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1.
Prensa méd. argent ; Prensa méd. argent;107(3): 143-151, 20210000. tab, fig
Artículo en Inglés | LILACS, BINACIS | ID: biblio-1359736

RESUMEN

Antecedentes: al menos el 50% de los casos de aborto espontáneo recurrente son etiológicamente idiopáticos. Recientemente se han propuesto varios polimorfismos genéticos como factores de riesgo de susceptibilidad a la pérdida del embarazo. Objetivo: El objetivo del presente estudio de casos y controles es establecer la asociación entre los polimorfismos funcionales −2549 I / D en la región promotora del gen del factor de crecimiento endotelial vascular A (VEGFA) y el aborto espontáneo recurrente idiopático (IRSM) en una muestra de las mujeres jordanas. Sujetos y métodos: Se reclutaron 328 sujetos, 103 y 98 mujeres con IRSM primario y secundario, respectivamente, se seleccionaron 127 mujeres normales como grupo de control. Se aisló ADN genómico de una muestra de sangre extraída de cada participante, luego, se genotipificaron los polimorfismos I / D -2549 del gen VEGFA mediante la reacción en cadena de la polimerasa (PCR). Resultados: Los resultados obtenidos revelaron que el polimorfismo ID y el alelo D de VEGFA -2549 polimorfismos I / D tienen las frecuencias más altas en pacientes IRSM tanto primario como secundario, sin diferencia significativa entre los tres grupos en cuanto a polimorfismos y frecuencias alélicas, pacientes con DD + ID Los modelos genéticos tienen una asociación positiva con un alto riesgo de IRSM versus el modelo II, y los pacientes con alelo D son más propensos a tener IRSM que los que tienen el alelo I, no hay diferencia significativa en la asociación de polimorfismos VEGFA -2549 I / D con IRSM en los tres modelos genéticos de los pacientes con IRSM primario y secundario. Conclusión: los pacientes con modelo genético ID de polimorfismos I / D -2549 en la región promotora del gen VEGFA y el alelo D tienen mayor riesgo de IRSM


Background: At least 50% of the cases of recurrent spontaneous miscarriage are aetiologically idiopathic. Recently various genetic polymorphisms have been proposed as susceptibility risk factors for pregnancy loss. Objective: The aim of the present case control study is to establish the association between the functional −2549 I/D polymorphisms in the promoter region of the vascular endothelial growth factor A (VEGFA) gene and idiopathic recurrent spontaneous miscarriage (IRSM) in a sample of Jordanian women. Subjects and methods: 328 subjects were recruited, 103 and 98 women with primary and secondary IRSM, respectively, 127 normal women were selected as a control group. Genomic DNA was isolated from a blood sample withdrawn from each participant, then, -2549 I/D polymorphisms of VEGFA gene were genotyped by Polymerase Chain Reaction (PCR). Results: The obtained results revealed that ID polymorphism and D allele of VEGFA -2549 I/D polymorphisms have the highest frequencies in both primary and secondary IRSM patients, no significant difference between the three groups regarding polymorphisms and allele frequencies, patients with DD+ID genetic models have positive association with high risk of IRSM versus II model, and patients with D allele are more liable to have IRSM than those having I allele, no significant difference in the association of VEGFA -2549 I/D polymorphisms with IRSM in the three genetic models of the primary and secondary IRSM patients. Conclusion: patients with ID genetic model of -2549 I/D polymorphisms in the VEGFA gene's promotor region and D allele have higher risk for IRSM.


Asunto(s)
Humanos , Femenino , Polimorfismo Genético , ADN/sangre , Estudios de Casos y Controles , Aborto Espontáneo/patología , Reacción en Cadena de la Polimerasa , Factores de Crecimiento Endotelial , Aborto Habitual/etiología , Alelos , Modelos Genéticos
2.
Viruses ; 13(4)2021 03 25.
Artículo en Inglés | MEDLINE | ID: mdl-33806252

RESUMEN

Intrauterine transmission of the Chikungunya virus (CHIKV) during early pregnancy has rarely been reported, although vertical transmission has been observed in newborns. Here, we report four cases of spontaneous abortion in women who became infected with CHIKV between the 11th and 17th weeks of pregnancy. Laboratorial confirmation of the infection was conducted by RT-PCR on a urine sample for one case, and the other three were by detection of IgM anti-CHIKV antibodies. Hematoxylin and eosin (H&E) staining and an electron microscopy assay allowed us to find histopathological, such as inflammatory infiltrate in the decidua and chorionic villi, as well as areas of calcification, edema and the deposition of fibrinoid material, and ultrastructural changes, such as mitochondria with fewer cristae and ruptured membranes, endoplasmic reticulum with dilated cisterns, dispersed chromatin in the nuclei and the presence of an apoptotic body in case 1. In addition, by immunohistochemistry (IHC), we found a positivity for the anti-CHIKV antibody in cells of the endometrial glands, decidual cells, syncytiotrophoblasts, cytotrophoblasts, Hofbauer cells and decidual macrophages. Electron microscopy also helped in identifying virus-like particles in the aborted material with a diameter of 40-50 nm, which was consistent with the size of CHIKV particles in the literature. Our findings in this study suggest early maternal fetal transmission, adding more evidence on the role of CHIKV in fetal death.


