Study on the Hemoglobin levels among the Tibetan pregnant women in rural Lhasa / 中华预防医学杂志

<p><b>OBJECTIVE</b>To understand the level of hemoglobin (Hb) and determine the risk factors of Hb concentration among the Tibetan pregnant women in rural Lhasa.</p><p><b>METHODS</b>Between August 2008 and May 2011, a hospital-based study was conducted among 1 530 Tibetan pregnant women after getting their informed consent in agricultural and pastoral areas in maternity clinic or hospital in city, county and township level of Lhasa. Their blood samples were tested and related socio-demographic information was collected. Blood was collected on tip of finger and the Hb concentration was measured using B-Hemoglobin photometer. American Centers for Disease Control and Prevention(CDC) method was used to adjust the Hb measurements based on altitude for estimating the prevalence of anemia. Anemia was assessed according to WHO criteria. A hemoglobin concentration of less than 110 g/L in a pregnant woman was considered an indication of anemia.</p><p><b>RESULTS</b>From August 2008 to May 2011, 1 530 Tibetan pregnant women living at (3 716.4 ± 69.1) m above sea level in rural Lhasa were examined. The findings indicated that average Hb concentration was (122.0 ± 17.5) g/L; the Hb concentration of 1(st), 2(nd) and 3(rd) trimester were (125.5 ± 18.0), (122.5 ± 16.9) and (120.6 ± 17.4) g/L, respectively. The Hb concentration of pregnant women decreased with the increase of gestational age(P < 0.05). Based onCDC method and the adjusted Hb level, the prevalence of anemia in pregnant women were 85.6% (1 310/1 530), the prevalence of anemia of 1(st), 2(nd), and 3(rd)rd trimester were 79.5% (206/259) , 86.1% (395/459)and 87.3% (698/800), respectively (P < 0.05) . The rate of moderate and severe anemia were 46.7% (612/1 310) among pregnant women. Multiple linear regression analysis showed that high Hb level was associated significantly with low family income status (β = 2.74, 95%CI:1.73-3.74), no bad habits (drinking or smoking) (β = 7.34, 95%CI:4.87-9.81) and fewer times of pregnancies(β = -1.62, 95%CI:-2.93--0.31) after adjusting for potential confounding factors.</p><p><b>CONCLUSION</b>Hb concentration level in pregnancy was rather low in rural Lhasa. The increase of family income, reduction the intervals of pregnancies and no bad habits might benefit for the improvement of Hb level of pregnant women in this region.</p>

MRI manifestations of abnormalities in twin fetuses / 中华放射学杂志

Objective To investigate the supplementary roles of MRI in the diagnosis of fetal abnormalities in twin fetuses.Methods MRI manifestations of 22 twins were retrospectively analyzed after abnormalities were found by prenatal ultrasonography (US) from Sep 2005 to Dec 2012.Two rapid scanning sequences were used in the study,fast-imaging employing steady-state acquisition (FIESTA) and fast inversion recovery motion insensitive (FIRM).MRI findings were compared with those of prenatal US,induced labour or postpartum diagnosis.Results A total of 22 twins were reported with 23 abnormal fetuses in 20 twins and 2 normal twins.MRI confirmed central nervous system abnormalities in 3 abnormal fetuses which were anencephalus,meningoencephalocele and enlargement of lateral ventricles respectively.The case of meningoencephalocele was showed brain tissue protruding from the occipital defect on MRI,which was misdiagnosed as a cystic lymphagioma by US.The MRI diagnosis of anencephalus and enlarged lateral ventricles were accordant with US.MRI made the definite diagnosis in 5 chest abnormalities,which were left congenital diaphragmatic hernia (CDH) in 5 abnormal fetuses.They were diagnosed as possible CDH by US.Abdominal abnormalities (n=7,8 abnormal fetuses) included two fetuses in one twin with expanded digestive tract,one fetus with expanded colon and rectus and five fetuses with omphalocele.MRI diagnosis was compatible with US diagnosis in the 7 cases.Twins micromelia were found in one case with 2 abnormal fetuses.Conjoined twins in chest and abdomen were found in another case,which manifested as two hearts,one shared liver and independent urinary tracts and gastrointestinal tracts on MRI.One fetus in twin was dead (n=1,1 abnormal fetus).MRI showed small size and skin edema of the dead fetus.One acephalus acardius of twins (n=2,2 abnormal fetuses) was proved.Normal MRI manifestations were indicated in 2 cases which were suspected by US for abnormal digestive tract and cryptorachischisis respectively.Conclusions MRI,an important supplementary method of prenatal US diagnosis,shows valuable advantages including multi-plane manifestations,more extensive visual field and good soft tissue contrast.It is especially helpful in the diagnosis and treatment of multiple pregnancy.