WorldWideScience

Sample records for placenta percreta con

  1. Management of placenta percreta

    DEFF Research Database (Denmark)

    Clausen, Caroline; Lönn, Lars; Langhoff-Roos, Jens

    2014-01-01

    in the management of the conditions. A PubMed search was performed in April 2013 and the final review included 119 published placenta percreta cases. Conservative management, where the placenta is left in situ for resorption, seems to be associated with severe long-term complications of hemorrhage and infections......Publications on abnormally invasive placenta in general report what can be considered a mixture of the conditions true accreta, increta and percreta varieties. The aim of this review was to identify all published cases of the most severe condition, placenta percreta in order to describe...... cases for the local resection technique might in part explain the lower complication rates with that approach. Future prospective data collection activities should include intended as well as actual management, and long-term follow-up of all cases is of vital importance....

  2. Placenta percreta with urinary bladder involvement

    International Nuclear Information System (INIS)

    Al-Ojaimi, Eftekhar H.; Subramaniam, Balameenakshi V.

    2004-01-01

    A 37-years old Pakistani lady, who had previously undergone one cesarean delivery and one uterine curettage, was admitted to the labor ward at 29 weeks of gestation with history of sudden severe painless vaginal bleeding from a sonographically diagnosed placenta pervia. An immediate cesarean was performed and a live male infant was delivered. The placenta was morbidly adherent to the lower uterine segment and attempts at removal caused torrential bleeding, necesstiating cesarean hysterectomy. In addition, attempts to dissect the bldder from lower uterine segment was unsuccessful and, hence, the diagnosis of placenta percreta with involvement of urinary bladder was made. A modified posterior approach to the hyterectomy was carried out, with subsequent good recovery. (author)

  3. Per operative discovery of Placenta Praevia Percreta: A case report ...

    African Journals Online (AJOL)

    Placenta percreta is a rare pathological entity with challenging diagnostic and therapeutic requirements especially for resource limited settings. We present here the case of a 40 year old woman with a per operative diagnosis of placenta accreta during a caesarian section indicated for placenta praevia. We highlight the ...

  4. Bladder Saving Hysterectomy for Placenta Praevia Percreta | Dahiya ...

    African Journals Online (AJOL)

    Background: Placenta accreta is an abnormally firm attachment of placental villi to the uterine wall, which may cause postpartum hemorrhage. Placenta Percreta with invasion of the urinary bladder is a rare condition, which carries a high morbidity and mortality risk for mother and fetus. Case Report: The present case is of ...

  5. Intrapartal resection of the bicornuete uterus for placenta membranacea percreta

    Directory of Open Access Journals (Sweden)

    Sparić Radmila

    2007-01-01

    Full Text Available Placenta membranacea is a rare anomaly characterized by failure of villous atrophy during early gestation, and 30% of cases involve some form of placental adherence. Placenta percreta is infrequent, but life-threatening condition. Antenatal diagnosis of these placental anomalies is very difficult, but essential for reduction of the number and extent of possible complications. A 19-year-old primigravida was referred to us with 31- week pregnancy complicated by preeclampsia. Upon admission, ultrasound scan revealed eutrophic fetus in breech presentation, without any signs of retroplacental clot. At laparotomy, hemoperitoneum without any trophoblastic tissue emerging to the peritoneal cavity was found and placental abruption with uteroplacental apoplexy was suspected. In addition, unicervical symmetric bicornuate uterus with pregnancy in the left uterine horn was found. The lower segment uterine section was performed and 1800 grams live baby was delivered. Delivery of the placenta was unusually difficult. It was very large and densely adherent to the posterior uterine wall, which appeared to be composed of serosa in that area only. After removal of placenta, the hemorrhage could not be controlled, and resection of the left uterine horn was performed. Placenta accreta, increta and percreta ought to be considered in all cases of uterine anomalies in pregnancy and in cases of prenatal diagnosis of placenta membranacea.

  6. MRI of placenta percreta: differentiation from other entities of placental adhesive disorder.

    Science.gov (United States)

    Thiravit, Shanigarn; Lapatikarn, Sukanya; Muangsomboon, Kobkun; Suvannarerg, Voraparee; Thiravit, Phakphoom; Korpraphong, Pornpim

    2017-01-01

    To retrospectively review the MRI findings of placenta percreta and identify those helpful for differentiation from non-placenta percreta. The MRI images of 21 patients with a preliminary diagnosis of placental adhesive disorder scanned between 2005 and 2014 were evaluated. Radiologists blinded to the final diagnosis evaluated six previously described MRI findings of placenta adhesive disorder. The sensitivity, specificity, accuracy, negative predictive value (NPV), and positive predictive value (PPV) of MRI for the diagnosis of placenta percreta were also calculated. The study included 12 cases of placenta percreta and 9 cases of non-placenta percreta. Invasion of placental tissue outside the uterus was found only in placenta percreta (p = 0.045; sensitivity 41.7 %; specificity 100 %). All placenta percreta cases also had a moderate to marked degree of heterogeneous placental signal intensity (p = 0.063; sensitivity 100 %; specificity 33.3 %). The size of the dark bands on T2-weighted imaging, and the presence of disorganized intra-placental vessels, showed no statistically significant difference between placenta percreta and non-placenta percreta. The sensitivity, specificity, NPV, PPV, and accuracy of MRI for detection of placenta percreta were 91.7, 44, 80, 68, and 71.4 %, respectively. MRI is recommended for the evaluation of placenta percreta, with the most specific signs including the invasion of placental tissue outside the uterus on B-FFE sequences, and consideration of the degree of placental signal heterogeneity. The size of the T2 dark band alone, or bizarre disorganized intra-placental vessels, did not correlate with the severity of invasion.

  7. Placenta accreta spectrum: accreta, increta, and percreta.

    Science.gov (United States)

    Silver, Robert M; Barbour, Kelli D

    2015-06-01

    Placenta accreta can lead to hemorrhage, resulting in hysterectomy, blood transfusion, multiple organ failure, and death. Accreta has been increasing steadily in incidence owing to an increase in the cesarean delivery rate. Major risk factors are placenta previa in women with prior cesarean deliveries. Obstetric ultrasonography can be used to diagnose placenta accreta antenatally, which allows for scheduled delivery in a multidisciplinary center of excellence for accreta. Controversies exist regarding optimal management, including optimal timing of delivery, surgical approach, use of adjunctive measures, and conservative (uterine-sparing) therapy. We review the definition, risk factors, diagnosis, management, and controversies regarding placenta accreta. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Placenta percreta is associated with more frequent severe maternal morbidity than placenta accreta.

    Science.gov (United States)

    Marcellin, Louis; Delorme, Pierre; Bonnet, Marie Pierre; Grange, Gilles; Kayem, Gilles; Tsatsaris, Vassilis; Goffinet, François

    2018-05-04

    Abnormally invasive placentation is the leading cause of obstetric hysterectomy and can cause poor to disastrous maternal outcomes. Most previous studies of peripartum management and maternal morbidity have included variable proportions of severe and less severe cases. The aim of this study was to compare maternal morbidity from placenta percreta and accreta. This retrospective study at a referral center in Paris includes all women with abnormally invasive placentation from 2003 to 2017. Placenta percreta and accreta were diagnosed histologically or clinically. When placenta percreta was suspected before birth, a conservative approach leaving the placenta in situ was proposed because of the intraoperative risk of cesarean delivery. When placenta accreta was suspected, parents were offered a choice of a conservative approach or an attempt to remove the placenta, to be followed in case of failure by hysterectomy. Maternal outcomes were compared between women with placenta percreta and those with placenta accreta/increta. The primary outcome measure was a composite criterion of severe acute maternal morbidity including at least one of the following: hysterectomy during cesarean delivery, delayed hysterectomy, transfusion of ≥ 10 units of packed red blood cells, septic shock, acute kidney injury, cardiovascular failure, maternal transfer to intensive care, or death. Of the 156 women included, 51 had placenta percreta and 105 placenta accreta. Abnormally invasive placentation was suspected antenatally nearly four times more frequently in the percreta than the accreta group (96.1% (49/51) vs. 25.7% (27/105), P placentation (48.7%), the rate of antenatal decisions for conservative management was higher in the percreta than the accreta group (100% (49/49) vs. 40.7% (11/27), Paccreta group (86.3% (44/51) vs. 28/105 (26.7%), P placentation diameter > 6 cm showed similar results (86.0% (43/50) vs. 48.7% (19/38), P accreta group (52.9% (27/51) vs. 20.9% (22/105), P accreta

  9. [Placenta percreta with bladder invasion: an uncommon cause of hematuria during pregnancy].

    Science.gov (United States)

    Sierra-Solís, A; Leo-Barahona, M; Romero-López, A I; Gómez-Guerrero, J M

    2014-01-01

    Placenta percreta with bladder invasion is a very uncommon condition that can lead to very severe complications in pregnant women. Although it is often diagnosed during delivery, imaging techniques are very useful for early diagnosis, which is fundamental for planning surgery and avoiding potentially lethal complications. We present the case of a woman with a history of cesarean section who presented with hematuria and low back pain. The diagnosis of placenta percreta with bladder invasion was suggested after ultrasonography and magnetic resonance imaging and was confirmed at surgery. We provide a brief review of the literature, emphasizing the role of imaging techniques. Copyright © 2012 SERAM. Published by Elsevier Espana. All rights reserved.

  10. Hemoperitoneum Caused by Placenta Percreta in the Third Trimester of Pregnancy

    Directory of Open Access Journals (Sweden)

    Maryam Asgharnia

    2009-06-01

    Full Text Available The placental adhesive disorders such as placenta accreta andplacenta percreta are the rare causes of serious obstetric hemorrhages.They are associated with high maternal morbidity andmortality. Placenta percreta is usually diagnosed in the thirdtrimester of pregnancy as a massive postpartum hemorrhagewhen an attempt to remove the placenta reveals lack of acleavage plane. Here we report an unusual presentation of placentapercreta as hemoperitoneum and hemorrhagic shock inthe third trimester of pregnancy. A 33-year-old woman wasadmitted to hospital at the 35th weeks of gestation with abdominalpain and hemorrhagic shock. Laparotomy was immediatelyperformed because of intra-abdominal bleeding. Uponinspection, a posterior laceration of the uterus was noted.Pathologic investigation of the uterus showed placenta percreta.The patient recovered uneventfully. Spontaneous ruptureof the uterus can be occured in the absence of uterinetrauma. In the differential diagnosis of a pregnant woman presentingwith hypotension, abdominal pain, and fetal death, ruptureof the uterus caused by placenta percreta should be considered.Rapid diagnosis, blood transfusion, and emergency laparotomyare the key steps in successful management.

  11. Placenta percreta causing acute abdomen in the second trimester of pregnancy

    International Nuclear Information System (INIS)

    Hussain, M.; Bhutta, S. Z.; Sarwar, S.

    2004-01-01

    Two cases of acute abdomen due to haemoperitoneum caused by placenta percreta in the second trimester are presented. Both had a history of previous lower segment caesarean section, a factor well-known to predispose the condition. How- ever, the rarity of the condition, presenting in mid pregnancy makes diagnosis and management difficult. Optimum ways of management are discussed. (author)

  12. Behandling af placenta percreta kræver involvering af flere specialer

    DEFF Research Database (Denmark)

    Clausen, Caroline; Lönn, Lars; Albrechtsen, Charlotte Krebs

    2011-01-01

    Placenta percreta is a rare life-threatening obstetrical condition, often resulting in severe haemorrhage and hysterectomy. The incidence seems to be increasing, probably secondary to the increase in caesarean section rates. We present a protocol for an elective multidisciplinary approach with pr...

  13. Balloon-Assisted Occlusion of the Internal Iliac Arteries in Patients with Placenta Accreta/Percreta

    International Nuclear Information System (INIS)

    Bodner, Leonard J.; Nosher, John L.; Gribbin, Christopher; Siegel, Randall L.; Beale, Stephanie; Scorza, William

    2006-01-01

    Background. Placenta accreta/percreta is a leading cause of third trimester hemorrhage and postpartum maternal death. The current treatment for third trimester hemorrhage due to placenta accreta/percreta is cesarean hysterectomy, which may be complicated by large volume blood loss. Purpose. To determine what role, if any, prophylactic temporary balloon occlusion and transcatheter embolization of the anterior division of the internal iliac arteries plays in the management of patients with placenta accreta/percreta. Methods. The records of 28 consecutive patients with a diagnosis of placenta accreta/percreta were retrospectively reviewed. Patients were divided into two groups. Six patients underwent prophylactic temporary balloon occlusion, followed by cesarean section, transcatheter embolization of the anterior division of the internal iliac arteries and cesarean hysterectomy (n = 5) or uterine curettage (n = 1). Twenty-two patients underwent cesarean hysterectomy without endovascular intervention. The following parameters were compared in the two groups: patient age, gravidity, parity, gestational age at delivery, days in the intensive care unit after delivery, total hospital days, volume of transfused blood products, volume of fluid replacement intraoperatively, operating room time, estimated blood loss, and postoperative morbidity and mortality. Results. Patients in the embolization group had more frequent episodes of third trimester bleeding requiring admission and bedrest prior to delivery (16.7 days vs. 2.9 days), resulting in significantly more hospitalization time in the embolization group (23 days vs. 8.8 days) and delivery at an earlier gestational age than in those in the surgical group (32.5 weeks). There was no statistical difference in mean estimated blood loss, volume of replaced blood products, fluid replacement needs, operating room time or postoperative recovery time. Conclusion. Our findings do not support the contention that in patients with

  14. Incidence and Risk Factors for Placenta Accreta/Increta/Percreta in the UK: A National Case-Control Study

    Science.gov (United States)

    Fitzpatrick, Kathryn E.; Sellers, Susan; Spark, Patsy; Kurinczuk, Jennifer J.; Brocklehurst, Peter; Knight, Marian

    2012-01-01

    Background Placenta accreta/increta/percreta is associated with major pregnancy complications and is thought to be becoming more common. The aims of this study were to estimate the incidence of placenta accreta/increta/percreta in the UK and to investigate and quantify the associated risk factors. Methods A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women. Results The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR) 14.41, 95%CI 5.63–36.85), other previous uterine surgery (aOR 3.40, 95%CI 1.30–8.91), an IVF pregnancy (aOR 32.13, 95%CI 2.03–509.23) and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58–254.96) had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13–1.50 for every one year increase in age). Conclusions Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly. PMID:23300807

  15. Incidence and risk factors for placenta accreta/increta/percreta in the UK: a national case-control study.

    Directory of Open Access Journals (Sweden)

    Kathryn E Fitzpatrick

    Full Text Available Placenta accreta/increta/percreta is associated with major pregnancy complications and is thought to be becoming more common. The aims of this study were to estimate the incidence of placenta accreta/increta/percreta in the UK and to investigate and quantify the associated risk factors.A national case-control study using the UK Obstetric Surveillance System was undertaken, including 134 women diagnosed with placenta accreta/increta/percreta between May 2010 and April 2011 and 256 control women.The estimated incidence of placenta accreta/increta/percreta was 1.7 per 10,000 maternities overall; 577 per 10,000 in women with both a previous caesarean delivery and placenta praevia. Women who had a previous caesarean delivery (adjusted odds ratio (aOR 14.41, 95%CI 5.63-36.85, other previous uterine surgery (aOR 3.40, 95%CI 1.30-8.91, an IVF pregnancy (aOR 32.13, 95%CI 2.03-509.23 and placenta praevia diagnosed antepartum (aOR 65.02, 95%CI 16.58-254.96 had raised odds of having placenta accreta/increta/percreta. There was also a raised odds of placenta accreta/increta/percreta associated with older maternal age in women without a previous caesarean delivery (aOR 1.30, 95%CI 1.13-1.50 for every one year increase in age.Women with both a prior caesarean delivery and placenta praevia have a high incidence of placenta accreta/increta/percreta. There is a need to maintain a high index of suspicion of abnormal placental invasion in such women and preparations for delivery should be made accordingly.

  16. Case Report: Uterine Artery Embolization for the Management of Placenta Percreta Bleeding

    International Nuclear Information System (INIS)

    Uribe, Jorge Ricardo; Acosta, Mauricio; Otalora, Andres Felipe; Caballero, Ligia Mercedes

    2011-01-01

    Placental adhesion abnormalities, though rare, are of clinical significance due to their high morbidity and mortality. Timely diagnosis using various imaging methods results in a dramatic reduction of these consequences, as it leads to the interdisciplinary management of the pregnant patient. Placenta percreta is the term used to describe the invasion of trophoblast through the different layers of the uterus beyond the serosa. Uterine or hypogastric arterial embolization is the method of choice for reducing peripartum bleeding and facilitating the surgical procedure.

  17. The management and outcomes of placenta accreta, increta, and percreta in the UK: a population-based descriptive study.

    Science.gov (United States)

    Fitzpatrick, K E; Sellers, S; Spark, P; Kurinczuk, J J; Brocklehurst, P; Knight, M

    2014-01-01

    To describe the management and outcomes of placenta accreta, increta, and percreta in the UK. A population-based descriptive study using the UK Obstetric Surveillance System (UKOSS). All 221 UK hospitals with obstetrician-led maternity units. All women diagnosed with placenta accreta, increta, and percreta in the UK between May 2010 and April 2011. Prospective case identification through the monthly mailing of UKOSS. Median estimated blood loss, transfusion requirements. A cohort of 134 women were identified with placenta accreta, increta, or percreta: 50% (66/133) were suspected to have this condition antenatally. In women with a final diagnosis of placenta increta or percreta, antenatal diagnosis was associated with reduced levels of haemorrhage (median estimated blood loss 2750 versus 6100 ml, P = 0.008) and a reduced need for blood transfusion (59 versus 94%, P = 0.014), possibly because antenatally diagnosed women were more likely to have preventative therapies for haemorrhage (74 versus 52%, P = 0.007), and were less likely to have an attempt made to remove their placenta (59 versus 93%, P accreta, increta, or percreta who have no attempt to remove any of their placenta, with the aim of conserving their uterus, or prior to hysterectomy, have reduced levels of haemorrhage and a reduced need for blood transfusion, supporting the recommendation of this practice. © 2013 RCOG.

  18. Value of pelvic embolization in the management of severe postpartum hemorrhage due to placenta accreta, increta or percreta

    International Nuclear Information System (INIS)

    Soyer, Philippe; Morel, Olivier; Fargeaudou, Yann; Sirol, Marc; Staub, Fabrice; Boudiaf, Mourad

    2011-01-01

    Objectives: To evaluate the role, efficacy and safety of pelvic embolization in the management of severe postpartum hemorrhage in women with placenta accreta, increta or percreta. Methods: The clinical files and angiographic examinations of 12 consecutive women with placenta accreta (n = 4), increta (n = 2) or percreta (n = 6) who were treated with pelvic embolization because of severe primary (n = 10) or secondary (n = 2) postpartum hemorrhage were reviewed. Before embolization, four women had complete placental conservation, four had partial placental conservation, three had an extirpative approach and one had hysterectomy after failed partial conservative approach. Results: In 10 women, pelvic embolization was successful and stopped the bleeding, after one (n = 7) or two sessions (n = 3). Emergency hysterectomy was needed in two women with persistent bleeding after embolization, both with placenta percreta and bladder involvement first treated by extirpation. One case of regressive hematoma at the puncture site was the single complication of embolization. Conclusions: In women with severe postpartum hemorrhage due to placenta accreta, increta or percreta, pelvic embolization is effective for stopping the bleeding in most cases, thus allowing uterine conservation and future fertility. Further studies, however, should be done to evaluate the potential of pelvic embolization in women with placenta percreta with bladder involvement.

  19. Placenta Previa Percreta: A Case Report of Successful Management via Conservative Surgery

    Directory of Open Access Journals (Sweden)

    Silvia Canonico

    2013-01-01

    Full Text Available Placenta percreta is one of the most serious complications of placenta previa and is frequently associated with severe obstetric hemorrhage usually necessitating hysterectomy. We present a case of placenta previa percreta diagnosed by ultrasound and magnetic resonance imaging techniques, in which we accomplished conservative management of postpartum hemorrhage. The management we propose includes the following steps: preventive catheterization of the descending aorta via transhumeral access; Stark cesarean delivery; uterotonics drugs; Affronti endouterine square hemostatic sutures; intrauterine application of Bakri balloon and partial filling with 100 mL of normal saline; B Lynch suture, hysterorrhaphy, and filling a Bakri balloon with up to 500 mL of normal saline; reversible radiological embolization; and/or surgical ligation of the uterine arteries. The bleeding stopped following placement of Affronti sutures combined with external (B-Lynch suture and internal (Bakri balloon uterine compression. Our experience indicates that this conservative method can be considered an option in the management of selected cases of pregnancy at high risk for intrapartum hemorrhage.

  20. Placenta Percreta Invading Broad Ligament and Parametrium in a Woman with Two Previous Cesarean Sections: A Case Report

    Directory of Open Access Journals (Sweden)

    Mansoureh Vahdat

    2012-01-01

    Full Text Available Introduction. The incidence of placenta accreta has dramatically increased due to increasing caesarean section rate all over the world. Placenta percreta is the most severe form of placenta accretes. It frequently results in maternal morbidity and mortality mainly caused by massive obstetric hemorrhage or emergency hysterectomy. Percreta invading into the broad ligament has rarely been previously reported. Case presenting. We presented a case of placenta percreta invading left broad ligament and parametrium in a woman with two previous cesarean sections, which led to massive intraoperative hemorrhage during hysterectomy and transient ischemic encephalopathy. Conclusion. In cases of parametrial involvement, it would be more difficult to decide whether to remove placenta or leave it in site. In surgical removal neither local excision of placental bed and uterine repair nor traditional hysterectomy is adequate if parametrium invaded by placenta. We suggest delayed elective hysterectomy in such cases. So, pregnancy-induced pelvic congestion would be decreased, we can gather an expert team of gynecologists, urologists, and vascular surgeons, we could get plenty of blood products, and we may have the chance to administer methotrexate.

  1. Invasive placenta previa. Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta

    Energy Technology Data Exchange (ETDEWEB)

    Chen, Xin; Zhang, Xinjuan; Wang, Shanshan; Shi, Honglu; Gao, Fei; Wang, Guangbin [Shandong University, Department of MR, Shandong Medical Imaging Research Institute, Jinan, Shandong (China); Shan, Ruiqin [Jinan Maternity and Child Care Hospital, Department of Obstetrics, Jinan (China); Zhao, Lianxin [Qilu Hospital of Shandong University, Department of Radiology, Jinan, Shandong (China); Song, Qingxu [Qilu Hospital of Shandong University, Department of Radiation Oncology, Jinan, Shandong (China); Zuo, Changting [Shandong Provincial Hospital Affiliated to Shandong University, Department of Obstetrics and Gynaecology, Jinan, Shandong (China); Qian, Tianyi [MR Collaborations NE Asia, Siemens Healthcare, Beijing (China); Limperopoulos, Catherine [Children' s National Health System, Division of Diagnostic Imaging and Radiology, Washington, DC (United States); George Washington University School of Medicine, Department of Radiology, Washington, DC (United States)

    2018-02-15

    To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. Significant differences were found in nine MRI features between women with PP and those with PA (P <0.05). Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P < 0.001; odds ratio = 4.165, P = 0.018 respectively), and the combination of the two MRI features to distinguish PP from PA yielded an AUC of 0.92 for its predictive performance. Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. (orig.)

  2. Invasive placenta previa: Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta.

    Science.gov (United States)

    Chen, Xin; Shan, Ruiqin; Zhao, Lianxin; Song, Qingxu; Zuo, Changting; Zhang, Xinjuan; Wang, Shanshan; Shi, Honglu; Gao, Fei; Qian, Tianyi; Wang, Guangbin; Limperopoulos, Catherine

    2018-02-01

    To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. Significant differences were found in nine MRI features between women with PP and those with PA (P Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. • Placental bulge type-II demonstrated the strongest independent association with PP. • Uterine serosal hypervascularity is a useful feature for differentiating PP from PA. • MRI features associated with abnormal vessels increase the risk of massive haemorrhage.

  3. Invasive placenta previa. Placental bulge with distorted uterine outline and uterine serosal hypervascularity at 1.5T MRI - useful features for differentiating placenta percreta from placenta accreta

    International Nuclear Information System (INIS)

    Chen, Xin; Zhang, Xinjuan; Wang, Shanshan; Shi, Honglu; Gao, Fei; Wang, Guangbin; Shan, Ruiqin; Zhao, Lianxin; Song, Qingxu; Zuo, Changting; Qian, Tianyi; Limperopoulos, Catherine

    2018-01-01

    To characterise MRI features of invasive placenta previa and to identify specific features for differentiating placenta percreta (PP) from placenta accreta (PA). Forty-five women with PP and 93 women with PA who underwent 1.5T placental MRI were included. Two radiologists independently evaluated the MRI features of invasive placenta previa, including our novel type of placental bulge (i.e. placental bulge type-II, characterized by placental bulge with distorted uterine outline). Pearson's chi-squared or Fisher's two-sided exact test was performed to compare the MRI features between PP and PA. Logistic stepwise regression analysis and the area under the receiver operating characteristic curve (AUC) were performed to select the optimal features for differentiating PP from PA. Significant differences were found in nine MRI features between women with PP and those with PA (P <0.05). Placental bulge type-II and uterine serosal hypervascularity were independently associated with PP (odds ratio = 48.618, P < 0.001; odds ratio = 4.165, P = 0.018 respectively), and the combination of the two MRI features to distinguish PP from PA yielded an AUC of 0.92 for its predictive performance. Placental bulge type-II and uterine serosal hypervascularity are useful MRI features for differentiating PP from PA. (orig.)

  4. Serum ischemia modified albumin level and its relationship with the thiol/disulfide balance in placenta percreta patients.

    Science.gov (United States)

    Uyanikoglu, Hacer; Sak, Muhammet Erdal; Tatli, Faik; Hilali, Nese Gul; Sak, Sibel; Incebiyik, Adnan; Barut, Mert Ulas; Erel, Ozcan; Gonel, Ataman

    2018-06-08

    The pathogenesis of placenta percreta (PP) is not very well known. This study was designed to analyse the oxidative stress (OS), the thiol/disulphide balance, and ischaemia-modified albumin (IMA) the women with PP. The study included 38 pregnant women with PP and 40 similarly aged healthy pregnant women in their third trimester of gestation. We measured the IMA, native and total thiols, and disulphide concentrations in the maternal sera of all of the participating women. The IMA levels were higher and the native and total thiols were lower in the PP group than in the control group. However, there was no statistical significance with respect to the thiol/disulphide balance between the two groups. The results of this study suggest that an increase in the ischaemia and OS and a decrease in the antioxidant status may contribute to the pathogenesis of PP. Impact statement What is already known on this subject? Placenta percreta (PP) is a serious complication of pregnancy. Although there are several studies investigating the pathophysiological mechanism of PP, whether the pathology results from a lack of decidua or from the over-invasiveness of trophoblasts remains controversial. The pathology of PP is poorly understood. What do the results of this study add? This prospective study has shown an increased ischaemia modified albumin (IMA) and a decreased antioxidant capacity in the patients with placenta percreta. The results from 38 women with PP suggest that the serum concentrations of IMA and the oxidative stress parameters may be able to predict PP in cases of uncertainty. What are the implications of these findings for clinical practice and/or further research? The implication of these findings shed light on understanding the pathogenesis of PP for further research.

  5. Intraoperative intermittent blocking of the common iliac arteries in cases of placenta percreta without the use of fluoroscopy; Intraoperative intermittierende Blockung der Arteriae iliacae communes bei Placenta percreta unter Vermeidung von Roentgenstrahlung

    Energy Technology Data Exchange (ETDEWEB)

    Heinze, S. [Frankfurt Univ. (Germany). Inst. of Forensic Medicine; Klinikum Oldenburg (Germany). Inst. of Diagnostic and Interventional Radiology; Filsinger, B. [St. Marienkrankenhaus, Ludwigshafen (Germany). Maternity Clinic; Kastenholz, G.; Schroeder, R.J. [St. Marienkrankenhaus, Ludwigshafen (Germany). Dept. of Radiology

    2016-12-15

    The number of patients with placenta accreta, percreta and increta is increasing. The morbidity and mortality are higher mostly due to hemorrhage. Therefore, new methods to reduce the risk of severe bleeding are necessary. Three patients were treated in collaboration by obstetricians, urologists, anesthesiologists, and radiologists. An MRI of the pelvis was performed and the diameters and lengths of the iliac arteries were measured to avoid fluoroscopy during the preoperative placement of catheter balloons into the iliac arteries. During the operational procedure the balloons were inflated and deflated depending on the operative site and the occurrence of bleeding. In comparison to the literature, severe bleeding was clearly reduced. No complications of the intervention were observed. The presented method to reduce severe bleeding might represent significant progress in the management of abnormal placenta implantation. Nevertheless, further controlled studies are needed in order to establish evidence-based recommendations.

  6. Intraoperative intermittent blocking of the common iliac arteries in cases of placenta percreta without the use of fluoroscopy

    International Nuclear Information System (INIS)

    Heinze, S.; Klinikum Oldenburg; Filsinger, B.; Kastenholz, G.; Schroeder, R.J.

    2016-01-01

    The number of patients with placenta accreta, percreta and increta is increasing. The morbidity and mortality are higher mostly due to hemorrhage. Therefore, new methods to reduce the risk of severe bleeding are necessary. Three patients were treated in collaboration by obstetricians, urologists, anesthesiologists, and radiologists. An MRI of the pelvis was performed and the diameters and lengths of the iliac arteries were measured to avoid fluoroscopy during the preoperative placement of catheter balloons into the iliac arteries. During the operational procedure the balloons were inflated and deflated depending on the operative site and the occurrence of bleeding. In comparison to the literature, severe bleeding was clearly reduced. No complications of the intervention were observed. The presented method to reduce severe bleeding might represent significant progress in the management of abnormal placenta implantation. Nevertheless, further controlled studies are needed in order to establish evidence-based recommendations.

  7. Placenta Percreta in First Trimester after Multiple Rounds of Failed Medical Management for a Missed Abortion

    Directory of Open Access Journals (Sweden)

    Jaimin Shah

    2017-01-01

    Full Text Available Background. The detection of a morbidly adherent placenta (MAP in the first trimester is rare. Risk factors such as multiparity, advanced maternal age, prior cesarean delivery, prior myomectomy, placenta previa, or previous uterine evacuation place patients at a higher risk for having abnormal placental implantation. If these patients have a first trimester missed abortion and fail medical management, it is important that providers have a heightened suspicion for a MAP. Case. A 24-year-old G4P3003 with 3 prior cesarean deliveries underwent multiple rounds of failed medical management for a missed abortion. She had a dilation and curettage that was complicated by a significant hemorrhage and ultimately required an urgent hysterectomy. Conclusion. When patients fail medical management for a missed abortion, providers need to assess the patient’s risk factors for a MAP. If risk factors are present, a series of specific evaluations should be triggered to rule out a MAP and help further guide management. Early diagnosis of a MAP allows providers to coordinate a multidisciplinary treatment approach and thoroughly counsel patients. Ensuring adequate resources and personnel at a tertiary hospital is essential to provide the highest quality of care and improve outcomes.

  8. Placenta paraaortic with bladder invasion: A plea for multidisciplinary approach

    International Nuclear Information System (INIS)

    Shawish, Fahmy M. I.; Hammad, Fayez T.; Kazim, Essa M.

    2007-01-01

    Placenta previa percreta with the urinary bladder invasion is a rare but potentially lethal condition. It has an increasing clinical significance due to its association with previous cesarean sections and uterine curettage. Herein, we report on a patient with placenta percreta and bladder invasion, who presented with hematuria and in whom delivery was delayed to almost full term highlighting the potential catastrophic results and the need for a multidisciplinary approach with the need to involve surgeons who are familiar with vascular and urologic surgery. We also present an elegant MRI of placenta percreta invading the urinary bladder, which shows that MRI is potentially an excellent diagnostic diagnostic modality in this difficult condition. (author)

  9. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta

    OpenAIRE

    Matsuzaki, Satoko; Matsuzaki, Shinya; Ueda, Yutaka; Tanaka, Yusuke; Kakuda, Mamoru; Kanagawa, Takeshi; Kimura, Tadashi

    2014-01-01

    Objective - Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM). Study Design - Case report and review of the literature. Results -...

  10. Placenta Accreta and Total Placenta Previa in the 19th Week of Pregnancy

    Science.gov (United States)

    Findeklee, S.; Costa, S. D.

    2015-01-01

    Placentation disorders are the result of impaired embedding of the placenta in the endometrium. The prevalence of these disorders is estimated to be around 0.3 %. A history of previous prior uterine surgery (especially cesarean section and curettage) is the most common risk factor. Impaired placentation is differentiated into deep placental attachment; marginal, partial and total placenta previa; and placenta accreta, increta and percreta. Treatment depends on the severity of presentation and ranges from expectant management to emergency hysterectomy. In most cases, preterm termination of pregnancy is necessary. We report here on the case of a 39-year-old woman with placenta accreta and total placenta previa who underwent hysterectomy in the 19th week of pregnancy. PMID:26366004

  11. Tumorigenic Factor CRIPTO-1 Is Immunolocalized in Extravillous Cytotrophoblast in Placenta Creta

    Directory of Open Access Journals (Sweden)

    Carla Letícia Bandeira

    2014-01-01

    Full Text Available CRIPTO-(CR1 is a protein associated with tumorigenesis and metastasis. Here we demonstrate that CR-1 expression in normal and creta placentas is associated with various degrees of uterine invasion. Cytokeratin (CK and CR-1 protein expression was visualized by immunohistochemical staining of formalin-fixed, paraffin-embedded placental specimens (control placentas, n=9; accreta, n=6; increta, n=10; percreta, n=15. The pattern of extravillous trophoblast (EVT cell morphology was distinctive in creta placentas: densely-compacted cell columns and large star-shaped cells with a typically migratory phenotype, not common among third trimester control placentas. Quantification revealed higher CR-1 immunoreactivities in accreta (P=0.001, increta (P=0.0002, and percreta placentas (P=0.001 than in controls. In contrast to controls, there was a significant positive relationship between CR-1 and CK reactivity in all creta placentas (accreta, P=0.02; increta, P=0.0001, and percreta, P=0.025. This study demonstrated CR-1 expression in the placental bed, its increased expression in creta placentas, and EVT cells as the main CR-1-producing cell type. Morphological examination revealed an immature and invasive trophoblast profile in creta placentas, suggesting impairment of the trophoblast differentiation pathway. These findings provide important new insights into the pathophysiology of abnormal creta placentation and its gestational consequences.

  12. Escalating placenta invasiveness: repeated placenta accreta at the limit of viability

    Directory of Open Access Journals (Sweden)

    Greenbaum S

    2016-04-01

    Full Text Available Shirley Greenbaum,1 Alla Khashper,2 Elad Leron,1 Eric Ohana,1 Mihai Meirovitz,1 Reli Hershkovitz,1 Offer Erez1 1Department of Obstetrics and Gynecology, 2Department of Radiology, Soroka University Medical Center, School of Medicine, Ben-Gurion University of the Negev, Be’er Sheva, Israel Abstract: Placenta percreta is an obstetric condition in which the placenta invades through the myometrium. This is the most severe form of placenta accreta and may result in spontaneous uterine rupture, a rare complication that threatens the life of both mother and fetus. In this case report, we describe a 32-year-old woman in her fourth pregnancy, diagnosed with repeated placenta accreta, which was eventually complicated by spontaneous uterine rupture at 24 weeks’ gestation. This patient had a history of abnormal placentation in prior pregnancies and previous uterine injuries. This case demonstrates a pattern of escalating placental invasiveness, and raises questions regarding the process of abnormal placentation and the manifestation of uterine rupture in scarred uteri. Keywords: placenta percreta, uterine injury, laparoscopy, dilatation and curettage, residua, cesarean section scar, spontaneous uterine rupture

  13. Escalating placenta invasiveness: repeated placenta accreta at the limit of viability

    Science.gov (United States)

    Greenbaum, Shirley; Khashper, Alla; Leron, Elad; Ohana, Eric; Meirovitz, Mihai; Hershkovitz, Reli; Erez, Offer

    2016-01-01

    Placenta percreta is an obstetric condition in which the placenta invades through the myometrium. This is the most severe form of placenta accreta and may result in spontaneous uterine rupture, a rare complication that threatens the life of both mother and fetus. In this case report, we describe a 32-year-old woman in her fourth pregnancy, diagnosed with repeated placenta accreta, which was eventually complicated by spontaneous uterine rupture at 24 weeks’ gestation. This patient had a history of abnormal placentation in prior pregnancies and previous uterine injuries. This case demonstrates a pattern of escalating placental invasiveness, and raises questions regarding the process of abnormal placentation and the manifestation of uterine rupture in scarred uteri. PMID:27143953

  14. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Satoko Matsuzaki

    2015-04-01

    Full Text Available Objective - Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta, the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM. Study Design - Case report and review of the literature. Results - A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion - Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  15. A Case Report and Literature Review of Midtrimester Termination of Pregnancy Complicated by Placenta Previa and Placenta Accreta.

    Science.gov (United States)

    Matsuzaki, Satoko; Matsuzaki, Shinya; Ueda, Yutaka; Tanaka, Yusuke; Kakuda, Mamoru; Kanagawa, Takeshi; Kimura, Tadashi

    2015-04-01

    Objective Concurrent placenta previa and placenta accreta increase the risk of massive obstetric hemorrhage. Despite extensive research on the management of placenta previa (including placenta accreta, increta, and percreta), the number and quality of previous studies are limited. We present a case of placenta accreta requiring an induced second-trimester abortion because of premature rupture of the membranes (PROM). Study Design Case report and review of the literature. Results A 41-year-old female presented at 20 weeks of gestation with placenta previa and PROM. Ultrasonography revealed placenta accreta with multiple placental lacunae. She then developed massive hemorrhaging just prior to a planned termination of pregnancy. We performed a hysterectomy with the intent of preserving life because of the failure of the placenta to detach and blood loss totaling 4,500 mL. Conclusion Previous studies suggest that second-trimester pregnancy terminations in cases of placenta previa which are not complicated with placenta accreta do not have a particularly high risk of hemorrhage. However, together with our case, the literature suggests that placenta previa complicated with placenta accreta presents a significant risk of hemorrhage both during delivery and intraoperatively. Further reports are needed to evaluate the most appropriate treatment options.

