Antibacterial activity of amniotic fluid against Staphylococcus aureus, Candida albicans and Brucella abortus.

Sixty amniotic fluid samples from sixty patients between 14--42 weeks gestation were studied for antibacterial activity against Staphylococcus aureus, Brucella abortus and antifungal activity against Candida albicans. Both antibacterial and antifungal activity of the amniotic fluid were observed. When antimicrobial activity was correlated with gestational age, it was found to increase with the period of gestation. Maximum antimicrobial activity of the amniotic fluid was found to be present in the samples obtained between 36--42 weeks of gestation. All samples before 20 weeks gestation showed week antibacterial activity against Staphylococcus aureus, but comparatively strong reaction against Candida albicans and Brucella abortus.     

The effect of smoking and caffeine on the fetus and placenta in pregnancy

The aim of this study was to determine the effects of tobacco use and consumption of caffeine in pregnancy on the fetus and placenta by measuring the body weights, head circumferences, and lengths of newborns, and also weights and diameters of placentas. In this prospective study, two main groups were chosen for the study: Group I: A total of 63 pregnant non-smokers; were separated into two subgroups according to their daily caffeine intake; less than 300 mg (Ia) (n = 44), and more than 300 mg (Ib) (n = 19). Group II: 60 pregnant smokers were also separated into two subgroups; daily caffeine intake less than 300 mg (IIa) (n = 43), and more than 300 mg (IIb) (n = 17). The newborns and placentas of both groups were examined. The body weights, lengths, and head circumferences of newborns and also weights and diameters of placentas were measured. The pregnant non-smokers consuming caffeine more than 300 mg/day had statistically significant lower weights of newborns and placentas (p < 0.05). However, there was no significant difference between groups according to the lengths, head circumferences of newborns and diameters of placentas. There were significantly lower body weights of newborns and placentas in pregnant smokers (p < 0.05). There was no difference according to the diameters of placentas, and lengths and head circumferences of newborns in either group. In conclusion, it is suggested that smoking in pregnancy should be prevented both for the health of newborns and mothers, and also caffeine including beverages like tea and coffee should be limited in pregnancy.     

Neopterin concentrations in fetal and maternal blood: a marker of cell-mediated immune activation.

OBJECTIVE: Neopterin is generated by macrophages and monocytes in response to cytokine and endotoxin stimulation and is a sensitive marker of the severity of infectious-, autoimmune-, and alloimmune-mediated inflammatory disorders. This study was designed to evaluate fetal and maternal neopterin concentrations during the second half of pregnancy. STUDY DESIGN: We conducted a cross-sectional analysis of serum neopterin values with a sensitive radioimmunoassay in 35 paired fetal and maternal and 8 neonatal samples. The fetal and maternal samples were obtained between 20 and 38 weeks' gestation at the time of diagnostic cordocentesis. All maternal, fetal, and neonatal samples were derived from uncomplicated pregnancies resulting in term delivery of appropriately grown fetuses. RESULTS: Fetal neopterin concentrations increased across gestation (r = 0.64, P <.001), and mean values were significantly higher than paired maternal values (6.28 [+/-2.44] ng/mL vs 2.05 [+/-0.87] ng/mL, P <.001]. In contrast, maternal neopterin concentrations did not correlate with gestational age (r = 0.22, P =.24). No significant correlation was found between fetal and maternal values (r = 0.34, P =.07). CONCLUSION: Fetal neopterin values rise significantly across gestation. They are substantially greater than maternal levels and are not correlated significantly with paired maternal levels. These findings are the first report of a physiologically normal range for fetal neopterin concentrations in a sample of uncomplicated pregnancies. The values suggest progressive increases in fetal cell-mediated immunity and macrophage-monocyte activation as gestation progresses.     

Medroxyprogesterone acetate modulates the immune response in the uterus,cervix and placenta in a mouse model of preterm birth

Objective. These studies sought to determine whether a progestational agent, specifically medroxyprogesterone acetate (MPA) prevents inflammation-induced preterm birth, in a mouse model, through modulation of the host immune response.

