中华围产医学杂志最新文献

{"title":"Diagnostic value of three sections of aortic arch under ultrasonography in fetal aortic coarctation","authors":"Juan Wu, Yun Liu, Ming Wang, Xinxia Wang, Shan Lin, R. Yuan, Hezhou Li, S. Cui","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.013","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.013","url":null,"abstract":"Objective \u0000To investigate the diagnostic value of three sections of aortic arch under ultrasonography, including the three vessels and tracheal view (3VT), long-axis and coronal view of the aortic arch, in fetal coarctation of the aorta (CoA) and the reasons for missed diagnosis and misdiagnosis. \u0000 \u0000 \u0000Methods \u0000This study involved 52 fetuses with CoA who were identified by prenatal ultrasonography and confirmed in postnatal operation in the Third Affiliated Hospital of Zhengzhou University from June 2013 to June 2018. Echocardiographic findings of all cases were analyzed retrospectively to summarize the prenatal imaging features. \u0000 \u0000 \u0000Results \u0000The 3VT was displayed in all cases (100%). The long-axis view of the aortic arch was observed in 88.5%, while the coronal view was observed in 76.9%. Among the 52 cases, nine were missed diagnosis and three were misdiagnosed due to unsatisfactory views of the three sections of aortic arch. All cases showed an increased ratio of the pulmonary artery to the aorta diameter in 3VT, which was a critical indicator of CoA in prenatal ultrasonographic diagnosis. Satisfactory aortic arch coronal views were obtained in 40 cases and all showed constriction at the isthmus of aortic arch and an connection to the descending aorta. Out of the 46 with a satisfactory long-axis view of the aortic arch, a narrow isthmus of aortic arch was shown in 38 cases, with the inner diameter of (1.8±0.2) mm ranging from 0.9 to 2.9 mm. \u0000 \u0000 \u0000Conclusions \u0000Observation of three sections of aortic arch under ultrasonography is of great importance in prenatal diagnosis of CoA. \u0000 \u0000 \u0000Key words: \u0000Aortic coarctation; Aorta, thoracic; Ultrasonography, prenatal; Fetal heart","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"669-672"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48769449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bedside ultrasound for diagnosis of appendicitis in preterm infants","authors":"Heng Li, Di Jin, Jiaqiang Fu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.006","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.006","url":null,"abstract":"Objective \u0000To investigate the sonographic features of appendicitis in preterm infants. \u0000 \u0000 \u0000Methods \u0000A total of 28 cases of premature infants with acute appendicitis diagnosed by bedside abdominal ultrasound in the First Hospital of Jilin University from November 2012 to January 2019 were recruited. Basic clinical information, abdominal ultrasound images, surgical results, management and outcomes were collected and analyzed. Descriptive statistical methods were used for data analysis. \u0000 \u0000 \u0000Results \u0000Among the 28 cases, 21 (75.0%) were males and seven (25.0%) were females. All of them were diagnosed as having acute appendicitis with perforation according to the bedside ultrasound. Five (17.8%) presented direct signs of appendicitis, i.e. partial structure of the appendix and perforation site. The other 23 (82.2%) showed indirect signs, including heterogeneous echotexture or hypoechoic patterns between the liver and right kidney in six cases, heterogeneously hypoechoic areas between the bowels in the right lower abdomen in seven cases, and dissociative effusion between the bowels in the right lower abdomen with poor sound transmission and disorder of surrounding intestinal structure in ten cases. Twenty-one out of the 28 cases (75.0%) exhibited bowel wall thickening at right lower abdomen, absence of intestinal peristalsis and effusion echoes between the intestines with poor sound transmission. Emergent surgeries were performed and diagnoses of appendicitis with perforation were confirmed. All the 21 cases were discharged after full recovery. Seven cases (25.0%) showed confined cystic images and received conservative treatment. One of them developed adhesive intestinal obstruction during follow-ups and underwent surgical treatment, during which local formations of wrapping after appendiceal perforation and obstruction due to surrounding intestinal adhesion were observed. The other six cases recovered after conservative management with gradually reduced peritoneal effusion, normal omental echo patterns and improved inflammatory indicators and abdominal symptoms, and no ileus occurred during follow-ups after discharge. \u0000 \u0000 \u0000Conclusions \u0000Symptoms of appendicitis in preterm infants are non-specific, and perforation is more likely to be seen. Bedside