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1.
J Korean Med Sci ; 35(10): e73, 2020 Mar 16.
Artigo em Inglês | MEDLINE | ID: mdl-32174066

RESUMO

BACKGROUND: Twin-to-twin transfusion syndrome (TTTS) is a serious complication of monochorionic twin pregnancies. It results from disproportionate blood supply to each fetus caused by abnormal vascular anastomosis within the placenta. Amniotic fluid (AF) is an indicator reflecting the various conditions of the fetus, and an imbalance in AF volume is essential for the antenatal diagnosis of TTTS by ultrasound. In this study, two different mass spectrometry quantitative approaches were performed to identify differentially expressed proteins (DEPs) within matched pairs of AF samples. METHODS: We characterized the AF proteome in pooled AF samples collected from donor and recipient twin pairs (n = 5 each) with TTTS by a global proteomics profiling approach and then preformed the statistical analysis to determine the DEPs between the two groups. Next, we carried out a targeted proteomic approach (multiple reaction monitoring) with DEPs to achieve high-confident TTTS-associated AF proteins. RESULTS: A total of 103 AF proteins that were significantly altered in their abundances between donor and recipient fetuses. The majority of upregulated proteins identified in the recipient twins (including carbonic anhydrase 1, fibrinogen alpha chain, aminopeptidase N, alpha-fetoprotein, fibrinogen gamma chain, and basement membrane-specific heparan sulfate proteoglycan core protein) have been associated with cardiac or dermatologic disease, which is often seen in recipient twins as a result of volume overload. In contrast, proteins significantly upregulated in AF collected from donor twins (including IgGFc-binding protein, apolipoprotein C-I, complement C1q subcomponent subunit B, apolipoprotein C-III, apolipoprotein A-II, decorin, alpha-2-macroglobulin, apolipoprotein A-I, and fibronectin) were those previously shown to be associated with inflammation, ischemic cardiovascular complications or renal disease. CONCLUSION: In this study, we identified proteomic biomarkers in AF collected from donor and recipient twins in pregnancies complicated by TTTS that appear to reflect underlying functional and pathophysiological challenges faced by each of the fetuses.


Assuntos
Líquido Amniótico/metabolismo , Transfusão Feto-Fetal/diagnóstico , Proteômica , Biomarcadores/metabolismo , Feminino , Humanos , Recém-Nascido , Placenta/metabolismo , Gravidez , Gravidez de Gêmeos , Diagnóstico Pré-Natal , Proteoma
2.
Life Sci ; 243: 117290, 2020 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-31923420

RESUMO

AIMS: To investigate the therapeutic effects of human amniotic mesenchymal stem cells (hAMSCs) on paraquat (PQ)-induced pulmonary fibrosis in rats and investigate the inflammatory mechanisms. MAIN METHODS: hAMSCs were identified by morphological, flow cytometry and immunocytochemistry. A pulmonary fibrosis model was induced by administering PQ to rats. The hAMSCs group was treated with hAMSCs after 6 h of PQ poisoning. At 21 days after hAMSCs transplantation, lungs were harvested for H&E, Masson and immunohistochemical staining to evaluate pulmonary histopathology, collagen deposition, CD3+ cell infiltration and hAMSCs colonization. Arterial blood was used for lactic acid analysis and venous blood was used to detect TNF-α, IL-6, and TGF-ß1 by ELISA method. KEY FINDINGS: hAMSCs can improve the lung structure and decrease collagen deposition induced by PQ. The membranes of CD3+ T cell in the PQ group were round and complete, while that in the hAMSCs group rats exhibited punctate or diffuse staining. In addition, the CD3+ cell was decreased by hAMSCs administration, and MAB1281-positive cells were detected in lung of hAMSCs group rats. The survival rate of the hAMSCs group was significantly higher than that of the PQ group at 21 days after injection. TNF-α, IL-6, TGF-ß1 and lactic acid were significantly decreased by hAMSCs administration. SIGNIFICANCE: hAMSCs have a significant therapeutic effect on pulmonary fibrosis induced by acute PQ poisoning and can improve survival rate in rats. Furthermore, hAMSCs administration can improve lung histopathology and reduce collagen deposition by reducing inflammatory CD3+ T cell infiltration, inflammatory cytokine expression and lactic acid levels.


