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Aim To investigate the expression of formyl peptide receptor 2 (FPR2) in maternal blood, umbilical blood, and placenta of patients with gestational diabetes mellitus (GDM), and to analyze the changes of other pro‐inflammatory cytokines in blood, including interleukin 33 (IL‐33), IL‐1β, tumor necrosis factor alpha (TNF‐α), and C‐reactive protein (CRP), so as to reveal the pathogenesis of GDM. Methods FPR2, IL‐33, IL‐1β, T TNF‐α, and CRP in maternal blood and umbilical cord blood of 50 pregnant women with GDM and 30 normal pregnant women were analyzed by ELISA method to explore the correlation between inflammatory factors and blood glucose. The expression of FPR2 in placental tissues was analyzed by PCR and immunohistochemistry. Results The expression of FPR2 in maternal blood of gestational diabetes patients was significantly higher than that of normal pregnant women, and other inflammatory factors IL‐33 and IL‐1β in maternal blood were also significantly increased. The expression of FPR2 in umbilical cord blood of gestational diabetes was higher than that of normal pregnant women, but the difference was not significant. Other inflammatory factors IL‐33, IL‐1β, and CRP in umbilical cord blood were also significantly increased. The expression of FPR2mRNA and protein in placental tissues of gestational diabetes was significantly higher than that of normal pregnant women. Conclusions The level of FPR2, IL‐33, and IL‐1β in maternal blood was related to the pathogenesis of GDM and these inflammatory factors could be used as special candidate direction of marks for the prevention, clinical treatment and drug design of GDM, laying a new theoretical foundation for the treatment of GDM.

Rationale Pituitary tumor apoplexy (PTA) is a rare clinical syndrome which requires urgent diagnosis and treatment due to its life-threatening consequences. Management of undiagnosed pituitary tumor before pregnancy is a problem during pregnancy. Patient concerns We reported a case with PTA which was not diagnosed before pregnancy presenting with vomiting associated with hyponatremia during the third trimester. After supplying the sodium the patient presented with dysarthria and hemiplegia. Diagnoses MRI examination showed PTA accompanied with extrapontine myelinolysis (EPM). Interventions The patient was given hydrocortisone according to the symptoms gradually to taper off dose, at the same times oral levothyroxine therapy (25μg/day) was given. Outcomes The patient delivered a healthy baby via cesarean section at hospital at 38 + 1 week of gestation. We performed MRI examination regularly and the tumor regressed significantly 8 months postpartum. Lessons We reported a case as PTA associated with EPM. Headache during pregnancy is often nonspecific, so careful medical history inquiry is very important.

Rationale Patients with situs inversus totalis (SIT) and complete atrioventricular (AV) block are extremely rare, and only few cases have been reported up to now. Due to the rarity of such condition and its anatomical complexity, we reported this case as a reference for obstetricians, providing valuable insights into potential clinical treatment. Patient concerns We reported a case of 30-year-old patient with complete AV block, and her heart rate was only about 45 beats per minute. Diagnoses The patient was diagnosed with term delivery with SIT and complete AV block. Interventions A temporary pacemaker (TPM) was implanted before cesarean section (CS) because of complete AV block. Outcomes CS was performed successfully after the implantation of a TPM. The heart rate remained stable, and the 24-hour blood loss was limited. Lessons This study presents a complex heart disease case which needed more frequent antenatal examination and restriction of physical activity. To reduce the risk of pregnancy, basic disease needed to be cured before pregnancy. Our findings could provide guidance for future clinical studies.

Rationale About 60,0000 people are involved in traffic accident each year in China and spinal cord injury (SCI) often occurs. Pregnant women with paraplegia is rare, and they face higher risk during pregnancy and childbirth. Patient concerns We report a case of a 35-year-old patient with SCI, who had vaginal forceps delivery at 38 weeks and 5 days of gestation. Diagnoses The patient was diagnosed with term pregnancy with traumatic tetraplegia. Interventions A vaginal forceps delivery was performed at 38 weeks and 5 days of gestation. Outcomes A vaginal forceps delivery of the patient was smooth. After delivery the patient recovered quickly, her vaginal blood was less, blood pressure was favoring. Lessons This study presents a case with traumatic tetraplegia during pregnancy. We suggest that regular prenatal care is necessary.

Rationale:Gastrointestinal carcinoma is rare during pregnancy. It is usually diagnosed at an advanced stage because special gastrointestinal symptoms are generally overlooked during pregnancy, and there are many limitations and contraindications for using diagnostic tools during pregnancy.Pa