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Objective:The correlation between in vitro fertilization-embryo transfer (IVF-ET) pregnancy and preeclampsia was studied by the propensity score matching. Methods:4 823 pregnant women with delivery gestational weeks >24 weeks were selected, including 481 in IVF group and 4 342 in natural pregnancy group. The propensity score model was established by using 16 maternal covariates, and the propensity score matching samples (924 cases) were obtained to evaluate the correlation between IVF-ET and preeclampsia.Results:⑴ Before matching, the incidence of preeclampsia in the IVF group was higher than that in the natural pregnancy group (9.8% vs 3.3%, P<0.05). Multivariate regression analysis showed that IVF-ET was a risk factor for preeclampsia (a OR=1.887; 95% CI: 1.23-2.89, P=0.003); After matching propensity score, OR was 2.067 (95% CI: 1.24-3.44, P=0.005), confirming that there was a significant association between IVF-ET and preeclampsia. ⑵ Before matching, the incidence of preeclampsia in IVF group was significantly higher than that in natural pregnancy group in singleton pregnancy (9.0% vs 3.1%, a OR=2.530, 95% CI: 1.63-3.94, P>0.05); In twin pregnancy, there was no significant difference in the incidence of preeclampsia between the two groups (12.7% vs 7.5%, a OR=1.004, 95% CI: 0.35-2.87, P=0.994); The result of propensity score matching is consistent with that before matching. Conclusions:Propensity score matching analysis showed that the risk of preeclampsia increased after IVF-ET pregnancy, IVF-ET was an important risk factor for preeclampsia in singleton pregnancy, and IVF-ET did not increase the risk of preeclampsia in twin pregnancy. It is suggested that the correlation between IVF and preeclampsia may be disturbed by twin pregnancy.
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With the continuous elucidation of the molecular mechanism of primordial follicle activation, clinical in vitro activation (IVA) has gradually become a clinical treatment for premature ovarian insufficiency (POI) and reduced ovarian reserve (DOR). This article will review the mechanism of phosphatase and tensin homolog (PTEN)/phosphatidylinositol-3-kinase (PI3K), hippo signal and mammalian target of rapamycin complex 1 (mTORC1) signal involved in the activation of primordial follicles, and the application of IVA in patients with POI and DOR.
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Since the two-child policy has been fully liberalized, the number of elderly women has increased, and the widespread application of assisted reproductive technology has increased the proportion of high-risk pregnancy year by year, which adds new challenges to obstetric work. High-risk pregnancy not only increases the risk of pregnancy complications, but also threatens the health of mother and child. Prenatal screening and pregnancy care for high-risk pregnant women are essential to ensure their safety through pregnancy and delivery. In recent years, with the continuous improvement of prenatal screening and hierarchical medical system, high-risk pregnant women have received more intensive monitoring and active intervention. At the same time, the promotion of Internet + hospitals has also achieved initial results in the field of obstetrics, which has increased the convenience of perinatal health care services. However, there are still differences in maternal health status between urban and rural areas and among different regions, and the supply capacity of maternal and child health services needs to be improved. In terms of reducing maternal and perinatal mortality, obstetric workers and maternal women still need to work together to improve the management of high-risk pregnancies, prevent adverse pregnancy outcomes, and ensure the safety of mothers and infants.
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Acute pancreatitis in pregnancy is a rare but serious disease, and its incidence has shown a significant upward trend in recent years. Due to the progress of diagnosis and treatment technology, the maternal and infant mortality caused by this disease has decreased. However, it is still a great threat to the health of mothers and infants because of its acute onset, many complications, atypical clinical manifestations and difficulties in diagnosis.Therefore, early diagnosis and standardized treatment are the key to reduce the harm to pregnant women and fetuses. This article will review the epidemiology, etiology, diagnosis and treatment of acute pancreatitis in pregnancy.
