Preterm birth prediction in pregnant women over than 35 years. Observational analytical cohort study

Introduction. Premature birth can occur at any age; however, it is important to note that the risk of preterm birth can vary based on several factors, including the mother’s medical history, general health, and lifestyle. There is thought to be a relationship between maternal age and the risk of preterm birth, although the exact nature of this relationship may vary. At the same time, it is considered for ages over 35, an increased risk factor for the evolution of pregnancies with complications. Pregnant women over 35 face a higher risk of premature birth. This increased risk may be associated with age-related factors such as underlying health conditions, higher rates of multiple pregnancies (due to fertility treatments), and potential placental dysfunction. Material and methods. In the given study, the biomarkers IL-6, IL-8, IL-10, IL-12, SDF-1α and VEGF in amniotic fluid (AF) and maternal blood were investigated, considering the above as predictive of premature birth outcome. At the same time, the oxidative stress status of maternal blood and amniotic fluid collected in the second trimester of pregnancy was identified. Results. In the research, we obtained statistically significant increases in the biomarkers AAT-isopropyl, G-GTP, HPL-isopropyl from the amniotic fluid taken from pregnant women over 35 years of age in the second trimester of pregnancy in those pregnant women who had a preterm birth. In the serum of pregnant women with premature birth, an increase in the concentration of carnosine-histidine peptides, G-GTP, GR and SH (thiol) groups was identified, and the decrease in the values of SDF 1α, HPL – hexane and IL-12 were statistically significant in the serum pregnant women compared to that of the amniotic fluid. Identifying the values of biochemical mediators during pregnancy can be a method of predictive diagnosis Conclusions. Our study shows the relationship between some concentrations of oxidative stress biomarkers (AAT-isopropyl, HPL-isopropyl and G-GTP, IL-12) in amniotic fluid, and values of (Carnosine Histidine Peptide, GR and SH and SDF-1α) in the serum of pregnant women, in the second trimester of pregnancy

Особенности течения беременности у жнщин после 35 лет: преимущества и проблемы

Centrul Naţional de Sănătate a Reproducerii şi Genetică MedicalăIn recent years, as in the industrialized world, our country also chose to postpone childbearing. Traditionally, in Republic of Moldova, the delay children were coming from rural families, but in the past decade the rate of urban newborns is increasing. Pregnant women with advanced maternal age have an increased risk of pregnancy complications such as pre-eclampsia, gestational diabetes, placenta abruption, pre-term delivery and caesarean delivery. The maternal management may require a broader assessment of the systematic examination, prevention and diminution of adverse perinatal outcomes that contribute to decisions about the timing of childbearing.За последние годы в Республике Молдова, как и во всех промышленно-развитых странах, деторождение отлаживается «на потом». Зачастую поздние роды встречаются в сельской местности, хотя в последние десятилетия смещение рождений в старших возрастных группах беременных особенно характерно для городского населения. С возрастом растёт риск беременности, осложнённой преэклампсией, гестационным диабетом, отслойкой плаценты, преждевременными родами и кесаревым сечением. При современном уровне развития перинатальной диагностики, профилактики и уменьшения неблагоприятных перинатальных исходов, важен менеджмент правильно выбранной стратегии, способствующий решению проблем и уменьшению рисков детородного возраста

The importance of citokines in prognosis of placenta abruptio in pregnancy over 35

