Secreted Frizzled-Related Protein 5 in Serum and Urine of Post-Partum Women with Gestational Diabetes Mellitus

Secreted frizzled-related protein 5 (SFRP5) is a newly identified member of the SFRP family produced by the adipose tissue which can act as an anti-inflammatory adipokine. The aim of the study was to assess SFRP5 levels in the serum and urine of women with gestational diabetes mellitus (GDM) in the early post-partum period with reference to their laboratory test results, body composition and hydration status. The study subjects included two groups: 22 GDM patients and 24 healthy controls. Maternal body composition and hydration status were evaluated by the bioelectrical impedance analysis (BIA) method. The serum and urine SFRP5, leptin and ghrelin concentrations were determined via enzyme-linked immunosorbent assay (ELISA). No significant differences were observed between the GDM and healthy groups with regard to the serum and urine SFRP5 concentrations. In the GDM group serum and urine SFRP5 levels correlated positively. The serum SFRP5 concentrations correlated negatively with hemoglobin A1c (HgbA1c) and leptin serum levels in the controls. In the control and GDM groups the serum and urine SFRP5 levels correlated negatively with the serum ghrelin levels. It appears that ghrelin as well as SFRP5 could influence the metabolic homeostasis 48 hours after delivery. A significant correlation between concentrations of SFRP5 in the serum and urine seems to suggest that urine sampling may represent an alternative to the current standard of management i.e. blood sampling. Further research in this field is required

SFRP5-leptin ratio as a promising index in post-partum women with gestational diabetes mellitus

INTRODUCTION: Gestational diabetes mellitus (GDM) has often been referred to as the “marker” for the development of diabetes, obesity and cardiovascular diseases in future lives of women. In the current literature the adiponectin-leptin ratio is presented as a valuable index to estimate adipose tissue dysfunction. OBJECTIVES: The aim of the study was to investigate the significance of a novel parameter, i.e. the ratio of serum concentration of secreted frizzled-related protein 5 (SFRP5) to that of leptin in the early post-partum period. The associations between SFRP5/leptin ratio and maternal laboratory test results, body composition and hydration status were also assessed. PATIENTS AND METHODS: 26 mothers diagnosed with gestational diabetes mellitus (GDM) and 28 healthy controls were enrolled in the study. Body composition and hydration status of the patients were evaluated with the use of bioelectrical impedance analysis (BIA) method. The serum concentrations of SFRP5, leptin, fatty acid-binding protein 4 (FABP4) and ghrelin were determined via enzyme-linked immunosorbent assay (ELISA). RESULTS: SFRP5/leptin ratio was lower in the GDM mothers in comparison to that of the control group. There were positive correlations between SFRP5/leptin ratio and total cholesterol and low-density lipoprotein cholesterol (LDL) levels. The SFRP5/leptin ratio correlated negatively with total body water (TBW) and extracellular water (ECW). CONCLUSIONS: The SFRP5/leptin ratio appears to be a promising index for evaluating of metabolic disturbances in mothers with a history of GDM

The use of dietary supplements in preconception phase of women in Lublin province in the era before the COVID pandemic

Introduction and purpose Nutrition in the preconception phase as well as during pregnancy represents one of the most important factors that affect the development and well-being of the fetus and newborn. The aim of this study was to evaluate the dietary supplements during preconception among Polish women from the Lublin Province.   Material and methods The survey was conducted in a population of 260 women, who were randomly included in the study. The women were asked to anonymously complete a questionnaire regarding the possible intake of supplementation. The questions included in the questionnaire concerned the frequency and type of dietary supplements taken.   Results A slight majority of women (53%) did not take dietary supplements during the contraceptive period. The most commonly used was folic acid (45%), the least frequently - vitamin A (2%). The frequency of using dietary supplements by women in the pre-conception period does not correlate with the level of their place of residence, financial situation or age, however, it is related to the level of education - people with higher education used supplementation more often before pregnancy. Women's awareness of supplementation during pregnancy increases significantly. Women take many more supplements during pregnancy than they took before pregnancy. The average supplementation before pregnancy was 0.48, and during pregnancy it increases significantly and amounts to 0.83.   Conclusions Women's awareness of supplementation during pregnancy increases significantly. Women take many more supplements during pregnancy than they took before pregnancy.The awareness of women should be increased and supplementation of recommended nutrients should be improved in order to prevent the effects of supplements deficiency

