EVALUATION OF CAFFEINE CONSUMPTION AND EFFECT DURING PREGNANCY AMONG WOMEN IN THE UAE

Objective: To investigate the relationship between caffeine consumption among pregnant women in the UAE and spontaneous abortion and stillbirth.Methods: A retrospective cross-sectional survey has been conducted on 97 pregnant ladies randomly selected from Al Ain city in the UAE. Only pregnant women with caffeine intake were included in the study.Results: The results showed that: 61.9% of women consumed coffee, 34% consumed tea, and 4.1% consumed soft drinks during pregnancy. 43% of women who consumed caffeine during pregnancy had at least one spontaneous abortion, 10.3% suffered from stillbirth and 17.5% gave birth to underweight babies. Cross tabulation between spontaneous abortion and caffeine consumption did not show high significance using Pearson Chi-Square for correlation (p-value 0.103), The likelihood ratio shows significant results (p-value 0.039).Conclusion: Providing comprehensive counselling for pregnant women is essential in order to prevent the negative impact of caffeine consumption.Keywords: Caffeine, Pregnant, Abortion, Miscarriag

Comparison of maternal and fetal blood levels of caffeine and its metabolite. A pilot study

Objective: The aim of the study was to compare caffeine and paraxanthine concentrations in venous blood of pregnant women and in the umbilical cord blood of their newborns. Materials and Methods: Pregnant women who gave birth at the Clinic of Obstetrics, Gynecology and Oncology, 2nd Faculty of Medicine, Medical University of Warsaw were included in the study. Caffeine and paraxanthine concentrations were analyzed in 30 samples of venous blood serum drawn from the women before delivery and 30 samples of umbilical cord blood serum of their newborns. Caffeine intake in the last 24 hours before delivery was estimated using a questionnaire. Statistical analysis employed a linear logistic regression model, Wilcoxon rank sum test and a non-parametric Spearman’s rank correlation coefficient. Results: No difference was found between caffeine concentration in maternal venous blood and neonatal umbilical cord blood. However, paraxanthine level in venous blood was higher than in umbilical cord blood (p = 0.04). Conclusions: Caffeine consumed by a pregnant woman passes through the placenta to the fetus freely

Clinical Experiences of Fetal Ovarian Cyst: Diagnosis and Consequence

Ovarian cysts are the most frequent, prenatally diagnosed intra-abdominal cysts. Fetal ovarian cyst often presents complication such as torsion and seems to be an indication for surgical intervention. In this study, we reviewed pre- and post-natal medical records and ultrasonography of 17 fetuses that were diagnosed with ovarian cysts. In a total of 17 cases, postnatal surgery was performed in 7 infants. Of these cases, four cases of ovarian cyst torsion were confirmed. In the remaining 10 fetuses, one case regressed completely during pregnancy, and the other nine cases including two complex cysts resolve spontaneously after birth. Postnatal symptomatic cysts or cysts with a diameter greater than 5 cm that do not regress or enlarge should be treated, but uncomplicated asymptomatic cysts less than 5 cm in diameter should only be observed and reassessed by serial ultrasonography. If they regress spontaneously, no surgical intervention is necessary independent of their sonographic findings

The Effects of Maternal Caffeine Intake on a Fetus

The United States has been noted as the country with the greatest caffeine consumption in the world. More than half of all Americans are said to consume caffeine on a daily basis. Caffeine is easily available in a variety of dietary products including coffee, tea, soft drinks, and chocolate. Many pregnant women are unaware of the potential risk that excessive caffeine consumption can have on their unborn child. The purpose of this paper is to explore the ramifications of caffeine intake on a fetus. The studies reviewed propose that heavy maternal caffeine consumption, that of more than 300 mg daily, is associated with increased risk of spontaneous abortion or delivery of an infant of low birth weight. Most researchers agreed that caffeine does cause preterm labor and delivery, nor does it act as a human teratogen

Congenital chloride diarrhea and Pendred syndrome : case report of siblings with two rare recessive disorders of SLC26 family genes

Background Congenital chloride diarrhea (CLD; OMIM 214700) is a rare autosomal recessive disorder caused by pathogenic variations in the solute carrier family 26 member A3 (SLC26A3) gene. Without salt substitution, this chronic diarrheal disorder causes severe dehydration and electrolyte disturbances. Homozygous variants in the nearby gene SLC26A4 disrupt anion exchange in the inner ear and the thyroid, causing Pendred syndrome (PDS; OMIM 274600), which is the most frequent form of syndromic deafness. Case presentation We report an unusual co-occurrence of two rare homozygous mutations in both the SLC26A3 and SLC26A4 genes, causing a rare combination of both CLD and PDS in two siblings. Although the clinical pictures were typical, the combined loss of these anion transporters might modulate the risk of renal injury associated with CLD. Conclusions Familial presentation of two rare autosomal recessive disorders with loss of function of different SLC26 anion transporters is described. Independent homozygous variants in the SLC26A3 and SLC26A4 genes cause CLD and PDS in siblings, shedding light on co-occurrence of rare recessive traits in the progeny of consanguineous couples.Peer reviewe

Ultrastructural changes in the developing chicken cornea following caffeine administration.

