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Pregnancy, maternal, fetal

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https://www.readbyqxmd.com/read/29655601/placental-disposition-of-the-immunosuppressive-drug-tacrolimus-in-renal-transplant-recipients-and-in-ex-vivo-perfused-placental-tissue
#1
J J M Freriksen, D Feyaerts, P H H van den Broek, O W H van der Heijden, J van Drongelen, H W van Hamersvelt, F G M Russel, R G van der Molen, R Greupink
Currently, tacrolimus is the most potent immunosuppressive agent for renal transplant recipients and is commonly prescribed during pregnancy. As data on placental exposure and transfer are limited, we studied tacrolimus placental handling in samples obtained from renal transplant recipients. We found transfer to venous umbilical cord blood, but particularly noted a strong placental accumulation. In patient samples, tissue concentrations in a range of 55-82 ng/g were found. More detailed ex vivo dual-side perfusions of term placentas from healthy women revealed a tissue-to-maternal perfusate concentration ratio of 113 ± 49 (mean ± SEM), underlining the placental accumulation found in vivo...
April 12, 2018: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29653020/developmental-toxicity-of-flucytosine-following-administration-to-pregnant-rats-at-a-specific-time-point-of-organogenesis
#2
Sakiko Fujii, Kaoru Yabe, Yuki Kariwano-Kimura, Masatoshi Furukawa, Kouta Itoh, Masao Matsuura, Masao Horimoto
To investigate the abnormalities that are specific to administration of flucytosine at one time point during embryonic organogenesis, flucytosine was administered orally to pregnant SD rats in a single dose on day 11 of pregnancy at 25 or 35 mg/kg. Fetuses on day 20 of pregnancy were externally, viscerally and skeletally examined. Maternal body weight gain and food consumption were suppressed the day after administration of a 35 mg/kg. Fetal examinations revealed various alterations in both dose groups: externally preaxial polydactyly in the hind limb; skeletally fused lumbar centrum, absent sacral centrum, supernumerary sacral vertebra, and absent ribs...
April 13, 2018: Congenital Anomalies
https://www.readbyqxmd.com/read/29652282/perioperative-management-of-transcatheter-aortic-and-mitral-double-valve-in-valve-implantation-during-pregnancy-through-left-ventricular-apical-approach
#3
Suresh Chengode, Rahul Vijaykumar Shabadi, Ram Narayan Rao, Nasser Alkemyani, Hilal Alsabti
Pregnant women with stenotic degeneration of bioprosthetic cardiac valves may require another valve replacement procedure when their symptoms deteriorate with progression of pregnancy, but fetal mortality is higher with cardiac surgery done on cardiopulmonary bypass. Transcatheter valve-in-valve implantation may help to improve the fetal and maternal outcomes in these situations. Double valve-in-valve implantation is rare and has not been reported in a pregnant patient. We report, for the first time, the case of a pregnant woman with stenotic bioprosthetic valves in the mitral and aortic positions, who underwent a successful concomitant, transcatheter, double valve-in-valve implantation through the left ventricular apical route during the second trimester of her precious pregnancy...
April 2018: Annals of Cardiac Anaesthesia
https://www.readbyqxmd.com/read/29651732/maternal-cadmium-levels-during-pregnancy-and-the-relationship-with-preeclampsia-and-fetal-biometric-parameters
#4
Fan Wang, Fengyun Fan, Lianyun Wang, Wen Ye, Qiong Zhang, Shuangshuang Xie
Preeclampsia, which is caused by multiple factors, still remains one of the most serious complications of pregnancy. This study was designed to determine cadmium levels in women with preeclampsia compared to those of normotensive women. In this case-control study, maternal blood, umbilical cord blood, and placental cadmium levels were measured by an inductively coupled plasma mass spectrometry system in 51 women presenting consecutively with preeclampsia and 51 normotensive pregnant women. Groups were matched for maternal age, parity, and gestational age...