  16. Increased placental trophoblast inclusions in placenta accreta.

    Science.gov (United States)

    Adler, E; Madankumar, R; Rosner, M; Reznik, S E

    2014-12-01

    Trophoblast inclusions (TIs) are often found in placentas of genetically abnormal gestations. Although best documented in placentas from molar pregnancies and chromosomal aneuploidy, TIs are also associated with more subtle genetic abnormalities, and possibly autism. Less than 3% of non-aneuploid, non-accreta placentas have TIs. We hypothesize that placental genetics may play a role in the development of placenta accreta and aim to study TIs as a potential surrogate indicator of abnormal placental genetics. Forty cases of placenta accreta in the third trimester were identified in a search of the medical records at one institution. Forty two third trimester control placentas were identified by a review of consecutively received single gestation placentas with no known genetic abnormalities and no diagnosis of placenta accreta. Forty percent of cases with placenta accreta demonstrated TIs compared to 2.4% of controls. More invasive placenta accretas (increta and percreta) were more likely to demonstrate TIs than accreta (47% versus 20%). Prior cesarean delivery was more likely in accreta patients than controls (67% versus 9.5%). Placenta accreta is thought to be the result of damage to the endometrium predisposing to abnormal decidualization and invasive trophoblast growth into the myometrium. However, the etiology of accreta is incompletely understood with accreta frequently occurring in women without predisposing factors and failing to occur in predisposed patients. This study has shown that TIs are present at increased rates in cases of PA. Further studies are needed to discern what underlying pathogenic mechanisms are in common between abnormal placentation and the formation of TIs. Published by Elsevier Ltd.

  17. Morbidly Adherent Placenta: Interprofessional Management Strategies for the Intrapartum Period.

    Science.gov (United States)

    Baird, Suzanne McMurtry; Troiano, Nan H; Kennedy, Margaret Betsy Babb

    "Morbidly adherent placenta" is a term that describes the continuum of placenta accreta, increta, and percreta. The incidence of this type of abnormal placentation has increased significantly over recent decades. The reason is probably multifactorial but, partly, because of factors such as the increasing number of cesarean births. Women at greatest risk are those who have myometrial damage caused by a previous cesarean birth, with either anterior or posterior placenta previa overlying the uterine scar. This condition poses significant risks of morbidity and/or mortality to the pregnant woman and her fetus. A multidisciplinary approach to care throughout pregnancy is essential. This article describes the classification of morbidly adherent placenta, risk factors, methods of diagnosis, potential maternal and fetal complications, and intrapartum clinical management strategies to optimize outcomes.

  18. Leaving the placenta in situ versus conservative and radical surgery in the treatment of placenta accreta spectrum disorders.

    Science.gov (United States)

    Kutuk, Mehmet S; Ak, Mehmet; Ozgun, Mahmut T

    2018-03-01

    To compare different treatment methods in the management of placenta accreta spectrum (PAS) disorders. In a retrospective cohort study, medical records were retrieved for patients who underwent elective surgery at 24 weeks of pregnancy or more after a diagnosis of PAS disorder (creta, increta, or percreta) at a center in Turkey between May 2, 2010, and August 10, 2016. The final analysis included patients whose diagnosis was confirmed intraoperatively and for whom complete data were available. Patients were divided into three groups: group 1 included those who underwent hysterectomy without placental removal, group 2 included patients whose placenta was left in situ, and group 3 included those who underwent placental removal and conservative surgery. Among 79 included patients (33 creta, 18 increta, 28 percreta), 27 (34%) were in group 1, 15 (19%) in group 2, and 37 (47%) in group 3. Total blood loss and the amounts of blood products transfused were lowest in group 2; significant differences between groups were noted (all P ≤ 0.001). Surgical complication rates were similar between groups (4/27 [15%], 1/15 [7%], and 11/37 [30%], respectively; P=0.119). Overall uterine preservation rates were not significantly different between groups 2 and 3 (14/15 [93%] vs 33/37 [89%]; P>0.99). Leaving the placenta in situ could become the treatment of choice for PAS disorders. © 2017 International Federation of Gynecology and Obstetrics.

  19. The role of interventional radiology in reducing haemorrhage and hysterectomy following caesarean section for morbidly adherent placenta

    International Nuclear Information System (INIS)

    Teixidor Viñas, M.; Chandraharan, E.; Moneta, M.V.; Belli, A.M.

    2014-01-01

    Aim: To report experience of prophylactic occlusion balloon catheters (POBCs) in both internal iliac arteries before caesarean section, with or without embolization, to preserve the uterus and reduce haemorrhage. Methods and materials: Twenty-seven women diagnosed with morbidly adherent placenta (MAP) and with suspected placenta percreta underwent POBC placement before caesarean section. The balloons were inflated immediately after delivery of the baby. The patients' case notes were reviewed retrospectively for histological grading of MAP, blood loss, transfusion, requirement of uterine artery embolization (UAE), or hysterectomy, radiation dose, and infant or maternal morbidity and mortality. Results: MAP was confirmed histologically as percreta in 17, accreta in eight, and increta in two women. Mean blood loss was 1.92 l (range 0.5–12 l). Postpartum haemorrhage (PPH) occurred in nine patients. Eight were referred for UAE, which was successful in six. Immediate peri-partum hysterectomy was performed in one patient. Three women in total required hysterectomy, two after recurrent haemorrhage after UAE. No foetal morbidity or mortality occurred. No maternal mortality occurred. There was one case of iliac artery thrombosis, which resolved with conservative therapy. Conclusion: POBC, with or without UAE, contributes to reduction of blood loss and preservation of the uterus in women with MAP. - Highlights: • Management of morbidly adherent placenta requires a multidisciplinary team approach. • Prophylactic occlusion balloon catheters reduce blood loss and help avoid hysterectomy. • Protocols ensure correct management of placenta percreta patients and minimise risk

  20. Retrospective analysis of obstetric and anesthetic management of patients with placenta accreta spectrum disorders.

    Science.gov (United States)

    Riveros-Perez, Efrain; Wood, Cristina

    2018-03-01

    To assess the management and maternal outcomes of placenta accreta spectrum (PAS) disorders. A retrospective chart review was conducted of patients diagnosed with PAS disorders (placenta creta, increta, or percreta) who were treated at a US tertiary care center between February 1, 2011, and January 31, 2016. Obstetric management, anesthetic management, and maternal outcomes were analyzed. A total of 43 cases were identified; placenta previa was diagnosed among 33 (77%). Median age was 33 years (range 23-42). Median blood loss was 1500 mL (interquartile range 1000-2500); blood loss was greatest among the 10 patients with placenta percreta (3250 mL, interquartile range 2200-6000). Transfusion of blood products was necessary among 14 (33%) patients, with no difference in frequency according to the degree of placental invasion (P=0.107). Surgical complications occurred among 10 (23%) patients. Overall, 30 (70%) patients received combined spinal-epidural plus general anesthesia, 4 (9%) received only general anesthesia, and 9 (21%) underwent surgery with combined spinal-epidural anesthesia. One patient experienced difficult airway and another experienced accidental dural puncture. Placenta previa and accreta coexist in many patients, leading to substantial bleeding related to the degree of myometrial invasion. An interdisciplinary team approach plus the use of combined spinal-epidural anesthesia, transitioning to general anesthesia, were advisable and safe. © 2017 International Federation of Gynecology and Obstetrics.

  1. The recurrence risk of placenta accreta following uterine conserving management.

    Science.gov (United States)

    Cunningham, K M; Anwar, A; Lindow, S W

    2015-01-01

    Placenta accreta is a condition of abnormal placental attachment that was usually treated by hysterectomy. Techniques to conserve the uterus are now commonly used and series of subsequent pregnancy outcomes have been reported. The recurrence risk of placenta accreta is now a relevant detail and is currently not known. This work was performed to calculate the recurrence risk by reviewing the published literature. A literature search using the terms "placenta accreta", "placenta percreta", "placenta increta", "abnormal placental attachment" and "placental attachment disorder" followed by hand-searching identified 6 papers that contained data concerning recurrence of placenta accreta in subsequent pregnancies following initial conservative treatment. Overall 407 pregnancies were recorded and 85.7% of women reported achieved a subsequent pregnancy following conservative treatment. The risk of recurrence of placental attachment disorder in a subsequent pregnancy was 19.9% (weighted mean, 95% CI 12.2-27.7). The recurrence risk of placental attachment disorder following uterine conservation treatments is 20% . This risk should be discussed with women with an antenatal diagnosis of a placental attachment disorder who may be considering uterine conservation in order to retain the option of a future pregnancy.

  2. Conservative Management of Placenta Accreta/Increta after Vaginal Birth

    Science.gov (United States)

    Peiffer, S.; Reinhard, J.; Reitter, A.; Louwen, F.

    2012-01-01

    Aim: Aim of the study was to show that conservative management with preservation of the uterus and of fertility is possible in patients with placenta accreta/increta after vaginal delivery. Method: A retrospective analysis of patients with placental attachment disorders after vaginal delivery was done in a perinatal centre between November 2009 and April 2011. The patient collective was identified using the ICD-10 codes for placenta accreta/increta/percreta, and patient records were analysed for risk factors, maternal morbidity, preservation of the uterus and of fertility, and neonatal outcome. Results: Three cases of placenta increta were identified in the last 1.5 years out of a total of 1457 vaginal deliveries, and all 3 cases were treated conservatively. Mean maternal age was 35.3 years; gestational age ranged from 39 to 41 weeks, and mean duration between delivery of the child and delivery of the placenta was 44.67 days (range: 14–100 days). Two patients developed symptoms of endomyometritis, including fever, leukocytosis and increased CRP levels. All 3 women were successfully managed with preservation of the uterus. Conclusion: In selected cases with placenta accreta/increta after vaginal delivery, it is possible to avoid surgical procedures, particularly hysterectomy procedures, and successfully manage these patients conservatively with preservation of the uterus. PMID:25308979

  3. Placenta Praevia

    African Journals Online (AJOL)

    Department of Obstetrics & Gynaecology, Jos University Teaching Hospital, Jos ... Screening ultrasonography in women with history of multiple caesarean sections .... B. MSB. Placenta Praevia: Incidence, Risk Factors, Maternal And Fetal Outcomes In A Nigerian Teaching ... These high figures from all the centres stress the.

  4. Placenta previa

    Science.gov (United States)

    ... cervix is the opening to the birth canal. Causes During pregnancy, the placenta moves as the womb stretches and ... care provider can diagnose this condition with a pregnancy ultrasound. ... or part of the cervix, a vaginal delivery can cause severe bleeding. This can be deadly to both ...

  5. Another look at ultrasound and magnetic resonance imaging for diagnosis of placenta accreta.

    Science.gov (United States)

    Budorick, Nancy E; Figueroa, Reinaldo; Vizcarra, Michael; Shin, James

    2017-10-01

    To compare the ability of magnetic resonance imaging (MRI) and ultrasound (US) in the diagnosis of placenta accreta, to examine the success of various sonographic and MRI features to correctly predict invasive placenta, and to define a specific role for MRI in placenta accreta. After Institutional Review Board approval, a blinded retrospective review was undertaken of US and MRI findings from 45 patients who had an obstetrical US and placental MRI between August 2006 and January 2012. Correlation with clinical history and pathologic findings was performed. US and MRI had similar sensitivity, specificity and positive and negative predictive values for placenta accreta. The best predictors of invasion by US were loss of the myometrial mantle, increased intraplacental vascularity and loss of the bladder wall echogenicity. The best predictors of invasion by MRI were loss of retroplacental myometrial mantle, a heterogeneous placenta, and intraplacental hemorrhage. Body mass index (BMI) did not affect the ability to make a diagnosis by either US or MRI. MRI proved effective in better evaluation of a posterior placenta with suspicion of placenta accreta. There was modality disagreement in 11 of 45 cases and MRI was correct in 9 of these 11 cases, all true negative (TN) cases. MRI should be considered in any case with posterior placenta previa and suspicion of accreta, in any case with clinical suspicion for accreta and discordant US findings, and in any case in which percreta is suspected.

  6. Cell-free placental mRNA in maternal plasma to predict placental invasion in patients with placenta accreta.

    Science.gov (United States)

    El Behery, Manal M; Rasha L, Etewa; El Alfy, Yehya

    2010-04-01

    To evaluate whether measuring cell-free placental mRNA in maternal plasma improves the diagnostic accuracy of ultrasound and color Doppler in detecting placental invasion in patients at risk for placenta accreta. Thirty-five singleton pregnant women of more than 28 weeks of gestation and at risk for placenta accreta underwent ultrasound and color Doppler assessment. Cell-free placental mRNA in maternal plasma was measured using real-time reverse-transcription polymerase chain reaction. Patients were classified into 2 groups based on the findings at cesarean delivery and histological examination: women with placenta accreta (n=7) and women without placenta accreta (n=28). The median MoM (multiples of the median) value of cell-free placental mRNA was significantly higher in patients with placenta accreta than in those without placenta accreta (6.50 vs 2.60; Pplacental mRNA was significantly elevated in patients with placenta increta and percreta than in those with simple accreta. Six false-positive results were found on ultrasound, all from patients without placenta accreta and an insignificant rise in cell-free placental mRNA levels. Measuring cell-free placental mRNA in maternal plasma may increase the accuracy of ultrasound and color Doppler in prenatal prediction of placental invasion in patients with suspected placenta accreta. Copyright 2009 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  7. Contribution of placenta accreta to the incidence of postpartum hemorrhage and severe postpartum hemorrhage.

    Science.gov (United States)

    Mehrabadi, Azar; Hutcheon, Jennifer A; Liu, Shiliang; Bartholomew, Sharon; Kramer, Michael S; Liston, Robert M; Joseph, K S

    2015-04-01

    To quantify the contribution of placenta accreta to the rate of postpartum hemorrhage and severe postpartum hemorrhage. All hospital deliveries in Canada (excluding Quebec) for the years 2009 and 2010 (N=570,637) were included in a retrospective cohort study using data from the Canadian Institute for Health Information. Placenta accreta included placental adhesion to the uterine wall, musculature, and surrounding organs (accreta, increta, or percreta). Severe postpartum hemorrhage included postpartum hemorrhage with blood transfusion, hysterectomy, or other procedures to control bleeding (including uterine suturing and ligation or embolization of pelvic arteries). Rates, rate ratios, population-attributable fractions (ie, incidence of postpartum hemorrhage attributable to placenta accreta), and 95% confidence intervals (CIs) were estimated. Logistic regression was used to quantify associations between placenta accreta and risk factors. The incidence of placenta accreta was 14.4 (95% CI 13.4-15.4) per 10,000 deliveries (819 cases among 570,637 deliveries), whereas the incidence of placenta accreta with postpartum hemorrhage was 7.2 (95% CI 6.5-8.0) per 10,000 deliveries. Postpartum hemorrhage among women with placenta accreta was predominantly third-stage hemorrhage (41% of all cases). Although placenta accreta was strongly associated with postpartum hemorrhage (rate ratio 8.3, 95% CI 7.7-8.9), its low frequency resulted in a small population-attributable fraction (1.0%, 95% CI 0.93-1.16). However, the strong association between placenta accreta and postpartum hemorrhage with hysterectomy (rate ratio 286, 95% CI 226-361) resulted in a population-attributable fraction of 29.0% (95% CI 24.3-34.3). Placenta accreta is too infrequent to account for the recent temporal increase in postpartum hemorrhage but contributes substantially to the proportion of postpartum hemorrhage with hysterectomy.

  8. Planned caesarean in the interventional radiology cath lab to enable immediate uterine artery embolization for the conservative treatment of placenta accreta

    International Nuclear Information System (INIS)

    Bouvier, A.; Sentilhes, L.; Thouveny, F.; Bouet, P.-E.; Gillard, P.; Willoteaux, S.; Aubé, C.

    2012-01-01

    Aim: To evaluate the feasibility and efficacy of routine uterine artery embolization (UAE) immediately after planned caesareans performed in the cath lab for conservative treatment of placenta accreta. Materials and methods: A retrospective study included all patients who had a planned caesarean in the cath lab for conservative treatment of placenta accreta at Angers University Hospital, which is a tertiary care centre, from April 2001 to September 2010. Twelve patients underwent UAE immediately after caesarean with the placenta left partially or totally in situ. The success rate of embolization, blood loss, and complications were reported. Results: Diagnosis of abnormal placentation was confirmed by caesarean findings in 14 cases. Four patients had a percreta form with bladder invasion. In seven cases blood loss was insignificant and UAE was prophylactic; no secondary haemorrhage was observed in this group. Postpartum haemorrhage occurred in five cases: control of immediate postpartum bleeding by embolization was successful in three and failed in two leading to hysterectomy. In one case uterine necrosis occurred 6 weeks after embolization, requiring a hysterectomy. Delayed complications resulted in hysterectomy and partial bladder resection 3 months after delivery for one of the patients with placenta percreta. Conclusion: UAE immediately after a caesarean performed in the cath lab is a feasible therapeutic option for conservative treatment of placenta accreta. Advantages include reducing stress and risks associated with transferring women with potentially unstable haemodynamics.

  9. Perioperative Internal Iliac Artery Balloon Occlusion, In the Setting of Placenta Accreta and Its Variants: The Role of the Interventional Radiologist.

    Science.gov (United States)

    Petrov, David A; Karlberg, Benjamin; Singh, Kamalpreet; Hartman, Matthew; Mittal, Pardeep K

    2017-11-10

    Placenta accreta and its variants (increta and percreta) are conditions of abnormal placentation that are encountered with increasing frequency. The spectrum of placenta accreta (including placenta increta and percreta) involves an abnormal attachment of the placental chorionic villi to the uterine myometrium. This abnormal attachment leads to increased adherence of the placenta to the uterus and abnormal placental-uterine separation at the time of delivery. Placental invasion into, or through the myometrium is associated with increased postpartum morbidity and mortality as a result of uterine hemorrhage during and following cesarean section. A multidisciplinary clinical approach to the treatment of patients with placenta accreta is recommended by the American College of Obstetricians and Gynecologists. As potential members of an interdisciplinary team, interventional radiologists can perform prophylactic internal iliac arterial balloon occlusion as an adjunctive therapy for reducing potentially life-threatening postpartum hemorrhage. The procedure involves placement of a balloon catheter into the internal iliac or common iliac arteries bilaterally prior to cesarean section. Following delivery, and prior to placental separation, the catheter balloons are inflated with a pre-determined volume of saline leading to transient occlusion of the internal iliac arteries and reduced uterine blood flow. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Placenta Accreta at 15 Weeks of Gestational Age and Uterus Preservation with Hysterectomy Abortion

    Directory of Open Access Journals (Sweden)

    Farahnaz Farzaneh

    2017-10-01

    Full Text Available Placenta accrete refers to an abnormality of placental implantation in which the anchoring placental villi attached to myometrium rather than decidua resulting in a morbidity adherent placenta. Placenta increta (chorionic villi penetrate into the myometrium and placenta percreta (chorionic villi penetrate through the myometrium to the uterine serosa or adjacent organs are related, but more severe, abnormalities of placental implantation. The pathogenesis is primarily attributed to defective decasualization of the implantation site. Placenta accreta has been recognized mostly in the third trimester however may also present in second trimester. It has very heavy, life-threatening hemorrhage to both the mother and fetus. The authors’ report a patient with two previous cesarean deliveries, who had been referred for pregnancy termination from Iranian legal medicine organization with 15 weeks of gestational age and placenta acctera. In this patient, uterus preservation and hysterectomy abortion was performed. The case totally lost 1500 cc blood and she was discharged from hospital two days later, with feeling of well- being. We have examined this patient after 1.5 months, she wasn’t vaginal bleeding and the uterus was in the pelvic and serum BHCG (with titer was negative.

  11. Antenatal Sonographic Diagnosis and Clinical Significance of Placenta Previa Accreta after Cesarean Section.

    Science.gov (United States)

    Liu, Zhen-Zhen; Wei, Yao; Wang, Ruo-Jiao; Xu, Wen; Shi, Zhi-Min; Dai, Qing

    2017-10-30

    Objective To investigate the clinical and antenatal sonographic characteristics of placenta previa accreta after cesarean section. Methods The data of 21 inpatients diagnosed as placenta previa accreta after cesarean section in PUMC Hospital from 2006 to 2016 were retrospectively reviewed. The clinical and ultrasound features were recorded and compared among three placental accreta groups,including placenta accrete group(n=5),increta group(n=12),and percreta group(n=4). The relationship between the placental thickness at the uterine anterior lower segment level and the blood loss of the following cesarean section was tested. Results Of 21 patients,placenta previa was diagnosed by ultrasound in 20 cases(95.2%) and placenta previa accreta was diagnosed in 9 cases(42.9%). Antenatal ultrasound findings included following signs:loss of "clear zone"(15/18,83.3%),myometrial thinning(12/18,66.7%),abnormal placental lacunae(12/19,63.2%),bladder wall interruption(2/18,11.1%),and uterovesical hypervascularity(4/9,44.4%). Myometrial thinning(J-T=64.000,P=0.036),abnormal placental lacunae(J-T=74.500,P=0.032) and the placental thickness at the uterine anterior lower segment level(U=83.000,P=0.010) showed significant difference among different placenta accreta groups. Placental thickness at the uterine anterior lower segment level showed linear correlation with the blood loss of the following cesarean section(r=0.669,P=0.002). The blood loss of the following cesarean section showed significant difference among different placenta accreta groups(U=118.500,P=0.000). Conclusions The clinical and sonographic manifestations of placenta previa accreta after cesarean section show a spectrum of demographic characteristics. The measurement of thickness of placenta at the anterior lower segment may help the evaluation of the clinical prognosis of this special pathology.

  12. The Placenta Economy

    DEFF Research Database (Denmark)

    Kroløkke, Charlotte; Dickinson, Elizabeth; Foss, Karen A.

    2018-01-01

    This article examines the human placenta not only as a scientific, medical and biological entity but as a consumer bio-product. In the emergent placenta economy, the human placenta is exchanged and gains potentiality as food, medicine and cosmetics. Drawing on empirical research from the United......, in the emergent bio-economy, the dichotomy between the inner and the outer body is deconstructed, while the placenta gains clinical and industrial as well as affective value....

  13. Utility of ultrasound and magnetic resonance imaging in prenatal diagnosis of placenta accreta: A prospective study

    International Nuclear Information System (INIS)

    Satija, Bhawna; Kumar, Sanyal; Wadhwa, Leena; Gupta, Taru; Kohli, Supreethi; Chandoke, Rajkumar; Gupta, Pratibha

    2015-01-01

    Placenta accreta is the abnormal adherence of the placenta to the uterine wall and the most common cause for emergency postpartum hysterectomy. Accurate prenatal diagnosis of affected pregnancies allows optimal obstetric management. To summarize our experience in the antenatal diagnosis of placenta accreta on imaging in a tertiary care setup. To compare the accuracy of ultrasound (USG) with color Doppler (CDUS) and magnetic resonance imaging (MRI) in prenatal diagnosis of placenta accreta. Prospective study in a tertiary care setup. A prospective study was conducted on pregnant females with high clinical risk of placenta accreta. Antenatal diagnosis was established based on CDUS and MRI. The imaging findings were compared with final diagnosis at the time of delivery and/or pathologic examination. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated for both CDUS and MRI. The sensitivity and specificity values of USG and MRI were compared by the McNemar test. Thirty patients at risk of placenta accreta underwent both CDUS and MRI. Eight cases of placenta accreta were identified (3 vera, 4 increta, and 1 percreta). All patients had history of previous cesarean section. Placenta previa was present in seven out of eight patients. USG correctly identified the presence of placenta accreta in seven out of eight patients (87.5% sensitivity) and the absence of placenta accreta in 19 out of 22 patients (86.4% specificity). MRI correctly identified the presence of placenta accreta in 6 out of 8 patients (75.0% sensitivity) and absence of placenta accreta in 17 out of 22 patients (77.3% specificity). There were no statistical differences in sensitivity (P = 1.00) and specificity (P = 0.687) between USG and MRI. Both USG and MRI have fairly good sensitivity for prenatal diagnosis of placenta accreta; however, specificity does not appear to be as good as reported in other studies. Both modalities have complimentary

  14. [Two- and three-dimensional power Doppler ultrasound in the follow-up of placenta accreta treated conservatively].

    Science.gov (United States)

    Roulot, A; Barranger, E; Morel, O; Soyer, P; Héquet, D

    2015-02-01

    To determinate the potential of 2D and 3D-ultrasound in the follow-up of patients with placenta accreta treated conservatively. Seven patients with placenta accreta treated conservatively during June 2007 and September 2009 were included. The follow-up consisted in clinical examination and 2D/3D-ultrasound once a month. Criteria studied included clinical outcome, echogenicity at 2D-ultrasound, vascularisation at colour Doppler, Mean Grey at 3D-ultrasound and vascularisation, flow and perfusion index. Seven women with invasive placenta (3 placentas accreta and 2 percreta) were studied. The mean follow-up was 228 days [75-369]. Mean delay for complete elimination of residual placenta was 280 days [120-365]. The two main results were: presence of an increased anechogenicpart in residual placenta before complete resorption for all patients; a systematic and concomitant stop of genital haemorrhage and vascularisation at colour Doppler. High degrees of variability in parameters measured at 3D-ultrasound were observed between patients so that correlations with clinical outcome were found. Long and regular follow-up is essential after conservative management but the role of 3D-ultrasound compared to 2D-ultrasound was not demonstrated in this study. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  15. Placenta accreta spectrum: pathophysiology and evidence-based anatomy for prenatal ultrasound imaging.

    Science.gov (United States)

    Jauniaux, Eric; Collins, Sally; Burton, Graham J

    2018-01-01

    Placenta accreta spectrum is a complex obstetric complication associated with high maternal morbidity. It is a relatively new disorder of placentation, and is the consequence of damage to the endometrium-myometrial interface of the uterine wall. When first described 80 years ago, it mainly occurred after manual removal of the placenta, uterine curettage, or endometritis. Superficial damage leads primarily to an abnormally adherent placenta, and is diagnosed as the complete or partial absence of the decidua on histology. Today, the main cause of placenta accreta spectrum is uterine surgery and, in particular, uterine scar secondary to cesarean delivery. In the absence of endometrial reepithelialization of the scar area the trophoblast and villous tissue can invade deeply within the myometrium, including its circulation, and reach the surrounding pelvic organs. The cellular changes in the trophoblast observed in placenta accreta spectrum are probably secondary to the unusual myometrial environment in which it develops, and not a primary defect of trophoblast biology leading to excessive invasion of the myometrium. Placenta accreta spectrum was separated by pathologists into 3 categories: placenta creta when the villi simply adhere to the myometrium, placenta increta when the villi invade the myometrium, and placenta percreta where the villi invade the full thickness of the myometrium. Several prenatal ultrasound signs of placenta accreta spectrum were reported over the last 35 years, principally the disappearance of the normal uteroplacental interface (clear zone), extreme thinning of the underlying myometrium, and vascular changes within the placenta (lacunae) and placental bed (hypervascularity). The pathophysiological basis of these signs is due to permanent damage of the uterine wall as far as the serosa, with placental tissue reaching the deep uterine circulation. Adherent and invasive placentation may coexist in the same placental bed and evolve with advancing

  16. ACCRETA COMPLICATING COMPLETE PLACENTA PREVIA IS CHARACTERIZED BY REDUCED SYSTEMIC LEVELS OF VASCULAR ENDOTHELIAL GROWTH FACTOR AND EPITHELIAL-TO-MESENCHYMAL TRANSITION OF THE INVASIVE TROPHOBLAST

    Science.gov (United States)

    Wehrum, Mark J.; Buhimschi, Irina A.; Salafia, Carolyn; Thung, Stephen; Bahtiyar, Mert O.; Werner, Erica F.; Campbell, Katherine H.; Laky, Christine; Sfakianaki, Anna K.; Zhao, Guomao; Funai, Edmund F.; Buhimschi, Catalin S.

    2011-01-01

    OBJECTIVE To characterize serum angiogenic factor profile of women with complete placenta previa and determine if invasive trophoblast differentiation characteristic of accreta, increta or percreta shares features of epitehelial-mesenchymal-transition (EMT). STUDY DESIGN We analyzed gestational age matched serum samples from 90 pregnant women with either complete placenta previa (n=45) or uncomplicated pregnancies (n=45). Vascular-endothelial-growth-factor (VEGF), placental-growth-factor (PlGF) and soluble fms-like-tyrosine-kinase-1 (sFlt-1) were immunoassayed. VEGF and phosphotyrosine (P-Tyr) immunoreactivity was surveyed in histological specimens relative to expression of vimentin and cytokeratin-7. RESULTS Women with previa and invasive placentation [accreta (n=5); increta (n=6); percreta (n=2)] had lower systemic VEGF (invasive previa: median [IQR]: 0.8[0.02–3.4] vs. control: 6.5[2.7–10.5] pg/mL, P=0.02). VEGF and P-Tyr immunostaining predominated in the invasive extravillous trophoblasts (EVT) which co-expressed vimentin and cytokeratin-7, a EMT feature and tumor-like cell phenotype. CONCLUSIONS Lower systemic free VEGF and a switch of the interstitial EVT to a metastable cell phenotype characterize placenta previa with excessive myometrial invasion. PMID:21316642

  17. Pseudotumors of the placenta.

    Science.gov (United States)

    Bruner, Evelyn T

    2016-01-01

    The placenta is one of the most common gross pathology specimens encountered by surgical pathologists, yet primary tumors are exceptionally rare and even rarer are entities with the potential to mimic malignancy. There are many nonneoplasticmass forming lesions in the placenta that are important to be aware of as many of these can be associated with adverse outcomes in the mother and fetus. Also important are entities which may be observed microscopically in the placenta and potentially confused as a malignancy. Knowledge of these potential pitfalls is essential to avoid making an incorrect diagnosis and causing undue alarm. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Zika virus and placenta

    Institute of Scientific and Technical Information of China (English)

    Beuy Joob; Viroj Wiwanitkit

    2016-01-01

    Zika virus infection is the new arboviral infection problem. The serious outcome of infection and induction of abnormal infant become the big issue in reproductive medicine. The pathogenesis and pathology of the placenta in the affected case is an interesting issue. Here, the authors focus and discuss on this topic in this short article.

  19. MRI features of placenta accreta

    International Nuclear Information System (INIS)

    Cao Manrui; Du Mu; Huang Yi; Liu Bingguang; Zhang Fangjing; Guo Jimin; Zhu Zhijun

    2012-01-01

    Objective: To investigate the MRI features of placenta accreta. Methods: From Apr 2009 to Jun 2011, 15 patients with placenta accrete received MRI examination. In them, placenta accreta was diagnosed based on clinical manifestations or postoperative histopathology. The MR features of placenta accreta in them (study group) were retrospectively analyzed and compared with those in 15 pregnant women without placenta accreta (control group) with Fisher exact test. Results: In the 15 patients with placenta accreta,uterine bulging and (or) a focal outward contour bulge was detected in 14 patients; heterogeneous signal intensity in the placenta was detected in 15 patients; dark intraplacental bands on T 2 -weighted images was detected in 15 patients; and increased subplacental vascularity was detected in 11 patients on T 1 - weighted images. In the study group, 14 patients showed at least three of the above four features, and in all of them uterine bulging and (or) a focal outward contour bulge, heterogeneous signal intensity in the placenta and dark intraplacental bands on T 2 -weighted images were detected; one patient showed heterogeneous signal intensity in the placenta, dark intraplacental bands on T 2 -weighted images and increased subplacental vascularity. In the control group,none patient had three of the above features.Uterine bulging and (or) a focal outward contour bulge, heterogeneous signal intensity in the placenta, dark intraplacental bands on T 2 -weighted images and increased subplacental vascularity were detected in 3, 6, 3 and 4 patients (P=0.000, 0.001, 0.000 and 0.027), respectively. Conclusions: The main MRI features of placenta accreta are uterine bulging and (or) a focal outward contour bulge, heterogeneous signal intensity in the placenta and dark intraplacental bands on T 2 -weighted images Besides, increased subplacental vascularity also could provide useful information for the diagnosis of placenta accreta. (authors)

  20. Placenta: How It Works, What's Normal

    Science.gov (United States)

    ... placental problems include placental abruption, placenta previa and placenta accreta. These conditions can cause potentially heavy vaginal bleeding. ... health care provider will recommend a C-section. Placenta accreta. This condition occurs when the blood vessels and ...

  1. Placenta accreta and anesthesia: A multidisciplinary approach

    OpenAIRE

    R S Khokhar; J Baaj; M U Khan; F A Dammas; N Rashid

    2016-01-01

    Placenta accreta (an abnormally adherent placenta) is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  2. Placenta accreta and anesthesia: A multidisciplinary approach

    Directory of Open Access Journals (Sweden)

    R S Khokhar

    2016-01-01

    Full Text Available Placenta accreta (an abnormally adherent placenta is one of the two leading causes of peripartum hemorrhage and the most common indication for peripartum hysterectomy. Placenta accreta may be associated with significant maternal hemorrhage at delivery owing to the incomplete placental separation. When placenta accreta is diagnosed before delivery, a multidisciplinary approach may improve patient outcome.

  3. [Placenta accreta--prenatal diagnosis, treatment].

    Science.gov (United States)

    Tsankova, M; Marinov, B; Bozhilov, D; Pirnareva, E

    2013-01-01

    Placenta accreta is a potentially life threatening obstetric condition that requires a multidisciplinary management. Placenta praevia and previous Cesarean section are the two most important known risk factors for placenta accreta. This study presents two patients having both of the foremention risk factors diagnosed ultrasonographically with placenta accreta in the second trimester. Ultrasound findings considered suggestive of placenta accreta are: presence of placental lacunae (vascular spaces), loss of the hyperehoic uterine serosa-bladder wall interface, loss of the retroplacental hypoechoic clear space, hypervascularity of the interface between the uterine wall and the bladder wall/isthmico-cervical zone, presence of placenta praevia, either anterior or posterior, overlying the uterine scar. Both of the cases with suspected placenta accreta ended successfully by planned preterm Cesarean hysterectomy with the placenta left in situ. Placenta accreta is a significant cause of maternal morbidity and mortality and the most common reason for urgent postpartum hysterectomy.

  4. Magnetic resonance imaging is often misleading when used as an adjunct to ultrasound in the management of placenta accreta spectrum disorders.

    Science.gov (United States)

    Einerson, Brett D; Rodriguez, Christina E; Kennedy, Anne M; Woodward, Paula J; Donnelly, Meghan A; Silver, Robert M

    2018-06-01

    23% and in underdiagnosis in 14% of all cases. When ultrasound suspected severe disease (percreta) in 14 cases, magnetic resonance imaging changed the diagnosis in only 2 cases. Lastly, the proportion of accurate diagnosis with magnetic resonance imaging did not improve over time (61-65%, P = .96 for trend) despite increasing volume and increasing numbers of changed diagnoses. Magnetic resonance imaging resulted in a change in diagnosis that could alter clinical management of placenta accreta spectrum disorders in more than one third of cases, but when changed, the diagnosis was often incorrect. Given its high cost and limited clinical value, magnetic resonance imaging should not be used routinely as an adjunct to ultrasound in the diagnosis of placenta accreta spectrum until evidence for utility is clearly demonstrated by more definitive prospective studies. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. PLACENTA PRAEVIA- TIMELY DECISION MANDATORY!

    Directory of Open Access Journals (Sweden)

    Kshama Kedar

    2017-11-01

    Full Text Available BACKGROUND Antepartum Haemorrhage (APH is still a grave obstetric emergency contributing to a significant amount of maternal and perinatal morbidity and mortality in our country. Placenta Praevia (PP complicates 0.33%1 to 0.55%2 of all pregnancies. This study is to evaluate how far we have come and the effect of treatment on the perinatal and maternal outcome and study the maternal and foetal outcome in placenta praevia and its prevalence in tertiary care hospital. The aim of the study is to study the maternal and foetal outcome in placenta praevia and assess the importance of early diagnosis and treatment. Objective of the study was to determine the cause of placenta praevia and assess the value of current obstetric practice in managing placenta praevia. MATERIALS AND METHODS Prospective study was carried out in a tertiary care hospital on 60 patients who presented with PP in the ANC OPD and in emergency over a period of 2 years with gestational age >28 weeks and no blood dyscrasias or bleeding source other than the uterus. RESULTS Maximum cases (69.11% were unbooked, more in multiparous (41.67% and commonly associated with previous caesarean section (41.6%. 41.46% belonged to 25-29 years of age. 56.67% were more than 36 weeks of gestation at the time of admission. Out of 60, 9 (15% had absent foetal heart sound and 6 (10% had foetal distress at time of admission. 56 (93.3 cases delivered by caesarean section, 29 (48.3% cases were elective, while 27 (45% were done in emergency. 1 (1.6% underwent caesarean hysterectomy. 16 (26.6% had PPH postoperatively managed by medical methods. 2 (3.3% had scar dehiscence and 3 (5% patients went in sepsis. Commonest complication (26.67% was anaemia. 5 (8.3% babies of placenta praevia were premature. CONCLUSION Placenta praevia constitutes 35% of the causes of placental bleeding leading to antepartum haemorrhage, which is a leading cause of maternal morbidity. Hence, timely diagnosis and intervention is of

  6. Caesarean section combined with temporary aortic balloon occlusion followed by uterine artery embolisation for the management of placenta accreta

    International Nuclear Information System (INIS)

    Duan, X.-H.; Wang, Y.-L.; Han, X.-W.; Chen, Z.-M.; Chu, Q.-J.; Wang, L.; Hai, D.-D.