Assuntos
Líquido Amniótico/citologia , Herbicidas/toxicidade , Inflamação/prevenção & controle , Células-Tronco Mesenquimais/citologia , Paraquat/toxicidade , Fibrose Pulmonar/induzido quimicamente , Fibrose Pulmonar/prevenção & controle , Animais , Feminino , Humanos , Masculino , Ratos , Ratos Sprague-Dawley , Taxa de Sobrevida
3.
Adv Exp Med Biol ; 1237: 61-74, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31302870

RESUMO

Transamniotic stem cell therapy (TRASCET) is a novel prenatal therapeutic alternative for the treatment of congenital anomalies. It is based upon the principle of augmenting the pre-existing biological role of select populations of fetal stem cells for targeted therapeutic benefit. For example, amniotic fluid-derived mesenchymal stem cells (afMSCs) play an integral role in fetal tissue repair, validating the use of afMSCs in regenerative strategies. The simple intra-amniotic delivery of these cells in expanded numbers via TRASCET has been shown to promote the repair of and/or significantly ameliorate the effects associated with major congenital anomalies such as neural tube and abdominal wall defects. For example, TRASCET can induce partial or complete coverage of experimental spina bifida through the formation of a host-derived rudimentary neoskin, thus protecting the spinal cord from further damage secondary to amniotic fluid exposure. Furthermore, TRASCET can significantly reduce the bowel inflammation associated with gastroschisis, a common major abdominal wall defect. After intra-amniotic injection, donor stem cells home to the placenta and the fetal bone marrow in the spina bifida model, suggesting a role for hematogenous cell routing rather than direct defect seeding. Therefore, the expansion of TRASCET to congenital diseases without amniotic fluid exposure, such as congenital diaphragmatic hernia, as well as to maternal diseases, is currently under investigation in this emerging and evolving field of fetal stem cell therapy.


Assuntos
Âmnio/metabolismo , Doenças Fetais/metabolismo , Doenças Fetais/terapia , Transplante de Células-Tronco Mesenquimais , Líquido Amniótico/citologia , Feminino , Humanos , Células-Tronco Mesenquimais/citologia , Gravidez , Disrafismo Espinal/terapia
4.
BJOG ; 127(2): 159-169, 2020 01.
Artigo em Inglês | MEDLINE | ID: mdl-31376240

RESUMO

OBJECTIVES: To resolve the controversy regarding the presence of a microbiota in the placenta. DESIGN: Classical and molecular microbiological study. SETTING: All samples were collected during caesarean section. POPULATION: A total of 28 human placentas and six murine placentas. METHODS: All 28 human placentas were checked for 16S rRNA gene amplification products. Three locations from four selected human placentas and three 'environmental controls' for each placenta were placed in seven culture media. The four selected human placentas were further analysed using Gram stain, immunohistochemistry for bacteria, electron microscopy, and TaqMan RT-qPCR. Six placentas from three SPF mice were cut into four pieces each, and further analysed for 16S rRNA gene amplification. MAIN OUTCOME MEASURES: Microbiological and molecular evidence of bacteria. RESULTS: None of the placental cultures used for the full analysis, or their environmental cultures, was positive for bacterial growth. None of the other methods showed any evidence of bacteria. Immunohistochemistry showed negligible bacterial counts. None of the murine placentas showed evidence of 16S rRNA gene amplification. CONCLUSIONS: Our results support that the fetal environment in the womb is sterile. Based on the immunohistochemistry and the limit of detection of the other methods used, if a placental microbiome exists, it is of extreme low biomass, and thus its effect on clinical phenotypes is probably minor, if it exists at all. TWEETABLE ABSTRACT: Using several microbiological and molecular methods in parallel, we found no compelling evidence of bacteria in human and mouse placentas.


Assuntos
Líquido Amniótico/microbiologia , Microbioma Gastrointestinal/fisiologia , Microbiota/genética , Placenta/microbiologia , RNA Ribossômico 16S/fisiologia , Líquido Amniótico/imunologia , Animais , Feminino , Microbioma Gastrointestinal/imunologia , Humanos , Imuno-Histoquímica , Metagenômica , Camundongos , Placenta/imunologia , Gravidez , RNA Ribossômico 16S/genética , Análise de Sequência de DNA
5.
J Matern Fetal Neonatal Med ; 33(1): 113-119, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30021504

RESUMO

Background: The two most commonly used nomograms for amniotic fluid index (AFI) were developed by Moore and Cayle and Magann et al. However, there are several inconsistencies between the two methods.Objective: The aim of the study was to determine whether these differences carry clinical significance.Methods: A retrospective cohort of women with singleton pregnancies evaluated for AFI during pregnancy at a tertiary medical center in 2007-2014 were divided into five groups: group A, definite oligohydramnios-AFI below the fifth percentile according to the nomograms of both Moore and Cayle and Magann et al.; group B, intermediate oligohydramnios-AFI below the fifth percentile according to only one nomogram (Moore and Cayle); group C, euhydramnios-normal AFI according to both nomograms; group D, intermediate polyhydramnios-AFI above the 95th percentile according to one nomogram (Magann et al.); group E, definite polyhydramnios-above the 95th percentile according to both nomograms. The association of group by maternal and perinatal outcomes was analyzed.Results: A total of 6987 women were included: group A, 996 (14%); group B, 1344 (19%); group C, 2561 (37%); group D, 1051 (15%); group E, 1034 (15%). Group B (intermediate oligohydramnios) was characterized by significantly lower rates of adverse perinatal outcomes than group A (definite oligohydramnios): small for gestational age neonate (12.3 versus 15.2%, p = .05), neonatal intensive care unit admission (11.1 versus 21.5%; p < .001), composite respiratory outcome (4.8 versus 9.8%; p < .001), and neonatal sepsis (6.4 versus 10.8%; p < .001). No such differences were found between groups B and C. Group D (intermediate polyhydramnios) differed from group E (definite polyhydramnios) by lower rates of 5 minutes Apgar score <7 (1.3 versus 3.2%; p = .003), neonatal intensive care unit admission (10.9 versus 14.4%; p = .02), and major congenital anomalies (1.7 versus 5.6%; p = .02). There was no difference in these parameters between groups D and C.Conclusion: This study suggests that intermediate oligohydramnios and intermediate polyhydramnios are not associated with adverse perinatal outcomes. Outcome in these pregnancies is similar to pregnancies with euhydramnios. Commonly used AFI nomograms should be updated.


