The impact of the gene variants fv leiden, fii g20210a, mthfr c677t and pai-1 4g/5g on pregnancy loss in women from central Serbia

© 2020, University of Kragujevac, Faculty of Science. All rights reserved. Thrombophilia is a condition of enhanced functionality of the haemostatic system with an increased tendency for thrombosis, and it can be a congenital, acquired, or complex defect. Pregnancy can be the cause of acquired transitory thrombophilia, which may lead to complications if inherited thrombophilia is also present. The aim of this study was to determine the genetic structure of the population based on the frequency of the gene variants factor V Leiden G1691A, factor II G20210A, methylenetetrahydrofolate reductase C677T, and plasminogen activator inhibitor-1 4G/5G, as well as to investigate the predictive value of these gene variants in repeated miscarriages. The study included 87 female patients from Central Serbia with an average age of 32.7±4.5 years with inherited thrombophilia and previous miscarriages, with or without intrauterine foetal death. The exclusion criteria included the existence of gynaecological and infectious aetiology and the deficit of factors important for the coagulation process. The resulting genotypes were in Hardy-Weinberg equilibrium. The frequency of genotypes with mutated alleles was significantly higher in this group of patients than in the control group for all variants except factor II G20210A. The most commonly mutated alleles were the plasminogen activator inhibitor-1 4G allele (0.61) and methylenetetrahydrofolate reductase T allele (0.47). Double mutation of plasminogen activator inhibitor-1 4G/5G and methylenetetrahydrofolate reductase C677T was dominant in patients with recurrent pregnancy loss (46.15%). The presence of a combination of genetic variants of the plasminogen activator inhibitor-1 4G/5G and methylenetetrahydrofolate reductase C677T is a significant predictor of spontaneous abortions in women with inherited thrombophilia in Central Serbia

Zuclopenthixol decanoate in pregnancy: Successful outcomes in two consecutive off springs of the same mother

Introduction. Almost all individual antipsychotics are classified into the intermediate pregnancy risk category as no or limited data exist about human pregnancy outcomes. We presented the case of zuclopenthixol decanoate using in two successive pregnancies of the same woman, which had not been published in the available peer-reviewed literature. Case report. A middle-age female subject who suffered from schizophrenia received zuclopenthixol decanoate injection during her two consecutive pregnancies. About four and a half months before diagnosis of the first pregnancy (~3.5 years after psychosis emergence), zuclopenthixol decanoate (400 mg every other week, im injection) was introduced to the treatment protocol (due to previous non-compliance with halo-peridol and risperidone). A significant clinical improvement was achieved and the dose during pregnancy was reduced to 200 mg once monthly and maintained to date. In both pregnancies the women gave birth to healthy girls who have been developing normally until now, at their ages of 6 months and of 3.5 years. During pregnancy and after giving birth to children the mothers' psychiatric status and her social functioning were significantly improved and are still stable. Close monitoring of the mother's health, a multidisciplinary approach to both her treatment and the monitoring of pregnancies as well as the complete compliance with the prescribed drug protocol were likely to be crucial for the therapeutic success. Conclusion. A favorable outcome of the present case suggests that the zuclopenthixol decanoate is a rational therapeutic option for pregnant women suffering from psychosis when the expected benefit exceed the potential risk, but a definitive evidence for its safety requires large, controlled studies

Characteristics of Pregnancy, Delivery and The Postpartum Period in Pregnant Women Diagnosed with Gestational Diabetes Mellitus

Gestational diabetes mellitus refers to both transient diabetes that arises during pregnancy and is restored postpartum as well as forms of the disease that arise for the first time during pregnancy and persistently exhibit insulin-dependence (type 1) after childbirth. The basis for the development of gestational diabetes is the existence of insulin resistance

The reasons for unusable lipemic blood plasma in transfusion treatment

Introduction/Objective The increased presence of lipid particles in blood is one of most common reasons that transfusion units are unusable. The risk factors for lipemic plasma in donated blood are not completely known. The aim of this study is to identify the factors that influence plasma to be fatty so that we can prevent further storage costs and eliminate unusable transfusion units. Methods This case–control study was conducted in 2017, and 1552 respondents were included in the study. The control group included 1502 subjects whose blood was not lipemic, while 50 patients with lipemic blood were selected for the case group. The presence of lipemic blood was assessed by inspec-tion, while data were collected by clinical laboratory tests and a questionnaire. Results Our findings show that multiple blood donors with lipemic blood were significantly older (p < 0.0005) and have higher systolic and diastolic pressure (p < 0.0005), high triglyceride levels (p < 0.0005), and lower levels of hemoglobin (p < 0.0005). Additionally, the presence of lipemic plasma was associated with female sex (p = 0.002), blood type (p = 0.016), heart disease (p < 0.0005), smoking (p < 0.005), diabetes (p = 0.001), lipid intake prior to blood donation (p < 0.005) and venipuncture therapy (p < 0.0005). Systolic pressure is a reliable predictor of lipemic blood (AUROC = 0.901, p < 0.0005). Conclusion Our study provided a rational explanation and identified some of the risk factors that may help identify potential donors with lipemic blood