    2015-01-01

    Aim: To determine the efficacy and safety of caesarean section combined with temporary aortic balloon occlusion followed by uterine artery embolisation (UAE) for the treatment of patients with placenta accreta. Materials and methods: This retrospective study involved 42 patients with placenta accreta. All patients underwent caesarean section combined with temporary aortic balloon occlusion followed by UAE through the right femoral approach. Results: All patients were confirmed to have placenta praevia and accreta, including five patients with placenta percreta, at the time of delivery. The technical success rate of the combined treatment was 97.6% (41/42). Forty-one patients underwent successful caesarean section with conservation of the uterus. Hysterectomy was required in one (3.1%) patient. The amount of blood loss and blood transfusion, and the operation time were was 586 ± 355 ml, 422 ± 83 ml and 65.5 ± 10.6 minutes, respectively. The mean postoperative hospital stay, occlusion time and fetal radiation dose were 5.5 ± 2.6 days, 22.4 ± 7.2 minutes and 4.2 ± 2.9 mGy, respectively. There were no significant changes before and 7 days after the endovascular procedure in creatinine levels (56.8 ± 13.8 μmol/l versus 63.4 ± 16.7 μmol/l, p = 0.09) or urea nitrogen (6.3 ± 2.5 μmol/l versus 7.4 ± 3.8 μmol/l, p = 0.17). There were no access-site complications after the endovascular procedure and no complications related to the intervention during follow-up. Conclusion: Temporary aortic balloon occlusion followed by UAE can effectively control postpartum haemorrhage during placental dissection, and reduce transfusion requirements, hysterectomy rate, and operation time in patients with placenta accreta. -- Highlights: •Aortic balloon occlusion can overcome the collateral flow from other arteries. •UAE can effectively manage secondary postpartum haemorrhage. •The aortic balloon can rapidly and easily insert. •The mean

  7. Postpartum MR diagnosis of retained placenta accreta

    Energy Technology Data Exchange (ETDEWEB)

    Tanaka, Yumiko Oishi; Itai, Yuji [Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan); Shigemitsu, Sadahiko [Department of Obstetrics and Gynecology, Ryugasaki Saiseikai General Hospital, Ryagasaki (Japan); Ichikawa, Yoshihito; Sohda, Satoshi; Yoshikawa, Hiroyuki [Department of Obstetrics and Gynecology, Institute of Clinical Medicine, University of Tsukuba, 1-1-1 Tennodai, 305-8575, Tsukuba, Ibaraki (Japan)

    2004-06-01

    Retained placenta accreta can cause catastrophic postpartum hemorrhage. This study aims to determine whether MR imaging can differentiate retained placenta accreta from postpartum hemorrhage caused by other conditions. Fourteen cases suspicious for retained placenta were examined with MR imaging. Signal intensity, the enhancing pattern of uterine contents, and flow voids within the myometrium were retrospectively studied. As hysterectomy was performed in only two cases, final diagnosis was based on clinical outcome and analysis of uterine contents. Final diagnoses were retained placenta accreta in seven cases, retained normally attached placenta in four, hematoma in two, and placental site trophoblastic tumor (PSTT) in one. All seven cases with placenta accreta had a very hyperintense area on T2-weighted images, showing transient early enhancement. None demonstrated delayed strong enhancement around the hyperintense area. In two cases with retained normally attached placenta and in both with hematomas, there were no hyperintense areas on T2-weighted images. Of these, only one showed transient early enhancement. Flow voids were observed in four cases with placenta accreta, one with normally attached placenta, and the case with PSTT. A markedly hyperintense area on T2-weighted images and transient early enhancement without delayed strong enhancement between the mass and the myometrium can indicate retained placenta accreta. (orig.)

  8. Postpartum MR diagnosis of retained placenta accreta

    International Nuclear Information System (INIS)

    Tanaka, Yumiko Oishi; Itai, Yuji; Shigemitsu, Sadahiko; Ichikawa, Yoshihito; Sohda, Satoshi; Yoshikawa, Hiroyuki

    2004-01-01

    Retained placenta accreta can cause catastrophic postpartum hemorrhage. This study aims to determine whether MR imaging can differentiate retained placenta accreta from postpartum hemorrhage caused by other conditions. Fourteen cases suspicious for retained placenta were examined with MR imaging. Signal intensity, the enhancing pattern of uterine contents, and flow voids within the myometrium were retrospectively studied. As hysterectomy was performed in only two cases, final diagnosis was based on clinical outcome and analysis of uterine contents. Final diagnoses were retained placenta accreta in seven cases, retained normally attached placenta in four, hematoma in two, and placental site trophoblastic tumor (PSTT) in one. All seven cases with placenta accreta had a very hyperintense area on T2-weighted images, showing transient early enhancement. None demonstrated delayed strong enhancement around the hyperintense area. In two cases with retained normally attached placenta and in both with hematomas, there were no hyperintense areas on T2-weighted images. Of these, only one showed transient early enhancement. Flow voids were observed in four cases with placenta accreta, one with normally attached placenta, and the case with PSTT. A markedly hyperintense area on T2-weighted images and transient early enhancement without delayed strong enhancement between the mass and the myometrium can indicate retained placenta accreta. (orig.)

  9. Interventions for suspected placenta praevia.

    Science.gov (United States)

    Neilson, J P

    2003-01-01

    Because placenta praevia is implanted unusually low in the uterus, it may cause major, and/or repeated, antepartum haemorrhage. The traditional policy of care of women with symptomatic placenta praevia includes prolonged stay in hospital and delivery by caesarean section. To assess the impact of any clinical intervention applied specifically because of a perceived likelihood that a pregnant woman might have placenta praevia. A comprehensive electronic search was performed to identify relevant literature. Searched databases included the Trials Register maintained by the Cochrane Pregnancy and Childbirth Group (August 2002), and the Cochrane Controlled Trials Register (The Cochrane Library, Issue 2, 2002). Any controlled clinical trial that has assessed the impact of an intervention in women diagnosed as having, or being likely to have, placenta praevia. Data were extracted, unblinded, by the author without consideration of results. Three trials were included, involving a total of 114 women. Both tested interventions (home versus hospitalisation and cervical cerclage versus no cerclage) were associated with reduced lengths of stay in hospital antenatally: weighted mean difference (WMD) respectively -18.50 days (95% confidence interval (CI) -26.83 to -10.17), -4.80 days (95% CI -6.37 to -3.23). Otherwise, there was little evidence of any clear advantage or disadvantage to a policy of home versus hospital care. The one woman who had a haemorrhage severe enough to require immediate transfusion and delivery was in the home care group. Cervical cerclage may reduce the risk of delivery before 34 weeks: relative risk (RR) 0.45 (95% CI 0.23 to 0.87), or the birth of a baby weighing less than two kilograms RR 0.34 (0.14 to 0.83) or having a low five minute Apgar score RR 0.19 (0.04 to 1.00). In general, these possible benefits were more evident in the trial of lower methodological quality. There are insufficient data from trials to recommend any change in clinical practice

  10. [MANAGEMENT OF PLACENTA ACCRETA, DIAGNOSED BEFORE BIRTH].

    Science.gov (United States)

    Dimitrov, A; Garnizov, T; Frundeva, B; Masseva, A; Zlatkov, V

    2015-01-01

    The optimal management of placenta accreta and until now remains unclear. The reasons for this are a rarity of this condition and the considerable heterogeneity of the group under the term "placenta accreta." Total hysterectomy during caesarean section is the most common approach to a known placenta accreta. Planned or emergency perinatal hysterectomy is associated with several complications--damage to the urinary tract, relaparotomiya, massive blood transfusions and stay in ICU. The average blood loss is about 3000 ml. To reduce blood loss in perinatal hysterectomy contribute: preliminary uterine artery occlusion, istmus-coporal longitudinal hysterectomy for extraction of the fetus, placental extraction along with the uterus. To save the woman's uterus at placenta accreta are using the following methods: cutting the uterine wall on which is located the placenta, imposing single stitches covering 2-3 cm in 1 cm, around the placental area; removal of the maximum possible part of the placenta; using longitudinal hysterectomy. So far, there are no comparative studies of the efficacy of different surgical techniques to preserve the uterus cases of placenta accreta. Extraction of the placenta to be done after the administration of uterotonics and devascularization the uterus. To reduce bleeding from the uterus after removal of parts of the placenta and according to the situation can be used: x-back hemostatic sutures from internal side of the uterus, tamponade with gauze roll, balloon catheters or haemostatic mushrooms. Conservative surgical treatment of placenta accreta is not always possible. In hospital Maternity Hospital-Sofia for the period 1986-2000 there were 17 cases of placenta accreta diagnosed only at birth. Maintaining the uterus was successful in 35% of these cases.

  11. Microvascularization on collared peccary placenta

    DEFF Research Database (Denmark)

    Santos, Tatiana Carlesso; Oliveira, Moacir Franco; Dantzer, Vibeke

    2012-01-01

    and fetal compartments of the placentae. The immunolocalization of vimentin in the vascular endothelium and in the smooth muscle cells of blood vessels showed indented capillaries along the uterine epithelium and the trophoblast at the sides of complementary maternal and fetal microfolds, or rugae...... into a microvascular network wall in a basket-like fashion. At the base of these baskets venules were formed. On the fetal side, arterioles branched centrally in the fetal rugae into a capillary network in a bulbous form, complementary to the opposite maternal depressions forming the baskets. At the base...

  12. Reoccurrence of retained placenta at vaginal delivery

    DEFF Research Database (Denmark)

    Nikolajsen, Sys; Løkkegaard, Ellen Christine Leth; Bergholt, Thomas

    2013-01-01

    To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery.......To estimate the prevalence and validate the diagnosis of retained placenta in nulliparous women and the risk of reoccurrence at subsequent vaginal delivery....

  13. Steroid metabolism in the mouse placenta

    International Nuclear Information System (INIS)

    Okker-Reitsma, G.H.

    1976-01-01

    The purpose of the study described in this thesis was to investigate the capacity for steroid synthesis of the mouse placenta - especially the production of progesterone, androgens and estrogens - and to determine, if possible, the relation of steroid synthesis to special cell types. In an introductory chapter the androgen production in the mouse placenta is surveyed by means of a histochemical and bioindicator study of different stages of development of the placenta. The metabolism of [ 3 H]-dehydroepiandrosterone and [ 3 H]-progesterone by mouse placental tissue in vitro is studied. The metabolism of [ 3 H]-progesterone by the mouse fetal adrenal in vitro is also studied

  14. The placenta in toxicology. Part III : Pathologic assessment of the placenta

    OpenAIRE

    Cline, J Mark; Dixon, Darlene; Ernerudh, Jan; Faas, Marijke M; Göhner, Claudia; Häger, Jan-Dirk; Markert, Udo R; Pfarrer, Christiane; Svensson-Arvelund, Judit; Buse, Eberhard

    2014-01-01

    This short review is derived from the peer-reviewed literature and the experience and case materials of the authors. Brief illustrated summaries are presented on the gross and histologic normal anatomy of rodent and macaque placentas, including typical organ weights, with comments on differences from the human placenta. Common incidental findings, background lesions, and induced toxic lesions are addressed, and a recommended strategy for pathologic evaluation of placentas is provided.

  15. Decellularization of placentas: establishing a protocol

    Directory of Open Access Journals (Sweden)

    L.C.P.C. Leonel

    2017-11-01

    Full Text Available Biological biomaterials for tissue engineering purposes can be produced through tissue and/or organ decellularization. The remaining extracellular matrix (ECM must be acellular and preserve its proteins and physical features. Placentas are organs of great interest because they are discarded after birth and present large amounts of ECM. Protocols for decellularization are tissue-specific and have not been established for canine placentas yet. This study aimed at analyzing a favorable method for decellularization of maternal and fetal portions of canine placentas. Canine placentas were subjected to ten preliminary tests to analyze the efficacy of parameters such as the type of detergents, freezing temperatures and perfusion. Two protocols were chosen for further analyses using histology, scanning electron microscopy, immunofluorescence and DNA quantification. Sodium dodecyl sulfate (SDS was the most effective detergent for cell removal. Freezing placentas before decellularization required longer periods of incubation in different detergents. Both perfusion and immersion methods were capable of removing cells. Placentas decellularized using Protocol I (1% SDS, 5 mM EDTA, 50 mM TRIS, and 0.5% antibiotic preserved the ECM structure better, but Protocol I was less efficient to remove cells and DNA content from the ECM than Protocol II (1% SDS, 5 mM EDTA, 0.05% trypsin, and 0.5% antibiotic.

  16. Reproductive performance of Friesian mares after retained placenta and manual removal of the placenta

    NARCIS (Netherlands)

    Sevinga, M; Hesselink, JW; Barkema, H.W.

    2002-01-01

    Because the incidence of retained placenta in Friesian mares is estimated to be high, and no reports have been published on the reproductive performance of Friesian mares after retained placenta, we studied postpartum reproductive performance in Friesian brood mares with (n = 54) and without (n =

  17. Assessing gene function in the ruminant placenta.

    Science.gov (United States)

    Anthony, R V; Cantlon, J D; Gates, K C; Purcell, S H; Clay, C M

    2010-01-01

    The placenta provides the means for nutrient transfer from the mother to the fetus, waste transfer from the fetus to the mother, protection of the fetus from the maternal immune system, and is an active endocrine organ. While many placental functions have been defined and investigated, assessing the function of specific genes expressed by the placenta has been problematic, since classical ablation-replacement methods are not feasible with the placenta. The pregnant sheep has been a long-standing animal model for assessing in vivo physiology during pregnancy, since surgical placement of indwelling catheters into both maternal and fetal vasculature has allowed the assessment of placental nutrient transfer and utilization, as well as placental hormone secretion, under unanesthetized-unstressed steady state sampling conditions. However, in ruminants the lack of well-characterized trophoblast cell lines and the inefficiency of creating transgenic pregnancies in ruminants have inhibited our ability to assess specific gene function. Recently, sheep and cattle primary trophoblast cell lines have been reported, and may further our ability to investigate trophoblast function and transcriptional regulation of genes expressed by the placenta. Furthermore, viral infection of the trophoectoderm layer of hatched blastocysts, as a means for placenta-specific transgenesis, holds considerable potential to assess gene function in the ruminant placenta. This approach has been used successfully to "knockdown" gene expression in the developing sheep conceptus, and has the potential for gain-of-function experiments as well. While this technology is still being developed, it may provide an efficient approach to assess specific gene function in the ruminant placenta.

  18. [Management of placenta previa and accreta].

    Science.gov (United States)

    Kayem, G; Keita, H

    2014-12-01

    Produce recommendations for the management of placenta previa and placenta accrete. A literature search was conducted using Medline and the Cochrane Library over a period from 1950 to 31/12/2013. Recommendations of the latest scientific societies have also been consulted. In cases of placenta previa, if bleeding episode before 34weeks gestation occurs, a short hospitalization and tocolysis may help stop bleeding (grade C). Vaginal delivery is preferable when the distance between the internal cervical os and the placental edge is greater than 20mm. When this distance is less than 20mm, vaginal delivery is possible (professional consensus). Caesarean section is recommended in cases of placenta overlapping the internal os (professional consensus). Antenatal screening placenta accreta could improve care (EL3). Upon discovery of a placenta accreta during childbirth, it is better to avoid a forced removal of the placenta (grade C). Conservative treatment or cesarean hysterectomy are possible (grade C). The management of placental abnormalities should be planned and managed with a multidisciplinary team (professional consensus). The use of blood-saving techniques such as "cell saver" is possible in situations where early intraoperative bleeding would be>1500mL (grade C). There are no studies that have sufficient methodological value to recommend an anesthetic technique [general anaesthesia (GA) or neuraxial anaesthesia] over another in the context of placental abnormalities (grade B). When a major bleeding risk is identified, GA can be chosen in order to avoid emergency conversions in difficult conditions (professional consensus). Placental insertion abnormalities require anesthetic and obstetric coordination. Delivery must be planned in a suitable structure. Copyright © 2014. Published by Elsevier Masson SAS.

  19. IFPA Meeting 2010 Workshops Report II: Placental pathology; trophoblast invasion; fetal sex; parasites and the placenta; decidua and embryonic or fetal loss; trophoblast differentiation and syncytialisation.

    Science.gov (United States)

    Al-Khan, A; Aye, I L; Barsoum, I; Borbely, A; Cebral, E; Cerchi, G; Clifton, V L; Collins, S; Cotechini, T; Davey, A; Flores-Martin, J; Fournier, T; Franchi, A M; Fretes, R E; Graham, C H; Godbole, G; Hansson, S R; Headley, P L; Ibarra, C; Jawerbaum, A; Kemmerling, U; Kudo, Y; Lala, P K; Lassance, L; Lewis, R M; Menkhorst, E; Morris, C; Nobuzane, T; Ramos, G; Rote, N; Saffery, R; Salafia, C; Sarr, D; Schneider, H; Sibley, C; Singh, A T; Sivasubramaniyam, T S; Soares, M J; Vaughan, O; Zamudio, S; Lash, G E

    2011-03-01

    Workshops are an important part of the IFPA annual meeting. At IFPA Meeting 2010 diverse topics were discussed in twelve themed workshops, six of which are summarized in this report. 1. The placental pathology workshop focused on clinical correlates of placenta accreta/percreta. 2. Mechanisms of regulation of trophoblast invasion and spiral artery remodeling were discussed in the trophoblast invasion workshop. 3. The fetal sex and intrauterine stress workshop explored recent work on placental sex differences and discussed them in the context of whether boys live dangerously in the womb.4. The workshop on parasites addressed inflammatory responses as a sign of interaction between placental tissue and parasites. 5. The decidua and embryonic/fetal loss workshop focused on key regulatory mediators in the decidua, embryo and fetus and how alterations in expression may contribute to different diseases and adverse conditions of pregnancy. 6. The trophoblast differentiation and syncytialisation workshop addressed the regulation of villous cytotrophoblast differentiation and how variations may lead to placental dysfunction and pregnancy complications. Copyright © 2011 Elsevier Ltd. All rights reserved.

  20. Perinatal outcome and near-miss morbidity between placenta previa versus abruptio placentae

    International Nuclear Information System (INIS)

    Siddique, S.A.; Tariq, G.; Sheikh, A.; Hussain, F.S.U.; Memon, K.A.

    2010-01-01

    To compare perinatal outcome and near-miss morbidities between placenta previa versus abruptio placentae in patients of antepartum haemorrhage (APH). Patients with APH diagnosed as placenta previa and abruptio placentae who delivered after 24 weeks of regnancy were selected from labour room. Outcome measures were birth weight, neonatal intensive care admission, stillbirth, perinatal mortality rates, near-miss, surgical intensive care admission, postpartum haemorrhage, hysterectomy, massive transfusion, renal failure, coagulopathy and maternal death. Stillbirth was defined as a fetus weighing greater or equal to 500 gm showing no sign of life after birth. Near-miss was defined as severe organ dysfunction which if not treated appropriately, could result in death. Descriptive statistics were calculated and chi-square was applied with significance level < 0.05. Stillbirths and perinatal mortality rates were significantly higher in abruptio placentae, 52.97% versus 18.18% and 534/1000 versus 230/1000 (p < 0.01). Near-miss cases were also significantly higher in abruptio placentae, 22.27%. Verus 11.18% (p < 0.01). Hypovolemic shock and coagulation failure were also significantly higher in abruptio placentae (p < 0.05). (author)

  1. Marcadores de estrés oxidativo en placentas de gestantes añosas

    Directory of Open Access Journals (Sweden)

    Silvia Suárez

    2007-12-01

    Full Text Available Introducción: Un factor de riesgo alto ginecoobstétrico que contribuye a la morbimortalidad materna perinatal es la edad materna mayor de 35 años. Es posible que el estado oxidativo en la placenta de la gestante añosa sea mayor a la de la gestante no añosa. Objetivo: Evaluar el estado oxidativo de la placenta en gestantes mayores de 35 años. Diseño: Estudio observacional y transversal. Lugar: Hospital Nacional Docente Materno Infantil San Bartolomé y Centro de Investigación de Bioquímica y Nutrición de la Universidad Nacional Mayor de San Marcos. Material biológico: 28 placentas de gestantes de 35 años o más y 28 placentas de gestantes de menos de 35 años, obtenidas de partos vaginales a término. Intervenciones: La muestra de placenta se homogenizó al 10% con buffer fosfato 10 mM, pH 7,4, se centrifugó a 2000 rpm por 5’. Parte del sobrenadante se usó para analizar lipoperoxidación y glutatión (GSH; el sobrenadante restante fue centrifugado a 42 000 rpm por 1 hora, para medir actividad de superóxido dismutasa (SOD. Principales medidas de resultados: Estado oxidativo de placentas obtenidas de mujeres añosas y no añosas. Resultados: La actividad de la SOD y el contenido de GSH placentarios en añosas fue 43,52 U/g de tejido y 4,67 µmol/mL x 10-²; para el grupo control fueron 54,13 U/g de tejido y 6,02 µmol/mL x 10-², respectivamente; en ambos hubo significancia estadística (p < 0,05. La medición de TBARS (lipoperoxidación no mostró diferencias significativas. Conclusiones: Las placentas obtenidas de mujeres añosas muestran menor capacidad de defensa antioxidante frente a las placentas obtenidas de mujeres no añosas.

  2. Conservative Management of Placenta Accreta in a Multiparous Woman

    OpenAIRE

    Jennifer C. Hunt

    2010-01-01

    Placenta accreta refers to any abnormally invasive placental implantation. Diagnosis is suspected postpartum with failed delivery of a retained placenta. Massive obstetrical hemorrhage is a known complication, often requiring peripartum hysterectomy. We report a case of presumed placenta accreta in a patient following failed manual removal of a retained placenta. We describe an attempt at conservative management with methotrexate in a stable patient desiring future fertility. Treatment was ...

  3. Gluconeogenesis in rat placenta during foetal development

    International Nuclear Information System (INIS)

    Bagewadikar, R.S.; Sharma, C.; Nadkarni, G.B.

    1977-01-01

    Variations in glycogen levels in rat placenta have been correlated with gluconeogenesis in this tissue. Placental homogenate could synthesize substantial amounts of glucose from L-alanine-U- 14 C in early pregnancy. This has been substantiated by the observed enhancement in the activities of glucose 6-phosphatase, fructose 1, 6-diphosphatase and phosphoenolpyruvate carboxykinase. Gluconeogenic activity in placenta could proceed till the foetal liver was able to take over this function. The increase or decrease in placental glycogen is concomitant with glycogen synthetase, but not phosphorylase, activity. The reversible catalytic properties of placental aldolase also show subtle functional changes during and late phases of gestation. (author)

  4. Gluconeogenesis in rat placenta during foetal development

    Energy Technology Data Exchange (ETDEWEB)

    Bagewadikar, R S; Sharma, C; Nadkarni, G B [Bhabha Atomic Research Centre, Bombay (India). Biochemistry and Food Technology Div.

    1977-01-01

    Variations in glycogen levels in rat placenta have been correlated with gluconeogenesis in this tissue. Placental homogenate could synthesize substantial amounts of glucose from L-alanine-U-/sup 14/C in early pregnancy. This has been substantiated by the observed enhancement in the activities of glucose 6-phosphatase, fructose 1, 6-diphosphatase and phosphoenolpyruvate carboxykinase. Gluconeogenic activity in placenta could proceed till the foetal liver was able to take over this function. The increase or decrease in placental glycogen is concomitant with glycogen synthetase, but not phosphorylase, activity. The reversible catalytic properties of placental aldolase also show subtle functional changes during and late phases of gestation.

  5. INTRODUCTION The incidence of retained placenta varies greatly ...

    African Journals Online (AJOL)

    balance between the post-partum haemorrhage risk of leaving the placenta in ... Conclusion: Retained placenta still remains a potentially life threatening condition in ... obstetric services by high skilled health care providers in ensuring a properly conducted .... of the preterm placenta may require more uterine work and time ...

  6. Correlation between placenta and umbilical cord morphplogy and ...

    African Journals Online (AJOL)

    Context: The ability of the fetus to grow and thrive in-utero depends on a number of factors of which the placenta is a contributor. The umbilical cord is an essential organ connecting the fetus to the placenta and a healthy placenta is essential for good perinatal outcome. Objectives: The study aims at determining the ...

  7. Evolution of the Placenta in Eutherian Mammals

    DEFF Research Database (Denmark)

    Carter, Anthony Michael; Mess, A

    2007-01-01

    of eutherian mammals had an endotheliochorial placenta or a haemochorial one. Research has been stimulated by improved understanding of the relations between the orders of mammals provided by molecular phylogenetics. In part, the uncertainties arise from doubt about how to root the mammalian tree. Resolution...

  8. The sick placenta - the role of malaria

    NARCIS (Netherlands)

    Brabin, B. J.; Romagosa, C.; Abdelgalil, S.; Menéndez, C.; Verhoeff, F. H.; McGready, R.; Fletcher, K. A.; Owens, S.; D'Alessandro, U.; Nosten, F.; Fischer, P. R.; Ordi, J.

    2004-01-01

    The human placenta is an ideal site for the accumulation of Plasmodium falciparum malaria parasites, and as a consequence serious health problems arise for the mother and her baby. The pathogenesis of placental malaria is only partially understood, but it is clear that it leads to a distinct

  9. The Placenta: Applications in Orthopaedic Sports Medicine.

    Science.gov (United States)

    McIntyre, James Alexander; Jones, Ian A; Danilkovich, Alla; Vangsness, C Thomas

    2018-01-01

    Placenta has a long history of use for treating burns and wounds. It is a rich source of collagen and other extracellular matrix proteins, tissue reparative growth factors, and stem cells, including mesenchymal stem cells (MSCs). Recent data show its therapeutic potential for orthopaedic sports medicine indications. To provide orthopaedic surgeons with an anatomic description of the placenta, to characterize its cellular composition, and to review the literature reporting the use of placenta-derived cells and placental tissue allografts for orthopaedic sports medicine indications in animal models and in humans. Systematic review. Using a total of 63 keyword combinations, the PubMed and MEDLINE databases were searched for published articles describing the use of placental cells and/or tissue for orthopaedic sports medicine indications. Information was collected on placental tissue type, indications, animal model, study design, treatment regimen, safety, and efficacy outcomes. Results were categorized by indication and subcategorized by animal model. Outcomes for 29 animal studies and 6 human studies reporting the use of placenta-derived therapeutics were generally positive; however, the placental tissue source, clinical indication, and administration route were highly variable across these studies. Fourteen animal studies described the use of placental tissue for tendon injuries, 13 studies for osteoarthritis or articular cartilage injuries, 3 for ligament injuries, and 1 for synovitis. Both placenta-derived culture-expanded cells (epithelial cells or MSCs) and placental tissue allografts were used in animal studies. In all human studies, commercial placental allografts were used. Five of 6 human studies examined the treatment of foot and ankle pathological conditions, and 1 studied the treatment of knee osteoarthritis. A review of the small number of reported studies revealed a high degree of variability in placental cell types, placental tissue preparation, routes

  10. Failed manual removal of the placenta after vaginal delivery

    DEFF Research Database (Denmark)

    Bjurström, Johanna; Collins, Sally; Langhoff-Roos, Jens

    2018-01-01

    PURPOSE: A retained placenta after vaginal delivery where manual removal of placenta fails is a clinical challenge. We present six cases that illustrate the heterogeneity of the condition and discuss the etiology and terminology as well as the clinical management. METHODS: Members of the European...... and the UK provide examples of various treatment strategies such as ultrasound-guided vaginal removal, removal of the placenta through a hysterotomy and just leaving the placenta in situ. The placentas were all retained, but it was only possible to diagnose abnormal invasion in the one case, which had...

  11. Magnetic resonance imaging of placenta accreta

    Science.gov (United States)

    Varghese, Binoj; Singh, Navdeep; George, Regi A.N; Gilvaz, Sareena

    2013-01-01

    Placenta accreta (PA) is a severe pregnancy complication which occurs when the chorionic villi (CV) invade the myometrium abnormally. Optimal management requires accurate prenatal diagnosis. Ultrasonography (USG) and magnetic resonance imaging (MRI) are the modalities for prenatal diagnosis of PA, although USG remains the primary investigation of choice. MRI is a complementary technique and reserved for further characterization when USG is inconclusive or incomplete. Breath-hold T2-weighted half-Fourier rapid acquisition with relaxation enhancement (RARE) and balanced steady-state free precession imaging in the three orthogonal planes is the key MRI technique. Markedly heterogeneous placenta, thick intraplacental dark bands on half-Fourier acquisition single-shot turbo spin-echo (HASTE), and disorganized abnormal intraplacental vascularity are the cardinal MRI features of PA. MRI is less reliable in differentiating between different degrees of placental invasion, especially between accreta vera and increta. PMID:24604945

  12. Magnetic resonance imaging of placenta accreta

    Directory of Open Access Journals (Sweden)

    Binoj Varghese

    2013-01-01

    Full Text Available Placenta accreta (PA is a severe pregnancy complication which occurs when the chorionic villi (CV invade the myometrium abnormally. Optimal management requires accurate prenatal diagnosis. Ultrasonography (USG and magnetic resonance imaging (MRI are the modalities for prenatal diagnosis of PA, although USG remains the primary investigation of choice. MRI is a complementary technique and reserved for further characterization when USG is inconclusive or incomplete. Breath-hold T2-weighted half-Fourier rapid acquisition with relaxation enhancement (RARE and balanced steady-state free precession imaging in the three orthogonal planes is the key MRI technique. Markedly heterogeneous placenta, thick intraplacental dark bands on half-Fourier acquisition single-shot turbo spin-echo (HASTE, and disorganized abnormal intraplacental vascularity are the cardinal MRI features of PA. MRI is less reliable in differentiating between different degrees of placental invasion, especially between accreta vera and increta.

  13. Magnetic resonance imaging of placenta accreta

    International Nuclear Information System (INIS)

    Varghese, Binoj; Singh, Navdeep; George, Regi A.N; Gilvaz, Sareena

    2013-01-01

    Placenta accreta (PA) is a severe pregnancy complication which occurs when the chorionic villi (CV) invade the myometrium abnormally. Optimal management requires accurate prenatal diagnosis. Ultrasonography (USG) and magnetic resonance imaging (MRI) are the modalities for prenatal diagnosis of PA, although USG remains the primary investigation of choice. MRI is a complementary technique and reserved for further characterization when USG is inconclusive or incomplete. Breath-hold T2-weighted half-Fourier rapid acquisition with relaxation enhancement (RARE) and balanced steady-state free precession imaging in the three orthogonal planes is the key MRI technique. Markedly heterogeneous placenta, thick intraplacental dark bands on half-Fourier acquisition single-shot turbo spin-echo (HASTE), and disorganized abnormal intraplacental vascularity are the cardinal MRI features of PA. MRI is less reliable in differentiating between different degrees of placental invasion, especially between accreta vera and increta

  14. Transfer RNA methylases in rat placenta

    International Nuclear Information System (INIS)

    Jagtiani, S.K.; Narurkar, L.M.; Narurkar, M.V.

    1977-01-01

    Presence of tRNA methylases (5-adenosylmethionine : tRNA methyltransferases) was demonstrated at various stages of gestation in rat placenta, the enzyme being 50-100% higher than that of adult rat liver during early gestation. Placental tRNA methylases were shown to differ from those of liver in the extent of methylation. Glycine methyltransferase (S-adenosylmethionine : glycine methyltransferase), a regulatory enzyme in adult rat liver, was absent in placenta throughout gestation. The placental tRNA methylases could be inhibited in vitro by semipurified glycine methyltransferase from adult rat liver. The high placental tRNA methylase activity was comparable with the inhibitor-free enzyme activity of the adult rat liver. S-adenosyl-[Me- 14 C]-methionine was used in the investigation. (author)

  15. A novel scoring system for predicting adherent placenta in women with placenta previa.

    Science.gov (United States)

    Tanimura, Kenji; Morizane, Mayumi; Deguchi, Masashi; Ebina, Yasuhiko; Tanaka, Utaru; Ueno, Yoshiko; Kitajima, Kazuhiro; Maeda, Tetsuo; Sugimura, Kazuro; Yamada, Hideto

    2018-04-01

    Placenta previa (PP) is one of the most significant risk factors for adherent placenta (AP). The aim of this study was to evaluate the diagnostic efficacy of a novel scoring system for predicting AP in pregnant women with PP. This prospective cohort study enrolled 175 women with PP. The placenta previa with adherent placenta score (PPAP score) is composed of 2 categories: (1) past history of cesarean section (CS), surgical abortion, and/or uterine surgery; and (2) ultrasonography and magnetic resonance imaging findings. Each category is graded as 0, 1, 2, or 4 points, yielding a total score between 0 and 24. When women with PP had PPAP score ≥8, they were considered to be at a high risk for AP and received placement of preoperative internal iliac artery occlusion balloon catheters. If they were found to have AP during CS, they underwent hysterectomy or placenta removal using advanced bipolar with balloon catheter occlusion. The predictive accuracy of PPAP score was evaluated. In total, 23 of the 175 women with PP were diagnosed as having AP, histopathologically or clinically. Twenty-one of 24 women with PPAP score ≥8 had AP, whereas two of 151 women with PPAP score PPAP scoring system may be useful for predicting AP in women with PP. Copyright © 2018 Elsevier Ltd. All rights reserved.

  16. The placenta of the salp (Tunicata: Thaliacea).

    Science.gov (United States)

    Bone, Q; Pulsford, A L; Amoroso, E C

    1985-01-01

    The morphology of the mature 'placenta' of the pelagic tunicate Salpa fusiformis is described, and it is shown that two syncytial layers, intimately connected by interdigitating microvilli, separate maternal and embryonic circulations. The central placental layer facing the maternal circulation is bordered by membrane infoldings; the cortical layer facing the embryonic circulation is bordered by extensively branching microvilli. Both layers are of maternal origin, although embryonic leucocytes pass into, and add to, the cortical layer.

  17. Magnetic resonance imaging of the normal placenta

    International Nuclear Information System (INIS)

    Blaicher, Wibke; Brugger, Peter C.; Mittermayer, Christoph; Schwindt, Jens; Deutinger, Josef; Bernaschek, Gerhard; Prayer, Daniela

    2006-01-01

    The goal of this study was to provide a representative description of the normal placenta with contrast medium-free magnetic resonance imaging (MRI) in order to determine a standard of reference. One hundred consecutive singleton pregnancies were investigated by MRI without application of a contrast medium. The mean gestational age (GA) at the time of investigation was 29.5 weeks (range 19-40). Patients with suspected utero-placental insufficiency (UPI) or placental anomalies were excluded. Signal intensities were assessed and correlated with the respective GA. Antenatal MRI without contrast medium was able to depict placental status and morphological changes during gestation. A regular homogeneous structure was found in weeks 19-23. Subsequently, sporadic, slightly marked lobules appeared, which increased in number and markedness with ongoing gestation. Stratification of the lobules was observed after 36 weeks. The ratio of placental and amniotic fluid signal intensities decreased significantly with higher GA and with placental grading. MRI is well suited as an imaging method for the placenta. Our data may be used as a reference in the assessment of the placenta on MRI, and may have further clinical impact with respect to the determination of UPI

  18. Magnetic resonance imaging of the normal placenta

    Energy Technology Data Exchange (ETDEWEB)

    Blaicher, Wibke [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria)]. E-mail: wibke.blaicher@meduniwien.ac.at; Brugger, Peter C. [Center of Anatomy and Cell Biology, University Hospital of Vienna (Austria); Mittermayer, Christoph [Department of Pediatrics, Division of Neonatology and Intensive Care, University Hospital of Vienna (Austria); Schwindt, Jens [Department of Pediatrics, Division of Neonatology and Intensive Care, University Hospital of Vienna (Austria); Deutinger, Josef [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria); Bernaschek, Gerhard [Department of Gynecology and Obstetrics, University Hospital Vienna (Austria); Prayer, Daniela [Department of Radiology, Division of Neuroradiology, University Hospital of Vienna (Austria)

    2006-02-15

    The goal of this study was to provide a representative description of the normal placenta with contrast medium-free magnetic resonance imaging (MRI) in order to determine a standard of reference. One hundred consecutive singleton pregnancies were investigated by MRI without application of a contrast medium. The mean gestational age (GA) at the time of investigation was 29.5 weeks (range 19-40). Patients with suspected utero-placental insufficiency (UPI) or placental anomalies were excluded. Signal intensities were assessed and correlated with the respective GA. Antenatal MRI without contrast medium was able to depict placental status and morphological changes during gestation. A regular homogeneous structure was found in weeks 19-23. Subsequently, sporadic, slightly marked lobules appeared, which increased in number and markedness with ongoing gestation. Stratification of the lobules was observed after 36 weeks. The ratio of placental and amniotic fluid signal intensities decreased significantly with higher GA and with placental grading. MRI is well suited as an imaging method for the placenta. Our data may be used as a reference in the assessment of the placenta on MRI, and may have further clinical impact with respect to the determination of UPI.

  19. A thick placenta: a predictor of adverse pregnancy outcomes.

    Science.gov (United States)

    Miwa, Ichiro; Sase, Masakatsu; Torii, Mayumi; Sanai, Hiromi; Nakamura, Yasuhiko; Ueda, Kazuyuki

    2014-01-01

    The aim of this study is to evaluate the efficacy of an ultrasonographic measurement of placental thickness and the correlation of a thick placenta with adverse perinatal outcome. Placental thickness was measured in single gravidas, 16 to 40 weeks of gestation, between 2005 and 2009. Placentas were considered to be thick if their measured thickness were above the 95th percentile for gestational age. The incidence of thick placentas was 4.3% (138/3,183). Perinatal morbidity and neonatal conditions were worse in cases with thick placenta rather than without thick placenta. Ultrasonographic measurement of placental thickness is a simple method to estimate placental size. Thick placenta may be a useful predictor of adverse pregnancy outcomes.

  20. MATERNAL AND PERINATAL OUTCOME IN ABRUPTIO PLACENTA

    Directory of Open Access Journals (Sweden)

    Prabha Janakiram

    2017-08-01

    Full Text Available BACKGROUND Antepartum Haemorrhage (APH is the leading cause of vaginal bleeding. It is also the important cause of maternal morbidity as well as perinatal morbidity. APH is defined as bleeding per vagina occurring after 28 weeks of gestation and before the birth of the baby. Among APH, abruptio placenta and placenta previa are the leading cause that endanger the life of the mother and a great risk to high unfavourable perinatal outcome. Placental abruption is the bleeding from the premature separation of the normally implanted placenta after 20 weeks of gestations and prior to the birth of the foetus/foetuses. It is the major contribution of obstetric haemorrhage and complicates 0.8 to 1% of pregnancies worldwide. Placental abruption is the premature separation of implanted placenta before the delivery of foetus/foetuses. The aim of the study is to analyse the risk factors associated with abruption and hence methods can be formulated to prevent maternal mortality and morbidity. MATERIALS AND METHODS The present study is a retrospective study and was done in the Department of Obstetrics and Gynaecology from July to December, 2016, for a period of 6 months in the year 2016 at Government K.A.P.V. Medical College, Trichy, South India. RESULTS The total number of abruption placenta cases reported during the study period- June 2016 to November 2016 were 40. The total number of livebirth during same period was 5,348. The stillbirth rate was 42.5% and neonatal death rate was 22.5%. Clinical information were collected, maternal age, parity, gestational age at parity, prior history of abruption, clinical presentation like pain, bleeding, type of abruption like concealed or revealed amount of retroplacental clots and its size and degree of abruption associated with hypertensive disorders, mode of delivery, abruption-delivery interval, maternal complications, requirement of blood transfusions and immediate neonatal outcome. The results of studies were

  1. Morphological changes in human placenta of wet snuff users

    International Nuclear Information System (INIS)

    Ashfaq, M.; Malik, M.A.