April 12, 2018: Biological Trace Element Research
https://www.readbyqxmd.com/read/29651447/impaired-gal-9-dysregulates-the-pbmc-induced-th1-th2-imbalance-in-abortion-prone-matings
#5
Mengzhou He, Ming Jiang, Yuan Zhou, Fanfan Li, Meitao Yang, Yao Fan, Yin Xie, Rajluxmee Beejadhursing, Ling Feng, Dongrui Deng
Recurrent miscarriage is defined as the loss of 3 or more consecutive pregnancies; however, the underlying immunologic mechanisms that trigger pregnancy loss remain largely unelucidated. Galectin-9 (Gal-9) may modulate a variety of biologic functions and play an important role in Th1/Th2 immune deviation. To analyze the mechanism of Gal-9 in abortion, we used the classical abortion-prone mouse model (DBA/2-mated CBA/J mice) to detect the expression of Gal-9 at the maternal-fetal interface. We also mimicked the immune environment of pregnancy by culturing trophoblast cells with peripheral blood mononuclear cells (PBMCs) to explore how Gal-9 might be involved in the pathogenesis of abortion...
2018: Journal of Immunology Research
https://www.readbyqxmd.com/read/29649190/updated-cdc-recommendations-for-using-artemether-lumefantrine-for-the-treatment-of-uncomplicated-malaria-in-pregnant-women-in-the-united-states
#6
Sarah-Blythe Ballard, Allison Salinger, Paul M Arguin, Meghna Desai, Kathrine R Tan
Malaria infection during pregnancy is associated with an increased risk for maternal and fetal complications. In the United States, treatment options for uncomplicated, chloroquine-resistant Plasmodium falciparum and P. vivax malaria in pregnant women are limited to mefloquine or quinine plus clindamycin (1). However, limited availability of quinine and increasing resistance to mefloquine restrict these options. Strong evidence now demonstrates that artemether-lumefantrine (AL) (Coartem) is effective and safe in the treatment of malaria in pregnancy...
April 13, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29649034/obstructive-sleep-apnea-in-pregnant-women-a-review-of-pregnancy-outcomes-and-an-approach-to-management
#7
Jennifer E Dominguez, Andrew D Krystal, Ashraf S Habib
Among obese pregnant women, 15%-20% have obstructive sleep apnea (OSA) and this prevalence increases along with body mass index and in the presence of other comorbidities. Prepregnancy obesity and pregnancy-related weight gain are certainly risk factors for sleep-disordered breathing in pregnancy, but certain physiologic changes of pregnancy may also increase a woman's risk of developing or worsening OSA. While it has been shown that untreated OSA in postmenopausal women is associated with a range of cardiovascular, pulmonary, and metabolic comorbidities, a body of literature is emerging that suggests OSA may also have serious implications for the health of mothers and fetuses during and after pregnancy...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29643846/lilrb4-decrease-on-udcs-exacerbate-abnormal-pregnancy-outcomes-following-toxoplasma-gondii-infection
#8
Shaowei Zhan, Jing Zheng, Haixia Zhang, Mingdong Zhao, Xianbing Liu, Yuzhu Jiang, Chunyan Yang, Liqin Ren, Zhiqiang Liu, Xuemei Hu
Toxoplasma gondii ( T. gondii ) infection in early pregnancy can result in miscarriage, dead fetus, and other abnormalities. The LILRB4 is a central inhibitory receptor in uterine dendritic cells (uDCs) that plays essential immune-regulatory roles at the maternal-fetal interface. In this study, T. gondii -infected human primary uDCs and T. gondii -infected LILRB4-/- pregnant mice were utilized. The immune mechanisms underlying the role of LILRB4 on uDCs were explored in the development of abnormal pregnancy outcomes following T...
