30 research outputs found
Perinatal Changes of Cardiac Troponin-I in Normal and Intrauterine Growth-Restricted Pregnancies
Intrauterine growth restriction (IUGR) implies fetal hypoxia, resulting in blood flow redistribution and sparing of vital organs
(brain, heart). Serum cardiac Troponin-I (cTnI), a well-established marker of myocardial ischaemia, was measured in 40 mothers
prior to delivery, the doubly clamped umbilical cords (representing fetal state), and their 20 IUGR and 20 appropriate-forgestational-age (AGA) neonates on day 1 and 4 postpartum. At all time points, no differences in cTnI levels were observed between
the AGA and IUGR groups. Strong positive correlations were documented between maternal and fetal/neonatal values (r ≥ .498,
P ≤ .025 in all cases in the AGA and r ≥ .615,
P ≤ .009 in all cases in the IUGR group). These results may indicate (a) normal
heart function, due to heart sparing, in the IUGR group (b) potential crossing of the placental barrier by cTnI in both groups
Investigation of Midtrimester Amniotic Fluid Factors as Potential Predictors of Term and Preterm Deliveries
Aims. Our aim is to investigate, in 13 cases (delivering preterm) and 21 matched (for age, parity, and gestational age) controls (delivering at term), whether midtrimester amniotic fluid concentrations of elastase, secretory leukocyte proteinase inhibitor (SLPI), soluble intercellular adhesion molecule-1, and soluble vascular cell adhesion molecule predict asymptomatic intra-amniotic inflammation/infection and preterm labor. Results. Concentrations of all substances were not statistically different among mothers, delivering preterm or at term. SLPI concentrations significantly increased in women, going into labor without ruptured membranes, irrespective of pre- or term delivery (P < .007, P < .001, resp) and correlated with elastase (r = 0.508, P < .002). Conclusions. Midtrimester amniotic fluid SLPI concentrations significantly decrease when membrane rupture precedes pre- or full-term labor. However, none of the investigated substances predict preterm delivery
Circulating Levels of Inflammatory Markers in Intrauterine Growth Restriction
We aimed to investigate possible alterations in circulating levels of the perinatal stress markers high sensitivity (hs)-CRP, PAI-1, and S100B—probably reflecting brain and adipose tissue inflammation—in intrauterine growth-restricted-(IUGR) and appropriate-for-gestational-age-(AGA) pregnancies, given that these groups differ in fat mass and metabolic mechanisms involving aseptic inflammation. Serum hs-CRP, PAI-1, and S100B levels were measured in 40 mothers, and their 20 AGA and 20 IUGR full-term fetuses and neonates on postnatal days 1 and 4. hs-CRP, PAI-1, and S100B levels did not differ at all time points between AGA and IUGR groups. We conclude that the lack of difference in hs-CRP, PAI-1 and S100B levels, between IUGR and AGA fetuses/neonates—despite the lower birth weight, reflecting reduced fat mass in the former—might indicate more intense adipose tissue and nervous system inflammation in IUGRs. However, implication of other inflammation-related mechanisms, common in the IUGR state (e.g. preeclampsia), cannot be excluded
Cord Blood Ischemia-Modified Albumin Levels in Normal and Intrauterine Growth Restricted Pregnancies
Ischemia-modified albumin (IMA) is a sensitive biomarker of cardiac
ischemia. Intrauterine growth restriction (IUGR) may imply fetal hypoxia,
resulting in blood flow centralization in favour of vital organs (brain, heart,
adrenals—“brain sparing effect”). Based on the latter, we
hypothesized that cord blood IMA levels should not differ between IUGR and
appropriate-for-gestational-age (AGA) full-term pregnancies. IMA was measured
in blood samples from doubly-clamped umbilical cords of 110 AGA and 57
asymmetric IUGR pregnancies. No significant differences in IMA levels
were documented between AGA and IUGR groups. IMA levels were elevated in
cases of elective cesarean section (P = .035), and offspring of
multigravidas (P = .021). In conclusion, “brain
sparing effect” is possibly responsible for the lack of differences in
cord blood IMA levels at term, between IUGR and AGA groups. Furthermore, higher
oxidative stress could account for the elevated IMA levels in cases of elective
cesarean section, and offspring of multigravidas
Circulating Osteoprotegerin and sRANKL Concentrations in the Perinatal Period at Term The Impact of Intrauterine Growth Restriction
Background: Intrauterine growth restriction (IUGR) has been associated
with low bone mass in infancy and increased risk for osteoporosis
development in adult life. Osteoprotegerin (OPG) and receptor activator
of nuclear factor-kappa B ligand (RANKL) are main determinants of bone
