Evaluation of tissue metalloproteinase inhibitor TIMP-1 and Survivin levels during third trimester pregnancy — a preliminary report

Objectives: A proper implantation of trophoblastic cells and an appropriate metalloproteinases activity is required to cause disintegration of basal membranes of cells. The activity of tissue matrix metaloproteinases can be inhibited by their matrix inhibitors — TIMP-s. Survivin is a member of inhibitor of apoptosis proteins family (IAP), that suppresses caspase activation, influences VEGF expression and promotes proliferative action of endothelial cells. Material and methods: The aim of the study was to assess concentrations of two independent anti-apoptotic factors. TIMP-1 and survivin in serum of women in their third trimester of pregnancy and in umbilical cord blood of neonates – drawn separately from veins and arteries. The study group consisted of 29 pregnant women in physiological pregnancy and with correct fetal development, in gestational age between 37 to 40 weeks of gestation. Blood used in the study was collected from maternal cubital fossa veins and from neonatal umbilical cords (from veins and from arteries separately). The research was conducted using TIMP-1 and Survivin ELISA kits from R & D Systems according to manufacturers’ recommendations and protocols. Results: The concentrations of TIMP-1 were similar and independent of the source of blood samples. Arterial values of TIMP-1 in umbilical cord compared to maternal and fetal veins were slightly lower, but no statistical difference was found. The mean concentrations of Survivin were comparable but we found that in some cases the results in cord blood serum in both vessels-vein and arteries were almost negative. Arterial values of Survivin in umbilical cord compared to maternal blood were higher, but no statistical difference was found. Conclusions: In III-rd trimester of pregnancy parameters of Timp-1 and Survivin — anti-apoptotic substances concentration were similar in maternal and cord blood in both artery and vein. We found no increased activity of selected antiapoptotic factors

Evaluation of soluble concentration Fas and Fas ligand in maternal and cord blood 3rd trimester of pregnancy

Objectives: The the study was to estimate the concentrations of antiapoptotic sFas and pro-apoptotic FasL in the serum of pregnant women in the third trimester of pregnancy and in the cord blood serum of neonates from vein and arteries separately. The correlation could be crucial for evaluation of apoptosis process intensity in placenta and the role of fetal blood circulation system on distribution of sFas and FasL. Material and methods: The study group consisted of 28 pregnant women in physiological pregnancy, between 38– 41 weeks. Vein blood was taken from maternal elbow vein and umbilical cord, separately from vein and arteries. The research was done by sets for sFas and FasL from R&D Systems Elisa kit. Results: In arterial and vein cord blood there were much more lower concentrations of sFas than in maternal blood-arterial cord blood 3351.78 pg/mL, vein cord blood 3351.78 pg/mL versus maternal blood 5769.62 pg/mL (p < 0.001). No differ­ence was found in sFas concentrations between cord arterial and vein blood sera. Statistical difference was found between mean concentration of Fas ligand in maternal blood serum (71.36 pg/mL) and arterial cord blood serum (164.57 pg/mL) p < 0.05 (p = 0.001). Cord arterial blood serum showed much higher concentrations of FasL than maternal blood serum. No difference was found between cord arterial and vein blood sera concentrations of FasL: 164.57 pg/mL vs. 170.00 pg/mL (p = 0.701). Conclusions: Obtained results suggest no influence of sFas and FasL production on fetal organism apoptosis. Lowering of sFas concentration in fetal blood could mean the increase of apoptosis in fetal organism compared to maternal. Higher concentration of FasL in cord blood than in mothers suggests higher apoptosis intensification in fetal circulation and no influence of blood flow across placenta on its concentration

Use of alternative methods in the treatment of anemia in pregnant women – prospective observational study

Objectives: Anemia in pregnant women is a common condition, diagnosed when the concentration of hemoglobin falls below 11 g/dL. Taking into consideration the accounts of nephrologists about good results of treatment of secondary anemia using erythropoietin in patients with renal failure, we tried to use EPO to cure anemia in pregnant women.  The aim of the study was to evaluate the results of EPO treatment on pregnant women diagnosed with iron deficiency anemia, as well as possible side effects.  Material and methods: The study consisted of 25 patients: Group I — treated with iron supplement administered parenterally — Ferrum Lek every two days intramuscularly.  Group II — treated with recombinant human erythropoietin — 1000 j intravenously every three days, with oral iron sup- plements.  Results: After a week of treatment the positive response was higher in the second group (92.3% in II, vs 33.3% in I, p < 0.005). The average increase of hemoglobin and RBC was significantly higher in II group.  An increase in hemoglobin did not correlate with the age of women (r = 0.07) or with the duration of pregnancy (r = 0.08). However, a negative correlation was found between basic hemoglobin level and its increase after treatment (r = 0.602).  Conclusions: EPO administered with the oral dose of iron in pregnant women with anemia caused by iron deficiency shows higher effectiveness than the use of iron preparations parenterally.  The usage of EPO during pregnancy is not related to any dangerous side effects for the mother or fetus.

