Effects of maternal iron status on placental and fetal iron homeostasis.

Iron deficiency is common worldwide and is associated with adverse pregnancy outcomes. The increasing prevalence of indiscriminate iron supplementation during pregnancy also raises concerns about the potential adverse effects of iron excess. We examined how maternal iron status affects the delivery of iron to the placenta and fetus. Using mouse models, we documented maternal homeostatic mechanisms that protect the placenta and fetus from maternal iron excess. We determined that under physiological conditions or in iron deficiency, fetal and placental hepcidin did not regulate fetal iron endowment. With maternal iron deficiency, critical transporters mediating placental iron uptake (transferrin receptor 1 [TFR1]) and export (ferroportin [FPN]) were strongly regulated. In mice, not only was TFR1 increased, but FPN was surprisingly decreased to preserve placental iron in the face of fetal iron deficiency. In human placentas from pregnancies with mild iron deficiency, TFR1 was increased, but there was no change in FPN. However, induction of more severe iron deficiency in human trophoblast in vitro resulted in the regulation of both TFR1 and FPN, similar to what was observed in the mouse model. This placental adaptation that prioritizes placental iron is mediated by iron regulatory protein 1 (IRP1) and is important for the maintenance of mitochondrial respiration, thus ultimately protecting the fetus from the potentially dire consequences of generalized placental dysfunction.

Stereological Analysis of Adolescent Placentas and Anthropometric Characteristics of Newborns.

INTRODUCTION: Knowledge of the size of surfaces available for transport is important for assessing the amount of nutrients that can be transmitted to the fetus for its normal growth and development. AIM: The aim of our study, was to determine the stereological structural parameters of the parenchymal part of placenta, ratio of birth weight and placental weight, and to determine their correlation with the body length and head circumference of the newborns of adolescent pregnant women. METHODS: The study was conducted on a total of 60 human placentas of term pregnancy, divided into two groups according to the age of pregnant women. The experimental group consisted of 30 placenta of pregnant women aged 13-19. The control group consisted of 30 placenta of pregnant women aged 20-35. Computer assisted morphological analysis of images of histological preparations using stereological methods was performed. RESULTS: Surface density of terminal villi of adolescent placentas is significant higher than the control group (t = 14,179, df = 29, p <0,0001). The T-test (t = -5,868, df = 29, p <0,0001) showed statistically significant difference in the surface density of fibrinoid in two compared groups. T-test (t = 6.438, df = 29, p <0.0001) found that total surface of terminal villi was significantly higher in adolescent placentas. The T-test (t = -6,747, df = 29, p <0,0001) found that total surface of fibrinoid was significantly lower in adolescent group. The T-test (t = 4.203, df = 29, p <0.0001) found that the ratio of birth weight of newborn and adolescent placental weight was significantly higher in relation to the control group. CONCLUSION: Adolescent placentas was more efficient in increasing the weight of newborns, compared to the control group placentas.

Challenges in the Routine Praxis Diagnosis of Hydatidiform Mole: a Tertiary Health Center Experience.

INTRODUCTION: Hydatidiform moles (HM), presenting as complete (CHM) and partial (PHM) form, are rare pregnancy disorder. Diagnosis is based on clinical presentation, ultrasound imaging findings and pathological examination of products of conception. Protein p57, encoded by CKDN1C gene, is paternally imprinted and maternally expressed gene and provides quick insight in genetic basis of HM and allows distinction of CHM from all other conceptions. compare the preevacuational and pathohistological diagnosis with outcome of p57 immunostaining. MATERIAL AND METHODS: All cases of HM diagnosed between January 2011 and December 2015 were included in this research. Maternal age, gestational age and input diagnosis data were recored. p57 immunostaining was performed in order to evaluate the diagnosis based on tissue slides examination. RESULTS: There were 198 cases of histologically confirmed HM, 185 PHM, 12 CHM and one case of undefined HM. Mean maternal age in the CHM group was 24,7 and in the PHM group 26,9 years, with no significant differences among these two groups (p=0,27). For CHM mean gestational age was estimated at eight and for PHM 9,2 gestational weeks. Pregnant woman older than 40 years present significant earlier compared with younger woman (p<0,01), and those younger than 20 years tend to present at the beginning of the second trimester more often than older women (p<0,05). In the CHM group, 9 (75%) input diagnoses were mola in obs, and 3 (25%) of them were signed as abortion, unlike the PHM where 126 (67%) were qualified as abortion, 35 (19%) as blighted ovum, and 26 (14%) were suggestive for molar pregnancy. p57 immunostaining results confirmed all pathohistological diagnosis of CHM whereas 8% of PHM demonstrated divergent p57 expression. CONCLUSION: PHM, compared with CHM, represent a greater diagnostic challenge for both gynecologist and pathologist even when presenting in more advanced pregnancies.

