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02 May 2021, Volume 37 Issue 5 Previous Issue    Next Issue

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Clinical limitations and practical exploration direction of sFlt-1/PlGF for PE prediction. XIAO Xi-rong，LI Xiao-tian 2021, 37(5): 515-519.  DOI: 10.19538/j.fk2021050103 Abstract ( )   Fetal - placental unit ischemia and hypoxia caused by placental insufficiency is one of the important links in the pathogenesis of preeclampsia（PE）. The series of changes produced by vasoactive factors in response to hypoxia can serve as an important method of predicting，diagnosis and monitoring PE. The ratio of sFlt-1，a splice variant of FMS like tyrosine kinase 1（Flt-1），and placental growth factor（PlGF）（sflt1/PlGF）has a high negative predictive value in predicting PE.Meanwhile，sflt1/PlGF also has great value in preeclampsia diagnosis and condition monitoring. However，there are still many problems to be solved. In this paper，the recent research achievements in this field will be summarized，some limitations will be discussed，and the direction of clinical practice will be discussed.

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Prevention of preeclampsia with low-dose aspirin：limitations and clinical selectivity. HE Ying-dong，CHEN Qian 2021, 37(5): 519-522.  DOI: 10.19538/j.fk2021050104 Abstract ( )   Low-dose aspirin during pregnancy is a widely used method to prevent preeclampsia. In clinical work，there is a situation of expanding the indications of aspirin use and overestimating the preventive effect. This article will introduce the limitations of aspirin in preventing preeclampsia based on evidence-based medical data，in order to accurately select the itargeted population，and avoid the abuse of low-dose aspirin during pregnancy.

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Early prevention and control of preeclampsia in primary level medical institutions. ZHANG Qin-jian，YAN Jian-ying 2021, 37(5): 522-526.  DOI: 10.19538/j.fk2021050105 Abstract ( )   Preeclampsia（PE） is a syndrome based on hypertension and multi-system involvement and damage. It is a pregnancy-specific disease that seriously affects maternal and fetal health worldwide，and it is also one of the main causes of maternal perinatal death.Although there is a lot of investment in the research of preeclampsia and a lot of work has been done to improve the clinical management guidelines，there is a lack of management suggestions for primary level.With the special considerations and challenges unique to primary-level medical institutions，the suggestions for prevention and control of preeclampsia at those region should follow the principle of combining evidence with practice，and efforts should be made to be concise，simplifying operation procedure to improve management efficiency.There is a need to focus on low-cost screening and interventions in the community，which will help to promote the effective implementation of the policy of early prevention and treatment of preeclampsia at the primary level.

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Important clinical points in the prevention of preeclampsia in pregnant women with medical complications. GAO Jin-song，LIU Jun-tao 2021, 37(5): 526-531.  Abstract ( )   The women with medical complications such as chronic hypertension，diabetes，systemic lupus erythematosus，antiphospholipid syndrome and chronic kidney disease have a increased risk of preeclampsia and other adverse pregnancy outcomes. Patients with high risk of developing preeclampsia could receive low dose aspirin to prevent preeclampsia. The best pregnancy outcome can be achieved by performing multidisciplinary management and paying attention to the evaluation and treatment of basic diseases.

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Prevention and management of preeclampsia in twin pregnancies. SHEN Hong-fei，LI Jia-po 2021, 37(5): 531-535.  DOI: 10.19538/j.fk2021050107 Abstract ( )   Preeclampsia（PE） is a severe complication of pregnancy，which is closely related to the occurrence of adverse maternal and perinatal outcomes，and is the main cause of severe complications in pregnant women. The incidence of preeclampsia in twin pregnancies is 3-4 times higher than that in singleton pregnancies；additionally，preeclampsia occurs earlier in twin pregnancies，which has a greater impact on pregnant women and perinatal infants. Based on the clinical characteristics of twin pregnancies，this paper reviews the prevention and clinical management of preeclampsia in twin pregnancies in combination with the published guidelines and expert consensus for diagnosis and treatment of hypertensive disorder complicating pregnancy（HDCP）.

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Out-of-hospital monitoring and management of blood pressure during pregnancy. CHEN Yi-xuan，NIU Jian-min 2021, 37(5): 535-538.  DOI: 10.19538/j.fk2021050108 Abstract ( )   Out-of-hospital monitoring of blood pressure is an important part of blood pressure management during pregnancy，including home blood pressure measurement（HBPM）and ambulatory blood pressure measurement（ABPM）. HBPM is an important measure for out-of-hospital monitoring and management of blood pressure in pregnancy. HBPM based on mobile Internet is suitable for blood pressure management of all types of hypertensive disorders during pregnancy and of normal pregnant women.

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Management of early-onset preeclampsia in hospitals at different levels. HE Jing，HONG Yan-yu 2021, 37(5): 539-542.  DOI: 10.19538/j.fk2021050109 Abstract ( )   Early-onset preeclampsia has the feature of special gestational week at onset, and some cases progress very quickly and have severe complications, so multidisciplinary support is needed, including maternal support at critical condition, obstetrical clinic support and rescue of preterm neonates in severe cases. Therefore, the medical institutions of all levels must know whether they have the ability to deal with such cases before accepting the patients for treatment. The hospitals without the related support should contact and refer the patients to higher-level hospitals as soon as possible after initial management when the patients’condition is relatively stable, and give professional management during the referral. Nevertheless, for the preeclampsia cases which are not suitable for referral, the collaboration among different levels of hospitals and high-quality consultation are also involved.

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Enhancing cognition and management of postpartum preeclampsia and HELLP syndrome. LIU Xiao-xia，ZOU Li 2021, 37(5): 542-546.  DOI: 10.19538/j.fk2021050110 Abstract ( )   Preeclampsia-eclampsia is a disease that seriously affects the health of mothers and children globally. Early screening of risk factors，early prevention，early diagnosis and early intervention are important measures for the treatment of preeclampsia-eclampsia. However，the scientific management of perinatal preeclampsia，and the prevention and treatment of postpartum HELLP syndrome and delayed-onset postpartum preeclampsia-eclampsia also need to be paid more attention.Timely diagnosis and treatment are of great significance to improve maternal and fetal outcomes in clinical work.This article summarizes a number of studies and guidelines on the diagnosis and treatment of perinatal preeclampsia，postpartum HELLP syndrome and delayed-onset postpartum preeclampsia-eclampsia，in order to gain attention，perform early management and improve the prognosis in clinical practice.

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Studies and application of information technology in the management of high-risk pregnancies. XU Bei，ZHU Yuan-fang 2021, 37(5): 546-549.  DOI: 10.19538/j.fk2021050111 Abstract ( )   The management of high-risk pregnancy is the key and difficult point of maternal health care. In the information era，medical informationalized management methods based on the Internet+platform，intelligent technology，etc.，have significant application value in the management of high-risk pregnancy，which can greatly increase the work efficiency of medical staff，improve adverse pregnancy outcomes，and ensure the safety of mothers and infants.