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https://www.readbyqxmd.com/read/29242046/the-feasibility-and-acceptability-of-self-testing-for-proteinuria-during-pregnancy-a-mixed-methods-approach
#1
Katherine L Tucker, Liza Bowen, Carole Crawford, Philippa Mallon, Lisa Hinton, Mei-Man Lee, Jason Oke, Kathryn S Taylor, Carl Heneghan, Clare Bankhead, Lucy Mackillop, Tim James, Pippa Oakeshott, Lucy C Chappell, Richard J McManus
OBJECTIVE: To investigate feasibility and acceptability of self-testing for proteinuria during pregnancy. STUDY DESIGN: Mixed methods approach which included: an accuracy study where pregnant women (n = 100) and healthcare professionals (n = 96) tested seven synthetic protein samples and completed a questionnaire, a feasibility study where pregnant women who were self-monitoring their blood pressure were asked to self-test for proteinuria (n = 30), and an online questionnaire about women's experiences of self-testing (n = 200)...
November 23, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29239061/progesterone-inhibited-endoplasmic-reticulum-stress-associated-apoptosis-induced-by-interleukin-1%C3%AE-via-the-grp78-perk-chop-pathway-in-bewo-cells
#2
Ling Liu, Yan Zhang, Yankui Wang, Wei Peng, Ning Zhang, Yuanhua Ye
AIM: Pre-eclampsia (PE) is a pregnancy complication characterized by new onset maternal hypertension and proteinuria. Its underlying mechanisms are unclear. This study investigated the relationship between progesterone and endoplasmic reticulum stress (ERS) associated apoptosis induced by interleukin (IL)-1β via the glucose regulated protein 78 (GRP78)/protein kinase RNA-like endoplasmic reticulum kinase (PERK)/C/EBP-homologous protein (CHOP) pathway in BeWo cells. METHODS: Venous blood and placental tissues were collected from PE patients, normal pregnancy and preterm delivery cases, respectively...
December 14, 2017: Journal of Obstetrics and Gynaecology Research
https://www.readbyqxmd.com/read/29230859/placenta-microstructure-and-microcirculation-imaging-with-diffusion-mri
#3
Paddy J Slator, Jana Hutter, Laura McCabe, Ana Dos Santos Gomes, Anthony N Price, Eleftheria Panagiotaki, Mary A Rutherford, Joseph V Hajnal, Daniel C Alexander
PURPOSE: To assess which microstructural models best explain the diffusion-weighted MRI signal in the human placenta. METHODS: The placentas of nine healthy pregnant subjects were scanned with a multishell, multidirectional diffusion protocol at 3T. A range of multicompartment biophysical models were fit to the data, and ranked using the Bayesian information criterion. RESULTS: Anisotropic extensions to the intravoxel incoherent motion model, which consider the effect of coherent orientation in both microvascular structure and tissue microstructure, consistently had the lowest Bayesian information criterion values...
December 11, 2017: Magnetic Resonance in Medicine: Official Journal of the Society of Magnetic Resonance in Medicine
https://www.readbyqxmd.com/read/29222938/role-of-angiogenic-factors-in-the-pathogenesis-and-management-of-pre-eclampsia
#4
REVIEW
Nnabuike C Ngene, Jagidesa Moodley
The cause of pre-eclampsia is unknown. Different postulates have been developed to explain its pathogenesis. The two-stage theory and angiogenic imbalance are two notable postulates of the disease. Together, they propose that there is a lack of cytotrophoblastic invasion of the uterine spiral arteries in pre-eclampsia. The lumen of these arteries remains narrow instead of converting to the wide channels seen in normal pregnancy, and result in poor placental perfusion. Coupled with maternal susceptibility, this process leads to the release of mediators, including an excess of anti-angiogenic factors that result in the clinical manifestations of the disease...
December 9, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29222389/natural-killer-cells-and-t-lymphocytes-in-pregnancy-and-pre-eclampsia
#5
EDITORIAL
Erin B Taylor, Jennifer M Sasser
Although pre-eclampsia (PE), a hypertensive disorder of pregnancy, has significant maternal and fetal morbidity and mortality worldwide, the mechanisms contributing to this disease have not been fully elucidated. Studies in patients and experimental models have shown that changes in the number or function of immune cells of both the adaptive and innate immune systems contribute to the development and pathogenesis of PE. This commentary summarizes our current understanding of the role of the immune system in the pathogenesis of PE, specifically focussing on dysfunction of natural killer (NK) cells and T lymphocyte populations...
