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https://www.readbyqxmd.com/read/28404739/feeding-your-baby-in-utero-how-the-uteroplacental-circulation-impacts-pregnancy
#1
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
#2
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...
April 10, 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
#3
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
#4
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...
March 29, 2017: Journal of Physiology
https://www.readbyqxmd.com/read/28295303/separation-and-characterization-of-maternal-cardiac-and-vascular-sounds-in-the-third-trimester-of-pregnancy
#5
Diana Riknagel, Henrik Zimmermann, Richard Farlie, Dorte Hammershøi, Samuel E Schmidt, Morten Hedegaard, Peter Humaidan, Johannes J Struijk
OBJECTIVE: To characterize the vascular sounds of the uteroplacental blood flow obtained by microphones. METHODS: The present retrospective study took place in an anechoic chamber facility at Aalborg University, Aalborg, Denmark, in 2012, and included pregnant participants aged 18-40 years with a singleton pregnancy at 32-36 weeks and a parity of 0-2. Abdominal Doppler ultrasonography was performed bilaterally on the uterine arteries. Subsequently, in the same positions, sound recordings were performed with microphones...
March 13, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28290978/a-30-year-old-female-found-to-have-a-couvelaire-uterus-with-placenta-accreta-during-planned-cesarean-delivery
#6
Omici N Uwagbai, Arthur C Wittich
A case of Couvelaire uterus with placenta accreta found during scheduled repeat low transverse Cesarean section will be discussed within this article. First described in the 1900s, Couvelaire syndrome, also known as uteroplacental apoplexy, is a rare form of nonfatal placenta abruption complication. The case involves a 30-year-old gravida 3 para 2 otherwise healthy female with an uncomplicated pregnancy and two previous cesarean deliveries without complication. She received routine prenatal care. During her pregnancy, she did not experience any symptoms such as vaginal bleeding or abdominal pain...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28282780/early-onset-preeclampsia-is-associated-with-perinatal-mortality-and-severe-neonatal-morbidity
#7
Joris J A van Esch, Arno F van Heijst, Anton F J de Haan, Olivier W H van der Heijden
OBJECTIVE: To evaluate neonatal outcomes of pregnancies complicated by early-onset preeclampsia (PE) and compare these outcomes to those of gestational age matched neonates born to mothers whose pregnancy was not complicated by early-onset PE. METHODS: We analyzed the outcome in 97 neonates born to mothers with early-onset PE (24-32 weeks amenorrhea at diagnosis) and compared it to that of 680 gestational age-matched neonates born between 25-36 weeks due to other etiologies and admitted to the Neonatal Intensive Care Unit (NICU) of a tertiary referral hospital in the Netherlands...
February 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28279446/incidence-and-pregnancy-outcomes-of-superimposed-preeclampsia-with-or-without-proteinuria-among-women-with-chronic-hypertension
#8
Sayuri Nakanishi, Shigeru Aoki, Ami Nagashima, Kazuo Seki
OBJECTIVE: To investigate the incidence and pregnancy outcomes of superimposed preeclampsia (PE) with or without proteinuria among women with chronic hypertension. METHODS: This retrospective study included 142 women with essential hypertension diagnosed at ⩽20weeks of gestation, managed at a tertiary center. They were divided into three groups (non-PE, PE with proteinuria, and PE without proteinuria) to compare pregnancy outcomes. The non-PE group was further divided into two subgroups (controlled and uncontrolled hypertension)...
January 2017: Pregnancy Hypertension
https://www.readbyqxmd.com/read/28276297/decidual-vasculopathy-placental-location-and-association-with-ischemic-lesions
#9
Joanna Sy Chan, Debra S Heller, Rebecca N Baergen
Decidual vasculopathy (DV) is a general term for a number of lesions involving uteroplacental vessels. It is often seen in preeclamptic placentas and indicates a disorder of uteroplacental malperfusion and is associated with placental ischemia and infarction. Although some have advocated submitting special sections in order to better document DV, it is unclear which placental sections have the highest yield in demonstrating these abnormal vessels. Seventy-six consecutive cases of decidual vasculopathy were identified and evaluated for location of DV, as well as presence of other lesions of ischemic change, infarcts, and retroplacental hematomas...
