Placenta praevia: Preach and perception

Placenta praevia is a known obstetric condition that causes complications to mother and fetus. This study was done to evaluate the knowledge of placenta praevia amongst the obstetric patients. A cross sectional study was carried out in Hospital Ipoh, Perak among 323 antenatal and postnatal patients. Socio-demographic parameters (ie age, race, parity, occupation, educational level) and history of placenta praevia were studied in relation to level of knowledge and attitude towards placenta praevia. Twenty (6.2%) from 323 women had current or past history of placenta praevia. Three had history of placenta praevia while 17 had current placenta praevia with prevalence of 5.3%. The mean score of knowledge achieved by patients was 11.8 which indicated overall poor knowledge. Occupation, level of education and history of placenta praevia were found to have a relationship with level of knowledge regarding placenta praevia in all obstetric patients. There was a significant relationship between attitude of patients with current and history of placenta praevia to level of knowledge regarding placenta praevia. (p=0.037, <0.05). In conclusion, the knowledge and attitude towards placenta praevia among obstetric patients in Hospital Ipoh was better in those who had higher education status, white-collar occupation and currently pregnant with placenta praevi

Cesarean scar defects and placental abnormalities – a 3 year survey study

The placenta is an essential organ for embryonic and fetal development, ensuring nutrient uptake, gas exchange (via the mother\u27s blood supply), waste elimination, thermo-regulation, immunological and hormonal factors, etc. The most common placental abnormalities are represented by placenta previa, and a morbidly adherent placenta (in the form of accreta, increta, and percreta placenta). This study was performed on a sample of 99 patients diagnosed with abnormalities of placentation who underwent cesarian delivery during a period of 3 years in Bucur Maternity Hospital. Seven patients were diagnosed with morbidly adherent placenta (5 accreta and 2 percreta subtypes), the others having placenta previa (65 with lateral disposition, 18 marginal, and 9 central insertion). All patients had been diagnosed by ultrasound (which was also used for general monitoring), being confirmed during operation and histopathologically. Complications required 4 emergency peripartum hysterectomies, with no maternal mortality but with fetal death in one case. The research literature shows that about half of women with placenta previa have several episodes of bleeding, being the leading cause of antepartum hemorrhage. For some women with placenta previa/accrete, hemorrhaging is severe and requires hysterectomy as a necessary step to control the life-threatening situation. Thus, such patients should be carefully monitored to avoid as much as possible the medical, social, and psychological implications of this critical therapeutic procedure

Dose-Dependent Enhancement of Morphine-Induced Analgesia\ud by Ingestion of Amniotic Fluid and Placenta

Ingestion of amniotic fluid and placenta by rats has been shown to enhance opioid-mediated analgesia. The present studies were designed to examine the effect of several doses and volumes of placenta and amniotic fluid on tail-flick latency in rats treated with 3 mg/kg morphine. The optimal dose of amniotic fluid was found to be 0.25 ml, although 0.50 and 1.0 ml also produced significant enhancement. Doses of 0.125 and 2 ml of amniotic fluid were ineffective, as was a dose of 0.25 ml diluted to 2 ml with saline. The optimal dose of placenta was found to be 1 placenta, although the resulting enhancement was not significantly greater than that produced by 0.25, 0.50, 2.0 or 4.0 placentas. Doses smaller than 0.25 placenta or larger than 4.0 placentas were ineffective. The most effective doses of amniotic fluid and placenta correspond to the amounts delivered with each pup during parturition

Placentophagia in Nonpregnant Rats:\ud Influence of Estrous Cycle Stage and Birthplace