Asunto(s)
Feto Abortado/patología , Aborto Espontáneo/patología , Aborto Espontáneo/virología , Fiebre Chikungunya/complicaciones , Transmisión Vertical de Enfermedad Infecciosa , Feto Abortado/virología , Adulto , Anticuerpos Antivirales/sangre , Fiebre Chikungunya/virología , Virus Chikungunya/patogenicidad , Femenino , Técnicas Histológicas , Humanos , Inmunoglobulina M/sangre , Embarazo
3.
Pituitary ; 23(2): 120-128, 2020 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-31728906

RESUMEN

OBJECTIVE: To evaluate the maternal-fetal outcomes of CAB-induced pregnancies in patients with prolactinoma in a large cohort. METHODS: The prevalence of tumor growth, miscarriage, preterm, low birth weight, congenital malformations and impairment in neuropsychological development in children among women treated with CAB were assessed in a Brazilian multicentre retrospective observational study, RESULTS: We included 194 women with a mean age of 31 (17-45) years, 43.6% presenting microadenomas and 56.4% macroadenomas, at prolactinoma diagnosis. In 233 pregnancies, CAB was withdrawn in 89%, after pregnancy confirmation. Symptoms related to tumor growth occurred in 25 cases, more frequently in macroadenomas. The overall miscarriage rate was 11%, although higher in the subgroup of patients with CAB maintainance after pregnancy confirmation (38% vs. 7.5%). Amongst the live-birth deliveries, preterm occurred in 12%, low birth weight in 6% and congenital malformations in 4.3%. Neuropsychological development impairment was reported in 7% of cases. CONCLUSIONS: Our findings confirm previous results of safety in maternal and fetal outcomes in CAB-induced pregnancies; nevertheless, CAB maintenance after pregnancy confirmation was associated with higher miscarriage rate; result that must be further confirmed.


Asunto(s)
Cabergolina/uso terapéutico , Agonistas de Dopamina/uso terapéutico , Prolactinoma/patología , Aborto Espontáneo/patología , Adolescente , Adulto , Anciano , Femenino , Humanos , Hiperprolactinemia/patología , Persona de Mediana Edad , Embarazo , Complicaciones Neoplásicas del Embarazo , Estudios Retrospectivos , Adulto Joven
4.
J Matern Fetal Neonatal Med ; 32(5): 768-775, 2019 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-29113531

RESUMEN

OBJECTIVE: This study aims to investigate the presence of Cytomegalovirus (CMV), herpes virus simplex (HSV), and parvovirus B19 (PVB19) in the placental tissue of patients who underwent abortions without an otherwise-defined aetiology. STUDY DESIGN: This cross-sectional study was conducted in a high-risk obstetric maternity facility at a University Hospital in Belo Horizonte, Brazil, from January 2013 to December 2015. We included placenta samples obtained from spontaneous abortions of unknown aetiology. Seventy placenta samples were identified and were classified according to histopathological characteristics. All samples were analysed using immunohistochemistry and polymerase chain reaction for CMV, PVB19, and HSV. The clinical variables were collected from the medical records of patients to verify the association of infection with villitis. The patients were divided into the following groups: I) with villitis (n = 28) and II) without villitis (n = 42). METHODS: Immunohistochemistry used monoclonal anti-CMV antibody (NCL-CMVpp65, Leica Biosystems, Wetzlar, Germany), anti-PVB19 antibody (NCL-PARVO, Leica Biosystems, Wetzlar, Germany), and anti-HSV1/HSV2 antibodies (NCL-HSV-1 and HSV2, Leica Biosystems, Wetzlar, Germany). The data were analysed using the Statistical Package for Social Sciences (SPSS Inc, Chicago, IL) 19.0. RESULTS: Viral agents were detected in five patients (7.14%) in the villitis group. Three patients were positive for CMV, one for PVB19, and one for HSV type 2. Foetal and maternal complications were significantly higher in the group with villitis compared with those in the group without villitis (p = .002). CONCLUSIONS: The prevalence of transplacental viral infections as a cause of spontaneous abortion should be considered high in the placenta with villitis. Thus, this study highlights the need for developing diagnostic tests to clarify the aetiology of abortion and foetal loss.


Asunto(s)
Aborto Espontáneo/virología , Citomegalovirus/aislamiento & purificación , Parvovirus B19 Humano/aislamiento & purificación , Placenta/virología , Simplexvirus/aislamiento & purificación , Aborto Espontáneo/patología , Adulto , Estudios Transversales , Femenino , Humanos , Placenta/patología , Embarazo , Adulto Joven
5.
Sci Rep ; 8(1): 12274, 2018 08 16.
Artículo en Inglés | MEDLINE | ID: mdl-30116009

RESUMEN

During decidualization, endometrial stromal cells undergo reticular stress (RS) and unfolded protein response (UPR), allowing the endoplasmic reticulum-expansion and immunomodulators production. Physiological RS generates the activation of sensing proteins, inflammasome activation and mature-IL-1ß secretion, associated with pro-implantatory effects. We focus on the impact of RS and UPR on decidualized cells and whether they induce a physiological sterile inflammatory response through IL-1ß production. Human endometrial stromal cell line (HESC) after decidualization treatment with MPA + dibutyryl-cAMP (Dec) increased the expression of RS-sensors (ATF6, PERK and IRE1α) and UPR markers (sXBP1 and CHOP) in comparison with Non-dec cells. Then we found increased NLRP3 expression in Dec cells compared with Non-dec cells. In fact STF-083010 (an IRE1α inhibitor) prevented this increase. Downstream, increased levels of active caspase-1 on Dec cells were detected by FAM-Flica Caspase-1 associated with an increase in IL-1ß production. Moreover, the treatment with STF-083010 decreased the invasion index observed in Dec cells, evaluated by an in vitro model of implantation. In endometrial biopsies from recurrent spontaneous abortion patients an increased expression of IRE1α was found in comparison with fertile women; while recurrent implantation failure samples showed a lower expression of sXBP1, TXNIP and NLRP3 than fertile women, suggesting that RS/UPR tenors might condition endometrial receptivity.


