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https://www.readbyqxmd.com/read/28718233/haemodynamic-preservation-in-caesarean-sections-by-low-dose-0-5-hyperbaric-bupivacaine
#1
Maqsood Ahmad, Mumtaz Ahmad, Naveel Atif
BACKGROUND: Spinal anaesthesia is technique of choice for caesarean sections and hyperbaric bupivacaine is a recommended drug for this popular block. Although safe but few complications are haemodynamic changes, postdural puncture headache, cauda equina syndrome and radiculopathy. However, hypotension remains the common side effect which is believed to occur in 95% of patients resulting in reduction of uteroplacental perfusion causing foetal acid-base abnormalities. Various doses regimes are in safe anaesthesia practice for providing regional anaesthesia for such patients with least detrimental effects on foetal outcome...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28695336/experimentally-induced-intrauterine-growth-restriction-in-rabbits-leads-to-differential-remodelling-of-left-versus-right-ventricular-myocardial-microstructure
#2
Julia Schipke, Anna Gonzalez-Tendero, Lidia Cornejo, Alper Willführ, Bart Bijnens, Fatima Crispi, Christian Mühlfeld, Eduard Gratacós
Intrauterine growth restriction (IUGR) is associated with foetal cardiac remodelling and dysfunction together with increased risk of cardiovascular disease in adulthood. Experimental data concerning effects of IUGR on cardiomyocyte and microvascularization anatomy are inconsistent and it is unknown whether both ventricles are similarly susceptible to in utero undersupply. Foetal IUGR was induced in pregnant rabbits at 25 days of gestation by selective ligation of uteroplacental vessels. Foetal echocardiography showed systolic and diastolic dysfunction of both ventricles and body and heart weight were significantly reduced in response to IUGR...
July 10, 2017: Histochemistry and Cell Biology
https://www.readbyqxmd.com/read/28662830/matrix-metalloproteinases-in-normal-pregnancy-and-preeclampsia
#3
Juanjuan Chen, Raouf A Khalil
Normal pregnancy is associated with marked hemodynamic and uterine changes that allow adequate uteroplacental blood flow and uterine expansion for the growing fetus. These pregnancy-associated changes involve significant uteroplacental and vascular remodeling. Matrix metalloproteinases (MMPs) are important regulators of vascular and uterine remodeling. Increases in MMP-2 and MMP-9 have been implicated in vasodilation, placentation, and uterine expansion during normal pregnancy. The increases in MMPs could be induced by the increased production of estrogen and progesterone during pregnancy...
2017: Progress in Molecular Biology and Translational Science
https://www.readbyqxmd.com/read/28640514/de-novo-abnormal-uteroplacental-circulation-in-the-third-trimester-pregnancy-outcome-and-pathological-implications
#4
Julia Binder, Caitriona Monaghan, Baskaran Thilaganathan, Silvia Carta, Asma Khalil
OBJECTIVE: Hypertensive disorders of pregnancy (HDP) are associated with impaired placentation, as evidenced by abnormal uterine artery (UtA) Doppler. UtA mean pulsatility index (PI) shows a progressive decline with gestational age (GA). However, previous studies have reported that a proportion of pregnancies demonstrate worsening of the UtA Doppler. The aim of this study was to investigate the incidence of HDP according to the change in the UtA mean PI between the second and third trimester...
June 22, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28632498/can-early-ultrasonography-explain-the-lower-miscarriage-rates-in-twin-as-compared-to-singleton-pregnancies-following-assisted-reproduction
#5
Ana Póvoa, Alexandra Matias, Pedro Xavier, Isaac Blickstein
OBJECTIVE: To compare first trimester 2D conventional and 3D power Doppler angiography measures in twins and singletons following assisted reproduction. METHODS: We prospectively evaluated 50 singleton and 47 twin pregnancies that eventually ended in live births. Patients were recruited from a single assisted reproductive technology (ART) center with standard treatment protocols. Obstetric ultrasound was performed at 8-9 weeks +6 days. Intervillous flow, uteroplacental circulation and uterine artery pulsatility (PI) and resistance index (RI) using two-dimensional (2D) ultrasound examination were evaluated...
