Objective: To investigate the clinical characteristics and maternal and fetal prognosis of pregnant women with acute fatty liver of pregnancy (AFLP). Methods: The clinical data of 86 AFLP pregnant women admitted to the Third Affiliated Hospital of Guangzhou Medical University from September 2017 to August 2022 were collected, and their general data, clinical characteristics, laboratory tests and maternal and fetal outcomes were retrospectively analyzed. Results: (1) General information: the age of the 86 pregnant women with AFLP was (30.8±5.4) years, and the body mass index was (21.0±2.5) kg/m². There were 50 primiparas (58.1%, 50/86) and 36 multiparas (41.9%, 36/86). There were 64 singleton pregnancies (74.4%, 64/86) and 22 twin pregnancies (25.6%, 22/86). (2) Clinical characteristics: the main complaints of AFLP pregnant women were gastrointestinal symptoms, including epigastric pain (68.6%, 59/86), nausea (47.7%, 41/86), anorexia (46.5%, 40/86), vomiting (39.5%, 34/86). The main non-gastrointestinal symptoms were jaundice of skin and/or scleral (54.7%, 47/86), edema (38.4%, 33/86), fatigue (19.8%, 17/86), bleeding tendency (16.3%, 14/86), polydipsia or polyuria (14.0%, 12/86), skin itching (8.1%, 7/86), and 17.4% (15/86) AFLP pregnant women had no obvious symptoms. (3) Laboratory tests: the incidence of liver and kidney dysfunction and abnormal coagulation function in AFLP pregnant women was high, and the levels of blood ammonia, lactate dehydrogenase and lactic acid were increased, and the levels of hemoglobin, platelet and albumin decreased. However, only 24 cases (27.9%, 24/86) of AFLP pregnant women showed fatty liver by imageology examination. (4) Pregnancy outcomes: ① AFLP pregnant women had a high incidence of pregnancy complications, mainly including renal insufficiency (95.3%, 82/86), preterm birth (46.5%, 40/86), hypertensive disorders in pregnancy (30.2%, 26/86), gestational diabetes mellitus (36.0%, 31/86), fetal distress (24.4%, 21/86), pulmonary infection (23.3%, 20/86), disseminated intravascular coagulation (16.3%, 14/86), multiple organ dysfunction syndrome (16.3%, 14/86), hepatic encephalopathy (9.3%, 8/86), and intrauterine fetal death (2.3%, 2/86). ② Treatment and outcome of AFLP pregnant women: the intensive care unit transfer rate of AFLP pregnant women was 66.3% (57/86). 82 cases were improved and discharged after treatment, 2 cases were transferred to other hospitals for follow-up treatment, and 2 cases (2.3%, 2/86) died. ③ Neonatal outcomes: except for 2 cases of intrauterine death, a total of 106 neonates were delivered, including 39 cases (36.8%, 39/106) of neonatal asphyxia, 63 cases (59.4%, 63/106) of neonatal intensive care unit admission, and 3 cases (2.8%, 3/106) of neonatal death. Conclusions: AFLP is a severe obstetric complication, which is harmful to mother and fetus. In the process of clinical diagnosis and treatment, attention should be paid to the clinical manifestations and laboratory tests of pregnant women, early diagnosis and active treatment, so as to improve maternal and fetal outcomes.
Pregnancy ; Infant, Newborn ; Female ; Humans ; Adult ; Retrospective Studies ; Premature Birth/epidemiology* ; Pregnancy Complications/diagnosis* ; Fatty Liver/diagnosis* ; Fetal Death ; Stillbirth

BACKGROUNDTo evaluate the safety of intracytoplasmic sperm injection (ICSI) with epididymal or testicular sperm, this study compared children born after ICSI treatment with epididymal or testicular sperm with children conceived after ICSI with ejaculated sperm.

METHODSThis retrospective study included 317 children born after ICSI with percutaneous epididymal sperm aspiration (PESA), 103 children born after ICSI with testicular sperm aspiration (TESA), and a control group of 1008 children born after ICSI with ejaculated sperm. All of the patients received their assisted reproductive treatment in the Reproductive Medicine Center of the First Affiliated Hospital of Zhengzhou University from January 2004 to December 2011. Data, such as the rate of stillbirths, perinatal mortality, gestational age, birth weight, and the rate of congenital malformations of the three groups, were compared.

RESULTSPESA and TESA children were not different from ICSI children in the rate of stillbirths, perinatal mortality, infant mortality rate, gestational age, the rate of prematurity, and the rate of malformations (P > 0.05). A slight increase in birth defects was reported in the TESA group compared with those in the control group, but there was no significant difference between the groups (P > 0.05).