Prior parturitional experience and genotype have previously been found to affect the proportion of nonpregnant female rats and mice that will eat foster placenta. The present series of experiments was designed to investigate the influence of estrous cycle stage on placentophagia in rats. Foster placenta was presented to nonpregnant Long-Evans females, purchased from a commercial breeder, for 15 min on 5 consecutive days. We found that virgin placentophages were most likely to have eaten placenta on the first presentation, unless the first presentation occurred during proestrus. In fact, virgins would not eat placenta for the first time during proestrus, regardless of test-day. However, once they had eaten placenta, either in a nonproestrus stage, or, in the case of primiparae, during parturition, they would eat placenta during proestrus. Long-Evans rats born in our laboratory differed from the purchased rats, manifesting an incidence of placentophagia that was too low to be analyzed by stage of the estrous cycle; when tested as primiparae, however, there were no differences between the two groups

Placenta Ingestion Enhances Analgesia\ud Produced by Vaginal/Cervical\ud Stimulation in Rats

Ingestion of placenta has previously been shown to enhance opiate-mediated analgesia (measured as tail-flick latency) induced either by morphine injection or by footshock. The present study was designed to test whether placenta ingestion would enhance the partly opiate-mediated analgesia produced by vaginal/cervical stimulation. Nulliparous Sprague-Dawley rats were tested for analgesia, using tail-flick latency, during and after vaginal/cervical stimulation; the tests for vaginal/cervical stimulation-induced analgesia were administered both before and after the rats ate placenta or ground beef. Placenta ingestion, but not beef ingestion. significantly heightened vaginal/cervical stimulation-induced analgesia. A subsequent morphine injection provided evidence that, as in a previous report, placenta ingestion, but not beef ingestion, enhanced morphine-induced analgesia

Placental Flattening via Volumetric Parameterization

We present a volumetric mesh-based algorithm for flattening the placenta to a canonical template to enable effective visualization of local anatomy and function. Monitoring placental function in vivo promises to support pregnancy assessment and to improve care outcomes. We aim to alleviate visualization and interpretation challenges presented by the shape of the placenta when it is attached to the curved uterine wall. To do so, we flatten the volumetric mesh that captures placental shape to resemble the well-studied ex vivo shape. We formulate our method as a map from the in vivo shape to a flattened template that minimizes the symmetric Dirichlet energy to control distortion throughout the volume. Local injectivity is enforced via constrained line search during gradient descent. We evaluate the proposed method on 28 placenta shapes extracted from MRI images in a clinical study of placental function. We achieve sub-voxel accuracy in mapping the boundary of the placenta to the template while successfully controlling distortion throughout the volume. We illustrate how the resulting mapping of the placenta enhances visualization of placental anatomy and function. Our code is freely available at https://github.com/mabulnaga/placenta-flattening .Comment: MICCAI 201

First report of caprine abortions due to Chlamydia abortus in Argentina.

Infectious abortions of goats in Argentina are mainly associated with brucellosis and toxoplasmosis. In this paper, we describe an abortion outbreak in goats caused by Chlamydia abortus. Seventy out of 400 goats aborted. Placental smears stained with modified Ziehl-Neelsen stain showed many chlamydia-like bodies within trophoblasts. One stillborn fetus was necropsied and the placenta was examined. No gross lesions were seen in the fetus, but the inter-cotyledonary areas of the placenta were thickened and covered by fibrino-suppurative exudate. The most consistent microscopic finding was found in the placenta and consisted of fibrinoid necrotic vasculitis, with mixed inflammatory infiltration in the tunica media. Immunohistochemistry of the placenta was positive for Chlamydia spp. The results of polymerase chain reaction targeting 23S rRNA gene performed on placenta were positive for Chlamydia spp. An analysis of 417 amplified nucleotide sequences revealed 99% identity to those of C. abortus pm225 (GenBank AJ005617) and pm112 (GenBank AJ005613) isolates. To the best of our knowledge, this is the first report of abortion associated with C. abortus in Argentina

KADAR TNF-aIL-6 DAN APOPTOSIS TROFOBLAST PLASENTA Pada Preeklampsia-Eklampsia dan non Preklampsia-Eklampsia