January 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28270884/critical-imperative-for-the-reform-of-british-interpretation-of-fetal-heart-rate-decelerations-analysis-of-figo-and-nice-guidelines-post-truth-foundations-cognitive-fallacies-myths-and-occam-s-razor
#10
REVIEW
Shashikant L Sholapurkar
Cardiotocography (CTG) has disappointingly failed to show good predictability for fetal acidemia or neonatal outcomes in several large studies. A complete rethink of CTG interpretation will not be out of place. Fetal heart rate (FHR) decelerations are the most common deviations, benign as well as manifestation of impending fetal hypoxemia/acidemia, much more commonly than FHR baseline or variability. Their specific nomenclature is important (center-stage) because it provides the basic concepts and framework on which the complex "pattern recognition" of CTG interpretation by clinicians depends...
April 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/28252205/oxidative-damage-and-nitric-oxide-synthase-induction-by-surgical-uteroplacental-circulation-restriction-in-the-rabbit-fetal-heart
#11
Horacio Figueroa, Cristobal Alvarado, Jorge Cifuentes, Mauricio Lozano, Jocelyn Rocco, Claudia Cabezas, Sebastian Illanes, Elisenda Eixarch, Edgar Hernández-Andrade, Eduard Gratacós, Carlos E Irarrazabal
OBJECTIVE: This study investigated the role of oxidative damage and nitric oxide (NO) synthases in the fetal heart using a model of intrauterine growth restriction (IUGR) induced by uteroplacental circulation restriction (UCR). METHODS: New Zealand white rabbits kept under 12 hr light cycles, with food and water provided ad libitum, were subjected at day 25 of pregnancy to 40%-50% uteroplacental artery ligation. We analyzed the gene expression of enzymes linked to nitric oxide synthesis (iNOS, eNOS, HO-1, and ARG-2), HIF-1α and the state of oxidative stress (protein carbonyl levels) in fetal heart homogenates...
March 2, 2017: Prenatal Diagnosis
https://www.readbyqxmd.com/read/28211140/anesthesia-for-fetal-surgery
#12
REVIEW
Monica A Hoagland, Debnath Chatterjee
Fetal therapy is an exciting and growing field of medicine. Advances in prenatal imaging and continued innovations in surgical and anesthetic techniques have resulted in a wide range of fetal interventions including minimally invasive, open mid-gestation, and ex-utero intrapartum treatment procedures. The potential for maternal morbidity is significant and must be carefully weighed against claimed benefits to the fetus. Appropriate patient selection is critical, and a multidisciplinary team-based approach is strongly recommended...
April 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28195189/protective-effect-of-maternal-uteroplacental-insufficiency-on-oxygen-induced-retinopathy-in-offspring-removing-bias-of-premature-birth
#13
Silke Becker, Haibo Wang, Baifeng Yu, Randy Brown, Xiaokun Han, Robert H Lane, M Elizabeth Hartnett
To address the hypothesis that maternal uteroplacental insufficiency (UPI) increases severity of retinopathy of prematurity, we developed a composite rat model of UPI and oxygen-fluctuations and removed premature birth as a confounding factor. Timed-pregnant Sprague-Dawley dams underwent bilateral uterine artery ligation or anesthesia (control) at e19.5. Full-term pups developed in room air (RA) or an oxygen-induced retinopathy (OIR) model. Isolectin-stained retinal flat-mounts were analyzed for percent of areas of avascular/total retina (AVA) and of intravitreal neovascular/total retina (IVNV)...
February 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28169504/re-uteroplacental-doppler-flow-and-pregnancy-outcome-in-women-with-tetralogy-of-fallot-m-a-m-kampman-a-s-siegmund-c-m-bilardo-d-j-van-veldhuisen-a-balci-m-a-oudijk-h-groen-b-j-m-mulder-j-w-roos-hesselink-g-sieswerda-m-w-m-de-laat-k-m-sollie-szarynska-and-p
#14
COMMENT
https://www.readbyqxmd.com/read/28164084/comparison-of-phenylephrine-and-ephedrine-in-treatment-of-spinal-induced-hypotension-in-high-risk-pregnancies-a-narrative-review
#15
REVIEW
Sasima Dusitkasem, Blair H Herndon, Monsicha Somjit, David L Stahl, Emily Bitticker, John C Coffman
PURPOSE: To compare maternal and fetal effects of intravenous phenylephrine and ephedrine administration during spinal anesthesia for cesarean delivery in high-risk pregnancies. SOURCE: An extensive literature search was conducted using the US National Library of Medicine, MEDLINE search engine, Cochrane review, and Google Scholar using search terms "ephedrine and phenylephrine," "preterm and term and spinal hypotension," "preeclampsia and healthy parturients," or "multiple and singleton gestation and vasopressor...