    2008-01-01

    Wet snuff is commonly used by both males and females in different parts of Pakistan. Apart from other ingredients, tobacco is the major component of snuff. Adverse effects of smoking on morphology of human placenta have been shown by some previous studies. But snuff is not considered as dangerous as smoking during pregnancy. This study was designed to see the effects of snuff on morphology of human placenta. In present study total 80 human placentae, 40 from normal and 40 from snuff users were used. This study was carried out in the Department of Anatomy Basic Medical Sciences Institution (BSMI) Karachi. Duration of study was six months. Samples were obtained from Gynaecology and Obstetric unit-I JPMC. Placentae washed well with running tap water to remove blood clots. Umbilical cord and other membranes were removed and placenta gently squeezed to expel the foetal blood. Gross features like weight, diameters, central thickness and attachment of umbilical cord were noted in normal and snuff users' placentae. Then placentae were preserved in 10% formalin for at least five days before the sectioning for micromorphology. Placentae divided in two groups-A and B. 4 macro m thick sections of the tissue were taken on rotary microtome and stained with H and E, Mallorys trichrome and methanamine silver for different histological observations. Mircromorpholgical changes have been observed in placentae of snuff users leading to loss of functional components of placentae. This loss of functional component may have deleterious effects on outcome of pregnancy. No significant gross morphological changes were found in snuff user placentae. Wet snuff effect the micromorphology of placenta leading to loss of functional component and in turn effects the exchange of materials between mother and foetus which may leads to intrauterine growth retardation. Loss of trophoblasts may lead to hormonal imbalance necessary for normal pregnancy and this imbalance can cause premature labour

  2. Kinetics of silica nanoparticles in the human placenta

    DEFF Research Database (Denmark)

    Poulsen, Marie Sønnegaard; Mose, Tina; Maroun, Lisa Leth

    2015-01-01

    choriocarcinoma cell line and the ex vivo perfused human placenta. Nanotoxicity in BeWo cells was examined by the MTT assay which demonstrated decreased cell viability at concentrations >100 µg/mL. In the placental perfusion experiments, antipyrine crossed the placenta rapidly, with a foetal:maternal ratio of 0...

  3. Delivery of placenta before baby in ruptured uterus | Ameh | Annals ...

    African Journals Online (AJOL)

    An unusual case of ruptured uterus characterized by spontaneous delivery of the placenta while the foetus is retained in the abdomen is presented. The management and prevention of ruptured uterus in Sub- Saharan Africa is discussed. Key Words: Delivery of placenta, ruptured uterus. Annals of African Medicine Vol.3(3) ...

  4. Economic and reproductive consequences of retained placenta in dairy cattle.

    NARCIS (Netherlands)

    Joosten, I.; Stelwagen, J.; Dijkhuizen, A.A.

    1988-01-01

    The financial losses due to retained placenta in Dutch dairy cattle were estimated by using two different methods of calculation. A data-set containing the birth records of 160,188 Meuse-Rhine-Yssel cows provided data on the reproductive performance of cows with and without retained placenta. The

  5. Risk factors for placenta praevia in Southern Nigeria | Eniola | East ...

    African Journals Online (AJOL)

    Design: A prospective case control study. Setting: A tertiary center - Obafemi Awolowo ... Conclusions: From our study, the risk factors for placenta praevia are a history of retained placenta, previous caesarean section, previous abortion, grand multiparity and maternal age over 35 years. (East African Medical Journal: 2002 ...

  6. Oxygen diffusive conductance in placentae from control and diabetic women

    DEFF Research Database (Denmark)

    Mayhew, T M; Sørensen, Flemming Brandt; Klebe, J G

    1993-01-01

    . maternal erythrocytes and plasma, villous trophoblast, villous stroma, fetal plasma and fetal erythrocytes. From partial conductances and birthweights, total and specific conductances for each placenta were determined. No differences were detected between diabetic placentae in different classes (A, B, C, D...

  7. Endothelial and lipoprotein lipases in human and mouse placenta

    DEFF Research Database (Denmark)

    Lindegaard, Marie L S; Olivecrona, Gunilla; Christoffersen, Christina

    2005-01-01

    Placenta expresses various lipase activities. However, a detailed characterization of the involved genes and proteins is lacking. In this study, we compared the expression of endothelial lipase (EL) and LPL in human term placenta. When placental protein extracts were separated by heparin-Sepharos...

  8. Association of placenta praevia with repeat cesarean section in ...

    African Journals Online (AJOL)

    Background: Several risk factors for placenta praevia exist, including previous cesarean section(C/S). This association has been investigated long time ago, however in this hospital there is no documented evidence. This study was done to assess the risk of placenta praevia based on number of previous cesarean sections.

  9. Isotopic location of the placenta. Experience of Lariboisiere Hospital

    International Nuclear Information System (INIS)

    Naccache, Gilbert.

    1974-01-01

    All isotopic placenta location techniques make use of the vascularisation difference between the placenta and the neighbouring tissues. The principle is based on the amount of blood in the intervillous space and the maternal blood circulation rate in the placenta area. The techniques, all based on this principle, differ by the nature of the radioelement and the performance of the instruments used. Mention is made of the qualities governing the choice of radioisotope injected, with emphasis on the need to reduce the foetal irradiation. Two kinds of scintigraphic equipment are used, one with a mobile detector moving above the woman's abdomen and the other using a fixed detector, the scintillation camera, which gives the placenta image very rapidly. The practical details of an experiment covering 49 cases of placenta location, using a scintillation camera and sup(99m)Tc-labelled red blood cells, are described in full [fr

  10. Conservative Management of Placenta Accreta in a Multiparous Woman

    Directory of Open Access Journals (Sweden)

    Jennifer C. Hunt

    2010-01-01

    Full Text Available Placenta accreta refers to any abnormally invasive placental implantation. Diagnosis is suspected postpartum with failed delivery of a retained placenta. Massive obstetrical hemorrhage is a known complication, often requiring peripartum hysterectomy. We report a case of presumed placenta accreta in a patient following failed manual removal of a retained placenta. We describe an attempt at conservative management with methotrexate in a stable patient desiring future fertility. Treatment was unsuccessful and led to the development of a disseminated intrauterine infection complicated by a bowel obstruction, requiring both a hysterectomy and small bowel resection. In hemodynamically stable patients, conservative management of placenta accreta may involve leaving placental tissue in situ with subsequent administration of methotrexate. However, ongoing close observation is required to identify complications.

  11. Endovascular Interventions for the Morbidly Adherent Placenta

    Directory of Open Access Journals (Sweden)

    Claire Kaufman

    2018-05-01

    Full Text Available Morbidly adherent placentas are a spectrum of abnormalities ranging from placental invasion of the myometrium to invasion past the myometrium and muscular layers into adjacent structures. This entity is becoming more prevalent recently with increased number of cesarean deliveries. Given the high risk of morbidity and mortality, this was traditionally treated with pre-term planned cesarean hysterectomy. However, recently, uterine preservation techniques have been implemented for those women wishing to preserve future fertility or their uterus. Early identification is crucial as studies have shown better outcomes for women treated at tertiary care facilities by a dedicated multidisciplinary team. Interventional radiologists are frequently included in the care of these patients as there are several different endovascular techniques which can be implemented to decrease morbidity in these patients both in conjunction with cesarean hysterectomy and in the setting of uterine preservation. This article will review the spectrum of morbidly adherent placentas, imaging, as well as the surgical and endovascular interventions implemented in the care of these complex patients.

  12. The Programming Power of the Placenta

    Science.gov (United States)

    Sferruzzi-Perri, Amanda N.; Camm, Emily J.

    2016-01-01

    Size at birth is a critical determinant of life expectancy, and is dependent primarily on the placental supply of nutrients. However, the placenta is not just a passive organ for the materno-fetal transfer of nutrients and oxygen. Studies show that the placenta can adapt morphologically and functionally to optimize substrate supply, and thus fetal growth, under adverse intrauterine conditions. These adaptations help meet the fetal drive for growth, and their effectiveness will determine the amount and relative proportions of specific metabolic substrates supplied to the fetus at different stages of development. This flow of nutrients will ultimately program physiological systems at the gene, cell, tissue, organ, and system levels, and inadequacies can cause permanent structural and functional changes that lead to overt disease, particularly with increasing age. This review examines the environmental regulation of the placental phenotype with particular emphasis on the impact of maternal nutritional challenges and oxygen scarcity in mice, rats and guinea pigs. It also focuses on the effects of such conditions on fetal growth and the developmental programming of disease postnatally. A challenge for future research is to link placental structure and function with clinical phenotypes in the offspring. PMID:27014074

  13. Placenta accreta: diagnosis, management and the molecular biology of the morbidly adherent placenta.

    Science.gov (United States)

    Goh, William A; Zalud, Ivica

    2016-01-01

    Placenta accreta is now the chief cause of postpartum hemorrhage resulting in maternal and neonatal morbidity. Prenatal diagnosis decreases blood loss at delivery and intra and post-partum complications. Ultrasound is critical for diagnosis and MRI is a complementary tool when the diagnosis is uncertain. Peripartum hysterectomy has been the standard of therapy but conservative management is increasingly being used. The etiology of accreta is due to a deficiency of maternal decidua resulting in placental invasion into the uterine myometrium. The molecular basis for the development of invasive placentation is yet to be elucidated but may involve abnormal paracrine/autocrine signaling between the deficient maternal decidua and the trophoblastic tissue. The interaction of hormones such as Relaxin which is abundant in maternal decidua and insulin-like 4, an insulin-like peptide found in placental trophoblastic tissue may play role in the formation of placenta accreta.

  14. Abnormal labyrinthine zone in the Hectd1-null placenta.

    Science.gov (United States)

    Sarkar, Anjali A; Sabatino, Julia A; Sugrue, Kelsey F; Zohn, Irene E

    2016-02-01

    The labyrinthine zone of the placenta is where exchange of nutrients and waste occurs between maternal and fetal circulations. Proper development of the placental labyrinth is essential for successful growth of the developing fetus and abnormalities in placental development are associated with intrauterine growth restriction (IUGR), preeclampsia and fetal demise. Our previous studies demonstrate that Hectd1 is essential for development of the junctional and labyrinthine zones of the placenta. Here we further characterize labyrinthine zone defects in the Hectd1 mutant placenta. The structure of the mutant placenta was compared to wildtype littermates using histological methods. The expression of cell type specific markers was examined by immunohistochemistry and in situ hybridization. Hectd1 is expressed in the labyrinthine zone throughout development and the protein is enriched in syncytiotrophoblast layer type I cells (SynT-I) and Sinusoidal Trophoblast Giant cells (S-TGCs) in the mature placenta. Mutation of Hectd1 results in pale placentas with frequent hemorrhages along with gross abnormalities in the structure of the labyrinthine zone including a smaller overall volume and a poorly elaborated fetal vasculature that contain fewer fetal blood cells. Examination of molecular markers of labyrinthine trophoblast cell types reveals increased Dlx3 positive cells and Syna positive SynT-I cells, along with decreased Hand1 and Ctsq positive sinusoidal trophoblast giant cells (S-TGCs). Together these defects indicate that Hectd1 is required for development of the labyrinthine zonethe mouse placenta. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Study of placenta of children born with congenital malformations.

    Science.gov (United States)

    Stoll, Claude; Alembik, Yves; Dott, Béatrice; Roth, Marie-Paule

    2003-01-01

    The malformations in this study were observed in a series of 279,642 consecutive births of known outcome registered in our Registry of congenital anomalies. For each case, more than 50 factors included in the registration forms were studied. One of the factors studied was the placenta. For each malformed child, a control was chosen. Cases with maternal known factors impairing placenta function, i.e. vasculopathy and diabetes, were excluded. In each category of malformations studied, the malformed children were divided into isolated and non-isolated (multiple malformed) cases. The weight of placenta of isolated cases was not lower than the weight of placenta of the controls. In contrast, the weight of placenta of the cases with non-isolated malformations was lower than the weight of placenta of the controls and of the isolated cases, for all categories of malformations but gastroschisis and omphalocele. The mean weights at birth of the cases with multiple malformations were also lower than those of the controls. The human placenta discounts a principal functional part, the maternal blood in the intervillous space. Congenital malformations may interact with this function.

  16. D2-40/podoplanin expression in the human placenta

    Science.gov (United States)

    Wang, Yuping; Sun, Jingxia; Gu, Yang; Zhao, Shuang; Groome, Lynn J.; Alexander, J. Steven

    2011-01-01

    Placental tissue expresses many lymphatic markers. The current study was undertaken to examine if D2-40/podoplanin, a lymphatic endothelial marker, was expressed in the human placentas, and how it is altered developmentally and pathologically. We studied D2-40/podoplanin and VEGFR-3 expressions in placentas from normotensive pregnancies at different gestational ages and in placentas from women with clinically defined preeclampsia. D2-40 expression in systemic lymphatic vessel endothelium served as a positive control. Protein expression for D2-40, VEGFR-3, and β-actin were determined by Western blot in placentas from normotensive (n=6) and preeclamptic (n=5) pregnancies. Our results show that D2-40/podoplanin was strongly expressed in the placenta, mainly as a network plexus pattern in the villous stroma throughout gestation. CD31 was limited to villous core fetal vessel endothelium and VEGFR-3 was found in both villous core fetal vessel endothelium and trophoblasts. D2-40/podoplanin expression was significantly decreased, and VEGFR-3 significantly increased in preeclamptic placental tissues compared to normotensive placental controls. Placental villous stroma is a reticular-like structure, and the localization of D2-40 to the stroma suggests that a lymphatic-like conductive network may exist in the human placenta. D2-40/podoplanin is an O-linked sialoglycoprotein. Although little is known regarding biological functions of sialylated glycoproteins within the placenta, placental D2-40/podoplanin may support fetal vessel angiogenesis during placenta development and reduced D2-40/podoplanin expression in preeclamptic placenta may contribute to altered interstitial fluid homeostasis and impaired angiogenesis in this pregnancy disorder. PMID:21095001

  17. Cervical Length in Patients at Risk for Placenta Accreta.

    Science.gov (United States)

    Rac, Martha W F; McIntire, Donald D; Wells, C Edward; Moschos, Elysia; Twickler, Diane D

    2017-07-01

    To evaluate cervical length measurements in women with placenta accreta compared to women with a nonadherent low-lying placenta or placenta previa and evaluate this relationship in terms of vaginal bleeding, preterm labor, and preterm birth. We conducted a retrospective cohort study between 1997 and 2011 of gravidas with more than 1 prior cesarean delivery who had a transvaginal ultrasound examination between 24 and 34 weeks for a low-lying placenta or placenta previa. Cervical length was measured from archived images in accordance with national guidelines by a single investigator, who was blinded to outcomes and ultrasound reports. The diagnosis of placental accreta was based on histologic confirmation. For study purposes, preterm birth was defined as less than 36 weeks, and cervical lengths of 3 cm or less were considered short. Standard statistical analyses were used. A total of 125 patients met inclusion criteria. The cohort was divided into patients with (n = 43 [34%]) and without (n = 82 [66%]) placenta accreta and stratified by gestational age at the ultrasound examinations. Women with placenta accreta had shorter cervical length measurements during their 32- to 34-week ultrasound examinations (mean ± SD, 3.23 ± 0.98 versus 3.95 ± 1.0 cm; P accreta had shorter cervical lengths at 32 to 34 weeks than women with a nonadherent low-lying placenta or placenta previa, but this finding did not correlate with a higher risk of vaginal bleeding or preterm labor resulting in preterm birth before 36 weeks. © 2017 by the American Institute of Ultrasound in Medicine.

  18. Chorioallantoic placenta defects in cloned mice

    International Nuclear Information System (INIS)

    Wakisaka-Saito, Noriko; Kohda, Takashi; Inoue, Kimiko; Ogonuki, Narumi; Miki, Hiromi; Hikichi, Takafusa; Mizutani, Eiji; Wakayama, Teruhiko; Kaneko-Ishino, Tomoko; Ogura, Atsuo; Ishino, Fumitoshi

    2006-01-01

    Somatic cell nuclear transfer technology has been applied to produce live clones successfully in several mammalian species, but the success rates are very low. In mice, about half of the nuclear transfer embryos undergo implantation, but very few survive to term. We undertook detailed histological analyses of placentas from cloned mouse embryos generated from cumulus cells at 10.5 dpc of pregnancy, by which stage most clones have terminated their development. At 10.5 dpc, the extraembryonic tissues displayed several defined histological patterns, each reflecting their stage of developmental arrest. The most notable abnormality was the poor development of the spongiotrophoblast layer of diploid cells. This is in contrast to the placental hyperplasia frequently observed in somatic clones at 12.5 dpc or later stages. A variety of structural abnormalities were also observed in the embryos. Both placental and embryonic defects likely contribute to the low success rate of the mouse clones

  19. Morphological aspects of placenta of the Bradypus variegatus Shinz, 1825

    OpenAIRE

    Amorin, Marleyne José Afonso Accyoli Lins; Miglino, Maria Angélica; Amorin Júnior, Adelmar Afonso; Santos, Tatiana Carlesso dos

    2003-01-01

    Estudaram-se os aspectos morfológicos da placenta e das membranas fetais de 03 placentas de bichos-preguiça (Bradypus variegatus), adultas e prenhes, originárias da Zona da Mata do Estado de Pernambuco. Essas estruturas foram obtidas de 03 fêmeas doadas pela Universidade Federal de Pernambuco, das quais duas encontravam-se congeladas e a terceira foi colhida mediante realização de cirurgia cesariana, onde mãe e feto foram preservados. Depois de descongeladas, as placentas foram fixadas em sol...

  20. The role of shear wave elastography in the assessment of placenta previa-accreta.

    Science.gov (United States)

    Alıcı Davutoglu, Ebru; Ariöz Habibi, Hatice; Ozel, Ayşegül; Yuksel, Mehmet Aytac; Adaletli, Ibrahim; Madazlı, Riza

    2018-06-01

    To evaluate the value of shear wave elastography (SWE) in the prediction of morbidly adherent placenta. Forty-three women with normal placental location and 26 women with anteriorly localized placenta previa were recruited for this case-control study. Placental elasticity values in both the groups were determined by SWE imaging. SWE values were higher in the placenta previa group in all regions than in normal localized placentas (p  .05). Placental stiffness is significantly higher in placenta previa than normal localized placentas. However, we could not demonstrate any statistically significant difference in the elasticity values between the placenta previa with and without accreta.

  1. A rare case report of hysterotomy for retained placenta accreta in bicornuate uterus

    OpenAIRE

    Reena Sharma; Amit Gupta; Usha K. Chaudhary; Ajay Sharma; Arvind Kumar

    2015-01-01

    Retained placenta is a common third stage complication. Placenta accreta is due to abnormal invasive placental implantation. Many cases of Post-partum haemorrhage (PPH) are caused by placenta accreta and may lead to peripartum hysterectomy. We here report a case of placenta accreta in a patient following two failed attempts of manual removal of retained placenta followed by conservative management with methotrexate in stable patient. Both attempts were unsuccessful and led to septicaemia, req...

  2. Septic Shock after Conservative Management for Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Ying-Cheng Chiang

    2006-03-01

    Conclusion: At present, there is no consensus about the optimal treatment for placenta accreta. Conservative treatment appears to be an alternative in selected patients, but the complications such as sepsis should be carefully identified and appropriately managed.

  3. Research on human placenta-derived mesenchymal stem cells ...

    African Journals Online (AJOL)

    Research on human placenta-derived mesenchymal stem cells transfected with pIRES2-EGFP-VEGF165 using liposome. ... African Journal of Biotechnology. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue ...

  4. Mitochondrial pathway of apoptosis and related proteins in placenta ...

    African Journals Online (AJOL)

    eclampsia (PE).This study aimed at evaluating the mitochondrial pathway of apoptosis in placenta of pregnant women with pre-eclampsia and correlate it with severity and pregnancy outcome . Apoptosis was assessed by measuring DNA ...

  5. PLACENTA ACCRETA AND THE DEVELOPING WORLD – A REVIEW

    African Journals Online (AJOL)

    2010-12-12

    Dec 12, 2010 ... Conclusion: Optimal treatment of women with placenta accreta requires .... vascular endothelial damage which occurs with aging, .... been described as a potentially easier alternative to ... thereby leading to its necrosis.

  6. Is human placenta proteoglycan remodeling involved in pre-eclampsia?

    OpenAIRE

    Warda, Mohamad; Zhang, Fuming; Radwan, Moustafa; Zhang, Zhenqing; Kim, Nari; Kim, Young Nam; Linhardt, Robert J.; Han, Jin

    2007-01-01

    Impaired placento-fetal communication is a coherent symptom of exaggerated pre-eclampsia. The impact of the cellular expression of different glycosaminoglycans (GAGs) in this event on the placenta in pre-eclampsia is still obscure. This is the first study aimed at discovering the relationship between structural alterations of different sulfated GAGs at the molecular level and the development of pre-eclampsia in inflicted placenta. Sulfated GAGs were isolated and purified from control and pre-...

  7. Vascular corrosion casting of normal and pre-eclamptic placentas.

    Science.gov (United States)

    Yin, Geping; Chen, Ming; Li, Juan; Zhao, Xiaoli; Yang, Shujun; Li, Xiuyun; Yuan, Zheng; Wu, Aifang

    2017-12-01

    Pre-eclampsia is an important cause of maternal and fetal morbidity and mortality that is associated with decreased placental perfusion. In the present study, vascular corrosion casting was used to investigate the differences in structural changes of the fetoplacental vasculature between normal and pre-eclamptic placentas. An improved epoxy resin vascular casting technique was used in the present study. Casting media were infused into 40 normal and 40 pre-eclamptic placentas through umbilical arteries and veins in order to construct three dimensional fetoplacental vasculatures. The number of branches, diameter, morphology and peripheral artery-to-vein ratio were measured for each specimen. The results indicated that the venous system of normal placentas was divided into 5-7 grades of branches and the volume of the vascular bed was 155.5±45.3 ml. In severe pre-eclamptic placentas, the volume was 106.4±36.1 ml, which was significantly lower compared with normal placentas (P<0.01). The venous system of pre-eclamptic placentas was divided into 4-5 grades of branches, which was much more sparse compared with normal placentas. In additions, the diameters of grade 1-3 veins and grade 2-3 arteries were significantly smaller in severe pre-eclampsia (P<0.05). In conclusion, pre-eclamptic placentas displayed a decreased volume of vascular bed, smaller diameters of grade 1-3 veins and grade 2-3 arteries, and an increased peripheral artery-to-vein ratio, which may be a cause of the placental dysfunction during severe pre-eclampsia.

  8. Transplacental transfer of nitrosodimethylamine in perfused human placenta.

    OpenAIRE

    Annola, K.; Heikkinen, A.T.; Partanen, H.; Woodhouse, H.; Segerback, D.; Vahakangas, K.

    2009-01-01

    Nitrosodimethylamine (NDMA) is a carcinogenic compound present in tobacco smoke and food such as cured meat, smoked fish and beer. The O(6)-methylguanine formed in human cord blood in mothers highly exposed to such products implicates NDMA exposure of the fetus. Dual recirculating human placental perfusion was used to get direct evidence of the transplacental transfer of NDMA and DNA adduct formation in perfused human placenta. Eleven placentas from normal full-term pregnancies were collected...

  9. Histopathological, Ultrastructural and Apoptotic Changes in Diabetic Rat Placenta

    Directory of Open Access Journals (Sweden)

    Mehmet Gül

    2015-09-01

    Full Text Available Background: The exchange of substances between mother and fetus via the placenta plays a vital role during development. A number of developmental disorders in the fetus and placenta are observed during diabetic pregnancies. Diabetes, together with placental apoptosis, can lead to developmental and functional disorders. Aims: Histological, ultrastructural and apoptotic changes were investigated in the placenta of streptozotocin (STZ induced diabetic rats. Study Design: Animal experimentation. Methods: In this study, a total of 12 female Wistar Albino rats (control (n=6 and diabetic (n=6 were used. Rats in the diabetic group, following the administration of a single dose of STZ, showed blood glucose levels higher than 200 mg/dL after 72 hours. When pregnancy was detected after the rats were bred, two pieces of placenta and the fetuses were collected on the 20th day of pregnancy by cesarean incision under ketamine/xylazine anesthesia from in four rats from the control and diabetic groups. Placenta tissues were processed for light microscopy and transmission electron microscopy (TEM. Hematoxylin-eosin (HE and periodic acid Schiff-diastase (PAS-D staining for light microscopic and caspase-3 staining for immunohistochemical investigations were performed for each placenta. Electron microscopy was performed on thin sections contrasted with uranyl acetate and lead nitrate. Results: Weight gain in the placenta and fetuses of diabetic rats and thinning of the decidual layer, thickening of the hemal membrane, apoptotic bodies, congestion in intervillous spaces, increased PAS-D staining in decidual cells and caspase-3 immunoreactivity were observed in the diabetic group. After the ultrastructural examination, the apoptotic appearance of the nuclei of trophoblastic cells, edema and intracytoplasmic vacuolization, glycogen accumulation, dilation of the endoplasmic reticulum and myelin figures were observed. In addition, capillary basement membrane thickening

  10. Expression and function of endogenous retroviruses in the placenta.

    Science.gov (United States)

    Denner, Joachim

    2016-01-01

    Although the expression of endogenous retroviruses in the placenta of numerous species was observed a long time ago, their physiological function during gestation was demonstrated only very recently. Expression of retroviral envelope proteins, also called syncytins, in the placenta allows generation of the multinuclear syncytiotrophoblast as an outer cellular layer of the placenta by fusion of the trophoblast cells. This fusion process is crucial for the development of the placenta and for successful pregnancy. It is still unclear whether the immunosuppressive properties of the transmembrane envelope protein of the endogenous retroviruses expressed in the placenta contribute to immunosuppression to prevent the rejection of the semiallotransplant embryo. The presence of placenta cells expressing retroviral envelope proteins surrounded by immune cells deep in the maternal tissue supports an immunosuppressive function. It is important to emphasize that during evolution different species utilized ('enslaved') different endogenous retroviruses and that two or more endogenous retroviruses are involved in placentogenesis in each species. © 2016 APMIS. Published by John Wiley & Sons Ltd.

  11. Embarazo abdominal avanzado con feto vivo: Reporte de un caso y revisión de la literatura

    OpenAIRE

    Gélvez-Téllez, Samuel

    2015-01-01

    Objetivos: describir el caso de una paciente con embarazo abdominal a término y feto vivo, y realizar una revisión de la literatura sobre el diagnóstico y tratamiento, con énfasis en la extracción de la placenta y el uso de metotrexate para el manejo de la placenta residual. Materiales y métodos: se presenta el caso de una paciente con un embarazo abdominal avanzado de 38 semanas y 5 días de gestación, atendida en un hospital público de referencia de mediana complejidad, ubicado en el departa...

  12. Reliability of trans-abdominal ultrasonography in determining exact location of placenta in patients of placenta previa major

    International Nuclear Information System (INIS)

    Zafar, M.; Hayat, N; Gul, U.

    2017-01-01

    Objective: To determine the reliability of trans-abdominal ultrasonographical localization of placenta in cases of placenta previa major, by taking peroperative finding as gold standard. Study Design: Validation study. Place and Duration of Study: Maternity ward, Obstetrics and Gynecology department, Military Hospital Rawalpindi from 2007 to 2008. Patients and Methods: A total of 100 patients fulfilling the inclusion and exclusion criteria were recruited for the study. These patients were admitted to the maternity ward, where trans-abdominal ultrasound was performed, site of the placenta and its relation to the internal os was documented. These patients under went elective cesarean section, during which the site and relation of the placenta to the internal os was confirmed. Results: The mean age of patients was 34.23 +- 6.76 years. Transabdominal ultrasound had a sensitivity of 93.4 percent in localizing major placenta previa while the specificity was 83 percent. Positive predictive value was 94.7 percent, negative predictive value was 80 percent and accuracy 91 percent. Conclusion: Trans-abdominal ultrasound was found highly effective in diagnosing and localizing placenta previa. (author)

  13. Peripartal leukogram in cows with and without retained placenta

    Directory of Open Access Journals (Sweden)

    Lužajić Tijana

    2014-01-01

    Full Text Available The aim of this study was to investigate whether prepartal leukogram in cows with retained placenta could indicate the presence of subclinical systemic inflammatory response before the onset of disease. After calving, sixteen highly pregnant Holstein cows, aged 3 to 9 years, without clinical signs of the disease prior to calving were divided into two groups: the first group (n=9 were animals without retained placenta, or any visible inflammation after birth; the second group (n=7 were cows with retained placenta. Blood was sampled three times before parturition, at intervals of one week, and once 24 hours after birth. The number of total leukocytes, segmented and non segmented neutrophilic granulocytes (NG, lymphocytes and monocytes were determined by standard laboratory techniques. The results have shown that in the group of cows with retained placenta the number of mature neutrophils was slightly elevated in the third, second and last week before calving, and equal number of non segmented neutrophils in regard to the group with no retention. The results have also shown that, in both groups of cows, 24 hours after calving, the number of total leukocytes and the number of segmented neutrophils decreased, but the number of the non segmented neutrophils increased. Based on this, we can conclude that cows with retained placenta had no systemic inflammatory response during three weeks prepartal period, but 24 hours after calving, systemic inflammatory response was documented in all the cows. Moreover, the intensity of inflammatory response in cows with retained placenta was not more pronounced in comparison to cows without retained placenta. [Projekat Ministarstva nauke Republike Srbije, br. 175061

  14. The cervix as a natural tamponade in postpartum hemorrhage caused by placenta previa and placenta previa accreta: a prospective study.

    Science.gov (United States)

    El Gelany, Saad A A; Abdelraheim, Ahmed R; Mohammed, Mo'men M; Gad El-Rab, Mohammed T; Yousef, Ayman M; Ibrahim, Emad M; Khalifa, Eissa M

    2015-11-11

    Placenta previa and placenta accreta carry significant maternal and fetal morbidity and mortality. Several techniques have been described in the literature for controlling massive bleeding associated with placenta previa cesarean sections. The objective of this study was to evaluate the efficacy and safety of the use of the cervix as a natural tamponade in controlling postpartum hemorrhage caused by placenta previa and placenta previa accreta. This prospective study was conducted on 40 pregnant women admitted to our hospital between June 2012 and November 2014. All participating women had one or more previous cesarean deliveries and were diagnosed with placenta previa and/or placenta previa accreta. Significant bleeding from the placental bed during cesarean section was managed by inverting the cervix into the uterine cavity and suturing the anterior and/or the posterior cervical lips into the anterior and/or posterior walls of the lower uterine segment. The technique of cervical inversion described above was successful in stopping the bleeding in 38 out of 40 patients; yielding a success rate of 95%. We resorted to hysterectomy in only two cases (5%). The mean intra-operative blood loss was 1572.5 mL, and the mean number of blood units transfused was 3.1. The mean time needed to perform the technique was 5.4 ± 0.6 min. The complications encountered were as follows: bladder injury in the two patients who underwent hysterectomy and wound infection in one patient. Postoperative fever that responded to antibiotics occurred in 1 patient. The mean duration of the postoperative hospital stay was 3.5 days This technique of using the cervix as a natural tamponade appears to be safe, simple, time-saving and potentially effective method for controlling the severe postpartum hemorrhage (PPH) caused by placenta previa/placenta previa accreta. This technique deserves to be one of the tools in the hands of obstetricians who face the life-threatening hemorrhage of placenta

  15. Differential expression of GPR30 in preeclampsia placenta tissue and normal placenta tissue and its clinical significance

    Directory of Open Access Journals (Sweden)

    Ben-Zhou Feng

    2016-04-01

    Full Text Available Objective: To study the differential expression of GPR30 in preeclampsia placenta tissue and normal placenta tissue and its clinical significance. Methods: Preeclampsia placenta tissue and normal placenta tissue were collected and GPR30 expression levels were detected; human umbilical vein endothelial cells were cultured and processed with GRP30 inhibitor and GRP30 agonist combined with hypoxia-reoxygenation respectively, and cell apoptosis as well as pro-angiogenesis molecule and apoptosis molecule contents were detected. Results: mRNA content and protein content of GRP30 in preeclampsia placenta tissue were significantly lower than those in normal placenta tissue; apoptosis rate of G15 group was significantly higher than that of control group, VEGF and bFGF contents in supernatant were significantly lower than those of control group, and mRNA contents of Bax, Caspase-3 and Caspase-9 in cells were significantly higher than those of control group; apoptosis rate of H/R group was significantly higher than that of control group, VEGF and bFGF contents in supernatant were significantly lower than those of control group, and mRNA contents of Bax, Caspase-3 and Caspase-9 in cells were significantly higher than those of control group; apoptosis rate of G1 group was significantly lower than that of H/R group, VEGF and bFGF contents in supernatant were significantly higher than those of H/R group, and mRNA contents of Bax, Caspase-3 and Caspase-9 in cells were significantly lower than those of H/R group. Conclusions: Low expression of GPR30 in placenta tissue is closely associated with the occurrence of preeclampsia, enhancing GPR function can reduce endothelial cell apoptosis and increase the contents of pro-angiogenesis factors, and it has endothelial protection effect.

  16. Anesthesia for cesarean section in pregnancies complicated by placenta previa

    International Nuclear Information System (INIS)

    Imarengiaye, Charles O.; Osaigbovo, Etinosa P.; Tudjegbe, Sampson O.

    2008-01-01

    Objective was to evaluate the factors affecting the choice of anesthetic technique for cesarean section in women with placenta previa. In this retrospective study, the records of the labor Ward Theatre of the University of Benin Teaching Hospital, Benin City, Nigeria were examined from January 2000 to December 2004 to identify all the women who had cesarean section for placenta previa. The patient's socio-demographic characteristics, type of placenta previa, anesthesia technique, estimated blood loss, maternal and fetal outcomes were recorded. One hundred and twenty-six patients had cesarean section for placenta previa, however, only 81 patients 64.3% were available for analysis. General anesthesia was administered to 52/81 patients 64.2% and 29/81 patients 35.8% received spinal anesthesia. A history of antepartum bleeding was recorded in 61.7% n=50. Of 31 patients without antepartum hemorrhage APH, 15/31 had general anesthesia and 16/31 had spinal anesthesia. The patients who had APH, 37/50 had general anesthesia and 1/50 had spinal anesthesia. There was an increased chance of using general anesthesia and if APH were present p=0.03, odds ratio=3.1, 95% confidence interval=1.2-7.7. Spinal anesthesia may useful in patients with placenta previa. The presence of APH may encourage the use of general anesthesia for cesarean delivery. (author)

  17. Evaluation of placenta in foetal demise and foetal growth restriction.

    Science.gov (United States)

    Ch, Ujwala; Guruvare, Shyamala; Bhat, Sudha S; Rai, Lavanya; Rao, Sugandhi

    2013-11-01

    The study objective was to evaluate the pathological changes of the placenta in foetal death and foetal growth restriction and to find correlation of the findings with clinical causes. Prospective study at a tertiary care hospital. Gross and histopathological examinations of the placentae were carried out in pregnancies with foetal demise (IUD) and Foetal Growth Restriction (FGR). SPSS, version 11.5. Placentae of twenty seven women with foetal demise and of equal number of women with foetal growth restriction were studied. Placental weight was less than 10(th) percentile in 61.5% women in IUD group and in 93% women in the FGR group. Gross examination of placentae showed abnormalities in 12 (44%) women of IUD group and in 16 (59%) women of FGR group. Histopathological abnormalities were observed in 74.1% women of the IUD group and in 66.7% women of FGR group. Placental histopathology correlated with clinical risk factors in 60% women of IUD group and in 40% women of FGR group. Among the women with no clinically explainable cause for IUD and FGR, 86% and 57% had placental histopathological abnormalities respectively. The histopathological abnormalities of the placenta can be used to document the clinical causes of foetal demise and growth restriction; it may explain the causes in cases of clinically unexplained foetal demise and foetal growth restriction.

  18. Ultrasound predictors of placental invasion: the Placenta Accreta Index.

    Science.gov (United States)

    Rac, Martha W F; Dashe, Jodi S; Wells, C Edward; Moschos, Elysia; McIntire, Donald D; Twickler, Diane M

    2015-03-01

    We sought to apply a standardized evaluation of ultrasound parameters for the prediction of placental invasion in a high-risk population. This was a retrospective review of gravidas with ≥1 prior cesarean delivery who received an ultrasound diagnosis of placenta previa or low-lying placenta in the third trimester at our institution from 1997 through 2011. Sonographic images were reviewed by an investigator blinded to pregnancy outcome and sonography reports. Parameters assessed included loss of retroplacental clear zone, irregularity and width of uterine-bladder interface, smallest myometrial thickness, presence of lacunar spaces, and bridging vessels. Diagnosis of placental invasion was based on histologic confirmation. Statistical analyses were performed using linear logistic regression and multiparametric analyses to generate a predictive equation evaluated using a receiver operating characteristic curve. Of 184 gravidas who met inclusion criteria, 54 (29%) had invasion confirmed on hysterectomy specimen. All sonographic parameters were associated with placental invasion (P placental location, yielded an area under the curve of 0.87 (95% confidence interval, 0.80-0.95). Using logistic regression, a predictive equation was generated, termed the "Placenta Accreta Index." Each parameter was weighted to create a 9-point scale in which a score of 0-9 provided a probability of invasion that ranged from 2-96%, respectively. Assignment of the Placenta Accreta Index may be helpful in predicting individual patient risk for morbidly adherent placenta. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Fertility and obstetric outcome after conservative management of placenta accreta.