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Preeclampsia (PE) is characterized by hypertension and proteinuria. Despite extensive research, the etiology and pathogenesis of PE are not completely understood. Increasing evidence suggests that an exaggerated maternal systemic inflammatofrery response may play a central role in the pathogenesis of preeclampsia (PE). Regulatory T cells (Tregs) are a specialized subpopulation of T cells that act as potent suppressors of inflammation to prevent autoimmunity and graft rejection. A reduction in maternal Treg populations could prevent immunological tolerance of the fetus and has been associated with obstetrical complications, such as miscarriage, PE. The research of Treg in immunology is the focus of current research. In this paper, the relationship between the occurrence and development of regulatory Treg in preeclampsia is reviewed.
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Objective To investigate the correlation between peroxisome proliferator-activated re-ceptor-gamma ( PPAR-γ) gene polymorphism and preeclampsia ( PE) . Methods 110 PE patients and 110 normal pregnants who delivered in our hospital from May 2016 to October 2018 were selected as the study subjects. Detection of two loci of PPAR-γ gene by SNaPshot technique: rs10865710 and rs4684847. Re-sults ⑴ rs10865710:The genotype frequencies of CC, CG and GG in the control group were 44. 55％, 42. 73％ and 12. 73％, respectively, and those in the PE group were 31. 82％, 44. 55％ and 23. 64％, re-spectively. There was a critical difference in the distribution of genotype frequencies between the two groups (x2 =5. 975, P=0. 050); The frequencies of C and G alleles were 65. 91％ and 34. 09％ in the control group, 54. 09％ and 45. 91％ in the PE group, respectively. There was significant difference in the fre-quency distribution of C and G alleles between the two groups (x2 =6. 402, P=0. 015). ⑵ rs4684847:the genotype frequencies of CC, CT and TT in control group were 94. 55％, 5. 45％, 0, and those in PE group were 84. 55％, 15. 45％ and 0, respectively,with significant difference in the distribution of genotype frequencies between the two groups (x2 =5. 875, P =0. 015). The frequencies of C and T alleles in control group were 97. 27%, 2. 73% and those in PE group were 92. 27% and 7. 73%, respectively,with significant difference in allele frequency distribution between the two groups (x2 = 5. 551, P = 0. 030). ⑶ The frequency of GG genotype and G allele at rs10865710 locus in PE group was significantly higher than that in control group [OR (95% CI) =2. 600 (1. 190 - 5. 679), P = 0. 021; OR (95% CI) = 1. 64 (1. 117 -2. 411), P =0. 015]. The frequencies of CT genotype and T allele at rs4684847 locus in PE group were significantly higher than those in control group [OR (95% CI) =3. 168 (1. 199 -8. 374), P =0. 026; OR (95% CI) =2. 987 (1. 155 -7. 726), P =0. 030]. Conclusions The single nucleotide polymorphisms of PPAR-γ gene rs10865710 and rs4684847 may be related to the susceptibility to preeclampsia in Chinese population.