2017: Frontiers in Medicine
https://www.readbyqxmd.com/read/28151494/relationship-between-maternal-hemodynamics-and-plasma-natriuretic-peptide-concentrations-during-pregnancy-complicated-by-preeclampsia-and-fetal-growth-restriction
#16
S R Giannubilo, A Pasculli, E Tidu, A Biagini, V Boscarato, A Ciavattini
OBJECTIVE: A proper maternal cardiovascular adaptation to the pregnancy plays a key role for promoting an adequate uteroplacental perfusion, for ensuring normal fetal development and for preventing gestational hypertensive complications such as preeclampsia. This study aims to evaluate hemodynamic measurements obtained by noninvasive methods among preclamptic women with and without fetal growth restriction (FGR) and the relationship with plasma levels of natriuretic peptides. STUDY DESIGN: The study compared 98 pregnant women (n=48 with preeclampsia; n=50 normotensive pregnant women) and 50 nonpregnant normotensive control subjects undergoing anultrasonic cardiac output monitor (USCOM) and plasma assessment of atrial N-terminal pro B-type natriuretic peptide (NT-proBNP)...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28109704/nicotine-promotes-vascular-endothelial-growth-factor-secretion-by-human-trophoblast-cells-under-hypoxic-conditions-and-improves-the-proliferation-and-tube-formation-capacity-of-human-umbilical-endothelial-cells
#17
Hongbo Zhao, Lanxiang Wu, Yahui Wang, Jiayi Zhou, Ruixia Li, Jiabing Zhou, Zehua Wang, Congjian Xu
Pre-eclampsia, characterized as defective uteroplacental vascularization, remains the major cause of maternal and fetal mortality and morbidity. Previous epidemiological studies demonstrated that cigarette smoking reduced the risk of pre-eclampsia. However, the molecular mechanism remains elusive. In the present study, it is demonstrated that a low dose of nicotine decreased soluble vascular endothelial growth factor receptor 1 (sFlt1) secretion in human trophoblast cells under hypoxic conditions. Nicotine was then observed to promote vascular endothelial growth factor (VEGF) secretion by reducing sFlt1 secretion and increasing VEGF mRNA transcription...
January 17, 2017: Reproductive Biomedicine Online
https://www.readbyqxmd.com/read/28103875/effects-of-plasmodium-falciparum-infection-on-umbilical-artery-resistance-and-intrafetal-blood-flow-distribution-a-doppler-ultrasound-study-from-papua-new-guinea
#18
Maria Ome-Kaius, Stephan Karl, Regina Alice Wangnapi, John Walpe Bolnga, Glen Mola, Jane Walker, Ivo Mueller, Holger Werner Unger, Stephen John Rogerson
BACKGROUND: Doppler velocimetry studies of umbilical artery (UA) and middle cerebral artery (MCA) flow help to determine the presence and severity of fetal growth restriction. Increased UA resistance and reduced MCA pulsatility may indicate increased placental resistance and intrafetal blood flow redistribution. Malaria causes low birth weight and fetal growth restriction, but few studies have assessed its effects on uteroplacental and fetoplacental blood flow. METHODS: Colour-pulsed Doppler ultrasound was used to assess UA and MCA flow in 396 Papua New Guinean singleton fetuses...
January 19, 2017: Malaria Journal
https://www.readbyqxmd.com/read/28102332/dynamic-modeling-of-uteroplacental-blood-flow-in-iugr-indicates-vortices-and-elevated-pressure-in-the-intervillous-space-a-pilot-study
#19
Christian J Roth, Eva Haeussner, Tanja Ruebelmann, Franz V Koch, Christoph Schmitz, Hans-Georg Frank, Wolfgang A Wall
Ischemic placental disease is a concept that links intrauterine growth retardation (IUGR) and preeclampsia (PE) back to insufficient remodeling of uterine spiral arteries. The rheological consequences of insufficient remodeling of uterine spiral arteries were hypothesized to mediate the considerably later manifestation of obstetric disease. However, the micro-rheology in the intervillous space (IVS) cannot be examined clinically and rheological animal models of the human IVS do not exist. Thus, an in silico approach was implemented to provide in vivo inaccessible data...
January 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28094006/salt-aldosterone-and-extrarenal-na-sensitive-responses-in-pregnancy
#20
Paula Juliet Scaife, Markus Georg Mohaupt
Outside of pregnancy excessive salt consumption is known to be harmful being linked to increased blood pressure and cardiovascular disease. However, pregnancy represents a major change to a woman's physiology resulting in an intimate adaptation to environmental conditions. It is now becoming apparent that salt is essential for a number of these changes during pregnancy including haematological, cardiac adaptations as well as directly influencing placental development and the uteroplacental immune environment...
January 10, 2017: Placenta
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