Antiphospholipid syndrome (APS) is a complex thrombo-inflammatory autoimmune disease characterized by the presence of antiphospholipid antibodies (aPL). Women with APS are at high risk of recurrent ...early pregnancy loss as well as late obstetrical complications—premature birth due to placental insufficiency or severe preeclampsia. Accumulating evidence implies that vascular thrombosis is not the only pathogenic mechanism in obstetric APS, and that the direct negative effect of aPL on the placental cells, trophoblast, plays a major role. In this review, we summarize the current findings regarding the potential mechanisms involved in aPL-induced trophoblast dysfunction. Introduction on the APS and aPL is followed by an overview of the effects of aPL on trophoblast—survival, cell function and aPL internalization. Finally, the implication of several non-coding RNAs in pathogenesis of obstetric APS is discussed, with special emphasis of their possible role in trophoblast dysfunction and the associated mechanisms.
Introduction. There are three groups of disorders during pregnancy: disorders specific for pregnancy that resolve spontaneously or soon after delivery, acute hepatic disorders coinciding with ...pregnancy, and chronic disorders. Drug-induced liver disease prevails among women and it is estimated to be a leading cause of acute liver injury. Drug-induced hepatitis is rare in pregnancy with only a few cases reported in literature. Alpha-methyldopa is one of the commonly used drugs in pregnancy that could cause hepatotoxicity with different clinical presentations and possible adverse effects on normal course of pregnancy. Case outline. We reported a rare case of hepatotoxicity caused by alpha-methyldopa in 26 gestational weeks pregnancy in a 35-year-old patient admitted because of jaundice and elevated liver function tests. She had been using antihypertensive drug, alpha-methyldopa, from 12th gestational week, and no other medication or supplementation was recorded. Ultrasound of the abdomen excluded obstruction or any other abnormalities. Autoimmune panel was done. Biochemical analyses were indicative of toxic acute liver injury caused by alpha-methyldopa according to values of transaminase. After 13 days, patient was discharged recovered from the hospital. Conclusion. Diagnosis of alpha-methyldopa hepatotoxicity is challenging since the low incidence, unpredictability, diverse symptomatology and absence of specific biomarkers. That is why timely diagnosis is crucial for the well-being of both future mother and child.
Macrophage migration inhibitory factor (MIF) is a multifunctional cytokine abundantly present at the feto-maternal interface proposed to play a role in establishment of pregnancy. We have previously ...shown that pharmacological inhibition of enzymatic activity of MIF decreases extravillous trophoblast invasion and migration
. This study aimed to further elucidate potential role of endogenous trophoblast MIF, and to assess its importance for endovascular trophoblast cell function in particular. Attenuation of MIF by siRNA reduced HTR-8/SVneo cell invasion through Matrigel (59 % of control), expression of integrin α
(86 % of control) and levels of MMP2 and MMP9 (87 % and 57 % of control, respectively).
specific siRNA reduced the ability of HTR-8/SVneo to differentiate in to endothelial-like phenotype, as determined by Matrigel tube formation assay. The total tube length was decreased to 68.6 %, while the number of branching points was reduced to 57.8 % of control. HTR-8/SVneo cell capacity to integrate into HUVEC monolayers was reduced by knock-down of
. This could be partly caused by reduced N-cadherin expression to 63 % of control, which decreased with knock-down of
, as the expression of this protein was recently shown essential for trophoblast-endothelial interaction. These novel findings indicate a novel role for trophoblast MIF in spiral artery remodeling process.
New technological advances in complex production systems, accompanied with digitalization and implementation of different forms of information technology supported the paradigm Industry 4.0. This ...concept on the other side have making strong influence in all accompanied paradigms so right now we can talk about things such as Quality 4.0. In this paper we will research how implementation of ICT systems, especially web based applications, clouds and open source tools could contribute in development of the solution for improvement of the quality management. The specific system for management of quality documentation will be presented.
The pregnancy physiologically navigates, sort of speaking, the hematopoietic system in the direction of hypercoagulabile state, which grows stronger throughout the pregnancy and reaches its maximum ...at the time of the delivery. These changes are considered to be the protection of the pregnant woman during puerperium, but if over-emphasized, they could lead to complications in both mother and the fetus. The main hypothesis of pathophysiology of these problems, during pregnancy, is based on the events of forming the blood vessels between the placenta and the uterus. During the forming of placental circulation, as a result of non-adequate placentation and placental vascular thrombosis, certain secondary reactions may be manifested, such as: placental abruption, hypoxia and hypoxemia of the fetus, which result as fetal growth restriction. These states may be consequences of congenital or acquired thrombophilia. The therapy advised to these women varies, but there are no absolute evidences that it is obligatory. Clinical experience suggests that the use of aspirin, in the state of antiphospholipid syndrome, leads to better results, considering both the mother and the fetus.