ultrasonography mainly shows indirect signs of appendicitis, and direct signs in some infants. Bedside ultrasound can be an essential tool for the diagnosis of these conditions with high accuracy. \u0000 \u0000 \u0000Key words: \u0000Appendicitis; Point-of-care testing; Ultrasonography; Infant, premature","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"633-636"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48863174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health risk and management for small for gestational age infants","authors":"Shuaijun Li","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.017","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.017","url":null,"abstract":"Small for gestational age (SGA) infants are special populations, whose birth weights are less than the 10th percentile or two standard deviations below the mean for gestational age based on the Fenton growth chart in 2013. SGA is caused by various reasons and affects the short- and long-term health of infants. This review focused on the early health, physical and neurological development and incidence of metabolic diseases of SGA infants. \u0000 \u0000 \u0000Key words: \u0000Infant, small for gestational age; Health status; Growth","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"684-687"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46174774","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Values of procalcitionin and red blood cell distribution width in evaluating severity and prognosis of septicemia in preterm infants","authors":"Yuhong Zhao, Wenya Zhang, Tao Wang, Qian Zhao","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.008","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.008","url":null,"abstract":"Objective \u0000To analyze the variations of procalcitionin (PCT) and red blood cell distribution width (RDW) in premature infants with septicemia and to investigate their values in evaluating the severity and prognosis of septicemia. \u0000 \u0000 \u0000Methods \u0000A retrospective study was conducted to analyze the medical records of 96 premature infants diagnosed with septicemia and admitted to the First Affiliated Hospital of Anhui Medical University from December 1, 2014 to December 1, 2018. According to the severity of the disease and neonatal shock score, there were 42 cases selected to the severe septicemia group (severe clinical condition with shock, shock score >6 points) and 54 in the mild septicemia group (mild clinical condition without shock or shock score ≤6 points). Moreover, after three days' treatment, they were divided into two groups: death group (n=10) and survival group (n=86, survived during hospitalization). Peripheral venous blood samples were collected before and on the first and third day after treatment to detect PCT and RDW. Dynamic changes of the two indexes were compared between different groups. Mann-Whitney U test, Wilcoxon rank sum test, Friedman test or receiver operating characteristic (ROC) curve was used for statistical analysis. \u0000 \u0000 \u0000Results \u0000(1) Before and on the first and third day after treatment, the severe septicemia group had a higher level of PCT than the mild group [3.7 (0.4-37.3) vs 1.4 (0.2-5.0) ng/ml, 43.1 (18.7-83.0) vs 17.1 (4.1-34.6) ng/ml, 26.1 (3.8-67.3) vs 4.8 (0.3-32.9) ng/ml; Z=-2.017, -3.350 and -2.932; all P<0.05]. In both groups, PCT level on the first day after treatment was the highest, and that on the third day after treatment was higher than that before treatment (all P<0.05). On the first and third day after treatment, RDW in the severe group was higher than that in the mild group [16.5% (16.2%-18.6%) vs 16.3% (15.5%-17.3%), 16.1% (15.5%-19.4%) vs 15.7% (15.1%-16.5%); Z=-1.992 and -2.165; both P<0.05]. In the severe and mild groups, RDW on the first day after treatment was higher than that before and on the third day after treatment; in the mild group, RDW on the third day after treatment was lower than that before treatment, while in the severe group, RDW on the third day after treatment was higher than that before treatment (all P<0.05). (2) On the first and third day after treatment, PCT and RDW in the death group were higher than those in the survival group [PCT: 162.0 (62.9-187.2) vs 19.9 (4.3-46.1) ng/ml, 122.6 (65.0-180.8) vs 6.2 (0.5-32.9) ng/ml; Z=-4.114 and -4.594; RDW: 18.4% (16.9%-21.2%) vs 16.3% (15.7%-17.2%), 21.8% (20.6%-22.2%) vs 15.8% (15.2%-16.5%); Z=-3.307 and -4.831; all P<0.05]. In both groups, PCT on the first day after treatment was higher than that before and on the third day after treatment, and the level on the third day after treatment was higher than that before treatment (all P<0.05). In the death group, RDW on the first and third day after treatment were higher than that befo","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"641-647"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"69915741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prenatal