Neurochemical and cellular markers in human cervix of late pregnant, postpartal and non-pregnant women

BACKGROUND: The aim was to evaluate the peptidergic innervation and the dendritic cell content in the cervix uteri. METHODS: Cervical biopsies were obtained from late pregnant (n=5), postpartal (n=5) and non-pregnant (n=5) women. The samples were prepared for immunohistochemistry using antibodies to protein S-100 (S-100), calcitonin gene-related peptide (CGRP), vasoactive intestinal polypeptide (VIP), human peptide histidine isoleucine amide (PHM 27), neuropeptide tyrosine (NPY), and human histocompatibility complex class II subregion DR (HLA-DR). RESULTS: Nerve fibers positive for protein S-100, and dendritic cells positive for S-100 and HLA-DR were abundant in the cervix, especially at late pregnancy. CGRP, VIP, PHM-27 and NPY positive nerve fibers were present in non-pregnant, short nerve fibers and scattered immunoreactivity at term, and further scattered immunoreactivity after parturition. NPY positive nerve fibers were decreased at term, and after parturition a scattered immunoreactivity was observed. CONCLUSIONS: The abundant protein S-100 positive nerve fibers implies an impact of myelinated nerves in the cervix uteri during pregnancy. The abundant dendritic cells, positive for HLA-DR and S-100, especially at term, indicates a general activation of the immune system until late pregnancy and parturition. The changed occurrence and distribution of immunoreactivity for CGRP, VIP and PHM-27 suggest a release of these neuropeptides until term. The changes in NPY immunoreactivity indicate a release of NPY around parturition.     

Intraocular pressure in pregnant and non-pregnant Nigerian women

A number of hormones are known to affect intraocular pressure. Of these, the female sex hormones are the predominant ones to cause variations in intraocular pressure. The aim of this study was to determine if variation in sex hormones in pregnancy affects intraocular pressure. This study was a longitudinal one. 117 pregnant women aged 20 to 35 years in their first trimester of pregnancy were followed longitudinally throughout the course of pregnancy, and six weeks post partum. One hundred non pregnant women with a regular menstrual cycle of 26-29 days were also recruited and examined for changes in intraocular pressure. Intraocular pressure was measured with the handheld Kowa applanation tonometer. Mean Intraocular Pressure (MIOP) was 14.7 +/- 2.2 mmHg, 13.2 +/- 2.0 mmHg and 11.0 +/- 1.3 mmHg in the three trimesters respectively. There was thus a fall in Intraocular Pressure during pregnancy and this was highly statistically significant (P<0.0001). At 6 weeks postpartum MIOP increased to 14.2 +/- 1.8 mmHg. The difference between the mean values of Intraocular Pressure in the third trimester and 6 weeks postpartum was also statistically significant P<0.0001. Intraocular pressure decreased as pregnancy advanced. Postpartum, there was increase in intraocular pressure to near pre pregnant level. The difference in mean IOP between the pregnant and non pregnant women was statistically significant (P<0.05).     

Perinatal outcome in HIV-infected pregnant women

We have observed 74 HIV-seropositive and 48 HIV-seronegative drug-addicted women and 22 HIV-seropositive nondrug-addicted pregnant women during pregnancy and we report their perinatal outcome. 8 out of 96 HIV-seropositive patients had hematological signs of immunodeficiency and 2 of these patients were symptomatic belonging to CDC class III. We recorded 2 early and 3 late spontaneous abortions, no intrauterine fetal death and 3 neonatal deaths. Seropositive patients had 3 malformed babies, seronegative patients had 1. All these women had a high incidence of premature delivery and intrauterine fetal growth retardation: seropositive patients had a higher incidence of fetuses small for gestational age and a lower incidence of preterm delivery compared to seronegative patients, but the difference was not statistically significant. The incidence of malformation was comparable to the general population: 3 malformed babies were born to HIV-positive drug-addicted mothers, and 1 to a seronegative drug-addicted mother. These findings do not support the hypothesis of a direct detrimental effect of HIV on perinatal outcome. Consequences of fetal exposure to maternal HIV infection involve mostly postnatal life and development of acquired immunodeficiency.     

