BACKGROUNDMonochorionic multiple pregnancies (MMPs) are associated with higher rates of perinatal morbidity and mortality caused by interfetal vascular anastomoses in the monochorionic placenta, which can lead to fetal health interactions. In some circumstances, selective feticide of the affected fetus is necessary to save the healthy co-twin. We evaluated the effects and safety of our initial experiences using bipolar cord coagulation for the management of complicated MMPs.

METHODSUsing ultrasound-guided bipolar cord coagulation, we performed selective feticide on 14 complicated MMPs (5 with twin-twin transfusion syndrome, 4 with acardia, 3 with discordant structural anomalies, and 2 with severe selective intrauterine growth restriction). One patient with monochorionic triplets received the procedure twice to terminate 2 affected fetuses for different indications. Data regarding the operations, complications and neonatal outcomes were analyzed.

RESULTSCord occlusions were successfully performed in 13/14 (93%) cases. The failure happened in an acardiac fetus and the pregnancy was terminated by induction. The included cases delivered at a mean gestational age of 35.4 weeks with a perinatal survival rate of 11/13 (85%). Three operation-related complications occurred (21%), including membrane rupture of the terminated sac (1 case), preterm labor at 28 weeks gestation (1 case), and chorioamniotic membrane separation (1 case). Amnioinfusion was indicated in 11 procedures to expand the target sacs for entering the trocar and obtaining sufficient working space. However, in all 4 cases of acardia, the acardiac sacs showed extreme oligohydramnios and could not be well expanded by infusion; thus, the trocar had to be inserted from the sac of the preserved co-twin.

CONCLUSIONSThe application of bipolar cord coagulation in complicated MMPs is safe and improves the prognosis. Amnioinfusion is useful in helping to expand the target sac when the working space is limited.

Adult ; Female ; Humans ; Postoperative Complications ; etiology ; Pregnancy ; Pregnancy Complications ; surgery ; Pregnancy Reduction, Multifetal ; methods ; Pregnancy, Multiple ; Umbilical Cord ; surgery

Anemia, Hemolytic, Autoimmune ; etiology ; Female ; Humans ; Infant, Newborn ; Male ; Pregnancy ; Pregnancy Complications ; Sjogren's Syndrome ; complications

2534 women with ages of 18- 45 in 6 different areas were examined and tested. The results have shown that the rate of genital tract infection was different from one to another: urban of Ha Noi: 41,48%, suburb of Ha Noi: 59,35%, Thai Binh: 56,98, Ha Nam 58,39%, suburb of Hai duong: 52%, mountaine of Nghe an: 64,07%. The most common etiology was candida (14,7 - 42,8%) and G. vaginalis (8,7- 28,74%). The others were staphylococus aureus, E.coli, stretococcus group D and Enterobacilli.
Female Genital Diseases and Pregnancy Complications ; Etiology ; women ; Reproduction

The majority of patients with scleroderma have gastrointestinal involvement, and a few experience gastrointestinal hemorrhage, however, gastrointestinal hemorrhage due to Mallory-Weiss syndrome is very rare. We report upon a 24-year-old pregnant woman with scleroderma who had gastrointestinal hemorrhage due to Mallory-Weiss syndrome.
Adult ; Female ; Gastrointestinal Hemorrhage/diagnosis/*etiology ; Human ; Mallory-Weiss Syndrome/*diagnosis/*etiology ; Pregnancy ; Pregnancy Complications/*diagnosis ; Scleroderma, Systemic/*complications

OBJECTIVE: To investigate the factors related to prenatal anxiety, to observe the effect of prenatal anxiety on the mode of delivery, intrapartum hemorrhage, and to determine the correlation between prenatal anxiety and delivery outcome. METHODS: A total of 300 pregnant women were randomly enrolled from 3 hospitals of Changsha, China. The instruments of this survey were self-designed general information questionnaire, state-trait anxiety inventory (STAI), pregnancy pressure scale, and social support rating scale (SSRS). The delivery outcome was observed. RESULTS: The STAI showed that the state anxiety score of the pregnant women was 43.58±10.79, which was significantly higher than that of usual models (P<0.01). Multiple linear regression analysis showed that those factors, such as the item 2 of pregnancy pressure, relationship with mother-in-law, number of abortions, prenatal health condition, times of attending classes for pregnant women, psychological preparation for childbirth, relationship with mother, relationship with husband, item 3 and item 1 of pregnancy pressure, were all related to prenatal anxiety. The anxiety level between the non-indicative cesarean section group and the normal labor group had statistical difference (P<0.01). Intrapartum hemorrhage of cesarean section in the anxiety group had significant difference compared with the non-anxiety group (P<0.01). CONCLUSION Some factors have contributed to the anxiety level of the pregnant, such as psychological stress, relationship with mother-in-law, number of abortions, prenatal health conditions, times of attending classes for pregnant women, psychological preparation for childbirth, relationship with mother, and relationship with husband. Prenatal anxiety may lead to increased the rate of non-indicative cesarean section and intrapartum hemorrhage during the cesarean section.
Adult ; Anxiety ; etiology ; psychology ; Delivery, Obstetric ; Female ; Humans ; Pregnancy ; Pregnancy Complications ; etiology ; psychology ; Pregnancy Outcome ; Surveys and Questionnaires ; Young Adult