Asunto(s)
Endometrio/patología , Estrés del Retículo Endoplásmico , Respuesta de Proteína Desplegada , Aborto Espontáneo/metabolismo , Aborto Espontáneo/patología , Aborto Espontáneo/fisiopatología , Adulto , Caspasa 1/metabolismo , Línea Celular , Decidua/patología , Implantación del Embrión , Femenino , Humanos , Inflamación/patología , Interleucina-1beta/biosíntesis , Proteína con Dominio Pirina 3 de la Familia NLR/metabolismo , Recurrencia , Células del Estroma/metabolismo , Células del Estroma/patología , Trofoblastos/patología
6.
Mol Hum Reprod ; 23(7): 500-508, 2017 07 01.
Artículo en Inglés | MEDLINE | ID: mdl-28460003

RESUMEN

STUDY QUESTION: What is the role of the endocannabinoid system (eCS) on the lipopolysaccharide (LPS) effects on uterine explants from 7-day pregnant mice in a murine model of endotoxin-induced miscarriage? SUMMARY ANSWER: We found evidence for cannabinoid receptor type2 (CB2) involvement in LPS-induced increased prostaglandin-F2α (PGF2α) synthesis and diminished cyclic adenosine monophosphate (cAMP) intracellular content in uterine explants from early pregnant mice. WHAT IS KNOWN ALREADY: Genital tract infections by Gram-negative bacteria are a common complication of human pregnancy that results in an increased risk of pregnancy loss. LPS, the main component of the Gram-negative bacterial wall, elicits a strong maternal inflammatory response that results in embryotoxicity and embryo resorption in a murine model endotoxin-induced early pregnancy loss. We have previously shown that the eCS mediates the embryotoxic effects of LPS, mainly via CB1 receptor activation. STUDY DESIGN, SIZE, DURATION: An in vitro study of mice uterine explants was performed to investigate the eCS in mediating the effects of LPS on PGF2α production and cAMP intracellular content. PARTICIPANTS/MATERIALS, SETTING, METHODS: Eight to 12-week-old virgin female BALB/c or CD1 (wild-type [WT] or CB1-knockout [CB1-KO]) mice were paired with 8- to 12-week-old BALB/c or CD1 (WT or CB1-KO) males, respectively. On day 7 of pregnancy, BALB/c, CD1 WT or CD1 CB1-KO mice were euthanized, the uteri were excised, implantation sites were removed and the uterine tissues were separated from decidual and embryo tissues. Uterine explants were cultured and exposed for an appropriate amount of time to different pharmacological treatments. The tissues were then collected for cAMP assay and PGF2α content determination by radioimmunoassay. MAIN RESULTS AND THE ROLE OF CHANCE: In vitro treatment of uteri explants from 7-day pregnant BALB/c or CD1 (WT or CB1-KO) mice with LPS induced an increased production of PGF2α (P < 0.05) and a reduction of the tissue content of cAMP (P < 0.05). These effects were mediated by CB2 receptors since exposure to AM630 (a specific CB2 receptor antagonist) prevented these LPS-induced effects (P < 0.05). Collectively, our results suggest a role for the eCS mediating LPS-induced deleterious effects on reproductive tissues. LIMITATIONS, REASONS FOR CAUTION: Since our experimental design involves in vitro experiments of uterine explants, the extrapolation of the results presented here to humans is limited. WIDER IMPLICATIONS OF THE FINDINGS: Our findings provide evidence for the role of CB2 receptors in reproductive events as well as their participation as a mediator of LPS deleterious effects on reproductive tissues. LARGE SCALE DATA: None. STUDY FUNDING AND COMPETING INTEREST(S): Dr Ana María Franchi was funded by Agencia Nacional para la Promoción Científica y Tecnológica (PICT 2010/0813 and PICT 2013/0097) and by Consejo Nacional de Investigaciones Científicas y Técnicas (PIP 2012/0061). Dr Carlos Davio was funded by Agencia Nacional para la Promoción Científica y Tecnológica (PICT 2013/2050). The authors have no competing interests.


Asunto(s)
Aborto Espontáneo/metabolismo , AMP Cíclico/metabolismo , Lipopolisacáridos/farmacología , Receptor Cannabinoide CB1/genética , Receptor Cannabinoide CB2/genética , Útero/efectos de los fármacos , Aborto Espontáneo/inducido químicamente , Aborto Espontáneo/genética , Aborto Espontáneo/patología , Animales , Agonistas de Receptores de Cannabinoides/farmacología , AMP Cíclico/antagonistas & inhibidores , Dinoprost/biosíntesis , Modelos Animales de Enfermedad , Femenino , Eliminación de Gen , Expresión Génica , Humanos , Ratones , Ratones Endogámicos BALB C , Ratones Noqueados , Técnicas de Cultivo de Órganos , Embarazo , Receptor Cannabinoide CB1/deficiencia , Receptor Cannabinoide CB2/metabolismo , Útero/metabolismo , Útero/patología
7.
Rev Bras Ginecol Obstet ; 39(3): 110-114, 2017 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-28297732