Pregnancy-induced rhinitis: nose problems at the obstetrician's office

Introduction and purpose Pregnancy-induced rhinitis (PIR) manifests as nasal congestion, with resolution of symptoms after delivery. Pregnancy-induced rhinitis is a distinct condition from allergic rhinitis, it may not respond to treatment for allergic rhinitis. The first stage in providing adequate and effective management of PIR is to have a clear and appropriate diagnosis. Therefore, each patient-specific management of PIR must take careful consideration of a variety of circumstances. The aim of this study was to conduct a literature review on pregnancy-induced rhinitis. A literature review was carried out in the PubMed, MEDLINE, and Scopus databases using the terms ‘rhinitis and pregnancy’. Brief description of the state of knowledge Physiological factors underlying PIR are not well understood at the moment. There is no single explanation for the pathophysiological mechanism that would account for the changes in PIR. Nasal congestion is the primary nasal symptom in pregnancy-induced rhinitis. It can result in night-time mouth breathing and poor sleep quality. The mother's sleep may be negatively impacted by nasal congestion resulting in maternal hypertension, pre-eclampsia, and intrauterine growth retardation. Increasing awareness not only benefits pregnant patients' quality of life but also has a favourable impact on how a pregnancy turns out. Summary PIR has gained relevance in recent years due to its major effects on maternal quality of life as well as the identification of a relationship with OSAS in the mother and potential harmful consequences on the foetus. The mother's quality of life is significantly impacted by PIR, as shown, thus both the otorhinolaryngologist and the obstetrician must use caution in the early identification and treatment of pregnancy-induced rhinitis

Folic acid supplementation among students

Introduction: Pregnancy is a period in which the supply of vitamins, micro- and macroelements is essential for the proper growth of the fetus. One of the most important substances, which is believed to have a considerable influence on the proper fetus growth is folic acid. Folic acid (i.e. vitamin B9) plays a significant role in rapidly dividing cells and lack of this vitamin causes serious fetal defects - for example neural tube anomalies. Supplementation is important not only during pregnancy but also during the period of pregnancy planning. Methods: Students' knowledge regarding the importance of folic acid supplementation was verified using anonymous Internet questionnaire. The obtained results were analyzed using statistical methods and checked on the basis of scientific literature. Results: The percentage of students who supply folic acid is 18,1% and only 9,5% do this regularly. The most common cause of supply is due to the fact that that folate can be found in vitamin kits students usually take. Part of respondents claim that they plan the pregnancy and want the fetus to develop correctly. Other causes of vitamin B9 intake is prevention of arteriosclerosis, vascular system diseases, anemia, lung, esophagus and uterus cancer. Conclusion: Outcomes showed that students are not fully aware of the importance of vitamin B9 during pregnancy and there is a great need to share knowledge about folic acid supplementation among people in procreative age

Iron deficiency anemia in pregnancy: evaluation and management

Anemia is a condition in which the number of red blood cells (RBC) is insufficient to meet the body's physiological needs for oxygen transport. A limiting factor for the erythrocyte mass increase is iron deficiency, which can also have a negative impact on the pregnancy's prognosis. The most frequent pathogenic cause of anemia in pregnancy is iron deficiency anemia (IDA). Biochemical tests such as serum iron concentration, total iron binding capacity (TIBC), transferrin concentration, and ferritin concentration are decreased in iron deficiency anemia. In clinical practice, iron deficiency is defined as low serum ferritin or a decreased percentage of transferrin saturation by iron. Usually, the diagnosis begins with the determination of serum ferritin. Although iron supplementation for iron deficiency is advised as soon as the condition has been diagnosed, prophylactic iron delivery is still under discussion. In patients for whom oral iron is ineffective or contraindicated, intravenous iron can be used to restore lost iron

Treatment of obstetric cholestasis with polyunsaturated phosphatidylcholine and ursodeoxycholic acid

