| 3 | Risk Factors and Pregnancy Outcome in Women with a History of Cesarean Section Complicated by Placenta Accreta显示文摘Objective:To explore the risk factors and pregnancy outcomes in women with a history of cesarean section complicated by placenta accreta(PA).Methods:This case-control study included clinical data from singleton mothers with a history of cesarean section in 11 public tertiary hospitals in seven provinces of China between January 2017 and December 2017.According to the intraoperative findings after delivery,the study population was divided into PA and non-PA groups.We compared the pregnancy outcomes between the two groups,used multivariate logistic regression to analyze the risk factors for placental accreta.Results:For this study we included 11,074 pregnant women with a history of cesarean section;and of these,869 cases were in the PA group and 10,205 cases were in the non-PA group.Compared with the non-PA group,the probability of postpartum hemorrhage(236/10,205,2.31%vs.283/869,32.57%),severe postpartum hemorrhage(89/10,205,0.87%vs.186/869,21.75%),diffuse intravascular coagulation(3/10,205,0.03%vs.4/869,0.46%),puerperal infection(33/10,205,0.32%vs.12/869,1.38%),intraoperative bladder injury(1/10,205,0.01%vs.16/869,1.84%),hysterectomy(130/10,205,1.27%vs.59/869,6.79%),and blood transfusion(328/10,205,3.21%vs.231/869,26.58%)was significantly increased in the PA group(P<0.05).At the same time,the neonatal birth weight 3250.00(2950.00–3520.00)g vs.2920.00(2530.00–3250.00)g),the probability of neonatal comorbidities(245/10,205,2.40%vs.61/869,7.02%),and the rate of neonatal intensive care unit admission(817/10,205,8.01%vs.210/869,24.17%)also increased significantly(P<0.05).Weight(odds ratio)(OR)=1.03,95%confidence interval(CI):1.01–1.05)),parity(OR=1.18,95%CI:1.03–1.34),number of miscarriages(OR=1.31,95%CI:1.17–1.47),number of previous cesarean sections(OR=2.57,95%CI:2.02–3.26),history of premature rupture of membrane(OR=1.61,95%CI:1.32–1.96),previous cesarean-section transverse incisions(OR=1.38,95%CI:1.12–1.69),history of placenta previa(OR=2.44,95%CI:1.50–3.96),and the combination of prenatal hemorrhage(OR=9.95,95%CI:8.42–11.75)and placenta previa(OR=91.74,95%CI:74.11–113.56)were all independent risk factors for PA.Conclusion:There was an increased risk of adverse outcomes in pregnancies complicated by PA in women with a history of cesarean section,and this required close clinical attention.Weight before pregnancy,parity,number of miscarriages,number of previous cesarean sections,history of premature rupture of membranes,past transverse incisions in cesarean sections,a history of placenta previa,prenatal hemorrhage,and placenta previa were independent risk factors for pregnancies complicated with PA in women with a history of cesarean section.These independent risk factors showed a high value in predicting the risk for placentab accreta in pregnancies of women with a history of cesarean section. | Yingyu Liang Lizi Zhang Shilei Bi Jingsi Chen Shanshan Zeng Lijun Huang Yulian Li Minshan Huang Hu Tan Jinping Jia Suiwen Wen Zhijian Wang Yinli Cao Shaoshuai Wang Xiaoyan Xu Ling Feng Xianlan Zhao Yangyu Zhao Qiying Zhu Hongbo Qi Lanzhen Zhang Hongtian Li Lili Du Dunjin Chen | 2022 | Maternal-Fetal Medicine2022，4，3： | 1 |
| 5 | Cellular and Molecular Atlas of Peripheral Blood Mononuclear Cells from a Pregnant Woman After Recovery from COVID-19显示文摘Objective:This study aimed to investigate the immune response of a pregnant woman who recovered from the coronavirus disease 2019(COVID_(R)S)by using single-cell transcriptomic profiling of peripheral blood mononuclear cells(PBMCs)and to analyze the properties of different immune cell subsets.Methods:PBMCs were collected from the COVID_(R)S patient at 28 weeks of gestation,before a cesarean section.The PBMCs were then analyzed using single-cell RNA sequencing.The transcriptional profiles of myeloid,T,and natural killer(NK)cell subsets were systematically analyzed and compared with those of healthy pregnant controls from a published single-cell RNA sequencing data set.Results:We identified major cell types such as T cells,B cells,NK cells,and myeloid cells in the PBMCs of our COVID_(R)S patient.The increase of myeloid and B cells and decrease of T cells and NK cells in the PBMCs in this patient were quite distinct compared with that in the control subjects.After reclustering and Augur analysis,we found that CD16 monocytes and mucosal-associated invariant T(MAIT)cells were mostly affected within different myeloid,T,and NK cell subtypes in our COVID_(R)S patient.The proportion of CD16 monocytes in the total myeloid population was increased,and the frequency of MAIT cells in the total T and NK cells was significantly decreased in the COVID-RS patient.We also observed significant enrichment of gene sets related to antigen processing and presentation,T-cell activation,T-cell differentiation,and tumor necrosis factor superfamily cytokine production in CD16 monocytes,and enrichment of gene sets related to antigen processing and presentation,response to type II interferon,and response to virus in MAIT cells.Conclusion:Our study provides a single-cell resolution atlas of the immune gene expression patterns in PBMCs from a COVID_(R)S patient.Our findings suggest that CD16-positive monocytes and MAIT cells likely play crucial roles in the maternal immune response against severe acute respiratory syndrome coronavirus 2 infection.These results contribute to a better understanding of the maternal immune response to severe acute respiratory syndrome coronavirus 2 infection and may have implications for the development of effective treatments and preventive strategies for the coronavirus disease 2019 in pregnant women. | Lili Du Yingyu Liang Xiaoyi Wang Lijun Huang Xingfei Pan Jingsi Chen Dunjin Chen | 2023 | Maternal-Fetal Medicine2023，5，2： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员