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Objective The aim of this study was to evaluate the number of Treg cells in preeclamp-sia (PE) patients, to explore the expression levels of microRNA-210 (microRNA-210) and forkhead box p3 (Foxp3) genes in preeclampsia, and to reveal the regulatory mechanism of microRNA-210 and Foxp3 in preeclampsia. Methods Serum levels of cytokines [ interleukin ( IL)-6, IL-10, IL-17, and transforming growth factor-beta 1 (TGF-β1)] were detected with enzyme-linked immunosorbent assay (ELISA). 29 pa-tients with late-onset preeclampsia (≥36 weeks of gestation) , 27 pregnant women with normal uncomplicat-ed pregnancies (≥36 weeks of gestation) and 20 healthy non-pregnant women were enrolled in the study. Reverse-transcription polymerase chain reaction ( qRT-PCR) was performed to detect mRNA expression for maternal placenta retinoic acid-related orphan receptor C (RORc), Foxp3, and miR-210. Foxp3 protein expression was evaluated by Western blot. Results ⑴The serum levels of IL-6, IL-17 and TGF-beta 1 in preeclampsia patients were significantly higher than those in normal pregnant women, and the level of Treg cytokine IL-10 was lower than that in normal pregnant women ( P <0. 05 ) . ⑵ The percentage of CD4 +CD25 +CD127 - /CD4 +T cells in peripheral blood of preeclampsia patients was significantly lower than that of normal pregnancy group and healthy non-pregnant women ( P <0. 001 ) . ⑶ The mRNA expression of Foxp3 in placenta of preeclampsia patients was significantly lower than that of normal pregnant women, RORc in preeclampsia patients was significantly higher than that of normal pregnant women, and the expres-sion of microRNA210 in preeclampsia patients was enhanced ( P<0. 01 ) . ⑷ Consistent with mRNA ex-pression results, lower protein expression levels of Foxp3 was observed in patients with PE compared with normal pregnant subjects. Conclusions Treg cells decreased in preeclampsia patients and Treg/Th17 im-balance existed in preeclampsia patients, which regulate maternal immune tolerance to fetuses. The expres-sion of Foxp3 in placenta of preeclampsia patients was significantly decreased, which was correlated with the expression of microRNA-210.
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Preeclampsia is one of the main causes of high morbidity and mortality of pregnant women and perinatal infants worldwide. Affected by many factors, preeclampsia has a complex pathogen-esis and can cause involvement of multiple organs and systems. Its pathogenesis is still unclear. Current research suggests that maternal immune system indirectly involved in the pathophysiology of preeclampsia change, that is, abnormal activation of innate immune cells and unbalanced differentiation of T helper cell subsets interfere with normal immune regulation, and interact with inflammatory response of the body, which produces cytotoxic environment at the maternal-fetal interface and affects trophoblast inva-sion. Therefore, clarifying the role of the immune system can not only clarify the pathogenesis of pre-eclampsia, but also contribute to the development of diagnosis and treatment of preeclampsia. This paper reviews the research status of immune system in preeclampsia, including innate immunity and adaptive immunity . The immune mechanism of preeclampsia is elaborated mainly from immune regulation mediated by T lymphocyte, natural killer ( NK) cell, macrophage and human leukocyte antigen.
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Fetal congenital heart disease is one of the important reasons that seriously affect the outcome of perinatal children.In recent years,with the development of molecular genetic technology,prenatal diagnosis of fetal congenital heart disease has made breakthrough progress.Targeted panel sequencing of congenital heart disease fetus can significantly improve the detection rate of chromosome copy number variations.It is helpful to correctly assess the prognosis of the fetus in prenatal clinical consultation and provide a more objective basis for pregnant women to continue their pregnancy.
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Objective@#To evaluate the effectiveness and safety of the use of noninvasive high-frequency oscillation ventilation (nHFOV) in very low birth weight infants.@*Method@#A total of 36 cases received nHFOV between January 2016 and October 2016 in Children′s Hospital, Zhejiang University School of Medicine, including 24 males and 12 females, with the gestational age of (27.5±2.5) weeks and birth weight of(980±318)g. The data of the ventilator settings, side effects, and changes of the respiratory function before and after nHFOV were collected and analyzed retrospectively. Nonparametric tests or t tests or χ2 tests were used.@*Result@#Thirty-two (89%) out of the 36 cases successfully avoided intubation or re-intubation after using of nHFOV. nHFOV was used as the rescue treatment after failure of other noninvasive ventilation in 17 cases, and as the prophylactical treatment preventing re-intubation after extubation in the remaining 19 cases. There were significant decreases in the incidences of apnea and desaturation(SpO2<0.85), the level of PaCO2, and the FiO2 24 h after the initiation of the nHFOV as the rescue therapy((1.2±1.1)vs.(6.3±2.1)episodes , (1.1±1.2) vs.(4.3±1.5) episodes, (43±8) vs.(56±10) mmHg, 0.30±0.07 vs. 0.39±0.11, respectively; 1 mmHg=0.133 kPa, t=7.562, 8.913, 4.179, 3.437 respectively, all P<0.01). No significant changes were found in FiO2 and PaCO2 levels 24 h after initiation of nHFOV as the prophylactical therapy after extubation (0.42±0.12 vs.0.40±0.10, (49±8)vs.(48±7)mmHg, t=0.872 and 0.501 respectively, both P>0.05), except for the significant decreases in the mean airway pressure ((7.9±2.6)vs.(9.6±1.6)cmH2O, 1 cmH20=0.098 kPa, t=2.198, P=0.041). There were 4 cases suffered from nasal septum injury, while no other nHFOV related complications were noted.@*Conclusion@#nHFOV can be applied in preterm infants as a rescue treatment after the failure of other noninvasive ventilation, or prophylactically used in patients who have high risk of re-intubation.
