Antigens HLA-G, sHLA- G and sHLA- class I in reproductive failure.

It can be supposed that relation between HLA-G polymorphism and sHLA-G protein expression are associated with successful embryo implantation and pregnancy maintenance. The aim of the study was the estimation specific differences in expression of sHLA-G and sHLA- class I antigens in women with reproductive failure in comparison with fertile women. The study sample enrolled 80 women, divided into 2 groups. The study group (B) enrolled 60 women with reproductive failure including 20 women with 3 recurrent spontaneous abortions in the first trimester of pregnancy (RSA), 20 women with empty sac (ES) and 20 women with 3 consecutive in-vitro fertilization failures (IVFf). The control group (C) enrolled 20 fertile women with at least 2 children. Soluble HLA- class I antigens (sHLA-I) and soluble HLA-G (sHLA-G) were determined using ELISA test kits from IBio Vendor Labolatory Medicine, Inc. HLA-G allele found in individuals in our study were identified by comparing the obtained bp sequences of exon 2., 3. and 4. with bp sequences of HLA-G antigen published at the Nolan Research Institute website. The highest concentration of sHLA-I is noted among women with HLA-G 10401 allele which differed significantly for the mean sHLA-I concentration calculated for all the remaining alleles (

Ocular manifestations in a newborn from a pregnancy complicated by an antiphospholipid syndrome – a case report

The paper presents a case of ophthalmologic manifestations, episcleritis and retinal branch vein thrombosis, in a neonate born to a mother with antiphospholipid syndrome (APS) in the course of systemic lupus erythematosus. Female neonate (birth weight 1150 g, Apgar scores 6, 7 and 7) was born with respiratory distress syndrome, moderate anemia and grades I and II intraventricular hemorrhage. Ophthalmic examination revealed an enormous pre-retinal hemorrhage with accompanying thrombotic changes typical of retinal vein in the fundus of the left eye. Episcleritis was found in the anterior segment of the eye and later confirmed by ultrasound. Laboratory tests showed increased levels of maternal antibodies aCL IgG, antyβ2GP1 IgG and antyβ2GP1 IgM. No ANA, LA and SS-A/SS-B antibodies were detected. Increased concentrations of aCL IgG and a lengthening APTT were observed in newborn blood at first but the parameters normalized by 6 months of age. Our observations allowed us to conclude that early examination of neonates born to mothers with antiphospholipid syndrome is essential as it allows fast identification of pathological retinal changes by means of assessing the presence of aPL antibodies

Birth status and twin birth weight discordance

Abstract Objectives: The aim of the research was to estimate the influence of birth weight discordance on birth status of twins. Material and methods: Material of the research consisted of 560 foetuses derived from successful twin pregnancies. In the analysis the following factors were taken into consideration: birth status, gasometry, and birth weight discordance. Results: The degree of birth weight discordance under 10% was noted in 50% of twin pregnancies (n=140), discordance of 10%-20% was observed in 30.7% (n=86), and >20 % - in 19,3% (n=54). Conclusions: Birth weight discordance is an important risk factor for fetal and neonatal morbidity which is higher in smaller twins than in larger ones. Along with the degree of birth weight discordance, an increased risk of neonatal complications was observed