RESUMEN

Purpose To describe the frequencies of chromosomal abnormalities found in abortion material, and to observe its correlation to maternal age. Methods A retrospective study was conducted based on data obtained from the databank of a medical genetics laboratory in Belo Horizonte, MG, Brazil. A total of 884 results from products of conception analysis were included, 204 of which were analyzed by cytogenetics, and 680 by molecular biology based on quantitative fluorescence polymerase chain reaction (QF-PCR). The frequency of individual chromosomal aberrations and the relationship between the presence of anomalies and maternal age were also evaluated. Results The conventional cytogenetics technique was able to detect 52% of normal and 48% of abnormal results in the analyzed material. Quantitative fluorescence polymerase chain reaction revealed 60% of normal and 40% of abnormal results from the samples evaluated by this method. The presence of trisomy 15 was detected only by cytogenetics, as it was not included in the QF-PCR routine investigation in the laboratory. A significant increase in abnormal results was observed among women aged 35 years or older compared with younger women (p = 0.02). Conclusion Chromosomal aberrations are still a major cause of spontaneous abortion, and the conventional cytogenetics technique is efficient for miscarriage material analysis, but molecular methods such as QF-PCR are adequate complementary strategies to detect the major chromosomal anomalies, leading to technical reports with reliable results.


Asunto(s)
Aborto Espontáneo/genética , Aberraciones Cromosómicas/estadística & datos numéricos , Aborto Espontáneo/patología , Adulto , Femenino , Humanos , Edad Materna , Embarazo , Estudios Retrospectivos
8.
Rev. bras. ginecol. obstet ; Rev. bras. ginecol. obstet;39(3): 110-114, Mar. 2017. tab, graf
Artículo en Inglés | LILACS | ID: biblio-843926

RESUMEN

Abstract Purpose To describe the frequencies of chromosomal abnormalities found in abortion material, and to observe its correlation to maternal age. Methods A retrospective study was conducted based on data obtained from the databank of a medical genetics laboratory in Belo Horizonte, MG, Brazil. A total of 884 results from products of conception analysis were included, 204 of which were analyzed by cytogenetics, and 680bymolecular biology basedon quantitative fluorescence polymerase chain reaction (QF-PCR). The frequency of individual chromosomal aberrations and the relationship between the presence of anomalies and maternal age were also evaluated. Results The conventional cytogenetics technique was able to detect 52% of normal and 48% of abnormal results in the analyzed material. Quantitative fluorescence polymerase chain reaction revealed 60% of normal and 40% of abnormal results from the samples evaluated by this method. The presence of trisomy 15 was detected only by cytogenetics, as it was not included in the QF-PCR routine investigation in the laboratory. A significant increase in abnormal results was observed among women aged 35 years or older compared with younger women (p = 0.02). Conclusion Chromosomal aberrations are still a major cause of spontaneous abortion, and the conventional cytogenetics technique is efficient for miscarriage material analysis, but molecular methods such as QF-PCR are adequate complementary strategies to detect the major chromosomal anomalies, leading to technical reports with reliable results.


Resumo Objetivos Descrever a frequência de anomalias cromossômicas encontradas em material de aborto, e observar se estas estão relacionadas com a idade materna. Métodos Foi realizado um estudo retrospectivo no banco de dados de um laboratório de genética médica em Belo Horizonte, MG. O estudo incluiu 204 resultados avaliados por citogenética, e 680 resultados por biologia molecular baseada em reação em ensaio fluorescente da reação em cadeia da polimerase (QF-PCR), totalizando um número de 884 análises. A frequência de diferentes anomalias cromossômicas e a relação entre a presença de anomalias e a idade materna também foi avaliada. Resultados A citogenética convencional foi capaz de detectar 52% de resultados normais e 48% de resultados anormais no material analisado. A QF-PCR revelou 60% de resultados normais e 40% de anormais nas amostras avaliadas por esta técnica. A presença da trissomia 15 foi detectada por citogenética,mas até então não era incluída na investigação por QF-PCR no laboratório. Umaumento significativo na quantidade de resultados anormais foi observado em mulheres comidade de 35 anos ou mais, quando comparado a mulheres mais jovens (p = 0,02). Conclusão As aberrações cromossômicas são causas importantes de abortos espontâneos, e o estudo citogenético é eficaz para a análise das amostras de material de aborto, mas as técnicas moleculares, como a QF-PCR, representam métodos complementares adequados para detectar as principais anomalias cromossômicas, possibilitando a liberação de laudos com resultados confiáveis.


Asunto(s)
Humanos , Femenino , Embarazo , Adulto , Aborto Espontáneo/genética , Aberraciones Cromosómicas/estadística & datos numéricos , Aborto Espontáneo/patología , Edad Materna , Estudios Retrospectivos
9.
Placenta ; 36(6): 674-80, 2015 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-25819809

RESUMEN

INTRODUCTION: Symptomatic or asymptomatic Shiga toxin producing Escherichia coli (STEC) infections during early pregnancy may cause maternal or fetal damage mediated by Shiga toxin type 2 (Stx2). The aim of this study is to elucidate the mechanisms responsible for early pregnancy loss in rats treated with Stx2. METHODS: Sprague Dawley pregnant rats were intraperitoneally injected at day 8 of gestation with a sublethal dose (0.5 ng of Stx2/g of total body weight, 250 µl) of purified Stx2. Control rats were injected with the same volume of PBS. The expression of globotriaosylceramide (Gb3) glycosphingolipid receptor for Stx2 was evaluated by thin-layer chromatography (TLC). Regions of hypoxia in decidual tissue were determined by pimonidazole immunohistochemistry and vascular endothelial growth factor (VEGF) expression by Western blot and immunohistochemistry. Tumor necrosis factor-alpha (TNF-α) levels in serum and decidual tissue were evaluated by ELISA. Serum progesterone levels were determined by RIA. RESULTS: Decidual tissue from both, control and Stx2-treated rats showed similar expression of Gb3 receptor. Intrauterine growth restriction was observed in Stx2-treated rats, associated with hypoxia and an increase of decidual TNF-α levels. Decrease of serum progesterone levels and decidual VEGF expression were also demonstrated. DISCUSSION: Our findings indicate that Stx2 reaches the uteroplacental unit, binds Gb3 and triggers damage in decidual tissue. Poor oxygen supply accompanied with damage in the uteroplacental unit and inflammation could be responsible for the early pregnancy loss. Decrease in the pregnancy protective factors, serum progesterone and local VEGF, may contribute to the pregnancy loss.