resorption. Objectives: To investigate OPG and soluble RANKL (sRANKL)
concentrations in maternal, fetal and neonatal serum of IUGR patients
and appropriate for gestational age (AGA) pregnancies. Additionally,
plasma intact parathormone (PTH) concentrations were evaluated. Methods:
Circulating OPG, sRANKL and PTH concentrations were measured in 40
mothers and their singleton full-term fetuses-neonates (AGA: n = 20, and
IUGR: n = 20) on postnatal days 1 (N1) and 4 (N4). Results: No
significant differences in OPG, sRANKL or PTH concentrations were
observed between AGA and IUGR groups. In both groups, maternal OPG
concentrations were elevated compared with fetal, and N1 and N4
concentrations (p <= 0.045 in all cases). N4 sRANKL concentrations were
elevated compared with maternal, fetal and N1 ones (p <= 0.01 in all
cases). Fetal and N1 sRANKL concentrations correlated positively with
PTH levels (r = 0.642, p = 0.024 and r = 0.584, p = 0.046,
respectively). Conclusions: The lack of a difference in circulating OPG,
sRANKL or PTH concentrations between IUGR cases and AGA controls
suggests that the low bone mass of IUGR infants may not be related to
higher bone resorption rates. The increased maternal, compared with
fetal/neonatal, OPG concentrations may suggest their placental origin.
The lower OPG and higher sRANKL concentrations in fetuses and neonates
could represent high bone resorption rates. Copyright (C) 2009 S. Karger
AG, Base
Perinatal changes of plasma resistin concentrations in pregnancies with normal and restricted fetal growth
Background: The adipocytokine resistin inhibits adipogenesis and induces
insulin resistance. Intrauterine growth-restricted (IUGR) neonates have
reduced fat mass and changes of endocrine/metabolic mechanisms,
predisposing to insulin resistance and metabolic syndrome in adult life.
Objectives: To investigate plasma resistin concentrations in maternal,
fetal and neonatal samples from IUGR and appropriate-for-gestational-age
(AGA) pregnancies and correlate them with respective insulin
concentrations. Methods: Plasma resistin and insulin concentrations were
determined in 40 mothers and their 20 IUGR and 20 AGA singleton
full-term fetuses and neonates on postnatal day 1 (N1) and day 4 (N4).
Results: No significant differences in resistin concentrations were
observed between AGA and IUGR groups. In the AGA group, maternal
resistin concentrations were significantly lower compared to fetal, N1
and N4 ones (p = 0.003, p = 0.017 and p = 0.039, respectively). Maternal
resistin concentrations positively correlated with fetal ones (r =
0.527, p = 0.02). In the IUGR group, maternal resistin concentrations
were significantly lower compared to N1 (p < 0.001) and positively
correlated with N4 concentrations (r = 0.626, p = 0.007). In both
groups, the effect of gender, mode of delivery, parity and adjusted
birth weight (customized centiles) on resistin concentrations was not
significant. No correlation between resistin and insulin concentrations
was documented. Conclusions: Lack of difference in resistin
concentrations between IUGR and AGA groups, and lack of correlation
between resistin and insulin concentrations as well as customized
centiles, possibly suggests that resistin may not be directly involved
in the regulation of insulin sensitivity and adipogenesis in the
perinatal period. Mode of delivery and parity are not associated with
circulating resistin concentrations. Copyright (C) 2007 S. Karger AG,
Basel
Endometrioid adenocarcinoma arising from colon endometriosis
Endometriosis-associated intestinal tumors represent the malignant transformation of gastrointestinal endometriosis. Approximately 50 cases have been reported in the literature. They are most commonly found among women aged 30–60 years, whereas exogenous hormone therapy and obesity are primary risk factors for the malignant transformation of endometriotic lesions. Clinical features simulate a primary colonic carcinoma. A high index of suspicion in conjunction with careful histological and immunohistochemical examination (CK7, CK20, CDX2, CD10, ER, and PR) is important for establishing a correct diagnosis. In this article, a rare case of a postmenopausal woman with no risk factors and conflicting clinical presentation, diagnosed with endometriosis-associated intestinal tumor, is described
Cord blood galectin-1 and-3 concentrations in term pregnancies with normal restricted and increased fetal growth
Objective: To determine levels of galectins (gal)-1 and -3 (implicated
in angiogenesis/immunologic mechanisms) in intrauterine growth
restricted (IUGR), large (LGA) and appropriate for gestational age (AGA)
pregnancies, as these groups differ in fat mass, angiogenic patterns and
immune responses.