Collagenase activity in the cervix of non-pregnant and pregnant women

Summary Cervical biopsies were obtained from non pregnant patients and from pregnant at various stages of gestation and during labour. The tissues were extract with a Ca⁺⁺-containing buffer, and collagenase activity was determined in these extracts using a solid phase assay in which triple helical¹²⁵I-labelled collagen was cleaved. Collagenase was detected in all samples but significantly elevated activity was only present in labour at 6–8 cm cervical dilatation. This provides direct evidence for the crucial role of specific collagen degradation during cervical ripening and dilatation.     

Plasma adiponectin concentrations in non-pregnant, normal and overweight pregnant women

AIMS: Adiponectin is an adipokine that has anti-diabetic, anti-atherogenic, anti-inflammatory and angiogenic properties. This hormone has been implicated in both the physiological adaptation to normal pregnancy and in obstetrical complications. The aims of this study were to determine normal maternal plasma concentrations of adiponectin throughout gestation and to explore the relationships between plasma adiponectin concentration, pregnancy, and maternal overweight. METHODS: A cross-sectional study was designed to include normal pregnant (normal weight and overweight; 11-42 weeks of gestation), and non-pregnant women. Plasma adiponectin concentration was determined by immunoassay. Non-parametric statistics were used for analysis. RESULTS: (1) Adiponectin was detectable in the plasma of all patients; (2) there was no significant differences in the median adiponectin concentration between pregnant and non-pregnant women; (3) plasma adiponectin concentrations were negatively correlated with gestational age only among normal weight pregnant women; and (4) overweight patients had significantly lower plasma adiponectin concentrations than normal weight women. CONCLUSIONS: Consistent with the increased insulin resistance and weight gain that occur in pregnancy, adiponectin concentrations were negatively correlated with gestational age. The results of this study and the nomogram herein presented, can serve as the basis to explore the relationship between adiponectin and pregnancy complications and facilitate the clinical use of this important adipokine.     

Electrical impedance spectroscopy of the cervix in non-pregnant and pregnant women

OBJECTIVES: We sought to validate and measure the electrical impedance of the uterine cervix in non-pregnant and pregnant women by spectroscopy. STUDY DESIGN: Cervical stromal impedance (CSI) was measured in 50 non-pregnant, 20 1st, 20 2nd and 50 3rd trimester pregnant women. The technique was also validated by comparing in vivo data to a finite element (FE) model of cervical tissue. RESULTS: CSI agreed well with the FE model and was highly reproducible in all study groups. Mean (S.E.) CSI at 4-819 kHz was higher in pregnant (2.78 +/- 0.09 Omega m) compared to non-pregnant (2.38 +/- 0.07, p < 0.01) women, and in the 3rd trimester (3.08 +/- 0.13) compared to non-pregnant (p < 0.01), 1st trimester (2.42 +/- 0.12, p < 0.001) and 2nd trimester (2.20 +/- 0.05, p < 0.001) pregnant women. CONCLUSION: Measurement of CSI provides a non-invasive method of assessing cervical tissue characteristics. Cervical extracellular matrix synthesis and leukocyte infiltration may account for the increased tissue impedance noted in the 3rd trimester.     

Predicting lapse when stopping smoking among pregnant and non-pregnant women.

This study aimed to investigate factors predicting lapse among pregnant and non-pregnant women when trying to stop smoking. A total of 40 women, pregnant and non-pregnant, were investigated over a 2-week period when trying to stop smoking. One-quarter of the women lapsed every day. Not being pregnant was a significant predictor for the occurrence of any lapse during the time period, whereas age, number of years of smoking, number of earlier attempts to stop smoking, and number of cigarettes smoked per day did not predict lapse. There was a four times higher risk for lapse in non-pregnant compared with pregnant women. Being pregnant gives an opportunity to help stop smoking with a considerably lower risk of lapse compared with non-pregnant women.     