Asunto(s)
Aborto Espontáneo/patología , Hipoxia/patología , Inflamación/patología , Toxina Shiga II , Aborto Espontáneo/inducido químicamente , Aborto Espontáneo/metabolismo , Animales , Femenino , Hipoxia/metabolismo , Inflamación/metabolismo , Embarazo , Ratas , Ratas Sprague-Dawley , Trihexosilceramidas/metabolismo , Factor de Necrosis Tumoral alfa/metabolismo , Factor A de Crecimiento Endotelial Vascular/metabolismo
10.
J Reprod Immunol ; 89(2): 207-11, 2011 May.
Artículo en Inglés | MEDLINE | ID: mdl-21529964

RESUMEN

Sound stress exposure increases fetal loss via inflammatory pathways. Inflammation is known to up-regulate cell adhesion molecules, such as vascular cell adhesion molecule-1 (VCAM-1), which mediates the adhesion of leukocytes to the vascular endothelium. In this work, we studied the frequency of VCAM-1(+) vessels at the fetomaternal interface in stressed and non-stressed pregnant CBA/J female mice mated with DBA/2J (high fetal loss model) or BALB/c (low fetal loss model) males. The high fetal loss model had fewer large vessels on gestation day 6.5, and stress reduced the frequency of large vessels to a similar number in both high and low fetal loss models. In the high fetal loss model, however, the frequency of VCAM-1+ vessels was dramatically increased. This study shows that VCAM-1 expression is modulated by stress at the fetomaternal interface in abortion-prone cross-breeding.


Asunto(s)
Aborto Espontáneo/metabolismo , Regulación de la Expresión Génica , Placenta/metabolismo , Estrés Fisiológico , Molécula 1 de Adhesión Celular Vascular/biosíntesis , Aborto Espontáneo/patología , Animales , Femenino , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Endogámicos CBA , Placenta/patología , Embarazo
11.
Invest. clín ; Invest. clín;50(3): 327-333, sept. 2009. tab, graf
Artículo en Español | LILACS | ID: lil-564795

RESUMEN

La patogénesis de los abortos espontáneos recurrentes es multifactorial; probablemente se debe a la interacción de varios factores ambientales y genéticos. El polimorfismo C677T del gen de la metiltetrahidrofolato reductasa (MTHFR), ha sido implicado como factor de riesgo para aborto espontáneo recurrente (AR). El objetivo de este trabajo fue investigar la asociación del polimorfismo C677T de la MTHFR como factor de riesgo en AR idiopático. Se analizaron 80 muestras de ADN, correspondientes a 30 mujeres con AR y a 50 mujeres controles. A través de la reacción en cadena de la polimerasa (PCR) se amplificó un fragmento de 198 pares de base (pb), el cual se sometió a digestión con la enzima de restricción HinfI, que reconoce el sitio de restricción creado por la transición C>T en la posición 677. La frecuencia alélica de la MTHFR en el grupo de estudio y control fue 35% y 33% respectivamente; para el alelo T y 65% y 67% respectivamente, para el alelo C. No se encontró diferencia significativa entre el alelo T ni el C al ser comparados en ambos grupos. No se demostró un factor predisponente entre el polimorfismo C677T de la MTHFR y el AR en la muestra estudiada.


The pathogenesis of recurrent spontaneous abortion is multifactorial, presumably involving the interaction of several genetic and environmental factors. The methylenetetrahydrofolate reductase (MTHFR) gene C677T polymorphism has been implicated as risk factor for recurrent spontaneous abortion (RA). The main objective of this research was to investigate the association between the C677T polymorphism of the MTHFR gene as a genetic risk factor for idiopathic RA. Molecular analysis was performed in 80 DNA samples from 30 patients with RA and among 50 healthy control subjects. Using the Polymerase Chain Reaction (PCR), a 198 bp (bases pairs) fragment, was digested with the restriction enzyme HinfI, which can recognize the C > T substitution responsible for the polymorphism. 677T MTHFR allele frequencies for group with RA and the control group were 35% and 33%, respectively and 677C MTHFR allele frequencies were 65% and 67%, respectively. There was no significant difference in allele frequency between these two groups. The data presented in this study fail to support the relationship between MTHFR C677T polymorphism and risk in women with RA.


