New research models and novel signal analysis in studies on preterm labor: a key to progress?

Preterm labor affects up to 20% of pregnancies, is considered a main cause of associated neonatal morbidity and mortality and is responsible for neonatal care costs of multimillion euros. In spite of that, the commercial market for this clinical indication is rather limited, which may be also related to high liability. Consequently, with only a few exceptions, preterm labor is not in the orbit of great interest of the pharmaceutical industry. Coordinated effort of research community may bring the change and help required to reduce the influence of this multifactorial syndrome on society. Between the novel techniques that are being explored in a SAFE (The Special Non-Invasive Advances in Fetal and Neonatal Evaluation Network) group, there are new research models of preterm labor as well as novel methodology of analysis of biological signals. In this article, we briefly describe new clinical and nonclinical human models of preterm labor as well as summarize some novel methods of data processing and analysis that may be used in the context of preterm labor

Przerastające łożysko jako przyczyna samoistnego pęknięcia macicy we wczesnym drugim trymestrze u wieloródki bez wywiadu zabiegów na macicy

Background: Prevalence of uterine rupture at delivery has been recently estimated at less than 1 in 2500 deliveries. Spontaneous uterine rupture in the early mid-trimester (16 weeks gestation or less), is far less frequent. We report a case of uterine rupture due to placenta percreta in otherwise uncomplicated pregnancy. Case: A 35-year-old, gravida 5, para 5, at 15wk 2d gestation (menstrual age) with negative history of uterine scarring suddenly developed symptoms of incipient hypovolemic shock while being hospitalized for imminent miscarriage. On exploratory laparotomy we found a midline uterine rupture infi ltrated by the placenta. Supracervical hysterectomy was performed. Postoperative lab analysis confi rmed the elevated serum AFP levels. Conclusion: Abnormal placentation and subsequent uterine rupture should be taken into consideration also in women in the second trimester who have no history of uterine instrumentation.Częstość występowania okołoporodowego pęknięcia macicy szacuje się na 1 na 2500 porodów, powikłanie to występuje zwykle po rozpoczęciu porodowej czynności skurczowej. Jedną z przyczyn tego nagłego stanu położniczego jest przerastanie łożyska, do czego predysponują wcześniej wykonywane zabiegi na macicy (na przykład łyżeczkowanie). Samoistne pęknięcie macicy we wczesnym drugim trymestrze (poniżej 16 tygodnia) zdarza się natomiast wyjątkowo rzadko. Praca przedstawia przypadek samoistnego pęknięcia macicy z powodu przerastania łożyska u pacjentki bez wywiadu zabiegów na macicy. Opis przypadku: 35 letnia wieloródka bez wywiadu zabiegów na macicy w 16. tygodniu (15 tyg. 2 dni) piątej ciąży, zgłosiła ból narastający brzucha z towarzyszącymi objawami hipowolemii podczas pobytu w klinice z powodu zagrażającego poronienia. Podczas zabiegu laparotomii zwiadowczej stwierdzono pośrodkowe pęknięcie macicy nacieczone przez przerastające łożysko. Wykonano zabieg nadpochwowego wycięcia macicy. Pooperacyjne badania dodatkowe potwierdziły znacznie podwyższone poziomy alfa fetoproteiny (AFP) Wniosek: Nieprawidłowo przebiegający rozwój łożyska i następowe pęknięcie macicy powinny być brane pod uwagę jako jedna z przyczyn bólu i nagłej hipowolemii także u kobiet w drugim trymestrze ciąży bez wywiadu zabiegów na macicy

Serum soluble Fas ligand (sFasL) in patients with primary squamous cell carcinoma of the esophagus.

Esophageal carcinomas have been shown to express Fas ligand (FasL) and down-regulate Fas to escape from host immune surveillance. Circulating soluble FasL (sFasL) has been suggested to provide protection from Fas-mediated apoptosis. The aim of this study was to assess serum sFasL levels in esophageal cancer. The pretreatment levels of sFasL in the serum of 100 patients with esophageal squamous cell cancer and 41 healthy volunteers were determined by ELISA. Probability of survival was calculated according to the method of Kaplan-Meier. The prognostic influence of high and low level of sFasL was analyzed with the log-rank test. The mean serum level of sFasL in patients with esophageal cancer was significantly higher than that in healthy donors (1.567+/-1.786 vs 0.261+/-0.435,

Personalized embryo transfer (pET) guided by endometrial receptivity (ER) assessment — a possibility to increase effectiveness of IVF procedures. Review of available methods

The continuous development of assisted reproductive techniques (ART) implies the search for solutions that could increase the effectiveness of available methods. In the context of in vitro fertilization (IVF), a significant proportion of failures are due to unsuccessful embryo transfers. At this stage the most important issue is proper dialogue between implanting embryo and the maternal endometrium. Therefore, it seems justified to assess endometrial receptivity (ER), defined as the tissue's ability to accept an embryo to attach and invade into the mucosa. Window of implantation (WOI), is a certain period in which implantation of the properly developed embryo is possible. The cause of endometrial receptivity disorders is believed to be the disturbed expression of cytokines and endometrial surface proteins, the presence of which has been proven in commonly diagnosed diseases such as endometriosis or chronic endometritis. Despite many years of research on endometrial receptivity, the area of ​​diagnostic methods enabling clinical monitoring of ER still remains undeveloped. The aim of this study is to review the utility of selected markers and the available methods of ER assessment, ranging from noninvasive ultrasound, through endometrial fluid analysis, to genomic studies based on endometrial biopsy, in order to increase the effectiveness of IVF. Such an approach could potentially be a significant step towards personalizing medical procedures especially in patients diagnosed with repeated implantation failure (RIF)

Reductionist and system approaches to study the role of infection in preterm labor and delivery

A substantial number of patients with preterm labor and delivery do not show clinical signs of infection, however, it is the subclinical form which is the main causative factor and often results in premature delivery. The hitherto commonly applied methods of inflammation detection are based either on potentially hazardous amniocentesis or still insufficient inflammation-related protein measurement in the serum or other biological fluids