Study design. Using an established mouse model of inflammation-induced preterm birth, the activation of the immune response in maternal serum, uterus, cervix and placenta was assessed. In addition, the ability of MPA to modulate this response was investigated. Message RNA and protein expression were assessed by quantitative PCR and ELISAs respectively.

Results. Intrauterine inflammation promotes a significant up-regulation of both TH1 and TH2 mediators in all tissues studies though the response is divergent by time and tissue studied. MPA significantly differentially regulates this immune response in the uterus, cervix and placenta.

Conclusions. In the setting of inflammation-induced preterm birth, the host immune response is activated and not limited to a traditional TH1 bias. The ability of MPA to modulate the immune response may be a critical mechanism by which progestins prevent preterm birth.     

Medroxyprogesterone acetate modulates the immune response in the uterus, cervix and placenta in a mouse model of preterm birth.

OBJECTIVE: These studies sought to determine whether a progestational agent, specifically medroxyprogesterone acetate (MPA) prevents inflammation-induced preterm birth, in a mouse model, through modulation of the host immune response. STUDY DESIGN: Using an established mouse model of inflammation-induced preterm birth, the activation of the immune response in maternal serum, uterus, cervix and placenta was assessed. In addition, the ability of MPA to modulate this response was investigated. Message RNA and protein expression were assessed by quantitative PCR and ELISAs respectively. RESULTS: Intrauterine inflammation promotes a significant up-regulation of both TH1 and TH2 mediators in all tissues studies though the response is divergent by time and tissue studied. MPA significantly differentially regulates this immune response in the uterus, cervix and placenta. CONCLUSIONS: In the setting of inflammation-induced preterm birth, the host immune response is activated and not limited to a traditional TH1 bias. The ability of MPA to modulate the immune response may be a critical mechanism by which progestins prevent preterm birth.     

Placental aminopeptidase A as a possible barrier of angiotensin II between mother and fetus

Aminopeptidase A (AP-A EC 3.4.11.7), which is a membrane-bound zinc metalloprotease, is present in the placenta. AP-A selectively hydrolyzes N-terminal glutamyl and aspartyl residues and cleaves angiotensin II to form angiotensin III. To determine the role of placental aminopeptidase A under physiological and pathological conditions, we evaluated its immunolocalization and enzymatic activities in the placenta. AP-A was localized in the basal zone of the syncytiotrophoblast, in the membranes of the cytotrophoblast, and in fetal arterioles and venules within the stem villi. AP-A activity in the microsomal fraction of placental villi seemed to be remained essentially constant throughout gestation. The renin-angiotensin system is considered to be accelerated in pre-eclampsia. This AP-A activity was higher in pre-eclampsia (2.86+/-0.30 nmol beta NA/mg protein/h) than in uncomplicated pregnancy from 28 to 41 weeks of gestation (2.08+/-0.18 nmol beta NA/mg protein/h). Angiotensin II evoked AP-A activity in first trimester trophoblast, and Losartan and PD 123177 in combination significantly inhibited this induction of AP-A activity. The results of immunohistochemical evaluation and enzymatic activity suggested that placental aminopeptidase A may play a role as a component of the barrier of angiotensin II between mother and fetus.     

Temporal and spatial expression of glyceraldehyde 3-phosphate dehydrogenase (Gapdh) in the mouse placenta

Glucose metabolism in trophoblast cells is essential to provide the required energy for the development and function of the placenta. Glyceraldehyde 3-phosphate dehydrogenase (Gapdh), a key enzyme in the glycolysis pathway has been considered ubiquitously expressed in cells. There is, however, a growing body of evidence suggesting that Gapdh has many functions in pathways unrelated to glucose metabolism. In the present study, we show that GAPDH expression and sub-cellular localization changes through gestation in the mouse placenta. Our findings raise the possibility that GAPDH has multiple functions in trophoblast cells and the developing placenta, while also cautioning against its use as an endogenous reference or standard for gene expression in the placenta.     