Assuntos
Líquido Amniótico/fisiologia , Indicadores Básicos de Saúde , Nomogramas , Resultado da Gravidez , Adulto , Feminino , Idade Gestacional , Humanos , Oligo-Hidrâmnio/diagnóstico , Poli-Hidrâmnios/diagnóstico , Gravidez , Nascimento Prematuro/diagnóstico , Estudos Retrospectivos , Ultrassonografia Pré-Natal/métodos , Ultrassonografia Pré-Natal/normas , Adulto Jovem
6.
BMC Infect Dis ; 19(1): 1042, 2019 Dec 10.
Artigo em Inglês | MEDLINE | ID: mdl-31823777

RESUMO

BACKGROUND: Toxoplasma gondii is an opportunistic protozoan parasite that can infect all warm-blooded animals including humans and cause serious clinical manifestations. Toxoplasmosis can be diagnosed using histological, serological, and molecular methods. In this study, we aimed to detect T. gondii RE gene in various human samples by in house and commercial real time polymerase chain reactions. METHODS: A total of 38 suspected cases of toxoplasmosis [peripheral blood (n:12), amnion fluid (n:11), tissue (n:9), cerebrospinal fluid (n:5), and intraocular fluid (n:1)] were included to the study. An in house and a commercial RT-PCR were applied to investigate the T. gondii RE gene in these samples. RESULTS: The compatibility rate of the two tests was 94.7% (37/38). When the commercial RT-PCR kit was taken as reference, the sensitivity and specificity of in house RT-PCR test was 87.5 and 100%. When the in house RT-PCR test was taken as reference, the commercial RT-PCR kit has 100% sensitivity and 96.8% specificity. Incompatibility was detected in only in a buffy coat sample with high protein content. CONCLUSIONS: Both the commercial and in house RT-PCR tests can be used to investigate T. gondii RE gene in various clinical specimens with their high sensitivity and specificity. In house RT-PCR assay can be favorable due to cost savings compared to using the commercial test.


Assuntos
DNA de Protozoário/metabolismo , Reação em Cadeia da Polimerase em Tempo Real/métodos , Toxoplasma/genética , Líquido Amniótico/microbiologia , Animais , Buffy Coat/microbiologia , DNA de Protozoário/isolamento & purificação , Humanos , Masculino , Kit de Reagentes para Diagnóstico , Toxoplasma/isolamento & purificação , Toxoplasmose/diagnóstico , Toxoplasmose/microbiologia , Turquia
7.
Vet J ; 253: 105376, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31685134

RESUMO

While recent work demonstrated that enrofloxacin and ciprofloxacin reach the fetoplacental unit without causing obvious lesions in the 9-month-old equine fetus or resulting foal, many practitioners still hesitate to prescribe a fluoroquinolone during pregnancy. Since early gestation is a critical time for fetal skeletal development, if fluoroquinolones are chondrotoxic to the fetus at any point during gestation, this period would be important. The aim of this study was to assess the effects of 2 weeks' exposure to enrofloxacin on the equine fetus between 46 and 60 days gestation. Twelve pregnancies from nine healthy mares were allocated into two groups: untreated (n=7), or treatment (7.5mg/kg enrofloxacin, PO×14days, n=6). Abortion was induced with prostaglandin 24h after the last enrofloxacin dose, or on the equivalent day of gestation for untreated mares. Four of nine mares were rebred for a second cycle and were assigned to the opposite treatment to serve as their own controls. Fetal fluids from treated mares were analysed for enrofloxacin and ciprofloxacin concentrations. Fetal organs (heart, lungs, spleen, kidney, and liver) and limbs were examined histopathologically. Enrofloxacin and ciprofloxacin diffused to the fetal fluids during early gestation and did not result in detectable abnormalities in the fetus after 14 days of treatment. While current research does not determine long-term foal outcomes, enrofloxacin may be useful for select bacterial infections in pregnant mares.


