Application of Smart Mobile Medical Services in Maternal Health Care Management

In order to standardize the health management of pregnant women, improve the health level of pregnant women, and improve the outcome of pregnancy with the help of the smartphone mobile terminal app, the 100 pregnant women who gave birth in the hospital and participated in the management of the health assistant app were selected as the observation group, and the 100 hospitalized pregnant women who did not participate in the management of the app were selected as the control group. The two groups of pregnant women were compared in their knowledge of health care, compliance of prenatal examination, delivery mode, and follow-up rate. The results showed that the observation group was significantly higher than the control group in the knowledge of health care during pregnancy and perinatal period, the rate of natural childbirth, the compliance rate of prenatal examination, and the follow-up rate. After the system was launched, the number of registered pregnant women reached more than 60% of the total number of pregnant women in the hospital, the number of clicks reached more than 2 million times, the number of clinic settlement accounted for more than 30%, and the interpretation rate of fetal heart rate in outpatient and remote clinics reached more than 20%. The diagnosis and treatment process has been significantly improved, and the implementation effect has reached the expectation. O2O maternal and child service mode has been realized through mobile internet technology. It has been proved that the use of smart mobile terminals in the out-of-hospital health care management of pregnant women not only facilitates medical staff to provide timely personalized medical services for pregnant women but also is convenient for pregnant women to obtain health care knowledge through multiple channels, improve the quality of home health management for pregnant women, and effectively improve the pregnancy outcome.

Women’s psychological health, family function, and social support during their third trimester of pregnancy within the COVID-19 epidemic: A cross-sectional survey

Objective: The study aims to investigate women’s psychological health, family function, and social support during the third trimester within the COVID-19 epidemic. Method: From January 30, 2020 to February 26, 2020, 177 pregnant women during their third trimester (mean gestation time was 37.05±4.06 weeks) in a maternal and children’s hospital were investigated using the Self-Rating Anxiety Scale (SAS), the Edinburgh Postnatal Depression Scale, the Family APGAR Index, and the Perceived Social Support Scale. Non-parametric tests were conducted in the study. The statistical significance was set as p < 0.05. Result: The incidence rate of the participants’ anxiety and depression during the COVID-19 epidemic was 19.21% and 24.29%, respectively. The participants’ greatest concerns in the previous week were the risk of virus transmission (79.66%), and the prenatal examination and fetal growth (70.62%). The SAS ranks were higher in the participants who were concerned about the prenatal examination and fetal growth and work-related affairs. Conclusion: The participants’ psychological health was indirectly affected by the epidemic through the supply of medical resources and work-related factors. The medical staff should employ family support and social resources to guarantee the accessibility of medical services and living materials to decrease the pregnant women’s stress and further improve their psychological health.

A Model of Developmental Support for Children after TTTS – Case Study

This paper describes a model of developmental support of a nine-year-old girl, born as a twin in the 27th week of pregnancy, with significant perinatal history. Prenatal examination diagnosed Twin-Twin Transfusion Syndrome (TTTS). Due to premature birth and numerous developmental dysfunctions resulting from it, the girl required the assistance of complex specialist care. However, in the first four years of the child’s life, the strategy of developmental support was drastically neglected. The basic aim of the study was to present the author’s individual model of support, designed especially for the four-year-old girl together with recommendations of conduct for therapists and the child’s parents. The model was developed on the basis of a multi-profile diagnosis, which allowed proposing an individual strategy for intensive developmental support for children after TTTS. Developmental support activities in the proposed model were performed for 58 months, and after this period diagnosis revealed significant changes in the level of functioning of the child regarding ways of responding to communication with the environment. The study confirmed the efficiency of an individual model of developmental support, indicating its beneficial results.

Hygroma Colli

Background : Hygroma coli is a malformation of the lymphatic system in the form of a membrane cyst filled with fluid, limited by the epithelium that is located in the anterolateral or occipito-cervical region. The prenatal diagnosis of cystic hygroma coli by ultrasound is based on an apparently bilateral, mostly symmetrical, and sometimes unilateral cystic structure located in the occipitocervical region. Large hygroma coli can cause pressure on the respiratory tract and digestion, so it requires management as soon as possible.The main treatment modality is surgical excision to remove the cystic lesion. The prognosis of a hygroma coli cyst depends on its size and the action taken because it is rare for cases to experience spontaneous regression.Destination : Reported a case of hygroma colliMethods : Case ReportCase Report : Case 24 years old women with preterm G1P0A0L0 26-27 weeks + Hygroma colli + IUFD + Suspected COVID-19. On ultrasound examination, it was found that BPD =4,71; AC = 15,91; FL = 2,89; EFW = 330 gr; FHR = (-); Cyst = 5,06 x 3,26. The presence of head presentation, IUFD, hygroma colli was found. The patient was planned for labor induction and the progress of labor was followed. Patient provided inform consent that baby was death during pregnancy and need to be labored. The baby was born, weight 300 gr, body length 14 cm and A/S 0/0. Postmortem physical examination revealed findings of hygroma colli infants such membrane cyst filled with fluid that located in the occipito-cervical region. Conclusion: Hygroma colli is a malformation of the lymphatic system and the prognosis or complications depends on the size of cyst. Careful prenatal examination is required in diagnosis and termination of pregnancyKeywords: Hygroma Colli, prenatal diagnosis

