ABSTRACT
<p><b>OBJECTIVE</b>To investigate the risk factors of intrauterine hepatitis B virus (HBV) infection and the impact of HBV DNA on the infection.</p><p><b>METHODS</b>The serum levels of HBsAg, HbsAb, HBeAg, HBeAb, HBcAb and HBV DNA were determined in blood samples from 230 HBsAg-positive pregnant women and their newborns by enzyme-linked immunosorbent assay (ELISA) and fluorescence quantitative PCR (FQ-PCR), respectively. The newborns acquiring HBV infection via intrauterine transmission were selected as the case group and others as the control group. The risk factors for intrauterine HBV infection were analyzed by non-conditional logistic regression model.</p><p><b>RESULTS</b>Six infants were found to be HBsAg-positive, and 18 HBV DNA-positive, and 3 of them were positive for both HBsAg and HBV DNA. The rate of intrauterine HBV infection was 9.6% (22/230). The grade of HBV DNA level was identified as the only risk factor of intrauterine HBV infection by non-conditional logistic regression model, with odds ratio (OR) of 1.57 (95% confidence interval 1.12-2.21). Of the 119 pregnant women positive for HBV DNA, 18 were diagnosed as having intrauterine HBV infection, and the likeliness of the infection significantly increased for a maternal serum HBV DNA level > or =10(7) copies/ml (chi(2)=7.92, P<0.05).</p><p><b>CONCLUSION</b>The grade of serum HBV DNA level is the predominant risk factor for intrauterine HBV infection in pregnant women, and for those with serum HBV DNA lever > or =10(7) copies/ml, the chance for intrauterine HBV infection can be significantly increased.</p>
Subject(s)
Female , Humans , Infant, Newborn , Pregnancy , DNA, Viral , Blood , Genetics , Enzyme-Linked Immunosorbent Assay , Hepatitis B , Virology , Hepatitis B Antibodies , Blood , Hepatitis B Surface Antigens , Blood , Hepatitis B virus , Genetics , Allergy and Immunology , Infectious Disease Transmission, Vertical , Logistic Models , Odds Ratio , Polymerase Chain Reaction , Pregnancy Complications, Infectious , Blood , Virology , Risk FactorsABSTRACT
<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>