diagnosis of two fetuses with renal structural anomalies caused by 17q12 deletion syndrome","authors":"H. Pan, Hai-rong Wu, Lin Li, Jie Fu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.014","url":null,"abstract":"Objective \u0000To analyze the prenatal clinical characteristics and genetic diagnosis of two fetuses with chromosome 17q12 deletion syndrome mainly manifested by renal structural abnormalities. \u0000 \u0000 \u0000Methods \u0000Clinical data of two pregnant women admitted to Peking University First Hospital in 2017 due to ultrasound indication of fetal kidney structure abnormality in the second trimester were collected. Results of fetal chromosome karyotype analysis and array-based comparative genomic hybridization (aCGH), and aCGH detection of peripheral blood in the two couples were reviewed. \u0000 \u0000 \u0000Results \u0000(1) In both pregnancies of case 1 and case 2, no abnormal chromosome karyotype was found. In case 2, the fetal fluorescence in situ hybridization (FISH) results showed no abnormality. (2) During the first pregnancy of case 1, there was a 1.351 Mb of single-copy deletion in chromosome 17q12 (34 817 422-36 168 104) and a 1.187 Mb of single-copy duplication in chromosome 3p26.3 (838 934-2 026 269) extracted from umbilical cord blood. Moreover, a 1.299 Mb of single copy duplication in chromosome 3p26.3 (726 645-2 026 269) extracted from maternal peripheral blood was detected. (3) DNA analysis of the umbilical cord blood of case 2 showed a 1.351 Mb of single copy deletion in 17q12. No abnormal copy number variants (CNVs) were detected in the peripheral DNA of the couple. \u0000 \u0000 \u0000Conclusions \u0000Invasive prenatal detection of CNVs in cases with abnormal fetal kidney ultrasound findings might help to confirm the diagnosis and guide genetic counseling. \u0000 \u0000 \u0000Key words: \u0000Chromosome deletion; Chromosomes, Human, Pair 17; Ultrasonography, prenatal; DNA copy number variations; Kidney; Congenital abnormalities","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"673-677"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47190873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of radiofrequency ablation for fetal reduction in monochorionic twin pregnancies over 26 weeks of gestation","authors":"Xiaodan Wang, H. Qi, Nan Shan, Li Chen, Yuni Yang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.011","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.011","url":null,"abstract":"Objective \u0000To investigate the efficacy and safety of radiofrequency ablation for fetal reduction in monochorionic twin pregnancies at gestational age over 26 weeks. \u0000 \u0000 \u0000Methods \u0000A retrospective study was performed based on the clinical data of 51 patients who underwent fetal reduction by radiofrequency ablation in the First Affiliated Hospital of Chongqing Medical University from May 2013 to July 2018. Clinical data including basic information, surgical data (such as ablation duration, power and the number of cycles), perinatal complications and pregnancy outcomes were collected. Differences in pregnancy outcomes were compared between the group with gestational age >26 weeks (n=17, group A) and that ≤26 weeks (n=34, group B) using t-test, rank-sum test and Chi-square test or Fisher's exact test. \u0000 \u0000 \u0000Results \u0000(1) The indications of fetal reduction were malformation in one of the twins, twin-to-twin transfusion syndrome, twin reversed arterial perfusion sequence and selective intrauterine growth restriction [45.1% (23/51), 15.7% (8/51), 19.6% (10/51) and 19.6% (10/51)]. The differences in the proportion of different indications between group A and B were statistically significant [12/17, 1/17, 0/17, 4/17 vs 32.4% (11/34), 20.6% (7/34), 29.4% (10/34), 17.7% (6/34), P=0.009]. Those in the group A required longer operation duration than the group B [M(min-max), 20(7-40) vs 15(3-29) min, Z=2.550, P=0.011]. (2) The gestational age of the 51 patients was (23.7±4.7) weeks (15+1-32+6 weeks), the overall survival rate of the remaining fetuses was 86.3% (44/51) and the preterm birth rate was 50.0% (22/44). The gestational age at operation was (28.9±2.5) weeks (26+1-32+6 week) in group A and (21.1±3.1) weeks (15+1-25+2 weeks) in group B. The survival rate of the remaining fetuses and the preterm birth rate in group A were significantly higher than those in group B [17/17 vs 79.4% (27/34), P=0.046; 12/17 vs 37.0% (10/27), χ2=4.697, P=0.030]. \u0000 \u0000 \u0000Conclusions \u0000Fetal reduction at gestational age >26 weeks, of which the main surgical indication is malformation in one of the twins, may increase the risk of preterm birth, but can improve the overall survival rate of the remaining fetuses without increasing the maternal and infant morbidity. Therefore, radiofrequency