June 20, 2017: Journal of Perinatal Medicine
https://www.readbyqxmd.com/read/28629246/clinical-significance-of-primary-symptoms-in-women-with-placental-abruption
#6
Youwen Mei, Yonghong Lina
BACKGROUND: To evaluate the clinical significance of primary symptoms in women with placental abruption. METHODS: A retrospective study of 273 cases of placental abruption was performed. The subjects were classified into 2 groups according to primary symptoms: 210 cases of vaginal bleeding group and 63 cases of abdominal pain group. The clinical features, maternal and neonatal outcomes were compared between two groups. RESULTS: The incidence of preeclampsia and preterm birth in vaginal bleeding group was significantly lower than abdominal pain group, while the incidence of premature rupture of membrane (PROM) in the former group was higher than that in the latter group...
June 19, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28626073/increased-vascular-and-uteroplacental-matrix-metalloproteinase-1-and-7-levels-and-collagen-i-deposition-in-hypertension-in-pregnancy-role-of-tnf
#7
Wei Li, Ning Cui, Marc Q Mazzuca, Karina M Mata, Raouf A Khalil
Preeclampsia is manifested as maternal hypertension-in-pregnancy (HTN-Preg) and fetal growth restriction. Placental ischemia could be an initiating event; however, the molecular targets and intermediary mechanisms are unclear. We tested the hypothesis that placental ischemia could target vascular and uteroplacental matrix metalloproteinases (MMPs) through cytokines-mediated mechanism. MMP levels and distribution were measured in aorta, uterus and placenta of normal pregnant rats (Preg), and pregnant rats with reduced uterine perfusion pressure (RUPP)...
June 16, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/28612673/can-flavonoid-rich-chocolate-modulate-arterial-elasticity-and-pathological-uterine-artery-doppler-blood-flow-in-pregnant-women-a-pilot-study
#8
Emma von Wowern, Per Olofsson
INTRODUCTION: Dark chocolate has shown beneficial effects on cardiovascular health and might also modulate hypertensive complications in pregnancy and uteroplacental blood flow. Increased uteroplacental resistance is associated with systemic arterial stiffness. We aimed to investigate the short-term effect of flavonoid-rich chocolate on arterial stiffness and Doppler blood flow velocimetry indexes in pregnant women with compromised uteroplacental blood flow. METHODS: Doppler blood flow velocimetry and digital pulse wave analysis (DPA) were performed in 25 women pregnant in the second and third trimesters with uterine artery (UtA) score (UAS) 3-4, before and after 3 days of ingestion of chocolate with high flavonoid and antioxidant contents...
June 14, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28577098/effect-of-cytokines-on-the-formation-tube-like-structures-by-endothelial-cells-in-the-presence-of-trophoblast-cells
#9
D I Sokolov, T Yu Lvova, L S Okorokova, K L Belyakova, A R Sheveleva, O I Stepanova, V A Mikhailova, S A Sel'kov
Despite ample data on cytokine secretion in the uteroplacental interface, the influence of microenvironment cells, in particular, trophoblast cells on angiogenesis and the role of cytokines in this process remain poorly studied. We studied the influence of cytokines on the formation of tube-like structures by endothelial cells in the presence of trophoblast cells and showed that trophoblast cells suppressed the angiogenic potential of endothelial cells. Antiangiogenic cytokines IFN-γ, IL-10, TNF-α, and TGFβ via modulation of trophoblast cells stimulated the formation of tube-like structures by endothelial cells...
June 3, 2017: Bulletin of Experimental Biology and Medicine
https://www.readbyqxmd.com/read/28524718/placental-protein-13-pp13-induced-vasodilation-of-resistance-arteries-from-pregnant-and-nonpregnant-rats-occurs-via-endothelial-signaling-pathways
#10
Tijana Drobnjak, Sveinbjörn Gizurarson, Natalia I Gokina, Hamutal Meiri, Maurizio Mandalá, Berthold Huppertz, George Osol
Placental protein 13 (PP13) induces hypotension in rats. This study aims to evaluate PP13 effects on isolated uterine arteries from nonpregnant and mid-pregnant rats. Vessels were isolated, cannulated, and pressurized to 50 mmHg within an arteriograph, preconstricted and exposed to increasing PP13 concentrations (10(-13)-10(-8) M). PP13 elicited 38-50% arterial vasodilation with half-maximum response (EC50) = 1 pM. The relaxation was mediated by activating the endothelial-signaling pathways of prostaglandin and nitric oxide (NO)...