Catedra Obstetrica şi Ginecologie USMF „Nicolae Testemiţanu” Centrul de Sănătate a Reproducerii şi Genetică MedicalăPlacenta abruption (PA) is often accompanied by profuse bleeding, in some cases the onset of hemorrhagic shock and even disseminated intravascular coagulation (DIC). Early diagnosis of this complication and the application of preventive methods in pregnant with compromise prediction would change both the mother and fetus risks. The objective of this study was to investigate the correlation between cytokine levels in fetal amniotic fluid (AF) and maternal blood samples in the second trimester of pregnancy in pregnant women after 35 years which was subsequently certified placenta abruptio. It was found that the onset of placenta abruptio is preceded by a significant increase of IL-12 and VEGF in AF and IL-6 in maternal blood. Decolarea prematură a placentei, adesea este însoţită de hemoragii abundente în unele cazuri cu declanşarea şocului hemoragic şi chiar sindromului CID. Diagnosticul precoce al acestei complicaţii cât şi aplicarea metodelor profilactice la gravidele cu pronostic compromis ar schimba atât riscul matern cât şi cel fetal. Obiectivul studiului dat a fost de a investiga corelaţia dintre nivelul citokinelor în lichidul amniotic (LA) fetal și sângele matern, prelevate în trimestrul II de sarcină la gravide cu vârsta după 35 ani la care ulterior s-a atestat decolarea prematură a placentei. S-a constatat că declanşarea decolării premature a placentei este precedată de creşterea semnificativă ale IL-12 și VEGF în LA şi a IL-6 în sângele matern

The incidence of complications in pregnancy obtained by the IVF method in women over 35 years

Catedra Obstetrica şi Ginecologia USMF „Nicolae Testemiţanu” Centrul de Sănătate a Reproducerii şi Genetică MedicalăThe quality of the IVF (in vitro fertilization) outcome in pregnancy is proportional to the overall condition of the pregnant. Such careful prenatal monitoring and forecast risks in pregnancy could improve the features complications that compromise the evolution of pregnancy in women over 35 age, especially obtained by IVF method. The aim is to assess the incidence of complications in pregnancy obtained by IVF method compared to the control group. Analysing the incidence of complications in pregnancy of 218 subjects, of which 167 with spontaneously conceived pregnancy (group I) and 51 of pregnancy conceived through IVF (group II) we found that both groups shows appropriate similar dynamic of gestation with the exception of mode of delivery by caesarean section where was about 84% in the IVF group vs 23.3% in the control group. Calitatea evoluţiei sarcinii obţinute prin metoda FIV (fertilizării in vitro) este direct proporţională cu starea generală a gestantei. Astfel monitorizarea prenatală minuţioasă şi pronosticul riscurilor în sarcină ar putea ameliora particularităţile complicaţiilor ce compromit o sarcină la gravidele peste 35 de ani, mai cu seamă obţinută prin metoda FIV. Scopul studiului este de a evolua incidenţa complicaţiilor în sarcina obţinută prin metoda FIV în raport cu grupul control. Analizând evoluţia sarcinii şi incidenţa complicaţiilor la 218 gravide, din care 167 cu sarcina concepută spontan (lotul I) şi 51 cu sarcina concepută prin FIV (lotul II) s-a constatat că indiferent de modul de concepere, dinamica sarcinii este aproximativ similară la ambele loturi cu exceptia modalităţii naşterii prin Cezariana care s-a atestat în circa 84% din lotul FIV vs 23,3% din lotul martor

Slow-Release Formulation of Cowpea Mosaic Virus for In Situ Vaccine Delivery to Treat Ovarian Cancer.

The plant viral nanoparticle cowpea mosaic virus (CPMV) is shown to be an effective immunotherapy for ovarian cancer when administered as in situ vaccine weekly, directly into the intraperitoneal (IP) space in mice with disseminated tumors. While the antitumor efficacy is promising, the required frequency of administration may pose challenges for clinical implementation. To overcome this, a slow release formulation is developed. CPMV and polyamidoamine generation 4 dendrimer form aggregates (CPMV-G4) based on electrostatic interactions and as a function of salt concentration, allowing for tailoring of aggregate size and release of CPMV. The antitumor efficacy of a single administration of CPMV-G4 is compared to weekly administration of soluble CPMV in a mouse model of peritoneal ovarian cancer and found to be as effective at reducing disease burden as more frequent administrations of soluble CPMV; a single injection of soluble CPMV, does not significantly slow cancer development. The ability of CPMV-G4 to control tumor growth following a single injection is likely due to the continued presence of CPMV in the IP space leading to prolonged immune stimulation. This enhanced retention of CPMV and its antitumor efficacy demonstrates the potential for viral-dendrimer hybrids to be used for delayed release applications

