Maternal serum thrombospondin-1 is significantly altered in cases with established preeclampsia

Purpose: The aim of the study was to investigate whether maternal serum TSP-1 level was associated with PE.

Materials and methods: In our case control study, 84 pregnant women in the third trimester were included. Forty-one of them were healthy and 43 of them were with the diagnosis of PE. The diagnosis was based on the definitions of the National High Blood Pressure Education Program working Group on High Blood Pressure in Pregnancy. Preeclamptic patients were divided into two subgroups as mild and severe. Blood pressure (BP) of pregnant women were obtained in left-side lying position using a mercury sphygmomanometer after at least 10 minutes of rest. Ten milliliters of venous blood was taken from every pregnant women and dispensed into lithium heparin and serum was obtained. Samples were stored at ?80?°C until analyzed. Serum TSP-1 level was measured using enzyme-linked immunosorbent assay (ELISA). All tests were two-tailed and p < .05 was considered to be statistically significant.

Results: TSP-1 level was significantly lower in PE group than in controls (p?=?.003). Platelet counts were similar in two groups (p = .26). TSP-1 levels were significantly lower in severe PE than in mild PE cases. According to the subgroup analysis, TSP-1 level was found significantly lower in severe preeclampsia group compared to control group (p = .015).

Conclusions: In light of the association between endothelial dysfunction and preeclampsia, we claim that lower levels of TSP-1 which is released mostly from endothelial cells seem to reflect disease severity in PE. Our study reveals that maternal serum TSP-1 levels decrease in pregnant women presenting with PE and TSP-1 may be a new biomarker for the detection of PE and even severity of it. Further studies especially prospective ones with greater numbers of cases are needed.     

Human growth and chronic disease: A memorial to Jim Tanner

Context: Memorial to Jim Tanner.

Objective: To examine the links between early growth and chronic disease in later life.

Methods: Literature review.

Results: There is now a developmental model for the origins of chronic disease in which the causes to be identified are linked to normal variations in feto-placental, infant and childhood growth and development. These variations lead to variations in the supply of nutrients to the baby that permanently alters gene expression, a process known as ‘programming’.

Conclusions: Variations in the processes of development programme the function of a few key systems that are linked to chronic disease—the immune system, anti-oxidant defences, inflammatory responses, the number and quality of stem cells, neuro-endocrine settings and the balance of the autonomic nervous system. There is not a separate cause for each different disease. Which chronic disease originates during development may depend more on timing than on qualitative differences in exposures to external influences.     

Association between hypertensive disorders complicating pregnancy and risk of placenta accreta: a meta-analysis and systematic review

Objective: Previous studies have reported a positive association between hypertensive disorders complicating pregnancy and placenta accreta. However, whether hypertensive disorders complicating pregnancy associated with placenta accreta is still not clear. The objective was to systematically review the literature to determine a possible association between hypertensive disorders complicating pregnancy and placenta accreta. Methods: A systematic search of PubMed database, the Cochrane Library, Willy Online Library, and ScienceDirect database through 1st December 2015, was conducted. Two authors independently assessed data extraction and quality of the studies using the Newcastle-Ottawa Scale. Assessment of heterogeneity and analysis of data were operated by Review Manager 5.3.0. Results: Three studies involving 4174 patients who developed hypertensive disorders complicating pregnancy of a total of 38,004 pregnant women were selected. The result of our meta-analysis revealed that pregnancy induced hypertension was significantly associated with a reduction of placenta accreta (OR = 0.50, 95% CI: 0.30–0.82; heterogeneity: I² = 13%, p = 0.32). Conclusions: Our meta-analysis demonstrated that the risk of placenta accreta is reduced in women with hypertensive disorders complicating pregnancy. Further well-designed studies are warranted to testify the result and explored any potential mechanism association between hypertensive disorders complicating pregnancy and placenta accreta.     

HCMV Infection of Human Trophoblast Progenitor Cells of the Placenta Is Neutralized by a Human Monoclonal Antibody to Glycoprotein B and Not by Antibodies to the Pentamer Complex

Human cytomegalovirus (HCMV) is the major viral cause of congenital infection and birth defects. Primary maternal infection often results in virus transmission, and symptomatic babies can have permanent neurological deficiencies and deafness. Congenital infection can also lead to intrauterine growth restriction, a defect in placental transport. HCMV replicates in primary cytotrophoblasts (CTBs), the specialized cells of the placenta, and inhibits differentiation/invasion. Human trophoblast progenitor cells (TBPCs) give rise to the mature cell types of the chorionic villi, CTBs and multi-nucleated syncytiotrophoblasts (STBs). Here we report that TBPCs are fully permissive for pathogenic and attenuated HCMV strains. Studies with a mutant virus lacking a functional pentamer complex (gH/gL/pUL128-131A) showed that virion entry into TBPCs is independent of the pentamer. In addition, infection is blocked by a potent human neutralizing monoclonal antibody (mAb), TRL345, reactive with glycoprotein B (gB), but not mAbs to the pentamer proteins pUL130/pUL131A. Functional studies revealed that neutralization of infection preserved the capacity of TBPCs to differentiate and assemble into trophospheres composed of CTBs and STBs in vitro. Our results indicate that mAbs to gB protect trophoblast progenitors of the placenta and could be included in antibody treatments developed to suppress congenital infection and prevent disease.     

