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Aims: Ultrasonography is the preferred technique to evaluate the status of maternal and fetal health during pregnancy. Non-obstetric acute or chronic conditions occurring during pregnancy must be diagnosed as early as possible to permit timely and necessary treatment for the sake of maternal and fetal health. The purpose of this study was to evaluate the safety and value of contrast-enhanced ultrasonography (CEUS) during pregnancy.Materials and methods: This prospective study included 14 pregnant women requiring pregnancy termination and six healthy pregnant women. The 14 pregnant women requiring pregnancy termination underwent CEUS prior to surgery to investigate the pattern of contrast agent diffusion. The six healthy pregnant women did not undergo CEUS. The structure of placentae with and without contrast agent injection were also compared by light microscopy.Results: CEUS analysis failed to identify any signs of contrast agents in the umbilical cord blood and fetus. There were no obvious changes in the morphology of placentae with and without contrast agent injection under light microscope. CEUS identified the need for early treatment in one pregnant woman with an ovarian tumor.Conclusions: Due to the protective effect of the placental barrier on the fetus, CEUS during pregnancy may represent a safe form of imaging technology that can provide valuable information for the diagnosis of non-obstetric acute or chronic disorders and to guide thefuture treatment of pregnant women.

COVID-19 (Corona Virus Disease 2019) has spread globally and is highly infectious, causing psychological disturbances such as anxiety, depression, or both. Pregnant women, as a vulnerable population, need further attention. This study aims to evaluate the psychological impact of pregnant women during COVID-19 to constitute base data for solution guidance. Using a self-designed questionnaire, self-rated anxiety scale (SAS), and self-rated depression scale (SDS), we conducted a web-based survey on 1160 pregnant women from February 20 to April 30, 2020. The prevalence of anxiety and depression during pregnancy was shown to be 12.93% and 31.21%, respectively. Besides, younger age, housewives, lower education level, and early pregnancy all contributed to psychological disturbance during the COVID-19 pandemic. The results revealed significant variations in cognitive and behavioral responses based on the levels of the COVID-19 pandemic concerns, perceptions of life impacts and family concerns, preparation of personal protection equipment and motherhood, and the need for psychological counseling (P 0.05). Regarding their primary concerns, 73.2% of the participants worried about the health and safety of childbirth. And 90.6% of respondents anticipated scheduling prenatal appointments to avoid crowds. Pregnant women are susceptible to anxiety/depression during the COVID-19 outbreak, necessitating immediate psychological care and intervention.

Chronic obstructive pulmonary disease (COPD) is a heterogeneous illness associated with aberrant inflammatory immune reaction in the lung in response to noxious particles and gases. Our previous epidemiological studies discovered that long-term exposure to air pollution PM was associated with an increase in the incidence of COPD and lung function decline, but the impact of air pollution on the onset of COPD and its pathogenesis remains obscure. In recent years, long noncoding RNAs (lncRNAs) have been documented to have a crucial role in COPD. Our preliminary study found that the expression of lncRNA MHC-R in the lung tissues of rats exposed to air pollution PM was dramatically elevated, and the specific expression was mainly focused on the immune-related MHC I, antigen-presenting, and adaptive immune response. After transcription factor prediction, it was found that GATA3 could be combined with the specific sequence of the lncRNA MHC-R promoter region. Dendritic cells (DCs) are necessary antigen-presenting cells (APCs) with the most potent antigen-presenting function. We proved that GATA3/lncRNA MHC-R might regulate the immune activities of DCs to participate in the pathogenic mechanism of COPD induced by air pollution PM, which opens up a new way for early COPD diagnosis and treatment.

OBJECTIVETo establish normal reference range for the fetal right myocardial performance index (RMPI), and compare the reference range between in vitro fertilization (IVF) fetuses and spontaneous pregnancy (SP) fetuses by automatic measurement of the RMPI.METHODSFrom September 2019 to January 2020, 410 participants, who were at 19-40 weeks' gestation, were enrolled into the current study. Among 410 participants, there were 371 spontaneous pregnancies which were matched as control group, and the experimental group involved 39 singleton pregnancies conceived by IVF. RMPI was calculated as (a-b)/b. The three readings were obtained and averaged per examination, with intra-observer repeatability assessed by intraclass correlation coefficient (ICC) and 95% confidence interval (CI). The ‘a’ and ‘b’ intervals were measured at 3 different caliper positions in each fetus: beginning of the original valve clicks (‘original’), beginning of the reflected tricuspid and pulmonary closure clicks (‘reflected’), and peak of valve clicks (‘peak’).RESULTSThe RMPI of SP fetuses was 0.43±0.05 (mean ± standard deviation (SD)), and the RMPI of IVF fetuses was 0.42 ±0.05 (mean ± SD). There was no significant difference in normal reference range of right MPI between IVF fetuses and SP fetuses. No strong correlation was also noted between RMPI with gestational age and heart rate.CONCLUSIONNormal reference ranges of RMPI of IVF fetuses and SP fetuses were established, and no significant difference between IVF fetuses and SP fetuses was found.

Background COVID-19(Corona Virus Disease 2019) outbreaks around the world and is highly infectious, which may cause people prone to anxiety and depression. As a particular group, pregnant women need more attention. The aim of study is to investigate the mental health status of pregnant women during the outbreak of COVID-19, and analyze factors affecting the mental health status of pregnant women.Methods Using a self-designed questionnaire, self-rated anxiety scale(SAS), self-rated depression scale (SDS), we conducted a web-based survey on 1160 pregnant women during the outbreak of COVID-19.Results Compared with general adults in some regions of China, the scores of SAS and SDS were both significantly higher in pregnant women during the outbreak of COVID-19 (P Conclusions During the outbreak of COVID-19, pregnant women are prone to anxiety or depression, highlighting the necessity of further attention on those subjects. It is of great significance to provide on-time psychological intervention and psychological counseling for pregnant women with poor mental health.