Assuntos
Anti-Infecciosos/farmacologia , Enrofloxacina/farmacologia , Feto/efeitos dos fármacos , Doenças dos Cavalos/tratamento farmacológico , Aborto Animal , Alantoide/metabolismo , Líquido Amniótico/metabolismo , Animais , Anti-Infecciosos/farmacocinética , Anti-Infecciosos/toxicidade , Enrofloxacina/farmacocinética , Enrofloxacina/toxicidade , Feminino , Doenças dos Cavalos/patologia , Cavalos , Gravidez
8.
Pan Afr Med J ; 33: 279, 2019.
Artigo em Francês | MEDLINE | ID: mdl-31692819

RESUMO

Multicystic dysplastic kidney (MCDK) is the most common Congenital Abnormalities of Kidney and Urinary Tract (CAKUT) in clinical practice. Its etiology and pathogenesis are still controversial and obstruction is a generally accepted causative assumption. Obstetric ultrasound is the gold standard for prenatal diagnosis and for the detection of other associated malformations. Prenatal management is based on ultrasound monitoring of pregnancy, of the disease, of the occurrence of other anomalies and of the amount of amniotic fluid. This study aims to report our experience in the Department of Gynecology-Obstetrics 2 at the University Hospital Hassan II-Fez in order to clarify the epidemiology of MCDK, highlight the role of obstetric ultrasound in positive and etiological diagnosis while describing the various sonographic appearances. It is essential to schedule for screening tests during pregnancy in order to assess the evolution of the disease diagnosed in the prenatal period, to implement a strategy in postpartum care and to establish a prognosis.


Assuntos
Líquido Amniótico/metabolismo , Rim Displásico Multicístico/diagnóstico por imagem , Ultrassonografia Pré-Natal/métodos , Anormalidades Múltiplas/diagnóstico por imagem , Feminino , Humanos , Recém-Nascido , Masculino , Gravidez , Estudos Retrospectivos
9.
Harefuah ; 158(11): 728-731, 2019 Nov.
Artigo em Hebraico | MEDLINE | ID: mdl-31721516

RESUMO

INTRODUCTION: There are two methods to diagnose oligohydramnios: maximal vertical pocket (MVP) and amniotic fluid index (AFI). Following a recent large Cochrane review and other studies, MVP is being recommended as the method of choice by professional societies, after it was shown to result in fewer inductions of labor and C-sections (CS), without compromising neonatal outcome. There is controversy regarding the management of isolated oligohydramnios (IO). It is unclear whether this finding reflects an underlying pathological process, and therefore management protocols differ between different institutions. Studies have shown a higher rate of CS (RR of >2) in IO. Whether this is a true complication of IO or is a result of different confounders like labor inductions and primigravidity is unclear. The effects on neonatal outcomes are also unclear; whereas some authors did not show any adverse effects, others have shown higher rates of neonatal intensive care unit (NICU) admissions, lower Apgar scores and higher rate of Meconium aspiration syndrome. Some studies have shown a higher rate of undiagnosed small for gestational age (SGA) in IO pregnancies. There is no consensus regarding the optimal management and time of delivery. Until now, common practice was to induce labor at term, and some advocate induction in late preterm. Recently, the growing awareness to early term morbidity has led practitioners to question the benefit of early induction. There are several studies that have shown maternal hydration to improve AFI, but there is insufficient data to show the effect on outcomes. In conclusion, many questions regarding IO are still unanswered, and further research, specifically RCT studies, is needed.


Assuntos
Síndrome de Aspiração de Mecônio , Oligo-Hidrâmnio , Líquido Amniótico , Feminino , Humanos , Recém-Nascido , Trabalho de Parto Induzido , Síndrome de Aspiração de Mecônio/diagnóstico , Oligo-Hidrâmnio/diagnóstico , Oligo-Hidrâmnio/terapia , Gravidez , Resultado da Gravidez
10.
Acta Neurobiol Exp (Wars) ; 79(3): 261-269, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31587018

RESUMO

The application of stem cells as a therapy for degenerative disease holds great promise. Substantial evidence suggests that stem cell derived exosomes are a novel cell-free therapy for the corresponding cells. Exosomes are less complex as compared to their parental cells, due to the fewer number of membrane proteins. In addition, the smaller size and lower risk of immunogenicity makes exosomes potentially safe therapeutic nano-carriers. A large number of ongoing research studies are focused on characterizing exosomes that were derived from different sources, for their potential use in various therapeutic applications. In the present study, we focused on characterizing human amniotic fluid stem cell derived exosomes for future therapeutic applications, such as paracrine therapy/nano carrier. In addition, we characterized exosomes derived from SH-SY5Y and BE(2)-M17 cells, which are a known neuronal model, for further characteristic analyses of neuronal differentiation and neurobiology. Finally, we compared various exosome isolation techniques and procedures and evaluated exosome yield.