CONCLUSIONICSI with epididymal or testicular sperm does not lead to more stillbirths or congenital malformations compared with ICSI using ejaculated sperm.

Adult ; Congenital Abnormalities ; epidemiology ; Epididymis ; Female ; Fetal Death ; epidemiology ; Follow-Up Studies ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Retrospective Studies ; Sperm Injections, Intracytoplasmic

BACKGROUNDEarly onset severe preeclampsia is a specific type of severe preeclampsia, which causes high morbidity and mortality of both mothers and fetus. This study aimed to investigate the clinical definition, features, treatment, outcome and risk factors of early onset severe preeclampsia in Chinese women.

METHODSFour hundred and thirteen women with severe preeclampsia from June 2006 to June 2009 were divided into three groups according to the gestational age at the onset of preeclampsia as follows: group A (less than 32 weeks, 73 cases), group B (between 32 and 34 weeks, 71 cases), and group C (greater than 34 weeks, 269 cases). The demographic characteristics of the subjects, complications, delivery modes and outcome of pregnancy were analyzed retrospectively.

RESULTSThe systolic blood pressure at admission and the incidence of severe complications were significantly lower in group C than those in groups A and B, prolonged gestational weeks and days of hospitalization were significantly shorter in group C than those in groups A and B. Liver and kidney dysfunction, pleural and peritoneal effusion, placental abruption and postpartum hemorrhage were more likely to occur in group A compared with the other two groups. Twenty-four-hour urine protein levels at admission, intrauterine fetal death and days of hospitalization were risk factors that affected complications of severe preeclampsia. Gestational week at admission and delivery week were also risk factors that affected perinatal outcome.

CONCLUSIONSEarly onset severe preeclampsia should be defined as occurring before 34 weeks, and it is featured by more maternal complications and a worse perinatal prognosis compared with that defined as occurring after 34 weeks. Independent risk factors should be used to tailor the optimized individual treatment plan, to balance both maternal and neonatal safety.

Adult ; Cardiovascular Diseases ; epidemiology ; etiology ; Female ; Fetal Death ; Gestational Age ; Humans ; Pre-Eclampsia ; epidemiology ; mortality ; Pregnancy ; Pregnancy Complications ; epidemiology ; mortality ; Risk Factors

OBJECTIVETo study the mechanism of brain development delay in rats with intrauterine growth retardation (IUGR) by examining the expression of nerve growth factor (NGF) and tyrosine kinase receptor A (Trk A) in the brain.

METHODSThirty-two pregnant rats were randomly fed with a normal diet (control group) or lower protein diet (IUGR group) during pregnancy (n=16 each). The pup rats were sacrificed at 0, 7, 14 or 21 days after birth. The protein levels of NGF and TrkA in the brain were determined by Western blot and immunohistochemistry staining.

RESULTSThe levels of NGF and TrkA in the brain in pup rats of the IUGR group were significantly lower than those in the control group 0, 7, 14 and 21 days after birth.

CONCLUSIONSThe decreased expression of protein levels of NGF and TrkA in the brain might be one of the causes of brain development delay in IUGR rats.

Animals ; Birth Weight ; Brain Chemistry ; Female ; Fetal Death ; epidemiology ; Fetal Growth Retardation ; epidemiology ; metabolism ; Immunohistochemistry ; Nerve Growth Factor ; analysis ; Pregnancy ; Rats ; Rats, Wistar ; Receptor, trkA ; analysis

OBJECTIVEThis research was to compare the occurrence levels of birth defect, to describe the distribution of primary birth defects in different range of monitored ages and to provide data to China birth-defect monitoring system.

METHODSA retrospective study on birth defect was conducted in two counties, Shanxi province, China, which covered birth defects among fetuses after 20 weeks' gestational age from 2002 through 2004. Data collected on birth defect cases mainly included extrinsic and visceral anomaly.

RESULTSThe occurrence rates of the monitored structural birth defects significantly increased with the increase of age. The occurrence rates were 17.6, 34.0, 43.6, and 53.7 per 1000 births, for different statistical range, from 20-week to 27-week gestational age, 7 days, 1 year and 3 years after birth, respectively. The range from 28-week gestational age to 7 days after birth was usually regarded as the routinely monitored range. If the occurrence rate was calculated from the 20-week gestational age, it appeared a 2.1-time increase. However, if the range was changed to 1 or 3 years after birth, the occurrence rate increased to 2.7 or 3.3 times high, respectively. The distribution of time when birth-defect was identified was significantly different by categories with majority of neural tube defect cases diagnosed at antepartum or 7 days after birth. Visceral defects were mainly found at 7 days after birth but increased with age, even some were diagnosed at 1 year after birth.

