1.Budd-Chiari syndrome and pregnancy
Weirong REN ; Xingshun QI ; Guohong HAN
Journal of Clinical Hepatology 2014;31(4):307-310
Budd-Chiari syndrome (BCS)is a rare liver disease,and there are mutual influences between BCS and pregnancy.The rela-tionship between BCS and pregnancy is systematically discussed,and the points we should pay attention to in the diagnosis and treatment of this disease are pointed out as follows:First,pregnancy is a risk factor for BCS;pregnant women with the clinical manifestations of portal hy-pertension and (or)inferior vena cava hypertension should be highly suspected of having BCS.Second,pregnancy is risky in BCS patients;pregnancy is allowable in BCS patients who have a stable condition after treatment,but they should be kept under rigorous surveillance dur-ing pregnancy and after delivery to avoid thrombosis recurrence.Third,BCS may lead to infertility in women;patients with unexplained in-fertility should be evaluated by abdominal ultrasound and computed tomography to clarify the diagnosis of BCS.
2.Correlation between Stress Reaction and other Stress Related Factors in Neurosis Patients
Weirong REN ; Qianjin JIANG ; Liju QIAN ; Zhixia WU
Chinese Journal of Clinical Psychology 2000;0(04):-
Objective: To investigate the correlation between stress reaction and other related psychological stress factors such as life events, social support, and coping style in neurosis patients comparing with the group of healthy persons. Methods: 88 neurosis and 100 healthy persons were examined with LES (Life Event Scale), PSSS (Perceived Social Support Scale), TCSQ (Trait Coping Style Questionnaire), SRQ(Stress Reaction Questionnaire). Results: The scores of stress reaction, family events and negative coping style of neurosis group were significantly higher than those of healthy group, and the scores of social support out of family and positive coping style were significantly lower than those of healthy group. The regression analysis and path analysis revealed that in neurosis group stress reaction was directly correlated with negative coping style and social events, but in healthy group it was correlated with negative coping style and family events. Conclusion: Stress reaction may be directly affected with negative coping style and social events in neurosis patients, whereas it may be done with negative coping style and family events in healthy persons.
3.Prenatal multidisciplinary consultation for diagnosis and treatment of fetal deformity
Chun SHEN ; Yuxiu ZHUANG ; Weirong GU ; Yunyun REN ; Shan ZHENG ; Kuiran DONG ; Xianmin XIAO
Chinese Journal of Perinatal Medicine 2014;(12):817-821
Objective To summarize the experience of multidisciplinary consultation for prenatal fetal deformity, and to explore the mode suitable for China. Methods The Obstetrics and Gynecology Hospital of Fudan University and Children's Hospital of Fudan University established a joint multidisciplinary consultation center, including obstetrics, pediatrics, pediatric surgery, ultrasound and other departments. A total of 3 378 pregnant women visited the consultation center from July 31, 2003 to August 1, 2013. After consultation, treatment was divided into three classes:pregnancy termination, pregnancy continuation and perinatal treatment. Follow-up was made through correspondence and telephone communication. Retrospective analysis on reasons for consultation, fetal structural abnormalities of the classification system, chronological order of abnormalities, gestational weeks of diagnosis, maternal-related factors, treatment and prognosis was performed. Results (1) Reasons for consultation:Among 3 378 women undertaking prenatal multidisciplinary consultation, 3 243 (96.00%) were due to fetal factors, and 135 (4.00%) were due to maternal factors. (2) Classification of fetal structural abnormalities:Among the 3 243 cases undertaking consultation with fetal factors, fetal abnormality was found in 80.85%(2 622/3 243). The most common were neurological abnormalities(23.19%, 608/2 622), followed by urinary tract malformation (20.25%, 531/2 622) and cardiovascular malformation (15.48%, 406/2 622). These were followed by digestive system malformation, limb deformities and space-occupying lesions. There were 156 cases of multiple malformations. (3) Average gestational weeks for diagnosis of fetal deformity:The 2 622 cases of fetal deformity were diagnosed at a mean (26.7± 2.1) of gestational weeks (21.1–30.4 weeks). Urinary tract malformations were detected at (24.0±0.7) weeks, whereas digestive system malformations were detected at (28.3±2.6) weeks. (4) Induced labor:Induced labor cases accounted for 35.66% (935/2 622), among which, 92 cases were fetal intrauterine death and 843 cases were active choice. The several highest induced labor rates resulted from multiple malformations (75.64%, 118/156), abdominal wall defects (62.22%, 28/45), diaphragmatic hernia (61.54%, 24/39), cleft lip and palate (55.32%, 26/47) and cardiovascular malformations (49.51%, 201/406). For nervous system (27.80%, 169/608), urinary tract (25.80%, 137/531) and digestive system malformations (26.94%, 66/245), induced labor rates were <30%. For abdominal lesions (14.04%, 25/178) and sacrococcygeal teratoma (13.64%, 3/22), induced labor rates were<15%. (5) Continuation of pregnancy in 1 687 cases:Cesarean section was conducted in 1 046(61.94%). Neonatal death occurred in 117(6.94%).(6) Perinatal treatment:Twenty-one cases were treated during pregnancy, including thirteen cases with fetal ascites and hydrothorax treated by drainage, five cases with fetal anemia treated by intrauterine transfusion and three cases with fetal tachycardia treated by digoxin. Ten cases were treated by ex-utero intrapartum treatment. After birth, 297 newborns immediately underwent neonatal surgery. Among these, 259 cases underwent radical surgery, eleven palliative surgery, and sixteen elective surgery after follow-up. Conclusions Prenatal multidisciplinary consultation can make comprehensive multidisciplinary assessment of fetal prognosis and improve the diagnosis and treatment of structural malformations.