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Cardiac arrest in pregnancy is the emergency sereve case in clinic,which can threaten life and health of the fetus and pregnant women.Pregnancy cardiac arrest once happened,providing health care providers should start high quality chest compressions immediately,open the airway and commence ventilation,activate an emergency call system in which all providers in the maternal/neonatal resuscitation teams.We read from several aspects of 2014 the United States society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy in order to improve the cardiopulmonary resuscitation quality of pregnant women after cardiac arrest and optimize maternal and neonatal outcomes.
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Objective To explore the change of Doppler velocity waveforms in the fetal main pulmonary artery in patients with early onset severe preeclampsia and to assess its value in fetal lung maturity.Methods A prospective study was conducted to analyze fetal main pulmonary artery velocity waveforms parameters including acceleration time(AT),ejection time(ET),acceleration time/ejection time (AT/ET),peak systolic velocity (PSV) in 30 cases of pregnant women with early onset severe preeclampsia.According to neonatal outcome,these cases were divided into respiratory distress syndrome (RDS) group (18 cases) and non-RDS group (12 cases).Each group was compared with 54 cases and 36 cases that were normal and had corresponding gestational age separately.Doppler parameters were compared between these two groups and their corresponding normal control groups.Results Gestational age at sonographic examination,gestational age at delivery and birth weight of neonates in RDS group were significantly lower than those in non-RDS group(all P ＜0.001).The value of AT,ET,AT/ET,PSV were lower in RDS group than those in gestational age-matched control group(all P ＜0.05),while there were no significant difference between non-RDS group and gestational age-matched control group(all P ＞ 0.05).Conclusions Doppler ultrasound monitoring fetal main pulmonary artery velocity waveforms to evaluate fetal lung maturity in patients with early onset severe preeclampsia has clinical application value.
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Objective:To investigate the role of serum RGS2 protein,Ang Ⅱ and AT1R in the Pathogenesis of Preeclampsia and it's impact on the severity of the disease.Methods:Totally 50 patients with PE collected from Shenzhen Maternity and Child Healthcare Hospital,Southern Medical University during October 2015-September 2016 were recruited as PE group(PE with FGR group 17 cases and PE without FGR group 33 cases),40 cases of healthy pregnant women were collected as the control group.ELISA was used to detect the serum RGS2 protein,Ang Ⅱ and AT1R levels.he differences between the groups were compared.Logistic regression was used to analyze the correlation between the three indexes and the severity of PE.Results:①In PE group plasma RGS2 protein,Ang Ⅱ,AT1R levels and systolic blood pressure,diastolic blood pressure,sampling gestational age,maternal gestational age,neonatal birth weight were higher than those in control group(P ＜ 0.05);There was no significant difference on RGS2 protein level,systolic blood pressure and diastolic blood pressure between PE with FGR group and PE without FGR group(P＞0.05),There was significant difference on the Ang Ⅱ,AT1R level and newborn weight(P ＜ 0.05).②Logistic regression analysis showed that RGS2 、Ang Ⅱ and AT1R were the independent risk factors of PE.(the crude odds ratio of RGS2,Ang Ⅱ and AT1R were ＞ 1,P ＜ 0.05.After adjust the sampling of gestational age the OR values were ＞ 1,P ＜0.05.After adjust the other two indicators the OR values were ＞ 1,P ＜0.05,except for Ang Ⅱ.).③RGS2 protein,Ang Ⅱ,AT1R levels were positively correlated with PE,systolic and diastolic blood pressure(P ＜ 0.05).Ang Ⅱ,AT1R levels were negatively correlated with neonatal birth weight (P ＜ 0.05).RGS2 was not related with neonatal birth weight (P ＞ 0.05).Conclusions:Plasma RGS2 protein,Ang Ⅱ and AT1R may be associated with the pathogenesis of PE and Ang Ⅱ and AT1R may be associated with the severity of the disease.
