Placental thrombomodulin expression in recurrent miscarriage

<p>Abstract</p> <p>Background</p> <p>Early pregnancy loss can be associated with trophoblast insufficiency and coagulation defects. Thrombomodulin is an endothelial-associated anticoagulant protein involved in the control of hemostasis and inflammation at the vascular beds and it's also a cofactor of the protein C anticoagulant pathway.</p> <p>Discussion</p> <p>We evaluate the Thrombomodulin expression in placental tissue from spontaneous recurrent miscarriage and voluntary abortion as controls. Thrombomodulin mRNA was determined using real-time quantitative polymerase chain reaction. Reduced expression levels of thrombomodulin were found in recurrent miscarriage group compared to controls (1.82-fold of reduction), that corresponds to a reduction of 45% (from control group Delta CT) of thrombomodulin expression in spontaneous miscarriage group respect the control groups.</p> <p>Summary</p> <p>We cannot state at present the exact meaning of a reduced expression of Thrombomodulin in placental tissue. Further studies are needed to elucidate the biological pathway of this important factor in the physiopathology of the trophoblast and in reproductive biology.</p

Diabetes during Pregnancy: A Transgenerational Challenge

: For many years, gestational diabetes mellitus (GDM) has been defined as "a glucose intolerance of variable magnitude that begins or is first diagnosed in pregnancy" and that, in most cases, resolves after delivery [...]

Cesarean Section Revealing an Unsuspected Renal Angiomyolipoma in a Woman with Severe Hypertension During Pregnancy: A Case Report

Renal angiomyolipomas are uncommon during pregnancy, but it is important to consider them in the differential diagnosis, for the increased risk of complications such as bleeding, renal artery compression, and renovascular hypertension

Management of fibroids in perimenopausal women

PURPOSE OF REVIEW: This article reviews fibroids management in the perimenopausal period, and addresses future directions in care. RECENT FINDINGS: Aromatase inhibitors, selective estrogen receptor modulators and antiprogestogens for medical management and minimally surgical techniques are promising treatments. SUMMARY: The disease and the symptoms may persist in the peri and postmenopausal periods. The assumption that they will resolve with the onset of the menopause is too simplistic and not always valid. The number of perimenopausal women who wish to retain their uterus for reasons other than childbearing is increasing. The accurate diagnosis of these conditions may result in minor surgical or medical treatments being directed at the specific pathology and may avoid the need for major surger

Maternal Inherited Thrombophilia in Monochorionic Twin Pregnancy with Twin-Twin Transfusion Syndrome

Background: To study the frequency of inherited thrombophilia in monochorionic twin pregnancies with twin-twin transfusion syndrome (TTTS). Methods: At the Department of Obstetrics of the Polytechnic University of Marche (Ancona, Italy) a population of monochorionic diamniotic pregnant women was selected retrospectively. After termination of the pregnancy, genotyping for Factor I, Factor V Leiden, Factor II and Methylenetetrahydrofolate Reductase (MTHFR), as well as activities of the plasma proteins C and S, was performed. Results: Regarding the 32 patients with TTTS, from a cohort of 104 monochorionic pregnancies recruited, at least one thrombophilic defect was more frequent (OR: 3.24), and the allele polymorphism frequency was higher for Factor I (OR: 4.4) and for Factor V Leiden (OR: 11.66). Conclusions: Maternal inherited thrombophilia, possibly also inherited from monochorial fetuses, may result in impaired development of the placental vascular architecture. This inheritance hypothesis may explain why only a fraction of monochorionic diamniotic twins develop TTTS

Maternal Inherited Thrombophilia in Monochorionic Twin Pregnancy with Twin-Twin Transfusion Syndrome

Background: To study the frequency of inherited thrombophilia in monochorionic twin pregnancies with twin-twin transfusion syndrome (TTTS). Methods: At the Department of Obstetrics of the Polytechnic University of Marche (Ancona, Italy) a population of monochorionic diamniotic pregnant women was selected retrospectively. After termination of the pregnancy, genotyping for Factor I, Factor V Leiden, Factor II and Methylenetetrahydrofolate Reductase (MTHFR), as well as activities of the plasma proteins C and S, was performed. Results: Regarding the 32 patients with TTTS, from a cohort of 104 monochorionic pregnancies recruited, at least one thrombophilic defect was more frequent (OR: 3.24), and the allele polymorphism frequency was higher for Factor I (OR: 4.4) and for Factor V Leiden (OR: 11.66). Conclusions: Maternal inherited thrombophilia, possibly also inherited from monochorial fetuses, may result in impaired development of the placental vascular architecture. This inheritance hypothesis may explain why only a fraction of monochorionic diamniotic twins develop TTTS

[310-POS]: Potential role of Klotho protein in the pathophysiology of preeclampsia

OBJECTIVES: An aging-suppressor gene, klotho, is a candidate factor for vascular disease because its deficiency leads to impaired endothelium-dependent vasodilation and impaired angiogenesis. The aim was to verify a possible relation among the expression of the klotho gene, single nucleotide polymorphisms (SNP) in the promoter region, and placenta aging. METHODS: Placentas were collected from normal pregnancies (n=34) and pregnancies complicated by Preeclampsia (n=34), matched for gestational age. Klotho mRNA and protein were determined using Real-Time PCR and Western blot, respectively. SNPs (i.e.: -744delA, and -395A/G) were investigated using allele-specific PCR. Expression of pluripotency markers (i.e.: Nanog, and Oct-4) and telomere length measurement were assessed using Real-Time PCR. RESULTS: Real-Time PCR analyses demonstrated a significant down-regulation of Klotho ( 83%; p=0.005) in patients with Preeclampsia versus Controls. Results of Western Blot agreed with Real-Time PCR ones. Polymorphism analysis results suggest that -744delA allele is associated with 3-fold increased risk for preeclampsia. Real-Time PCR investigation revealed a significant down-regulation of pluripotency markers in pathological group. CONCLUSIONS: Klotho expression is decreased in preeclamptic pregnancies. Further data are required to confirm the role of this protein in pathophysiology of preeclampsia and the possible link to long term outcomes

Placental Alpha Hemoglobin Stabilizing Protein (AHSP) and recurrent miscarriage

AHSP inhibits cellular production of the reactive oxygen species. Reduced AHSP indicates reduced protection against oxidative stressors. Our objective was to investigate AHSP levels in recurrent miscarriage (RM). Trophoblast was collected from women of 10 weeks gestation: voluntary abortion controls (VA, n = 10); spontaneous first miscarriage with subsequent normal pregnancy (SMSN, n = 15) or with subsequent miscarriage (SMSM, n = 5); RM previously investigated (RMPS, n = 5) or not previously investigated (RM, n = 5). AHSP mRNA and protein were determined using real-time quantitative polymerase chain reaction (PCR) and Western blot, respectively. One-way ANOVA was performed to assess statistical significance (p < 0.05). ahsp mRNA levels were maximally reduced in RM and RMPS (8.0 × 10−6 ± 1.3 and 8.1 × 10−6 ± 0.7, respectively) compared with SMSN and VA (16.1 × 10−6 ± 2.3 and 26.1 × 10−6 ± 2.7, respectively). SMSM showed levels significantly reduced as well (9.0 × 10−6 ± 2.3). In RM, a reduced defense from oxidative stressors is evident at first miscarriage, identifying women at high risk for subsequent eventful pregnancy. Reduced AHSP may identify women at risk of experiencing further miscarriages