December 15, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29221766/screening-for-fetal-growth-restriction-and-placental-insufficiency
#6
REVIEW
Melanie C Audette, John C Kingdom
Fetal growth restriction (FGR) continues to be a leading cause of preventable stillbirth and poor neurodevelopmental outcomes in offspring, and furthermore is strongly associated with the obstetrical complications of iatrogenic preterm birth and pre-eclampsia. The terms small for gestational age (SGA) and FGR have, for too long, been considered equivalent and therefore used interchangeably. However, the delivery of improved clinical outcomes requires that clinicians effectively distinguish fetuses that are pathologically growth-restricted from those that are constitutively small...
December 5, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29214752/evaluation-of-sflt-1-plgf-ratio-for-predicting-and-improving-clinical-management-of-pre-eclampsia-experience-in-a-specialized-perinatal-care-center
#7
Hélène Caillon, Cécile Tardif, Erwan Dumontet, Norbert Winer, Damien Masson
BACKGROUND: Management of pregnant women at high risk of pre-eclampsia (PE) requires frequent monitoring, with referral to specialized perinatal care centers. Reliable tests are necessary to improve prediction of PE and related complications and to assess disease severity and progression. An imbalance in two biomarkers, soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF), is involved in PE pathogenesis. The sFlt-1 to PlGF ratio is increased in pregnant women before the onset of PE...
March 2018: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/29211491/complications-and-care-related-to-pregnancy-labor-and-delivery-among-active-component-service-women-u-s-armed-forces-2012-2016
#8
Shauna Stahlman, Catherine T Witkop, Leslie L Clark, Stephen B Taubman
Diagnoses of "complications of pregnancy, childbirth, and the puerperium" include both morbid complications and indications for routine care of pregnant women. During 2012-2016, a total of 55,601 U.S. service members with live births (n=63,879) had 657,060 medical encounters with primary diagnoses of "pregnancy complications." The most frequent diagnoses were "other" specified conditions complicating pregnancy, childbirth, or the puerperium. Numbers of medical encounters with a primary (first-listed) diagnosis of any pregnancy-related complication or indication for care decreased marginally each year between 2012 (n=178,703) and 2016 (n=146,282)...
November 2017: MSMR
https://www.readbyqxmd.com/read/29208234/vitamin-d-attenuates-sphingosine-1-phosphate-s1p-mediated-inhibition-of-extravillous-trophoblast-migration
#9
Melissa Westwood, Khiria Al-Saghir, Sarah Finn-Sell, Cherlyn Tan, Elizabeth Cowley, Stéphane Berneau, Daman Adlam, Edward D Johnstone
INTRODUCTION: Failure of trophoblast invasion and remodelling of maternal blood vessels leads to the pregnancy complication pre-eclampsia (PE). In other systems, the sphingolipid, sphingosine-1-phosphate (S1P), controls cell migration therefore this study determined its effect on extravillous trophoblast (EVT) function. METHODS: A transwell migration system was used to assess the behaviour of three trophoblast cell lines, Swan-71, SGHPL-4, and JEG3, and primary human trophoblasts in the presence or absence of S1P, S1P pathway inhibitors and 1,25(OH)2D3...
December 2017: Placenta
https://www.readbyqxmd.com/read/29208037/uterine-rupture-in-a-primigravid-patient-an-uncommon-but-severe-obstetrical-event-a-case-report
#10
Lotte Posthumus, Marielle Eveline Donker
BACKGROUND: A spontaneous rupture of the unscarred uterus in a primigravid patient is extremely rare and is associated with high perinatal and maternal morbidity and mortality. CASE PRESENTATION: A 34-year-old white primigravid woman, 31 + 3 weeks of gestation, presented with pre-eclampsia and developed a sudden acute abdomen. An emergency laparotomy was performed and a uterine rupture was found as the cause of the event. A stillborn girl was born. CONCLUSION: A rupture of the pregnant uterus should always be considered in a pregnant woman presenting with abdominal pain, even in a primigravid patient...