Methods: Cord-blood (UC) gal-1 and -3 concentrations were measured in 30
IUGR, 30 LGA and 20 AGA singleton full-term infants and their mothers
(MS).
Results: IUGR, LGA and AGA groups did not differ in gal-1 and -3
concentrations. UC gal-1 levels were lower when mothers were older [b=
-0.651, CI 95% -1.186 (-0.116), P = 0.018] and UC gal-3 levels were
increased when mothers presented gestational diabetes [b=9.836, CI
95% 3.833- (15.839), P=0.002]. In IUGRs MS gal-3 and in LGAs UC gal-1
were decreased in multiparas [b = -5.372, CI 95% -9.584- (-1.161),
P=0.014], and [b=-7.540, CI 95% -14.606- (-0.473), P=0.037],
respectively. No correlations were found between MS or UC gal-1 and
gal-3 concentrations.
Conclusions: Lower UC gal-1 levels, when mothers were older, and
increased UC gal-3 levels in cases of gestational diabetes, possibly
reflect angiogenic activity. In multiparas, decreased MS gal-3 and UC
gal-1 levels in IUGR/LGA, respectively, might imply inflammatory
response against immunosuppression expected in subsequent pregnancies,
as compared to the first one
Perinatal collagen turnover markers in intrauterine growth restriction
Objective: To investigate bone and connective tissue collagen turnover
in intrauterine growth restricted (IUGR) pregnancies, by determining
circulating markers of type I collagen synthesis (carboxy-terminal
propeptide of type I procollagen [PICP], representing bone formation)
and degradation (cross-linked telopeptide of type I collagen [ICTP],
representing bone resorption) as well as type III collagen synthesis
(N-terminal propeptide of type-III procollagen [PIIINP], reflecting
growth and tissue maturity). Methods: Plasma PICP, ICTP and PIIINP
concentrations were measured in 40 mothers and their 20 asymmetric IUGR
and 20 appropriate for gestational age (AGA) full-term fetuses and
neonates on postnatal day 1-(N1) and 4-(N4). Results: Fetal PICP, fetal
and N4 ICTP, as well as fetal, N1 and N4 PIIINP concentrations were
higher in the IUGR group (p <= 0.038, in all cases). In both groups,
maternal PICP, ICTP and PIIINP concentrations were lower than fetal, N1
and N4 ones (p < 0.001, in each case). Conclusions: Type I collagen
turnover is enhanced in IUGR than AGA fetuses/neonates. Similarly,
fetal/neonatal PIIINP concentrations are elevated in IUGR, probably due
to stress, responsible for induction of tissue maturation, and/or to
impaired excretory renal function, leading to reduced protein clearance.
Fetal/neonatal PICP, ICTP and PIIINP concentrations are higher than
maternal concentrations, possibly reflecting increased skeletal growth
and collagen turnover in the former
Endometrioid adenocarcinoma arising from colon endometriosis
Endometriosis-associated intestinal tumors represent the malignant
transformation of gastrointestinal endometriosis. Approximately 50 cases
have been reported in the literature. They are most commonly found among
women aged 3060 years, whereas exogenous hormone therapy and obesity are
primary risk factors for the malignant transformation of endometriotic
lesions. Clinical features simulate a primary colonic carcinoma. A high
index of suspicion in conjunction with careful histological and
immunohistochemical examination (CK7, CK20, CDX2, CD10, ER, and PR) is
important for establishing a correct diagnosis. In this article, a rare
case of a postmenopausal woman with no risk factors and conflicting
clinical presentation, diagnosed with endometriosis-associated
intestinal tumor, is described