Assuntos
Líquido Amniótico/metabolismo , Exossomos/metabolismo , Neurônios/citologia , Células-Tronco/citologia , Diferenciação Celular/fisiologia , Linhagem Celular Tumoral , Separação Celular/métodos , Humanos
11.
J Knee Surg ; 32(11): 1143-1154, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31533151

RESUMO

Placental-derived tissues are a known source of anti-inflammatory and immune modulating factors. Published pilot data on amniotic suspension allograft (ASA) for the treatment of osteoarthritis (OA) demonstrated safety and trends for improved pain and function. A multicenter randomized controlled trial was designed to evaluate the efficacy of symptom modulation with ASA compared with saline and hyaluronic acid (HA) in subjects with knee OA. A total of 200 subjects were randomized 1:1:1 to ASA, HA, or saline, with subjects blinded to their allocation. Changes from baseline of patient-reported outcomes (PROs)-EQ-5D-5L, Knee Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS), Tegner, and Single Assessment Numerical Evaluation (SANE)-were compared between groups. Patients reporting unacceptable pain at 3 months were considered treatment failures and withdrawn from the study. Statistical analysis was completed by comparing changes in PROs from baseline to 3 and 6 months for all groups. Comparison of demographics between treatment groups showed no significant differences between groups. Patients reporting unacceptable pain at 3 months in each group were ASA (13.2%), HA (68.8%), and saline (75%). Patients receiving ASA demonstrated significantly greater improvements from baseline for overall pain (VAS), KOOS pain, and KOOS-activities of daily living scores compared with those in the HA group (3 months) and both groups (6 months). ASA patients had significantly greater improvements in KOOS symptom scores compared with HA and saline at 3 and 6 months, respectively. OMERACT-OARSI responder rates for ASA, HA, and saline groups were 69.1, 39.1, and 42.6%, respectively (p = 0.0007). Subjects receiving ASA treatment showed greater improvements in PROs and fewer patients reported unacceptable pain compared with HA and saline. The evidence presented in this Level I Randomized Controlled Trial suggests that ASA injection is an effective treatment for the nonoperative management of symptomatic knee OA.


Assuntos
Líquido Amniótico , Ácido Hialurônico/administração & dosagem , Osteoartrite do Joelho/terapia , Viscossuplementos/administração & dosagem , Atividades Cotidianas , Adulto , Idoso , Feminino , Humanos , Injeções Intra-Articulares , Masculino , Pessoa de Meia-Idade , Osteoartrite do Joelho/complicações , Osteoartrite do Joelho/fisiopatologia , Medição da Dor , Método Simples-Cego , Transplante Homólogo , Resultado do Tratamento , Escala Visual Analógica
13.
Pesqui. vet. bras ; 39(8): 600-605, Aug. 2019. tab, ilus
Artigo em Inglês | LILACS, VETINDEX | ID: biblio-1040735

RESUMO

Considering the representativeness of dairy cattle in our country, the concern about the mortality rates of the animals increases each time. Regarding to calf mortality, the Respiratory Distress Syndrome (RDS) has an important relevance during the neonatal period, and it is present in immature lungs. The amniotic fluid is in direct contact with the fetus, and it is able to offer evidence about his maturity. The aim of this study was to standardize the characteristics of the amniotic fluid, color, aspect, viscosity, quantification of lamellar body and surfactant evaluation by the Clements test and cytology, of term-born, mature and healthy calves. There were used 50 Black and White Holstein calves, which mothers were observed at calving in order to collect the amniotic fluid by puncture in the moment of exposure of the fetal membrane through the vaginal canal. Most amniotic fluid had a clear and hazy appearance due to varying degrees of viscosity and the presence or absence of clots. The Clements test could be adapted to the bovine species by the modification consisting in the addition of 3mL of amniotic fluid and 1mL of 95% ethanol. The methodology of the lamellar body count by the automated particle counter is not applicable for the bovine because of the small size of their lamellar body. The Nile Blue staining is unsatisfactory on predicting fetal maturity on the bovine species, different from cytology using Hematoxylin-Shorr stain. The presence of orange cells, increase in large amounts at the end of pregnancy. The cell stained orange counting, cells which are found in great amounts at the end of pregnancy. The present study stablished new parameters for evaluation of fetal and pulmonary maturity in the bovine species.(AU)


O objetivo desse estudo foi reunir novos dados práticos sobre a avaliação da maturidade pulmonar em neonatos bovinos, padronizando as características do líquido amniótico de bezerros maduros e hígidos, o que proporcionará a oportunidade de tratamento precoce dos animais prematuros, evitando prejuízos econômicos, principalmente quando consideramos os animais de alto valor genético. Amostras de líquido amniótico foram coletadas de 50 vacas da Raça Holandesa Preta e Branca. Corpos lamelares foram identificados por microscopia eletrônica de transmissão como estruturas de tamanho aproximado de 130nm, o que impede sua contagem em analisadores automáticos. O teste de Clements sofreu adaptações de técnica e se mostrou viável com a diluição de 3mL de líquido amniótico em 1mL de etanol a 95%. A citologia utilizando o método de Hematoxilina-Shorr, diferentemente do teste de Azul de Nilo, foi eficaz na identificação das células orangiofílicas, indicativas de maturidade fetal. Esses métodos mostraram-se originais e úteis ferramentas para a avaliação de maturidade pulmonar na espécie bovina, porém estudos com bezerros prematuros ainda são necessários.(AU)