Higher prevalence of vitamin D deficiency in German pregnant women compared to non-pregnant women

Purpose

Adequate vitamin D status is crucial for normal development of the fetus and for maternal health. As data on vitamin D status (25-hydroxyvitamin D, 25(OH)D) in German women of different states of pregnancy were not available, this study compared the vitamin D status of German women in all trimesters of pregnancy with that of non-pregnant women.

Methods

The study sample of 858 women (18–45 years) was recruited from April 2013 to March 2015 as a part of the cross-sectional Germany-wide VitaMinFemin study. Serum 25(OH)D levels were determined using chemiluminescence immunoassay.

Results

A total of 78.1% of the pregnant women and 53.9% of the non-pregnant women had a vitamin D status <50.0 nmol/L (p < 0.001). In pregnant women, the multivariate binary analysis showed that winter [odds ratio (OR) 13.5], longitude of residence between 6.3°E and 8.9°E (OR 2.0) or 9.0°E and 10.9°E (OR 2.3) and third trimester (OR 2.3) were associated with a higher risk of vitamin D status <25.0 nmol/L, whereas increasing age per one year (OR 0.9) with a lower risk. Compared with non-pregnant women, pregnant women were 3.7 times more likely to have a vitamin D status <25.0 nmol/L.

Conclusion

A low vitamin D status is prevalent among German pregnant women and should be improved to supply mother and fetus adequately.

     

Release of beta-endorphin in response to physical exercise in non-pregnant and pregnant women

The effect of physical exercise on beta-endorphin (beta-E) concentration in plasma was studied in 8 non-pregnant and in 8 pregnant women in their last trimester of pregnancy, using a 10-min bicycle ergometer test. In the non-pregnant women the mean beta-E levels were 2.4 +/- 0.7 (S.E.) pmol/l before the test, 4.3 +/- 0.9 pmol/l at the end of the test, and 4.3 +/- 0.6 and 5.0 +/- 2.0 pmol/l 15 and 30 min after the test, respectively, declining thereafter. In the pregnant women the mean beta-E values were 5.1 +/- 2.0 pmol/l before the test, 7.3 +/- 1.7 pmol/l at the end of the test, 6.7 +/- 2.0 pmol/l 15 min after the test, and 12.6 +/- 4.1 pmol/l 60 min after the test, declining thereafter. Thus, beta-E secretion increased in response to exercise both in non-pregnant and in pregnant women, the response lasting longer in pregnant women.     

Maternal complications after Caesarean section in HIV-infected pregnant women

A study of maternal complications after elective Caesarean section in HIV-infected women was carried out from January 1999 to April 2001. The control group consisted of all the seronegative pregnant women who underwent the elective Caesarean section during the study period. The study group was divided into two subgroups. Subgroup 1 patients were given 600 mg zidovudine (ZDV) orally and 300 mg lamivudine (3TC) daily from 34 to 38 weeks' gestation. Subgroup 2 patients were given 600 mg ZDV orally daily from 34 to 38 weeks' gestation and 150 mg nevirapine orally on the morning of the Caesarean section day. In both groups, the elective Caesarean section was carried out at 38 weeks' gestation and ZDV syrup (2 mg/kg) was given orally to the newborn immediately in the operating theatre and then every 6 h for 4 weeks. No statistically significant differences in maternal complications were found between the HIV-infected and non HIV-infected women.     

Criteria for the oral glucose tolerance test in pregnant and non-pregnant Nigerian women

In order to establish diagnostic criteria for detection of abnormal oral glucose tolerance test (OGTT) in pregnant and non-pregnant Nigerian women, the test was performed in 25 non-pregnant and 60 pregnant non-diabetic women at various trimesters of pregnancy. The upper limit of normal plasma glucose was the same as that from caucasian populations with respect to the fasting values but much less at 60 and 120 min. When compared to the non-pregnant controls, fasting plasma glucose was significantly lower during pregnancy, however, there was no change in glucose tolerance during pregnancy. The possible reasons for these observations are discussed and it would appear that our criteria would be the ideal ones to use for clinical purposes in Nigerian women.     

