To explore clinical values of early standardized management in children delivered by gestational diabetes mellitus (GDM) pregnant women and their follow-up.

From January 1 to December 31, 2015, a total of 140 neonates who delivered by GDM pregnant women at The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University were selected into GDM group (received early standardized management). Meanwhile, another 130 neonates who delivered by mothers had not been diagnosed with GDM during pregnancy were included into control group (received routine management). The general clinical data, maternal pre-pregnancy body mass index (BMI), feeding patterns within 3 months after birth, and follow-up information of physical development and neuropsychology development of 2 groups were analyzed. The birth weight, maternal pre-pregnancy BMI, physical development and neuropsychology development at 1-year and 2-year old were analyzed by independent-samples t test. The gender composition ratio and the proportion of preterm infants were compared by chi-square test. This study protocol was in line with the Institutional Review Board of The Affiliated Wuxi Maternity and Child Health Care Hospital of Nanjing Medical University (Approval Number: 2016-01-0729-12), and informed contents were obtained from the guardians of all subjects.

①There were no significant differences in the gender composition ratio, the proportion of preterm infants, birth weight and other general clinical data between two groups (P>0.05). ②The maternal pre-pregnancy BMI in GDM group was (22.1±3.1) kg/m^2, which was higher than that of control group (20.6±2.4) kg/m^2, and there was a statistically significant difference between two groups (t=4.275, P<0.001). There was also a statistically significant difference in the proportion of mothers with different pre-pregnancy BMI between two groups (χ²=10.560, P=0.005). ③There was no significant difference between two groups in the proportion of different feeding methods within 3 months after birth (P>0.05). ④There were no significant differences in the height, weight, head circumference and BMI between two groups at 1-year and 2-year old during follow-up (P>0.05). ⑤There were no significant difference in the proportion of normal weight, overweight and obesity between two groups at the time point of two-year follow-up (P>0.05). ⑥There were no significant differences in the scores of developmental quotient between two groups at 1-year and 2-year old during follow-up (P>0.05). In GDM group, the actual age of adaptive ability, language ability, and social behavior were lower than those of control group at 1-year and 2-year old during follow-up. There were statistically significant differences between two groups (one-year old: t=-2.022, -2.880, -3.981; P<0.05; two-year old: t=-5.420, -4.857, -2.298; P<0.05). But there were no significant differences between two groups in the actual age of gross motor and fine motor (P>0.05). ⑦Among 140 newborns in GDM group, 98 (70.0%) had good blood glucose control during pregnancy. The birth weight, proportion of low birth weight and macrosomia in newborns born to mothers with poor blood glucose control during pregnancy were higher than those born to mothers with good blood glucose control, but the difference were not statistically significant (P>0.05). At the time of follow-up to the age of 2-year old, the height and weight of newborns born to those with poor blood glucose control during pregnancy were higher than those born to those with good blood glucose control during pregnancy, but there were no statistical differences between two groups (P>0.05). In addition, there was no significant difference in the proportion of normal weight, overweight and obesity between those with poor blood glucose control and those with good control during pregnancy (P>0.05).

It is of great significance for GDM pregnant women to carry out early standardized management from perinatal period. In addition to paying attention to nutrition and feeding methods of children delivered by GDM pregnant women to avoid physical development deviation, clinical attention should also be paid to the guidance of children′s neuropsychological development so as to promote their physical and mental development in an all-round way.

Prenatal ultrasonography is the routine prenatal examination method. Fetal MRI, due to its safety, multi-planar capabilities, excellent soft tissues contrast, large fields of views and independence of ionizing radiation, has been used in prenatal diagnosis, and can provide useful additional fetal informations when prenatal ultrasonography is inadequate. The additional information provided by fetal MRI may have an impact on pretreatment communication, the choices of treatment and delivery. Fetal MRI is especially useful in diagnosing fetal nervous system diseases. This review aims to interpret the fetal MRI section of American Fetal Imaging Guide (2014), in order to guide clinical works for antenatal specialists, obstetricians, ultrasound doctors and radiologists.

The newest 2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care (hereinafter referred to 2015 Update) had been published in October 2015, which had adopted new systematic review process and new American Heart Association (AHA) classification system for classes of recommendation (COR) and levels of evidence (LOE). So the part of pediatric basic life support (PBLS) had been adjusted. In order to strengthen the first aid cardiopulmonary resuscitation (CPR) skills of pediatric doctors, the authors introduce briefly the highlights of PBLS and CPR quality in 2015 Update. Compared with the 2010 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, the updated contents are as follows. ①Identifying of the population of PBLS application; ②Reaffirming chest compressions-airway-ventilation (C-A-B) as the CPR operation sequence; ③Providing the pediatric cardiac arrest algorithms for a single rescuer and for 2 or more rescuers; ④Limiting the depths of chest compression: no more than 6 cm for adolescents; ⑤Recommending the frequency of chest compression: 100 to 120 beats/min; ⑥Comparing the advantages and disadvantages of traditional CPR and chest compressions alone of CPR; ⑦Emphasizing high quality CPR and so on, which are aimed to improve the success rate of CPR and survival of children of respiratory and cardiac arrest.

Up to now postpartum hemorrhage is still the major reason for maternal death. This paper focuses on definition, etiology, diagnosis and treatment of postpartum hemorrhage according to the Guideline on the Prophylaxis and Treatment of Postpartum Hemorrhage 2009 and 2014, to help gynecology and obsterics clinicians recognizing, diagnosing and treating postpartum hemorrhage timely, in order to reduce the maternal mortality.

Preeclampsia is a unique syndrome of pregnancy that is potentially dangerous for both mother and fetus, which is considered as a leading cause of maternal and perinatal mortality during pregnancy. It is very important to develop an effective prevention of preeclampsia. The most effective medication of preventing preeclampsia was observed in low-dose aspirin use, which was recommended to prevent preeclampsia in many countries. On September 2014, the United States Preventive Services Task Force (USPSTF) recommends the use of low-dose aspirin as a preventive medication in women who are at high risk for preeclampsia, which will be discussed in this review.