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Cardiac arrest in pregnancy is the emergency sereve case in clinic,which can threaten life and health of the fetus and pregnant women.Pregnancy cardiac arrest once happened,providing health care providers should start high quality chest compressions immediately,open the airway and commence ventilation,activate an emergency call system in which all providers in the maternal/neonatal resuscitation teams.We read from several aspects of 2014 the United States society for Obstetric Anesthesia and Perinatology consensus statement on the management of cardiac arrest in pregnancy in order to improve the cardiopulmonary resuscitation quality of pregnant women after cardiac arrest and optimize maternal and neonatal outcomes.
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ObjectiveTo evaluate the effects of diagnosis of cervical insufficiency and different management on pregnancy outcomes.MethodsFrom June 2004 to May 2010, a retrospective analysis was carried out on 554 patients with cervical insufficiency in nine hospitals in Guangdong Province, China. The patients were divided into two groups, the cervical cerclage surgical treatment group (surgical group,n=357) and the expectant treatment group (n=197). These patients were then re-diagnosed according to the unified diagnostic criteria by the American College of Obstetricians and Gynecologists (2014), and divided into the definite diagnosis group (n=425) and the indefinite diagnosis group (n=129). The two independent samplest-test andChi-square test were used to compare pregnancy outcomes between the definite and indefinite diagnosis groups, and the different treatment groups.ResultsThe full-term delivery rate in the surgical group was significantly higher than that in the expectant treatment group [40.3% (144/357) vs 23.4% (46/197),χ2=16.254, P=0.000], and the late abortion rate was lower in the surgical group than in the expectant treatment group [22.4%(80/357) vs 40.1% (79/197),χ2=19.419,P=0.000]. In women with a definite diagnosis of cervical insufficiency, full-term delivery rate [44.7% (117/262) vs 20.9% (34/163),χ2=24.844,P=0.000], and newborn body weight were significantly higher in the surgical group [(2 664.3±762.2) vs (2 416.9±845.0) g,t=1.160,P=0.014] than in the expectant treatment group and the late abortion rate was significantly lower [21.4% (56/262) vs 41.1% (67/163),χ2=19.021,P=0.000]. Cervical cerclage in the indefinite diagnosis group did not resulted in raising the full-term delivery rate [28.4% (27/95) vs 35.3% (12/34),χ2=0.561], preterm delivery rate [46.3%(44/95) vs 29.4% (10/34),χ2=2.940], late abortion rate [25.3% (24/95) vs 35.3% (12/34),χ2=1.252] and newborn body weight [(2 526.5±761.8) vs (2 683.4±725.8) g,t=0.004] compared with expectant treatment group (allP>0.05). Pregnancy outcomes in the surgical treatment group in relation to twin pregnancies were not significantly different in the≥28 weeks delivery rate [81.4% (37/46) vs 69.2% (18/26),χ2=1.156], late abortion rate [19.6% (9/46) vs 30.8% (8/26),χ2=1.156] and newborn birth weight [(2 003.2±621.0) vs (1 807.5±609.4) g, t=0.057] compared with those in the expectant treatment group (allP>0.05).ConclusionsIn accordance with the diagnostic criteria for cervical insufficiency and indications for cervical cerclage in surgical cases, cervical cerclage can effectively improve pregnancy outcome. But cervical cerclage is not recommended in twin pregnancies with cervical insufficiency.