2018: Frontiers in Microbiology
https://www.readbyqxmd.com/read/29643161/the-collaborative-ipd-of-sleep-and-stillbirth-cribss-is-maternal-going-to-sleep-position-a-risk-factor-for-late-stillbirth-and-does-maternal-sleep-position-interact-with-fetal-vulnerability-an-individual-participant-data-meta-analysis-study-protocol
#9
Minglan Li, John M D Thompson, Robin S Cronin, Adrienne Gordon, Camille Raynes-Greenow, Alexander E P Heazell, Tomasina Stacey, Vicki Culling, Victoria Bowring, Edwin A Mitchell, Lesley M E McCowan, Lisa Askie
INTRODUCTION: Accumulating evidence has shown an association between maternal supine going-to-sleep position and stillbirth in late pregnancy. Advising women not to go-to-sleep on their back can potentially reduce late stillbirth rate by 9%. However, the association between maternal right-sided going-to-sleep position and stillbirth is inconsistent across studies. Furthermore, individual studies are underpowered to investigate interactions between maternal going-to-sleep position and fetal vulnerability, which is potentially important for producing clear and tailored public health messages on safe going-to-sleep position...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29643159/role-of-iodine-containing-multivitamins-during-pregnancy-for-children-s-brain-function-protocol-of-an-ongoing-randomised-controlled-trial-the-swiddich-study
#10
Sofia Manousou, Birgitta Johansson, Anna Chmielewska, Janna Eriksson, Kerstin Gutefeldt, Carl-Johan Tornhage, Robert Eggertsen, Helge Malmgren, Lena Hulthen, Magnus Domellöf, Helena Nystrom Filipsson
INTRODUCTION: Iodine is essential for normal brain development. Moderate and severe fetal iodine deficiency results in substantial to serious developmental delay in children. Mild iodine deficiency in pregnancy is associated with neurodevelopmental deficits in the offspring, but evidence from randomised trials is lacking. The aim of the Swedish Iodine in Pregnancy and Development in Children study is to determine the effect of daily supplementation with 150 µg iodine during pregnancy on the offspring's neuropsychological development up to 14 years of age...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29642923/association-of-maternal-serum-lipids-at-late-gestation-with-the-risk-of-neonatal-macrosomia-in-women-without-diabetes-mellitus
#11
Xiangxiang Wang, Qingbo Guan, Jiajun Zhao, Feifei Yang, Zhongshang Yuan, Yongchao Yin, Rui Fang, Lingwei Liu, Changting Zuo, Ling Gao
BACKGROUND: Macrosomia is a serious public health problem worldwide due to its increasing prevalence and adverse influences on maternal and neonatal outcomes. Maternal dyslipidemia exerts potential and adverse impacts on pregnant women and newborns. However, the association between maternal serum lipids and the risk of macrosomia has not yet been clearly elucidated. We explored the association between the maternal lipids profile at late gestation and the risk of having macrosomia among women without diabetes mellitus (DM)...
April 11, 2018: Lipids in Health and Disease
https://www.readbyqxmd.com/read/29642803/expression-of-n-acetylglucosaminyltransferase-iii-promotes-trophoblast-invasion-and-migration-in-early-human-placenta
#12
Qinyin Deng, Xiru Liu, Zhongmei Yang, Lan Xie
INTRODUCTION: Trophoblast migration and invasion at the maternal-fetal interface are crucial events for normal placentation and successful pregnancy. This progress is well controlled by many placenta-specific factors. Inadequate trophoblast invasion results in poor placenta plantation or even complications such as preeclampsia. It has been shown that N-acetylglucosaminyltransferase III (GnT-III) participates in tumor invasion and metastasis as a suppressor; however, the expression of GnT-III and its role in normal pregnancy is unclear...
January 1, 2018: Reproductive Sciences
https://www.readbyqxmd.com/read/29630094/mir-4421-regulates-the-progression-of-preeclampsia-by-regulating-cyp11b2
#13
X Gao, H Li, J-X Wei
OBJECTIVE: Preeclampsia is a serious disease that affects maternal and fetal health in pregnancy. Mechanism of miRNA in preeclampsia has gradually been explored. This study mainly investigated the mechanism of miR-4421 in preeclampsia. PATIENTS AND METHODS: The expression of miR-4421 in 42 preeclampsia tissues and 42 normal pregnancy placentas tissues was detected by qRT-PCR. The relationship between the miR-4421 level and clinicopathological features of preeclampsia was analyzed...
March 2018: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/29630016/opioid-detoxification-during-pregnancy-a-systematic-review
#14
Mishka Terplan, Hollis J Laird, Dennis J Hand, Tricia E Wright, Ashish Premkumar, Caitlin E Martin, Marjorie C Meyer, Hendrée E Jones, Elizabeth E Krans
OBJECTIVE: To systematically review maternal and neonatal outcomes associated with opioid detoxification during pregnancy. DATA SOURCES: PubMed, PsycINFO, EMBASE, Cochrane, and ClinicalTrials.gov databases were searched from January 1, 1966, to September 1, 2016. METHODS OF STUDY SELECTION: English-language studies that reported outcomes associated with opioid detoxification among pregnant women with opioid use disorder were included. Nonoriginal research articles (case reports, editorials, reviews) and studies that failed to report outcomes for detoxification participants were excluded...
April 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29630015/maternal-pyrexia-and-villitis-of-unknown-etiology
#15
Dorothy F Graham, Eileen Sung, Bligh Berry
BACKGROUND: Villitis of unknown etiology is an inflammatory placental condition associated with adverse pregnancy outcomes, including fetal growth restriction and preterm birth. CASE: We describe maternal pyrexia with daily rigors in the third trimester of two consecutive pregnancies in the same woman. In her second pregnancy, we found no evidence of infection despite an extensive antenatal investigation (blood and urine cultures, serologies, chest X-ray, abdominal ultrasonogram, echocardiogram)...
