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Microbes are commonly sensitive to shifts in the physiological and pathological state of their hosts, including mothers and babies. From this perspective, the microbiome may be a good indicator for diseases during pregnancy and has the potential to be used for perinatal health monitoring. This is embodied in the application of microbiome from multi body sites for auxiliary diagnosis, early prediction, prolonged monitoring, and retrospective diagnosis of pregnancy and infant complications, as well as nutrition management and health products developments of mothers and babies. Here we summarized the progress in these areas and explained that the microbiome of different body sites is sensitive to different diseases and their microbial biomarkers may overlap between each other, thus we need to make a diagnosis prudently for those diseases. Based on the microbiome variances and additional anthropometric and physical data, individualized responses of mothers and neonates to meals and probiotics/prebiotics were predictable, which is of importance for precise nutrition and probiotics/prebiotics managements and developments. Although a great deal of encouraging performance was manifested in previous studies, the efficacy could be further improved by combining multi-aspect data such as multi-omics and time series analysis in the future. This review reconceptualizes maternal and infant health from a microbiome perspective, and the knowledge in it may inspire the development of new options for the prevention and treatment of adverse pregnancy outcomes and bring a leap forward in perinatal health care.
Asunto(s)
Femenino , Humanos , Recién Nacido , Embarazo , Microbiota , Probióticos/efectos adversos , Estudios RetrospectivosRESUMEN
Hepatolenticular degeneration (HLD) is Wilson's disease, which is an autosomal recessive inherited disease caused by gene abnormality and copper transport disorder in liver cells. The pregnancy of HLD patients is safe. During pregnancy, the treatment of eliminating copper should be continued, the dosage of drugs should be reduced according to the condition, and regular monitoring should be done. HLD patients with satisfactory copper control had better pregnancy outcomes than untreated HLD patients. The treatment during pregnancy should be individualized, and perinatal care should be coordinated by obstetrics, hepatology, liver transplantation, genetic counseling, pharmacy, anesthesiology, pediatrics and other disciplines.
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Based on the latest research results at home and abroad, this paper firstly elaborated the interaction mechanism between pregnancy and lupus nephritis, then pointed out the importance and research progress of pregnancy management, next introduced the content and deficiency of the management in patient with lupus nephritis .And on this basis, it gives some advices on the development and research of pregnancy management in patients with lupus nephritis in order to provide a reference for effective improvement of adverse pregnancy outcomes and the realization the pregnancy safety in patients with lupus nephritis.
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Based on the latest research results at home and abroad, this paper firstly elaborated the interaction mechanism between pregnancy and lupus nephritis, then pointed out the importance and research progress of pregnancy management, next introduced the content and deficiency of the management in patient with lupus nephritis.And on this basis, it gives some advices on the development and research of pregnancy management in patients with lupus nephritis in order to provide a reference for effective improvement of adverse pregnancy outcomes and the realization the pregnancy safety in patients with lupus nephritis.
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Objective To establish a clinical nursing pathway for elderly parturients. Methods The clinical nursing pathway draft for elderly parturients were designed though the method of case analysis and literature review. Delphi method was used by 10 experts engaged in clinical medical or nursing with 2 rounds. Results The recovery rates of the two Delphi method were 100%, the experts who put forward the proposal on the 2 rounds of expert conclusion were 60.00% (6/10) and 20.00% (2/10) respectively. The expert's familiarity with the correspondence is 0.90, the coefficient of judgment is 0.80 and the coefficient of authority is 0.85.The mean value and standard deviation of the 2 rounds of correspondence were 3.60～5.05 (standard deviation 0.34～0.94) and 3.91～4.13 (standard deviation 0.26～0.60)respectively. The coordination coefficients of the 2 rounds of experts consultation were 0.441 and 0.592 (all P＜0.001). The clinical nursing pathway for elderly parturients with pregnancy management were three stages: confirmed pregnancy to 13+6weeks, 14 weeks to 27+6days pregnant and 28 weeks pregnant to childbirth, including a total of 74 projects for 4 modules such as medical history collection, physical examination, clinical laboratory and other examination and nursing measures. Conclusions The practicable clinical nursing pathway for elderly parturients was constructed because its high degree of familiarity,authority,coordination and concentration. The statistical analysis results are reliable,it is beneficial to standardize the pregnancy management for elderly parturients and improve the quality of clinical nursing.
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Objective To investigate the effect of pregnancy management of gestational diabetes mellitus (GDM) on pregnancy outcome.Methods One hundred and two patients of GDM was as our case group and 100 patients with non-diabetic and no medical complications in pregnant women in the same period were as control group who all hospitalized from January 2008 to December 2011.The information of maternal and prenatal complications were collected.Results Pregnancy women were underwent the pregnancy management.No significant difference was seen in terms of the incidences of pregnancy induced hypertension polyhydramnios,preterm delivery,premature rupture of membranes and postpartum hemorrhage between case group and control group(x2 =1.33,0.80,0.68,0.35,0.20,respectively,P ＞ 0.05),so were other indices including of the incidences of fetal macrosomia,fetal distress,neonatal asphyxia,hyperbilirubinemia and neonatal hypoglycemia between the two groups(x2 =0.09,0.23,0.15,0.15,0.49,respectively,P ＞0.05).Conclusion Enhancing the management and standardized treatment of GDM can control the level of serum glucose and decrease the maternal and prenatal complications.