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Objective To analyze monitoring data on congenital heart disease (CHD) in Shenzhen city from 2009 to 2013.Methods This study described epidemiological characteristics of perinatal CHD.Patients with CHD were divided into isolated CHD group and complex CHD group (the patients were found with malformations of other systems).The prognosis,social and demographic characteristics,and complications of pregnancy were analyzed.Results The average incidence rate of CHD was 7.25‰,of which 94.36％ were diagnosed by ultrasound,of which 33.20％ were diagnosed before delivery.The top three cardiovascular abnormalities were patent ductus arteriosus,patent foramen ovale,and ventricular septal defect.There were about 14.11％ of CHD with other system malformations,mainly including musculoskeletal system,facial features,and nervous system.Compared isolated cardiac malformations and complex cardiacmalformations,significant differences were found in the age stratification,culture degree,prognosis,diagnosis time,incidence rate of complication of pregnancy,and childbirth complications rate (P ＜0.01).Conclusions Most CHDs were diagnosed by ultrasound.Simple cardiovascular malformation was common,especially CHD with two or more types of cardiovascular malformations.The incidence rate of CHD in 30 to 40-year-old women,stillbirth rate,incidence of prenatal diagnostic rate were significantly higher than the simple CHD group.
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Objective To evaluate the clinical effect of ligation of the descending branch of uterine artery and compression sutures at the lower uterine segment in managing postpartum bleeding due to pernicious placenta previa. Methods Clinical data of 227 patients with pernicious placenta previa, admitted to Shenzhen Maternity and Child Healthcare Hospital between June 2010 and June 2013, were retrospectively analyzed. Eight-two women,who were admitted between June,2010 to December,2011, receiving B-Lynch sutures combined with uterine lower segment packing after delivering the baby and placenta during cesarean section were assigned as the control group. Another 145 cases, who were admitted between January 2012 to June 2013, receiving ligation of the descending branch of uterine artery and compression sutures at the lower uterine segment, were defined as the observational group. Several indicators during and after the operation were compared between the two groups. T-test or Chi-square test were applied for statistics. Results The duration of operation in the observational group was shorter than in the control [(92±26) vs (106±32) min, t=3.579, P<0.01]. The estimated blood loss during the operation, the total blood loss during the first 24 h after delivery and the blood loss during the operation for placenta percreta in the observational group were all lower than in the control [(1 230±481) vs (1 858±632) ml, (1 475±236) vs (2 482±364) ml, and (2 131±515) vs (2 587±498) ml, t=8.413, 25.295 and 6.484, all P<0.01]. The adjusted postoperative hemoglobin values of the observational group were significantly higher than that of control [(82±21) vs (69±19) g/L, t= - 4.634, P<0.01]. Besides, significant differences were found between the observational and control group on the rates of hysterectomy, blood transfusion, and uterine artery embolization [1%(2/145) vs 7%(6/82), 40%(58/145) vs 66%(54/82), 2%(3/145) vs 12%(10/82), χ2=5.408, 13.945 and 9.904, P < 0.05 or 0.01]. The dosage of Carboprost Tromethamine required was smaller in the observational group [(573±104) vs (729±128) μg, t=9.971, P<0.01]. Conclusions Ligation of descending branch of uterine artery and compression sutures in the lower uterine segment during cesarean section in women with pernicious placenta previa is an effective and simple method to control bleeding resulting reduction of blood loss and the hysterectomy rate.
