Subchorionic hematoma as a risk factor of pregnancy and delivery in women with threatening abortion

Summary Objectives: The aim was to present pregnancy complications and outcome in the group of women with subchorionic hematoma (SCH) diagnosed in the first or second trimester of pregnancy. Methods: A retrospective study was performed to compare the perinatal outcome of 41 patients with SCH (study group) with 59 women treated of threatening abortion (control group). Age, obstetric history, the course of pregnancy and obstetric outcomes were analyzed. Results: More SCH patients lost the pregnancy before 22 weeks gestation when Compared to the control group (39.02% vs. 15.3%). The mean age of women in both groups was similar, but a previous loss of pregnancy was more often observed in SCH group (24.4% vs. 9.4%). The majority of SCH women were multiparas (63.25% vs. 43,75%). The frequency of perinatal complications such as premature delivery, intrauterine growth retardation (IUGR) or premature rupture of membranes (PROM), was similar in both groups, but pregnancy-induced hypertension (PIH) was observed more often in SCH group (p=0,008). The percentage of caesarean sections, the average condition of the newborns in Apgar score and weight were similar in both groups. There were no differences either in the frequency of meconium stained fluid or the presence of late decelerations in delivery CTG pattern. The patients with SCH delivered female fetuses more frequently; 81.25 % of those who delivered vaginally had incomplete placenta. Conclusions: 1. SCH is more frequent in multiparas, especially if previous pregnancy loss was reported. 2. About 40% of pregnancies with SCH are lost before 22 weeks gestation; bleeding is a bad prognostic factor. 3. SCH diagnosed at the beginning of pregnancy is a risk factor of PIH in the third trimester. 4. SCH diagnosed in early pregnancy does not influence the method of delivery and does not increase the risk of adverse pregnancy outcome

Markers of oxidative stress in pregnancies complicated by pregnancy induced hypertension and intrahepatic cholestasis

Abstract Objective: The aim of the study was to investigate levels of superoxide dismutase (CuZnSOD-1), catalase (CAT), glutathione peroxidase (GPx) and malonodialdehyde (MDA) in groups of pregnant women with pregnancy induced hypertension (PIH), hypertension recognized before pregnancy (HA) or intrahepatic cholestasis. Material and methods: 33 women with PIH, 6 with HA and 12 with cholestasis were compared with 33 healthy pregnant women. Levels of enzymes were assessed in blood samples. Methods of delivery and obstetric results were presented. Results: SOD and GPx levels did not differ significantly in any of the investigated groups. A tendency for lower mean levels of CAT in the group of PIH women, and a higher level of MDA in the group of women with HA has been noted. The mean CAT level was significantly lower in PIH and HA patients delivered instantaneously due to the risk of eclampsia. All mean levels of enzymes in the group of women with cholestasis were similar to the ones in the group of healthy women. Patients with PIH and HA gave birth more often by cesarean section, but the overall condition of the newborns was satisfactory. Conclusions: There is no substantial evidence that the level of oxidative enzymes in a blood sample can be an indicator of oxidative stress in pregnant women with PIH, HA or cholestasis. Although CAT levels were lower in PIH and HA women who had cesarean section due to the risk of eclampsia, there was no correlation between these enzyme levels and the clinical outcome of patients or the condition of the newborns

Association of Maternal and Fetal Single-Nucleotide Polymorphisms in Metalloproteinase (MMP1, MMP2, MMP3, and MMP9) Genes with Preeclampsia

Background. Metalloproteinases (MMPs) play a pivotal role during the process of trophoblast invasion and placentation. The appearance of five functional single-nucleotide polymorphisms (SNP) in the genes of the metalloproteinases most commonly implicated in the implantation process may influence the development of preeclampsia. Methods. Blood samples were collected from 86 mothers and 86 children after preeclampsia and 85 mothers and 85 children with uncomplicated pregnancies. The distribution of genotypes for −1607 1G/2G MMP1, −735 C/T MMP2, −1306 C/T MMP2, −1171 5A/6A MMP3, and −1562C/T MMP9 polymorphisms was determined by RFLP-PCR. Results. The occurrence of 1G/1G MMP1 or 5A/5A MMP3 genotype in the mother or 1G/1G MMP1 or 5A/6A MMP3 genotype in the child is associated with preeclampsia development. Moreover, simultaneous maternal and fetal 1G/1G homozygosity increases the risk of preeclampsia development 2.39-fold and the set of maternal 5A/5A and fetal 5A/6A MMP3 genotypes by over 4.5 times. No association between the carriage of studied MMP2 or MMP9 polymorphisms and the predisposition to preeclampsia was found. Conclusion. The maternal 1G/1G MMP1 and 5A/5A MMP3 and fetal 1G/1G MMP1 and 5A/6A MMP3 gene polymorphisms may be strong genetic markers of preeclampsia, occurring either individually or together

