Placental proteins in the normal menstrual cycle, in occult pregnancy and in early normal pregnancy in the same subject

Assays of SP1 and of hCG were done in three successive menstrual cycles in a woman undergoing artificial insemination from a donor. The day of ovulation was determined by basal body temperature, and by assays of oestradiol and progesterone. In the first cycle no placental proteins were detected, in the second cycle there was a transient peak of SP1 and hCG 4 days after ovulation. In the third cycle both proteins were first detected 12 days after ovulation, then increased rapidly in concentration and the patient went on to a normal pregnancy.     

正常妊娠胎盘滋养细胞表面Fas配体表达的研究

目的通过对正常妊娠绒毛滋养细胞表面Fas配体表达的研究,进一步探讨母-胎免疫耐受机理。方法分别选取正常妊娠早、中、晚期绒毛组织,用免疫组织化学(免疫组化)的方法确定其Fas配体的表达,并通过HPIS-1000高清晰彩色病理图像免疫组化测量系统对其表达进行定量分析。结果正常妊娠各期绒毛滋养细胞表面均有Fas配体的表达;且不同孕周之间其表达量比较,差异具有显著性(P<0.05)。妊娠早、中、晚期绒毛滋养细胞表面Fas配体染色平均面积分别为(91.410±8.328)μm2、(101.322±11.480)μm2、(97.461±10.517)μm2;平均光度分别为0.227±0.0325、0.261±0.021、0.145±0.015;积分光度分别为21.391±4.636,25.993±6.231,18.588±3.897。结论绒毛滋养细胞表面Fas配体的表达在维持妊娠及胎儿正常发育中起着重要作用。母胎界面的Fas配体介导的特异性Fas(+)T淋巴细胞凋亡,可能是母-胎免疫耐受的重要机理之一。     

Placental localization of 15-hydroxy-prostaglandin dehydrogenase in early and term human pregnancy.

The human placenta possesses a large capacity for inactivation of prostanoids. This is due to the presence of large quantities of the NAD(+)-linked 15-hydroxy-prostaglandin dehydrogenase (PGDH type I; EC 1.1.1.141). In order to investigate whether a specific localization of PGDH is at the origin of the increasing placental PGDH activity during early pregnancy, PGDH activity was localized histochemically in placental tissue obtained in early pregnancy and at term. Intracellular PGDH activity was present in three distinct compartments in the placenta. First, the syncytiotrophoblast and second, the underlying cytotrophoblast layer of placental terminal villi contained PGDH. Third, scattered throughout the sections, we found chorion-like cells which showed strong staining for PGDH activity. The intensity of staining in samples before 12 weeks of gestation was much less than in samples after 12 weeks of gestation, which were comparable to those at term. Thus, the fetal cell layers at the boundary between the fetal tissues and the maternal blood have a great potential to inactivate prostanoids suggesting that the fetus protects itself against prostanoids of maternal origin.     

Placental transfer of thiamphenicol in term pregnancy.

The placental transfer of thiamphenicol was studied in 21 subjects at term after an intravenous bolus injection of 1000 mg of the drug. Detectable antibiotic levels were present in umbilical blood and amniotic fluid within 15 min of maternal administration. With the dosage applied, minimum concentrations required for the inhibition of many Gram-positive and Gram-negative organisms causing intrauterine infections were attained in maternal plasma, cord plasma and amniotic fluid. The value of thiamphenicol for the treatment of intrauterine infections is discussed.     

Placental site trophoblastic tumor arising from antecedent molar pregnancy

OBJECTIVE: Placental site trophoblastic tumor (PSTT) is a rare form of gestational trophoblastic disease. Little is known about its pathogenesis and natural history. METHODS: This report describes two cases that arose in patients with documented complete hydatidiform moles and summarizes the antecedent prenatal histories of PSTTs based on a detailed Medline literature analysis. CASES: A 28-year-old, G(2)P(2) female had a live, 12-week gestation fetus and a coexisting molar pregnancy. Her hCG levels dropped promptly from 1.5 million to 23,273 IU/ml after termination, but rose shortly thereafter together with the onset of recurrent vaginal bleeding. Curettage revealed persistent mole. Persistently elevated hCG led to hysterectomy disclosing a fundal PSTT. The second case was that of a 48-year-old, G(2) woman who presented with symptoms of preeclampsia, hyperthyroidism, and elevated hCG. Curettage yielded a complete hydatidiform mole. Although the hCG level decreased for a short period, it soon increased despite treatment with methotrexate. A second curettage revealed a PSTT. DISCUSSION: A Medline literature analysis of PSTT, which consists almost entirely of individual cases and several small series, disclosed that PSTT is preceded in 61% of cases by normal term pregnancy, 12% molar pregnancy, 9% spontaneous abortion, 8% therapeutic abortion, and 3% with ectopic pregnancy, stillbirths or preterm delivery. No information is known in 7%. This report describes two additional cases of PSTT preceded by complete molar pregnancy. CONCLUSIONS: PSTT is a well recognized, but uncommon form of gestational trophoblastic disease. Although little is known about its pathogenesis, it is preceded not uncommonly by an abnormal pregnancy, including a molar pregnancy.     