May 2017: Hypertension in Pregnancy
https://www.readbyqxmd.com/read/28506758/decreased-homodimerization-and-increased-timp-1-complexation-of-uteroplacental-and-uterine-arterial-matrix-metalloproteinase-9-during-hypertension-in-pregnancy
#11
Juanjuan Chen, Zongli Ren, Minglin Zhu, Raouf A Khalil
Preeclampsia is a complication of pregnancy manifested as hypertension-in-pregnancy (HTN-Preg) and often intrauterine growth restriction (IUGR). Placental ischemia could be an initiating event, but the molecular mechanisms are unclear. To test the hypothesis that dimerization of matrix metalloproteinases (MMPs) plays a role in HTN-Preg and IUGR, the levels/activity of MMP-9, tissue inhibitor of metalloproteinase (TIMP-1), and their dimerization forms were measured in the placenta, uterus, and uterine artery of normal pregnant (Preg) rats and a rat model of reduced uteroplacental perfusion pressure (RUPP)...
May 12, 2017: Biochemical Pharmacology
https://www.readbyqxmd.com/read/28483805/treating-the-dysfunctional-placenta
#12
Colin Peter Sibley
Placental dysfunction underlies major obstetric diseases such as pre-eclampsia and fetal growth restriction (FGR). Whilst there has been a little progress in prophylaxis there are still no treatments for placental dysfunction in normal obstetric practice. However, a combination of increasingly well described in vitro systems for studying the human placenta, together with the availability of more appropriate animal models of pre-eclampsia and FGR, has facilitated a recent surge in work aimed at repurposing drugs and therapies, developed for other conditions, as treatments for placental dysfunction...
May 8, 2017: Journal of Endocrinology
https://www.readbyqxmd.com/read/28483162/quo-vadis-trophoblast-exploring-the-new-ways-of-an-old-cell-lineage
#13
Sascha Drewlo, D Randall Armant
Trophoblast cells are the first embryonic lineage to differentiate during human development, and are needed to sustain fetal life through their role in constructing a placenta. As the fetus grows, the trophoblast rapidly expands and further differentiates to produce an extravillous subtype that invades the maternal tissues. Some of the extravillous trophoblast cells find their way into the reproductive tract, and can be safely captured by noninvasive collection from the endocervical canal, similarly to a Pap smear...
April 26, 2017: Placenta
https://www.readbyqxmd.com/read/28454696/effect-of-glucocorticoids-on-mechanisms-of-placental-angiogenesis
#14
Aslı Ozmen, Gozde Unek, Emin Turkay Korgun
The benefits of antenatal glucocorticoid (GC) treatment to promote human fetal lung maturation are well established. However, reports have emerged indicating that maternal exposure to high concentrations of circulating GCs alters placental and fetal development. Because many adult-onset metabolic and cardiovascular disorders have their origins in utero, the importance of prenatal conditions should be considered in detail. Therefore, this review aims to present an overview of the GC effect on placental and fetal development, specifically with regard to mechanisms of placental angiogenesis...
April 2017: Placenta
https://www.readbyqxmd.com/read/28443480/adverse-placental-perfusion-and-pregnancy-outcomes-in-a-new-nonhuman-primate-model-of-gestational-protein-restriction
#15
Victoria H J Roberts, Jamie O Lo, Katherine S Lewandowski, Peter Blundell, Kevin L Grove, Christopher D Kroenke, Elinor L Sullivan, Charles T Roberts, Antonio E Frias
Maternal malnutrition during pregnancy impacts fetal growth, with developmental consequences that extend to later life outcomes. In underdeveloped countries, this malnutrition typically takes the form of poor dietary protein content and quality, even if adequate calories are consumed. Here, we report the establishment of a nonhuman primate model of gestational protein restriction (PR) in order to understand how placental function and pregnancy outcomes are affected by protein deficiency. Rhesus macaques were assigned to either a control diet containing 26% protein or switched to a 13% PR diet prior to conception and maintained on this PR diet throughout pregnancy...