ablation is a safe and effective procedure for twin pregnancies >26 weeks of gestation. \u0000 \u0000 \u0000Key words: \u0000Pregnancy, twin; Pregnancy reduction, multifetal; Radiofrequency ablation; Pregnancy trimester, second","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"657-662"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47030908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A quality improvement program to facilitate breastfeeding for very low birth weight infants","authors":"Hong-Fei Zhu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.007","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.007","url":null,"abstract":"Objective \u0000To analyze the effectiveness of a quality improvement program for facilitating breastfeeding and improving clinical outcomes for very low birth weight infants (VLBWI). \u0000 \u0000 \u0000Methods \u0000VLBWI admitted to the Neonatal Intensive Care Unit of Shaoxing Women and Children's Hospital before the implementation of the quality improvement program from February 2016 to January 2017 were retrospectively selected as control group (n=84), while those admitted after the implementation from August 2017 to July 2018 were enrolled as intervention group (n=75). Primary outcomes included breastfeeding rates by biological mothers and duration of achieving full enteral feeding and the secondary outcomes included duration of peripherally inserted central venous catheters (PICC) and parenteral nutrition, PICC associated infections, average body weight growth rates during hospitalization, preterm-associated complications and mortality between the two groups were compared. Two independent sample t test, rank-sum test and Chi-square test or Fisher's exact test were used as statistical methods. \u0000 \u0000 \u0000Results \u0000Compared with the control group, the intervention group had significantly increased breastfeeding rate [82.7% (62/75) vs 36.9% (31/84), χ2=34.183, P<0.001] and a shorter time to achieve full enteral feeding [M(P25-P75): 13(10-16) vs 17(14-23) d, Z=-4.542, P<0.001]. Moreover, the PICC indwelling time and parenteral nutrition duration were both significantly shortened after the implementation of quality improvement program [M(P25-P75): 10(7-13) vs 14(11-20) d, 12(9-15) vs 16(13-22) d, Z=-4.902 and -4.677; both P<0.001], but no statistical differences were found in any other secondary outcomes. \u0000 \u0000 \u0000Conclusions \u0000The quality improvement program is a feasible and practical approach to effectively improve breastfeeding rates in VLBWI and shorten the time required to achieve full enteral feeding. \u0000 \u0000 \u0000Key words: \u0000Breast feeding; Infant, very low birth weight; Quality improvement","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"637-640"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49484873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progress in association of vitamin D and bronchopulmonary dysplasia in preterm infants","authors":"Y. Liu","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.09.010","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.09.010","url":null,"abstract":"Bronchopulmonary dysplasia (BPD) remains a common problem in preterm infants and affects the prognosis of these infants. Apart from playing a role in bone metabolism, vitamin D is also involved in regulation of gene expression, immunity, inflammation responses and lung development and restoration, which happens to coincide with the pathological process of BPD, suggesting its potential role in the pathogenesis of BPD. In addition, preterm infants are at high risk of vitamin D deficiency, hence more in-depth research on the association between vitamin D deficiency and BPD in preterm infants is needed. In recent years, some animal experiments had shown evidence of the benefits from vitamin D against BPD, but more clinical research is required. Vitamin D supplementation in early life may be a new approach to prevent and treat BPD. \u0000 \u0000 \u0000Key words: \u0000Bronchopulmonary dysplasia; Vitamin D; Vitamin D deficiency; Infant, premature","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"652-656"},"PeriodicalIF":0.0,"publicationDate":"2019-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44407006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"X-linked dominant chondrodysplasia punctata 2 with severe phenotype in one female fetus: a case report","authors":"Yan Liu, Qing-qing Wu, Li Wang, Bin Xu, Yike Yang","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.08.014","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.08.014","url":null,"abstract":"We reported a female fetus diagnosed with X-linked dominant chondrodysplasia punctata 2 with severe phenotype. The fetus was found with abnormal short limbs, thick metaphysis on the right lower limb and a narrow and small thorax by prenatal