CONCLUSIONThe routine Chinese monitoring program might detect approximately 1/3 of those structural birth defects with the base of current technique and monitoring range from 28-week gestational age to 7 days after birth. The result of our findings should be of help to other related studies.

Adult ; China ; epidemiology ; Congenital Abnormalities ; epidemiology ; Female ; Fetal Death ; epidemiology ; Fetal Mortality ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Prevalence ; Retrospective Studies

OBJECTIVETo study the epidemiological characteristics of congenital hydrocephalus in Chinese perinatal.

METHODSFrom 1996 to 2004, data gained from Chinese Birth Defects Monitoring Network were used to depict the epidemiology of congenital hydrocephalus in China. All perinatal born in hospitals had an access within 7 days after delivery. The affected cases were divided into two groups-isolated and syndromic hydrocephalus. And prevalence rates were calculated by year, by sex, by birth area (urban versus rural), by maternal age group and by geographic area (north versus south). Of the affected, fetal age at birth, birth weight, perinatal outcome and prenatal diagnosis were analysed.

RESULTSAll 3012 perinatal with congenital hydrocephalus were identified among 4,282,536 births, then an overall prevalence rate was 7.03/10,000, rates of isolated and syndromic hydrocephalus were 5.67/10,000 and 1.36/10,000 respectively. Furthermore, the annual prevalence rates of hydrocephalus presented an increasing trend during that period. The rates in male and female births, in urban and rural area, were 7.09/10,000 and 6.76/10,000, 5.49/10,000 and 10.10/10,000 respectively. There were significant differences among maternal-age-specific prevalence rates, the highest (11.42/10,000) was in an age < 20 years group. For total and isolated hydrocephalus, higher rates were found in north part of China. On the contrary, a higher rate of syndromic hydrocephalus was observed in south part of China. Among the infants with hydrocephalus, the ratio of preterm delivery and of low birth weight were 57.97% and 50.92% respectively. The ratio of congenital hydrocephalus diagnosed antenatally, which could be an indicator representing the capability of detecting the malformation both prenatally and postnatally, showed an upward trend similar to the prevalence rates. The perinatal fatality rates of the total, isolated and syndromic hydrocephalus were 87.75%, 88.66% and 83.91% correspondingly.

CONCLUSIONBased on comparison between prevalence rates in China and those reported in foreign countries, our country might be listed into a higher epidemic region of the congenital hydrocephalus. Significant differences were identified between rural and urban areas, between north and south parts of China. The improvement ability in prenatal and postnatal diagnosis should be partly accounted for the increasing prevalence rates of hydrocephalus in Chinese perinatal. The poor birth quality of the affected predicts poor prognosis.

China ; epidemiology ; Congenital Abnormalities ; epidemiology ; Female ; Fetal Death ; Humans ; Hydrocephalus ; epidemiology ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Trimester, Second ; Pregnancy Trimester, Third ; Prevalence ; Rural Population ; Urban Population

OBJECTIVETo explore the clinical features and prognosis of early-onset preeclampsia.

METHODSA total of 115 cases of early-onset preeclampsia were recruited from January 1999 to December 2004 and the data analyzed in terms of the incidence, manifestation, maternal and fetal complications.

RESULTThe early-onset preeclampsia accounted for 13.4% of all preeclampsia diagnosed. The perinatal mortality was 13.3% in early-onset preeclampsia. Dysfunction and hepatic dysfunction were the main maternal complications. The gestational ages at admission and at delivery were significantly correlated with perinatal prognosis (P<0.001). Most cases received regular treatment had good prognosis.

CONCLUSIONEarly-onset preeclampsia is a severe type of preeclampsia.

Adult ; China ; epidemiology ; Female ; Fetal Death ; Gestational Age ; Humans ; Infant Mortality ; Infant, Newborn ; Pre-Eclampsia ; diagnosis ; epidemiology ; Pregnancy ; Pregnancy Outcome

OBJECTIVETo study the trend of under 5 years old children mortality and the leading cause of the deaths in China from 1996 to 2000.

METHODSThe data presented in this report were obtained from the national child mortality surveillance network, including 116 counties (cities) throughout China. The target population was all children under 5 years old in the monitored areas whose mothers or fathers had resided in the area for at least one year. The data were collected and reported by health workers at the three-level network.