Asunto(s)
Humanos , Femenino , Aborto Espontáneo/patología , Aborto Habitual/patología , Polimorfismo Genético/genética , Embriología , Obstetricia
12.
Rev. obstet. ginecol. Venezuela ; 69(1): 12-19, mar. 2009. ilus
Artículo en Español | LILACS | ID: lil-523012

RESUMEN

Describir los defectos del tubo neural en productos menores de 20 semanas de gestación y destacar las implicaciones y utilidad de su diagnóstico en el asesoramiento a la pareja. Se realizó un estudio prospectivol, transeccional, descriptivo en una muestra no probabilística, constituida por productos de abortos espontáneos menores de 20 semanas de gestación. Se examinaron sistemáticamente las características morfológicas externas y los hallazgos anormales se registraron mediante descripción y fotografía. Laboratorio de Investigación “Dr. Carlos R. Davauchelle”, Cátedra de Histología y Embriología de la Universidad del Zulia, Maracaibo. De los 55 productos estudiados, 27 (49,09 por ciento) corresponden al sexo masculino, 21 (38,18 por ciento) al sexo femenino, y 7 (12,43 por ciento) cuyo sexo no pudo ser determinado de acuerdo a las características morfológicas de los genitales externos. Sólo 5 (9,09 por ciento) presentaron defectos del tubo neural y las anomalías encontradas fueron: anencefalia, craneorraquisquisis, espina bífida lumbosacra, iniencefalia y encefalocele. La identificación de los defectos del tubo neural en la muestra estudiada sirve como punto de partida para ofrecer asesoramiento médico a los padres acerca del riesgo de recurrencia, la utilización de medidas de prevención, el plan de acción a seguir ante futuros embarazos y la posibilidad de ofrecer el diagnóstico prenatal.


Asunto(s)
Humanos , Masculino , Femenino , Embarazo , Aborto Espontáneo/patología , Anomalías Congénitas/embriología , Asesoramiento Genético/métodos , Defectos del Tubo Neural/diagnóstico , Obstetricia
13.
Ginecol Obstet Mex ; 76(2): 81-7, 2008 Feb.
Artículo en Español | MEDLINE | ID: mdl-18798400

RESUMEN

BACKGROUND: Gestational trophoblastic disease (GTD) comprises different types of placental changes distinguished by histologic hydropic degeneration and swelling of chorionic villi. OBJECTIVE: To report incidence of gestational trophoblastic disease in a general hospital. MATERIAL AND METHODS: A cross-sectional study in the period of January 2000 to June 2006 was made. Histopathologic report of specimen abortion with gestational trophoblastic disease was registered and we calculated the incidence of births, abortions and total pregnancies. RESULTS: In the study period, 142 cases of gestational trophoblastic disease were registered, and an incidence of 1:243 births and 1:31 abortions (1:274 pregnancies) was found. The average age of patients was 27.1 years (15 to 50), 67% of the cases were not clinically suspected. CONCLUSIONS: Histopathologic study of specimen abortions allows calculating precisely incidence of gestational trophoblastic disease, but the findings of this study may be different because numerators and denominators used in the calculation are not the same.


Asunto(s)
Aborto Espontáneo/patología , Enfermedad Trofoblástica Gestacional/epidemiología , Aborto Espontáneo/epidemiología , Adolescente , Adulto , Vellosidades Coriónicas/ultraestructura , Comorbilidad , Dilatación y Legrado Uterino , Femenino , Enfermedad Trofoblástica Gestacional/patología , Humanos , México/epidemiología , Persona de Mediana Edad , Embarazo
14.
Ginecol Obstet Mex ; 75(3): 168-71, 2007 Mar.
Artículo en Español | MEDLINE | ID: mdl-17547092

RESUMEN

Endometrial ossification is a rare endometrial pathology. Its predisposing factors include history of uterine curettage to metabolic abnormalities. It usually presents in patients with secondary infertility and history of first trimester pregnancy loss, accompanied by severe dysmenorrhea and dyspareunia. The diagnosis is suspected by OB-GYN history and USG findings, therapeutic strategies range from D&C to hysterectomy, we propose diagnosis and management by hysteroscopy in order to preserve future fertility and minimize uterine damage. A review of four cases during 1985-2004 from a large assisted reproduction center in Mexico City is presented.


Asunto(s)
Osificación Heterotópica/patología , Enfermedades Uterinas/patología , Aborto Espontáneo/patología , Adulto , Femenino , Humanos , Histeroscopía , Infertilidad Femenina/complicaciones , Infertilidad Femenina/patología
15.
Placenta ; 27(6-7): 740-3, 2006.
Artículo en Inglés | MEDLINE | ID: mdl-16026831

RESUMEN

Gestational trophoblastic diseases are a group of interrelated diseases of trophoblastic tissue that include partial hydatidiform mole, complete hydatidiform mole, invasive mole, choriocarcinoma, and placental site trophoblastic tumor. P63 is a p53 homologue that, in normal placentas, is expressed in the cytotrophoblast cells. The role of p63 in gestational trophoblastic diseases, however, merits further investigation. Immunohistochemistry with the p63 antibody (clone 4A4) was performed in formalin-fixed paraffin-embedded samples of hydropic abortion (n=10), partial hydatidiform mole (n=12), complete hydatidiform mole (n=12) and choriocarcinoma (n=5). P63 expression was quantitatively assessed as 0 (no stained cells), + (less than 10% positive cells), ++ (10-50% positive cells), and +++ (more than 50% positive cells). The intensity was scored as 0 (absence), + (weak), ++ (moderate), or +++ (strong). Statistical analysis was carried out by the Fisher test. In contrast to the other diagnoses, none of the choriocarcinomas analyzed exhibited p63-positive cells. There was no difference in distribution of p63 positive cells between hydropic abortion, partial hydatidiform mole, and complete hydatidiform mole. Concerning the intensity of immunostaining, there was difference only between partial hydatidiform mole and complete hydatidiform mole. According to our results, p63 might be useful to differentiate a choriocarcinoma from other gestational trophoblastic diseases. Besides, since the intensity of p63 expression was much stronger in partial hydatidiform mole and complete hydatidiform mole than in hydropic abortion, this feature may be helpful in distinguishing these two diagnoses in challenging cases.


