The differential expression of Kiss1, MMP9 and angiogenic regulators across the feto-maternal interface of healthy human pregnancies:implications for trophoblast invasion and vessel development

Genes involved in invasion of trophoblast cells and angiogenesis are crucial in determining pregnancy outcome. We therefore studied expression profiles of these genes in both fetal and maternal tissues to enhance our understanding of feto-maternal dialogue. We investigated the expression of genes involved in trophoblast invasion, namely Kiss1, Kiss1 Receptor (Kiss1R) and MMP9 as well as the expression of angiogenic ligands Vascular Endothelial Growth Factor-A ( VEGF-A) and Prokineticin-1 ( PROK1 ) and their respective receptors (VEGFR1, VEGFR2 and PROK1R ) across the feto-maternal interface of healthy human pregnancies. The placenta, placental bed and decidua parietalis were sampled at elective caesarean delivery. Real-time RT-PCR was used to investigate transcription, while immunohistochemistry and western blot analyses were utilized to study protein expression. We found that the expression of Kiss1 (p<0.001), Kiss1R (p<0.05) and MMP9 (p<0.01) were higher in the placenta compared to the placental bed and decidua parietalis. In contrast, the expression of VEGF-A was highest in the placental bed ( p<0.001 ). While VEGFR1 expression was highest in the placenta (p<0.01), the expression of VEGFR2 was highest in the placental bed (p<0.001). Lastly, both PROK1 (p<0.001) and its receptor PROK1R (p<0.001) had highest expression in the placenta. Genes associated with trophoblast invasion were highly expressed in the placenta which could suggest that the influence on invasion capacity may largely be exercised at the fetal level. Furthermore, our findings on angiogenic gene expression profiles suggest that angiogenesis may be regulated by two distinct pathways with the PROK1/PROK1R system specifically mediating angiogenesis in the fetus and VEGFA/VEGFR2 ligand-receptor pair predominantly mediating maternal angiogenesis

ARCHIVES OF GYNECOLOGY AND OBSTETRICS

Objective The study was designed to determine the protein levels of vascular endothelial growth factor (VEGF) in the placenta biopsies of patients with preeclampsia and compare with normal controls. Design Prospective cohort study. Methods The placental biopsies were obtained from ten patients with preeclampsia and ten patients of control group at the time of delivery. Avidin-biotin-peroxidase immunohistochemistry was then performed to identify levels of VEGF protein within the tissue and a semi-quantitative method was devised to score the amount of staining present in the sample. Two histopathologists who were blinded to the groups were asked to score each sample for the intensity of staining and the number of cells stained in a randomly selected per high-power fields of each sample. The resulting H-score was computed as a product of intensity and percent of cells stained. Results The VEGF expression was significantly higher in placenta biopsies of preeclamptic patients compared to that of controls (271.2 +/- 22.65 vs. 201.9 +/- 12.33, P = 0.000). Conclusion Immunostaining of VEGF is significantly higher in placenta biopsies of patients with preeclampsia

Nucleated red blood cells in infants of women with preterm labor and pre-eclampsia

WOS: 000231188000011PubMed ID: 1595826

Elektif sezaryenlerde farklı anestezi yöntemlerinin yenidoğan üzerine etkileri: Retrospektif çalışma

