancy and pregnancy outcomes were retrospectively analyzed. Results The average age of group A patients was (29.72±5.19) years old, and 83.46% of them came to hospital within 24 hours. There were significant differences in vomiting, abdominal pain, white blood cells, neutrophils, C-reactive protein, white blood cells in the feces, fibrinogen, prothrombin time, activated partial prothrombin time, thrombin time and the recovery time of the laboratory indicators between group A and group B (P<0.05). The neonatal weight of group A was lower than that of group C, and the difference was statistically significant (P<0.05). Regression analysis showed that hemoglobin and albumin had significant influence on acute diarrhea during pregnancy (P<0.05). Conclusion Pregnancy with acute diarrhea is a kind of severe obstetric complication, which may lead to adverse pregnancy.
ObjectiveSummary of Integrative traditional Chinese and Western medicine nursing management and their effects for acute pancreatitis in pregnancycare. MethodFrom January, 2010 to July, 2014, 17 patients of acute pancreatitis in pregnancy were retrospectively analyzed. The integrative traditional Chinese and Western medicine nursing management includes general nursing, critical care, Chinese medicine nursing [oral or nasogastric feeding of traditional Chinese medicine (TCM), TCM enema, Liuhedan abdominal external treatment, acupuncture care], puerperium care and discharge guidance. ResultsAll 17 patients using the integrative traditional Chinese and Western medicine nursing management were recovered from the attack of acute pancreatitis. Two out of 17 patients underwent cesarean delivery, 2 with natural birth during the course of acute pancreatitis and the rest 13 patients continued pregnancy. ConclusionsThe integrative traditional Chinese and Western medicine nursing management have certain advantages for managing acute pancreatitis in pregnancy, together with the maternal line puerperium care and healthy eating guidance can obtain satisfactory curative effects.
ObjectiveTo investigate the clinical characteristics of epileptics with pregnancy and then provide reference for standardized management of epileptics with pregnancy. MethodsFrom June 2012 to June 2021, epileptics with pregnancy who delivered in Jinan Central Hospital were selected as the research subjects. The clinical data such as the application of Antiseizure medications (ASMs) during pregnancy, seizure frequency, pregnancy outcomes, delivery ways, offspring feeding ways and the incidence of complications were investigated and analyzed. ResultsAmong 36 epileptics with pregnancy, 20 cases (55.56%) were treated with ASMs alone, 5 cases (13.88%) were treated with combined medication, and 11 cases (30.56%) were treated without ASMs during pregnancy. 15 cases (41.67%) adhered to systematic application of ASMs, 17 cases (47.22%) did not adhere to systematic application of ASMs, and 4 cases (11.11%) had unknown medication history. The frequency of seizures increased in 5 cases, decreased in 7 cases and unchanged in 24 cases during pregnancy. Pregnancy outcomes: full-term delivery in 33 cases (91.67%), preterm delivery in 1 case (2.78%) and abortion in 2 cases (5.56%). Delivery mode: cesarean section in 31 cases (91.18%), vaginal delivery in 3 cases (8.82%). After delivery, 4 cases (11.76%) were fed with milk powder and 30 cases (88.24%) were breast-fed. Complications: There were 6 cases complicated with anemia (16.67%), 5 cases complicated with gestational hypertension (13.89%), 3 cases complicated with gestational diabetes (8.33%), 4 cases complicated with premature rupture of membranes (11.11%), 2 cases complicated with fetal growth restriction (5.56%), 2 cases complicated with oligohydramnios (5.56%), 3 cases complicated with fetal distress (8.33%) and 3 cases complicated with neonatal asphyxia (8.33%). ConclusionsThe proportion of epileptics with pregnancy who were systematically treated with ASMs was low and the seizures were poorly controlled. There is a lack of standardized management for such patients in clinical practice.
ObjectiveTo systematically review the association between maternal folate supplementation during pregnancy and the risk of autism spectrum disorder (ASD) in the offspring.MethodsPubMed, EMbase, Web of Science, The Cochrane Library, Scopus, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect case-control and cohort studies on the association between maternal folate supplementation during pregnancy and the risk of ASD in the offspring from inception to December 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 and Stata 14.0 software.ResultsA total of 17 studies involving 10 812 cases and 876 241 controls were included. The results of meta-analysis showed that there was no significant association between maternal folate supplementation during pregnancy and the risk of ASD in the offspring in the total population. The subgroup analysis revealed that maternal folate supplementation during pregnancy was statistically associated with a reduced risk of ASD in the offspring in the Asian population (OR=0.71, 95%CI 0.53 to 0.96, P=0.03). However, there were no statistical correlations in European and American populations.ConclusionsCurrent evidence shows that maternal folate supplementation during pregnancy may reduce the risk of ASD in the offspring in the Asian population. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.