December 6, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29207220/-long-term-outcome-of-renal-function-in-women-with-preeclampia-and-pregestational-diabetes
#11
REVIEW
Carmela Vadalà, Valeria Cernaro, Rossella Siligato, Roberta Granese, Antonio Simone Laganà, Michele Buemi, Domenico Santoro
Pre-eclampsia (PE) is an important cause of acute renal failure and an important risk marker for subsequent chronic kidney disease. In normal pregnancy, there are marked changes in the renin-angiotensin system (RAS) including considerably elevated angiotensin II (ang II) levels. However, vascular resistance decreases markedly during normal pregnancy, suggesting that pregnant individuals are less sensitive to ang II than non-pregnant individuals. In contrast, during PE decreased circulating components of the RAS with enhanced sensitivity of ang II infusion have been reported...
December 5, 2017: Giornale Italiano di Nefrologia: Organo Ufficiale Della Società Italiana di Nefrologia
https://www.readbyqxmd.com/read/29206936/birthweight-of-singletons-born-after-cleavage-stage-or-blastocyst-transfer-in-fresh-and-warming-cycles
#12
Anick De Vos, Samuel Santos-Ribeiro, Lisbet Van Landuyt, Hilde Van de Velde, Herman Tournaye, Greta Verheyen
STUDY QUESTION: Does extended culture to the blastocyst stage affect singleton birthweight after either fresh or vitrified-warmed embryo transfer? SUMMARY ANSWER: Singleton birthweight z-scores did not vary significantly after a fresh blastocyst transfer, whereas the additional effect of vitrification remains inconclusive. WHAT IS KNOWN ALREADY: Observational studies have associated extended culture with an increased risk of preterm birth and low birthweight...
December 1, 2017: Human Reproduction
https://www.readbyqxmd.com/read/29206055/association-study-of-foxp3-gene-and-the-risk-of-0020-pre-eclampsia
#13
Milad Gholami, Reza Mirfakhraie, Reihaneh Pirjani, Robabeh Taheripanah, Sahar Bayat, Seyyedeh Anita Daryabari, Matina Noori, Sayyed Mohamad Hossein Ghaderian
Pre-eclampsia (PE) is a multifactorial pregnancy disorder, with serious consequences for both the mother and the fetus. Despite intense studies, the pathophysiology of PE remains enigmatic. Previous studies suggested that Treg dysfunction is involved in the pathogenesis of PE. We hypothesized that functional variants of the FOXP3 gene might be associated with PE via dysregulation of Treg cells. Of the 276 subjects, we genotyped three variants of FOXP3 by PCR-RFLP and Tetra ARMS-PCR methods. The genotypic frequencies of rs2232365 were found to be protective from the development of PE under codominant [odds ratio (OR) 0...
December 5, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29203340/decidual-acvr2a-regulates-extravillous-trophoblast-functions-of-adhesion-proliferation-migration-and-invasion-in-vitro
#14
Hannah E J Yong, Padma Murthi, Bill Kalionis, Rosemary J Keogh, Shaun P Brennecke
Decidual stromal cells form the largest proportion of maternal cells at the maternal-fetal interface. Our aim was to investigate the role of the pre-eclampsia associated decidual activin receptor, ACVR2A, in regulating trophoblast functions at this interface. St-T1b and HTR-8/SVneo cell lines were used to model decidual stromal and trophoblast cells respectively. St-T1b conditioned medium inhibited HTR-8/SVneo adhesion, proliferation, migration and invasion; all effects that were attenuated by decidual ACVR2A siRNA transfection...
November 14, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29198742/prediction-of-adverse-maternal-outcomes-from-pre-eclampsia-and-other-hypertensive-disorders-of-pregnancy-a-systematic-review
#15
REVIEW
U Vivian Ukah, Dane A De Silva, Beth Payne, Laura A Magee, Jennifer A Hutcheon, Helen Brown, J Mark Ansermino, Tang Lee, Peter von Dadelszen
BACKGROUND: The hypertensive disorders of pregnancy are a leading cause of maternal and perinatal mortality and morbidity. The ability to predict these complications using simple tests could aid in management and improve outcomes. We aimed to systematically review studies that reported on potential predictors of adverse maternal outcomes among women with a hypertensive disorder of pregnancy. METHODS: We searched MEDLINE, Embase and CINAHL (inception - December 2016) for studies of predictors of severe maternal complications among women with a hypertensive disorder of pregnancy...