Kohabitacja jako silny czynnik predykcyjny depresji okołoporodowej

al and methods: 117 pregnant women (at 32-40 weeks of gestation) and 105 postpartum patients (2-5 days after the delivery) were included in the study. The Edinburgh Postnatal Depression Scale (EPDS) was used as a screening test for symptoms of pre- and postnatal depression. The risk of appearance of depressive symptoms was assessed in three groups of pregnant and postpartum patients – married, unpartnered and cohabitating. Results: By means of the EPDS test, symptoms of perinatal depression were found in 17% of pregnant and 10% of postpartum women. In comparison to married women, the risk of appearance of depressive symptoms in unpartnered pregnant patients was almost 10-times higher (OR=9,34; 95% CI 1,42, 201,77), and several hundred times higher in cohabitating pregnant women (OR=975,86; 95% CI 116,73, 19502,00); the risk of depressive symptoms in postpartum unpartnered women was more than 2 times higher (OR=2,4; 95% CI 0,59, 9,72) and more than 20 times higher in cohabitating postpartum mothers (OR=23,2; 95% CI 5,89, 91,51). Conclusions: 1/ the marital status of pregnant and postpartum women has a substantial influence on the risk of the development of perinatal depressive symptoms; this risk is highly increased in a group of cohabitating women compared to patients remaining in a formal partnership as well as women who live unpartnered, 2/ clinical evaluation of women in the perinatal period should include the assessment of their psychosocial status, which can constitute a predicting factor of perinatal depression, 3/ pregnant women living in informal partnership should be put under strict psychological surveillance.Streszczenie Cel pracy: Celem pracy było zbadanie, czy stan cywilny kobiet będących w ciąży lub w połogu, ze szczególnym uwzględnieniem zjawiska kohabitacji, wpływa na częstość występowania objawów depresji okołoporodowej. Materiał i metody: Badaniem objęto 117 kobiet ciężarnych (w wieku ciążowym 32-40 tygodni) i 105 położnic (2-5 dzień połogu). Jako test skriningowy w kierunku obecności objawów depresji przed- i poporodowej zastosowano kwestionariusz EPDS (Edynburska Skala Depresji Okołoporodowej). Oceniono ryzyko wystąpienia objawów depresji w grupach kobiet ciężarnych i położnic - zamężnych, stanu wolnego i w kohabitacji. Wyniki: Przy pomocy testu EPDS objawy depresji okołoporodowej stwierdzono u 17% ciężarnych oraz 10% położnic. W porównaniu z grupa kobiet zamężnych, ryzyko wystąpienia objawów depresji u ciężarnych stanu wolnego było podwyższone blisko dziesięciokrotnie (OR=9,34; 95% CI 1,42, 201,77), natomiast aż kilkusetkrotnie u ciężarnych kohabitujących (OR=975,86; 95% CI 116,73, 19502,00); ryzyko wystąpienia objawów depresji u położnic stanu wolnego było podwyższone ponad dwukrotnie (OR=2,4; 95% CI 0,59, 9,72), natomiast ponad dwudziestokrotnie u położnic kohabitujących (OR=23,2; 95% CI 5,89, 91,51). Wnioski: 1) stan cywilny kobiet ciężarnych i położnic ma istotny wpływ na ryzyko wystąpienia objawów depresji okołoporodowej; ryzyko to zwiększa się wielokrotnie w grupie kobiet kohabitujących w stosunku do kobiet pozostających w związkach formalnych i kobiet wolnych nie żyjących z partnerem, 2) badanie kliniczne kobiet w okresie perinatalnym powinno uwzględniać ocenę ich stanu psychospołecznego, który może być czynnikiem predykcyjnym depresji okołoporodowej, 3) kobiety ciężarne żyjące w związkach nieformalnych powinny być objęte szczególnym nadzorem psychologicznym

Style radzenia sobie w sytuacjach stresowych a Lęk-stan i Lęk-cecha u kobiet z objawami depresji okołoporodowej

Abstract Objectives: The aim of the following study was to establish whether there is any connection between an elevation of anxiety experienced by women during pregnancy or postpartum and their styles of coping with stressful situations, as well as to assess if those factors influence higher risk of incidence of perinatal depressive symptoms. Material and methods: A total of 229 patients admitted to the Department of Foeto-Maternal Medicine, Pomeranian Medical University, Szczecin in 2006-2007, were recruited for the study. By means of the Edinburgh Postnatal Depression Scale (EPDS), a study group of 76 pregnant and postpartum women with high risk of perinatal depression was assigned, as well as a control group of 153 patients without such risk. The level of anxiety and ways of coping in stressful situations were measured by means of the CISS (Coping Inventory for Stressful Situations) and STAI (State-Trait Anxiety Inventory) questionnaires. Results: It has been shown that specific styles of coping in stressful situations and Anxiety-state or Anxiety-trait have substantial influence on higher risk of perinatal depressive symptoms in women. Conclusions: 1). The risk of perinatal depressive symptoms is associated with ways of coping with stressful situations or Anxietystate and Anxiety-trait., 2). the risk of perinatal depression among pregnant women increases with an elevation of emotion-concentrated styles of coping in stressful situations, 3). the risk of perinatal depression among postpartum women increases with an elevation of emotion-concentrated ways of coping in stressful situations and engagement in substitute activities, 4). analysis of undertaken research indicate for suitableness of early diagnosis of specific styles of coping in stressful situations in order to implement proper therapy directed at the reduction of the risk of perinatal depression.Streszczenie Cel pracy: W pracy zbadano, czy istnieje zależność między nasilaniem się lęku doświadczanego przez kobiety w okresie ciąży i połogu a stylami radzeniem sobie przez nie w sytuacjach stresowych, a także czy te czynniki wpływają na zwiększenie ryzyka wystąpienia objawów depresji okołoporodowej. Materiał i metody: W badaniach wzięło udział 229 pacjentek hospitalizowanych w Klinice Medycyny Matczyno-Płodowej Pomorskiej Akademii Medycznej w Szczecinie w latach 2006-2007. Przy użyciu Edynburskiej Skali Depresji Poporodowej (EPDS) wyodrębniono grupę badaną 76 kobiet ciężarnych i położnic z wysokim ryzykiem wystąpienia objawów depresji okołoporodowej oraz grupę kontrolną 153 pacjentek bez takiego ryzyka. Poziom lęku oraz style radzenia sobie w sytuacjach stresowych zmierzono przy użyciu kwestionariuszy CISS (Coping Inventory for Stressful Situations) i STAI (State-Trait Anxiety Inventory). Wyniki: Wykazano znaczący wpływ określonych stylów radzenia sobie w sytuacjach stresowych oraz Lęku-stanu i Lęku-cechy na nasilenie ryzyka wystąpienia objawów depresji okołoporodowej u kobiet. Wnioski: 1.Ryzyko wystąpienia objawów depresji okołoporodowej związane jest ze stylami radzenia sobie w sytuacjach stresowych oraz Lękiem-stanem i Lękiem-cechą. 2. Ryzyko wstąpienia objawów depresji okołoporodowej u ciężarnych wzrasta w przypadku stosowania stylu radzenia sobie w sytuacjach stresowych skoncentrowanego na emocjach. 3. Ryzyko wstąpienia objawów depresji okołoporodowej u położnic wzrasta w przypadku stosowania stylu skoncentrowanego na emocjach i angażowaniu się w czynności zastępcze. 4. Analiza przeprowadzonych badań wskazuje na celowość wdrażania wczesnej diagnostyki stylów radzenia sobie w sytuacjach stresowych u kobiet ciężarnych, celem podjęcia odpowiedniej terapii ukierunkowanej na zmniejszenie ryzyka rozwoju depresji okołoporodowej