A Multi-dimensional Online Survey of Experts, Patients and the Public on Early Detected Scoliosis in Fetus Caused by Spinal Hemivertebra

In recent years, with the increasing number of women in advanced maternal age and standardized protocol of prenatal examination in China, more fetuses have been detected with scoliosis caused by hemivertebra (HV). The objective of this study was to obtain the responses of different populations on early detected scoliosis in fetuses caused by spinal hemivertebra through a multi-dimensional survey. A self-administered anonymous web and social media-based multi-dimensional online survey were conducted. Four short questionnaires concerning fetuses with scoliosis secondary to hemivertebra were sent to spine/orthopedic surgeons, obstetricians/ultrasonologists, scoliosis patients, and the non-medical general public separately. Survey items mainly included whether continue the pregnancy, the responses of different populations, whether they have knowledge of HV and what they wanted to know most about HV among the general public group, etc. All the questions were single choice questions, and additional responses could be added if needed. A total of 5586 respondents including 647 spine surgeons, 227 orthopaedic surgeons, 350 obstetricians, 54 ultrasonologists, 246 scoliosis patients and 4062 general public participated in the survey. 41.89% spine surgeons, 25.99% orthopedic surgeons, 6.57% obstetricians, 17.48% scoliosis patients and 19.23% general public chose to continue pregnancy and seek treatment after birth. 4.02% spine surgeons, 7.49% orthopedic surgeons, 3.71% obstetricians, 26.83% scoliosis patients and 14.28% non-medical general public suggested or chose to terminate the pregnancy. 54.10% spine surgeons, 66.52% orthopedic surgeons suggested explain the pros and cons to the parents and let them make their own choices.

Clinical outcomes in congenital diaphragmatic hernia of the fetus

The objective: to characterize pregnancy course and clinical outcomes for newborns in cases of congenital diaphragmatic hernia, and to compare these data with the results of prenatal examinations Materials and methods. Results of complex prenatal examination of 259 fetuses as patients with diaphragmatic hernia, which were referred to the department of Fetal medicine in 2007–2020, were analyzed. Data on pregnancy course and clinical outcome for infants were collected in 144 cases: from medical records of the Institute (n=77), and by direct survey, if delivery and specialized care took place in other institutions (n=67). The results were compared depending on the clinical outcome and the place of care. Results. Among 144 cases with known outcome, 140 (97.2%) were singleton and 4 (2.8%) were twin pregnancies with only one affected fetus. Termination of pregnancy for fetal anomalies before to 22 weeks was performed in 16.7% (44/144), 83.3% of cases (120/144) ended in childbirth. Before 22 weeks for prenatal examination were referred 30.6% (44/144) of women, of them 54.5% (24/44) have chosen termination in presence of unfavorable prognosis, and in the remaining 45.5% (20/44) cases pregnancy was prolonged. Of the 120 labors, 92.5% were term and 7.5% preterm. Antenatal death after 22 weeks occurred in 4.2% (5/120) cases. Among liveborn infants before surgical correction in the clinics of the Institute have died 25% (18/72), and in other institutions 37.2% (16/43), р>0.05. Postoperative mortality was 13% (7/54) in the Institute and 42.3% (11/26) in other institutions, р=0.0032. The rate of associated pathology was significantly higher among children treated in other institutions (25.6% vs. 5.6%), but the proportion of operated patients did not differ significantly (60.5% in other institutions and 75% in the Institute). Comparison of data of prenatal examination showed significantly higher rate of associated pathology (26.3% vs. 3.2%), polyhydramnios (50.9% vs. 20.6%), right-sided hernia (21.2% vs. 6.3%) and liver herniation in left-sided hernia (81.8% vs. 28.8%) in the group with negative outcome. Conclusions. The majority of pregnancies with diaphragmatic hernia in the fetus ended in childbirth, with high mortality rate. Strategy of complex prenatal examination in cases of congenital diaphragmatic hernia, prognosis evaluation by multidisciplinary council with individualized pregnancy/labor management planning, and delayed surgical correction allow to optimize specialized care and to avoid ineffective surgical interventions in extremely severe clinical and anatomical variants of pathology. Keywords: congenital diaphragmatic hernia, prenatal diagnosis, chromosomal anomalies, congenital malformations, pregnancy, labor.