IL-12, IL-6 and IFN-γ production by lymphocytes of pregnant women with rheumatoid arthritis remission during pregnancy

Background: Rheumatoid arthritis (RA) is an autoimmune disease with progressive activity. The RA remission was observed in women during pregnancy, but the mechanism responsible for remission is hypothetical only and concerns mechanisms of immune regulation such as lymphocyte subpopulations and interleukin production

Przebieg ciąży i porodu u pacjentki z ostrą białaczką szpikową. Opis przypadku

Szacuje się, że ok. 1/1000 ciąż jest powikłana występowaniem nowotworu złośliwego, z czego największyodsetek dotyczy zachorowalności na raka szyjki macicy. Rozpoznanie białaczki przypada na ok. 1/100 000 ciężarnychi do dziś nie ma wystarczających doniesień na temat postępowania leczniczego w trakcie ciąży, jak i odległegowpływu ewentualnych terapii na dzieci urodzone z ciąż objętych leczeniem jeszcze za życia płodowego.Leczenie białaczek podczas ciąży jest o wiele trudniejsze z uwagi na fakt konieczności doboru terapii do każdejciąży z osobna, uwzględniając zaawansowanie ciąży oraz stan zdrowia zarówno matki, jak i dziecka. Mimokontrowersji, jakie wzbudza zastosowanie chemioterapii u kobiet ciężarnych, to dziś takie postępowanie wydajesię najlepszym sposobem leczenia, a negatywne skutki terapii zmniejszają się wraz z wiekiem ciąży

Chromogranin A demonstrates higher expression in preeclamptic placentas than in normal pregnancy

Abstract Background Although preeclampsia has long been recognized as a condition affecting late pregnancy, little is known of its pathogenesis or treatment. The placenta releases a number of hormones and molecules that influence the course of pregnancy, one of which is chromogranin A, a soluble protein secreted mainly from the chromaffin cells of the adrenal medulla. Its role in pregnancy and pregnancy-related disorders remains unclear. Therefore, the main aim of the proposed study is to determine whether chromogranin A is related with the occurrence of preeclampsia. Methods Placental samples were collected from 102 preeclamptic patients and 103 healthy controls, and Chromogranin A gene (CHGA) expression was measured using real-time RT-PCR, The RT-PCR results were verified on the protein level using ELISA. The normal distribution of the data was tested using the Shapiro-Wilk test. The clinical and personal characteristics of the groups were compared using the Student’s t-test for normally-distributed data, and the χ2 test for categorical variables. The Mann-Whitney U test was used for non-normally distributed data. As the log- transformation was not suitable for the given outcomes, the Box- Cox Transformation was used to normalize data from ELISA tests and CHGA expression. Values of P < .05 were considered statistically significant. Results Chromogranin A gene expression was found to be significantly higher in the study group than in controls. Protein analyses showed that although the CgA concentration in placental samples did not differ significantly, the catestatin (CST) level was significantly lower in samples obtained from women with preeclampsia, according to the controls. Conclusions for practice This study for the first time reveals that chromogranin A gene expression level is associated with preeclampsia. Moreover, the depletion in catestatin level, which plays a protective role in hypertension development, might be a marker of developing preeclampsia. Further studies may unravel role of Chromogranin A in the discussed disease

Placental Expression of NEMO Protein in Normal Pregnancy and Preeclampsia

Background. Preeclamptic pregnancies often present an intensified inflammatory state associated with the nuclear activity of NFκB. NEMO is an essential regulator of nuclear factor kappa B (NFκB) in cytoplasmic and nuclear cellular compartments. The aim of the present study is to examine the level and localization of the NEMO protein in preeclamptic and nonpreeclamptic placentas. Methods. The study includes 97 preeclamptic cases and 88 controls. NEMO distribution was analyzed immunohistochemically. Its localization in the nuclear and cytoplasmic fractions, as well as in total homogenates of placental samples, was studied by western blot and ELISA. Results. The western blot and ELISA results indicate a significant difference in NEMO concentration in the total and nuclear fractions between preeclamptic and control samples (p<0.01 and p<0.001, respectively). In the cytoplasmic complement, similar levels of NEMO were found in preeclamptic and control placentas. In addition, immunohistochemical staining revealed that the NEMO protein is mainly localized in the syncytiotrophoblast layer, with controls demonstrating a stronger reaction with NEMO antibodies. This study also shows that the placental level of NEMO depends on the sex of the fetus. Conclusions. The depletion of the NEMO protein in the cellular compartments of placental samples may activate one of the molecular pathways influencing the development of preeclampsia, especially in pregnancies with a female fetus. A reduction of the NEMO protein in the nuclear fraction of preeclamptic placentas may intensify the inflammatory state characteristic for preeclampsia and increase the level of apoptosis and necrosis within preeclamptic placentas