Background Whether the in vitro fertilization (IVF) has an effect on the cardiac function of the fetus is very important to evaluate the safety of the technique. The aim of this paper is to establish normal reference range for the fetal right myocardial performance index (RMPI), and compare the reference range between IVF fetuses and spontaneous pregnancy (SP) fetuses by automatic measurement of the RMPI. Methods Three hundred seventy-one spontaneous singleton pregnancies (the control group) and 39 singleton pregnancies conceived by IVF (the experimental group) were enrolled into the current study. An automatic measurement system was used to acquire the RMPI. The cardiac function of the two groups was compared by t-test. Results There was no significant difference in normal reference range of RMPI between IVF fetuses and SP fetuses (RMPI 0.42 ± 0.05 vs 0.43 ± 0.05). No strong correlation was also noted between RMPI with gestational age and heart rate. Conclusions Normal reference ranges of RMPI of IVF fetuses and SP fetuses were established, and no significant difference between IVF fetuses and SP fetuses in RMPI was found. Thus, these findings may suggest that IVF has little impact on cardiac function of the fetus.

Background Ischemic stroke is a serious public health issue with a continuously increasing incidence worldwide. This study explores the risk factors of large artery atherosclerotic (LAA) ischemic stroke based on carotid contrast-enhanced ultrasonography (CEUS). Methods A total of 110 patients with LAA ischemic stroke and 34 patients without stroke were included. All participants underwent standard ultrasonography and CEUS, from which carotid artery plaque characteristics were obtained. The predicted performance of artery plaques was evaluated using the area under the receiver operating characteristics (ROC) curve and sensitivity and specificity at the optimal cut-off point. Results Subjects with LAA ischemic stroke were more likely to have a history of hypertension than the control group (P = 0.009). The area under the ROC curve (AUROC) for plaque echogenicity was 0.609 (95% CI, 0.524–0.689). With a cut-off value of ≤ class II (echolucent or predominantly hypoechogenic plaque), the sensitivity and specificity were 84.55% and 32.35%, respectively. The AUROC for plaque thickness was 0.676 (95% CI, 0.593–0.751). With a cut-off value of > 2.4 mm, the sensitivity and specificity were 41.82% and 88.24%, respectively. The AUROC for intraplaque neovascularization was 0.807 (95% CI, 0.733–0.868). With a cut-off value of > grade 2 (extensive appearance of bubbles within plaque), the sensitivity and specificity were 70.91% and 82.35%, respectively. Conclusions Hypertension, echolucent (or predominantly hypoechogenic) plaque, plaque thickness, and degree of intraplaque neovascularization are significantly relevant to LAA ischemic stroke in adults. These results may be helpful for clinical prediction of ischemic stroke risk.

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Aims: Excessive placental invasion is a life-threatening obstetric disease. Determining the extent of placental villi invasion prenatally is crucial for formulating a surgical plan for pregnant women. The objective of this study was to explore the diagnostic accuracy of the Crystal Vue technique combined with two-dimensional (2D) ultrasound in detecting the degree of placenta accreta spectrum (PAS) located in the C-section scar area.Materials and methods: Twenty-seven pregnant women with a strong suspicion of PAS underwent 2D ultrasound combined with a Crystal Vue examination. The diagnosis of 2D ultrasound alone and Crystal Vue combined with 2D ultrasound was statistically calculated, respectively. Cohen’s kappa (k) was used to measure the consistency between these two ultrasound diagnosis and the postoperative diagnosis.Results: The postoperative diagnosis of 27 pregnant women was as follows: 6 cases of placental accreta, 11 cases of placental increta, 2 cases of placental percreta, 2 cases of placental accrete and placental increta, 2 cases of placental accreta and placental percreta, and 4 cases without PAS. Compared with the postoperative diagnosis, 20 cases (74.07%) were correctly diagnosed by 2D ultrasound alone, 6 cases were misdiagnosed, and one case the diagnosis was incomplete, which were substantially consistent with the postoperative diagnosis (k=0.612, p

Objective. This prospective study aimed to investigate the use of real-time three-dimensional hysterosalpingo-contrast sonography (4D-HyCoSy), using contrast agent SonoVue, with B mode hysterosalpingo-contrast sonography (B mode-HyCoSy), to evaluate tubal patency and the wall of the Fallopian tubes in infertility patients. Method. In total, we recruited 739 women with fertility requirements from the First Affiliated Hospital of Shantou Medical College between January 2017 and July 2018. All cases received 4D-HyCoSy using contrast agent SonoVue, immediately followed by the B mode-HyCoSy. Of these patients, 145 showed pathological findings in the Fallopian tubes during HyCoSy; 34 of these (62 Fallopian tubes) were verified by laparoscopy and the dye test against routine reference standards. Sonographic findings, along with laparoscopic findings and dye test results, were used to compare the two techniques using the Cohen kappa coefficient. We also investigated the duration of examination and pain score. Results. Compared with laparoscopy and the dye test, the tubal occlusion diagnostic accordance rates for 4D-HyCoSy were 88.7% (32+23)/62, with a kappa coefficient of 0.769 and a 76.9% agreement rate. Distal occlusion diagnostic accordance rates for 4D-HyCoSy were 100% (8/8) with a k coefficient of 1.000 and a 100% agreement rate. Conclusions. The use of 4D-HyCoSy, with B mode-HyCoSy, for the diagnosis of tubal patency is safe, feasible, noninvasive, and highly accurate. B mode-HyCoSy allowed us to observe tubal walls in an intuitive manner.