Caffeine is one of the most frequently consumed psychoactive substances. It has been known for many years that caffeine at high concentrations exerts harmful effects on both women's and laboratory animals' fertility, moreover it may impair normal development of many organs in the prenatal period. So far there have been few studies performed that demonstrate teratogenic effects of caffeine on structures of the developing eye, particularly the cornea. The aim of the study was to show ultrastructural changes in the developing cornea, as the effect of caffeine administration to chicken embryos. The experimental materials were 26 chicken embryos from incubated breeding eggs. Eggs were divided into two groups: control (n=30) in which Ringer liquid was administrated, and experimental (n=30) in which teratogenic dose of caffeine 3.5mg/egg was given. In 36th hour of incubation solutions were given with cannula through hole in an egg shell directly onto amniotic membrane. After closing the hole with a glass plate and paraffine, eggs were put back to incubator. In 10th and 19th day of incubation corneas were taken for morphological analysis with a use of electron microscopy. Administration of caffeine during chicken development causes changes of collagen fibers of Bowman's membrane patterns and of the corneal stroma but it also changes proportion of amount of collagen fibers and of the stromal cells

Changes in thickness of each layer of developing chicken cornea after administration of caffeine.

The aim of the study was the presentation of changes in thickness of each layer of a developing cornea, that came into being under an influence of caffeine which was administered to chicken embryos. Research materials were 26 chicken embryos from breeding eggs that had been incubated. Breeding eggs were divided into two groups: control (n=30) in which Ringer liquid was given, and experimental (n=30) in which teratogenic dose of caffeine was administrated - 3.5 mg/egg. In 36th hour of incubation solutions were given with cannula through a hole in an egg shell directly onto amniotic membrane. After closing the hole with paraffin, eggs were put back into incubator. On 10th and 19th day of incubation corneas were taken for morphometric and morphological analysis. In experimental groups reduction of corneal thickness, thickening of corneal epithelium and corneal endothelium as well as Bowman's and Descemet's membranes, decrease of thickness of corneal stroma in comparison with the control group have been observed. Caffeine causes thickness changes of all layers and decreases the total thickness of a developing cornea

Caffeine teratogenicity in rats : morphological characterization and hypothesized mechanisms

Caffeine consumption during pregnancy has been shown in the scientific literature to be associated with teratogenicity such as low birth weight, fetal malformations, and miscarriage. However, the morphological alterations of the offspring of dams exposed during pregnancy have not been consistently described, and the mechanisms why they occur remain elusive. Thus, we aimed to characterize the offspring malformations induced by moderate and high doses of caffeine during pregnancy. Dams were divided into three groups: control, moderate (0.3 g/L), and high dose (1.0 g/L) of caffeine, which was provided in the drinking water beginning on gestational day 1 and continuing throughout the entire gestation. At moderate doses, only one of the dams had stillborn pups, although no macroscopic malformations were observed. High doses of caffeine induced significantly more malformations (P<0.001) and early death (before P4). The malformations observed were related to fetal development and cardiovascular alterations, namely bruises, macrocephaly with short limbs, abnormal development (or absence) of head structures and limbs, labial malformations, hydrops fetalis, and poor placental formation. We discussed the proposed mechanisms by which caffeine might induce these phenotypes, which may involve down-regulation of adenosine A1 receptors, and increased mothers’ catecholamines. Our findings further confirm the evidence of the teratogenic effects of high doses of caffeine administered during pregnancy. These findings support the recommendation to avoid caffeine exposure during pregnancy

Caffeine teratogenicity in rats: morphological characterization and hypothesized mechanisms

Caffeine consumption during pregnancy has been shown in the scientific literature to be associated with teratogenicity such as low birth weight, fetal malformations, and miscarriage. However, the morphological alterations of the offspring of dams exposed during pregnancy have not been consistently described, and the mechanisms why they occur remain elusive. Thus, we aimed to characterize the offspring malformations induced by moderate and high doses of caffeine during pregnancy. Dams were divided into three groups: control, moderate (0.3 g/L), and high dose (1.0 g/L) of caffeine, which was provided in the drinking water beginning on gestational day 1 and continuing throughout the entire gestation. At moderate doses, only one of the dams had stillborn pups, although no macroscopic malformations were observed. High doses of caffeine induced significantly more malformations (P&lt;0.001) and early death (before P4). The malformations observed were related to fetal development and cardiovascular alterations, namely bruises, macrocephaly with short limbs, abnormal development (or absence) of head structures and limbs, labial malformations, hydrops fetalis, and poor placental formation. We discussed the proposed mechanisms by which caffeine might induce these phenotypes, which may involve down-regulation of adenosine A1 receptors, and increased mothers’ catecholamines. Our findings further confirm the evidence of the teratogenic effects of high doses of caffeine administered during pregnancy. These findings support the recommendation to avoid caffeine exposure during pregnancy. Keywords: Caffeine; offspring; teratogenicity; pregnancy; hydrops; cardiovascular alteration