Abstract Objective: Analysis of obstetric outcomes and laboratory results depending on blood serum level of bile acids (BA) in patients with obstetric cholestasis before treatment. Material and methods: The study was conducted among 43 pregnant women with obstetric cholestasis. The study population was divided into 3 groups, depending on blood serum level of bile acids before treatment: I group (n=15) – BA 11-15μmol/l, II group (n=13) – BA 15-20μmol/l and III group (n=15) – BA > 20μmol/l. Polyunsaturated phosphatidylcholine (PPC) treatment was used in I group, ursodeoxycholic acid (UDCA) in II group and combination of them in III group. Blood serum levels of transaminases, alkaline phosphatase and bilirubin were determined before treatment and during delivery. Bile acids concentrations were also assessed during delivery in maternal serum and cord blood. Results: No significant statistical difference was observed in patients age, number of primiparas, delivery method, neonatal birth weight and Apgar score. The earliest obstetric cholestasis diagnosis was observed in III group. Earlier pregnancy termination, higher transaminases and bile acids levels before treatment, larger differences (Δ) of transaminases and bile acids levels before treatment and during delivery as well as larger Δ in bile acids levels before treatment and in cord blood during delivery were observed in III group in comparison to I group. Conclusions: It seems that combined therapy with UDCA and PPC could be considered in obstetric cholestasis, especially in case of its early onset and/or severe course

Tocolytic therapy in threatened preterm labor

Summary The most important benefit of tocolysis is a 48-hour prolongation of gestational age in order to administer corticosteroids to reduce perinatal mortality and morbidity, as well as, if necessary, to gain time for “in utero” transfer to a tertiary centre with neonatal facilities. The tocolytic agents used in clinical practice can be grouped into six classes, namely: calcium channel blockers, betamimetics, magnesium sulfate, cyclooxygenase inhibitors, oxytocin receptor antagonists and nitric oxide donors. The use of them should be individualized and based on tocolytic effectiveness, safety, gestational age as well as maternal, fetal and neonatal outcomes. Data from clinical trials suggests that nifedipine appears to be the drug of first choice in the management of preterm labor

Restoring the patency of fallopian tubes using the transcervical selective hysterosalpingography methods - a clinical case analysis

Abstract Introduction: Infertility caused by tubal occlusion is a relatively frequent affliction among women of child-bearing age. A common cause of tubal occlusion are mucous plugs accumulated inside the fallopian tubes, which results in blocking them. Selective hysterosalpingography (SHSG) is a method of removing the obstruction located in a proximal section of the fallopian tube. The most serious complication developed from this procedure is a fallopian tube perforation, however, it affects less than 1% of patients who undergo the treatment. The clinical success of recanalization of the fallopian tubes is estimated at about 85-88% and the frequency of successful pregnancies after the treatment is about 27%. Aim: To show the usage and effectiveness of SHSG in diagnosis and treatment in the obstruction of proximal section of fallopian tube. Case report: The patient, 33 years old, diagnosed with primary infertility, qualified to the SHSG at Independent Public Clinical Hospital No. 4 in Lublin. The first stage of SHSG was the insertion of a catheter into the uterine cavity and introduction of a contrast agent to the uterine cavity. The fallopian tubes did not release the contrast into the peritoneal cavity. After increasing the contrast, delivery pressure agent obtained the free flow of the contrast agent into the peritoneal cavity through the right fallopian tube. The uterine outlet of the left fallopian tube was selectively catheterized and a micro tool was inserted into the left fallopian tube. As the result, both fallopian tubes were unblocked. Summary: SHSG is a non-invasive and safe method of removing the obstruction located in the proximal section of the fallopian tube. Women subjected to SHSG can return to their normal activities in a few hours after treatment

Kardiowersja elektryczna w leczeniu zaburzeń rytmu serca podczas ciąży – opis przypadku i przegląd literatury

The incidence of cardiac arrhythmias is estimated et 1.2 per 1000 pregnancies, usually in the third trimester, and 50% of them are asymptomatic. They may appear for the first time in pregnancy, or have a recurring character. An important risk factor related to their appearance is the presence of structural heart disease, which complicatesZaburzenia rytmu serca mogą wystąpić po raz pierwszy w ciąży lub mieć charakter nawracający. Istotnym czynnikiem ryzyka związanym z ich pojawieniem się jest obecność wady organicznej serca, która komplikuj