January 1, 2017: Reproductive Sciences
https://www.readbyqxmd.com/read/28436166/perinatal-loss-at-term-the-role-of-uteroplacental-and-fetal-doppler-assessment
#16
Caitriona Monaghan, Julia Binder, Baskaran Thilaganathan, José Morales-Roselló, Asma Khalil
OBJECTIVE: To examine the association of uterine artery (UtA) Doppler indices and cerebroplacental ratio (CPR) on perinatal outcome at term. METHODS: This retrospective cohort study conducted in a single tertiary referral centre included all singleton pregnancies undergoing ultrasound assessment in the third trimester, which subsequently delivered at term. Fetal biometry and Dopplers including the umbilical artery (UA), middle cerebral artery (MCA) and uterine artery were recorded...
April 24, 2017: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28404739/feeding-your-baby-in-utero-how-the-uteroplacental-circulation-impacts-pregnancy
#17
REVIEW
Joanna L James, Lawrence W Chamley, Alys R Clark
The utero-placental circulation links the maternal and fetal circulations during pregnancy, ensuring adequate gas and nutrient exchange, and consequently fetal growth. However, our understanding of this circulatory system remains incomplete. Here, we discuss how the utero-placental circulation is established, how it changes dynamically during pregnancy, and how this may impact on pregnancy success, highlighting how we may address knowledge gaps through advances in imaging and computational modeling approaches...
May 2017: Physiology
https://www.readbyqxmd.com/read/28396316/extravillous-trophoblast-and-endothelial-cell-crosstalk-mediates-leukocyte-infiltration-to-the-early-remodeling-decidual-spiral-arteriole-wall
#18
Ruhul H Choudhury, Caroline E Dunk, Stephen J Lye, John D Aplin, Lynda K Harris, Rebecca L Jones
Decidual spiral arteriole (SpA) remodeling is essential to ensure optimal uteroplacental blood flow during human pregnancy, yet very little is known about the regulatory mechanisms. Uterine decidual NK (dNK) cells and macrophages infiltrate the SpAs and are proposed to initiate remodeling before colonization by extravillous trophoblasts (EVTs); however, the trigger for their infiltration is unknown. Using human first trimester placenta, decidua, primary dNK cells, and macrophages, we tested the hypothesis that EVTs activate SpA endothelial cells to secrete chemokines that have the potential to recruit maternal immune cells into SpAs...
May 15, 2017: Journal of Immunology: Official Journal of the American Association of Immunologists
https://www.readbyqxmd.com/read/28381449/endocrinology-in-pregnancy-case-series-and-review-of-literature-pheochromocytoma-in-pregnancy
#19
Kim van der Weerd, Charlotte van Noord, Martine Loeve, Maarten F C M Knapen, Willy Visser, Wouter de Herder, Gaston J H Franssen, Caroline D van der Marel, Richard A Feelders
Pheochromocytoma in pregnancy is extremely rare. Early recognition is crucial as antepartum diagnosis can largely decrease maternal and fetal mortality rates. As symptoms of pheochromocytoma are rather similar to those of other far more common causes of hypertension during pregnancy, timely diagnosis is a challenge. In pregnant patients, similar to non-pregnant patients, increased plasma and/or 24h-urine (nor)metanephrine concentrations most reliably confirm the diagnosis pheochromocytoma. MRI and ultrasound are the only imaging modalities that can be used safely during pregnancy to localize the tumor...
April 5, 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28369926/uteroplacental-insufficiency-reduces-rat-plasma-leptin-concentrations-and-alters-placental-leptin-transporters-ameliorated-with-enhanced-milk-intake-and-nutrition
#20
Jessica F Briffa, Rachael O'Dowd, Karen M Moritz, Tania Romano, Lisa R Jedwab, Andrew J McAinch, Deanne H Hryciw, Mary E Wlodek
KEY POINTS: Uteroplacental insufficiency compromises maternal mammary development, milk production and pup organ development; this is ameliorated by cross-fostering, which improves pup growth and organ development and prevents adult diseases in growth-restricted (Restricted) offspring by enhancing postnatal nutrition. Leptin is transported to the fetus from the mother by the placenta; we report reduced plasma leptin concentrations in Restricted fetuses associated with sex-specific alterations in placental leptin transporter expression...
June 1, 2017: Journal of Physiology
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