    Science.gov (United States)

    Provansal, Magali; Courbiere, Blandine; Agostini, Aubert; D'Ercole, Claude; Boubli, Léon; Bretelle, Florence

    2010-05-01

    To determine the fertility and obstetric outcomes after conservative management of placenta accreta. A retrospective observational cohort study of all identified cases of placenta accreta from 1993 to 2007 in 2 tertiary university hospitals in France. For patients treated conservatively, maternal and fetal morbidity, reproductive function, fertility, and subsequent pregnancies were recorded. During the study period, 46 patients were treated by conservative management; 6 patients underwent a secondary hysterectomy. Of the remaining 40 patients, 35 were followed up for a median of 65 months (range 18-156 months). Patients resumed their menstrual cycles after a median of 130 days (range 48-176 days). Menses were irregular in 11 patients (31%), but none had amenorrhea. Twelve of the 14 patients desiring another pregnancy achieved a total of 15 pregnancies; 2 patients had recurrent placenta accreta. Five spontaneous abortions and 1 termination of pregnancy occurred during the first trimester. The median term at delivery was 37 weeks (range, 35-40 weeks). Four patients delivered prematurely. Conservative management of placenta accreta can preserve fertility, although the risk of recurrent placenta accreta appears to be high. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  20. Induced abortion and placenta complications in the subsequent pregnancy

    DEFF Research Database (Denmark)

    Zhou, Wei Jin; Nielsen, Gunnar Lauge; Larsen, Helle

    2001-01-01

    Background. To study the risk of placenta complications following an induced abortion as a function of the interpregnancy interval. Methods. This study is based on three Danish national registries; the Medical Birth Registry, the Hospital Discharge Registry, and the Induced Abortion Registry. All...... primigravida women from 1980 to 1982 were identified in these three registries. A total of 15,727 women who terminated the pregnancy with a first trimester induced abortion were selected to the abortion cohort, and 46,026 women who did not terminate the pregnancy with an induced abortion constituted...... or the Medical Birth Registry records. Results. A slightly higher risk of placenta complications following an abortion was found. Retained placenta occurred more frequently in women with one, two or more previous abortions, compared with women without any previous abortion of similar gravidity. Adjusting...

  1. A Case of Placenta Increta Mimicking Submucous Leiomyoma

    Directory of Open Access Journals (Sweden)

    Ali Ekiz

    2014-01-01

    Full Text Available In recent years with the increase in cesarean section rates, the frequency of placenta accreta cases rises. It causes 33–50% of all emergency peripartum hysterectomies. We present a 42-year-old case who was caught with early postpartum hemorrhage due to retained placental products. The ultrasonography showed a 65 × 84 mm mass in the uterine cavity after the delivery. Due to presence of early postpartum hemorrhage which needs transfusion, an intervention decision was made. The patient underwent curettage but the mass could not be removed so that placental retention was ruled out. Submucous leiomyoma was made as first-prediagnosis. Hysterectomy operation was performed as a curative treatment. Placenta increta diagnosis was made as a final diagnosis with pathological examination. As a result, placental attachment disorders may be overlooked if it is not a placenta previa case.

  2. Ultrasound detection of placenta accreta in the first trimester of pregnancy

    OpenAIRE

    Fatemeh Rahimi-Sharbaf; Ashraf Jamal; Elaheh Mesdaghinia; Masoumeh Abedzadeh- Kalahroudi; Shirin Niroomanesh; Fatemeh Atoof

    2014-01-01

    Background: Placenta accreta is considered a life-threatening condition and the main cause of maternal mortality. Prenatal diagnosis of placenta accreta usually is made by clinical presentation, imaging studies like ultrasound and MRI in the second and third trimester. Objective: To determine accuracy of ultrasound findings for placenta accreta in the first trimester of pregnancy. Materials and Methods: In a longitudinal study 323 high risk patients for placenta accreta were assessed. The eli...

  3. Scaling of the surface vasculature on the human placenta

    Science.gov (United States)

    Leonard, A. S.; Lee, J.; Schubert, D.; Croen, L. A.; Fallin, M. D.; Newschaffer, C. J.; Walker, C. K.; Salafia, C. M.; Morgan, S. P.; Vvedensky, D. D.

    2017-10-01

    The networks of veins and arteries on the chorionic plate of the human placenta are analyzed in terms of Voronoi cells derived from these networks. Two groups of placentas from the United States are studied: a population cohort with no prescreening, and a cohort from newborns with an elevated risk of developing autistic spectrum disorder. Scaled distributions of the Voronoi cell areas in the two cohorts collapse onto a single distribution, indicating common mechanisms for the formation of the complete vasculatures, but which have different levels of activity in the two cohorts.

  4. Characterization and partial purification of phospholipase D from human placenta

    DEFF Research Database (Denmark)

    Vinggaard, Anne Marie; Hansen, Harald S.

    1995-01-01

    We report the existence in the human placenta of a phosphatidylcholine- hydrolyzing phospholipase D (PLD) activity, which has been characterized and partially purified. Triton X-100 effectively solubilized PLD from the particulate fraction of human placenta in a dose-dependent manner. However......, Triton X-100 caused decreasing enzyme activities. Maximum transphosphatidylation was obtained with 2% ethanol. The enzyme was found to have a pH optimum of 7.0-7.5 and an apparent K(m) of 33 mol% (or 0.8 mM). Ca and Mg was not required for the enzyme activity. Addition of phosphatidyl-4,5-bisphosphate...

  5. A 3D co-culture microtissue model of the human placenta for nanotoxicity assessment

    DEFF Research Database (Denmark)

    Muoth, Carina; Wichser, Adrian; Monopoli, Marco

    2016-01-01

    and functionality of the placental tissue. The effects of NPs on the human placenta are not well studied or understood, and predictive in vitro placenta models to achieve mechanistic insights on NP-placenta interactions are essentially lacking. Using the scaffold-free hanging drop technology, we developed a well...

  6. [The conservative treatment of placenta accreta. A clinical case report].

    Science.gov (United States)

    Artuso, A; Rocchi, B; Garbo, S; Baudino, G; Repetti, F

    1993-09-01

    The following description is a clinical case of placenta accreta and its conservative treatment. According to some authors, abnormal adhesion of the placenta depends on the alteration of the equilibrium between the trophoblastic tissue invasion and the reaction of the decidua. Consequently we have various degrees of penetration of the myometrium by chorionic villi into areas of deficit, sparse or absent decidua. Whatever the pathogenetic mechanism, the final clinical picture is slight to deep penetration of the trophoblastic tissue into the uterine wall. That causes absence of the normal plane of cleavage between placenta and maternal decidua, no spontaneous placental detachment during the third stage of labour and no possible manual removal. The patient, primigravida, was admitted at the 36th Week of gestation with PROM and physiologically delivered a neonate weighing 1820 g, after she spontaneously began labour. The newborn was admitted in the neonatal-pathology ward because it was premature although the Apgar score at 1-5 minutes after birth was 5-9. Placental ejection was awaited for 1 hour, then manual exploration of the uterine cavity was undertaken. The normal plane of cleavage between placental tissue and decidua was absent and therefore manual extraction of the placenta was impossible. Surgery was stopped and, after informed consensus was obtained from the patient, a conservative treatment was tried. After cutting the umbilical cord as short as possible and checking for vaginal bleeding, the patient was moved to obstetrics ward.(ABSTRACT TRUNCATED AT 250 WORDS)

  7. Placenta as a source of hematopoietic stem cells

    NARCIS (Netherlands)

    E.A. Dzierzak (Elaine); C. Robin (Catherine)

    2010-01-01

    textabstractThe placenta is a large, highly vascularised hematopoietic tissue that functions during the embryonic and foetal development of eutherian mammals. Although recognised as the interface tissue important in the exchange of oxygen, nutrients and waste products between the foetus and mother,

  8. Placenta accreta: MRI antenatal diagnosis and surgical correlation.

    Science.gov (United States)

    Ha, T P; Li, K C

    1998-01-01

    We describe a case of a placenta previa accreta that was diagnosed antenatally by MRI with subsequent surgical confirmation. We show the advantages of ultrafast MRI single shot (SS) fast spin echo (FSE) techniques for accurate diagnosis with minimal scan time and fetal motion artifacts.

  9. Histopathological Study of Placentae in Low Birth Weight Babies in ...

    African Journals Online (AJOL)

    Histopathological Study of Placentae in Low Birth Weight Babies in India. JS Nigam, V Misra, P Singh, PA Singh, S Chauhan, B Thakur. Abstract. Background: The antenatal health-care given to pregnant women has great influence on the rates of perinatal death and morbidity. Amongst the different causes of perinatal ...

  10. Can venous ProBNP levels predict placenta accreta?

    Science.gov (United States)

    Ersoy, Ali Ozgur; Oztas, Efser; Ozler, Sibel; Ersoy, Ebru; Erkenekli, Kudret; Uygur, Dilek; Caglar, Ali Turhan; Danisman, Nuri

    2016-12-01

    Placenta previa (PP) is a potential life-threatening pregnancy complication. Pro-brain natriuretic peptide (ProBNP), creatine kinase (CK), cardiac form of CK (CK-MB) and Troponin I are circulatory biomarkers related to cardiac functions. We aimed to determine whether these biomarkers are related to PP and placenta accreta. In this case-control study, fifty-four pregnant women who attended our tertiary care center for perinatology with the diagnosis of PP totalis, and of them, 14 patients with placenta accreta were recruited as the study groups. Forty-six uncomplicated control patients who were matched for age, BMI were also included. Maternal venous ProBNP, CK, CK-MB and Troponin I levels were compared between the three groups. Obstetric history characteristics were comparable among groups, generally. CK and CK-MB levels were similar among three groups. Troponin I levels in the previa and accreta groups were significantly higher than the controls. ProBNP levels in the accreta group were significantly higher than other two groups. The multivariate regression model revealed that ProBNP could predict placental adhesion anomalies. Troponin I and ProBNP levels in PP cases were higher than controls and ProBNP could predict placenta accreta.

  11. Placenta Praevia: Incidence, Risk Factors, Maternal and Fetal ...

    African Journals Online (AJOL)

    Maternal complications included post-partum anaemia, postpartum haemorrhage & operative site infection. There were two maternal deaths (1.48%) and the perinatal mortality rate was 18.7%. Conclusion: The incidence of Placenta praevia was relatively high and associated with high maternal and perinatal complications.

  12. Nitrate Promotes Capsaicin Accumulation in Capsicum chinense Immobilized Placentas

    Directory of Open Access Journals (Sweden)

    Jeanny G. Aldana-Iuit

    2015-01-01

    Full Text Available In chili pepper’s pods, placental tissue is responsible for the synthesis of capsaicinoids (CAPs, the compounds behind their typical hot flavor or pungency, which are synthesized from phenylalanine and branched amino acids. Placental tissue sections from Habanero peppers (Capsicum chinense Jacq. were immobilized in a calcium alginate matrix and cultured in vitro, either continuously for 28 days or during two 14-day subculture periods. Immobilized placental tissue remained viable and metabolically active for up to 21 days, indicating its ability to interact with media components. CAPs contents abruptly decreased during the first 7 days in culture, probably due to structural damage to the placenta as revealed by scanning electron microcopy. CAPs levels remained low throughout the entire culture period, even though a slight recovery was noted in subcultured placentas. However, doubling the medium’s nitrate content (from 40 to 80 mM resulted in an important increment, reaching values similar to those of intact pod’s placentas. These data suggest that isolated pepper placentas cultured in vitro remain metabolically active and are capable of metabolizing inorganic nitrogen sources, first into amino acids and, then, channeling them to CAP synthesis.

  13. Management Outcomes of Abruptio Placentae at Nnamdi Azikiwe ...

    African Journals Online (AJOL)

    BACKGROUND: The objective of this study is to determine incidence, risk factors and management outcomes of abruptio placentae (AP) and comparing them with cases without AP who delivered within the same period. METHODS: A 10 year retrospective study of AP managed at Nnamdi Azikiwe University Teaching ...

  14. Risk factors for severe abruptio placenta in Mulago Hospital ...

    African Journals Online (AJOL)

    They were followed up and compared to five hundred women (controls) who had normal deliveries. Outcome variables: Socio-demographic characteristics, familial history, medical history, gynaecological and obstetric history. Results: The risk factors for severe abruptio placenta were low socio economic status (OR 10.5 ...

  15. Histopathological Study of Placentae in Low Birth Weight Babies in ...

    African Journals Online (AJOL)

    Chi‑square test with or without yate's correction was used as and when required. P < 0.05 was taken as .... For fixation, the placenta was cut into the multiple longitudinal slices of on-2 cm and kept ..... Source of Support: Nil. Conflict of Interest: ...

  16. [Histopathological changes in human placentas related to hypertensive disorders].

    Science.gov (United States)

    Artico, Luciano Guimarães; Madi, José Mauro; Godoy, Alessandra Eifler Guerra; Coelho, Celso Piccoli; Rombaldi, Renato Luís; Artico, Graziela Rech

    2009-01-01

    to determine the prevalence of histopathological changes, in human placentas, related to hypertensive syndromes. a transversal study that compares histopathological changes identified in 43 placentae from hypertensive pregnant women (HypPr), with the ones from 33 placentae from normotensive pregnant women (NorPr). The weight, volume and macroscopic and microscopic occurrence of infarctions, clots, hematomas, atherosis (partial obliteration, thickness of layers and presence of blood vessels hyalinization) and Tenney-Parker changes (absent, discreet and prominent), as well as the locating of infarctions and clots (central, peripheral or the association of both) have been analyzed. The chi2 and t Student tests have been used for the statistical analysis, as well as medians, standard deviations and ratios. It has been considered as significant, p<0.05. the macroscopic study of HypPr placentae have presented lower weight (461.1 versus 572.1 g) and volume (437.4 versus 542.0 cm(3)), higher infarction (51.2 versus 45.5%; p<0.05: OR=1.15) and clots (51.2 versus 15.1%; p<0.05; OR=5.4) ratios, as compared to the NorPr's. In the HypPr and NorPr, microscopic clots have occurred in 83.7 versus 45.5% (p<0.05; OR=4.3), respectively. Atherosis and Tenney-Parker changes have been statistically associated to the hypertensive syndromes (p<0.05). the obtained data allow us to associate lower placentary weight and volume, higher ratio of macro and microscopic infarction, clots, atherosis and Tenney-Parker changes to placentae of gestations occurring with hypertensive syndromes.

  17. Creatine biosynthesis and transport by the term human placenta.

    Science.gov (United States)

    Ellery, Stacey J; Della Gatta, Paul A; Bruce, Clinton R; Kowalski, Greg M; Davies-Tuck, Miranda; Mockler, Joanne C; Murthi, Padma; Walker, David W; Snow, Rod J; Dickinson, Hayley

    2017-04-01

    Creatine is an amino acid derivative that is involved in preserving ATP homeostasis. Previous studies suggest an important role for the creatine kinase circuit for placental ATP turnover. Creatine is obtained from both the diet and endogenous synthesis, usually along the renal-hepatic axis. However, some tissues with a high-energy demand have an inherent capacity to synthesise creatine. In this study, we determined if the term human placenta has the enzymatic machinary to synthesise creatine. Eleven placentae were collected following elective term caesarean section. Samples from the 4 quadrants of each placenta were either fixed in formalin or frozen. qPCR was used to determine the mRNA expression of the creatine synthesising enzymes arginine:glycine amidinotransferase (AGAT) and guanidinoacetate methyltransferase (GAMT), and the creatine transporter (SLC6A8). Protein expression of AGAT and GAMT was quantified by Western blot, and observations of cell localisation of AGAT, GAMT and SLC6A8 made with immunohistochemistry. Synthesis of guanidinoacetate (GAA; creatine precursor) and creatine in placental homogenates was determined via GC-MS and HPLC, respectively. AGAT, GAMT and SLC6A8 mRNA and protein were detected in the human placenta. AGAT staining was identified in stromal and endothelial cells of the fetal capillaries. GAMT and SLC6A8 staining was localised to the syncytiotrophoblast of the fetal villi. Ex vivo, tissue homogenates produce both GAA (4.6 nmol mg protein -1 h -1 ) and creatine (52.8 nmol mg protein -1 h -1 ). The term human placenta has the capacity to synthesise creatine. These data present a new understanding of placental energy metabolism. Copyright © 2017 Elsevier Ltd. All rights reserved.

  18. Cesarean scar pregnancy and early placenta accreta share common histology.

    Science.gov (United States)

    Timor-Tritsch, I E; Monteagudo, A; Cali, G; Palacios-Jaraquemada, J M; Maymon, R; Arslan, A A; Patil, N; Popiolek, D; Mittal, K R

    2014-04-01

    To determine, by evaluation of histological slides, images and descriptions of early (second-trimester) placenta accreta (EPA) and placental implantation in cases of Cesarean scar pregnancy (CSP), whether these are pathologically indistinguishable and whether they both represent different stages in the disease continuum leading to morbidly adherent placenta in the third trimester. The database of a previously published review of CSP and EPA was used to identify articles with histopathological descriptions and electronic images for pathological review. When possible, microscopic slides and/or paraffin blocks were obtained from the original researchers. We also included from our own institutions cases of CSP and EPA for which pathology specimens were available. Two pathologists examined all the material independently and, blinded to each other's findings, provided a pathological diagnosis based on microscopic appearance. Interobserver agreement in diagnosis was determined. Forty articles were identified, which included 31 cases of CSP and 13 cases of EPA containing histopathological descriptions and/or images of the pathology. We additionally included six cases of CSP and eight cases of EPA from our own institutions, giving a total of 58 cases available for histological evaluation (37 CSP and 21 EPA) containing clear definitions of morbidly adherent placenta. In the 29 cases for which images/slides were available for histopathological evaluation, both pathologists attested to the various degrees of myometrial and/or scar tissue invasion by placental villi with scant or no intervening decidua, consistent with the classic definition of morbidly adherent placenta. Based on the reviewed material, cases with a diagnosis of EPA and those with a diagnosis of CSP showed identical histopathological features. Interobserver correlation was high (kappa = 0.93). EPA and placental implantation in CSP are histopathologically indistinguishable and may represent different stages in

  19. Complement inhibitory proteins expression in placentas of thrombophilic women Complement inhibitory proteins expression in placentas of thrombophilic women

    Directory of Open Access Journals (Sweden)

    Przemysław Krzysztof Wirstlein

    2012-10-01

    Full Text Available Factors controlling complement activation appear to exert a protective effect on pregnancy. This is
    particularly important in women with thrombophilia. The aim of this study was to determine the transcript and
    protein levels of complement decay-accelerating factor (DAF and membrane cofactor protein (MCP in the
    placentas of women with acquired and inherited thrombophilia. Also, we assessed immunohistochemistry staining
    of inhibitors of the complement cascade, DAF and MCP proteins, in the placentas of thrombophilic women.
    Placentas were collected from eight women with inherited thrombophilia and ten with acquired thrombophilia.
    The levels of DAF and MCP transcripts were evaluated by qPCR, the protein level was evaluated by Western
    blot. We observed a higher transcript (p < 0.05 and protein (p < 0.001 levels of DAF and MCP in the placentas
    of thrombophilic women than in the control group. DAF and MCP were localized on villous syncytiotrophoblast
    membranes, but the assessment of staining in all groups did not differ. The observed higher expression level of
    proteins that control activation of complement control proteins is only seemingly contradictory to the changes
    observed for example in the antiphospholipid syndrome. However, given the hitherto known biochemical changes
    associated with thrombophilia, a mechanism in which increased expression of DAF and MCP in the placentas is
    an effect of proinflammatory cytokines, which accompanies thrombophilia, is probable.Factors controlling complement activation appear to exert a protective effect on pregnancy. This is
    particularly important in women with thrombophilia. The aim of this study was to determine the transcript and
    protein levels of complement decay-accelerating factor (DAF and membrane cofactor protein (MCP in the
    placentas of women with acquired and inherited thrombophilia. Also, we assessed immunohistochemistry

  20. Antioxidative Defense Enzymes in Placenta Protect Placenta and Fetus in Inherited Thrombophilia from Hydrogen Peroxide

    Directory of Open Access Journals (Sweden)

    Jelena Bogdanovic Pristov

    2009-01-01

    Full Text Available Our aim was to investigate the activities of antioxidative defense enzymes in the placenta, fetal blood and amnion fluid in inherited thrombophilia. Thrombophilia was associated with nearly threefold increase of activity (p < 0.001 of the placental catalase (81.1 ± 20.6 U/mg of proteins in controls and 270.0 ± 69.9 U/mg in thrombophilic subjects, glutathione (GSH peroxidase (C: 20.2 ± 10.1 U/mg; T: 60.0 ± 15.5 U/mg, and GSH reductase (C: 28.9 ± 5.6 U/mg; T: 72.7 ± 23.0 U/mg. The placental activities of superoxide dismutating enzymes—MnSOD and CuZnSOD, did not differ in controls and thrombophilia. Likewise, the activities of catalase and SOD in the fetal blood, and the level of ascorbyl radical which represents a marker of oxidative status of amniotic fluid, were similar in controls and thrombophilic subjects. From this we concluded that in thrombophilia, placental tissue is exposed to H2O2-mediated oxidative stress, which could be initiated by pro-thrombic conditions in maternal blood. Increased activity of placental H2O2-removing enzymes protects fetus and mother during pregnancy, but may increase the risk of postpartum thrombosis.

  1. Localización inmunocitoquímica de la hormona gonadotropina corionica en la placenta humana y en celulas tumorales

    Directory of Open Access Journals (Sweden)

    Geranina Escovar V.

    1982-06-01

    Full Text Available Mediante el uso de los métodos de peroxidasa anti-peroxidasa e inmunofluorescencia aplicada a tejidos desparafinados y tratados con tripsina, se estudiaron inmunocitoquímicamente un grupo de placentas y tumores malignos. Al utilizar anticuerpos anti-GCH, la hormona gonadotropina coriónica humana (GCH fue localizada en células del sincitiotrofoblasto de placentas de diferentes estados de desarrollo, se encontró, además, que las c6lulas de Langhan's y del citotrofoblasto fueron negativas a la inmuno-reacción. La mayoría de los tumores estudiados fueron encontrados positivos al aplicar los métodos mencionados. Se postula que la inmunosupresión selectiva del huésped por tumores y la inmunosupresión selectiva de tejidos maternos por tejidos fetales. podría estar mediada por la hormona gonadotropina coriónica.

  2. Placenta Maps: In Utero Placental Health Assessment of the Human Fetus.

    Science.gov (United States)

    Miao, Haichao; Mistelbauer, Gabriel; Karimov, Alexey; Alansary, Amir; Davidson, Alice; Lloyd, David F A; Damodaram, Mellisa; Story, Lisa; Hutter, Jana; Hajnal, Joseph V; Rutherford, Mary; Preim, Bernhard; Kainz, Bernhard; Groller, M Eduard

    2017-06-01

    The human placenta is essential for the supply of the fetus. To monitor the fetal development, imaging data is acquired using (US). Although it is currently the gold-standard in fetal imaging, it might not capture certain abnormalities of the placenta. (MRI) is a safe alternative for the in utero examination while acquiring the fetus data in higher detail. Nevertheless, there is currently no established procedure for assessing the condition of the placenta and consequently the fetal health. Due to maternal respiration and inherent movements of the fetus during examination, a quantitative assessment of the placenta requires fetal motion compensation, precise placenta segmentation and a standardized visualization, which are challenging tasks. Utilizing advanced motion compensation and automatic segmentation methods to extract the highly versatile shape of the placenta, we introduce a novel visualization technique that presents the fetal and maternal side of the placenta in a standardized way. Our approach enables physicians to explore the placenta even in utero. This establishes the basis for a comparative assessment of multiple placentas to analyze possible pathologic arrangements and to support the research and understanding of this vital organ. Additionally, we propose a three-dimensional structure-aware surface slicing technique in order to explore relevant regions inside the placenta. Finally, to survey the applicability of our approach, we consulted clinical experts in prenatal diagnostics and imaging. We received mainly positive feedback, especially the applicability of our technique for research purposes was appreciated.

  3. Placenta previa; MRI as an adjunct to ultrasound in assessment of suspected placental invasion

    Directory of Open Access Journals (Sweden)

    Asmaa M. Abdel Magied

    2018-03-01

    Full Text Available Objective: Evaluate adding MRI to ultrasound in imaging of placenta previa with suspected placenta accreta. Patients and methods: evaluation of 23 pregnant females presenting with placenta previa was done. The age ranged from 20 to 39 years (mean = 30.9. All of the patients were subjected to ultrasonography (US and magnetic resonance imaging (MRI of the pelvis at gestational age of 25–37 weeks prior to elective delivery. Results: 11 out of 23 patients were proved placenta accreta based on surgical and pathological reports. US suggested diagnosis of placenta previa/accreta in 8 patients and placenta previa without accreta in 15 cases. 7/8 was true positive (87.5% & one was false positive (12.5% with sensitivity 63.64%, accuracy 78.26%, and specificity 91.67%. MRI has suggested diagnosis of placenta previa/accreta in 8/23 & placenta previa with no accreta in 15/23 patients. MRI was found to give true positive results in 8/8 patients proved to be accreta. MRI gave true negative in 12 patients (80% & false negative in 3 (20% with sensitivity 72.73%, accuracy 86.96%, and specificity 100%. Conclusion: Combining MRI and ultra sound provide more diagnostic information and may reduce unnecessary interventions with favorable outcome. Keywords: Ultra sound, MRI, Placenta previa, Placenta accreta

  4. Estudio inmunohistoquímico de moléculas de adhesión en placentas de niños de bajo peso al nacer en el Hospital Universidad del Norte, Barranquilla (Colombia

    Directory of Open Access Journals (Sweden)

    Luz Alba Silvera Arenas

    2014-01-01

    Full Text Available Objetivo: Observar la expresión de moléculas de adhesión VCAM-1, ICAM-1 en placentas de niños de bajo peso al nacer. Se estudiaron 21 placentas de pacientes atendidas en el Hospital Universidad del Norte en el periodo de mayo a diciembre de 2006. Materiales y métodos: Se realizó estudio macroscópico de las placentas: forma, peso, diámetro grosor, consistencia, color, olor. Para estudios microscópicos se realizaron 5 cortes de la placa corial, uno del rollo de membrana y otro del cordón umbilical. Los cortes fueron fijados en formol al 10 %, incluidos en parafina, coloreados con hematoxilia - eosina para estudios morfológicos. Para estudios inmunohistoquímicos se usaron anticuerpos monoclonales Nova Castra para ICAM-1, VCAM-1, macrófagos. Resultados: Dieciocho placentas de forma redonda, 3 ovaladas; el peso varió entre 240 - 400 gramos; 3 presentaron infarto en los cotiledones. En la micro 18 presentaron necrosis hialina de la media, hiperplasia de la intima, macrófagos xantomatosos, infiltrado linfocitario en tres. En la inmunohistoquímica se observó expresión de ICAM-1, VCAM-1, en la basal de las vellosidades coriales, en la basal de los vasos sanguíneos y macrófagos en el estroma conjuntivo Conclusiones: En dieciocho de los casos los cambios fueron compatibles con preeclampsia, tres con proceso virales. La expresión de moléculas de adhesión y macrófago en la inmunohistoquímica nos sugiere que estas moléculas son fundamentales en los proceso fisiopatológicos de la placenta.

  5. Scintigraphy of the Placenta With {sup 113m}In

    Energy Technology Data Exchange (ETDEWEB)

    Lewitus, Z.; Lubin, E.; Rechnic, J.; Laor, J.; Eckerling, E. [Beilinson Medical Centre, University of Tel Aviv School of Medicine (Israel)

    1969-05-15

    The paper describes the merits of using {sup 113m}In in scintigraphic placental localization. The {sup 113m}In, generated from a commercial {sup 113}Sn cow, eluted with 0.05N HC1, stabilized with gelatin at pH 4.0 and autoclaved in the carrier-free form, becomes bound to the plasma proteins after being injected intravenously and stays in the vascular system long enough to enable scanning of the placental blood pools. The short physical half-life and the decay by isomeric transition reduces the radiation dose compared with other scanning agents. The minimal elimination of the molecule into the bladder during scanning has the advantage over the use of {sup 99m}Tc because it diminishes the possible confusion of activity in this area with a low-lying placenta. The placentography has been found of value in the diagnosis of placenta praevia, twins and hydatidiform mole. (author)

  6. Gene expression profiling of placentas affected by pre-eclampsia

    DEFF Research Database (Denmark)

    Hoegh, Anne Mette; Borup, Rehannah; Nielsen, Finn Cilius

    2010-01-01

    Several studies point to the placenta as the primary cause of pre-eclampsia. Our objective was to identify placental genes that may contribute to the development of pre-eclampsia. RNA was purified from tissue biopsies from eleven pre-eclamptic placentas and eighteen normal controls. Messenger RNA...... expression from pooled samples was analysed by microarrays. Verification of the expression of selected genes was performed using real-time PCR. A surprisingly low number of genes (21 out of 15,000) were identified as differentially expressed. Among these were genes not previously associated with pre-eclampsia...... as bradykinin B1 receptor and a 14-3-3 protein, but also genes that have already been connected with pre-eclampsia, for example, inhibin beta A subunit and leptin. A low number of genes were repeatedly identified as differentially expressed, because they may represent the endpoint of a cascade of events...

  7. Trophoblast cells of ruminant placentas - A mini review

    International Nuclear Information System (INIS)

    Igwebuike, U.M.

    2004-09-01

    Understanding of ruminant placental structure and function is essential for veterinarians and researchers. The ruminant placenta is classified as cotyledonary and synepitheliochorial on the bases of its gross anatomical features and histological characteristics respectively. The richly vascularized embryonic chorioallantois is lined on its outer surface by cells of the trophectodermal epithelium. These cells which assume specialized functions are referred to as trophoblast cells. Two morphologically and functionally distinct cell types have been recognized in the trophectoderm of the placenta of ruminant animals. These are the mononucleate trophoblast cells and the binucleate trophoblast cells. The occurrence, morphological characteristics, and specialized functions of these trophoblast cells, in relation to conceptus nutrition and survival in utero are discussed in this review. (author)

  8. From Placenta to Polycystic Ovarian Syndrome: The Role of Adipokines

    Directory of Open Access Journals (Sweden)

    Chiara Sartori

    2016-01-01

    Full Text Available Adipokines are cytokines produced mainly by adipose tissue, besides many other tissues such as placenta, ovaries, peripheral-blood mononuclear cells, liver, muscle, kidney, heart, and bone marrow. Adipokines play a significant role in the metabolic syndrome and in cardiovascular diseases, have implications in regulating insulin sensitivity and inflammation, and have significant effects on growth and reproductive function. The objective of this review was to analyze the functions known today of adiponectin, leptin, resistin, and visfatin from placenta throughout childhood and adolescence. It is well known now that their serum concentrations during pregnancy and lactation have long-term effects beyond the fetus and newborn. With regard to puberty, adipokines are involved in the regulation of the relationship between nutritional status and normal physiology or disorders of puberty and altered gonadal function, as, for example, premature pubarche and polycystic ovarian syndrome (PCOS. Cytokines are involved in the maturation of oocytes and in the regular progression of puberty and pregnancy.

  9. The human placenta--an alternative for studying foetal exposure

    DEFF Research Database (Denmark)

    Myren, Maja; Mose, Tina; Mathiesen, Line

    2007-01-01

    Pregnant women are daily exposed to a wide selection of foreign substances. Sources are as different as lifestyle factors (smoking, daily care products, alcohol consumption, etc.), maternal medication or occupational/environmental exposures. The placenta provides the link between mother and foetus......, and though its main task is to act as a barrier and transport nutrients and oxygen to the foetus, many foreign compounds are transported across the placenta to some degree and may therefore influence the unborn child. Foetal exposures to environmental and medicinal products may have impact on the growth...... of the foetus (e.g. cigarette smoke) and development of the foetal organs (e.g. methylmercury and thalidomide). The scope of this review is to give insight to the placental anatomy, development and function. Furthermore, the compounds physical properties and the transfer mechanism across the placental barrier...

  10. Placenta-derived exosomes: potential biomarkers of preeclampsia

    Directory of Open Access Journals (Sweden)

    Pillay P

    2017-10-01

    Full Text Available Preenan Pillay,1,2 Kogi Moodley,1 Jagidesa Moodley,3 Irene Mackraj3 1Discipline of Human Physiology, Nelson R Mandela School of Medicine, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa; 2Pearson Institute of Higher Education, Midrand, South Africa; 3Women’s Health and HIV Research Group, Nelson R Mandela School of Medicine, School of Laboratory Medicine and Medical Sciences, University of KwaZulu-Natal, Durban, South Africa Abstract: Preeclampsia remains a leading cause of maternal and fetal mortality, due to ineffective treatment and diagnostic strategies, compounded by the lack of clarity on the etiology of the disorder. Although several clinical and biological markers of preeclampsia have been evaluated, they have proven to be ineffective in providing a definitive diagnosis during the various stages of the disorder. Exosomes have emerged as ideal biomarkers of pathological states, such as cancer, and have more recently gained interest in pregnancy-related complications, due to their role in cellular communication in normal and complicated pregnancies. This occurs as a result of the specific placenta-derived exosomal molecular cargo, which may be involved in normal pregnancy-associated immunological events, such as the maintenance of maternal–fetal tolerance. This review provides perspectives on placenta-derived exosomes as possible biomarkers for the diagnosis/prognosis of preeclampsia. Using keywords, online databases were searched to identify relevant publications to review the potential use of placenta-derived exosomes as biomarkers of preeclampsia. Keywords: placenta-derived exosomes, preeclampsia, biomarkers

  11. Changes in mitochondrial respiration in the human placenta over gestation.

    Science.gov (United States)

    Holland, Olivia J; Hickey, Anthony J R; Alvsaker, Anna; Moran, Stephanie; Hedges, Christopher; Chamley, Lawrence W; Perkins, Anthony V

    2017-09-01

    Placental mitochondria are subjected to micro-environmental changes throughout gestation, in particular large variations in oxygen. How placental mitochondrial respiration adapts to changing oxygen concentrations remains unexplored. Additionally, placental tissue is often studied in culture; however, the effect of culture on placental mitochondria is unclear. Placental tissue was obtained from first trimester and term (laboured and non-laboured) pregnancies, and selectively permeabilized to access mitochondria. Respirometry was used to compare respiration states and substrate use in mitochondria. Additionally, explants of placental tissue were cultured for four, 12, 24, 48, or 96 h and respiration measured. Mitochondrial respiration decreased at 11 weeks compared to earlier gestations (p = 0.05-0.001), and mitochondrial content increased at 12-13 weeks compared to 7-10 weeks (p = 0.042). In term placentae, oxidative phosphorylation (OXPHOS) through mitochondrial complex IV (p Respiration was increased (p ≤ 0.006-0.001) in laboured compared to non-laboured placenta. After four hours of culture, respiration was depressed compared to fresh tissue from the same placenta and continued to decline with time in culture. Markers of apoptosis were increased, while markers of autophagy, mitochondrial biogenesis, and mitochondrial membrane potential were decreased after four hours of culture. Respiration and mitochondrial content alter over gestation/with labour. Decreased respiration at 11 weeks and increased mitochondrial content at 12-13 weeks may relate to onset of maternal blood flow, and increased respiration as a result of labour may be an adaptation to ischaemia-reperfusion. At term, mitochondria were more susceptible to changes in respiratory function relative to first trimester when cultured in vitro, perhaps reflecting changes in metabolic demands as gestation progresses. Metabolic plasticity of placental mitochondria has relevance to placenta

  12. Risk factors for placenta praevia presenting with severe vaginal ...

    African Journals Online (AJOL)

    Results: Significant predictors for severe bleeding in parturients with placenta praevia were: previous history of evacuation of the uterus or dilation and curettage (O.R. 3.6, CI: 1.1-12.5), delivery by caesarean section in previous pregnancy (O.R. 19.9, CI: 6.4-61.7), residing more than ten kilometres from Mulago hospital (O.R. ...

  13. Maternal outcome after conservative management of abnormally invasive placenta

    Directory of Open Access Journals (Sweden)

    Hsiu-Wei Su

    2017-06-01

    Conclusion: In this small series, we observed a low successful uterine preservation rate and a high maternal complication rate. We recommend that primary cesarean hysterectomy should be used as the treatment of choice for mild to severe abnormally invasive placenta. Conservative management should be reserved for women with a strong fertility desire and women with extensive disease that precludes primary hysterectomy due to surgical difficulty.

  14. Pregnancy Complicated with Maternal Pulmonary Hypertension and Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Jeng-Hsiu Hung

    2007-06-01

    Full Text Available Pregnancy is contraindicated in cases of maternal pulmonary hypertension, a highly morbid disease affecting young women of childbearing age. The rate of heart failure increases gradually with the severity of pulmonary hypertension. In certain instances, the severity of maternal pulmonary hypertension in rheumatic heart diseases can be higher than in congenital heart diseases. Placenta accreta is an important cause of bleeding in the second half of pregnancy and in labor. In severe cases, hysterectomy is the only way to manage the bleeding during cesarean section. A 33-year-old gravida, G2P0AA1, suffering from rheumatic heart disease with mitral valve stenosis and pulmonary hypertension, was referred to our high-risk pregnancy center at 10+3 weeks of gestation due to lower abdominal pain and brownish vaginal bleeding. She had received 2 mitral valve replacements in Shenzhen, China, at the ages of 22 and 26, respectively. Ultrasound scan of the abdomen at 12+2 gestational weeks showed that the internal cervix was completely covered with the placenta, and a retroplacental hypoechoic space measuring 35 × 13 mm was observed at the upper posterior margin of the placenta. On color Doppler scan, an area of lacunar lake flow was observed in the hypoechoic space of the placenta and a spiral artery with low blood flow resistance was detected. The pulsation of the placental flow was synchronized with the maternal pulse rate. Team specialists, including neonatologists, pulmonary physicians, pediatric cardiologists, hema-tologists, anesthesiologists, psychiatrists and social workers, as well as high-risk obstetricians were consulted in an effort to minimize fetal and maternal morbidity and mortality. At 29+2 weeks, the patient developed preeclampsia and delivered a healthy newborn by cesarean section, the uterus being preserved by square compression sutures. The gravida tolerated the procedures and was discharged in stable condition.

  15. Human Placenta Extract Therapy for Feline Hepatic Lipidosis

    OpenAIRE

    2018-01-01

    Feline hepatic lipidosis (HL), the most common hepatobiliary disease in cats, is characterized by the accumulation of excessive triglycerides (TGs) in more than 80% of hepatocytes. Forced oral feeding is recommended as the only therapy for this disease but the prognosis is often poor. As human placenta extract (Laennec) has been used to improve hepatic metabolism, we investigated the efficacy of this drug for the treatment of cats with HL. Ten cats diagnosed with HL in this study were treated...

