[Fetal activin A in labor complicated by meconium-stained amniotic fluid]. / Plodowa aktywina A w porodzie powiklanym obecnoscia smólki w plynie owodniowym.

OBJECTIVE: During pregnancy the placenta and the fetal membranes are the main sources of activin A. An increased level of activin A has been found in the serum of women with preeclampsia, diabetes mellitus and intrauterine growth restriction. Meconium is the predictor for adverse perinatal outcome, such as meconium aspiration syndrome or brain damage. The aim of our study was to evaluate the levels of fetal activin A in labors complicated by meconium-stained amniotic fluid. MATERIAL AND METHODS: Cord blood samples were collected from 65 full-term neonates from single pregnancies. In each case, the hematological parameters of cord blood and activin A (ELISA--Oxford Bio-Innovation Activin A Assay Kit) were assessed. RESULTS: There were no significant differences in the concentration of activin A in cord blood between the group with and the group without meconium-stained amniotic fluid. The mean count of nucleated erythrocytes and white blood cells as well as the percentage of reticulocytes was significantly higher in the meconium group. There were no significant differences between concentration of fetal activin A in a vaginal delivery (0.58 +/- 0.38 ng/ml) and cesarean section after labor (0.44 +/- 0.32 ng/ml) or elective cesarean section (0.62 +/- 0.47 ng/ml) groups. There were also no correlations between the levels of activin A and the parameters of fetal acid base status or cord blood hematological values. CONCLUSIONS: Fetal activin A has a limited significance for diagnosing fetal hypoxia in labors complicated by meconium-stained amniotic fluid. There were no correlations between the parameters of fetal acid base status and fetal activin A. The levels of fetal activin A do not depend on the mode of the delivery. Meconium-stained amniotic fluid resulted in significant changes of the hematological variables in cord blood.

[Maternal serum Th1 and Th2 cytokines in preterm and term delivery]. / Stezenie wybranych interleukin grupy Th1 i Th2 w surowicy krwi matek w porodzie przedwczesnym i porodzie o czasie.

UNLABELLED: The immune system is responsible for the development of a typical pregnancy, including the induction of labor. OBJECTIVES: The aim of our study was to determine the concentration of maternal serum Th1 and Th2 cytokines, which have opposite biological effects, in preterm and term labor. MATERIAL AND METHODS: 88 patients were divided into four groups: normal pregnancy (n = 20), threatened preterm labor (n = 22), preterm delivery (n = 24) and term delivery (n = 22). Maternal serum interleukins 1, 6, 8 and 10 were measured with ELISA R&D Systems kits (USA). In all patients CRP was estimated and the blood specimen were analyzed using an automated hematology cell analyzer. RESULTS: Women in term and preterm delivery group had significantly higher mean IL-beta, IL-6 and IL-8 concentrations than patients in normal pregnancy and these with threatened preterm labor. In addition, the highest WBC and CRP concentration were found in women in preterm delivery compared with other groups. CONCLUSIONS: Maternal serum Th1 cytokines concentrations increase in preterm and term delivery. Determination of maternal serum IL-6, IL-8 and IL-10 may play an essential role in estimations of the preterm labor risk.

[Biophysical and biochemical intrapartum fetal assessment in relation to hematological varaiables in umbilical cord blood]. / Sródporodowa biochemiczna i biofizyczna ocena stanu plodu, a parametry hematologiczne krwi pepowinowej.

UNLABELLED: The analysis of the hematological variables of umbilical cord blood can be useful in broadening our knowledge of both physiological and pathological processes undergoing during prenatal period. OBJECTIVES: The aim of our study was to evaluate the hematological parameters of umbilical cord blood in cases of either the abnormal fetal heart rate or the confirmed fetal acidosis. MATERIAL AND METHODS: A study group consisted of 458 neonates, live-born term of 38 to 41 completed weeks of single gestation. In each case, the hematological cord blood parameters were assessed. Fetal acidosis was diagnosed when the umbilical cord blood pH was below 7,15. Fetal heart rate (FHR) was assessed according to FIGO criteria. Statistical analysis was conducted using Mann-Withney tests, analysis of variance, p-value < 0.05 was considered as significant. RESULTS: The values of WBC (16,5 vs. 13,8x109), NRBC (25,1 vs. 7,3 /100 WBC) and HCT (51,8 vs. 46,5%) were higher in cases of fetus acidosis compare to non-acidemic fetuses. The significant differences in RBC, PLT, NRBC, HCT, HG were observed between group with abnormal and normal FHR. CONCLUSIONS: Fetal distress resulted in significant changes of the hematological variables in umbilical cord blood. Fetal hemopoetic system responds in specific manner to asphyxia. A precise analysis of fetal hematological variables may help to establish an exact onset and degree of fetal hypoxia.

[Inflammatory mediators and hematological parameters in cord blood in labor complicated by meconium-stained amniotic fluid]. / Mediatory zapalenia oraz parametry hematologiczne krwi plodu w porodzie powiklanym obecnoscia smolki w plynie owodniowym.