April 6, 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29629873/a-maternally-sequestered-biopolymer-stabilized-vascular-endothelial-growth-factor-vegf-chimera-for-treatment-of-preeclampsia
#16
Omar C Logue, Fakhri Mahdi, Heather Chapman, Eric M George, Gene L Bidwell
BACKGROUND: Preeclampsia is a hypertensive syndrome that complicates 3% to 5% of pregnancies in the United States. Preeclampsia originates from an improperly vascularized and ischemic placenta that releases factors that drive systemic pathophysiology. One of these factors, soluble fms-like tyrosine kinase-1, is believed to sequester vascular endothelial growth factor (VEGF), leading to systemic endothelial dysfunction and hypertension. With the goal of targeting soluble fms-like tyrosine kinase-1 while simultaneously preventing fetal exposure to VEGF, we fused VEGF to elastin-like polypeptide, a biopolymer carrier that does not cross the placental barrier (ELP-VEGF)...
December 8, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29627841/preeclampsia-as-a-form-of-type-5-cardiorenal-syndrome-an-underrecognized-entity-in-women-s-cardiovascular-health
#17
Janani Rangaswami, Mario Naranjo, Peter A McCullough
BACKGROUND: Preeclampsia is a multisystem vascular disorder of pregnancy that remains a leading cause of maternal and fetal morbidity and mortality. Preeclampsia remains an underrecognized risk factor for future cardiovascular and kidney disease in women and represents the confluence of preexisting vascular risk factors with superimposed endothelial injury from placental mediated anti-angiogenic factors. SUMMARY: This review highlights the close relationship between preeclampsia and future cardiovascular and kidney disease...
April 4, 2018: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29627779/low-dose-warfarin-maternal-anticoagulation-and-fetal-warfarin-syndrome
#18
Ana R Sousa, Rita Barreira, Edmundo Santos
Fetuses exposed to warfarin during pregnancy are at an increased risk of developing an embryopathy known as fetal warfarin syndrome or warfarin embryopathy. The most consistent anomalies are nasal hypoplasia and stippling of vertebrae or bony epiphyses. Management of pregnant patients on anticoagulation is challenging. Current guidelines suggest the use of warfarin if the therapeutic dose is ≤5 mg/day. We report the case of a newborn with signs of warfarin embryopathy born from a mother anticoagulated with warfarin due to mechanical mitral and aortic heart valves...
April 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29627031/pregnancy-outcomes-in-women-with-spinal-muscular-atrophy-a-review
#19
REVIEW
Elena Abati, Stefania Corti
Spinal muscular atrophy (SMA) is an autosomal recessive disease characterized by muscle weakness and atrophy resulting from progressive degeneration and loss of the anterior horn cells in the spinal cord and brain stem nuclei. The onset of weakness ranges from prenatal age to young adulthood. Thus, many female patients reach fertile age and may consider getting pregnant. However, only little information is available about outcomes and complications of pregnancy in women with SMA. In this review, we compared different studies on the subject, then we analyzed outcomes in the different stages of the pregnancy (preconceptional period, embryonal period, fetal period, delivery and post partum), with a special focus on maternal and fetal complications, prematurity, mode of delivery, anesthesiological risk, respiratory function and influence of pregnancy on the disease course...
May 15, 2018: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/29626981/placental-lipoprotein-lipase-activity-is-positively-associated-with-newborn-adiposity
#20
Margaret J R Heerwagen, Diane L Gumina, Teri L Hernandez, Rachael E Van Pelt, Anita W Kramer, Rachel C Janssen, Dalan R Jensen, Theresa L Powell, Jacob E Friedman, Virginia D Winn, Linda A Barbour
INTRODUCTION: Recent data suggest that in addition to glucose, fetal growth is related to maternal triglycerides (TG). To reach the fetus, TG must be hydrolyzed to free fatty acids (FFA) and transported across the placenta, but regulation is uncertain. Placental lipoprotein lipase (pLPL) hydrolyzes TG, both dietary chylomicron TG (CM-TG) and very-low density lipoprotein TG (VLDL-TG), to FFA. This may promote fetal fat accretion by increasing the available FFA pool for placental uptake...
April 2018: Placenta
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