Introduction/Objective. Increased incidence of cesarean sections leads to the reduction of incidence of instrumental vaginal deliveries. The aim of this study was to analyze the trends of forceps ...deliveries at the tertiary healthcare facility. Methods. The study was performed at the Clinic of Gynecology and Obstetrics, covering a 30-year period, from 1987 to 2016 with a total of 198,882 births. Results. Forceps delivery rate was significantly lowering during time, while the cesarean section rates were rising. Conclusion. Using linear, cubic and quadratic prediction models, we can estimate that in the year 2020 there will be no more forceps deliveries. However, minding the confidence interval of 95% some forceps deliveries might still be carried out. Since it has been shown that the forceps is a very useful obstetric tool, this very important skill might soon be neglected due to the lack of training.
nema
Immunoglobulins from sera of patients with antiphospholipid syndrome (APS) decrease trophoblast cell invasion in vitro. This study aimed to extend understanding of cellular effects of immunoglobulins ...from APS (aPL+) in HTR-8/SVneo cells. aPL+ IgG induced change in effector molecules important for cell invasion was investigated further. After 1h of culture 21% cells bound aPL+ IgG, as opposed to 6% in control (aPL-). This was accompanied by increase in phospho-p38 at 30min. After 24h treatment aPL+IgG decreased protein levels of integrin subunits α1 (78% of control; p<0.01), α4 (65% of control, p<0.01), α5 (76% of control; p<0.01) and β1 (80% of control; p<0.01), and secreted gal-1 (68% of control; p<0.05). ProMMP-9 was reduced to 70% of control (p<0.001). Treatment with inhibitor of p38 MAPK signaling SB202190 reversed inhibition in integrin β1 and secreted gal-1. Involvement of p38 MAPK signaling and decrease in integrin subunit α4
proMMP-9, and secreted gal-1 in HTR-8/SVneo cells are novel and extend the list of mediators of trophoblast invasion affected by aPL.
Infection is increasingly considered to contribute to pathological conditions
in pregnancy. The placenta acts as a protective immunological fetomaternal
barrier which recognizes microbes by pattern ...recognition receptors on the
trophoblast. Lipopolysaccharide (LPS) is a cell wall constituent of
Gram-negative bacteria that elicits a strong immune response. In this study,
LPS from E. coli was used to treat the HTR-8/SVneo trophoblast cell line and
examine its influence on cytokines IL-6, IL-8 and MIF using real-time PCR,
metalloproteinases (MMP)-2 and -9 by gelatin zymography, and Western analysis
of integrin subunits ?1 and ?1, all known to contribute to migration of human
trophoblasts in vitro. The results described herein for the first time, show
that MIF mRNA and secreted MIF protein were significantly elevated (2.5-3-
and 2-fold, respectively) in LPS-treated cells. MMP-2 and MMP-9 levels were
increased, as well as cell migration, as judged by a wound-healing test,
however, no changes in the studied integrin subunits, cell viability or cell
numbers were observed. The data obtained furthers our understanding of LPS
actions on the trophoblast in vitro, additionally implicate MIF, and suggest
that infection in vivo could indeed alter the functional characteristics of
the trophoblast.
Fetal echocardiography - 25-year experience in Serbia Vrzic-Petronijevic, Svetlana; Petronijevic, Milos; Parezanovic, Vojislav ...
Srpski arhiv za celokupno lekarstvo,
2019, Letnik:
147, Številka:
1-2
Journal Article
Odprti dostop
Introduction/Objective. Congenital heart diseases are the most common congenital anomalies. The objective of the study was to determine reliability, specificity, and sensitivity of fetal ...echocardiography in detection of congenital heart diseases in a referral center for fetal echocardiography. Methods. We analyzed 14,500 fetal echocardiography exams (FEC) between 1991 and 2014, performed in two tertiary centers. Results. The average maternal age at the time of diagnosis was 32 years. The mean gestational age at the time of diagnosis was 25.9 weeks. The most common indications for FEC were suspicious abnormal cardiac findings in obstetrical screening sonography (50.6%). Among 9,055 examined fetuses, pathological finding on the fetal heart was found in 638 cases. The most common congenital heart diseases were structural anomalies of the fetal heart in 81%, of which 13.3% were fetuses with hypoplastic left heart syndrome and 11.2% with ventricular septal defect. Of all fetuses with diagnosed congenital heart defect, 46.2% were born alive and had good postnatal prognosis, while 2.7% died in utero, and 10.6% died in the early neonatal period. Pregnancy was terminated in 40.4% of fetuses with severe congenital heart defect. Sensitivity of the diagnostic procedure in our study was 95.9%, and specificity was 99.9%. Conclusion. Our study proves that FEC is a reliable, informative diagnostic tool in detecting congenital heart defects with high specificity and sensitivity. With multidisciplinary approach, it provides an optimal time window for improving perinatal outcome.
nema
PDF