PURPOSE: The authors hereby describe a case of Wernicke-Korsakoff syndrome with accompanying ocular findings that is caused by hyperernesis gravidarum. METHODS: We experienced a 27-year-old female at 12 weeks of pregnancy, who visited our clinic because of weight loss, gait disturbance, decreased mentality and dizziness after prolonged vomiting for 2 months. Neurological examination demonstrated ataxia of gait and loss of orientation. Ophthalmologic examination showed decreased visual acuity, upbeat nystagmus, diplopia and retinal hemorrhage. RESULTS: We report a relatively rare case of Wernicke-Korsakoff syndrome with ophthalmic symptoms induced by hyperemesis gravidarum. CONCLUSIONS: If a pregnant women has symptoms of severe vomiting along with other ocular findings such as retinal hemorrhage or restricted extraocular movement, one must suspect the diagnosis of Wernicke-Korsakoff syndrome, and should start appropriate treatment immediately.
Vision Disorders/*etiology ; *Pregnancy Complications ; Pregnancy ; Korsakoff Syndrome/*etiology/*physiopathology ; *Hyperemesis Gravidarum ; Humans ; Female ; Eye Diseases/*etiology ; Adult

PURPOSE: We report a case of branch retinal artery occlusion (BRAO) in a healthy pregnant woman. METHODS: A 29-year-old pregnant woman presented with decreased vision in her left eye. She had a pale retina with macular edema consistent with BRAO. An extensive workup was performed to determine an etiologic factor. All test results were within normal limits except for her factor VIII activity. Her visual acuity improved from finger counting to 20/30 over 2 months without any treatment. RESULTS: This case suggests that BRAO can occur in healthy patients without any systemic or ocular disorders. CONCLUSIONS: BRAO can occur in healthy patients without any systemic or ocular disorders, despite an extensile evaluation.
Adult ; Factor VIII/analysis ; Female ; Humans ; Macular Edema/etiology ; Pregnancy ; *Pregnancy Complications, Hematologic ; Retinal Artery Occlusion/*etiology ; Vision Disorders/etiology

PURPOSE: We report a case of branch retinal artery occlusion (BRAO) in a healthy pregnant woman. METHODS: A 29-year-old pregnant woman presented with decreased vision in her left eye. She had a pale retina with macular edema consistent with BRAO. An extensive workup was performed to determine an etiologic factor. All test results were within normal limits except for her factor VIII activity. Her visual acuity improved from finger counting to 20/30 over 2 months without any treatment. RESULTS: This case suggests that BRAO can occur in healthy patients without any systemic or ocular disorders. CONCLUSIONS: BRAO can occur in healthy patients without any systemic or ocular disorders, despite an extensile evaluation.
Adult ; Factor VIII/analysis ; Female ; Humans ; Macular Edema/etiology ; Pregnancy ; *Pregnancy Complications, Hematologic ; Retinal Artery Occlusion/*etiology ; Vision Disorders/etiology

Intrauterine infection is an important cause of some birth defects worldwide. The most common pathogens include rubella virus, cytomegaloviurs, ureaplasma urealyticum, toxoplasma, etc. General information about these pathogens in epidemiology, consequence of birth defects, and the possible mechanisms in the progress of birth defects, and the interventions to prevent or treat these pathogens' infections are described. The infections caused by rubella virus, cytomegaloviurs, ureaplasma urealyticum, toxoplasma, etc. are common, yet they are proved to be fatal during the pregnant period, especially during the first trimester. These infections may cause sterility, abortion, stillbirth, low birth weight, and affect multiple organs that may induce loss of hearing and vision, even fetal deformity and the long-term effects. These pathogens' infections may influence the microenvironment of placenta, including levels of enzymes and cytokines, and affect chondriosome that may induce the progress of birth defect. Early diagnosis of infections during pregnancy should be strengthened. There are still many things to be settled, such as the molecular mechanisms of birth defects, the effective vaccines to certain pathogens. Birth defect researches in terms of etiology and the development of applicable and sensitive pathogen detection technology and methods are imperative.
Animals ; Congenital Abnormalities ; etiology ; Female ; Humans ; Infant, Newborn ; Placenta Diseases ; complications ; Pregnancy ; Pregnancy Complications, Infectious ; Pregnancy Outcome ; Pregnancy Trimester, First ; Rubella ; complications ; Toxoplasma ; pathogenicity ; Ureaplasma urealyticum ; pathogenicity

Adult ; Cesarean Section ; Female ; Humans ; Postoperative Complications ; Pregnancy ; Pregnancy, Ectopic ; etiology