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Objective To observe the clinical effects of different fluid therapies in treating severe preeclampsia complicated by ascites. Methods Between Jan. 2010 and Dec. 2012, patients with severe preeclampsia complicated by ascites in Shenzhen Maternity and Child Healthcare Hospital were included in this study. The treatment group ( n=55 ) were given intravenous drip of 6% hydroxyl starch 130/0. 4 plus furosemide, and the control group (n=52) received intravenous drip of 5%human serum albumin plus furosemide. The mean arterial pressure, respiratory rate, heart rate, oxyhemoglobin saturation, colloid osmotic pressure, hematocrit and the incidence of acute pulmonary edema were observed and compared between the two groups. Results Twenty-four hours after cesarean section, the mean arterial pressure of the treatment group was significantly lower than that of the control group, whereas heart rate and oxyhemoglobin saturation were significantly higher (all P0. 05). The average duration of edema after treatment was significantly shorter in the treatment group [(2. 43±0. 37) d versus (3. 74±0. 59) d, P<0. 01]. Conclusion 6% hydroxyl starch 130/4. 0 plus furosemide can effectively elevate the colloid osmotic pressure, resolve edema, improve hypovolemia, sustain oxygen supply to the organs and decrease the complication of pulmonary edema in patients with severe preeclampsia complicated by ascites.
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AIM:To investigate the clinical significance of microRNA-26a-5p (miR-26a-5p)-regulated mye-loid cell leukemia-1 (MCL-1) expression in the development of maternal preeclampsia.METHODS:Plasma and placen-tal tissues were collected from 21 cases of normal pregnancy, 13 cases of maternal gestational hypertension, 15 cases of mild preeclampsia and 26 cases of severe preeclampsia.The levels of plasma and placental miR-26a-5p and placental MCL-1 mRNA were detected by real-time PCR.Western blotting analysis was used to determine the protein expression of placen-tal MCL-1.The clinical significance of the above parameters was also analyzed.RESULTS:miR-26a-5p expression gradu-ally increased(P<0.01) in the 4 groups of maternal plasma and placentas with the disease development, and the mRNA expression of MCL-1 was significantly reduced in the placentas (P<0.01), both showing a significant negative correlation (P<0.01).Meanwhile, the expression of miR-26a-5p and MCL-1 protein in the placental tissues was negatively correla-ted (P<0.01).The miR-26a-5p up-regulation in maternal plasma and placental tissues was negatively correlated with ges-tational age, maternal plasma albumin levels and fetal weight, while it was positively correlated with maternal blood pres-sure and urinary protein level (P<0.01), which was in contrary to the down-regulation of placental MCL-1.CONCLU-SION:Up-regulation of miR-26a-5p is involved in the occurrence and development of preeclampsia by down-regulation of MCL-1.
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<p><b>OBJECTIVE</b>To detect structural changes in the brain in fetuses with agenesis of the corpus callosum (ACC) and holoprosencephaly (HPE) in the first trimester.</p><p><b>METHODS</b>The ultrasound data were analyzed retrospectively in 620 normal singleton fetuses between 11 and 13(+6) gestational weeks, 5 fetuses diagnosed to have ACC, and 13 fetuses with HPE. The midbrain diameter (MD) and falx diameter (FD) were measured and their ratio (MD/FD) was calculated for comparative analysis.</p><p><b>RESULTS</b>No significant difference was found in the MD, FD, and MD/FD ratio between fetuses with ACC and HPE (P>0.05). Compared to the normal fetuses, all the fetuses with ACC and HPE showed significantly increased mean MD and MD/FD ratio (P<0.05); 4 (80%) fetuses with ACC and 11 (84.6%) with HPE had a reduced FD. All the fetuses with ACC and HPE had MD/FD ratios greater than 1, which were below 1 in all the normal fetuses.</p><p><b>CONCLUSION</b>In the first trimester, fetuses with ACC and HPE have measurable abnormalities in the midbrain and falx area of the brain, and these changes, represented by abnormal midsagittal MD, FD and their ratio, can be of value in detecting ACC or HPE in fetuses in the first trimester.</p>