RESULTSThe neonatal mortality rate (NMR), infant mortality rate (IMR) and under 5 years old mortality rate (U(5)MR) in China dropped to 22.8, 32.2, 39.7 per 1,000 live births in 2000, respectively (they were 24.0, 36.0, 45.0 respectively in 1996), which declined 5.0%, 10.6%, 11.8% from 1996 to 2000, respectively. In urban areas, NMR, IMR and U(5)MR dropped to 9.5, 11.8, 13.8 per 1,000 live births in 2000, respectively (they were 12.2, 14.8, 16.9 respectively in 1996), which declined 22.1%, 20.3%, 18.3% from 1996 to 2000, respectively. In rural areas, NMR, IMR and U(5)MR dropped to 25.8, 37.0, 45.7 per 1,000 live births in 2000, respectively (they were 26.7, 40.9, 51.4 respectively in 1996), which declined 3.4%, 9.5%, 11.1% from 1996 to 2000, respectively. There was a steady decline in the U(5)MR due to diarrhea, pneumonia, neural tube defects and drowning in China.

CONCLUSIONIn urban/rural areas, the overall decline in NMR, IMR and U(5)MR from 1996 to 2000 was spectacular. Especially the U(5)MR due to avoidable deaths such as pneumonia and diarrhea was dropped markedly in rural areas.

Cause of Death ; trends ; Child Mortality ; trends ; Child, Preschool ; China ; epidemiology ; Fetal Death ; Humans ; Infant ; Infant Mortality ; trends ; Infant, Newborn ; Rural Population ; statistics & numerical data ; Urban Population ; statistics & numerical data

OBJECTIVETo explore the factors associated with perinatal death of hepatic diseases in pregnancy (HDIP) and make feasible suggestions and measures for perinatal care of high risk patients.

METHODSThe 80 perinatal death cases of hepatic diseases in pregnancy (HDIP) during 1991-2000 in our hospital were analyzed retrospectively.

RESULTSThe perinatal mortality of HDIP in our hospital during the last 10 years was 17.99 approximately 65% was in utero death. Perinatal mortality was different between male (21.64%) and female (10.11%) (P<0.01). Compared first 5 years with last 5 years author found that the perinatal mortality of HDIP had no significant decrease (P>0.05). The perinatal mortality in city and suburbs had decreased, while in the floating population from other provinces the perinatal mortality had increased. The perinatal death was mainly caused by pregnancy induced hypertension (PIH) and asphyxia. But for the HBV carrier mothers the causes of death included umbilical cord problems, premature rupture of membrane and asphyxia.

CONCLUSIONSThe perinatal death mortality was increased by HDIP, deaths were essentially associated with pregnancy induced hypertension and asphyxia and the floating population and male gender were high risks. To enhance the management of HDIP or immigration, take effective therapies of hepatitis and improvement of resuscitation of newborns are critically important.

Adolescent ; Adult ; Cause of Death ; Female ; Fetal Death ; epidemiology ; Fetal Distress ; etiology ; mortality ; Humans ; Infant Mortality ; Infant, Newborn ; Liver Diseases ; complications ; mortality ; Male ; Pre-Eclampsia ; complications ; mortality ; Pregnancy ; Pregnancy Complications ; mortality ; Retrospective Studies ; Sex Factors

The objective of this investigation was to evaluate dose-incidence relationships on the prenatal effects of gamma-radiation. Pregnant ICR mice were exposed on day 11.5 after conception, coincident with the most sensitive stage for the induction of major congenital malformations, with 0.5-4.0 Gy of gamma-radiations. The animals were sacrificed on day 18 of gestation and the fetuses were examined for mortality, growth retardation, change in head size and any other morphological abnormalities. With increasing radiation dose, incidence of small head, growth retarded fetuses, cleft palate, dilatation of cerebral ventricle and abnormalities of the extremities in live fetuses rose. The threshold doses of radiation that induced cleft palate and dilatation of cerebral ventricle, and abnormal extremities were between 1.0 and 2.0 Gy, and between 0.5 and 1.0 Gy, respectively.
Animals ; Bone and Bones/*abnormalities/radiation effects ; Congenital Abnormalities/embryology/epidemiology/*radionuclide imaging ; Female ; Fetal Death ; Fetal Resorption/epidemiology/radionuclide imaging ; *Gamma Rays ; Incidence ; Mice ; Mice, Inbred ICR ; Pregnancy ; *Prenatal Exposure Delayed Effects ; *Whole-Body Irradiation