The expression of insulin-like growth factor and insulin-like growth factor binding protein mRNAs in mouse placenta

Insulin-like growth factors (IGFs) and IGF binding proteins (IGFBPs) are paracrine regulators of tissue growth and development, and are expressed at the sites of biological action. To study the role of the IGFs and IGFBPs in mouse placental development, we determined the temporal and spatial expression patterns of the mRNAs at embryonic days 10.5 to 18.5 by in situ hybridization. IGF-II mRNA was expressed strongly in mesoderm and fetal blood vessels of early placenta and in labyrinthine trophoblast of later placenta. In the junctional zone, IGF-II mRNA was expressed first in spongiotrophoblasts, later strongly in glycogen cells and variably in giant cells. IGFBP-2 mRNA was expressed weakly in spongiotrophoblasts and glycogen cells. IGFBP-2, -5 and -6 mRNAs were detected in the stroma of the metrial gland. Myometrium expressed IGFBP-2 mRNA strongly, IGFBP-6 mRNA moderately and IGFBP-5 mRNA weakly. The endothelium of maternal blood vessels in decidua expressed IGFBP-3 and -5 mRNAs, and some deeper vessels expressed IGFBP-4 mRNA. In the yolk sac, IGF-II mRNA was expressed in endoderm and mesoderm, whereas IGFBP-1, -2 and -4 mRNAs were expressed only in endoderm, and IGFBP-4 mRNA in mesoderm. Strong expression of IGF-II mRNA in glycogen cells suggests a role in the autocrine/paracrine regulation of invasion. Similar to rat and guinea pig, but in contrast to man and primates, IGFBP mRNAs, except IGFBP-4, were not expressed in mouse decidua. However, IGFBP-3, -4 and -5 mRNAs were expressed in endothelium of maternal blood vessels, and IGFBP-2 and -6 mRNAs in myometrium, where IGFBPs may play a critical role in regulating trophoblast invasion. These findings suggest possible biological roles of the peptides at the feto-maternal interface.     

Wnt2在植入胎盘组织中的表达及其对滋养细胞迁移和侵袭功能的影响

目的检测Wnt2在植入胎盘组织中的表达,分析Wnt2对滋养细胞凋亡、迁移和侵袭功能的影响。方法收集2020年7月至2021年1月于武汉大学中南医院妇产科行剖宫产的胎盘植入孕产妇胎盘组织15例(植入组)和正常孕产妇胎盘组织15例(对照组)。RT-PCR法和Western blot法检测胎盘组织中Wnt2表达水平,采用siRNA敲低HTR-8/Svneo细胞中Wnt2表达水平,流式细胞学法检测细胞凋亡,Transwell侵袭和迁移实验评估细胞的迁移和侵袭能力,RT-PCR法和Western blot法检测β-catenin、Bcl-2、Caspase-3、MMP-2和MMP-9表达水平。结果与对照组相比,植入组胎盘组织中Wnt2、MMP-2和MMP-9 mRNA和蛋白表达量均显著升高(均P<0.05)。转染敲低HTR-8/Svneo细胞Wnt2水平后,细胞凋亡率显著增加(P<0.05),细胞迁移和侵袭能力显著抑制(P<0.01),β-catenin、Bcl-2、MMP-2和MMP-9表达显著下降(均P<0.05),而Caspase-3表达显著升高(P<0.05)。结论植入胎盘组织中Wnt2蛋白表达显著升高,且Wnt2可能通过wnt/β-catenin信号通路参与了胎盘滋养细胞的凋亡、迁移和侵袭。     

Successful outcome after antepartum expulsion of placenta and fetus into the abdominal cavity; a case report

Spontaneous rupture of the uterus before labour is a rare event associated with a high incidence of maternal and fetal death. We report a case of spontaneous uterine rupture at 34 weeks' gestation in a patient's second pregnancy. The case is unusual because both the mother and baby survived despite the expulsion of the placenta with the fetus into the abdominal cavity prior to laparotomy.