Placental fatty acid transfer: a key factor in fetal growth.

The functionality of the placenta may affect neonatal adiposity and fetal levels of key nutrients such as long-chain polyunsaturated fatty acids. Fetal macrosomia and its complications may occur even in adequately controlled gestational diabetic (GDM) mothers, suggesting that maternal glycemia is not the only determinant of fetal glycemic status and wellbeing. We studied in vivo the placental transfer of fatty acids (FA) labeled with stable isotopes administered to 11 control and 9 GDM pregnant women (6 treated with insulin). Subjects received orally ¹³C-palmitic, ¹³C-oleic, and ¹³C-linoleic acids and ¹³C-docosahexaenoic acid (¹³C-DHA) 12 h before an elective caesarean section. FA were quantified by gas chromatography and ¹³C enrichments by gas chromatography-isotope ratio mass spectrometry. The ¹³C-FA concentration was higher in total lipids of maternal plasma in GDM patients versus controls, except for ¹³C-DHA. Moreover, ¹³C-DHA showed a lower placenta/maternal plasma ratio in GDM patients versus controls and a significantly lower cord/maternal plasma ratio. Other FA ratios studied were not different between GDM and controls. A disturbed ¹³C-DHA placental uptake occurred in GDM patients treated with diet or insulin, while the latter also had lower ¹³C-DHA levels in the venous cord. The tracer study pointed towards an impaired placental DHA uptake as a critical step, while the transfer of other ¹³C-FA was less affected. Patients with GDM treated with insulin could also have a greater fetal fat storage, which may have contributed to the reduced ¹³C-DHA in the venous cord observed. The DHA transfer to the fetus was reduced in GDM pregnancies compared to controls. This might have an influence on fetal neurodevelopment and long-term consequences for the child.

Acceptability, tolerability, and effects on symptoms and signs of vulvovaginitis of a non-soap, herbal-based intimate hygiene solution (Zelesse®).

OBJECTIVE: To evaluate the acceptability, tolerability, and effects on vulvovaginitis symptoms and signs of a non-soap, herbal-based intimate solution (Zelesse®). METHODS: We conducted a prospective, observational, multicenter study including adult women with symptoms and signs of vulvovaginitis with various etiologies, including candidiasis, trichomoniasis, bacterial vaginosis, and atrophic and irritative vaginitis. The presence and intensity of signs (edema, erythema, vaginal discharge) and symptoms (pruritus) of vulvovaginitis were evaluated before and after 5-15 days of daily use of Zelesse® alone or as a coadjuvant in antimicrobial therapy. Variables following a normal distribution and categorical variables were analyzed using the Student t-test and chi-square or Fisher's exact test, respectively. RESULTS: A total 137 women were enrolled in the study; 87 (63.5%) women received concomitant antimicrobials and 50 (36.5%) used Zelesse® only. Global symptom scores and frequency of patients with vulvovaginitis signs and symptoms, and their mean intensity, decreased after treatment in both patient groups. Vaginal pH and (in the Zelesse®-only group) vaginal flora remained unaltered. The product was safe, well tolerated, and highly accepted by patients. CONCLUSIONS: Zelesse®, the non-soap herbal-based solution in this study, may represent a safe and effective option for symptomatic relief of vulvovaginitis.

Reliability of examining the external iliac artery with Doppler ultrasound in the first trimester and its relationship with maternal blood pressure and uterine artery blood flow.

OBJECTIVE: To explore the reliability of examining the external iliac artery (EIA) at 11+0 to 13+6 weeks of gestation with Doppler ultrasound and its relationship with maternal characteristics and uterine artery blood flow. STUDY DESIGN: Cross-sectional study of 451 pregnant women undergoing an ultrasound scan in the first trimester. Mean pulsatility index (PI) of both EIAs was correlated to maternal characteristics (maternal age, parity, body mass index and mean arterial blood pressure (MAP)) and ultrasound parameters (crown-rump length (CRL) and mean uterine artery PI). Mean EIA-PI was logarithmically transformed to perform multiple linear regression analysis. The intra- and inter-observer reproducibilities of EIA-PI were examined. RESULTS: Satisfactory flow velocity waveforms were obtained from both EIA in all patients. There is a significant negative correlation between mean EIA pulsatility index and maternal blood pressure. Multiple linear regression analysis showed an independent contribution of MAP to log EIA-PI (mean) (standardized regression coefficient = -0.20, 95% CI: -0.005 to -0.002). The intra-class correlation coefficients (ICCs) for intraobserver and interobserver reproducibility were 0.94 (95% CI, 0.88-0.97) and 0.87 (0.76-0.94) respectively. CONCLUSIONS: Examining blood flow in the external iliac artery using Doppler ultrasound in the first trimester is feasible and reproducible. There is a negative correlation between mean EIA-PI and maternal blood pressure.