OBJECTIVE: Meconium-stained amniotic fluid at term gestation is a predictor for adverse perinatal outcome and is associated with increased peripartum infections, independent of other risk factors. The aim of our study was to evaluate concentrations of inflammatory mediators (such as cytokine IL-6 and intracellular adhesion molecule ICAM-1) and values of hematological parameters of cord blood in presence or absence of meconium in amniotic fluid in term labor. MATERIAL AND METHODS: Cord blood samples were obtained from 66 term normal neonates immediately after birth, Soluble ICAM-1 and IL-6 concentrations were measured with ELISA R&D Systems kits. The umbilical blood specimen was analyzed using an automated hematology cell analyzer. Blood films were stained using May-Grünwald-Giemsa method. RESULTS: There were no difference in concentrations of ICAM-1 and IL-6 in cord blood in groups with or without meconium-stained amniotic fluid. The mean count of umbilical nucleated red blood cells and white blood cells was significantly higher in meconium group. There was no correlation between the cord blood hematological values and ICAM-1 or IL-6. There was also no correlation between IL-6 and ICAM-I and duration of labor. The mode of delivery influenced cord blood IL-6 levels. CONCLUSIONS: There was no influence of meconium-stained amniotic fluid on cord blood IL-6 and ICAM-1 levels. Changes in hematological parameters in cord blood in meconium passage can suggest either fetus hypoxia or infection. Significant differences of concentrations of fetal IL-6 were associated with the mode of delivery.

Influence of perinatal factors on hematological variables in umbilical cord blood.

OBJECTIVE: The purpose of our study was to investigate any possible relationship between the duration of labor, the mode of delivery and the duration of rupture of membranes and hematological parameters in cord blood. MATERIAL AND METHODS: We studied 298 pregnant women who delivered term normal infants. The patients were divided into three groups according to the route of delivery: vaginal (n = 165), cesarean section after labor (n = 27) and elective cesarean section (n = 106). Immediately after delivery, umbilical cord blood samples were collected. RESULTS: The mode of delivery influenced white blood cells, hemoglobin, hematocrit, red blood cell distribution, platelets count and nucleated red blood cells. There was no correlation between the cord blood hematological values and the duration of labor, as well as the duration of rupture of membranes before delivery. CONCLUSION: The influence of mode of delivery, duration of labor and duration of ruptured membranes on hematological parameters in umbilical cord blood is limited.

Expression of estrogen receptors alpha and beta in term human myometrium.

We used immunohistochemistry to compare the expression of estrogen receptors (ERalpha and ERbeta) in term myometria of 32 pregnant women divided in two groups. Group I comprised of 16 women in labour and group II included 16 non-laboring gravidas. We observed cytoplasmatic localization of both ER isoforms and no differences in the ER expression between the two groups of patients. The abundance and specific localization of ERs in human term myometrium seems to be independent of its contractile activity which may point to the specific role of those receptors in late pregnancy myometrium.

[Retroperitoneal hematoma during pregnancy--diagnostic dilemma]. / Guz pozaotrzewnowy w przebiegu ciazy--trudnosci diagnostyczne.

A 43-year old gravida 4, para 3 woman in 22 weeks of gestation was admitted because of severe upper abdominal pain. On arrival at the hospital a complete blood cell count showed anemia with hemoglobin concentration of 9.3 g/dl. Other laboratory results including cancer markers, were normal. Ultrasound examination of abdomen showed tumor (diameter 7 cm) of heterogeneous echogenicity localized in lieno-renalis area. Magnetic resonance imaging revealed hyper intensive retroperitoneal masses in the left adrenal region not changing after contrast administration. Hormonal adrenal profile was normal. In 28 week of gestation ultrasound examination showed a significant decrease of tumor size and normal laboratory results. The patient was followed up on an outpatient basis without complication until readmission in 36 week of gestation for preterm labor. Three weeks later a cesarean section was performed. At the time of operation any retroperitoneal masses were not found. Clinical presentation, diagnostic procedures and the course of pregnancy let us to diagnose idiopathic retroperitoneal hematoma.

[Cord blood reticulocytes and reticulocyte subtypes in normal and complicated pregnancy]. / Retikulocyty krwi pepowinowej i ich frakcje w clazy fizjologicznej i powiklanej.

Reticulocyte analysis using flow cytometry increases the precision of reticulocyte enumeration and can evaluate the maturation of reticulocytes. Reticulocytes count and their subtypes may reflect function of hematopoesis, especially during hypoxia. This study was aimed to establish reticulocyte count and reticulocyte maturation profile in cord blood during normal pregnancy and pregnancy complicated by chronic intrauterine hypoxia. For this purpose we analysed 233 cord blood specimens derived from uneventful pregnancy and 58 cord blood specimens from complicated pregnancy. The gestational age ranged from 26 to 42 weeks. The following measurements were obtained (mean +/- standard deviation): reticulocyte absolute count - 268 +/- 63 10(9)/l, reticulocyte percentage - 6.4 +/- 1.5; high fluorescence reticulocyte HFR - 11.3 +/- 3.8%; medium reticulocyte fraction MFR - 18.1 +/- 4.7%; low reticulocyte fraction LFR - 70.7 +/- 7%; immature reticulocyte fraction IFR - 29.3 +/- 7%. The percentage values of reticulocytes decreased in cord blood according to gestational age increase, but maturation subpopulations did not change significantly. Reticulocyte fractions in normal pregnancy were different compared to complicated pregnancy.