ABSTRACT
The new variant B.1.1.529 of COVID-19 was reported to the WHO for the first time by South Africa on November 24， 2021. At present， Omicron has become the dominant strain in the world and is spreading rapidly. Although Omicron infected during pregnancy shows the lower risk of serious maternal and fetal complications than the previous variants and Delta variant， the rapid increase in the number of cases and the wide range of patients still worth attention of obstetricians. This article reviews the prevalence of Omicron variant infection， the clinical characteristics ， the prevention and the treatment of pregnant women infected with Omicron， as well as the breastfeeding of newborns. It is believed that Omicron infection will not increase the rate of early spontaneous abortion and the infant congenital malformations， but it may increase the risk of gestational hypertensive disorders， premature delivery， cesarean section， and postpartum hemorrhage in the third trimester of pregnancy.We put forward corresponding management strategies and suggestions to provide references for the diagnosis and treatment of novel coronavirus infection in pregnant women in China.
ABSTRACT
@#【Objective】To explore the effects of liver dysfunction in the third trimester of pregnancy on maternal outcomes and identify the factors affecting the maternal prognosis.【Methods】We collected the clinical data of 1 113 women with liver dysfunction in the third trimester of pregnancy （case group） and 1 113 normal pregnancies （control group） from the Third Affiliated Hospital of Sun Yat-sen University between January 2015 and December 2018. We compared the rates of cesarean section，premature delivery，placental abruption，postpartum hemorrhage and maternal mortality in the two groups，conducted the univariate and multivariate analysis for the case group and determined the prognostic risk factors by using Logistic regression. Receiver operating characteristic（ROC）curve analysis was applied to estimate the value of each independent risk factor for predicting liver dysfunction-related maternal mortality. 【Results】The rates of cesarean section，premature delivery，placental abruption，postpartum hemorrhage in the case group were higher than those in the control group（P < 0.05），and the odds ratios（ORs）were 3.59 ，7.81 ，10.68 and 2.93 ，respectively. The maternal mortality in the case group（1.2%）was higher than that in the control group（0.0%）（P < 0.05）. Logistic analysis revealed that high total bilirubin（TBIL），low prothrombin activity（PTA）and low fasting plasma glucose（FPG）were independent risk factors for liver dysfunction- related maternal mortality. The ROC curve analysis indicated that when TBIL was 235.4 μmol/L，the Youden′ s index in maximum was 0.331 with sensitivity of 0.818 and specificity of 0.513. When PTA was 20.5% ，the Youden′ s index in maximum was 0.366 with sensitivity of 0.821 and specificity of 0.545. When FPG was 3.11 mmol/L，the Youden′s index in maximum was 0.405 with sensitivity of 0.769 and specificity of 0.636.【Conclusion】Liver dysfunction in the third trimester of pregnancy has adverse effects on maternal outcomes. TBIL ，PTA and FPG are the factors affecting the maternal prognosis and may have certain predictive value for maternal death.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the efficacy and safety of misoprostol in term labour induction.</p><p><b>DATA SOURCES</b>Data from published English and Chinese literatures about misoprostol in term labour induction were identified from Medline and CBMdisk (using the search terms "misoprostol" and "labour induction") before 2001; hand searches of reference lists of original studies and reviews (including meta-analyses) and contact with investigators in this field before 2001.</p><p><b>STUDY SELECTION</b>Studies were included if they had data on misoprostol and labour induction. Altogether 623 articles were found and 124 were admitted, including 19,287 cases.</p><p><b>DATA EXTRACTION</b>Data were collected on efficacy and incidence of side-effects of misoprostol and oxytocin. Data were checked for consistency within the published articles and converted into a standard format for incorporation into a central database.</p><p><b>DATA SYNTHESIS</b>The average successful induction rate, rates of caesarean section; incidence of tachysystole, hypertonus of uterus and precipitous labour, and rates of meconium stained amniotic fluid between the misoprostol and oxytocin groups were significantly different (P < 0.05). There were no significant differences between the two groups concerning the average interval from the administration of misoprostol and oxytocin to the onset of labour, duration of the total stage of labour, incidence rate of foetal distress, neonatal asphyxia (1-minute Apgar score < and= 7), postpartum haemorrhage or amount of blood loss in postpartum.</p><p><b>CONCLUSIONS</b>Misoprostol is a superior agent over oxytocin on the induction of term labour, but its application might increase the risk of precipitous labour, abnormal uterine contractions or meconium stained amniotic fluid. Therefore, the dosages and regimens of the agent need further investigation.</p>