Пренатальные выявления врождённых аномалий методом инвазивной диагностики в Республике Молдова, риски и преимущество

Centrul Naţional de Sănătate a Reproducerii şi Genetica Medicală (CNSRGM)Background: Early identification of possible risks regarding congenital malformations on fetus, today, has become a common custom in developed societies, and the necessity for prenatal diagnosis simultaneously increases with the advent tendency to have children after age of 35. Material and methods: from 1298 pregnant women included in the study, during the years 2009-2011 were subjected to invasive prenatal diagnosis. Results: in 28 cases were detected chromosomal aberrations in the fetus. However, during that period, 202 newborns were identified with birth defects, and 70% of children with Down syndrome are born at mothers with age after 35 years. Conclusions: Strict compliance with the provisions of the National Prenatal Guidelines, which stated that pregnant after 35 years is group of the risk, would substantially reduce the number of congenital malformations detected postnatally, and although in three years of invasive prenatal diagnosis was attested successive increase request of this manipulation.Актуальность: раннее выявление возможных рисков, связанных с врождёнными пороками развития у плода, сегодня стало общепринятым фактом в развитых странах, а потребность пренатальной диагностике, одновременно, увеличивается с повышением тенденции рождения детей после 35 лет. Материал и методы исследований: 1298 беременных, включённых в исследование, в течение 2009-2011 гг. подверглись инвазивной пренатальной диагностике. Результаты: В 28 случаях были обнаружены хромосомные аберрации у плода. Тем не менее, в течение этого периода, 202 новорожденных были выявлены с врождёнными дефектами, и 70% детей с синдромом Дауна рождённые от матерей в возрасте старше 35 лет. Заключение: Строгое соблюдение соответствий положения «Национального Перинатального Руководителя», в котором специфицируется, что беременная после 35 лет входит в группу риска, позволит существенно уменьшить количество врождённых пороков обнаруженных после рождения, не смотря на то, что в течении трёх лет был выявлен последовательный рост потребности в инвазивной пренатальной диагностике

Прогностическая роль уровня цитокинов амниотической жидкости плода и крови матери в вероятности развития гестационной гипертензии

Pregnancy induced hypertension, which includes both gestational hypertension (GH) and preeclampsia, is the most common medical disorder and remains one of the major causes of maternal and fetal death. The pathogenesis of GH is still unknown, yet immunologic and inflammatory causes may play an important role in the pathophysiology of this disease. The purpose of this study is to investigate the midtrimester IL-6, IL-8, IL-10, IL-12, TNF-α, SDF-1a and VEGF in the amniotic fluid (AF) and maternal blood regarding the above as being predictive for the gestational hypertension outcome. In the group of 128 pregnant women over 35 years old the six ones have developed GH. Our study results demonstrate that GH is associated with a strong increase of IL-6, IL-12 in maternal blood and a significant decrease of serum IL-10. Although AF level of both IL-6 and IL-10 has been significantly lower in GH subjects. In conclusion this study shows the relationship between the midtrimester IL-6, IL-12 and IL-10 concentrations in AF and maternal serum and GH outcome.Артериальная гипертензия при беременности, включающая в себя гестационную гипертензию и преэклампсию, является наиболее частым из осложнений беременности и остаётся одной из основных причин материнской смертности и гибели плода. Патогенез гестационной гипертензии до сих пор полностью не изучен, однако иммунологические и воспалительные факторы могут играть важную роль в патофизиологии этого заболевания. Целью данного исследования является изучение в период второго триместра беременности соотношения концентраций IL-6, IL-8, IL-10, IL-12, TNF-α, SDF-1a и VEGF в амниотической жидкости плода и материнской сыворотке крови и их связь с последующим развитием гестационной гипертензии. В группе из 128 беременных в возрасте старше 35 лет, в шести случаях выявлено развитие гестационной гипертензии. Полученные результаты определили, что наличие гестационной гипертензии связано с существенным увеличением концентрации сывороточного IL-6 и IL-12 и одновременным снижением IL-10 в крови матери, при том, что в амниотической жидкости выявлено существенное снижение как IL-10, так и IL-6. В заключении данное исследование доказывает связь между уровнями IL-6, IL-10 и IL-12 в амниотической жидкости плода и крови матери, выявленными во втором триместре беременности, и последующим развитием гестационной гипертензии