  16. Placenta-derived exosomes: potential biomarkers of preeclampsia.

    Science.gov (United States)

    Pillay, Preenan; Moodley, Kogi; Moodley, Jagidesa; Mackraj, Irene

    2017-01-01

    Preeclampsia remains a leading cause of maternal and fetal mortality, due to ineffective treatment and diagnostic strategies, compounded by the lack of clarity on the etiology of the disorder. Although several clinical and biological markers of preeclampsia have been evaluated, they have proven to be ineffective in providing a definitive diagnosis during the various stages of the disorder. Exosomes have emerged as ideal biomarkers of pathological states, such as cancer, and have more recently gained interest in pregnancy-related complications, due to their role in cellular communication in normal and complicated pregnancies. This occurs as a result of the specific placenta-derived exosomal molecular cargo, which may be involved in normal pregnancy-associated immunological events, such as the maintenance of maternal-fetal tolerance. This review provides perspectives on placenta-derived exosomes as possible biomarkers for the diagnosis/prognosis of preeclampsia. Using keywords, online databases were searched to identify relevant publications to review the potential use of placenta-derived exosomes as biomarkers of preeclampsia.

  17. Branchial placenta in the viviparous teleost Ilyodon whitei (Goodeidae).

    Science.gov (United States)

    Uribe, Mari Carmen; De la Rosa-Cruz, Gabino; García-Alarcón, Adriana

    2014-12-01

    Intraluminal gestation, as it occurs in viviparous goodeids, allows a wide diversity of embryo-maternal metabolic exchanges. The branchial placenta occurs in embryos developing in intraluminal gestation when ovarian folds enter through the operculum, into the branchial chamber. The maternal ovarian folds may extend to the embryonic pharyngeal cavity. A branchial placenta has been observed in few viviparous teleosts, and there are not previous histological analyses. This study analysis the histological structure in the goodeid Ilyodon whitei. The moterno ovarian folds extend through the embryonic operculum and reach near the gills, occupying part of the branchial chamber. These folds extend also into the pharyngeal cavity. In some regions, the epithelia of the ovarian folds and embryo were in apposition, developing a placental structure in which, maternal and embryonic capillaries lie in close proximity. The maternal epithelium has desquamated cells which may enter through the branchial chamber to the pharyngeal cavity and the alimentary tract. The complex processes that occur in the ovaries of viviparous teleosts, and its diverse adaptations for viviparity, as the presence of branchial placenta, are relevant in the study of the evolution of vertebrate viviparity. © 2014 Wiley Periodicals, Inc.

  18. Management of Amniotic Sheet with a Hammock-like Placenta

    Directory of Open Access Journals (Sweden)

    Liangcheng Wang

    2016-09-01

    Full Text Available An amniotic sheet is a septation in the amniotic cavity with a perforation that allows amniotic fluid to pass through. Although the incidence of abnormal placental implantation is higher in such cases, the management recommendations remain unclear. We report a case of an amniotic sheet with a hammock-like placenta located in the center of the uterine cavity. A 25-year-old woman with a history of two dilation and curettage procedures was found to have an amniotic cavity separated by a septum that contained part of the placenta. At gestational Week 32, magnetic resonance images revealed that the placenta was attached from the anterior to posterior uterine walls and resembled a hammock hanging in the center of the uterus. Subsequently, continuous intravenous administration of ritodrine hydrochloride and magnesium sulfate were given. The pregnancy was extended to Week 36. Elective cesarean section was performed, and a 3212-g female infant was delivered. Thus, owing to the risk of umbilical cord complications and placental injury secondary to premature rupture of membranes, aggressive and careful perinatal management is required in such cases.

  19. Caesium transfer to placenta, urine and human milk

    International Nuclear Information System (INIS)

    Risica, S.; Rogani, A.; Tancredi, F.; Grisanti, A.; Grisanti, G.; Baronciani, D.; Del Prete, A.; Zanini, R.

    1997-01-01

    After the Chernobyl accident few measurements on radioactive contamination of maternal milk, placenta and urine of nursing mothers were carried out. Two previous studies on breast milk contamination were conducted in different Italian areas by the Physics Department of the National Institute of Health (Laboratorio di Fisica, Istituto Superiore di Sanita). In the first study conducted in collaboration with the Epidemiological Unit of the Lazio District, I-131, Cs-134 and Cs-137 concentrations were measured in mixed breast milk samples pooled from 5-10 women in the first week after delivery, from May 1986 to December 1987, in the Rome area. The second research was conducted, in collaboration with the Lecco Hospital, in 1989 on a group of women living in the Como Lake area (Lombardia), which was one of the areas of Northern Italy most heavily affected by Chernobyl fallout, because of intensive rainfall in the first few days after the accident. The specific diet and caesium content in maternal milk were studied recruiting pregnant women at the ''respiratory autogen training'' course. In this case, Cs-l37, Cs-134 and K-40 concentration in placenta and urine of the mothers under study had also been measured. Aim of this paper is to discuss these data and investigate the relationship between Cs-137 contamination of maternal milk, placenta and urine as a contribution to a better understanding of caesium metabolism in pregnant and nursing women

  20. Risk factors for unscheduled delivery in patients with placenta accreta.

    Science.gov (United States)

    Bowman, Zachary S; Manuck, Tracy A; Eller, Alexandra G; Simons, Marilee; Silver, Robert M

    2014-03-01

    Patients with suspected placenta accreta have improved outcomes with scheduled delivery. Our objective was to identify risk factors for unscheduled delivery in patients with suspected placenta accreta. This was a cohort study of women with antenatally suspected placenta accreta. Women who delivered prior to a planned delivery date were compared with women who had a scheduled delivery. Data were analyzed using a Student t test, χ(2), logistic regression, and survival analyses. Variables included in the analyses were episodes of antenatal vaginal bleeding, preterm premature rupture of membranes (PPROM), uterine contractions, prior cesarean deliveries, interpregnancy interval, parity, and patient demographic factors. A value of P accreta were identified. Thirty-eight (49.4%) had an unscheduled delivery. Demographics were similar between groups. Unscheduled patients delivered earlier (mean 32.3 vs 35.7 weeks, P accreta, those with antenatal vaginal bleeding were more likely to require unscheduled delivery. This risk increases further in the setting of PPROM and/or uterine contractions. These clinical factors should be considered when determining the optimal delivery gestational age for women with placental accreta. Copyright © 2014 Mosby, Inc. All rights reserved.

  1. Sclerotherapy with 6% polidocanol solution in patients with placenta accreta.

    Science.gov (United States)

    Malagón Reyes, Ricardo Mauricio; Castorena de Ávila, Rubén; Ángeles Vázquez, María de Jesús; Núñez Monteagudo, César Augusto; Mendieta Zerón, Hugo

    2016-10-01

    Placenta accreta is one of the main obstetrical complications worldwide. The aim of this study was to report the experience of managing placenta accreta with a 6% polidocanol solution sclerotherapy. We selected patients between 37 weeks of gestation and 38 weeks of gestation, diagnosed with placenta accreta, treated at the Maternal Perinatal Hospital "Monica Pretelini Sáenz", Toluca, Mexico, during the period from November 2013 to August 2014. The surgical technique has two steps: (1) fundic-arciform caesarean section followed by a 6% polidocanol sclerosing solution through a 6Fr neonatal feeding tube upon its reaching the placental bed; (2) total abdominal hysterectomy with internal hypogastric artery ligation. Data were collected from 11 patients with a mean age of 33.9 years (range, 26-42 years) and 2.8±0.6 days of hospitalization in the obstetrical intensive care unit. The majority of patients were classified as having pregnancies at an advanced age. All women were multigravidas. Bleeding volume exhibited a range between 2.5 L and 3 L without any case of neonatal death but one mother died because of coagulopathy. We conclude that the technique that we are reporting is feasible for implementation in obstetric hospitals, with technical and economic feasibility. Copyright © 2016. Published by Elsevier B.V.

  2. Modeling the variability of shapes of a human placenta.

    Science.gov (United States)

    Yampolsky, M; Salafia, C M; Shlakhter, O; Haas, D; Eucker, B; Thorp, J

    2008-09-01

    Placentas are generally round/oval in shape, but "irregular" shapes are common. In the Collaborative Perinatal Project data, irregular shapes were associated with lower birth weight for placental weight, suggesting variably shaped placentas have altered function. (I) Using a 3D one-parameter model of placental vascular growth based on Diffusion Limited Aggregation (an accepted model for generating highly branched fractals), models were run with a branching density growth parameter either fixed or perturbed at either 5-7% or 50% of model growth. (II) In a data set with detailed measures of 1207 placental perimeters, radial standard deviations of placental shapes were calculated from the umbilical cord insertion, and from the centroid of the shape (a biologically arbitrary point). These two were compared to the difference between the observed scaling exponent and the Kleiber scaling exponent (0.75), considered optimal for vascular fractal transport systems. Spearman's rank correlation considered pcentroid) was associated with differences from the Kleiber exponent (p=0.006). A dynamical DLA model recapitulates multilobate and "star" placental shapes via changing fractal branching density. We suggest that (1) irregular placental outlines reflect deformation of the underlying placental fractal vascular network, (2) such irregularities in placental outline indicate sub-optimal branching structure of the vascular tree, and (3) this accounts for the lower birth weight observed in non-round/oval placentas in the Collaborative Perinatal Project.

  3. NATOMICAL ASPECTS OF THE PLACENTA FROM ZEBU CATTLE RAISED IN THE ORIENTAL AMAZONIAN, BRAZIL ASPECTOS ANATÓMICOS DE LA PLACENTA DE ZEBUÍNOS CREADO EN EL AMAZÔNIA DEL ESTE ASPECTOS ANATÔMICOS DA PLACENTA DE ZEBUÍNOS CRIADOS NA AMAZÔNIA ORIENTAL, BRASIL.

    Directory of Open Access Journals (Sweden)

    Tânia Vasconcelos Cavalcante

    2009-04-01

    morphological characteristics from zebuine cattle from Oriental Amazonian region are similar to those found in zebu from other places with different climate and environment, so the placenta does not seem to be influenced by the ambient.

    KEY WORDS: Placentome, umbilical cord, uterus, Zebu cow.

    Los bóvidos de los zebuínas de las razas son mayoría del brasilen@o de los ganados debido a su rusticidade, alto funcionamiento reproductivo, gran adaptabilidad al clima tropical, resistencia y dirección fácil. El conocimiento perfecto del ciclo reproductivo estos animales pasa obligatorio para la evaluación anatómica de las agencias de la reproducción, en varones, y las hembras, de modo que los problemas observados de tal manera del punto de vista económico, como reproductiva, puedan adecuadamente estar, tratadas y diagnosised. Así, el trabajo tiene como objetivo para analizar las características anatómicas macrocospic de la placenta de los bóvidos, Indicus del tauro de Bos creado en la región del este de Amazônia que lleva con una perfil de éstos para las multitudes regionales guardadas en Amazonian las condiciones ambiente y climáticas. Los úteros de Gravídicos en diversos períodos del entrenamiento de la gestación (los 4 8 meses de vacas habían sido cebú recogido. Cada parte fue lavada en agua actual y el ligamento intercornual fue dividido, rompiéndose encima de los cornos uterinos.  Una sección dorsal a través del cérvix fue convertida fullfilled hasta el cuerpo del útero. Así, las membranas de los fetais habían sido exhibidas y habían sido perforateed quitando los líquidos y los fetais del embrión. La pieza fue invertida para la realización de la colección de referir datos a las características morfológicas. En el 10% seguido fueron fijados en la solución del formol, para el dissecação posterior. Para la

  4. Assessment of total placenta previa by magnetic resonance imaging and ultrasonography to detect placenta accreta and its variants.

    Science.gov (United States)

    Peker, Nuri; Turan, Volkan; Ergenoglu, Mete; Yeniel, Ozgur; Sever, Ahmet; Kazandi, Mert; Zekioglu, Osman

    2013-03-01

    To evaluate the importance of ultrasonography (US) and magnetic resonance imaging (MRI) in detecting placental adherence defects. Patients diagnozed with total placenta previa (n = 40) in whom hysterectomy was performed due to placental adherence defects (n = 20) or in whom the placenta detached spontaneously after a Cesarean delivery (n = 20) were included into the study between June 2008 and January 2011, at the Department of Obstetrics and Gynecology Ege University (lzmir Turkey). Gray-scale US was used to check for any placental lacunae, sub-placental sonolucent spaces or a placental mass invading the vesicouterine plane and bladder Intra-placental lacunar turbulent blood flow and an increase in vascularization in the vesicouterine plane were evaluated with color Doppler mode. Subsequently all patients had MRI and the results were compared with the histopathologic examinations. The sensitivity of MRI for diagnosis of placental adherence defects before the operation was 95%, with a specificity of 95%. In the presence of at least one diagnostic criterion, the sensitivity and specificity of US were 87.5% and 100% respectively, while the sensitivity of color Doppler US was 62.5% with a specificity of 100%. Currently MRI appears to be the gold standard for the diagnosis of placenta accreta. None of the ultrasonographic criteria is solely sufficient to diagnose placental adherence defects, however they assist in the diagnostic process.

  5. Real increasing incidence of hysterectomy for placenta accreta following previous caesarean section.

    LENUS (Irish Health Repository)

    Higgins, Mary F

    2013-11-01

    Placenta accreta, morbid adherence to the uterus to the myometrium, is commonest in association with placenta previa in women previously delivered by caesarean section (CS). It has become proportionally a greater cause of major maternal morbidity and mortality as the frequency of other serious obstetric complications has declined. The aim of this study was to examine the incidence of placenta accreta in the context of a rising caesarean delivery rate.

  6. Placenta accreta located in the posterior wall of the uterus: a case report

    OpenAIRE

    Ozler, Sibel; Oztas, Efser; Kadioglu, Nezaket; Sirvan, Levent; Uzunlar, Ozlem; Caglar, Turhan

    2016-01-01

    Abnormal invasive implantation of the placenta is thought to occur as a result of the defect in the decidua basalis of the women who have a history of cesarean delivery. Massive obstetric hemorrhage incidence is increased in placenta accreta cases. Although ultrasonographic and doppler examinations, and magnetic resonance imaging (MRI) are widely used, the diagnosis of placenta accreta in the early pregnancy weeks is poor. Therefore, the presence of life-threatening vaginal bleeding in the ea...

  7. Relationship between first trimester aneuploidy screening test serum analytes and placenta accreta.

    Science.gov (United States)

    Büke, Barış; Akkaya, Hatice; Demir, Sibel; Sağol, Sermet; Şimşek, Deniz; Başol, Güneş; Barutçuoğlu, Burcu

    2018-01-01

    The aim of this study is to determine whether there is a relationship between first trimester serum pregnancy-associated plasma protein A (PAPP-A) and free beta human chorionic gonadotropin (fβhCG) MoM values and placenta accreta in women who had placenta previa. A total of 88 patients with placenta previa who had first trimester aneuploidy screening test results were enrolled in the study. Nineteen of these patients were also diagnosed with placenta accreta. As probable markers of excessive placental invasion, serum PAPP-A and fβhCG MoM values were compared in two groups with and without placenta accreta. Patients with placenta accreta had higher statistically significant serum PAPP-A (1.20 versus 0.865, respectively, p = 0.045) and fβhCG MoM (1.42 versus 0.93, respectively, p = 0.042) values than patients without accreta. Higher first trimester serum PAPP-A and fβhCG MoM values seem to be associated with placenta accreta in women with placenta previa. Further studies are needed to use these promising additional tools for early detection of placenta accreta.

  8. Placenta accreta: pathogenesis of a 20th century iatrogenic uterine disease.

    Science.gov (United States)

    Jauniaux, E; Jurkovic, D

    2012-04-01

    Placenta accreta refers to different grades of abnormal placental attachment to the uterine wall, which are characterised by invasion of trophoblast into the myometrium. Placenta accreta has only been described and studied by pathologists for less than a century. The fact that the first detailed description of a placenta accreta happened within a couple of decades of major changes in the caesarean surgical techniques is highly suggestive of a direct relationship between prior uterine surgery and abnormal placenta adherence. Several concepts have been proposed to explain the abnormal placentation in placenta accreta including a primary defect of the trophoblast function, a secondary basalis defect due to a failure of normal decidualization and more recently an abnormal vascularisation and tissue oxygenation of the scar area. The vast majority of placenta accreta are found in women presenting with a previous history of caesarean section and a placenta praevia. Recent epidemiological studies have also found that the strongest risk factor for placenta praevia is a prior caesarean section suggesting that a failure of decidualization in the area of a previous uterine scar can have an impact on both implantation and placentation. Ultrasound studies of uterine caesarean section scar have shown that large and deep myometrial defects are often associated with absence of re-epithelialisation of the scar area. These findings support the concept of a primary deciduo-myometrium defect in placenta accreta, exposing the myometrium and its vasculature below the junctional zone to the migrating trophoblast. The loss of this normal plane of cleavage and the excessive vascular remodelling of the radial and arcuate arteries can explain the in-vivo findings and the clinical consequence of placenta accreta. Overall these data support the concept that abnormal decidualization and trophoblastic changes of the placental bed in placenta accreta are secondary to the uterine scar and thus

  9. Androgen receptor and histone lysine demethylases in ovine placenta.

    Directory of Open Access Journals (Sweden)

    Ellane R Cleys

    Full Text Available Sex steroid hormones regulate developmental programming in many tissues, including programming gene expression during prenatal development. While estradiol is known to regulate placentation, little is known about the role of testosterone and androgen signaling in placental development despite the fact that testosterone rises in maternal circulation during pregnancy and in placenta-induced pregnancy disorders. We investigated the role of testosterone in placental gene expression, and focused on androgen receptor (AR. Prenatal androgenization decreased global DNA methylation in gestational day 90 placentomes, and increased placental expression of AR as well as genes involved in epigenetic regulation, angiogenesis, and growth. As AR complexes with histone lysine demethylases (KDMs to regulate AR target genes in human cancers, we also investigated if the same mechanism is present in the ovine placenta. AR co-immunoprecipitated with KDM1A and KDM4D in sheep placentomes, and AR-KDM1A complexes were recruited to a half-site for androgen response element (ARE in the promoter region of VEGFA. Androgenized ewes also had increased cotyledonary VEGFA. Finally, in human first trimester placental samples KDM1A and KDM4D immunolocalized to the syncytiotrophoblast, with nuclear KDM1A and KDM4D immunostaining also present in the villous stroma. In conclusion, placental androgen signaling, possibly through AR-KDM complex recruitment to AREs, regulates placental VEGFA expression. AR and KDMs are also present in first trimester human placenta. Androgens appear to be an important regulator of trophoblast differentiation and placental development, and aberrant androgen signaling may contribute to the development of placental disorders.

  10. Transplacental pharmacokinetics of diclofenac in perfused human placenta.

    Science.gov (United States)

    Shintaku, Kyohei; Hori, Satoko; Tsujimoto, Masayuki; Nagata, Hideaki; Satoh, Shoji; Tsukimori, Kiyomi; Nakano, Hitoo; Fujii, Tomoyuki; Taketani, Yuji; Ohtani, Hisakazu; Sawada, Yasufumi

    2009-05-01

    The aims of this study were to evaluate the transplacental transfer properties of diclofenac and to determine the effect of L-lactic acid on the transplacental transfer of diclofenac. The maternal and fetal vessels of human placenta were perfused in a single-pass mode with a solution containing diclofenac and antipyrine. The transplacental pharmacokinetic model was fitted to the time profiles of the drug concentrations in the effluent and placenta to obtain transplacental pharmacokinetic parameters. In addition, chloride ion in the perfusate was partially replaced with L-lactic acid to see the change in the transplacental transfer properties of diclofenac. The TPT(ss) value (ratio of the rate of amount transferred across the placenta to that infused in the steady state) of diclofenac was 2.22%, which was approximately one-third that of antipyrine and was significantly reduced in the presence of L-lactic acid. The transplacental pharmacokinetic model could adequately explain the transplacental transfer of diclofenac with influx clearances from maternal and fetal perfusates to placental tissue of 0.276 and 0.0345 ml/min/g cotyledon and efflux rate constants from placental tissue to maternal and fetal perfusates of 0.406 and 0.0337 min(-1), respectively. By taking into account protein binding, the placental tissue/plasma concentration ratio in humans for diclofenac was estimated to be 0.108 ml/g of cotyledon and was smaller than that of antipyrine. In conclusion, human placental perfusion and transplacental pharmacokinetic modeling allowed us to determine the transplacental transfer properties of diclofenac quantitatively. Diclofenac may share transplacental transfer system(s) with L-lactic acid.

  11. Developmental peculiarities in placentae of ovine uniparental conceptuses.

    Directory of Open Access Journals (Sweden)

    Roberta Arena

    Full Text Available Genomic imprinting is an epigenetic phenomenon regulating mono-allelic expression of genes depending on their parental origin. Defective genomic imprinting is involved in several placental disorders, such as intrauterine growth restriction and pre-eclampsia. Uniparental embryos, having maternal-only or paternal-only genomes (parthenogenotes [PAR] and androgenotes [AND], respectively, are useful models to study placentation. The aim of this work was to reveal the effect of parental genome (maternal and paternal on placentation. To do this, uniparental (AND and PAR and biparental (CTR in vitro produced sheep embryos transferred to recipient females were collected at day 20 of pregnancy and their placentae were analyzed. qPCR analysis showed that imprinted genes (H19, IGF2R and DLK1 were expressed accordingly to their parental origin while the expression f DNA methyltransferases ( was disregulated, especially in PAR (P < 0.05. AND placentae were significantly hypomethylated compared to both PAR and CTR (P = 0.023. Chorion-allantoid of AND showed impaired development of vessels and reduced mRNA expression of vasculogenetic factors (ANG2 P = 0.05; VEGFR2 P< 0.001; TIE2 P < 0.001. Morphologically, PAR placentae were characterized by abnormal structure of the trophoectodermal epithelium and reduced total number (P<0.03 of Trophoblastic Binucleate Cells. A reduced implantation rate of both classes of uniparental embryos (P<0.03 was also noted. Our results provide new insights into the characterization of uniparental embryos and demonstrate the complementary role of parental genomes for the correct establishment of pregnancy. Thus, our findings may suggest new targets to improve our understanding of the origin of imprinting-related placental dysfunction.

  12. Mineral deficiency predisposes occurrence of retention of placenta in crossbred

    Directory of Open Access Journals (Sweden)

    S. K. Sheetal

    2014-12-01

    Full Text Available Aim: The present study was carried out to investigate the relationship between blood serum concentrations of macro and micro minerals and development of retention of placenta (ROP in crossbred cattle. Materials and Methods: The present study was carried out at Instructional Livestock Farm, Bihar Veterinary College and local Khatals in and around Patna. A total of 20 crossbred cattle (n=10 with normal expulsion of the placenta as control and n=10 with ROP were selected in the present study. Blood samples were collected from these animals and serum was separated and stored in the deep freezer at −20°C till further analysis. The estimation of serum macro-minerals (Ca, P, Ca/P ratio was done by Span diagnostic Kits (Surat, India and trace minerals or micro-minerals (Zn, Cu, and Fe were analyzed by atomic absorption spectrophotometer (Perkin Elmer AAS 220. Mean values were compared between both the groups at 0 h (at parturition and 12 h after parturition. Results: The mean values of serum calcium and zinc were found significantly lower in cattle having ROP than control at both 0 h and 12 h after parturition. The mean values of serum Ca and P ratio obtained at 0 hour were significantly lower in ROP groups as compared to control groups and non-significant at 12 h. The mean values of serum inorganic phosphorus, copper and iron was found non-significantly lower in ROP cases as compared to control. Conclusions: Macro and micro mineral deficiency such as calcium, iron, zinc and copper in blood serum may be predisposing factor for the occurrence of retention of placenta in crossbred cattle.

  13. Landscape of transcriptional deregulations in the preeclamptic placenta.

    Directory of Open Access Journals (Sweden)

    Daniel Vaiman

    Full Text Available Preeclampsia is a pregnancy disease affecting 5 to 8% of pregnant women and a leading cause of both maternal and fetal mortality and morbidity. Because of a default in the process of implantation, the placenta of preeclamptic women undergoes insufficient vascularization. This results in placental ischemia, inflammation and subsequent release of placental debris and vasoactive factors in the maternal circulation causing a systemic endothelial activation. Several microarray studies have analyzed the transcriptome of the preeclamptic placentas to identify genes which could be involved in placental dysfunction. In this study, we compared the data from publicly available microarray analyses to obtain a consensus list of modified genes. This allowed to identify consistently modified genes in the preeclamptic placenta. Of these, 67 were up-regulated and 31 down-regulated. Assuming that changes in the transcription level of co-expressed genes may result from the coordinated action of a limited number of transcription factors, we looked for over-represented putative transcription factor binding sites in the promoters of these genes. Indeed, we found that the promoters of up-regulated genes are enriched in putative binding sites for NFkB, CREB, ANRT, REEB1, SP1, and AP-2. In the promoters of down-regulated genes, the most prevalent putative binding sites are those of MZF-1, NFYA, E2F1 and MEF2A. These transcriptions factors are known to regulate specific biological pathways such as cell responses to inflammation, hypoxia, DNA damage and proliferation. We discuss here the molecular mechanisms of action of these transcription factors and how they can be related to the placental dysfunction in the context of preeclampsia.

  14. Accuracy of ultrasound for the prediction of placenta accreta.

    Science.gov (United States)

    Bowman, Zachary S; Eller, Alexandra G; Kennedy, Anne M; Richards, Douglas S; Winter, Thomas C; Woodward, Paula J; Silver, Robert M

    2014-08-01

    Ultrasound has been reported to be greater than 90% sensitive for the diagnosis of accreta. Prior studies may be subject to bias because of single expert observers, suspicion for accreta, and knowledge of risk factors. We aimed to assess the accuracy of ultrasound for the prediction of accreta. Patients with accreta at a single academic center were matched to patients with placenta previa, but no accreta, by year of delivery. Ultrasound studies with views of the placenta were collected, deidentified, blinded to clinical history, and placed in random sequence. Six investigators prospectively interpreted each study for the presence of accreta and findings reported to be associated with its diagnosis. Sensitivity, specificity, positive predictive, negative predictive value, and accuracy were calculated. Characteristics of accurate findings were compared using univariate and multivariate analyses. Six investigators examined 229 ultrasound studies from 55 patients with accreta and 56 controls for 1374 independent observations. 1205/1374 (87.7% overall, 90% controls, 84.9% cases) studies were given a diagnosis. There were 371 (27.0%) true positives; 81 (5.9%) false positives; 533 (38.8%) true negatives, 220 (16.0%) false negatives, and 169 (12.3%) with uncertain diagnosis. Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 53.5%, 88.0%, 82.1%, 64.8%, and 64.8%, respectively. In multivariate analysis, true positives were more likely to have placental lacunae (odds ratio [OR], 1.5; 95% confidence interval [CI], 1.4-1.6), loss of retroplacental clear space (OR, 2.4; 95% CI, 1.1-4.9), or abnormalities on color Doppler (OR, 2.1; 95% CI, 1.8-2.4). Ultrasound for the prediction of placenta accreta may not be as sensitive as previously described. Copyright © 2014 Mosby, Inc. All rights reserved.

  15. The placenta as a compensatory iodine storage organ.

    LENUS (Irish Health Repository)

    Burns, Robert

    2011-05-01

    The production of iodine-containing thyroid hormones necessary for brain development in the fetus depends not only on maternal dietary intake but also on placental iodine transport. The optimum level of iodine nutrition during pregnancy and the proportion of the pregnant population reaching this level have previously been evaluated. Little information exists on the ability of the placenta to either accumulate or store iodine. This study aims to investigate iodine uptake and tissue iodine content within placental tissue obtained from women delivering at term.

  16. Human placenta secretes apolipoprotein B-100-containing lipoproteins

    DEFF Research Database (Denmark)

    Munk-Madsen, Eva; Lindegaard, Marie Louise Skakkebæk; Andersen, Claus B

    2004-01-01

    Supply of lipids from the mother is essential for fetal growth and development. In mice, disruption of yolk sac cell secretion of apolipoprotein (apo) B-containing lipoproteins results in embryonic lethality. In humans, the yolk sac is vestigial. Nutritional functions are instead established very...... lipoproteins secreted from placental tissue showed spherical particles with a diameter of 47 +/- 10 nm. These results demonstrate that human placenta expresses both apoB and MTP and consequently synthesize and secrete apoB-100-containing lipoproteins. Placental lipoprotein formation constitutes a novel pathway...

  17. Gestational diabetes insipidus: a morphological study of the placenta.

    Science.gov (United States)

    Castiglione, F; Buccoliero, A M; Garbini, F; Gheri, C F; Moncini, D; Poggi, G; Saladino, V; Rossi Degl'Innocenti, D; Gheri, R G; Taddei, G L

    2009-12-01

    Gestational diabetes insipidus (GDI) refers to the state of excessive water intake and hypotonic polyuria. Those cases manifesting in pregnancy and referred to as GDI may persist thereafter or may be a transient latent form that resolves after delivery. Microscopic examination of affected subjects has not been previously reported. In the literature, there are various case reports and case series on diabetes insipidus in pregnancy. In this study, we present a case that had transient diabetes insipidus during pregnancy in which the placenta was examined.

  18. The role of prenatal alcohol exposure in abruptio placentae | du Toit ...

    African Journals Online (AJOL)

    Objective. To investigate the association between preconception and prenatal alcohol use and abruptio placentae. Methods. A case-control study of women with the clinical diagnosis of abruptio placentae, 65 cases and 66 controls, at Tygerberg Academic Hospital, Western Cape, South Africa. Women in whom a ...

  19. A genome-wide comparison of mesenchymal stem cells derived from human placenta and umbilical cord

    Directory of Open Access Journals (Sweden)

    Sen-Wen Teng

    2017-10-01

    Conclusion: We identified the consistence and specific DEGs of human placenta and umbilical cord based on the genome-wide comparison. Our results indicated that hMSCs derived from umbilical cord and placenta have different gene expression patterns, and most of specific genes are involved in the cell cycle, cell division, cell death, and cell developmental processes.

  20. Clinics in diagnostic imaging (133). Retained placenta from an intra-abdominal pregnancy.

    Science.gov (United States)

    Win, T; Tang, P H; Lim, T Y

    2011-01-01

    A 29-year-old Indonesian woman presented with abdominal pain seven months after an intra-abdominal pregnancy. Ultrasonography revealed a cystic mass in the pelvis and magnetic resonance imaging showed an umbilical stump within it, indicating a retained placenta. This was removed surgically, and on histology, an infarcted placenta was confirmed.

  1. An appraisal of retained placentae in Ibadan: a five year review ...

    African Journals Online (AJOL)

    During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births. Results: During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were ...

  2. [Placenta accreta: can prenatal diagnosis be performed? Ultrasound and MRI interests. About 27 cases].

    Science.gov (United States)

    Bauwens, J; Coulon, C; Azaïs, H; Bigot, J; Houfflin-Debarge, V

    2014-05-01

    To list ultrasonography signs identified when a placenta accreta is suspected. Secondary objectives are to analyze the relevance of diagnosis with ultrasonography and magnetic resonance imaging, and to know diagnosis circumstances in order to identify main risk factors. We present a monocentric retrospective study. All the cases of placentas accreta, observed from 2005 to 2010 at Lille University Hospital (France), have been included. Twenty-seven patients had a placenta accreta during this period. There was an antenatal suspicion for 22 cases and 21 were confirmed after delivery. Six cases were discovered per-partum. Diagnosis was suspected after metrorrhagia for 41% of women. In case of antenatal diagnosis, 100% of the patients had an anterior placenta praevia and an uterine scare. Fifty percent of the placentas accreta diagnosed per-partum were posterior. The most frequently ultrasonography signs are "intra-placental lacuna" (85.7%), "abnormal vascularization" (71.4%), "loss of normal hypoechoic retroplacental myometrial zone" (66.7%), "irregularity of the vesical wall" (66.7%). Sensibility of ultrasonography screening is 78%. Twenty-one magnetic resonance imaging examinations executed secondarily confirmed the diagnosis in 66.7% of the cases. Ultrasonography is a relevant exam for the diagnosis of placenta accreta. Posterior placenta should not be forsaken. Anterior placenta praevia in multiparous patients with a uterine scare should be a warning. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  3. Gray scale and Doppler ultrasound in placenta accreta: Optimization of ultrasound signs

    Directory of Open Access Journals (Sweden)

    Mohamed Shawky

    2016-09-01

    Conclusion: Ultrasound and Doppler examinations of placenta have signs highly suggestive of placenta accreta due to high sensitivity and specificity with placental lacunae of turbulent flow and retro-placental myometrial thickness ⩽1 mm are of the highest specificity.

  4. Exposure to air pollutants during the early weeks of pregnancy, and placenta praevia and placenta accreta in the western part of Japan.

    Science.gov (United States)

    Michikawa, Takehiro; Morokuma, Seiichi; Yamazaki, Shin; Fukushima, Kotaro; Kato, Kiyoko; Nitta, Hiroshi

    2016-01-01

    Placenta praevia is an obstetric complication involving placental implantation in the lower uterine segment. Given the suggested aetiology of placenta praevia, adverse biological effects of air pollutants, such as plasma viscosity increment, endothelial dysfunction, and systemic inflammation, have the potential to induce low implantation. We explored the association between exposure to air pollutants during the pregnancy period up to implantation, and placenta praevia, in pregnant Japanese women. The outcome also included placenta accreta, which often exists in combination with placenta praevia. From the Japan Perinatal Registry Network database, we obtained data on 40,573 singleton pregnant women in western Japan (Kyushu-Okinawa Districts) between 2005 and 2010. We assigned pollutant concentrations (suspended particulate matter [SPM], ozone, nitrogen dioxide [NO2], and sulphur dioxide [SO2]), measured at the nearest monitoring station to the respective delivery hospital of each woman. A logistic regression model was used to adjust for several covariates. The odds ratios (ORs) of placenta praevia per 10 units increase were 1.12 (95% confidence interval (CI)=1.01-1.23) for SPM over 0-4weeks of gestation, and 1.08 (1.00-1.16) for ozone. The association between exposure to NO2 and SO2, and praevia, was in the direction of increased risk. SPM exposure during 0-4weeks was associated with placenta accreta without praevia (OR=1.33, 95% CI=1.07-1.66). We found no association with exposure to air pollutants during 5-12weeks and the second trimester. Exposure to air pollutants through to implantation was positively associated with placenta praevia and accreta. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Placenta Prévia: Fatores de risco para o Acretismo Placenta Previa: Risk Factors for Accretion

    Directory of Open Access Journals (Sweden)

    Maria Regina Torloni

    2001-08-01

    Full Text Available Objetivo: investigação dos fatores de risco associados ao acretismo em pacientes com placenta prévia (PP. Métodos: foi realizada uma análise retrospectiva caso-controle de todos os prontuários de pacientes com diagnóstico de PP que tiveram seus partos na Maternidade Escola Vila Nova Cachoeirinha (São Paulo entre 1986 e 1998. O grupo com acretismo foi comparado ao grupo sem acretismo quanto à idade, paridade, antecedentes de abortamentos, curetagens e cesarianas, o tipo de PP e a área predominante de inserção placentária. Para avaliar a associação entre a variável dependente (acretismo placentário e as variáveis independentes (características maternas e placentária foram utilizados o teste do chi², análise univariada e multivariada, considerando-se significantes os valores de p Purpose: to investigate risk factors associated with accretion in placenta previa (PP patients. Methods: this was a retrospective case-control study of all the records of patients who delivered between 1986-1998 at Maternidade Escola de Vila Nova Cachoeirinha (São Paulo with a diagnosis of placenta previa. The groups with and without accretion were compared regarding age, parity, previous history of miscarriage, curettage and cesarean section, type of PP and predominant area of placental attachment. Possible associations between the dependent (accretion and independent (maternal and placental characteristics variables were evaluated using the chi² test, univariate and multivariate analyses. Results: reviewing 245 cases of PP, two risk factors were significantly associated with accretion: central placenta previa (odds ratio (OR: 2.93 and two or more previous cesarean sections(OR: 2.54. Based on these data, a predictive model was constructed, according to which a patient with central PP and two more previous cesarean sections has a 44.4% risk for accretion. Conclusions: results of the current study may help obstetricians in the classification of their

  6. The Case Report of Trigger Finger Improved with Hominis Placenta Pharmacopuncture Treatment

    Directory of Open Access Journals (Sweden)

    Jeong-Won Kim

    2010-12-01

    Full Text Available Objectives : The Purpose of this study is to investigate and report the effectiveness of Hominis Placenta using Pharmacopuncture treatment for trigger finger. Methods : 3 Patients are admitted at Dept. of Oriental Rehabilitation, Bu-Chun Jaseng Oriental Medicine Hospital, diagnosed as Trigger finger and treated with Hominis Placenta Pharmacopuncture. Each cases are measured and assessed by Quinnell's classification of triggering and VAS (Visual Analogue Scale scores. Results : 3 Patients of trigger finger have a different kind of cause and fingers lesion they have, but nodules are not significantly found up, so we could classify all of 3 patients to diffuse type. After treatment of Hominis placenta Pharmacopuncture, spontaneous pain and tenderness, grades of triggering are decreased significantly. We would expect that Hominis placenta Pharmacopuncture has a effect on degenerative diseases of diffuse type's tendon sheath. Conclusions : Trigger finger is generally divided into two stages, inflammatory and degenerative stage, and when degenerative stage, Hominis placenta pharmacopuncture appears to be effective.

  7. The Effect of Hominis Placenta Herbal Acupuncture on Bell's palsy

    Directory of Open Access Journals (Sweden)

    Yun Jeong-hun

    2000-07-01

    Full Text Available This report was done to observe the effect of Hominis placenta herbal acupuncture on Bell's palsy. The study group comprised 16 patients who arrived at Woo-suk university oriental hospital from January, 1999 till January, 2000 for Bell's palsy. All patients were divided into two group. One was herbal acupunture group, and the other was control group. Acupunture group was done herbal acupuncture therapy on the facial acupuncture points. Followings are achievement and a term of each group. In herbal acupuncture group, 100% motor recovery was 7 case, 75% was 1 case, and 25% motor recovery term was 7.38±5.21 days, 50% was 11.00±6.16 days, 75% was 15.13±9.55 days, 100% was 23.14±7.97 days. In control group, 100% motor recovery was 4 case, 75% was 2 case, 25% below was 2 case and 25% motor recovery term was 11.17±4.96days, 50% was 18.17±6.82 days, 75% was 29.50±6.95 days, 100% was 44.00±11.49 days. The above results indicate that Hominis placenta herbal acupuncture is a useful effect on Bell's palsy. thus, continuous herbal acupunture study will be needed for more clinical application on Bell' palsy.