中央性前置胎盘剖宫产术中应用卡前列素氨丁三醇时机的疗效研究

目的 探讨中央性前置胎盘剖宫产术中应用卡前列素氨丁三醇的时机对疗效的影响.方法 将148例中央性前置胎盘产妇按就诊顺序号分为观察组和对照组,每组74例.观察组注射卡前列素氨丁三醇的时间为断脐后,对照组则为胎盘娩出后.比较两组术中和术后24h内出血量、手术时间、胎盘自娩率及不良反应发生率等.结果 观察组的术中出血量明显少于对照组[（503.5±320.8） ml比（672.1 ±409.6） ml],胎盘自娩率明显高于对照组[79.73％（59/74）比54.05％（40/74）],手术时间明显短于对照组[（42± 15） min比（55±16） min],差异均有统计学意义（P＜ 0.05或＜ 0.01）;两组术后24h内出血量和不良反应发生率比较差异均无统计学意义（P＞0.05）.结论 中央性前置胎盘产妇行剖宫产术时,于断脐后即将卡前列素氨丁三醇注射入宫体可提高胎盘自娩率,缩短手术时间,减少术中出血量,值得临床借鉴和推广.     

中晚孕期出血原因分析及产前超声对中晚孕期出血妊娠结局的影响

【摘要】目的：研究分析中晚孕期出血原因，并探究产前超声对中晚孕期出血妊娠结局的影响。方法：选择我院收治的妊娠中晚孕期出血产妇129例，记为观察组。再选择同时期我院的妊娠正常产妇100例，记为对照组。对比两组前置胎盘等情况的发生率，确定出血原因，再深入探究前置胎盘的危险因素。最后对比产前超声检查和常规CT检查对中晚孕期出血的诊断结果，并统计分析妊娠结局的影响。结果：前置胎盘的主要危险因素是年龄、文化程度、流产史以及剖宫产史。产前超声检查准确度、敏感性以及特异性均显著高于常规CT检查，并且超声检查漏诊率低于CT检查。观察组剖宫产、早产、胎儿窘迫以及新生儿窒息比例显著高于对照组，差异均有统计学意义（均P＜0.05）。结论：中晚孕期出血的主要原因是前置胎盘、胎盘早剥等，年龄、流产史等是引起前置胎盘的危险因素。产前超声检查能高效检出中晚孕期出血，敏感度以及特异性都较高。     

Impacts of Maternal Nutrition on Vascularity of Nutrient Transferring Tissues during Gestation and Lactation

As the demand for food increases with exponential growth in the world population, it is imperative that we understand how to make livestock production as efficient as possible in the face of decreasing available natural resources. Moreover, it is important that livestock are able to meet their metabolic demands and supply adequate nutrition to developing offspring both during pregnancy and lactation. Specific nutrient supplementation programs that are designed to offset deficiencies, enhance efficiency, and improve nutrient supply during pregnancy can alter tissue vascular responses, fetal growth, and postnatal offspring outcomes. This review outlines how vascularity in nutrient transferring tissues, namely the maternal gastrointestinal tract, the utero-placental tissue, and the mammary gland, respond to differing nutritional planes and other specific nutrient supplementation regimes.     

Histoire et fonctions des Unités pour Malades Difficiles (1re partie). Du quartier de sûreté à l’Unité pour Malades Difficiles de Villejuif,plus d’un siècle de prise en charge

This article is the first in a series of three, dedicated to the history and functions of what is known as a UMD in France: Unités pour Malades Difficiles, or “Units for Difficult Patients”. This particular article focuses on the oldest such secure structure, UMD Henri Colin, created in 1910 in Villejuif as a quartier de sûreté, or a “secure ward”. The article aims to detail evolutions in treatment and the types of patient treated over more than one hundred years, parallel to social change. Four distinct chronological periods are examined, for their perspective on professional practice as much as for the reasons given for patients’ admission and the psychopathological profiles of “dangerous” patients. Clinical vignettes are used to illustrate this historical evolution.