Estimation of diagnostic value of the middle cerebral artery peak systolic velocity in prediction of fetal anemia in pregnancies complicated by alloimmunisation

Abstract The use of the middle cerbral artery peak systolic velocity (PSV) for the noninvasive diagnosis of fetal anemia in pregnancies complicated by alloimmunisation has the potential to reduce the number of invesive procedures. Objectives: The study was undertaken to determine the detection of fetal anemia by fetal middle cerebral artery peak systolic velociy (MCA PSV). Material and methods: 31 fetuses with red cell alloimmunisation were evaluated with Doppler ultrasongraphy. On the basis of ROC (AUC) analysis the cutoff point of MoM=1.215 with the highest sensitivity and specivicity was established. We examined the relation between MoM=1.215 and neonatal hemoglobin level and the maternal antibody titre in the indirect antiglobulin test. Sensitivity, specificity, positive and negative value and statistical significance were calculated. Conclusions: Data reported to date suggest that a threshold of 1.215 multiples of the median can be used to better diagnostic of fetal anemia

Association between HLA-DQA1, HLA-DQB1 alleles and risk of early pregnancy loss

The aim: The aim of the study is to identify HLA-DQA1, HLA-DQB1 allele and to assess the risk of early pregnancy loss of women, couples with reproductive failure in the first trimester of pregnancy in comparison with fertile women, couples. The study group (B) enrolled 61 couples with reproductive failure and the control group (C) enrolled 20 fertile couples with at least 2 children. Method: HLA-DQA1 gene typing was performed using PCR-sequence-specific primer (SSP) on the high resolution level according to established procedure of labeling and using the detection kit (FASTYPETM DQASSP Typing, FASTYPETM DQA „High Resolution” Typing Sheet) purchased from Bio-Synthesis (USA). Results: In female patient the highest risk quotient was associated with alleles HLA-DQA 01101/0105 OR 7,19 (95% CI 1,18-5,23; p=0,03) and HLA-DQB5 OR 3,67 (95% CI =1,11-12,0; p=0,037). The lowest but statistically significant risk of pregnancy failure in this group was related to allele HLA-DQB6 OR 0,48 (95% CI=0,22-1,04; p=0,087). In patient and control couples the significantly increased risk of pregnancy failure was related to the frequency of HLA-DQB5 allele OR 2,3 (95% CI 1,09-4,82; p=0,035) . The lowest risk quotient in the patient couples was associated with HLA-DQ 0302/0303 allele OR 0,44 (95% CI 0,14-1,36; p=ns). Conclusion: HLA-DQA and HLA-DQB allele might influence pregnancy outcome in the Polish population, but further studies are necessary in this regard

Clinical potential for noninvasive prenatal diagnosis through detection of fetal cells in maternal blood

Summary Fetal cells circulate in maternal blood and are considered a suitable means by which to detect fetal genetic and chromosomal abnormalities. This approach has the advantage of being noninvasive. Since the early 1990s, nucleated erythrocytes (NRBCs) have been considered good target cells for a number of techniques, including fluorescence-activated cell sorting and magnetic cell sorting, using antibodies such as anti-transferrin receptor and anti-?-hemoglobin antibodies, followed by analysis with fluorescence in situ hybridization or polymerase chain reaction. In the late 1990s, the National Institute of Child Health and Human Development Fetal Cell Isolation Study assessed the reliability of noninvasive prenatal diagnosis of fetal aneuploidy using NRBCs isolated from maternal circulation. This study revealed the limitations of NRBC separation using antibodies specific for NRBC antigens. A more recent study has demonstrated the efficiency and success of recovery of NRBCs using a galactose-specific lectin, based on the observation that erythroid precursor cells have a large quantity of galactose molecules on their cell surface. Thus, recent advances in this field enhance the feasibility of this diagnostic method. This review article focuses on various methods of detection of fetal cells within the maternal circulation, as well as the status of previous and current studies and the prospective view for noninvasive prenatal diagnosis using fetal cells from the maternal circulation