  8. DNA flow cytometric analysis in variable types of hydropic placentas

    Directory of Open Access Journals (Sweden)

    Fatemeh Atabaki pasdar

    2015-05-01

    Full Text Available Background: Differential diagnosis between complete hydatidiform mole, partial hydatidiform mole and hydropic abortion, known as hydropic placentas is still a challenge for pathologists but it is very important for patient management. Objective: We analyzed the nuclear DNA content of various types of hydropic placentas by flowcytometry. Materials and Methods: DNA ploidy analysis was performed in 20 non-molar (hydropic and non-hydropic spontaneous abortions and 20 molar (complete and partial moles, formalin-fixed, paraffin-embedded tissue samples by flow cytometry. The criteria for selection were based on the histopathologic diagnosis. Results: Of 10 cases histologically diagnosed as complete hydatiform mole, 9 cases yielded diploid histograms, and 1 case was tetraploid. Of 10 partial hydatidiform moles, 8 were triploid and 2 were diploid. All of 20 cases diagnosed as spontaneous abortions (hydropic and non-hydropic yielded diploid histograms. Conclusion: These findings signify the importance of the combined use of conventional histology and ploidy analysis in the differential diagnosis of complete hydatidiform mole, partial hydatidiform mole and hydropic abortion.

  9. Contents and localization of heavy metals in human placentae

    Energy Technology Data Exchange (ETDEWEB)

    Reichrtova, E.; Ursinyova, M.; Palkovicova, L.; Wsolova, L. [Institute of Preventive and Clinical Medicine, Bratislava (Slovakia)

    1998-06-01

    The placenta was used as an exposure index for the risk evaluation of prenatal fetal chemical exposure. Full-term placenta samples collected at maternity hospitals in 4 regions of different environmental pollutants and traffic density were examined for lead and cadmium contents using atomic absorption spectrometry (AAS). The results showed similar lead contents in placental samples from all selected regions, except for a small town with a lower traffic density. The findings may implicate traffic-related environmental lead pollution, rather than industrial sources. The highest concentration of cadmium was shown to be in the samples collected from the region with the highest proportion of smoking mothers (including passive smoking). Simultaneously, the placental samples were processed histochemically to determine the location of lead in the placental tissue (using light microscopy). The degree of placental metal contamination was done semiquantitatively, and the difference between the rural and industrial region was statistically compared. Parallel quantitative AAS analyses and semiquantitative histochemical lead analyses of human placental samples revealed analogous results regarding the level of placental contamination with metals. (orig.) (orig.) With 4 figs., 12 refs.

  10. Suspected invasive placenta: evaluation with magnetic resonance imaging

    International Nuclear Information System (INIS)

    Bour, Laurence; Place, Vinciane; Bendavid, Sandra; Fargeaudou, Yann; Portal, Jean-Jacques; Ricbourg, Aude; Sebbag, Delphine; Dohan, Anthony; Soyer, Philippe; Vicaut, Eric

    2014-01-01

    To determine the utility of magnetic resonance imaging (MRI) in diagnosing invasive placenta (IP). MRI findings in 32 women with suspected IP were evaluated independently by four readers. Interobserver agreement was calculated with kappa (κ) statistics. Associations between MRI findings and IP were assessed by univariate and multivariate analyses. Sensitivity, specificity and accuracy of MRI for the diagnosis of IP were estimated. Sixteen women (16/32; 50 %) had confirmed IP. Interobserver correlation for the diagnosis of IP was fair (κ = 0.40). Univariate analysis revealed that thinning or focal defect of the uteroplacental interface (P < 0.0001) was the most discriminating MRI variable in the differentiation between normal and IP. Overall sensitivity and specificity of MRI for the diagnosis of IP were 84 % [95 % CI: 75-94 %] and 80 % [95 % CI: 66-93 %], respectively. Thinning or focal defect of the uteroplacental interface was the most accurate finding (88 %) in the diagnosis of IP. Multivariate analysis revealed that thinning or focal defect of the uteroplacental interface was the single independent predictor of IP (P = 0.0006; OR = 64.99). MR imaging has 84 % sensitivity [95 % CI: 75-94 %] and 80 % specificity [95 % CI: 66-93 %] for the diagnosis of IP. Thinning or focal defect of the uteroplacental interface is the most discriminating independent MR variable in differentiating between normal placenta and IP. (orig.)

  11. Drug interactions at the human placenta: what is the evidence?

    Directory of Open Access Journals (Sweden)

    Miriam eRubinchik-Stern

    2012-07-01

    Full Text Available Pregnant women (and their fetuses are treated with a significant number of prescription and nonprescription medications. Interactions among those drugs may affect their efficacy and toxicity in both mother and fetus. Whereas interactions that result in altered drug concentrations in maternal plasma are detectable, those involving modulation of placental transfer mechanisms are rarely reflected by altered drug concentrations in maternal plasma. Therefore, they are often overlooked. Placental-mediated interactions are possible because the placenta is not only a passive diffusional barrier, but also expresses a variety of influx and efflux transporters and drug metabolizing enzymes. Current data on placental-mediated drug interactions are limited. In rodents, pharmacological or genetic manipulations of placental transporters significantly affect fetal drug exposure. In contrast, studies in human placentae suggest that the magnitude of such interactions is modest in most cases. Nevertheless, under certain circumstances, such interactions may be of clinical significance. This review describes currently known mechanisms of placental-mediated drug interactions and the potential implications of such interactions in humans. Better understanding of those mechanisms is important for minimizing fetal toxicity from drugs while improving their efficacy when directed to treat the fetus.

  12. Placenta-an alternative source of stem cells

    International Nuclear Information System (INIS)

    Matikainen, Tiina; Laine, Jarmo

    2005-01-01

    The two most promising practical applications of human stem cells are cellular replacement therapies in human disease and toxicological screening of candidate drug molecules. Both require a source of human stem cells that can be isolated, purified, expanded in number and differentiated into the cell type of choice in a controlled manner. Currently, uses of both embryonic and adult stem cells are investigated. While embryonic stem cells are pluripotent and can differentiate into any specialised cell type, their use requires establishment of embryonic stem cell lines using the inner cell mass of an early pre-implantation embryo. As the blastocyst is destroyed during the process, ethical issues need to be carefully considered. The use of embryonic stem cells is also limited by the difficulties in growing large numbers of the cells without inducing spontaneous differentiation, and the problems in controlling directed differentiation of the cells. The use of adult stem cells, typically derived from bone marrow, but also from other tissues, is ethically non-controversial but their differentiation potential is more limited than that of the embryonic stem cells. Since human cord blood, umbilical cord, placenta and amnion are normally discarded at birth, they provide an easily accessible alternative source of stem cells. We review the potential and current status of the use of adult stem cells derived from the placenta or umbilical cord in therapeutic and toxicological applications

  13. Optoacoustic measurements of human placenta and umbilical blood oxygenation

    Science.gov (United States)

    Nanovskaya, T. N.; Petrov, I. Y.; Petrov, Y.; Patrikeeva, S. L.; Ahmed, M. S.; Hankins, G. D. V.; Prough, D. S.; Esenaliev, R. O.

    2016-03-01

    Adequate oxygenation is essential for normal embryogenesis and fetal growth. Perturbations in the intrauterine oxidative environment during pregnancy are associated with several pathophysiological disorders such as pregnancy loss, preeclampsia, and intrauterine growth restriction. We proposed to use optoacoustic technology for monitoring placental and fetal umbilical blood oxygenation. In this work, we studied optoacoustic monitoring of oxygenation in placenta and umbilical cord blood ex vivo using technique of placenta perfusion. We used a medical grade, nearinfrared, tunable, optoacoustic system developed and built for oxygenation monitoring in blood vessels and in tissues. First, we calibrated the system for cord blood oxygenation measurements by using a CO-Oximeter (gold standard). Then we performed validation in cord blood circulating through the catheters localized on the fetal side of an isolated placental lobule. Finally, the oxygenation measurements were performed in the perfused placental tissue. To increase or decrease blood oxygenation, we used infusion of a gas mixture of 95% O2 + 5% CO2 and 95% N2 + 5% CO2, respectively. In placental tissue, up to four cycles of changes in oxygenation were performed. The optoacoustically measured oxygenation in circulating cord blood and in placental lobule closely correlated with the actual oxygenation data measured by CO-Oximeter. We plan to further test the placental and cord blood oxygenation monitoring with optoacoustics in animal and clinical studies.

  14. Placenta accreta and the developing world--a review.

    Science.gov (United States)

    Umezurike, C C; Feyi-Waboso, P A

    2010-12-01

    The rising Caesarean section rate in the developing world implies that the incidence of placenta accreta might be on the increase and this might worsen the maternal mortality burden. To draw the attention of Obstetricians and other relevant professionals to this emerging but challenging trend. Original research findings and reviews published in the English literature. Additional information was obtained from texts and electronic books such as CD ROMS. Online searches of electronic database (Medline, Pubmed and Embase), requests for reprints from corresponding authors and institutional/private subscriptions. Information obtained was categorised accordingly. Optimal treatment of women with placenta accreta requires recognition of the clinical risk factors, accurate pre-operative diagnosis and meticulous planning to ensure safety at the time of delivery. In view of the rising incidence of this condition, and the absence of a highly reliable antenatal diagnostic method especially in developing countries, a high index of suspicion and advanced preparation is required to reduce its associated maternal morbidity and mortality.

  15. Identification and analysis of multi-protein complexes in placenta.

    Directory of Open Access Journals (Sweden)

    Fuqiang Wang

    Full Text Available Placental malfunction induces pregnancy disorders which contribute to life-threatening complications for both the mother and the fetus. Identification and characterization of placental multi-protein complexes is an important step to integratedly understand the protein-protein interaction networks in placenta which determine placental function. In this study, blue native/sodium dodecyl sulfate polyacrylamide gel electrophoresis (BN/SDS-PAGE and Liquid chromatography-tandem mass spectrometry (LC-MS/MS were used to screen the multi-protein complexes in placenta. 733 unique proteins and 34 known and novel heterooligomeric multi-protein complexes including mitochondrial respiratory chain complexes, integrin complexes, proteasome complexes, histone complex, and heat shock protein complexes were identified. A novel protein complex, which involves clathrin and small conductance calcium-activated potassium (SK channel protein 2, was identified and validated by antibody based gel shift assay, co-immunoprecipitation and immunofluorescence staining. These results suggest that BN/SDS-PAGE, when integrated with LC-MS/MS, is a very powerful and versatile tool for the investigation of placental protein complexes. This work paves the way for deeper functional characterization of the placental protein complexes associated with pregnancy disorders.

  16. Glucose metabolism in cultured trophoblasts from human placenta

    International Nuclear Information System (INIS)

    Moe, A.J.; Farmer, D.R.; Nelson, D.M.; Smith, C.H.

    1990-01-01

    The development of appropriate placental trophoblast isolation and culture techniques enables the study of pathways of glucose utilization by this important cell layer in vitro. Trophoblasts from normal term placentas were isolated and cultured 24 hours and 72 hours in uncoated polystyrene culture tubes or tubes previously coated with a fibrin matrix. Trophoblasts cultured on fibrin are morphologically distinct from those cultured on plastic or other matrices and generally resemble in vivo syncytium. Cells were incubated up to 3 hours with 14 C-labeled glucose and reactions were stopped by addition of perchloric acid. 14 CO 2 production by trophoblasts increased linearly with time however the largest accumulation of label was in organic acids. Trophoblasts cultured in absence of fibrin utilized more glucose and accumulated more 14 C in metabolic products compared to cells cultured on fibrin. Glucose oxidation to CO 2 by the phosphogluconate (PG) pathway was estimated from specific yields of 14 CO 2 from [1- 14 C]-D-glucose and [6- 14 C]-D-glucose. Approximately 6% of glucose oxidation was by the PG pathway when cells were cultured on fibrin compared to approximately 1% by cells cultured in the absence of fibrin. The presence of a fibrin growth matrix appears to modulate the metabolism of glucose by trophoblast from human placenta in vitro

  17. Interobserver variability of sonography for prediction of placenta accreta.

    Science.gov (United States)

    Bowman, Zachary S; Eller, Alexandra G; Kennedy, Anne M; Richards, Douglas S; Winter, Thomas C; Woodward, Paula J; Silver, Robert M

    2014-12-01

    The sensitivity of sonography to predict accreta has been reported as higher than 90%. However, most studies are from single expert investigators. Our objective was to analyze interobserver variability of sonography for prediction of placenta accreta. Patients with previa with and without accreta were ascertained, and images with placental views were collected, deidentified, and placed in random sequence. Three radiologists and 3 maternal-fetal medicine specialists interpreted each study for the presence of accreta and specific findings reported to be associated with its diagnosis. Investigator-specific sensitivity, specificity, and accuracy were calculated. κ statistics were used to assess variability between individuals and types of investigators. A total of 229 sonographic studies from 55 patients with accreta and 56 control patients were examined. Accuracy ranged from 55.9% to 76.4%. Of imaging studies yielding diagnoses, sensitivity ranged from 53.4% to 74.4%, and specificity ranged from 70.8% to 94.8%. Overall interobserver agreement was moderate (mean κ ± SD = 0.47 ± 0.12). κ values between pairs of investigators ranged from 0.32 (fair agreement) to 0.73 (substantial agreement). Average individual agreement ranged from fair (κ = 0.35) to moderate (κ = 0.53). Blinded from clinical data, sonography has significant interobserver variability for the diagnosis of placenta accreta. © 2013 by the American Institute of Ultrasound in Medicine.

  18. The omniscient placenta: Metabolic and epigenetic regulation of fetal programming.

    Science.gov (United States)

    Nugent, Bridget M; Bale, Tracy L

    2015-10-01

    Fetal development could be considered a sensitive period wherein exogenous insults and changes to the maternal milieu can have long-term impacts on developmental programming. The placenta provides the fetus with protection and necessary nutrients for growth, and responds to maternal cues and changes in nutrient signaling through multiple epigenetic mechanisms. The X-linked enzyme O-linked-N-acetylglucosamine transferase (OGT) acts as a nutrient sensor that modifies numerous proteins to alter various cellular signals, including major epigenetic processes. This review describes epigenetic alterations in the placenta in response to insults during pregnancy, the potential links of OGT as a nutrient sensor to placental epigenetics, and the implications of placental epigenetics in long-term neurodevelopmental programming. We describe the role of placental OGT in the sex-specific programming of hypothalamic-pituitary-adrenal (HPA) axis programming deficits by early prenatal stress as an example of how placental signaling can have long-term effects on neurodevelopment. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Retained placenta in Friesian mares : reproductive performance after foal heat breeding versus breeding in a subsequent heat

    NARCIS (Netherlands)

    Sevinga, M; Hesselink, JW; Barkema, H.W.

    2001-01-01

    Postpartum reproductive performance was studied in 54 Friesian brood mares with and 50 without retained placenta. Retained placenta was defined as failure to expel all fetal membranes within 3 hours after the delivery of the foal. The group of mares with retained placenta was subdivided into mares

  20. Topical application of recombinant activated factor VII during cesarean delivery for placenta previa.

    Science.gov (United States)

    Schjoldager, Birgit T B G; Mikkelsen, Emmeli; Lykke, Malene R; Præst, Jørgen; Hvas, Anne-Mette; Heslet, Lars; Secher, Niels J; Salvig, Jannie D; Uldbjerg, Niels

    2017-06-01

    During cesarean delivery in patients with placenta previa, hemorrhaging after removal of the placenta is often challenging. In this condition, the extraordinarily high concentration of tissue factor at the placenta site may constitute a principle of treatment as it activates coagulation very effectively. The presumption, however, is that tissue factor is bound to activated factor VII. We hypothesized that topical application of recombinant activated factor VII at the placenta site reduces bleeding without affecting intravascular coagulation. We included 5 cases with planned cesarean delivery for placenta previa. After removal of the placenta, the surgeon applied a swab soaked in recombinant activated factor VII containing saline (1 mg in 246 mL) to the placenta site for 2 minutes; this treatment was repeated once if the bleeding did not decrease sufficiently. We documented the treatment on video recordings and measured blood loss. Furthermore, we determined hemoglobin concentration, platelet count, international normalized ratio, activated partial thrombin time, fibrinogen (functional), factor VII:clot, and thrombin generation in peripheral blood prior to and 15 minutes after removal of the placenta. We also tested these blood coagulation variables in 5 women with cesarean delivery planned for other reasons. Mann-Whitney test was used for unpaired data. In all 5 cases, the uterotomy was closed under practically dry conditions and the median blood loss was 490 (range 300-800) mL. There were no adverse effects of recombinant activated factor VII and we did not measure factor VII to enter the circulation. Neither did we observe changes in thrombin generation, fibrinogen, activated partial thrombin time, international normalized ratio, and platelet count in the peripheral circulation (all P values >.20). This study indicates that in patients with placenta previa, topical recombinant activated factor VII may diminish bleeding from the placenta site without initiation

  1. Hexachlorocyclohexanes (HCHs) in placenta and umbilical cord blood and dietary intake for women in Beijing, China

    International Nuclear Information System (INIS)

    Yu, Yanxin; Wang, Bin; Wang, Xilong; Wang, Rong; Wang, Wentao; Shen, Guofeng; Shen, Huizhong; Li, Wei; Wong, Minghong; Liu, Wenxin; Tao, Shu

    2013-01-01

    Placenta and umbilical cord blood are important media for investigating maternal–fetal exposure to environmental pollutants. Historically hexachlorocyclohexanes (HCHs) were once widely-used in China. In this study, residues of HCHs were measured in placenta and umbilical cord blood samples for 40 women from Beijing. The measured median values of HCHs were 62.0 and 68.8 ng/g fat in placenta and umbilical cord blood, respectively. Concentrations of HCHs in placenta and umbilical cord blood of urban cohort were higher than those of rural group due to enhanced consumption of fish, meat, and milk. Residues of HCHs in placenta were significantly correlated with total food consumption, dietary intake, and maternal age, and could be predicted using the parameters dependent upon ingestion of meat and milk. The transplacental exposure of fetuses to HCHs was revealed by a close association between the residual levels in the paired placenta and the paired umbilical cord blood samples. -- Highlights: •Medians of HCH in placenta and umbilical cord blood of 40 puerperal women from Beijing were 62.0 and 68.8 ng/g⋅fat. •HCHs in placenta and umbilical cord blood of urban cohort were higher than those of rural one. •HCH residues in placenta were significantly correlated with total food consumption, daily dietary intake, and maternal age. •The transplacental exposure of fetus to HCHs was revealed. -- HCHs in placenta of women in Beijing were significantly correlated with total food consumption, dietary intake, and maternal age

  2. Early Developmental and Evolutionary Origins of Gene Body DNA Methylation Patterns in Mammalian Placentas.

    Directory of Open Access Journals (Sweden)

    Diane I Schroeder

    2015-08-01

    Full Text Available Over the last 20-80 million years the mammalian placenta has taken on a variety of morphologies through both divergent and convergent evolution. Recently we have shown that the human placenta genome has a unique epigenetic pattern of large partially methylated domains (PMDs and highly methylated domains (HMDs with gene body DNA methylation positively correlating with level of gene expression. In order to determine the evolutionary conservation of DNA methylation patterns and transcriptional regulatory programs in the placenta, we performed a genome-wide methylome (MethylC-seq analysis of human, rhesus macaque, squirrel monkey, mouse, dog, horse, and cow placentas as well as opossum extraembryonic membrane. We found that, similar to human placenta, mammalian placentas and opossum extraembryonic membrane have globally lower levels of methylation compared to somatic tissues. Higher relative gene body methylation was the conserved feature across all mammalian placentas, despite differences in PMD/HMDs and absolute methylation levels. Specifically, higher methylation over the bodies of genes involved in mitosis, vesicle-mediated transport, protein phosphorylation, and chromatin modification was observed compared with the rest of the genome. As in human placenta, higher methylation is associated with higher gene expression and is predictive of genic location across species. Analysis of DNA methylation in oocytes and preimplantation embryos shows a conserved pattern of gene body methylation similar to the placenta. Intriguingly, mouse and cow oocytes and mouse early embryos have PMD/HMDs but their placentas do not, suggesting that PMD/HMDs are a feature of early preimplantation methylation patterns that become lost during placental development in some species and following implantation of the embryo.

  3. [Accuracy of placenta accreta prenatal diagnosis by ultrasound and MRI in a high-risk population].

    Science.gov (United States)

    Daney de Marcillac, F; Molière, S; Pinton, A; Weingertner, A-S; Fritz, G; Viville, B; Roedlich, M-N; Gaudineau, A; Sananes, N; Favre, R; Nisand, I; Langer, B

    2016-02-01

    Main objective was to compare accuracy of ultrasonography and MRI for antenatal diagnosis of placenta accreta. Secondary objectives were to specify the most common sonographic and RMI signs associated with diagnosis of placenta accreta. This retrospective study used data collected from all potential cases of placenta accreta (patients with an anterior placenta praevia with history of scarred uterus) admitted from 01/2010 to 12/2014 in a level III maternity unit in Strasbourg, France. High-risk patients beneficiated antenatally from ultrasonography and MRI. Sonographic signs registered were: abnormal placental lacunae, increased vascularity on color Doppler, absence of the retroplacental clear space, interrupted bladder line. MRI signs registered were: abnormal uterine bulging, intraplacental bands of low signal intensity on T2-weighted images, increased vascularity, heterogeneous signal of the placenta on T2-weighed, interrupted bladder line, protrusion of the placenta into the cervix. Diagnosis of placenta accreta was confirmed histologically after hysterectomy or clinically in case of successful conservative treatment. Twenty-two potential cases of placenta accreta were referred to our center and underwent both ultrasonography and MRI. All cases of placenta accreta had a placenta praevia associated with history of scarred uterus. Sensibility and specificity for ultrasonography were, respectively, 0.92 and 0.67, for MRI 0.84 and 0.78 without significant difference (p>0.05). The most relevant signs associated with diagnosis of placenta accreta in ultrasonography were increased vascularity on color Doppler (sensibility 0.85/specificity 0.78), abnormal placental lacunae (sensibility 0.92/specificity 0.55) and loss of retroplacental clear space (sensibility 0.76/specificity 1.0). The most relevant signs in MRI were: abnormal uterine bulging (sensitivity 0.92/specificity 0.89), dark intraplacental bands on T2-weighted images (sensitivity 0.83/specificity 0.80) or

  4. Increased Levels of Cell-Free Human Placental Lactogen mRNA at 28-32 Gestational Weeks in Plasma of Pregnant Women With Placenta Previa and Invasive Placenta

    Science.gov (United States)

    Sekizawa, Akihiko; Ventura, Walter; Koide, Keiko; Hori, Kyouko; Okai, Takashi; Masashi, Yoshida; Furuya, Kenichi; Mizumoto, Yoshifumi

    2014-01-01

    We compared the levels of cell-free human placental lactogen (hPL) messenger RNA (mRNA) in maternal plasma at 28 to 32 weeks of gestation between women with diagnosis of placenta previa or invasive placenta and women with an uneventful pregnancy. Sensitivity and specificity of hPL mRNA for the prediction of invasive placenta were further explored. Plasma hPL mRNA were quantified by real-time reverse-transcriptase polymerase chain reaction in women with placenta previa (n = 13), invasive placenta (n = 5), and normal pregnancies (n = 92). Median (range) hPL mRNA was significantly higher in women with placenta previa, 782 (10-2301) copies/mL of plasma, and in those with invasive placenta, 615 (522-2102) copies/mL of plasma, when compared to normal pregnancies, 90 (4-4407) copies/mL of plasma, P < .01 and P < .05, respectively. We found a sensitivity of 100% and a specificity of 61.5% for the prediction of invasive placenta among women with placenta previa. In conclusion, expression of hPL mRNA is increased in plasma of women with placenta previa and invasive placenta at 28 to 32 weeks of gestation. PMID:23744883

  5. Risk Factors and Consequent Outcomes of Placenta Previa: Report From a Referral Center

    Directory of Open Access Journals (Sweden)

    Soraya Saleh Gargari

    2016-12-01

    Full Text Available  Because of an unknown factor, the frequency of complicated pregnancy with placenta previa has been raised during past decade. This study was designed to deepen our understanding of risk factors and outcomes of placenta previa in our country. This study investigated 694 cases of placenta previa comparing with 600 healthy pregnant women with not overlie placenta in two referral and tertiary Obstetrics and Gynecological Hospital in Iran on the basis of the clinical and para-clinical analysis, in order to find the probable risk factors for occurrence of placenta previa and its effect on maternal and neonatal complications. The most important risk factor for the occurrence of placenta previa was advanced maternal age (P<0.001 and history of stillbirth (OR=117.2, CI=58.3-236.0. In the other hand, the most substantial outcome of this disorder was a reduction of gestational age (P<0.001 and low birth weight neonatally (P<0.001. The conservative follow-up should be programmed for women with placenta previa based on the type of risk factors which can provide the best possible management to decrease the morbidity and mortality of their related complications.

  6. Expression of human placental lactogen and variant growth hormone genes in placentas.

    Science.gov (United States)

    Martinez-Rodriguez, H G; Guerra-Rodriguez, N E; Iturbe-Cantu, M A; Martinez-Torres, A; Barrera-Saldaña, H A

    1997-01-01

    Previous studies comparing the expression levels of human placental lactogen (hPL) genes have shown varying results, due to, perhaps, the fact that in all of them only one placenta was being analyzed. Here, the expression of hPL and growth hormone variant (hGH-V) genes in fifteen term placentas was comparatively analyzed at the RNA level, using reverse transcription coupled to polymerase chain reaction (RT-PCR). The abundance of the combined RNA transcripts derived from these genes varied from one placenta to another. The authors found that hPL-4 transcripts were more abundant than those of hPL-3 in most samples (ratios from 1:1 to 6:1), transcripts from the putative hPL-1 pseudogene were more abundant at the unprocessed stage while those of the hGH-V gene were mostly processed. Again, the authors of this study observed wide variation from placenta to placenta in the abundance of both of these types of transcripts. The same was observed when a group of six placentas from abortuses and nine from pregnancies complicated by preclampsia, diabetes and hypertension was studied. The authors conclude that the disagreeing results reported in the literature which are not in agreement concerning the expression levels of hPL genes could be explained by normal variations of their expression levels among the different placentas analyzed.

  7. Myostatin in the placentae of pregnancies complicated with gestational diabetes mellitus.

    Science.gov (United States)

    Peiris, H N; Lappas, M; Georgiou, H M; Vaswani, K; Salomon, C; Rice, G E; Mitchell, M D

    2015-01-01

    Gestational diabetes mellitus (GDM) is characterised by maternal glucose intolerance and insulin resistance during pregnancy. Myostatin, initially identified as a negative regulator of muscle development may also function in the regulation of placental development and glucose uptake. Myostatin expression in placentae of GDM complicated pregnancies is unknown. However, higher myostatin levels occur in placentae of pregnancies complicated with preeclampsia. We hypothesise that myostatin will be differentially expressed in GDM complicated pregnancies. Myostatin concentrations (ELISA) were evaluated in plasma of presymptomatic women who later developed GDM and compared to plasma of normal glucose tolerant (NGT) women. Furthermore, myostatin protein expression (Western blot) was studied in placentae of pregnant women with GDM (treated with diet or insulin) compared to placentae of NGT women. No significant difference in myostatin concentration was seen in plasma of pre-symptomatic GDM women compared to NGT women. In placenta significant differences in myostatin protein expressions (higher precursor; p myostatin dimer expression (p Myostatin expression in placental tissue is altered under stress conditions (e.g. obesity and abnormal glucose metabolism) found in pregnancies complicated with GDM. We hypothesise that myostatin is active in these placentae and could affect glucose homoeostasis and/or cytokine production thereby altering the function of the placenta. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Ultrasound detection of placenta accreta in the first trimester of pregnancy.

    Science.gov (United States)

    Rahimi-Sharbaf, Fatemeh; Jamal, Ashraf; Mesdaghinia, Elaheh; Abedzadeh-Kalahroudi, Masoumeh; Niroomanesh, Shirin; Atoof, Fatemeh

    2014-06-01

    Placenta accreta is considered a life-threatening condition and the main cause of maternal mortality. Prenatal diagnosis of placenta accreta usually is made by clinical presentation, imaging studies like ultrasound and MRI in the second and third trimester. To determine accuracy of ultrasound findings for placenta accreta in the first trimester of pregnancy. In a longitudinal study 323 high risk patients for placenta accreta were assessed. The eligible women were examined by vaginal and abdominal ultrasound for gestational sac and placental localization and they were followed up until the end of pregnancy. The ultrasound findings were compared with histopathological examinations as a gold standard. The sensitivity, specificity, positive and negative predictive value of ultrasound were estimated for the first trimester and compared with other 2 trimesters in the case of repeated ultrasound examination. Ultrasound examinations in the first trimester revealed that 28 cases had the findings in favor of placenta accreta which ultimately was confirmed in 7 cases. The ultrasound sensitivity and specificity for detecting placenta accreta in the first trimester was 41% [95% CI: 16.2-62.7] and 88% [95% CI: 88.2-94.6] respectively. Ultrasound screening for placenta accreta in the first trimester of pregnancy could not achieve the high sensitivity as second and third trimester of pregnancy.

  9. Manual Removal of the Placenta after Vaginal Delivery: An Unsolved Problem in Obstetrics

    Science.gov (United States)

    Zimmermann, Roland

    2014-01-01

    The third stage of labor is associated with considerable maternal morbidity and mortality. The major complication is postpartum hemorrhage (PPH), which is the leading cause of maternal morbidity and mortality worldwide. Whereas in the event of PPH due to atony of the uterus there exist numerous treatment guidelines; for the management of retained placenta the general consensus is more difficult to establish. Active management of the third stage of labour is generally accepted as standard of care as already its duration is contributing to the risk of PPH. Despite scant evidence it is commonly advised that if the placenta has not been expelled 30 minutes after delivery, manual removal of the placenta should be carried out under anaesthesia. Pathologic adhesion of the placenta in the low risk situation usually is diagnosed at the time of delivery; therefore a pre- or intrapartum screening opportunity for placenta accreta would be desirable. But diagnosis of abnormalities of placentation other than placenta previa remains a challenge. Nevertheless the use of ultrasound and doppler sonography might be helpful in the third stage of labor. An improvement might be the implementation of standardized operating procedures for retained placenta which could contribute to a reduction of maternal morbidity. PMID:24812585

  10. Conservative surgical management of placenta accreta: a report of 3 cases.

    Science.gov (United States)

    Pliskow, Steven; Dai, Xiaorong; Kohner, Andrew; Kapnick, Jason

    2009-10-01

    Placenta accreta is often diagnosed at the time of delivery and is a cause of postpartum hemorrhage, morbidity and mortality. The standard treatment for placenta accreta is hysterectomy to avoid acute blood loss and shock. A conservative surgical approach to the treatment of placenta accreta will allow immediate cure while preserving the patient's future fertility. A 39-year-old woman with placenta accreta diagnosed at the time of vaginal delivery was successfully treated with resection of the placental implantation site. A 33-year-old woman and a 35-year-old woman with placenta accreta/increta diagnosed at the time of cesarean section were successfully treated with resection of the placental implantation site. One patient has since conceived and given birth. Placenta accreta and placenta increta can be safely and successfully treated, in some well-selected cases, by resection of the placental implantation site and uterine repair. This conservative surgical management provides immediate therapy, reduces blood loss and preserves fertility.

  11. Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

    Directory of Open Access Journals (Sweden)

    İbrahim Kalelioğllu

    2013-09-01

    Full Text Available Objective: We aimed to present our experience with the management of placenta invasion anomaly by reviewing clinical and operative features of the cases of cesarean hysterectomy performed due to placenta invasion anomaly. Methods: In this retropective study, the charts of all patients who underwent cesarean hysterectomy with an indication of placenta invasion anomaly in Istanbul Faculty of Medicine Department of Obstetrics and Gynecology between 2005 and 2012 were reviewed. Results: In this period a total of 85 patients underwent cesarean hysterectomy. 81 (95.3% cases had experienced at least one cesarean delivery before. Majority of the operations (82.4% were performed in elective conditions. In 16 (18.8% cases bilateral hypogastric artery ligation was carried out because of profuse bleeding. There were no mortalities in the intra- or postoperative period. In 18 (21.2% cases, intraoperative urology consultation was needed. Full- thickness bladder laceration occured in 17 patients, and partial cyctectomy was performed in one patient due to the placenta percreata invading posterior wall of the bladder. Transfusion was needed in 72 (84.7% cases during and 50 (58.8% patients after operation. Dilutional trombocytopenia developed in 17 (20% patients due to massive transfusion. Histopathologically the diganosis was placenta accreata in 55 (64.7%, placenta increata in 1 (1.2% and placenta percreata in 25 (29.4% patients. The incidence of placenta invasion anomaly rose from 0.2% (7/3435 in 2005-2006 up to 0.8% (37/4344 in 2011-2012. Conclusion: The incidence of placenta invasion anomaly is increasing progressively. Cesarean hysterectomy being its classical treatment is an operation with a high risk of morbidity and it should be performed by experienced teams after appropriate preparations in tertiary centers where multidiciplinary approach is possible.

  12. Macroscopic and histological characteristics of retained placenta: A prospectively collected case-control study.

    Science.gov (United States)

    Endler, Margit; Saltvedt, Sissel; Papadogiannakis, Nikos

    2016-05-01

    Retained placenta is a potentially fatal obstetric disorder due to postpartum hemorrhage, its pathophysiology is however unknown. We aimed to assess if retained placenta was associated with increased macroscopic and histological signs of placental maternal underperfusion, a pattern otherwise seen in preeclampsia and other disorders of defective placentation. This was a case-control study of retained (n = 49) and non-retained (n = 47) placentas, collected from full-term singleton and otherwise healthy pregnancies, carried out at a tertiary level obstetric department. Macroscopic and histological analysis was performed. Signs of maternal placental underperfusion and signs of placental inflammation, fetal vascular thrombo-occlusive disease and increased placental attachment were recorded in a primary and secondary analysis respectively. Variables were compared groupwise using unconditional logistic regression or comparison of median or mean values. Compared to non-retained placentas retained placentas had a significantly smaller surface area (p = 0.05), were more oblong in shape (OR 5.24 95% CI:1.34-20.21) and showed overall more signs of maternal underperfusion (OR 2.52 95% CI: 1.07-5.87). There was no significant difference in signs of placental inflammation, fetal vascular thrombo-occlusive disease or placenta accreta but basal plate myometrial fibers were more common among retained placentas. In regard to shape, surface area and histological signs of maternal placental underperfusion, retained placentas showed a histological pattern similar to that seen in preeclamptic placentas. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. A comparison of morbidity associated with placenta previa with and without previous caesarean sections

    International Nuclear Information System (INIS)

    Baqai, S.; Siraj, A.; Noor, N.

    2018-01-01

    To compare the morbidity associated with placenta previa with and without previous caesarean sections. Study Design: Retrospective comparative study. Place and Duration of Study: From March 2014 till March 2016 in the department of Obstetrics and Gynaecology at PNS Shifa hospital Karachi. Material and Methods: After the approval from hospital ethical committee, antenatal patients with singleton pregnancy of gestational age >32 weeks, in the age group of 20-40 years diagnosed to have placenta previa included in the study. All patients with twin pregnancy less than 20 years and more than 40 years of age were excluded. The records of all patients fulfilling the inclusion criteria were reviewed. Data had been collected for demographic and maternal variables, placenta previa, history of previous lower segment caesarean section (LSCS), complications associated with placenta previa and techniques used to control blood loss were recorded. Results: During the study period, 6879 patients were delivered in PNS Shifa, out of these, 2060 (29.9%) had caesarean section out of these, 47.3% patients had previous history of LSCS. Thirty three (1.6%) patients were diagnosed to have placenta previa and frequency of placenta previa was significantly higher in patients with previous history of LSCS than previous normal delivery of LSCS i.e. 22 vs. 11 (p=0.023). It was observed that the frequency of morbidly adherent placenta (MAP) and Intensive care unit (ICU) stay were significantly higher in patients with previous history of LSCS than previous history of normal delivery. Conclusion: Frequency of placenta previa was significantly higher in patients with history of LSCS. Also placenta previa remains a major risk factor for various maternal complications. (author)

  14. Effect of ethanol on placenta and liver of mice

    International Nuclear Information System (INIS)

    Tarachand, U.; Eapen, Jacob

    1977-01-01

    Chronic ingestion of ethanol in drinking water for 15 days induces fatty liver in non-pregnant female mice. A similar regimen fails to produce the same effect in liver and placenta of pregnant mice. In vivo incorporation of 14 C-chlorella protein hydrolysate into hepatic proteins, however, is impaired in both the pregnant and the non-pregnant mice following ethanol treatment. Placental and foetal liver protein syntheses remain unaffected by the treatment. A single intraperitoneal dose of ethanol in fed and fasted non-pregnant mice elicits a differential response with respect to incorporation of the labelled precursor. The results are discussed with reference to the apparent metabolic alterations due to pregnancy. (author)

  15. Inhibition of placenta growth factor with TB-403

    DEFF Research Database (Denmark)

    Nielsen, Dorte Lisbet; Sengeløv, Lisa

    2012-01-01

    INTRODUCTION: There is clinical evidence that therapies targeting the vascular endothelial growth factor pathway are effective in delaying cancer progression. However, tumors may be either intrinsically resistant or evolve resistance to such therapies. Hence, there is a need for new therapies...... targeting angiogenesis. AREAS COVERED: The data are obtained by searching in the PubMed database. The search terms used included antiangiogenic therapy, TB-403 (RO5323441), placenta growth factor (PlGF) and VEGFR-1 (Flt-1). We review preclinical data concerning the function and inhibition of Pl......GF and summarize data on expression of PlGF in cancer patients. Data from early-phase clinical trials of TB-403 (RO5323441), a monoclonal antibody inhibiting PlGF, are discussed. Future development strategies, therapeutic potentials and limitations of TB-403 are further evaluated. EXPERT OPINION: There are some...