Aim: Although there were several studies evaluating the effects of anesthetic techniques on fetuses during anesthesia for cesarean section, researches are still going on. In this study, we evaluated the effects of different anesthetic techniques on the fetuses in Ege University Hospital, retrospectivelly. Material and Methods: The study population consisted 157 women scheduled for elective cesarean section in our hospital at a period of six months between the years 2007-2008. Medical records of 157 women who were ASA 1 were evaluated. Medical records including demographic variables, hemoglobine concentrations, time interval between skin incision and delivery, Apgar scores, umbilical cord gas analyses, balloon- valve mask, entubation and needs for intensive care unit were recorded. Results: Spinal, epidural and general anesthesia were performed 63 (40.1%), 59 (37.6%) and, 35 women (22.3%), consequently. There were no differences between the groups according to the demographic datas, preoperative hemoglobin concentrations and gestational weeks. Time interval between skin incision and delivery was lower in general anesthesia group. While five minute Apgar scores were similar in both groups, 1 minute Apgar scores were significantly lower in general anesthesia group. There was no significant difference between the groups according to umbilical cord gas analyses, the number of newborns neccesiating entubation and neonatal intensive care unit. The number of newborns necessiating balloon- valve mask was higher in general anesthesia group. Conclusion: For elective cesarean section, although it was concluded that three anesthetic techniques had no advantages to each other in late period, for the pregnancies that fetuses were under risk, the choice of regional anesthesia was more convinience.Amaç: Sezaryende kullanılan anestezi yöntemlerinin yenidoğan üzerine olan etkileri ile ilgili yapılan bir çok çalışmaya rağmen araştırmalar halen devam etmektedir. Çalışmamızda, hastanemizde rutin sezaryen uygulamalarında kullanılan farklı anestezi tekniklerinin fetüs üzerine olan etkilerini retrospektif olarak inceledik. Yöntem ve Gereç: Ege Üniversitesi Tıp Fakültesi Hastanesi Kadın hastalıkları ve Doğum kliniğinde, 2007-2008 yılları arası 6 aylık dönemde primipar, ?38 haftalık, tek gebeliği olan, elektif sezaryen uygulanan, ASA I sınıfına dahil 157 kadın retrospektif olarak incelendi. Demografik veriler, hemoglobin değerleri, cilt insizyonu-bebek çıkış zamanı, yenidoğanın Apgar skorları, umblikal kord arter-ven kan gazı değerleri, balon-valv-maske, entübasyon ve ilk 24 saat içindeki yoğun bakım gereksinimler kaydedildi. Bulgular: 157 olgunun %40.1'ne (n:63) spinal anestezi, %22.3'ne (n:35) genel anestezi ve %37.6'na (n:59) epidural anestezi uygulandığı görüldü. Demografik veriler, preoperatif hemoglobin değerleri ve gebelik haftaları açısından gruplar arasında fark saptanmazken, insizyon-bebek çıkış zamanı genel anestezi grubunda daha kısa bulundu. 5. dk Apgar skorları açısından gruplar benzer, 1. dk Apgar skoru ise genel anestezi grubunda anlamlı olarak düşüktü. Umblikal arter-ven kan gazı değerleri açısında gruplar arasında anlamlı bir farklılık yoktu. Doğum sonrası balon-valv-maske gereksinimi olan yenidoğan sayısı genel anestezi grubunda daha yüksek bulunurken, entübasyon ve yoğun bakım gereksinimleri açısından fark saptanmadı. Sonuç: Elektif sezaryenlerde üç anestezi yönteminin de geç dönemde birbirlerine üstünlükleri olmadığı, ancak fetal açıdan riskli gebelerde rejyonal yöntemlerin tercih edilmesinin daha uygun olacağı kanısına varıldı

High-output cardiac failure in a fetus with thanatophoric dysplasia associated with large placental chorioangioma: Case report

PubMed ID: 22508320Placental chorioangioma is an angioma arising from chorionic tissue. Fetal thanatophoric dysplasia is a lethal skeletal dysplasia due to mutation of fibroblast growth factor receptor 3 gene. These two conditions are rare and their coexistence in a given fetus is even rarer. We present a case of a fetus with thanatophoric dysplasia having high-output cardiac failure due to a large placental chorioangioma. © 2011 Wiley Periodicals, Inc

Çoklu fetal anomali (OEIS kompleksi)

OEIS complex (omphalocele, exstrophy, imperforate anus, spinal defects) is a combination of anomalies with unknown etiology. It was first described by Carey and colleagues in 1978. The condition is also known as exstrophy of the cloaca (EC) and seen in about 1/200.000 to 400.000 pregnancies. The case we present here was 30 year old women with a fetus at 16-17 weeks of gestation, gravida 3, parity 0. The woman was informed of the diagnosis of multiple fetal anomaly. Detailed ultrasonography revealed 23 mm size omphalocele which included the liver and above the omphalosel sac there was a cord cyst, bilateral pes equinovarus and thoracal vertebral angulation was also present. The bladder could not be visualised. QF PCR (Polymeraz chain reaction) and chorion villus biopsy revealed 46 XY normal karyotype. The option of termination was offered to family and pregnancy was terminated. Our case did not include all the components of the OEIS complex but it can be evaluated as OEIS complex because it included some of the structural deformities seen in the OEIS complex. We considered our case to be within the parameters of the OEIS complex.OEIS kompleksi (omfalosel, mesane ekstrofisi, anüs imperforatus ve spina bifida) etiyolojisi net bilinmeyen anomaliler bütünüdür. İlk kez 1978 yılında Carey ve arkadaşları tarafından tanımlanmıştır. Bu durum kloaka ekstrofisi olarak da adlandırılır ve 200.000-400.000 doğumda bir görülür. Birçok olguda sporadik olarak oluşsa da, genetik anomaliler nedeniyle de oluşabilmektedir. Burada sunduğumuz olgu, 30 yaşında 16-17 hafta gravida 3 parite 0, dış merkezden çoklu fetal anomali tanısı ile kliniğimize başvurmuştur. Kliniğimizde yapılan ayrıntılı ultrasonografisinde, haftası ile uyumlu bir fetus ve fetal batın ön duvarında yaklaşık olarak 23 mm boyutunda, içerisinde karaciğerin izlendiği omfalosel hali, omfalosel kesesinin üst kısmında kordon kisti, fetal ayaklarda bilateral pes ekinovarus ve torakal vertebral bölgede angulasyon izlendi. Mesane görüntülenemedi. Olgunun QF polimeraz zincir reaksiyonu (PCR) ve koryon villus biopsisinin kültür sonuçları 46 XY normal olarak saptandı. Hastaya terminasyon seçeneği önerildi ve gebelik termine edildi. Olgumuz OEIS kompleksinin tüm anomalilerini bulundurmamaktadır ancak bazı bulgularını içermesi nedeniyle OEIS kompleksi içerisinde değerlendirilmiştir