Clinical data of 21 pregnant women with scrub typhus were analyzed retrospectively.They all had fever,13 of them with lymph nodes enlargement,12 with skin rashes,11 with eschar or ulcer,and 20 positive with Weil-Felix reaction.Oxytetracycline was given in 17 of them and other four were treated by azithromycin,with all cured.Seven of them gave natural childbirth at the 37th week of gestation,nine were aborted inductively,three aborted spontaneously and two delivered premature births.Scrub typhus was harmful to both pregnant women and their fetuses,early diagnosis and treatment are necessary for patients with it for avoiding exacerbation and reducing fatality.

Objective: To assess the performance of extracorporeal membrane oxygenation (ECMO) in the treatment of neonates with critical diseases. Methods: This study retrospectively analyzed the clinical data of nine critically ill neonates treated with ECMO because of cardiopulmonary failure due to respiratory disorders in Children's Hospital of Fudan University from August 2015 to April 2018. General information, diagnosis, indications and approaches of ECMO, clinical procedure of ECMO, laboratory results, weaning time, survival rate before discharge, length of stay, and mechanical and neurological complications were collected and described. Results: (1) There were six male and three female patients with an average gestational age and body weight of 39.6 weeks (35-41 weeks) and 3 600 g (2 580-4 650 g), respectively. Out of them, six cases survived after successfully weaning from ECMO. (2) Sepsis (two cases), meconium aspiration (two cases), pulmonary hypertension (three cases), diaphragmatic hernia (one case) and pulmonary dysplasia (one case) were diagnosed in the patients. All underwent veno-arterial (VA) ECMO using centrifugal pump. The median age to initiate ECMO was 40 h (23-100 h) after birth, and the median duration of ECMO support was 240 h (70-370 h). During the treatment with ECMO, cholestasis, intracranial hemorrhage and vocal cord paralysis occurred in three cases, and mechanical complications (mainly were bleeding, hemolysis, oxygenated membrane leakage and embolization) occurred in five cases. The mean length of hospital stay for the six survivors was 24 d (20-49 d), and two of them developed neurological complications mainly manifested as cerebral infarction. There were three died cases. One was a baby with diaphragmatic hernia who received hernia repair during ECMO after which celiac space syndrome and necrotizing enterocolitis were developed and his parents refused further treatment. In the second case, the parents gave up treatment when no improvement was achieved after two weeks of ECMO support. While the last case was complicated by severe cerebral hemorrhage during ECMO and died after receiving no further treatment. Conclusions ECMO is newly applied in the treatment of neonates in China and of great significance for critically ill neonates. However, much need to be learned about its utilization in this population considering the mortality and disability rate are still high.