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

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

Reductionist and system approaches to study the role of infection in preterm labor and delivery-0

<p><b>Copyright information:</b></p><p>Taken from "Reductionist and system approaches to study the role of infection in preterm labor and delivery"</p><p>http://www.biomedcentral.com/1471-2393/7/S1/S9</p><p>BMC Pregnancy and Childbirth 2007;7(Suppl 1):S9-S9.</p><p>Published online 1 Jun 2007</p><p>PMCID:PMC1892066.</p><p></p>ich monoclonal antibodies (mAbs) were spotted in a 3 × 3 pattern. After detection the plate was imaged with cooled charge-coupled device (CCD) camera. Location of anti-chemokine mAb spots in the mini-array and CCD camera image of a 3 × 3 mini-array within a single well. Among nine of the studied chemokines it is CCL19 (also previously known as MIP-3β) which was significantly decreased in sera of patients with preterm labor (see the text for full details)

Effect of short-term, low-dose treatment with tamoxifen in patients with primary dysmenorrhea

Current treatment of painful periods and other symptoms related to primary dysmenorrhea (PD) is usually commenced with non-steroidal anti-inflammatory drugs or oral contraceptives, which fails in about 10% of affected patients. Tamoxifen, a selective estrogen-receptor modulator (SERM), has been demonstrated to directly inhibit uterine contractions, causing improvement in uterine blood flow. It could be considered for application in selected groups of dysmenorrheic patients, for instance carriers of breast cancer-associated antigen (BRCA) genes, breast cancer survivors or women with advanced endometriosis. Thus the aim of the present study was to investigate the effect of short-term treatment with tamoxifen on PD and PD-related symptoms, as well as its direct effect on parameters of intrauterine pressure during the painful menstruation, in a group of dysmenorrheic patients. After two cycles of administration of tamoxifen we noted a significant decrease in bleeding together with reductions in the severity of menstrual cramps, diarrhea, headache, fatigue and anxiety. In intrauterine pressure assessments, tamoxifen significantly decreased propagation of uterine contractions. In conclusion, SERMs such as tamoxifen may constitute a therapeutic option in selected groups of patients, improving dysmenorrheic symptoms. Additionally to its receptor-mediated effects, tamoxifen was shown to exert a direct influence on uterine contractile activity that may explain the decrease of menstrual pain and cramps noted in the studied group

Chemokines Profiling of Patients with Preterm Birth

Introduction. Nowadays it is thought that the main cause of premature birth is subclinical infection. However, none of the currently used methods provide effective prevention to preterm labor. The aim of the study was to determine the concentration of selected chemokines in sera of patients with premature birth without clinical signs of infection (n=62), threatened preterm labor (n=47), and term births (n=28). Method. To assess the concentration of chemokines in the blood serum, we used a multiplex method, which allows the simultaneous determination of 40 chemokines per sample. The sets consist of the following chemokines: 6Ckine/CCL21, Axl, BTC, CCL28, CTACK/CCL27, CXCL16, ENA-78/CXCL5, Eotaxin-3/CCL26, GCP-2/CXC, GRO (GROα/CXCL1, GROβ/CXCL2 and GROγ/CXCL3), HCC-1/CCL14, HCC-4/CCL16, IL-9, IL-17F, IL18-BPa, IL-28A, IL-29, IL-31, IP-10/CXCL10, I-TAC/CXCL11, LIF, LIGHT/TNFSF14, Lymphotactin/XCL1, MCP-2/CCL8, MCP-3/CCL7, MCP-4/CCL13, MDC/CCL22, MIF, MIP-3α/CCL20, MIP-3-β/CCL19, MPIF-1/CCL23, NAP-2/CXCL7, MSPα, OPN, PARC/CCL18, PF4, SDF-1/CXCL12, TARC/CCL17, TECK/CCL25, and TSLP. Results. We showed possible implication of 4 chemokines, that is, HCC-4, I-TAC, MIP-3α, and TARC in women with symptoms of preterm delivery. Conclusion. On the basis of our findings, it seems that the chemokines may play role in the pathogenesis of preterm labor. Defining their potential as biochemical markers of preterm birth requires further investigation on larger group of patients