Assuntos
Animais , Bovinos , Desenvolvimento Embrionário , Líquido Amniótico , Pulmão/crescimento & desenvolvimento , Animais Recém-Nascidos/crescimento & desenvolvimento
14.
Biomed Khim ; 65(3): 245-250, 2019 Apr.
Artigo em Russo | MEDLINE | ID: mdl-31258149

RESUMO

The content of vasoactive compounds and arachidonic acid in the placenta and amniotic fluid was studied in full-term (39-40 weeks) physiological pregnancy and preeclampsia (PE). The content of metabolites of nitric oxide (NOx), endothelin-1, thromboxane B2 (TxB2), prostacycline (PGI2) and arachidonic acid was estimated using spectrophotometric, immunoenzyme methods and gas-liquid chromatography. It was found that in PE the content of vasoconstrictors, of endothelin and TxB2, increased in the placenta and amniotic fluid, while the content of vasodilators, PGI2 and NOx decreased. Despite the same directionality of changes in both studied objects, the degree of changes differed and was more pronounced in the placenta. A direct or inverse correlative relationship was found between various vasoactive components (depending on their effect on vascular tone). In the case of arachidonic acid changes in its content in PE correlated with the level of vasoactive compounds, the source of which it is. The revealed differences in the ratio of vasoactive components obviously play a pathogenetic role in the development of PE and its subsequent complications.


Assuntos
Líquido Amniótico/química , Ácido Araquidônico/análise , Placenta/química , Pré-Eclâmpsia , Endotelina-1/análise , Feminino , Humanos , Óxido Nítrico/análise , Gravidez , Prostaglandinas I/análise , Tromboxano B2/análise
15.
Nutr Hosp ; 36(4): 786-791, 2019 Aug 26.
Artigo em Espanhol | MEDLINE | ID: mdl-31282172

RESUMO

Introduction: Introduction: the situation with maternal breastfeeding is difficult to describe with any certainty, given the absence of any data gathered in maternity hospitals, and the timing of its onset has not been explicitly evaluated. Further research is needed to evaluate breastfeeding support measures. The objective of the present study was to determine the prevalence of early onset of maternal breastfeeding (EOMB) and to analyze the relationship with different maternal and newborn factors. Methods: a descriptive study was performed of births in a public hospital over a three-year period. The database used for the study derived from an electronic clinical record system designed by professionals. Descriptive and univariate analyses were performed. The association of early onset of maternal breastfeeding with other parameters from mother and newborn was analyzed by the Fisher's test. Results: the prevalence of EOMB was 88.4%. A total of 2,683 births were included in the study. Significant associations were found between this EOMB and different maternal factors, such as parity (p = 0.05) and weeks of gestation (p = 0.047), but not with age (p = 0.522). A strong association was also found with all the factors of the child (p = 0.000), such as weight, color of the amniotic fluid, the Apgar test at one and five minutes, the type of resuscitation required or the need for admission in the neonatal unit. Conclusions: There has been a high rate of (EOMB) in our setting.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Adulto , Fatores Etários , Líquido Amniótico , Análise de Variância , Índice de Apgar , Coeficiente de Natalidade , Peso ao Nascer , Cor , Estudos Transversais , Feminino , Humanos , Recém-Nascido , Idade Materna , Paridade , Gravidez , Fatores de Tempo
16.
J Perinat Med ; 47(6): 651-655, 2019 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-31287799

RESUMO

Background Classical karyotyping and copy-number variation sequencing (CNV-seq) are useful methods for the prenatal detection of chromosomal abnormalities. Here, we examined the potential of using a combination of the two methods for improved and accurate diagnosis. Methods From February 2013 to January 2018, 64 pregnant women showing indications for fetal chromosomal examination in the affiliated hospital of the Inner Mongolia Medical University were selected for this study. Amniotic fluid was collected and used for karyotype analysis and CNV-seq. Results Karyotype analysis of the 64 cases showed that six cases (9.38%) had chromosomal abnormalities. Using CNV-seq, in addition to three cases with numerical abnormalities of chromosomes, 14 cases were detected with CNV, of which five were pathogenic CNV, four were of uncertain clinical significance and five were polymorphic CNV. However, CNV-seq failed to detect one case with sex chromosome mosaicism and a balanced translocation carrier. The rate of abnormal chromosome and CNV detection was 26.56% (17/64) by CNV-seq. Conclusion Application of CNV-seq in prenatal diagnosis could allow the detection of submicroscopic chromosomal abnormalities and effectively reduce the birth of children with microdeletion and microduplication syndrome. Additionally, the combined application of karyotype analysis and CNV-seq can effectively improve the detection rate of chromosome abnormalities.