November 21, 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/29193667/with-adaptation-the-who-guidelines-on-calcium-supplementation-for-prevention-of-pre-eclampsia-are-adopted-by-pregnant-women
#16
Moshood O Omotayo, Stephanie L Martin, Rebecca J Stoltzfus, Stephanie E Ortolano, Erick Mwanga, Katherine L Dickin
The World Health Organization (WHO) recommends calcium supplementation for prevention of pre-eclampsia, but factors affecting adoption and acceptability of the recommendations among pregnant women have not been examined. We explored adoption of the WHO guidelines in Kenya, using the trials of improved practices. We recruited 38 pregnant women and assigned participants to three regimens representing potential trade-offs among daily dose, bioavailability, and acceptability. Participants were provided with supplements, requested to select preferred product type, counselled on how to take them, and interviewed 4 times over 6 weeks to assess their experiences...
November 28, 2017: Maternal & Child Nutrition
https://www.readbyqxmd.com/read/29191735/first-trimester-serum-afamin-concentrations-are-associated-with-the-development-of-pre-eclampsia-and-gestational-diabetes-mellitus-in-pregnant-women
#17
Allessandra Tramontana, Benjamin Dieplinger, Gerhard Stangl, Erich Hafner, Hans Dieplinger
OBJECTIVE: Aim of this study was to assess the prognostic capability of afamin to predict pregnancy complications. METHOD: First-trimester screening was consecutively performed in 4948 pregnant women, of whom 474 women developed pregnancy complications [gestational hypertension (n=84), pre-eclampsia (n=30), intrauterine growth restriction (n=107), preterm birth (n=44), and gestational diabetes mellitus (n=209)]. To each woman with pregnancy complications an uncomplicated pregnancy was matched for body mass index...
November 27, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29190766/developmental-peculiarities-in-placentae-of-ovine-uniparental-conceptuses
#18
Roberta Arena, Federica Zacchini, Paola Toschi, Luca Palazzese, Marta Czernik, Grażyna Ewa Ptak
Genomic imprinting is an epigenetic phenomenon regulating mono-allelic expression of genes depending on their parental origin. Defective genomic imprinting is involved in several placental disorders, such as intrauterine growth restriction and pre-eclampsia. Uniparental embryos, having maternal-only or paternal-only genomes (parthenogenotes [PAR] and androgenotes [AND], respectively), are useful models to study placentation. The aim of this work was to reveal the effect of parental genome (maternal and paternal) on placentation...
2017: PloS One
https://www.readbyqxmd.com/read/29189095/pregnancy-history-coronary-artery-calcification-and-bone-mineral-density-in-menopausal-women
#19
J P Beckman, J J Camp, B D Lahr, K R Bailey, A E Kearns, V D Garovic, M Jayachandran, V M Miller, D R Holmes
OBJECTIVE: This study examined relationships, by pregnancy histories, between bone mineral density (BMD) and coronary artery calcification (CAC) in postmenopausal women. METHODS: Forty women identified from their medical record as having pre-eclampsia (PE) were age/parity-matched with 40 women having a normotensive pregnancy (NP). Vertebral (T4-9) BMD and CAC were assessed by quantitative computed tomography in 73 (37 with PE and 36 with NP) of the 80 women. Analyses included linear regression using generalized estimating equations...
November 30, 2017: Climacteric: the Journal of the International Menopause Society
https://www.readbyqxmd.com/read/29187935/-haemorrhagic-stroke-of-the-brainstem-secondary-to-postpartum-eclampsia-about-a-case-and-literature-review
#20
REVIEW
Khadija Ennaqui, Assia Makayssi, Houssine Boufettal, Naima Samouh
Strokes are rare but severe accidents during pregnancy and post-partum period. They are responsible for high mortality and morbidity rates. Pre-eclampsia, eclampsia, and strokes are significantly related. Endothelial dysfunction, alteration of brain self-regulation and severe hypertension are, probably, the cause of many strokes in pregnant women and during postpartum period. We report a case of hemorrhagic stroke of the brainstem in a nonmonitored 21-year old patient at 38 weeks pregnant admitted with severe preeclampsia complicated by eclampsia and then by haemorrhagic stroke of the brainstem on the second post-operative day after cesarean section performed due to suspicion of retroplacental haematoma arisen since her admission...
2017: Pan African Medical Journal
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