Terapia płodu – ocena zastosowania shuntu komorowo-owodniowego w leczeniu wodogłowia

Objective: The aim of the study was to establish optimal diagnostic and therapeutic scheme and to assess the efficacy of intrauterine therapy of hydrocephalus. Material and methods: The study was carried out between 1992-2012 on the total of 222 fetuses with hydrocephalus, using Orbis-Sigma and ACCU-Flow valves (168 cases) and Cook’s shunts, according to a strictly defined diagnostic and therapeutic scheme. Results: In the first stage of the study (between 1992-2001), a total of 168 fetuses with prenatally diagnosed hydrocephalus received intrauterine therapy. In 91.6% of the cases the therapy resulted in a decreased size of cerebral ventricles. The valve dislocated in 23 cases (13.6%). Preterm delivery occurred in 44% of the affected neonates. Severe mental impairment occurred in 17.76%, average in 36.8%, and slight in 32.9% of the infants. Normal mental development at the age of 3 was observed in 12.5% of the children. A total of 11.2% of children did not require further neurosurgical reatment. In the second stage of the study (between 2006-2012) after therapy, the size of the right lateral cerebral ventricle decreased by 54.76% (average of 27.54 mm to 12.46 mm) and the left lateral cerebral ventricle decreased by 53.12% (average of 26.41 mm to 12.38 mm ) (p=0.0018). The maximum and minimum width of the cerebral cortex increased by 23.06% and 27% (average of 9.04 mm to 11.75 mm vs. 3.65 mm to 5mm), respectively. Early complications were observed in 22% of the cases: PROM (6), intrauterine fetal death (4), intrauterine infection (1), and premature detachment of the placenta (1). Average gestational age at delivery was 34 weeks, and 24% of the patients delivered at term. Conclusions: • Implantation of ventriculo- amniotic shunts proved to be an effective form of therapy, resulting in normalization of intracranial pressure. • In both stages of therapy, reduction of ventricular size in patients with hydrocephalus and good neurological outcome (45.4% in I stage, 60% in II stage) were observed • In the second stage of therapy, the size of lateral brain ventricles after fetal therapy was significantly lower (54%). A total of 18% of the neonates did not require neurosurgical treatment.Cel pracy: Opracowanie optymalnego sposobu postępowania diagnostyczno-terapeutycznego oraz ocena skuteczności terapii wewnątrzmacicznej wodogłowia u płodu. Materiał i metody: Leczenie wewnątrzmaciczne w przypadkach wodogłowia u płodu prowadzono w dwóch etapach u 222 ciężarnych, początkowo z użyciem zastawek Orbis-Sigma i ACCU-Flow (168 przypadków), a następnie shuntów Cook’a, wg ściśle przyjętego schematu postępowania diagnostyczno-terapeutycznego. Wyniki: W pierwszym etapie (w latach 1992-2001) zabiegi wewnątrzmaciczne wykonano na 168 płodach z rozpoznanym prenatalnie wodogłowiem. W 91,6 % uzyskano zmniejszenie układu komorowego mózgu. W 23 przypadkach (13,6 %) zestaw odbarczający uległ dyslokacji. W 44 % przypadków wystąpił poród przedwczesny. Upośledzenie w stopniu ciężkim wystąpiło u 17,76 % dzieci, w stopniu średnim u 36,8 %, w stopniu lekkim u 32,9%. Prawidłowy rozwój w 3 roku życia wykazywało 12,5 % dzieci, leczenia nie wymagało 11,2 % dzieci. W drugim etapie (2006-2012) wielkość prawej komory bocznej mózgu zmniejszyła się o 54,76% ( średnio z 27,54 mm do 12,46 mm), zaś komory bocznej lewej o 53,12% (średnio z 26,41 mm do 12,38 mm) (p=0,0018). Maksymalna szerokość kory mózgu wzrosła o 23,06% (średnio z 9,04 mm do 11,75mm), natomiast minimalna szerokość o 27% ( średnio z 3,65mm do 5mm). Powikłania wczesne terapii (do 7 dni od zabiegu) zaobserwowano u 22% pacjentek, w tym: PROM u 6 pacjentek, zgon wewnątrzmaciczny płodu u 4 pacjentek, infekcja wewnątrzmaciczna u 1 pacjentki, przedwczesne oddzielenie łożyska u 1 pacjentki. Średni czas trwania ciąży wyniósł 34 tyg. 24% pacjentek urodziło w terminie porodu. Wnioski: • Zakładanie shuntów komorowo-owodniowych okazało się skuteczną formą terapii powodującą normalizację ciśnienia wewnątrzczaszkowego. • W obu etapach obserwowano zmniejszenie wodogłowia po terapii oraz dobre efekty neurologiczne w I etapie – u 45,4% a w II etapie u ponad 60% dzieci. • W drugim etapie terapii szerokość komór bocznych mózgu mierzona po zabiegu była istotnie mniejsza (54%). 18% noworodków nie wymagało leczenia neurochirurgicznego