Aplicarea metodelor invazive în diagnosticul prenatal: retrospectiva rezultatelor pe anii 2009-2011

Indentifi carea precoce a posibilelor riscuri în ceea ce privesc malformaţiile congenitale ale fătului, astăzi, a devenit un obicei comun în societăţile dezvoltate, iar necesitatea unui diagnostic prenatal veridic, creşte odată cu apariţia tendinţei de a avea copil la vârsta după 35 de ani. Din 1298 gravide incluse în studiu, care pe parcursul anilor 2009-2011 au fost supuse diagnosticului prenatal invaziv, în 28 cazuri au fost depistate aberaţii cromozomiale la făt. Totodată, în perioada respectivă, au fost depistaţi 202 nounăscuţi cu malformaţii congenitale, iar circa 70% copii cu sindromul Down s-au născut de la mame cu vârsta după 35 de ani. Respectarea cu stricteţe a prevederilor Ghidului Naţional de Perinatologie, unde este specificat că gravida după 35 de ani face parte din grupul de risc, ar reduce substanţial de numărul malformaţiilor congenitale depistate postnatal, cu toate că în curs de trei ani s-a atestat o creştere succesivă a solicitării diagnosticului prenatal invaziv

Incidence of age-dependent chromosomal abnormalities, pre and postnatal diagnosis in the Republic of Moldova

Centrul Naţional de Sănătate a Reproducerii şi Genetică MedicalăWith advanced age of the pregnant woman, the risk of pregnancy evolution and appearance of genetic malformations increases. It is therefore important to make earlier a genetic consultation as an effective and in time complex prenatal diagnosis. This study was intended for coverage of the risk of advanced age of mother in connection with pre-and postnatal data dianostics in Republic of Moldova over three years. Cu vârsta avansată a gravidei, riscul evoluţiei unei sarcini şi apariţia malformaţiilor genetice creşte. În acest context, este important de a efectua un consult genetic precoce cât şi un diagnostic prenatal complex efectiv şi la timp. Studiul dat a fost destinat mediatizării riscului unei vârste înaintate a mamei în corelare cu datele dianosticului pre şi postnatal în Republica Moldova, pe parcursul a trei ani

Platelet aggregation induced by polystyrene and platinum nanoparticles is dependent on surface area

Nanoparticles are key components underlying recent technological advances in various industrial and medical fields, and thus understanding their mode of interaction with biological systems is essential. However, while several nanoparticle systems have been shown to interact with blood platelets, many questions remain concerning the mechanisms of platelet activation and the role that the physicochemical properties of nanoparticles play in inducing platelet aggregation. Here, using negatively charged polystyrene nanoparticles with sizes of 25, 50, 119, 151, 201 nm and negatively charged platinum nanoparticles with sizes of 7 and 73 nm, we show that it is not the size of the nanoparticles but rather the nanoparticle surface area that is critical in mediating the effects on platelet activation. The nanoparticles stimulate platelet aggregation through passive (agglutination) and activation of integrin αIIbβ3 through a pathway regulated by Src and Syk tyrosine kinase