Influence of maternal anemia during pregnancy on placenta and newborns.

INTRODUCTION: Sideropenic anemia is a common pregnancy disorder. Depending on severity, maternal anemia can significantly influence morphometric characteristic of placental tissue, pregnancy course and outcome. OBJECTIVES: to estimate if maternal anemia a) results with significant placental changes; b) influence on newborn weight, length and vitality. PATIENTS, MATERIAL AND METHODS: Research included 100 women and their newborns, 50 anemic, and 50 women in the control group. Sixty placentas were collected, placental mass and volume was determined, and blood vessels of terminal villi were stereologically analyzed. Newborns mass and body length, and Apgar scores within 1 and 5 minutes after delivery were recorded. THE RESULTS: Placentas of anemic pregnant women showed significant increase of terminal villi blood vessels (224.18 vs. 197.00 cm3; p < 0.0001), but total placental mass and volume did not differ significantly. Anemic mothers' newborns were significantly shorter (51.76 vs. 55.54 cm; p < 0.0001), smaller body mass (3048.00 vs. 3615.60 g; p < 0.0001) and delivered one week early (38.2 vs. 39.2 GW; p < 0.0001), but not significantly poorer vitality (p > 0.05) comparing with the control group. CONCLUSION: Sideropenic anemia increase placental maturity, that could be a possible cause of earlier spontaneous delivery among anemic women. The anemic mothers' newborns are shorter and lower body mass, but not poorer vitality index.

Stereological analysis of terminal villi of the placentas of pregnant woman with sideropenic anemia.

Iron deficiency, causing maternal sideropenic anemia, is one of the most frequent nutritive disorder that develops during the pregnancy. We collected 30 placentas from anemic mothers and 30 placentas from mothers belonging to the control group. Terminal villi (magnification 10x) and terminal villi capillaries (magnification 40x) were stereologically analyzed and numerically determined.In the placentas from anemic mothers we noted the values a) terminal villi: volume density 0,43 mm0, surface density 24.13 mm-1, total volume 185.57 cm3 and total surface 10.27 m2; b) capillaries of terminal villi: volume density 0.53 mm0 and total volume 224.18 cm3. In the placentas from mothers belonging to the control group we observed the following values a) terminal villi: volume density 0.44 mm0, surface density 22.27 mm-1, total volume 200.17 cm3 and total surface 10.15 m2; b) capillaries of terminal villi: volume density 0.42 mm0 and total volume 197.00 cm3. Compared with the control group anemic mothers' placentas have a significant higher values of surface density of terminal villi (p<0.05), volume density (p <0.01) and absolute volume (p<0.0001) of terminal villi capillaries, and significant lower values of absolute volume of terminal villi (p<0.05).In anemic mothers' placentas, the total volume of terminal villi changes disproportionately to the total surface of terminal villi with statistically significant increase of terminal villi capillaries compared with control group. 

Influence of maternal anemia during pregnancy on placenta and newborns.

INTRODUCTION: Sideropenic anemia is a common pregnancy disorder. Depending on severity, maternal anemia can significantly influence morphometric characteristic of placental tissue, pregnancy course and outcome. OBJECTIVES: to estimate if maternal anemia a) results with significant placental changes; b) influence on newborn weight, length and vitality. PATIENTS MATERIAL AND METHODS: Research included 100 women and their newborns, 50 anemic, and 50 women in the control group. Sixty placentas were collected, placental mass and volume was determined, and blood vessels of terminal villi were stereologically analyzed. Newborns mass and body length, and Apgar scores within 1 and 5 minutes after delivery were recorded. THE RESULTS: Placentas of anemic pregnant women showed significant increase of terminal villi blood vessels (224,18 vs. 197,00 cm(3); p<0,0001), but total placental mass and volume did not differ significantly. Anemic mothers' newborns were significantly shorter (51,76 vs. 55,54 cm; p<0,0001), smaller body mass (3048,00 vs. 3615,60 g; p<0,0001) and delivered one week early (38,2 vs. 39,2 GW; p<0,0001), but not significantly poorer vitality (p>0,05) comparing with the control group. CONCLUSION: Sideropenic anemia increase placental maturity, that could be a possible cause of earlier spontaneous delivery among anemic women. The anemic mothers' newborns are shorter and lower body mass, but not poorer vitality index.