Objectives: The aim of this study is to investigate the relation among TNF-a -6 concentration/expression with placental tissue infarction and apoptosis between PE-E and non PE-E. Material and method: Research subjects were 35 subjects, composed of 17 non PE-E and 18 PE-E parturient that delivery or hospitalized on Department of OBGYN Dr. Kariadi General Hospital Semarang. The concentration/expression of TNF- -6 were measured from vein blood sample and placental tissue by ELISA and immunohystochemistry (IHC) method. Apoptosis area was measured by IHC with Acridine orange staining. Results: The average of infarction on normal subjects was 12.5%, however, on PE-E was 35.3% (p=0.001). The average of apoptosis on normal subjects was 32.3 %, however, on PE-E subjects were 71.0% (p=0.001). The average of placenta TNFpg/ mL, on PE-E was 2.0 pg/mL (p<0.001). The average of serum TNFnormal subjects was 2.3 pg/mL, on PE-E was 2.8 pg/mL (p<0.001). The average of placenta IL- 6 concentration of normal subjects was 0.6 pg/mL, on PE-E was 1.3 pg/mL (p<0.001). The average of serum IL-6 concentration of normal subjects was 1.4 pg/mL, on PE-E was 2.0 pg/mL (p<0.001). There were a significant correlation among TNF-a -6 serum and placenta with apoptosis of placenta. Conclusion: Proinflammatory cytokines concentration on serum and placenta extract of subjects with PE-E were significantly higher than non PE-E. There was a significant correlation between proinflammatory cytokines concentration on serum or placenta with apoptosis of placental tissue. Keywords: TNF-a , IL-6, infarct, apoptosis, placenta, preeclampsia, eclampsia

Ingested placenta blocks the effect of morphine on gut transit in Long–Evans rats

Opioids produce antinociception, and ingested placenta or amniotic fluid modifies that antinociception. More specifically, ingested placenta enhances the antinociception produced by selective activation of central n-opioid or y-opioid receptors but attenuates that produced by activation of central A-opioid receptors. Opioids also slow gut transit by acting on central or peripheral A-opioid receptors. Therefore, we hypothesized that ingested placenta would reverse the slowing of gut transit that is produced by morphine, a preferential A-opioid-receptor agonist. Rats were injected with morphine either centrally or systemically and fed placenta, after which gastrointestinal transit was evaluated. We report here that ingested placenta reversed the slowing of gut transit produced by centrally administered morphine but did not affect the slowing of gut transit produced by systemically administered morphine. These results suggest another likely consequence of placentophagia at parturition in mammals—reversal of opioid-mediated, pregnancy-based disruption of gastrointestinal function—as well as an important consideration in opioid-based treatments for pain in humans—enhancement of desirable effects with attenuation of adverse effects

The platelet-derived growth factor receptor alpha promoter-directed expression of cre recombinase in mouse placenta.

BackgroundNumerous pathologies of pregnancy originate from placental dysfunction. It is essential to understand the functions of key genes in the placenta in order to discern the etiology of placental pathologies. A paucity of animal models that allow conditional and inducible expression of a target gene in the placenta is a major limitation for studying placental development and function.ResultsTo study the platelet-derived growth factor receptor alpha (PDGFRα)-directed and tamoxifen-induced Cre recombinase expression in the placenta, PDGFRα-CreER mice were crossed with mT/mG dual-fluorescent reporter mice. The expression of endogenous membrane-localized enhanced green fluorescent protein (mEGFP) and/or dTomato in the placenta was examined to identify PDGFRα promoter-directed Cre expression. Pregnant PDGFRα-CreER;mT/mG mice were treated with tamoxifen at various gestational ages. Upon tamoxifen treatment, reporter protein mEGFP was observed in the junctional zone (JZ) and chorionic plate (CP). Furthermore, a single dose of tamoxifen was sufficient to induce the recombination.ConclusionsPDGFRα-CreER expression is restricted to the JZ and CP of mouse placentas. PDGFRα-CreER mice provide a useful tool to conditionally knock out or overexpress a target gene in these regions of the mouse placenta