Care of HIV-infected pregnant women in maternal-fetal medicine programs

OBJECTIVE: To survey the evolution over the past decade of attitudes and practices of obstetricians in maternal-fetal medicine fellowship programs regarding the management of human immunodeficiency virus (HIV)-infected pregnant women. METHODS: Directors of all 65 approved maternal-fetal medicine training programs were sent questionnaires, responses to which were to reflect the consensus among members of their faculties. Programs were stratified based upon the number of HIV-infected pregnant patients cared for in the previous year. RESULTS: Responses reflect experience with over 1000 infected pregnant women per year, nearly one-quarter with advanced disease. Combination antiretroviral therapy was prescribed by all respondents, universally in the 2nd and 3rd trimesters. A three-drug regimen (often containing a protease inhibitor) was used more often by those who treated at least 20 HIV-infected pregnant patients per year than by those programs seeing a lower number of patients (80 vs 59%). Despite the known and unknown risks of the use of antiretrovirals during pregnancy, only half of all responding programs report adverse events to the Antiretroviral Pregnancy Registry; reporting was more common among the institutions seeing a higher number of patients (61 vs 45%). Seventy-eight percent of higher volume programs enroll their patients in clinical studies, usually multicenter, versus 35% of lower volume programs. CONCLUSIONS: Care for HIV+ pregnant women has dramatically changed over the past decade. Antiretroviral therapy is now universally prescribed by physicians involved in maternal-fetal medicine training programs. Given limited experience with these agents in the setting of pregnancy, it is essential for maternal-fetal medicine practitioners to actively report on adverse events and participate in clinical trials.     

Adeno-associated virus and human papillomavirus types in cervical samples of pregnant and non-pregnant women

Objective

To investigate the prevalence of AAV and HPV DNA and their types in cervical secretion from pregnant and non-pregnant women.

Study design

The samples were obtained from 40 pregnant and 62 non-pregnant women who were attended at the outpatient clinic of the Federal University Hospital of Espírito Santo, Southeastern Brazil. AAV and HPV were investigated by PCR and typed by PCR and/or RFLP.

Results

The occurrence of AAV in all samples was 25.5% (26/102): 81% (21/26) and 19% (5/26) for AAV2/3 and AAV5 species, respectively. AAV were observed in 35% (14/40) and 19% (12/62) of pregnant and non-pregnant women, respectively. HPV occurred in 22% of all samples; 25% (10/40) in pregnant and 20% (12/60) in non-pregnant women. HPV types were determined for 72.7% of the strains, most of which classified as high-risk. AAV–HPV co-infection was observed in 15.4% (4/26), mostly in pregnant women.

Conclusions

There was a greater prevalence of AAV and HPV in pregnant than in non-pregnant women, which suggests that the gestational state may play a role in reactivating the viruses.     

Comparison of plasma prostaglandins in the non-pregnant and pregnant women: a longitudinal study

Plasma levels of PGE2 and PGF2 alpha were determined in women from 24 to 40 weeks of pregnancy with non-pregnant women as controls. The plasma levels of PGE2 showed no significant changes as gestation advanced except for late pregnancy only. Furthermore, there were no significant differences observed between the control and pregnant subjects except late in pregnancy. On the other hand, the concentrations of PGF2 alpha in the pregnant subjects revealed a significant increase (p less than 0.005) compared with those of the controls, though no significant changes were observed with the advance of gestation except for late pregnancy. The PGF2 alpha/PGE2 ratio showed a six to ten times rise during pregnancy (p less than 0.005) compared with that of the controls. Therefore, the results obtained in the present study may explain the effectiveness of prostaglandin synthetase inhibitors in suppressing preterm uterine contraction and they also indicate the involvement of some factors in the initiation and inhibition of the myometrium contraction.