Asunto(s)
Aborto Espontáneo/metabolismo , Coriocarcinoma/metabolismo , Mola Hidatiforme/metabolismo , Proteínas de la Membrana/metabolismo , Trofoblastos/metabolismo , Neoplasias Uterinas/metabolismo , Aborto Espontáneo/patología , Adulto , Biomarcadores/metabolismo , Recuento de Células , Coriocarcinoma/patología , Femenino , Edad Gestacional , Humanos , Mola Hidatiforme/patología , Embarazo , Coloración y Etiquetado , Trofoblastos/patología , Neoplasias Uterinas/patología
16.
Bol. Hosp. San Juan de Dios ; 51(6): 290-295, nov.-dic. 2004. ilus
Artículo en Español | LILACS | ID: lil-426815

RESUMEN

Hoy en día se puede optar por una conducta más conservadora en el caso de los abortos espontáneos que ocurren antes de las 12 semanas de gestación gracias a un buen seguimiento sonográfico por vía vaginal. El aborto espontáneo es la complicación más común temprana del embarazo. Aproximadamente 10 a 20 por ciento de los embarazos clínicamente reconocidos, bajo las 20 semanas de gestación, sufrirá de un aborto espontáneo; 80 por ciento de aquellos ocurrirá en las primeras 12 semanas de gestación. Del total de abortos espontáneos, un tercio de estos ocurre antes de las 8 semanas de gestación, presentándose en su gran mayoría como huevos anembrionados. El uso de ultrasonido transvaginal ayuda al médico y al paciente para comprender la complicación de un embarazo causada por un sangrado temprano, asimismo orienta el manejo a seguir, el cual puede ser quirúrgico, médico o espectante. El manejo espectante es una alternativa para mujeres con falla temprana del embarazo menor de 12 semanas de gestación con signos vitales normales y sin evidencia de infección.


Asunto(s)
Humanos , Femenino , Embarazo , Aborto Espontáneo/terapia , Aborto Espontáneo , Aborto Espontáneo/epidemiología , Aborto Espontáneo/patología , Aborto Habitual/complicaciones , Alcoholismo/complicaciones , Analgésicos/efectos adversos , Aberraciones Cromosómicas , Edad Materna , Factores de Riesgo , Tabaquismo/efectos adversos
17.
Rev. chil. obstet. ginecol ; 68(5): 361-370, 2003. tab
Artículo en Español | LILACS | ID: lil-364502

RESUMEN

Objetivos: Analizar los resultados histopatológicos encontrados en el aborto espontáneo entre 12 y 22 semanas de gestación y su relación con los correspondientes antecedentes obstétricos y clínicos, para determinar los factores causantes. Métodos: Se estudiaron retrospectivamente cuatrocientas seis pacientes con aborto espontáneo entre 12 y 22 semanas de gestación ocurridos durante 1 año. Se incluyeron cientonueve casos con estudio histopatológico de los anexos ovulares y/o del feto. El aborto se clasificó: a) según ultrasonografía en: aborto con feto vivo, aborto con muerte fetal y restos de aborto y b) según edad gestacional (semanas) en tres grupos: A) entre 12 y 14,6, B) entre 15 y 18,6 y C) entre 19 y 22. Se analizaron antecedentes ginecoobstétricos: aborto recurrente (pérdida reproductiva recurrente consecutiva), embarazo con dispositivo intrauterino y antecedentes clínicos del aborto: deprendimiento placentario, infección ovular y huevo roto. Los hallazgos histopatológicos se clasificaron en: 1) lesiones inflamatorias, 2) lesiones placentarias no inflamatorias, 3) síndromes malformativos, 4) hidrops fetal y 5) alteraciones placentarias involutivas. Resultados: Las cientonueve pacientes tuvieron las siguientes lesiones histológicas: Inflamatorias 56% (corioamnionitis 53,2%), funisitis 24,8%, perivellositis 21,1%, vellositis 3,7%, deciduitis 8,3% y síndrome de infección del saco amniótico: 13,9%). Síndromes malformativos: 11%. Placentarias no inflamatorias: 7,3%. Hidrops fetal: 4,6%. Existieron alteraciones involutivas en el 14,7% de los abortos y no se encontraron lesiones en el 10,1% de los casos. Se identificaron lesiones en el 75,2% de los abortos. Más frecuentes en los abortos con feto vivo 83,6%, en comparación con los restos de aborto 68,4% y con el aborto con muerte fetal 65,7%, p< 0,05. Lesiones encontradas. Según edad gestacional: en el grupo A (corioamnionitis 29,7%, perivellositis 18,9%, síndromes malformativos 13,5%), en el grupo B (corioamnionitis 63,9%, funisitis 33,3%, perivellositis 22,2%) y en el grupo C (corioamnionitis 66,7%, funisitis 33,3%, síndrome de infección del saco amniótico 25%). Según ultrasonografía: con feto vivo (inflamatorias preferentemente), con feto muerto (inflamatorias, placentarias no inflamatorias, síndromes malformativos)...


