Effects of anticoagulation protein defect in maternal plasma on spontaneous abortion / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To investigate the mechanism of anticoagulation protein defect in the pathogenesis of unexplained recurrent miscarriage.</p><p><b>METHODS</b>Fifty-seven patients with a history of unexplained abortion were enrolled as the investigation group for tests of protein C, protein S, antithrombin III (AT-III), as well as activated protein C resistance (APC-R). The control group consisted of fifty healthy women with a history of normal pregnancy and delivery. Blood samples were obtained for, measuring serum activity of protein C, protein S, AT-III, and APC-R. Patients with positive APC-R were tested for factor V (FV) Leiden gene mutation by PCR-RFLP method.</p><p><b>RESULTS</b>Of the 57 patients, 12 (21.1%), 1 (1.8%), and 5 (8.8%) cases were found with protein S, protein C, and AT-III deficiency respectively, and 13 (22.8%) cases with positive results of APC-R. Of the control group, no protein C or AT-III deficiency was ever found, whereas 2 (4.0%) volunteers were presented with protein S deficiency and 3 (6.0%) with positive results of APC-R. No FV Leiden gene mutation was identified in all the patients with positive APC-R results. Late spontaneous abortion cases had higher incidence of anticoagulation protein defect than the early cases.</p><p><b>CONCLUSION</b>Anticoagulation protein defect may play a role in the pathogenesis of fetal loss, especially for those occurring in late stage of pregnancy.</p>

Clinical significance and prognosis of fetal arrhythmias / 中国医学科学杂志(英文版)

<p><b>OBJECTIVE</b>To explore fetal arrhythmia clinical significance and its correlation with fetal prognosis.</p><p><b>METHODS</b>Twenty-six cases of fetal arrhythmia detected among 12,799 pregnant women recorded over a ten-year period in Peking Uinon Medical College (PUMC) Hospital were reviewed retrospectively. Fetal arrhythmia was diagnosed by fetal auscultation, ultrasonography, electric fetal heart monitoring, and fetal echocardiography.</p><p><b>RESULTS</b>Twenty-six fetuses were documented with fetal arrhythmia (3 tachycardia, 4 bradycardia, 19 normal heart rate with irregular fetal cardiac rhythm). The incidence of fetal arrhythmia in our hospital was 0.2%. They were diagnosed at the average of 35 weeks' gestation (15 to 41 weeks). Twenty-two cases were diagnosed by antenatal fetal auscultation, 1 case was diagnosed by ultrasonography, and 3 cases were diagnosed by electric fetal heart monitoring. Fetal echocardiograms were performed on 17 fetuses, 6 cases (35.3%) of which showed that ventricular premature beats with normal structure of fetal heart. All neonates survived postnatally and 24 of them (92.3%) were followed up. Echocardiograms were performed for 16 neonates and 2 of them were identified as atrial septal defects with normal heart rhythms. The results of follow-up showed that the two patients had no apparent clinical manifestation. The echocardiogram showed that atrial septal defect obliterated already.</p><p><b>CONCLUSION</b>The prognosis is well for most of the fetuses with arrhythmias, with low incidence of heart deformation.</p>

Application of intrapartum fetal oxygen saturation rate monitoring / 中国医学科学院学报

<p><b>OBJECTIVE</b>To study the accuracy of the application of the intrapartum fetal oxygen saturation (FSO2) monitoring in predicting fetal acidosis and diagnosing intrauterine fetal distress.</p><p><b>METHODS</b>Continuous FSO2 monitoring as well as internal and external fetal heart rate monitoring were applied respectively in 60 women in labor during active phase of the first stage and the second stage. All the monitoring methods were validated with standard sensitivity, specificity, positive predictive value, negative predictive value, and accuracy on the bases of Apgar score and cord artery blood analysis.</p><p><b>RESULTS</b>The mean FSO2 in the active phase of the first stage were significantly higher than in the second stage of labor. FSO2 correlated with pH, PO2, PCO2, and base excess (BE) of cord blood to a significant degree. There was linear correlation between FSO2 and cord artery blood pH. Using 30% cutoff diagnosing intrauterine fetal distress, the sensitivity, specificity, and accuracy were 80%, 100% and 98.3%, respectively.</p><p><b>CONCLUSION</b>FSO2 monitoring is an effective method diagnosing intrauterine fetal distress.</p>

Screening by maternal serum markers for Down's syndrome / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the optimal method of screening for Down's syndrome (DS) with maternal serum mankers.</p><p><b>METHODS</b>Screening by maternal serum markers for Down's syndrome was offered to all 2886 pregnant women in Peking Union Medical Hospital during 1996.11-2001.3. Alpha-fetoprotein (AFP), human chorionic gonadotrophin (free beta-HCG) were used as markers during the first year of pregnancy. Alpha-fetoprotein, free human chorionic gonadotrophin (HCG) and pregnancy-associated plasma protein A (PAPP-A) were used as mid pregnancy and first-trimester markers in next three years. Amniocentesis and (CVS) were done in those defined as risk cases.</p><p><b>RESULTS</b>The detection rate of Down's syndrome by maternal serum markers was 3.8% (11/2886). The proportion of false positive results in group of triple markers (alpha FP, free beta-HCG, PAPP-A) was 5%.</p><p><b>CONCLUSIONS</b>The PAPP-A was a good marker to detect Down's syndrome in early pregnancy and may be used to predict the outcome during mid trimester of pregnancy. The AFP and free beta-HCG can be useful markers to detect Down's syndrome and fetal abnormality. While prenatal diagnostics can be shifted to an early pregnant period.</p>

A technique of continuous medical image digital restoration / 中国医学科学院学报

<p><b>OBJECTIVE</b>To set up a new technique of continuous medical image digital restoration for electronic record management.</p><p><b>METHODS</b>According to Freeman's chain-code principle, 92 fetal cardiotocography were scanned, thinned, trailed, and chain-coded by computer system.</p><p><b>RESULTS</b>92 paper-recorded cardiotocography, were transformed to digital data and saved by computer, 23 parameters were produced, which could be used in further study.</p><p><b>CONCLUSION</b>Capacity of a restoring instrument can be greatly saved since the using of digitalized restoration, so that more useful data can be stored in doctor's workstation. Digitalized data can be much easier used in electronic record management, for convenient studies research.</p>