Intrapartum management of category Ⅱ fetal heart rate tracings / 中国实用妇科与产科杂志

The category Ⅱ fetal heart rate(FHR)tracings,which have various forms,are the common patterns of electronic fetal monitoring(EFM)during labor.The correct identification and assessment of categoryⅡ FHR tracings,as well as the targeted intervention according to specific clinical conditions,can reduce the occurrence of adverse pregnancy outcomes.This article introduces the intrapartum management process of categoryⅡFHR tracings according to the three-tier system for the categorization of intrapartum EFM,and expounds the causes and intervention measures of different types of categoryⅡFHR tracings,so as to guide clinical practice.

Correlation between sleep apnea hypopnea syndrome and preeclampsia and the possible pathogenesis of preeclampsia / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the relationship between sleep apnea-hypopnea syndrome (SAHS) and preeclampsia and the possible pathogenesis of the latter.</p><p><b>METHODS</b>Twenty-five healthy pregnant women, 43 pregnant women with preeclampsia, and 27 with preeclampsia complicated by SAHS were enrolled in this study. Apnea-hypopnea index (AHI) and the lowest arterial oxygen saturation (LSaO2) were measured through a 7-hour polysomnography (PSG), and the maternal age, gestational age, body mass index and 24-hour urine protein were recorded.</p><p><b>RESULTS</b>All the indexes except for the maternal age and gestational age showed significant differences between the 3 groups. The two groups of preeclampsia patients showed a significant difference in BMI from the control cases. Significant positive correlations of AHI to BMI, MAP and 24-hour urine protein were noted; LSaO2 was found to inversely correlate to BMI, MAP, and 24-hour urine protein. In spite of the significant correlation of BMI to the other indexes, we found that BMI was less important than AHI and LSaO2.</p><p><b>CONCLUSION</b>SAHS may induce or aggravate preeclampsia. Greater attention should be given to the presence of SAHS in pregnant women with obesity, but obesity is not the predominant predisposing factor for preeclampsia.</p>

Clinical application of the Epworth sleepiness score in pregnant women with obstructive sleep apnea-hypopnea syndrome / 南方医科大学学报

<p><b>OBJECTIVE</b>To provide a convenient method for screening obstructive sleep apnea-hypopnea syndrome (OSAHS) in pregnant women.</p><p><b>METHODS</b>Seventy-eight pregnant women with suspected OSAHS were calculated for the EP index using Epworth sleepiness score (ESS) with also measurement of the neck circumference (NC) and body mass index (BMI). The apnea/hypopnea index (AHI) was calculated and the lowest SaO(2) (LSaO(2)) measured through a 7-h polysomnography (PSG). The women were then divided into 4 groups according to the AHI and LSaO(2). The ESS was compared with the PSG-AHI and the receiver operating characteristic curve (ROC) was generated.</p><p><b>RESULTS</b>All the clinical indexes (NC, BMI, EP, AHI, and LSaO(2)) showed significant differences between the 4 groups (P<0.05). EP and PSG were found to have greater correlations to AHI (r=0.759, P=0.000) than NC (r=0.668) and BMI (r=0.663). The area under the ROC of the EP (0.825) was greater than that of NC (0.772) and BMI (0.784). The index of EP showed greater clinical diagnostic value of OSAHS in pregnancy. Base on the ROC, EP at the optimal operating point of 7.5 had a sensitivity of 76.8% and specificity of 68.2% for diagnosis of OSAHS in pregnant women.</p><p><b>CONCLUSION</b>The ESS is an economic and convenient method for screening OSAHS in pregnant women with high diagnostic sensitivity and specificity.</p>

Expression of aquaporin-1 in human oligohydramnios placenta and fetal membranes / 南方医科大学学报

<p><b>OBJECTIVE</b>To detect aquaporin-1 mRNA (AQP1) expression in human oligohydramnios placenta and fetal membranes.</p><p><b>METHODS</b>Placenta and fetal membranes samples were obtained from 5 women with oligohydramnios and 5 with normal amniotic fluid volume. AQP-1 mRNA expression in the tissue samples was detected by semi-quantitative RT-PCR.</p><p><b>RESULTS</b>The expression of AQP1 mRNA was significantly lower in oligohydramnios placenta than in normal pregnancy placenta at term (P<0.05), and also significantly lower in oligohydramnios fetal membranes than in normal fetal membranes at term (P<0.05).</p><p><b>CONCLUSION</b>Alterations in AQP1 mRNA expressions in human placenta and fetal membranes may play an important role in the disorder of maternal-fetal fluid exchange and amniotic fluid volume.</p>

Expression of aquaporin 1 in human placenta and fetal membranes / 南方医科大学学报

<p><b>OBJECTIVE</b>To detect aquaporin1 (AQP1) expression in normal human placenta and fetal membranes.</p><p><b>METHODS</b>Human placenta and fetal membrane specimens were collected from 5 pregnant women with intact membranes undergoing elective cesarean sections at term. Expression and localization of AQP1 was detected by RT-PCR, Western blotting and immunohistochemistry.</p><p><b>RESULTS</b>AQP1 mRNA was detected in the placenta and fetal membranes by RT-PCR, and Western blotting also yielded positive results for the specimens, showing a specific band around 28 kD. Immunohistochemical staining showed AQP1 expression in the vascular endothelial cells and syncytiotrophoblasts of the placenta, epithelial cells of the amnion, and cytotrophoblasts of the chorion.</p><p><b>CONCLUSION</b>The presence of AQP1 expression in the placenta and fetal membranes suggest that AQP1 may play an important role in maternal-fetal fluid exchange and amniotic fluid balance.</p>