The incidence of down syndrome in newborns at the department of obstetrics and gynecology of the clinical center Kragujevac during the period 2007-2012

Objective. The main objective of this study was to determine the incidence of Down syndrome in newborn infants diagnosed prenatally and in newborn children in Kragujevac. Methods. This retrospective study included groups of 1208 pregnant women and 10,712 mothers aged 14-55 years, who came to the Gynecology and Obstetrics Clinic, Clinical Center Kragujevac during the period 2007-2012. Cells of amniotic fluid, taken during amniocentesis between 16 and 18 weeks of pregnancy, were cultured for 12 days and, after cytogenetic processing, stained and analyzed with light microscopy. Data were analyzed and presented descriptively. Results. During the four year period, between January 2007 and December 2011, 8 cases of Down syndrome were diagnosed by amniocentesis of 1208 amnions, which resulted in incidence of 1 in 151 amnions. Also, there were 15 cases of liveborn children with Down syndrome in 10822 liveborn babies, which made an incidence of 1 in 721 liveborns. The total of 1070 pregnancies were with mothers older than 35 years at the time of labor and 5 of 15 liveborn babies with Down syndrome were from mothers belonging to this group. Also, 9464 pregnancies were with mothers aged 18-35 years and in this group there were the last 10 cases of Down syndrome. There were 8 fetuses with Down syndrome, all diagnosed with trisomy 21, and all 8 aborted by choice of the Ethical committee of the Clinical Center Kragujevac. Conclusion. The decision of not having prenatal diagnostics for pregnancies, some by late amniocentesis, some by the decision of the family, resulted in Down syndrome liveborns

Association between inherited thrombophilia in pregnancy and micronucleus frequency in peripheral blood lymphocytes

© 2017 Šošić GM, Jović N, Rakić B, Dimitrijević A, Varjačić M. The aim of this study was to determine possible predictors of an increased frequency of micronucleus (MN) and the impact of thrombophilia on the chromosomal instability in peripheral blood lymphocytes (PBL) of pregnant women in their first trimester. This study was designed as a case-control study on 74 pregnant women. It was performed in the gestational age of 11 to 14 weeks, when blood samples were collected and incubated for 72 hours. The individual MN frequency in PBL was measured by cytokinesis-block micronucleus (CBMN) assay. Women were grouped in control group [≤4 MN/1000 binucleated (BN) cells] and case group (>4 MN/1000 BN cells). Potential mutagenic effects of exogenous/endogenous factors in pregnant women were analyzed. By analyzing the given results, it can be concluded that pregnant women with thrombophilia have 26.69-times more chance of having a frequency of >4 MN/1000 BN than pregnant women with no thrombophilia. Our research was primarily aimed at showing that the presence of thrombophilia was a statistically important predictor of an increased MN frequency in pregnant women and it can predict about one-third of the total variance in MN frequency in the studied population

Correlation between serum biochemical markers and early amniocentesis in diagnosis of congenital fetal anomalies

A combined test performed at the 12th week of gestation enables us to classify the pregnancy as high risk (risk higher than 1:300) or low risk (risk lower than 1:300) for congenital foetal anomalies, with great accuracy of 85 - 90%. According to the available data, the frequency of false positive results is estimated at around 5%. The objective of the study was to examine possible correlation between the serum marker values and amniocentesis results in prenatal diagnostics of congenital foetal anomalies. The study included 745 pregnant women monitored by the Genetic Counselling Service of the Clinic of Gynaecology and Obstetrics of the Clinics Centre Kragujevac. The subjects were included in the study under condition that CRL (embryonic crown-rump length) was from 45 to 84 mm and that the gestational age was at 11-13+6 weeks. Free (5 HCG and PAPP-A were determined from venous blood using commercial DPS-USA tests. Tests were based on the analytic principle of the immuno-chemiluminescence technique and were performed by application of the automatic Immulite 2000 analyzer by DPC-USA. The foetal nuchal translucency thickness (NT) and CRL were measured by Colour Doppler. The chromosome identification was performed after a certain number of cell divisions by stopping the cell division in metaphase of mitosis when the chromosomes were the most distinguishable. The foetal karyotype was prepared using G bands. In the total sample of pregnant women (n=745), there were six cases of pathological foetal karyotype. A statistical paradox in the frequency of congenital foetal anomalies in favour of younger population was noticed. A high coefficient of Spearman's rank correlation suggests great importance of the combined test in the detection of congenital foetal anomalies (p<o,o5). A high consistency was also proved for components of biochemical screening and ultrasonographic markers. The combined test, as a method of prenatal screening in the first trimester of pregnancy, if used at 11 -13+6 weeks1 gestation and for CRL of 45-84 mm, has a great importance in the detection of congenital foetal anomalies

The Impact of the Gene Variants FV Leiden, FII G20210A, MTHFR C677T and PAI-1 4G/5G on Pregnancy Loss in Women from Central Serbia

Thrombophilia is a condition of enhanced functionality of the haemostatic system with an increased tendency for thrombosis, and it can be a congenital, acquired, or complex defect. Pregnancy can be the cause of acquired transitory thrombophilia, which may lead to complications if inherited thrombophilia is also present