Assuntos
Transtornos Cromossômicos , Variações do Número de Cópias de DNA , Cariotipagem/métodos , Diagnóstico Pré-Natal , Adulto , Líquido Amniótico/citologia , China/epidemiologia , Aberrações Cromossômicas , Transtornos Cromossômicos/diagnóstico , Transtornos Cromossômicos/epidemiologia , Transtornos Cromossômicos/genética , Feminino , Idade Gestacional , Humanos , Gravidez , Diagnóstico Pré-Natal/métodos , Diagnóstico Pré-Natal/normas , Melhoria de Qualidade
17.
J Obstet Gynaecol Res ; 45(9): 1796-1808, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31313469

RESUMO

Considerable evidence has shown that intra-amniotic infection with Ureaplasma spp. increases the risk of chorioamnionitis and preterm labor. Ureaplasma spp. are among the smallest organisms, and their isolation is uncommon in routine clinical practice because of their size and high auxotrophy. Although Ureaplasma spp. have been reported as causative agents of preterm birth, they also have a high incidence in vaginal swabs collected from healthy reproductive-age women; this has led to questions on the virulence of Ureaplasma spp. and to them being considered as harmless commensal bacteria. Therefore, many efforts have been made to clarify the pathogenicity of Ureaplasma spp. at the molecular level. Ureaplasma spp. are surrounded by lipoproteins, including multiple-banded antigen. Both multiple-banded antigen and its derivative, that is, the synthetic lipopeptide, UPM-1, induce an inflammatory response in a preterm mice model, which was adequate to cause preterm birth or stillbirth. In this review, we present an overview of the virulence mechanisms of Ureaplasma spp. and treatment of ureaplasma infection during pregnancy to prevent possible serious sequelae in infants. In addition, relevant mechanisms underlying antibiotic resistance in Ureaplasma spp. are discussed. Ureaplasma spp. are naturally resistant against ß-lactam antibiotics because of the lack of a cell wall. Azithromycin is one of the effective agents that can control intrauterine ureaplasma infection. In fact, macrolide- and fluoroquinolone-resistant isolates of Ureaplasma spp. have already been observed in perinatal practice in Japan.


Assuntos
Antibacterianos/uso terapêutico , Azitromicina/uso terapêutico , Corioamnionite/microbiologia , Complicações Infecciosas na Gravidez/microbiologia , Infecções por Ureaplasma/microbiologia , Ureaplasma/patogenicidade , Adulto , Líquido Amniótico/microbiologia , Corioamnionite/tratamento farmacológico , Feminino , Humanos , Recém-Nascido , Doenças do Recém-Nascido/microbiologia , Doenças do Recém-Nascido/prevenção & controle , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Nascimento Prematuro/microbiologia , Nascimento Prematuro/prevenção & controle , Ureaplasma/efeitos dos fármacos , Infecções por Ureaplasma/tratamento farmacológico , Virulência
18.
BMC Pregnancy Childbirth ; 19(1): 258, 2019 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-31331296

RESUMO

BACKGROUND: In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes. METHODS: We performed a secondary analysis of the First Look Study, a multi-national, cluster-randomized trial of ultrasound during prenatal care. We evaluated all women enrolled from Guatemala, Pakistan, Zambia, Kenya and the Democratic Republic of Congo (DRC) who received an examination by prenatal ultrasound. We used pairwise site comparisons with Tukey-Kramer adjustment and multivariable logistic models with general estimating equations to control for cluster-level effects. The diagnosis of polyhydramnios was confrimed by an U.S. based radiologist in a majority of cases (62%). RESULTS: We identified 305/18,640 (1.6%) cases of polyhydramnios. 229 (75%) cases were from the DRC, with an incidence of 10%. A higher percentage of women with polyhydramnios experienced obstructed labor (7% vs 4%) and fetal malposition (4% vs 2%). Neonatal death was more common when polyhydramnios was present (OR 2.43; CI 1.15, 5.13). CONCLUSIONS: Polyhydramnios occured in these low and low-middle income countries at a rate similar to high-income contries except in the DRC where the incidence was 10%. Polyhydramnios was associated with obstructed labor, fetal malposition, and neonatal death. TRIAL REGISTRATION: NCT01990625 , November 21, 2013.


