Viral infection of the placenta leads to fetal inflammation and sensitization to bacterial products predisposing to preterm labor.

Pandemics pose a more significant threat to pregnant women than to the nonpregnant population and may have a detrimental effect on the well being of the fetus. We have developed an animal model to evaluate the consequences of a viral infection characterized by lack of fetal transmission. The experiments described in this work show that viral infection of the placenta can elicit a fetal inflammatory response that, in turn, can cause organ damage and potentially downstream developmental deficiencies. Furthermore, we demonstrate that viral infection of the placenta may sensitize the pregnant mother to bacterial products and promote preterm labor. It is critical to take into consideration the fact that during pregnancy it is not only the maternal immune system responding, but also the fetal/placental unit. Our results further support the immunological role of the placenta and the fetus affecting the global response of the mother to microbial infections. This is relevant for making decisions associated with treatment and prevention during pandemics.

Evidence for obtaining a second successive semen sample for intrauterine insemination in selected patients: results from 32 consecutive cases.

OBJECTIVE: The goal of this study was to compare the semen parameters of two successive samples obtained within an interval of less than 60 minutes from patients planning to undergo intrauterine insemination (IUI) whose first samples exhibited low semen quality. METHODS: Thirty-two consecutive patients were enrolled in the study. On the day of IUI, the semen analysis of the samples initially presented by all patients met at least two of the following criteria: sperm concentration <5×10(6)/mL, total sperm count <10×10(6), progressive sperm motility (a+b) in the native sample <30%, and total motile sperm count (TMSC) <4×10(6). A successive semen sample was obtained no more than 60 minutes after the first sample. RESULTS: Compared to the first sample, the second exhibited significantly (p<0.05) improved sperm concentration, TMSC, progressive motility, and vitality. Regarding TMSC, the most critical parameter on the day of IUI, 23 patients (71.8%) improved it, while nine (28.2%) displayed poorer outcomes. CONCLUSION: In defined cases, requesting a second successive ejaculate on the day of insemination may result in a high percentage of cases in an improvement of the quality of the sample.

Near-optimal glycemic control in Chilean women with pregestational type-2 diabetes: persistent macrosomia relates to maternal pre-pregnancy overweight.

UNLABELLED: After a 10-year program intending to improve glycemic control in diabetic pregnancies, we evaluated whether factors underlying macrosomia are similar for type-1 and -2 pregestational diabetic women. PATIENTS AND METHODS: Twenty-three pregnancies in type-1 diabetics (PDM1, age 28.3+/-1.1 years) and 51 pregnancies in type-2 diabetics (PDM2, age 32.8+/-0.6 years) were followed and treated with intensified insulin therapy. Several factors potentially influencing macrosomia were evaluated. STATISTICS: chi-square, Fisher's exact, Student's "t" and Mann-Whitney "U" tests, and ROC analysis. RESULTS: In PDM1 and PDM2, respectively, large-for-gestational-age (LGA) frequencies were 26.08% and 37.25% (NS), antepartum HbA1c values were 6.5+/-0.32 and 6.1+/-0.16 (NS), and pre-pregnancy body mass indexes (BMI) were 23.03+/-0.66 and 30.01+/-0.89 (p<0.0001). In PDM1 the main predictor of LGA was an antepartum HbA1c> or =6.8% (p=0.046), whereas in PDM2 pregestational BMI> or =24 the variable associated (p=0.032) with LGA newborns. CONCLUSIONS: PDM1 and PDM2 differ in the underlying factors related to macrosomia. Whereas in PDM1 the antepartum HbA1c emerged as the most significant variable, suggesting that glycemic control largely determines macrosomia, in PDM2 with near-optimal glycemic control, macrosomia related to pregestational BMI.

[Correlation between CA-125 marker with the presence and severity of pelvic endometriosis]. / Correlación entre valores del marcador Ca-125 con la presencia y severidad de endometriosis pelviana.

BACKGROUND: Endometriosis affects at least 15% of infertile women. The diagnosis is made by direct visualization of implants either at laparoscopy or laparotomy. Elevation of plasma CA-125 levels has been associated with the presence of endometriosis. AIM: To search for a correlation between CA-125 and the presence of endometriosis and its severity, among infertile patients requesting a diagnostic laparoscopy. PATIENTS AND METHODS: A total of 117 women were prospectively enrolled in the study between May 2000 and March 2002. A serum sample for CA-125 was taken immediately before surgery and the value obtained was correlated with the presence or absence of endometriosis and the severity of the disease. RESULTS: Sixty nine patients had endometriosis (59%). Patients with severe endometriosis, or grade IV, showed statistically significant higher levels of CA-125 compared to women without endometriosis or with grades I, II or III of the disease. DISCUSSION: The overall sensibility of CA-125 in detecting patients with endometriosis was low, however, it worked better for patients with advanced disease. Considering the rather low cost and simplicity of the test, we believe that it should be included in the evaluation of infertile couples.