ultrasound at 24+5 weeks of gestation. Non-invasive prenatal test indicated the risks of trisomies 21, 18 and 13 were low. The pregnancy was terminated at 27 weeks of gestation and postnatal X-ray imaging showed that the fetus had short femur and humerus, a narrow and small thorax, thickened metaphysis with a \"splashed paint spot\" pattern, and asymmetric shortened lower limbs. Whole-exome analysis showed that the fetus carried a heterozygous pathogenic mutation c.440G>A (p.Arg147His) in the EBP gene. The mutation was confirmed to be a de novo mutation as neither of her parents carried the same mutation. Thus, the patient was diagnosed as having X-linked dominant chondrodysplasia punctata 2. The severe phenotype of this case migh be related to random X chromosome inactivation. \u0000 \u0000 \u0000Key words: \u0000Chondrodysplasia punctata; Ultrasonography, prenatal; Whole exome sequencing; Female","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"610-613"},"PeriodicalIF":0.0,"publicationDate":"2019-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43445501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical characteristics and antibiotic susceptibility features of different types of invasive infections caused by group B Streptococcus: a multicenter prospective study","authors":"Xinzhu Lin, Yao Zhu, Ya-Lan Lin, Dengli Liu, Liping Xu, Rong-hua Zhong, Zhifang Liu, Dongmei Chen, Zhong-ling Huang, Hong Yang, Wenying Qiu, Chao Chen","doi":"10.3760/CMA.J.ISSN.1007-9408.2019.08.012","DOIUrl":"https://doi.org/10.3760/CMA.J.ISSN.1007-9408.2019.08.012","url":null,"abstract":"Objective \u0000To study the clinical manifestations and antibiotic sensitivity features of early- and late-onset invasive infections caused by group B Streptococcus (GBS). \u0000 \u0000 \u0000Methods \u0000A total of 96 infants with invasive GBS infections were enrolled prospectively from seven tertiary hospitals of GBS Infection Research Cooperative Group in southwest Fujian, such as Xiamen Maternal and Child Care Hospital, etc., from January 2016 to June 2018. According to the onset time of infection after birth, they were divided into early-onset GBS disease (GBS-EOD) group (<7 d, n=67) and the late-onset GBS disease (GBS-LOD) group (7-89 d, n=29). Clinical manifestations, disease spectrum, complications and outcomes of the two groups were compared. Drug sensitivity test was carried out using disk diffusion test. Chi-square or Fisher's exact test, two independent sample t-test or Mann-Whitney U tests were used for statistical analysis. \u0000 \u0000 \u0000Results \u0000(1) The average ages at onset in GBS-EOD and GBS-LOD groups were (15.8±6.7) h (0.5-142.0 h) and (25.0±8.1) d (9-89 d), respectively. The incidence of tachypnea, pallor, fever and convulsion were noted in 68.7% (46/67) vs 44.8% (13/29), 52.2% (35/67) vs 17.2% (5/29), 23.9% (16/67) vs 65.5% (19/29) and 7.5% (5/67) vs 48.3% (14/29) of GBS-EOD and GBS-LOD groups with χ2 values of 6.282, 10.199, 15.146 and 21.237 (all P<0.05). The main clinical manifestations of GBS-EOD were tachypnea and pallor, while most of the patients in the GBS-LOD group developed fever and convulsions. (2) The incidence of pneumonia, sepsis, meningitis, sepsis complicated by septic joints, pneumonia complicated by sepsis, sepsis complicated by meningitis and pneumonia complicated by sepsis and meningitis were noted in 43.3% (29/67) vs 20.7% (6/29), 9.0% (6/67) vs 17.2% (5/29), 0.0% (0/67) vs 3.4% (1/29), 0.0% (0/67) vs 6.9% (2/29), 31.3% (21/67) vs 13.8% (4/29), 6.0% (4/67) vs 31.0% (9/29) and 10.4% (7/67) vs 6.9% (2/29) of GBS-EOD and GBS-LOD groups. There was a statistically significant difference in the disease spectrum between the two groups (Fisher's exact test, all P<0.001). Compared with the GBS-LOD group, the GBS-EOD group had a higher incidence of pneumonia [85.1% (57/67) vs 41.4% (12/29), χ2=19.116, P<0.001] and a lower incidence of meningitis [16.4% (11/67) vs 41.4% (12/29), χ2=6.922, P=0.009]. Complications such as acute respiratory distress syndrome (ARDS), pulmonary hemorrhage, shock and persistent pulmonary hypertension of the newborn (PPHN) occurred much more in the GBS-EOD group than the GBS-LOD group [28.4% (19/67) vs 6.9% (2/29), 13.4% (9/67) vs 0.0% (0/29), 11.9% (8/67) vs 10.3% (3/29), 4.5% (3/67) vs 0.0% (0/29), χ2=13.683, P<0.001]. (3) Among the 96 patients, 23 (24.0%) had meningitis and 73 (76.0%) developed pneumonia and sepsis. Meningitis resulted in a higher fatality rate [17.4% (4/23) vs 4.1% (3/73), χ2=4.564, P=0.035] and longer average hospital stay [(37.2±12.6) vs (14.1±5.3) d, t=7.831, P<0.001] than pneumonia and sepsis. S","PeriodicalId":52320,"journal":{"name":"Chinese Journal of Perinatal Medicine","volume":"22 1","pages":"597-603"},"PeriodicalIF":0.0,"publicationDate":"2019-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46680251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}