Placental factor in spontaneous term labor in uncomplicated pregnancy

Objectives: To investigate the placental role in uncomplicated pregnancies and spontaneous term labor. Methods: Placentas were retrieved from women with uncomplicated pregnancies and compared between those with spontaneous term labor to those with elective cesarean delivery without labor. Placentas were analyzed for lesions consistent with maternal circulation abnormalities, lesions consistent with fetal thrombo-occlusive disease and inflammatory lesions, maternal or fetal responses. Results: The study included 139 pregnancies, 76 with term spontaneous deliveries (cases) and 63 with term elective cesarean deliveries (controls). Maternal age, gravidity, parity and BMI were significantly lower in the study group, but gestational age was higher as compared with the control group. Higher rate of maternal inflammatory lesions was observed in the study group compared to the control group, 21 vs. 1.6%, respectively, p = 0.001. No differences were observed in vascular lesions or in fetal inflammatory lesions between the groups. Conclusion: Placental maternal inflammatory changes play a role in spontaneous term labor, different from the involvement of the fetal compartment and placental vascular component in preterm labor.     

Placental development during early pregnancy: Effects of embryo origin on expression of chemokine ligand twelve (CXCL12)

The aim was to localize chemokine ligand twelve (CXCL12) in sheep placental tissues during early gestation and after assisted reproductive technologies (ART). Uteri were collected from naturally (NAT) mated ewes and ewes receiving embryo transfer (ET), in vitro fertilization (IVF) or in vitro activation (IVA). CXCL12 was immunolocalized to endometrial stroma, glands, and trophoblast. Greater CXCL12 immunoreactivity was present in trophoblast on day 22 and 24 and in NAT ewes compared to IVF and IVA. Increased CXCL12 expression suggests CXCL12 promotes implantation and placentation. Decreased CXCL12 in IVF and IVA embryos, may compromise pregnancy establishment when utilizing ART methods.     

Placental perfusion in normal pregnancy and early and late preeclampsia: A magnetic resonance imaging study

Objective

Our primary aim was to investigate if women with early or late preeclampsia have different placental perfusion compared with normal pregnancies. A secondary aim was to investigate if placental perfusion changes with increasing gestational age in normal pregnancy.

Methods

The study population included thirteen women with preeclampsia (five with early and eight with late preeclampsia) and nineteen women with normal pregnancy (ten with early and nine with late pregnancy). Early was defined as <34 weeks and late as ≥34 weeks gestation. All women underwent a magnetic resonance imaging (MRI) examination including a diffusion weighted sequence at 1.5 T. The perfusion fraction was calculated.

Results

Women with early preeclampsia had a smaller placental perfusion fraction (p = 0.001) and women with late preeclampsia had a larger placental perfusion fraction (p = 0.011), compared to women with normal pregnancies at the corresponding gestational age. The placental perfusion fraction decreased with increasing gestational age in normal pregnancies (p = 0.001).

Conclusion

Both early and late preeclampsia differ in placental perfusion from normal pregnant women. Observed differences are however in the opposite direction, suggesting differences in pathophysiology. Placental perfusion decreases with increasing gestational age in normal pregnancy.     

Placental expression of microRNA-17 and -19b is down-regulated in early pregnancy loss

Objective

First, to determine if microRNA-17 and -19b are expressed in villous samples at early stages of pregnancy. Second, to determine whether placental expressions of these microRNAs along with their main targets (PTEN, CREB-1, TGFβ-1 and TGFβ-RII) are altered in early pregnancy loss.

Study design

Expression levels of microRNAs and mRNA targets in villous samples from early pregnancy loss (n = 11) and matched normal cases (n = 20) by gestational age were determined by RT-PCR.

Results

Both microRNA-17 and -19b were expressed in all cases of normal pregnancy. They were significantly down-regulated (relative ratios: 0.35 and 0.34 respectively) in early pregnancy loss. Their main target, PTEN mRNA, was significantly up-regulated in early pregnancy loss (relative ratio: 2.6, 95%CI: 0.2–29.8). TGF-β1, CREB-1 and TGFβ-RII were not significantly different between the two groups.