The influence of vitamin C and E use on concentration of endothelin-1 and lipid peroxides in the serum of pregnant women with arterial hypertension

Introduction: Hypertension occurs in 6 to 10 percent of pregnancies. It remains one of the most common disorders in pregnancy and the leading causes of maternal and fetal morbidity. The changes in blood vessel endothelium have impact on the pathogenesis of hypertension and preeclampsia. Aim: The aim of this study was to establish endothelin-1 and lipids peroxides content in blood during hypertension and the influence of vitamin C and E supplementation on the concentration of both parameters. Materials and methods: Two study groups (pregnancy complicated with hypertension, pregnancy complicated with hypertension treated with vitamins C and E) and a control group with uncomplicated pregnancies were distinguished. Blood samples from maternal peripheral venous circulation were collected and ET-1 and lipids peroxides levels were determined from the blood samples. Results: Concentration of endothelin-1 in the group with hypertension and with vitamin supplementation was increased (66.18 ± 26.66 pg/ml) in comparison with normal pregnant (36.50 ± 13.25) and hypertension group (41.02 ± 15.98). The difference was significant. Lipid peroxides concentrations were significantly higher in the group with hypertension (1.18 ± 0.69) in comparison with both groups – controls (0.73 ± 0.35) and the group with hypertension and vitamin supplementation (0.77 ± 0.42). Conclusions: No significant differences in the endothelin-1 level between healthy pregnant and pregnant women with hypertension were found. Vitamin supplementation decreases the concentrations of lipid peroxides

Concentration of selected biochemical parameters in blood of pregnant women infected by HPV 16 and 18

Summary Asymptomatic HPV infection in pregnant women may be connected with changes of pro-inflammatory cytokines and proteolytic enzymes which may condition the persistence of infection during pregnancy. Aim: The main aim of the study was to evaluate the concentration of interleukin-1, TNF-α and α-1 antitrypsin in pregnant women infected by oncogenic types HPV. Materials and method: The study was conducted in 2008-2009 at the Department of Obstetrics and Gynecology, Medical University Lodz, on pregnant women in the third trimester of pregnancy. The study group consisted on 19 pregnant women HPV-16, -18 infected. The control group consisted on 34 pregnant women at the same gestational age, HPV-negative. The concentration of interleukin-1, TNF-α and α-1 antitripsin was estimated in blood. Results: The results of concentration interleukin-1, TNF-α and α-1 antitrypsin were similar in both groups of pregnant women. Conclusions: High risk HPV infection has no influence on the concentration of pro- inflammatory cytokines. In HPV infection during pregnancy the anti proteolytic defense did not decrease

Physiotherapy in obstetrics

Abstract Physical activity during pregnancy, active preparation for the delivery and rehabilitation after delivery are factors that can influence the quality of life of a woman at those stages of life. Treatment and prevention of leg edemas decreases the risk of hospitalization. Kinezytherapy helps pregnant women to prevent obesity and stay in good physical condition. Physiological changes in skeleton and muscle system may be the reason of pain during pregnancy and physiotherapy may effectively prevent it. Preparation for the delivery by physical activity, kinezytheraphy and respiratory exercises increase awareness and help a pregnant woman to participated more actively in the act of the delivery

The course of pregnancy and perinatal period in overweight or obese pregnant women with regard to the condition of the newborn – own experience

Summary Objectives: The aim of the study was to estimate whether obesity and overweight influence the course of a pregnancy and labor and to assess the condition of a newborn. Material and Methods: 92 cases of pregnant women with singleton pregnancy were analyzed and assessed. The patients were divided into three groups according to their body mass index. Women with BMI between 18.5 and 24.9 comprised the first group (controls), those with BMI from 25.0 to 29.9 – the second group (overweight but not obese) and those with BMI of 30 and above – the third one (obese). Results: Average weight gain in the course of a pregnancy was significantly lower in the obese group whereas average blood pressure in obese women was significantly higher than in the control group. Gestational complications, such as hypertension and gestational edemas were more common in the third group. Birth weight and neonatal outcome were similar in all groups. Conclusions: 1. There is a higher risk of complications in pregnancy in overweight and obese women. 2. Obesity of women may worsen the outcome of the neonate

Analysis of delivery types in women after previous cesarean section

Objective: The study was undertaken to analyze the course of pregnancy and delivery in women after previous cesarean section. Material and methods: The study group consisted of 1272 pregnant women after one cesarean section, who delivered at the 1st Department of Gynecology and Obstetrics, Medical University of Lodz between 1st January 2007 and 31st December 2010. Results: Among patients after previous cesarean section, the most numerous group constituted women whose pregnancy was resolved with an elective repeat cesarean section, without the attempt to deliver vaginally – 58,96% whereas the remaining 41,04% of the women were qualified to make an attempt at vaginal delivery. 48,28% of them succeeded to gave birth vaginally and 51,72% underwent repeat cesarean section. Conclusions: Proper qualification of patients after previous caesarean section for a natural vaginal birth allows a successful vaginal delivery. A critical analysis of the indications for surgical delivery needs to be performed in order to lower the rate of cesarean sections

Body mass changes during pregnancy and concentration of insulin and neuropeptide Y in women with regard to the BMI

Summary Introduction: Obesity poses a serious problem to human population as it increases the risk of diabetes, hypertension, metabolic syndrome. In pregnancy, obesity increases the frequency of its complications. Aim: The main aim of the study was to estimate the increase of body mass and insulin and neuropeptide Y concentrations in pregnant women. Material and methods: The changes of body mass and BMI in women before pregnancy and before delivery and the concentrations of insulin and neuropeptide Y in blood were estimated. Results. The increase of body mass and BMI during the pregnancy period was higher in the group with high body mass and I stage obesity and increase of insulin concentration depended on increase of the body mass. Higher concentration of NPY was found in the group of women with normal body mass and obese if compared to stages II and III of obesity. No correlation between insulin increase and concentration of NPY was found. Conclusions: In most pregnant women body mass gain is excessive and leads to obesity of different stages. Insulin concentration increases as BMI increases. Neuropeptide Y concentration in the obese women group was lower than in the normal weight group