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For each indicator, we provided necessary investments to practical solutions. As a result, a methodological proposal was presented to improve their actions, which was hierarchized by degrees of temporal urgency for their implementation. The design of the actions has great potential to improve and develop sustainability practices in WPOs and MSWC programs. Due to the low quality of primary data collected, we recommend the creation of the data control systems to continuously monitor.

The 12q terminal duplication is a chromosomal structural abnormality that has been rarely reported. The common clinical manifestations include intellectual disability and speech delay. We report two cases of patients with a duplication of chromosome 12q which was discovered incidentally during non-invasive prenatal genetic testing (NIPT).

Next generation sequencing-based NIPT and karyotype analysis confirmed the type and inheritance of the rearrangement, and chromosomal microarray-based analysis also confirmed the end replication.

One patient had a 18Mb 12q24.21q24.33 duplication. The other patient had a12.04Mb12.q24.31q24.33 duplication and a 9.56Mb deletion in 18p11.32p11.22. The duplicated regions on chromosome 12 and the deletion on chromosome 18 in the patients were pathogenic, and the fetuses may have clinical characteristics, such as mental retardation, facial deformities, and psychomotor retardation. Ultimately, both pregnant women chose to terminate their pregnancy.

The cases we reported show that NIPT cannot only detect conventional chromosomes, but can also detect microdeletions and microduplications, which broadens the scope of clinical application for NIPT and provides genetic information for high-risk pregnant women as early as possible.

The cases we reported show that NIPT cannot only detect conventional chromosomes, but can also detect microdeletions and microduplications, which broadens the scope of clinical application for NIPT and provides genetic information for high-risk pregnant women as early as possible.

The objectives of this study were to characterize the length of the second stage of labor in a large contemporary cohort of women with varying obstetrical histories and to investigate the factors associated with the length of the second stage.

This was a retrospective cohort study conducted at a tertiary medical center. Women with singleton spontaneous vaginal deliveries between the years 2005-2017 were included. The length of the second stage was compared between groups based on obstetrical history and maternal and obstetrical characteristics were evaluated to identify factors associated with the length of the second stage.

There were 100,759 deliveries included in the study. The second stage of labor was longest in nulliparous women with an epidural (median 96 min, interquartile range 53-142 min), which was 57 min longer than in nulliparous women without an epidural. In parous, grand-multiparous, grand-grand multiparous, and women with a prior cesarean delivery, all without an epidural, there was no clinically significant difference in the length of the second stage (median 6-7 min). The length of the second stage was significantly shorter in women delivering preterm compared to women delivering at term. Birthweight, previous cesarean delivery, gestational age, use of epidural analgesia, and induction of labor were all independently positively associated with the length of the second stage, while parity was negatively associated with the length of the second stage.

The median length of the second stage of labor was considerably longer than historically described in nulliparous women and relatively shorter in parous women.

The median length of the second stage of labor was considerably longer than historically described in nulliparous women and relatively shorter in parous women.

Granulosa cell tumor (GCT) is a rare type of ovarian malignancy with poor prognosis of recurrence. Anti-Mullerian hormone (AMH) is a promising serum biomarker for early diagnosis GCT, therefore we assessed its accuracy and clinical value.

A meta-analysis was performed to estimate the diagnostic accuracy. We searched the PubMed, Cochrane Literature Library and EMBASE database. After filtering, five studies met our criteria. Two independent reviewers extracted data and total 421 serum samples (70 GCT serum samples and 351 controls) were included in our analysis. The pooled values of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and Summary receiver operating characteristic (SROC) were calculated to assess the accuracy.

The pooled estimated for AMH were sensitivity 0.89 (95 % CI 0.78-0.95), specificity 0.93 (95 %CI 0.83-0.97). The area under the SROC was 0.93 (95 %CI 0.91-0.95).

Serum AMH can be used as a biomarker in clinical diagnosis of GCT with high accuracy.

Serum AMH can be used as a biomarker in clinical diagnosis of GCT with high accuracy.

To evaluate the effects of antenatal corticosteroids (ACS) administration on mortality and major neonatal complications in early life of preterm twins.

This study retrospectively enrolled 1 662 twins delivered at 25∼34

gestational weeks in China from January 2013 to December 2014. They were divided into ACS group and no-ACS group according to weather their mothers received ACS or not. Moreover, they were subgrouped as 25∼27

and 28∼34

gestational week groups. Multivariable logistic regression was used to analyze the effects of ACS on the incidence of mortality and major morbidities.

A total of 910 neonates (54.8 %) received one or more doses of ACS, and 752 neonates (45.2 %) did not receive any ACS. DNA Damage inhibitor No significant difference in infant mortality was observed between the ACS and no-ACS groups (P = 0.321). The ACS group had decreased incidence of respiratory distress syndrome (RDS) and mild RDS compared with the no-ACS group (both P < 0.05). There were no significant differences in the incidence of bHowever, our data suggest that it may not have a beneficial effect on mortality and other short-term morbidities.