Conclusion

microRNA-17 and -19b are expressed in early stages of pregnancy. They are down-regulated in villous samples from early pregnancy loss. We suggest that these main members of the microRNA-17-92 cluster might be involved in placental invasion and its dysregulation might also be related to other conditions characterized by defective placentation.     

Placental metabolism of dehydroepiandrosterone sulphate in normal pregnancy.

An intravenous injection of 50 mg dehydroepiandrosterone was given to 19 women at the 38th week of pregnancy. The concentration of androstenedione, testosterone, oestradiol and oestrone in plasma was measured at intervals following the injection. The concentration of androstenedione and testosterone rose rapidly; reaching a peak after 10 minutes and returning to near baseline level by 30 minutes. Oestradiol rose more slowly, reaching a peak after 45 minutes and being sustained at high levels for 3 1/2 hours before returning slowly to baseline. Oestrone rose yet more slowly and did not reach a peak until 2 1/2 hours after the injection. It is concluded that the steroid responses are too variable from one individual to another for this test to be useful in the clinical assessment of fetal wellbeing but that it was likely to be a powerful tool in the investigation of placental steroid biogenesis.     

Placental transfer of temazepam and fentanyl in early human pregnancy

The placental transfer of temazepam and fentanyl was studied in 37 women undergoing surgical termination of pregnancy between 12 and 17 weeks. The women received temazepam 10 mg, approximately 1 h pre-operatively and fentanyl 2 &mgr;g/kg intravenously, at induction of anaesthesia. A single 2 ml fetal blood sample was taken from each anaesthetized subject using an ultrasound-guided trans-abdominal puncture at either 5, 10, 15 or 20 min after administration of fentanyl. A maternal blood sample was collected simultaneously and both were assayed for temazepam and fentanyl. Both drugs were detected in all fetal serum samples. Fetal:maternal (F:M) drug concentration ratio was 0.38 for temazepam, which did not change between 60 and 120 min after oral administration to the mother. Overall F:M ratio for fentanyl was 1.87 for fentanyl, which increased from 1.42 at 5 min to 2.6 at 20 min. F:M ratio of fentanyl concentrations increased with time (r = 0.48, P < 0.003), whereas F:M ratio of temazepam concentrations did not change significantly with time, between 50 and 120 min after the drug was administered to the mother (r = 0.32, P = 0.06). F:M ratios changed with gestational age of the fetus for both drugs, increasing as gestational age increased in the case of temazepam (r = 0.47, P = 0.003) and decreasing in the case of fentanyl (r = 0.38, P = 0.02). These changes can be explained by variation in uterine blood flow, trophoblast membrane thickness and feto-placental metabolism. These results also indicate that the in-vitro study of these drugs is unlikely to reflect the in-vivo situation in early pregnancy.     

Placental protein 10 (PP10) in normal pregnancy and cholestasis of pregnancy

The circulating concentrations of placental protein 10 (PP10) were measured by radioimmunoassay in 288 women with normal pregnancy and ten women (55 samples) with cholestasis of pregnancy. Serum PP10 levels were not affected by changes in incubation and storage temperature, and no diurnal variation was observed. The highest PP10 levels (36-85 micrograms/l) in normal pregnancy were found at 34 weeks. The postpartum decline of serum PP10 concentration corresponded to an average half-life of 18 h. In cholestasis of pregnancy at 32-39 weeks, the serum PP10 levels were found to be lower than normal. Negative correlation was observed between aminotransferase and PP10 levels in serum and between the bile acid levels and the PP10 concentration. These results suggest that the severity of maternal liver disorder is reflected in the circulating PP10 concentration.     

Placental protein 10 (PP10) in normal pregnancy and cholestasis of pregnancy

Summary. The circulating concentrations of placental protein 10 (PP10) were measured by radioimmunoassay in 288 women with normal pregnancy and ten women (55 samples) with cholestasis of pregnancy. Serum PP10 levels were not affected by changes in incubation and storage temperature, and no diurnal variation was observed. The highest PP10 levels (36–85 μg/1) in normal pregnancy were found at 34 weeks. The postpartum decline of serum PP10 concentration corresponded to an average half-life of 18h. In cholestasis of pregnancy at 32–39 weeks, the serum PP10 levels were found to be lower than normal. Negative correlation was observed between aminotransferase and PP10 levels in serum and between the bile acid levels and the PP10 concentration. These results suggest that the severity of maternal liver disorder is reflected in the circulating PP10 concentration.