Assuntos
Apresentação no Trabalho de Parto , Complicações do Trabalho de Parto/epidemiologia , Poli-Hidrâmnios , Cuidado Pré-Natal , Ultrassonografia Pré-Natal , Adulto , Líquido Amniótico , Análise por Conglomerados , Países em Desenvolvimento/estatística & dados numéricos , Feminino , Saúde Global , Humanos , Incidência , Lactente , Mortalidade Infantil , Recém-Nascido , Poli-Hidrâmnios/diagnóstico , Poli-Hidrâmnios/epidemiologia , Gravidez , Cuidado Pré-Natal/métodos , Cuidado Pré-Natal/estatística & dados numéricos , Fatores de Risco , Fatores Socioeconômicos , Ultrassonografia Pré-Natal/métodos , Ultrassonografia Pré-Natal/estatística & dados numéricos
19.
J Perinat Med ; 47(7): 765-770, 2019 Sep 25.
Artigo em Inglês | MEDLINE | ID: mdl-31348763

RESUMO

Background Bisphenol A (BPA) is an estrogenic, endocrine-disrupting compound widely used in the industry. It is also a ubiquitous environmental pollutant. Its presence was confirmed in human fetuses, which results from maternal exposure during pregnancy. The mechanisms behind maternal-fetal transfer, and relationships between pregnant women and fetal exposures remain unclear. The aim of this study was to assess the impact of maternal exposure to BPA on the exposure of the fetus. Methods Maternal plasma and amniotic fluid samples were collected from 52 pregnant women undergoing amniocentesis for prenatal diagnosis of chromosomal abnormalities. BPA was measured by gas chromatography-mass spectrometry (GC-MS). The permeability factor - a ratio of fetal-to-maternal BPA concentration - was used as a measure delineating the transplacental transfer of BPA. Results The median concentration of maternal plasma BPA was 8 times higher than the total BPA concentration in the amniotic fluid (8.69 ng/mL, range: 4.3 ng/mL-55.3 ng/mL vs. median 1.03 ng/mL, range: 0.3 ng/mL-10.1 ng/mL). There was no direct relationship between the levels of BPA in maternal plasma and amniotic fluid levels. The permeability factor, in turn, negatively correlated with fetal development (birth weight) (R = -0.54, P < 0.001). Conclusion Our results suggest that the risk of fetal BPA exposure depends on placental BPA permeability rather than the levels of maternal BPA plasma concentration and support general recommendations to become aware and avoid BPA-containing products.


Assuntos
Líquido Amniótico/química , Compostos Benzidrílicos , Peso ao Nascer/efeitos dos fármacos , Troca Materno-Fetal , Fenóis , Placenta , Adulto , Poluentes Ocupacionais do Ar/efeitos adversos , Poluentes Ocupacionais do Ar/sangue , Poluentes Ocupacionais do Ar/química , Compostos Benzidrílicos/efeitos adversos , Compostos Benzidrílicos/sangue , Compostos Benzidrílicos/química , Exposição Ambiental/prevenção & controle , Estrogênios não Esteroides/efeitos adversos , Estrogênios não Esteroides/sangue , Estrogênios não Esteroides/química , Feminino , Cromatografia Gasosa-Espectrometria de Massas/métodos , Humanos , Exposição Materna/prevenção & controle , Permeabilidade , Fenóis/efeitos adversos , Fenóis/sangue , Fenóis/química , Placenta/metabolismo , Placenta/fisiopatologia , Gravidez , Segundo Trimestre da Gravidez
20.
J Obstet Gynaecol ; 39(7): 952-958, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31215267

RESUMO

Our objective was determining the effects of amniotic fluid (AF) and fetal cord blood (FCB) cotinine concentrations on pregnancy complications and the anthropometric measurements in the newborns whose mothers underwent amniocentesis. This study was conducted as a case-control study, in Turkey. A total of 250 pregnant women with amniocentesis indication were recruited into the study and the cotinine levels in the AF and FCB were determined. A smoking habit did not statistically affect the incidence of pregnancy complications (p>.05). The birth weights of the newborns were negatively correlated with the AF cotinine levels. The incidences of low birth weight, low Apgar scores and RDS were positively correlated with higher levels of cotinine in AF and FCB. It is important for healthcare staff to provide training and consultancy services for the health improvement of pregnant women and the prevention of smoking during pregnancy. Impact statement What is already known on this subject? The pre-pregnancy smoking habit usually continues during the pregnancy. A significant negative correlation was present between the foetal cord blood cotinine levels and the birth weight. What do the results of this study add? The anthropometric measurements of the newborns born from mothers with high AF cotinine levels were lower than newborns born from mothers with low amniotic fluid cotinine levels. Respiratory Distress syndrome is more often determined in newborns born from mothers with high AF cotinine levels. What are the implications of these findings for clinical practice and/or further research? Future studies should be performed to investigate the effects of cigarette smoking on the health problems, the growth characteristics and the neurological development of newborns and infants within the first year of life.


Assuntos
Líquido Amniótico/química , Peso ao Nascer , Cotinina/sangue , Complicações na Gravidez/sangue , Fumar/efeitos adversos , Adulto , Antropometria , Estudos de Casos e Controles , Feminino , Sangue Fetal/química , Humanos , Recém-Nascido , Gravidez , Síndrome do Desconforto Respiratório do Recém-Nascido/sangue , Síndrome do Desconforto Respiratório do Recém-Nascido/epidemiologia , Síndrome do Desconforto Respiratório do Recém-Nascido/etiologia , Fumar/sangue , Poluição por Fumaça de Tabaco/efeitos adversos , Turquia/epidemiologia
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