Asunto(s)
Femenino , Embarazo , Aborto Espontáneo/etiología , Aborto Espontáneo/patología , Enfermedades Placentarias , Segundo Trimestre del Embarazo , Factores de Riesgo
18.
Int J Gynaecol Obstet ; 73(2): 131-40, 2001 May.
Artículo en Inglés | MEDLINE | ID: mdl-11336732

RESUMEN

OBJECTIVE: The purpose of this research was to find out the frequency and type of fetal dysmorphism in spontaneous abortions among the Mexican population. METHOD: A prospective study was carried out in all the cases of spontaneous miscarriages occurring at the 'Dr. Manuel Gea González' General Hospital in Mexico City, from July 1989 to June 1999. RESULT: Two hundred and one empty sacs and 1555 well-defined embryos or fetuses were analyzed. Dysmorphism was observed in 48% of the cases, malformations being the most frequently found. Among malformations the largest group corresponded to morphological alterations not recognized in the postnatal life, facial clefts and closure defects of the abdominal wall were the known malformations of the postnatal period most frequently found. The most common syndromic entities were suggestive of bone dysplasia and Turner phenotype. CONCLUSION: The frequency of fetal dysmorphism in spontaneous abortions is higher than in newborns. Its diagnosis is very important for genetic counseling.


Asunto(s)
Anomalías Múltiples/genética , Anomalías Múltiples/patología , Aborto Espontáneo/genética , Aborto Espontáneo/patología , Diagnóstico Prenatal , Población Blanca/genética , Anomalías Múltiples/epidemiología , Aborto Espontáneo/epidemiología , Femenino , Humanos , Masculino , México/epidemiología , Embarazo , Estudios Prospectivos
19.
Ginecol Obstet Mex ; 67: 158-63, 1999 Apr.
Artículo en Español | MEDLINE | ID: mdl-10363414

RESUMEN

The fetal recurrent loss (P.F.R.), it is a clinical disturbance associated with multiple factors, that it are in a frustrating situation so much for the couples like for the doctor. The objective was to evaluate 39 couples with P.F.R. in order to establish the responsibility of each factor and proceed to treatment I specify, considering as success the get a pregnancy with viable product. The protocol included clinical history, histerosalpingography, ultrasound, analysis cromosomal, antibodies for TORCH and antiphospholipids, test endocrine specifies, genitals cultivation and biopsy of endometrial. 23% it of the fetal losses is due to only factor; 64.2% it is due to multiple factors and 12.8% they don't have apparent factor. The infectious factors, endocrine, anatomical and autoimmunity was the more constants. Pregnancy with viable product in the 82% was achieved of the cases. We concluded that the P.F.R. it is a problem that is due to multiple factors and that it require a diagnosis-therapeutic integral focus.


Asunto(s)
Aborto Espontáneo/etiología , Aborto Espontáneo/patología , Aborto Espontáneo/terapia , Biopsia , Endometrio/patología , Femenino , Humanos , Histerosalpingografía , Embarazo , Recurrencia , Ultrasonografía Prenatal
20.
Iatreia ; Iatreia;11(4): 145-161, dic. 1998. ilus, tab
Artículo en Español | LILACS | ID: lil-427919

RESUMEN

En el período comprendido entre septiembre 1 de 1996 y octubre 1 de 1997, se recolectó para estudios morfológico y citogenético un total de 84 productos de aborto espontáneo del 1° y 2° trimestres de la gestación, en diferentes servicios de ginecoobstetricia de la ciudad de Medellín. Dieciséis de los 84 se descartaron por contaminación o ausencia de tejidos apropiados para el estudio. De los 68 productos restantes en 60 (88,2 por ciento) Se establecieron cultivos para estudio citogenético, los cuales fueron exitosos en 34 casos (56, 7 por ciento). Diecisiete de los anteriores (50 por ciento) mostraron un cariotipo anormal con las siguientes alteraciones cromosómicas: monosomía X, 10 (58,8 por ciento)mosaicismos 5 (29,4 por ciento), trisomías 1 (5,9 por ciento) y tetraploidía 1 (5,9 por ciento). En 21 de los 68 productos (30,9 por ciento) (3 embriones y 18 fetos) fue posible el estudio morfológico. Doce de éstos, (2 embriones y 10 fetos; 57, 1 por ciento) mostraron alteraciones morfológicas externas o internas. El presente estudio citogenético y morfológico en productos de aborto espontáneo con edad gestacional menor de 20 semanas es el primero que se informa en nuestro medio y sus resultados son similares a los obtenidos en otros reportes que aparecen en la literatura


Eighty tour spontaneous abortion products, with gestational age under 20 weeks, were collected in ditterent obstetric and gynecologic services trom Medellin-Colombia between September 1996 and October 1997; they were studied both morphologically and cytogenetically. Sixteen of those products were discarded because of contamination or absence of suitable tissues for the study In 60 of the remaining 68 products (88°/~) cultures for cytogenetic studies were establishedJ and they were succesful in 34 cases (56J7%). Seventeen of. these (50%) showed an abnormal karyotype with the following chromosomal anomalies: X monosomies 10 (58J8%), mosaicisms 5 (29,4%)J trisomies 1 (5,9%), and tetráploidy 1 (5J9%). From the 68 products, a morphologic study was performed in 21 cases (3 embryos and 18 fetuses). Twelve products (2 embryos and 10 fetuses; 57 J 1 %) had external and/or jnternal anomalies This study of spontaneous abortions with gestational age under 20 weeks is the first in our country, and its results are similar to those published from other centers.


Asunto(s)
Humanos , Femenino , Embarazo , Aborto Espontáneo/genética , Aborto Espontáneo/patología , Feto Abortado/patología , Aberraciones Cromosómicas , Análisis Citogenético , Colombia
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