  16. Intentional placental removal on suspicious placenta accreta spectrum: still prohibited?

    Science.gov (United States)

    Matsubara, Shigeki; Takahashi, Hironori

    2018-01-01

    Intentional placental removal for abnormally invasive placenta (AIP) is fundamentally abandoned at planned surgery for it. Whether this holds true even after recent introduction of various hemostatic procedures is unclear. We discussed on this issue based on our own experiences and also on the recent reports on various hemostatic procedures. Studies directly answering this question have been lacking. We must weigh the balance between the massive bleeding and possibility of uterus-preservation when intentional placental removal strategy is employed. An almost forgotten strategy, the "intentional placental removal" for planned AIP surgery may regain its position when appropriate hemostatic procedures are concomitantly used depending on the situation. Even employing this strategy, quick decision to perform hysterectomy under multidisciplinary team may be important.

  17. MSX2 Induces Trophoblast Invasion in Human Placenta.

    Directory of Open Access Journals (Sweden)

    Hao Liang

    Full Text Available Normal implantation depends on appropriate trophoblast growth and invasion. Inadequate trophoblast invasion results in pregnancy-related disorders, such as early miscarriage and pre-eclampsia, which are dangerous to both the mother and fetus. Msh Homeobox 2 (MSX2, a member of the MSX family of homeobox proteins, plays a significant role in the proliferation and differentiation of various cells and tissues, including ectodermal organs, teeth, and chondrocytes. Recently, MSX2 was found to play important roles in the invasion of cancer cells into adjacent tissues via the epithelial-mesenchymal transition (EMT. However, the role of MSX2 in trophoblastic invasion during placental development has yet to be explored. In the present study, we detected MSX2 expression in cytotrophoblast, syncytiotrophoblast, and extravillous cytotrophoblast cells of first or third trimester human placentas via immunohistochemistry analysis. Furthermore, we found that the in vitro invasive ability of HTR8/SVneo cells was enhanced by exogenous overexpression of MSX2, and that this effect was accompanied by increased protein expression of matrix metalloproteinase-2 (MMP-2, vimentin, and β-catenin. Conversely, treatment of HTR8/SVneo cells with MSX2-specific siRNAs resulted in decreased protein expression of MMP-2, vimentin, and β-catenin, and reduced invasion levels in a Matrigel invasion test. Notably, however, treatment with the MSX2 overexpression plasmid and the MSX2 siRNAs had no effect on the mRNA expression levels of β-catenin. Meanwhile, overexpression of MSX2 and treatment with the MSX2-specific siRNA resulted in decreased and increased E-cadherin expression, respectively, in JEG-3 cells. Lastly, the protein expression levels of MSX2 were significantly lower in human pre-eclamptic placental villi than in the matched control placentas. Collectively, our results suggest that MSX2 may induce human trophoblast cell invasion, and dysregulation of MSX2 expression may

  18. Hysterectomy as a Management Option for Morbidly Adherent Placenta

    International Nuclear Information System (INIS)

    Ansar, A; Shuja, S.; Khan, S.; Malik, T.

    2014-01-01

    Objective: To determine the outcome of interval (delayed) hysterectomy as compared to cesarean (immediate) hysterectomy in cases of placental invasion in previous cesarean sections. Study Design: Comparative study. Place and Duration of Study: Department of Obstetrics and Gynecology, Unit II, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from January 2008 to June 2011. Methodology: The study subjects included 28 women with history of previous cesarean section who had low lying as well as morbidly adherent placenta (MAP) of variable degree. Patients were classified into two groups (group A and B) according to whether cesarean or interval hysterectomy was needed at time of delivery. Demographic data, obstetrical risk factors such as parity and number of previous cesarean sections were compared as well as radiological and histopathological findings, and details of the management. Chi-square, Fisher's exact and t-tests were used to compare proportions and mean values. Results: The frequency of MAP in previous cesarean sections turned out to be 1.83/1000 (28/15,340) deliveries. Mean maternal age (26.54 vs. 29.13 years, p=0.05), mean gestational age (33.8 vs. 36 weeks, p=0.05), estimated blood loss (2615.38 vs. 1506.6 mL, p=0.001), volume of blood transfused (9.76 vs. 2.9 pints, p=0.001) and the duration of hospital stay (10.69 vs. 32.86 days, p=0.001) differed significantly between group A and group B. One maternal death occurred in each group. Eight patients had other complications in group A compared to 3 patients in group B. Three neonatal deaths occurred in group A compared to nil in group B. Conclusion: The frequency of morbidly adherent placenta was 1.83/1000 deliveries. The management and outcome differed markedly according to emergency and scheduled antenatal diagnosis. Counselling and antenatal radiological screening can reduce the high morbidity and mortality associated with it. (author)

  19. COMPARISON OF ULTRASONOGRAPHIC PLACENTA EXAMINATION WITH PATHOHISTOLOGIC VERIFICATION OF FETAL ANOMALIES

    Directory of Open Access Journals (Sweden)

    Dragan Loncar

    2007-04-01

    Full Text Available Ultrasonographic diagnostics is a sovereign diagnostic method of discovering disorders in growth and development of embryo. The main aim of this research is The Comparison of Ultrasonographic Placenta Examination with Pathohistologic Treatment of Placenta considering those pregnancies previously verified to have embryo anomalies and which were ended by the procedure of feticide. During the period of 2001 – 2004, 15 pregnant women, with gestation between the 24th and 28th week, were hospitalized in our clinic. Ultrasonographic placenta examination was carried out during the expertise sonography immediately before deciding to commit feticide. The descriptive medical findings were divided into the clinical entities estimating the continuity of basal body, insertion, volume, and echo-structure of placenta substance. The procedure of feticide was carried out in regular treatments using intracardial application of 7,4 % KCl or transabdominal, intra-amnial instillation of 20 % NaCl under the control of ultrasound.The patients with the embryo anomalies were divided into three groups:I – the group with the diagnosis of embryo hydrocephalusII – the group with the diagnosis of other anomalies of growth of embryo's CNSIII – the group of patients with other embryo anomaliesPathohistologic placenta examinations were carried out in the Department of Pathology and Forensic Medicine in CC Kragujevac.The ultrasonographic placenta finding of the patients with the different embryo anomalies was not statistically very different (x2 – test; p=0,073. However, besides the lack of significant difference, what is reasonable considering the size of the sample, we notice quite different ultrasonographic findings of the placenta examination of the patients having the embryo with hydrocephalus in comparison to those patients having the other embryo anomalies of CNS. The ultrasonographic placenta examination of the patients having the other embryo anomalies was

  20. Gray scale and Doppler ultrasound in placenta accreta: Optimization of ultrasound signs

    OpenAIRE

    Mohamed Shawky; Essam AbouBieh; Alaa Masood

    2016-01-01

    Aim of work: To optimize ultrasound and Doppler signs in placenta accreta, and to clarify sensitivity and specificity. Patients & methods: This study included 50 pregnant women. The examinations were done in private center from January 2013 to November 2013. Patients have anterior low lying placenta or anterior placenta previa with history of previous CS. US was done using curvilinear or endovaginal transducer at frequency 3–5 MHz and 3–9 MHz. Results: This study included 50 pregnants w...

  1. Aspectos morfológicos da placenta da preguiça, Bradypus variegatus Shinz, 1825

    OpenAIRE

    Marleyne José Afonso Accyoli Lins Amorin; Maria Angélica Miglino; Adelmar Afonso Amorin Júnior; Tatiana Carlesso dos Santos

    2003-01-01

    Estudaram-se os aspectos morfológicos da placenta e das membranas fetais de 03 placentas de bichos-preguiça (Bradypus variegatus), adultas e prenhes, originárias da Zona da Mata do Estado de Pernambuco. Essas estruturas foram obtidas de 03 fêmeas doadas pela Universidade Federal de Pernambuco, das quais duas encontravam-se congeladas e a terceira foi colhida mediante realização de cirurgia cesariana, onde mãe e feto foram preservados. Depois de descongeladas, as placentas foram fixadas em sol...

  2. Infectious complications in morbidly adherent placenta treated with leaving placenta in situ: a cohort series and suggested approach.

    Science.gov (United States)

    Kutuk, Mehmet Serdar; Kilic, Aysegul; Ak, Mehmet; Ozgun, Mahmut

    2018-04-26

    The aim of this study is to assess the clinical and microbiological features of infections in patients with morbidly adherent placenta (MAP) treated by leaving placenta in situ (LPIS). Retrospective analysis of MAP cases who were treated by LPIS between 2 May 2010 and 15 March 2017. The inclusion criteria were gestational age at or above 24 weeks, prenatal diagnosis, elective operation, and complete data. Nineteen MAP cases were treated by LPIS during the study period. The mean ± SD duration for total placental resorbtion was 145 ± 47 days. Three patients were readmitted to the hospital because of fever (3/19). A total of 65 culture samples were taken from the patients during their follow- up periods. In four cases (4/12) cervical cultures showed positive growth [Escherichia coli (2), Klebsiella pneumoniae (1), mixed culture with Enterococcus spp. and E. coli (1)]. Fifteen (15/26) urine samples were sterile, three were polymicrobial. In eight cases, urine culture revealed E. coli growth (one E. coli and Enterococcus spp.). Three out of 16 (3/16) surgical incision samples revealed growth of E. coli. No bacterial growth was detected in blood cultures. Susceptibility results of Gram-negatives indicate that the resistance rates of beta-lactam antibiotics are high (14/20, 70%). No secondary surgical intervention occurred during the study period due to infection. Majority of postpartum cervical discharge, fever, and increased CRP levels do not represent morbid infections and/or sepsis. With early detection, and implementation of antibiotherapy (combination of an aminoglycoside and clindamycin), they can be easily controlled and secondary surgical interventions can be prevented.

  3. Differential expression of human beta defensins in placenta and detection of allelic variants in the DEFB1 gene from HIV-1 positive mothers Expresión diferencial en placenta de beta-defensinas humanas y detección de variantes alélicas en el gen DEFB1 de madres positivas para VIH-1

    Directory of Open Access Journals (Sweden)

    María Teresa Rugeles

    2011-04-01

    Full Text Available Introduction. Low infection rates in neonates born to HIV-1-seropositive mothers highlight the existence of natural defense mechanisms in the maternal-fetal interface. Human beta defensins (HBDs inhibit HIV-1 replication in vitro and their variants are associated with HIV-1 resistance/susceptibility.
    Objective. Levels of HBD mRNA expression in placentas were obtained from seropositive and healthy mothers to determine whether HIV-1 infection induces anti-viral factors.
    Materials and methods. HBD-1, -2 and -3 transcripts were quantified by real time RT-PCR, and A692G/G1654A/A1836G variants in the DEFB1 gene were evaluated by sequencing.
    Results. Transcript levels of HBD-1 were significantly higher, and those of HBD-3 were lower in placenta from seropositive mothers compared to controls. Additionally, simultaneous presence of the A692G A/G and A1836G G/G genotypes was associated with high expression of HBD-1 in all populations and the A692G variant in babies born to seropositive mothers was in Hardy-Weinberg disequilibrium.
    Conclusion. Contrasting results in levels of HBDs were probably due to viral stimuli and suggest that HIV-1 induce a differential expression of HBDs in placenta and these proteins could be involved in protecting against HIV-1 at least early in pregnancy. However, it was not possible to associate these findings directly with protection against HIV-1 vertical transmission since none of the newborn infants became infected.
    Introducción. Las bajas tasas de infección en neonatos nacidos de madres seropositivas para el VIH-1 resaltan la existencia de mecanismos de defensa natural en la interfase materno-fetal. Las beta-defensinas humanas inhiben la replicación del VIH-1 in vitro y sus polimorfismos están asociados con la resistencia o susceptibilidad al VIH-1.
    Objetivo. Comparar los niveles de expresión de ARNm de beta-defensinas humanas en placentas de madres seropositivas y en seronegativas para

  4. The placenta and foetal membranes of the lesser yellow house bat ...

    African Journals Online (AJOL)

    A discoidal hemodichorial placenta is present in Scotophilus borbonicus. Evidence is presented which suggests that histotrophic nutrition, in addition to hemotrophic nutrition, occurs. The foetal trophospongium phagocytoses cell debris and glandular secretions derived from the maternal endometrium (decidua basalis).

  5. Role of Doppler US and MRI in diagnosis of placenta accreta

    African Journals Online (AJOL)

    Manal Hamisa

    2014-10-19

    Oct 19, 2014 ... loss of retroplacental clear zone and disruption of bladder–uterine serosa interface with smallest ... Placenta accreta occurs when there is an abnormal adherence ... Those have or gave history of third trimester bleeding.

  6. Evolution of the placenta during the early radiation of placental mammals

    DEFF Research Database (Denmark)

    Mess, Andrea; Carter, Anthony M

    2007-01-01

    The chorioallantoic placenta is an organ of gaseous exchange that exhibits a high degree of structural diversity. One factor determining oxygen transfer across the placenta, the diffusion distance, is in part dependent on the number of cell layers separating maternal from fetal blood. This interh......The chorioallantoic placenta is an organ of gaseous exchange that exhibits a high degree of structural diversity. One factor determining oxygen transfer across the placenta, the diffusion distance, is in part dependent on the number of cell layers separating maternal from fetal blood...... of placental mammals, derived from molecular phylogenetics. We show that epitheliochorial placentation, the least invasive type, is a derived state and discuss factors that may have determined its evolution with reference to conflict theory, as applied to the allocation of resources between mother and fetus...

  7. Participation in environmental health research by placenta donation - a perception study

    DEFF Research Database (Denmark)

    Lind, Uffe; Mose, Tina; Knudsen, Lisbeth E

    2007-01-01

    background information but no follow up. METHODS: Nineteen semi-structured qualitative interviews were conducted with participants in the placenta perfusion study after donation of placenta. Observation studies were made of recruitment sessions. RESULTS: The interviewed participants are generally in favour......, but trust is something which needs to be created through "trust-work". Face-to-face interaction, written information material and informed consent forms play important parts in creating trusting relationships in medical research. CONCLUSION: Medical research ethics do not only amount to specific types......BACKGROUND: Much environmental health research depends on human volunteers participating with biological samples. The perception study explores why and how people participate in a placenta perfusion study in Copenhagen. The participation implies donation of the placenta after birth and some...

  8. Role of Doppler US and MRI in diagnosis of placenta accreta

    Directory of Open Access Journals (Sweden)

    Manal Hamisa

    2015-09-01

    Conclusion: In conclusion, data of the present study show that the use of transabdominal color Doppler ultrasonography complemented by MRI in suspected cases improves the diagnostic accuracy in prediction of placenta accreta in patients with previous cesarean delivery.

  9. Maternal Buprenorphine Dose, Placenta Buprenorphine and Metabolite Concentrations and Neonatal Outcomes

    Science.gov (United States)

    Concheiro, Marta; Jones, Hendreé E.; Johnson, Rolley E.; Choo, Robin; Shakleya, Diaa M.; Huestis, Marilyn A.

    2010-01-01

    Buprenorphine is approved as pharmacotherapy for opioid dependence in non-pregnant patients in multiple countries, and is currently under investigation for pregnant women in the US and Europe. This research evaluates the disposition of buprenorphine, opiates, cocaine, and metabolites in 5 term placentas from a US cohort. Placenta and matched meconium concentrations were compared, and relationships between maternal buprenorphine dose, placenta concentrations, and neonatal outcomes following controlled administration during gestation were investigated. Buprenorphine and/or metabolites were detected in all placenta specimens and were uniformly distributed across this tissue (CV<27.5%, 4 locations), except for buprenorphine in 3 placentas. In 2 of these, buprenorphine was not detected in some locations and, in the 3rd placenta, was totally absent. Median (range) concentrations were buprenorphine 1.6ng/g (not detected to 3.2), norbuprenorphine 14.9ng/g (6.2 to 24.2), buprenorphine-glucuronide 3ng/g (1.3 to 5.0) and norbuprenorphine-glucuronide 14.7ng/g (11.4 to 25.8). Placenta is a potential alternative matrix for detecting in utero buprenorphine exposure, but at lower concentrations (15–70 fold) than in meconium. Statistically significant correlations were observed for mean maternal daily dose from enrollment to delivery and placenta buprenorphine-glucuronide concentration, and for norbuprenorphine-glucuronide concentrations and time to neonatal abstinence syndrome (NAS) onset and duration, and for norbuprenorphine/norbuprenorphine-glucuronide ratio and maximum NAS score, and newborn length. Analysis of buprenorphine and metabolites in this alternative matrix, an abundant waste product available at the time of delivery, may be valuable for prediction of neonatal outcomes for clinicians treating newborns of buprenorphine-exposed women. PMID:20216119

  10. Placenta previa and risk of major congenital malformations among singleton births in Finland.

    Science.gov (United States)

    Kancherla, Vijaya; Räisänen, Sari; Gissler, Mika; Kramer, Michael R; Heinonen, Seppo

    2015-06-01

    Placenta previa has been associated with adverse birth outcomes, but its association with congenital malformations is inconclusive. We examined the association between placenta previa and major congenital malformations among singleton births in Finland. We performed a retrospective population register-based study on all singletons born at or after 22+0 weeks of gestation in Finland during 2000 to 2010. We linked three national health registers: the Finnish Medical Birth Register, the Hospital Discharge Register, and the Register of Congenital Malformations, and examined several demographic and clinical characteristics among women with and without placenta previa, in association with major congenital malformations. We estimated adjusted odds ratios and 95% confidence intervals using multivariable logistic regression models. The prevalence of placenta previa was estimated as 2.65 per 1000 singleton births in Finland (95% confidence interval, 2.53-2.79). Overall, 6.2% of women with placenta previa delivered a singleton infant with a major congenital malformation, compared with 3.8% of unaffected women (p ≤ 0.001). Placenta previa was positively associated with almost 1.6-fold increased risk of major congenital malformations in the offspring, after controlling for maternal age, parity, fetal sex, smoking, socio-economic status, chorionic villus biopsy, In vitro fertilization, pre-existing diabetes, depression, preeclampsia, and prior caesarean section (adjusted odds ratio = 1.55; 95% confidence interval, 1.27-1.90). Using a large population-based study, we found that placenta previa was weakly, but significantly associated with an increased risk of major congenital malformations in singleton births. Future studies should examine the association between placenta previa and individual types of congenital malformations, specifically in high-risk pregnancies. © 2015 Wiley Periodicals, Inc.

  11. Differential Expression of Growth-, Angiogenesis- and Invasion-Related Factors in The Development of Placenta Accreta

    OpenAIRE

    Jenn-Jhy Tseng; Min-Min Chou

    2006-01-01

    Placenta accreta is the major cause of maternal death complicated by massive peripartum hemorrhage. Its development is traditionally considered to be related to a decidual defect caused by previous cesarean deliveries or uterine curettages. Usually, placental villi firmly adhere to the superficial myometrium and deeply invade, or even penetrate, the uterine wall. Abnormal uteroplacental neovascularization is another characteristic. Therefore, we hypothesized that placenta accreta develops as ...

  12. Clearance of α-aminoisobutyric acid during in-situ perfusion of the guinea pig placenta

    International Nuclear Information System (INIS)

    Kelman, B.J.; Sikov, M.R.

    1983-05-01

    Extensive investigation of the transport of α-aminoisobutyric acid (AIB; a nonmetabolized amino acid) has shown that AIB is actively transported from mother to fetus across the hemochorial placenta of the guinea pig. As a step towards clarifying the relative rolls of active and passive movements of amino acids across the placenta, it would be useful to obtain concurrent measurements of transplacental movements of a substance which crosses the placenta rapidly by simple diffusion (water) and of a substance which is actively transported across the placenta (AIB). In our study, placentas from guinea pigs between 59 and 61 days of gestation were perfused in situ through cannulated umbilical vessels with the maternal circulation left intact. Tritiated water and 14 C-AIB were injected into a maternal jugular vein and maternal blood samples were obtained at 1 to 10 minute intervals; perfusate samples were collected sequentially after one pass through the placenta. Clearance of 14 C-AIB from mother to fetus (AIB/sub MF/) and AIB concentrations in placental tissue, maternal plasma, and perfusate were consistent in magnitude with data obtained by other invetigators who have clearly shown an active transport of AIB in the placenta. On the other hand, in this study AIB/sub MF/ ranged from approximately 50% to 96% of the clearance of 3 H-labeled water from mother to fetus (T/sub MF/) and that changes in AIB/sub MF/ correlated closely with changes in T/sub MF/ in all perfusions. Thus, it appears that AIB/sub MF/ closely paralleled T/sub MF/ and these data suggest that a relatively large component of AIB/sub MF/ is of passive origin in the in situ placenta

  13. INCIDENCE OF ABRUPTIO PLACENTAE IN PREECLAMPSIA IN A RURAL TERTIARY CARE HOSPITAL

    Directory of Open Access Journals (Sweden)

    Ratna Bulusu

    2016-11-01

    Full Text Available BACKGROUND Preeclampsia is a pregnancy specific disorder commonly defined as de novo hypertension and proteinuria after 20 weeks of gestational age. It occurs in 3-5% of pregnancies and is still a major cause of both foetal and maternal morbidity and mortality worldwide. One of the most serious and dreaded complication of preeclampsia is abruptio placentae. Placental separation from its implantation site before delivery of the foetus has been called abruption placentae or accidental haemorrhage. Various studies have shown that there is 2-2.5 fold increase in incidence of abruption in hypertensive disorder of pregnancy. The aim of the study is to study the incidence of abruptio placentae in women with preeclampsia. MATERIALS AND METHODS 100 pregnant women with preeclampsia attending the antenatal OPD as well as admitted to the antenatal ward and labour room fulfilling the inclusion criteria were enrolled in the study. The incidence of abruption placenta among these 100 women was studied. RESULTS Among the 100 women with preeclampsia enrolled in the study, abruptio placentae was noted in 14 women (14%. Maternal complications were seen in the form of anaemia (78.57%, need for blood transfusion (57.14%, shock (28.57%, postpartum haemorrhage (14.28% and puerperal sepsis (7.14%. Perinatal complications were seen in the form of low birth weight (57.14%, prematurity (35.71%, NICU admission (71.43% and intrauterine death (28.57%. CONCLUSION Abruptio placentae affects approximately 1% of all deliveries. However, the incidence significantly increases in cases of preeclampsia and other hypertensive disorders of pregnancy. Association of abruptio placentae in cases of preeclampsia varies from 10-50%. In our study, incidence of abruption placenta in preeclampsia is 14%.

  14. Altered gene expression in human placentas after IVF/ICSI.

    Science.gov (United States)

    Nelissen, Ewka C M; Dumoulin, John C M; Busato, Florence; Ponger, Loïc; Eijssen, Lars M; Evers, Johannes L H; Tost, Jörg; van Montfoort, Aafke P A

    2014-12-01

    Is gene expression in placental tissue of IVF/ICSI patients altered when compared with a spontaneously conceived group, and are these alterations due to loss of imprinting (LOI) in the case of imprinted genes? An altered imprinted gene expression of H19 and Pleckstrin homology-like domain family A member 2 (PHLDA2), which was not due to LOI, was observed in human placentas after IVF/ICSI and several biological pathways were significantly overrepresented and mostly up-regulated. Genomic imprinting plays an important role in placental biology and in placental adaptive responses triggered by external stimuli. Changes in placental development and function can have dramatic effects on the fetus and its ability to cope with the intrauterine environment. An increased frequency of placenta-related problems as well as an adverse perinatal outcome is seen in IVF/ICSI derived pregnancies, but the role of placental epigenetic deregulation is not clear yet. In this prospective cohort study, a total of 115 IVF/ICSI and 138 control couples were included during pregnancy. After applying several exclusion criteria (i.e. preterm birth or stillbirth, no placental samples, pregnancy complications or birth defects), respectively, 81 and 105 placentas from IVF/ICSI and control pregnancies remained for analysis. Saliva samples were collected from both parents. We quantitatively analysed the mRNA expression of several growth-related imprinted genes [H19, insulin-like growth factor 2 (IGF2), PHLDA2, cyclin-dependent kinase inhibitor 1C (CDKN1C), mesoderm-specific transcript homolog (MEST) isoform α and β by quantitative PCR] after standardization against three housekeeping genes [Succinate dehydrogenase A (SDHA), YWHAZ and TATA-binding protein (TBP)]. A quantitative allele-specific expression analysis of the differentially expressed imprinted genes was performed to investigate LOI, independent of the mechanism of imprinting. Furthermore, a microarray analysis was carried out (n = 10 in

  15. The association between maternal smoking and placenta abruption: a meta-analysis.

    Science.gov (United States)

    Shobeiri, Fatemeh; Masoumi, Seyedeh Zahra; Jenabi, Ensiyeh

    2017-08-01

    Several epidemiological studies have determined that maternal smoking can increase the risk of placenta abruption. To date, only a meta-analysis has been performed for assessing the relationship between smoking and placenta abruption. This meta-analysis was conducted to estimate the association between smoking and the risk of placenta abruption. A literature search was conducted in major databases such as PubMed, Web of Science, and Scopus from the earliest possible year to April 2016. The heterogeneity across studies was explored by Q-test and I 2 statistic. The publication bias was assessed using Begg's and Egger's tests. The results were reported using odds ratio (OR) estimate with its 95% confidence intervals (CI) using a random effects model. The literature search yielded 1167 publications until April 2016 with 4 309 610 participants. Based on OR estimates obtained from case-control and cohort studies, there was a significant association between smoking and placenta abruption (1.80; 95% CI: 1.75, 1.85). Based on the results of cohort studies, smoking and placenta abruption had a significant association (relative risk ratio: 1.65; 95% CI: 1.51, 1.80). Based on reports in epidemiological studies, we showed that smoking is a risk factor for placenta abruption.

  16. Prototype and Chimera-Type Galectins in Placentas with Spontaneous and Recurrent Miscarriages.

    Science.gov (United States)

    Unverdorben, Laura; Haufe, Thomas; Santoso, Laura; Hofmann, Simone; Jeschke, Udo; Hutter, Stefan

    2016-04-28

    Galectins are galactose binding proteins and, in addition, factors for a wide range of pathologies in pregnancy. We have analyzed the expression of prototype (gal-1, -2, -7, -10) and chimera-type (gal-3) galectins in the placenta in cases of spontaneous abortions (SPA) and recurrent abortions (RA) in the first trimester. Fifteen placental samples from healthy pregnancies were used as a control group. Nine placentas were examined for spontaneous abortions, and 12 placentas for recurrent abortions. For differentiation and evaluation of different cell types of galectin-expression in the decidua, immunofluorescence was used. For all investigated prototype galectins (gal-1, -2, -7, -10) in SPA and RA placenta trophoblast cells the expression is significantly decreased. In the decidua/extravillous trophoblast only gal-2 expression was significantly lowered, which could be connected to its role in angiogenesis. In trophoblasts in first-trimester placentas and in cases of SPA and RA, prototype galectins are altered in the same way. We suspect prototype galectins have a similar function in placental tissue because of their common biochemical structure. Expression of galectin 3 as a chimera type galectin was not found to be significantly altered in abortive placentas.

  17. Efficacy and Safety of Prophylactic Uterine Artery Embolization in Pregnancy Termination with Placenta Previa

    Energy Technology Data Exchange (ETDEWEB)

    Pei, Renguang, E-mail: mediprg@bjmu.edu.cn; Wang, Guoxiang; Wang, Heping; Huang, Xinyu; Yan, Xiaoxing; Yang, Xiaohua [Yijishan Hospital of Wannan Medical College, Department of Interventional Therapy (China)

    2017-03-15

    PurposeTo appraise the efficacy and safety of prophylactic uterine artery embolization in pregnancy termination with placenta previa.MethodsA cohort of 54 consecutive patients with placenta previa underwent prophylactic uterine artery embolization before vaginal delivery from February 2012 to March 2015. Vaginal delivery was attempted in all patients. Cesarean section or hysterectomy was introduced when vaginal delivery failed.ResultsVaginal delivery succeeded in 50 patients (93.6%) and failed in 4 patients (6.4%), thereupon converted to cesarean delivery. No patients resorted to hysterectomy. Six patients (11.1%) underwent blood transfusion. None of clinical characteristics, including maternal age, gestational age, history of abortion, history of cesarean delivery, and volume of vaginal bleeding, was significantly associated with complete placenta previa (P > 0.05). However, patients with complete placenta previa had a significantly lower successful rate of vaginal delivery than did patients without complete placenta previa (81 vs 100%, P = 0.038). The rate of complications was 3.7%. No major complications were observed.ConclusionUterine artery embolization is an effective and safe technique to assist pregnancy termination with placenta previa, which may lower the risk of cesarean section, hysterectomy, and blood transfusion.

  18. Efficacy and Safety of Prophylactic Uterine Artery Embolization in Pregnancy Termination with Placenta Previa

    International Nuclear Information System (INIS)

    Pei, Renguang; Wang, Guoxiang; Wang, Heping; Huang, Xinyu; Yan, Xiaoxing; Yang, Xiaohua

    2017-01-01

    PurposeTo appraise the efficacy and safety of prophylactic uterine artery embolization in pregnancy termination with placenta previa.MethodsA cohort of 54 consecutive patients with placenta previa underwent prophylactic uterine artery embolization before vaginal delivery from February 2012 to March 2015. Vaginal delivery was attempted in all patients. Cesarean section or hysterectomy was introduced when vaginal delivery failed.ResultsVaginal delivery succeeded in 50 patients (93.6%) and failed in 4 patients (6.4%), thereupon converted to cesarean delivery. No patients resorted to hysterectomy. Six patients (11.1%) underwent blood transfusion. None of clinical characteristics, including maternal age, gestational age, history of abortion, history of cesarean delivery, and volume of vaginal bleeding, was significantly associated with complete placenta previa (P > 0.05). However, patients with complete placenta previa had a significantly lower successful rate of vaginal delivery than did patients without complete placenta previa (81 vs 100%, P = 0.038). The rate of complications was 3.7%. No major complications were observed.ConclusionUterine artery embolization is an effective and safe technique to assist pregnancy termination with placenta previa, which may lower the risk of cesarean section, hysterectomy, and blood transfusion.

  19. Validación del sistema ultramicroelisa en la certificación de placenta humana como materia prima farmacéutica y cosmética

    Directory of Open Access Journals (Sweden)

    Maydelin Trujillo Alfonso

    Full Text Available Introducción: el Laboratorio de Control Viral de la Planta Derivados de la Placenta realiza la certificación de la placenta humana como materia prima farmacéutica y cosmética mediante el sistema ultramicroanalítico. Objetivo: validar el sistema ultramicroelisa de determinación de antígeno de superficie del virus de la hepatitis B, anticuerpos contra el virus de la hepatitis C y virus de inmunodeficiencia humana tipo 1 y 2 en muestras de suero de cordón umbilical. Métodos: se realizó la calificación de la operación y la validación del desempeño analítico de los sistemas UMELISA HBsAg Plus, UMELISA HCV y UMELISA HIV 1+2 Recombinant empleandocomo sistemas de referencia el Hepanostika HBsAg Uni-FormII, Hepanostika HCV Ultra y Vironostika HIV-Uni-Form II Ag/Ab. Resultados: la calificación de la operación para las tres técnicas analíticas resultó satisfactoria. Los parámetros de especificidad diagnóstica y analítica fueron de 100 %, así como la concordancia con las técnicas de referencia. El coeficiente de variación fue menor del 10 % durante el estudio de precisión interensayo, menor que el 20 % intraensayo y se demostró la robustez de las técnicas para pequeños cambios en la temperatura de incubación. Conclusiones: los sistemas ultramicroelisa utilizados como método de control de la calidad de la placenta humana resultaron específicos, precisos y robustos en las condiciones ensayadas, por lo que pueden emplearse de manera segura y confiable.

  20. HCH and DDT residues in human placentas in Murcia (Spain)

    International Nuclear Information System (INIS)

    Falcon, M.; Oliva, J.; Osuna, E.; Barba, A.; Luna, A.

    2004-01-01

    Organochlorinated insecticides are ubiquitous toxicants that are transplacentally transferred from mother to fetus and are reported to produce adverse health effects in pregnant woman and neonates. To investigate hexachlorocyclohexane (HCH) and 1,1,1-trichloro-2,2-bis(4-chlorophenyl)ethane (DDT) exposure in pregnant woman, a total of 102 placentas were analyzed by a gas chromatograph equipped with electron capture detector. Organochlorine residues were found in 69.6% of the samples. Lindane was detected in 24.5%, α-HCH in 2.9%, β-HCH in 6.9%, p,p'-DDE in 44.1%, p,p'-DDT in 14.7% and p,p'-DDD in 10.8% of the samples. The pattern of dispersal by these substances in Murcia is similar to that described by different authors in other countries. Therefore, the past use of DDT and the present employment of lindane seem to be reflected in body tissues of the residents of this area

  1. Characterization of a cocaine binding protein in human placenta

    International Nuclear Information System (INIS)

    Ahmed, M.S.; Zhou, D.H.; Maulik, D.; Eldefrawi, M.E.

    1990-01-01

    [ 3 H]-Cocaine binding sites are identified in human placental villus tissue plasma membranes. These binding sites are associated with a protein and show saturable and specific binding of [ 3 H]-cocaine with a high affinity site of 170 fmole/mg protein. The binding is lost with pretreatment with trypsin or heat. The membrane bound protein is solubilized with the detergent 3-(3-cholamidopropyl)dimethyl-ammonio-1-propane sulphonate (CHAPS) with retention of its saturable and specific binding of [ 3 H]-cocaine. The detergent-protein complex migrates on a sepharose CL-6B gel chromatography column as a protein with an apparent molecular weight of 75,900. The protein has an S 20,w value of 5.1. The binding of this protein to norcocaine, pseudococaine, nomifensine, imipramine, desipramine, amphetamine and dopamine indicates that it shares some, but not all, the properties of the brain cocaine receptor. The physiologic significance of this protein in human placenta is currently unclear

  2. Increased levels of metallothionein in placenta of smokers

    International Nuclear Information System (INIS)

    Ronco, Ana Maria; Arguello, Graciela; Suazo, Myriam; Llanos, Miguel N.

    2005-01-01

    Experiments were designed to evaluate and compare metallothionein (MT), zinc and cadmium levels in human placentas of smoking and non-smoking women. Smoking was assessed by self-reported cigarette consumption and urine cotinine levels before delivery. Smoking pregnant women with urine cotinine levels higher than 130 ng/ml were included in the smoking group. Determination of placental MT was performed by western blot analysis after tissue homogenization and saturation with cadmium chloride (1000 ppm). Metallothionein was analyzed with a monoclonal antibody raised against MT-1 and MT-2 and with a second anti mouse antibody conjugated to alkaline phosphatase. Zinc and cadmium were determined by neutron activation analysis and atomic absorption spectrometry respectively. Smokers showed higher placental MT and cadmium levels, together with decreased newborn birth weights, as compared to non-smokers. The semi-quantitative analysis of western blots by band densitometry indicated that darker bands corresponded to MT present in smokers' samples. This study confirms that cigarette smoking increases cadmium accumulation in placental tissue and suggests that this element has a stimulatory effect on placental MT production

  3. Morphometric Evaluation of Preeclamptic Placenta Using Light Microscopic Images

    Directory of Open Access Journals (Sweden)

    Rashmi Mukherjee

    2014-01-01

    Full Text Available Deficient trophoblast invasion and anomalies in placental development generally lead to preeclampsia (PE but the inter-relationship between placental function and morphology in PE still remains unknown. The aim of this study was to evaluate the morphometric features of placental villi and capillaries in preeclamptic and normal placentae. The study included light microscopic images of placental tissue sections of 40 preeclamptic and 35 normotensive pregnant women. Preprocessing and segmentation of these images were performed to characterize the villi and capillaries. Fisher’s linear discriminant analysis (FLDA, hierarchical cluster analysis (HCA, and principal component analysis (PCA were applied to identify the most significant placental (morphometric features from microscopic images. A total of 10 morphometric features were extracted, of which the villous parameters were significantly altered in PE. FLDA identified 5 highly significant morphometric features (>90% overall discrimination accuracy. Two large subclusters were clearly visible in HCA based dendrogram. PCA returned three most significant principal components cumulatively explaining 98.4% of the total variance based on these 5 significant features. Hence, quantitative microscopic evaluation revealed that placental morphometry plays an important role in characterizing PE, where the villous is the major component that is affected.

  4. Poor agreement between operators on grading of the placenta.

    LENUS (Irish Health Repository)

    Moran, M

    2011-01-01

    Abnormal placental grading is associated with poor pregnancy outcome. The aim of this study was to measure intra- and interobserver variability in placental grading. Five expert sonographers independently graded 90 images on two occasions, each viewing separated by 1 week. A number of measures were employed to standardise assessment and minimise potential for variation: prior agreement was established between observers on the classifications for placental grading; a controlled viewing laboratory was used for all viewings; ambient lighting was optimal and monitors were calibrated to the GSDF standard. Kappa (κ) analysis was used to measure observer agreement. Substantial variations between individuals\\' scores were observed. A mean κ-value of 0.34 (range from 0.19 to 0.50) indicated fair interobserver agreement over the two occasions and only nine of the 90 images were graded the same by all five observers. Intraobserver agreement had a moderate mean κ-value of 0.52, with individual comparisons ranging from 0.45 to 0.66. This study demonstrates that, despite standardised viewing conditions, Grannum grading of the placenta is not a reliable technique even among expert observers. The need for new methods to assess placental health is required and work is ongoing to develop 2D and 3D software-based methods.

  5. The sonographic appearance and obstetric management of placenta accreta

    Science.gov (United States)

    Cheung, Charleen Sze-yan; Chan, Ben Chong-pun

    2012-01-01

    Placenta accreta is a condition of abnormal placental implantation in which the placental tissue invades beyond the decidua basalis. It may invade into or even through the myometrium and adjacent organs, such as the urinary bladder. The incidence has been rising in recent years. It is one of the important obstetric complications nowadays, leading to significant maternal morbidity and mortality. In the past, this condition was often diagnosed at the time of delivery when massive and unexpected hemorrhage occurred. Hysterectomy, associated with significant physical and psychological consequences, was usually the only management option. As more obstetricians have become aware of this condition, early identification with antenatal imaging diagnostic technology has become possible. Ultrasound scan plays an important role in the antenatal diagnosis. Various sonographic features with different specificity and sensitivity have been described in the literature. In equivocal cases, magnetic resonance imaging may be helpful. With such information, more accurate counseling can be offered to the mothers and their families before delivery. The delivery can also be arranged at a favorable time and in an institution where multidisciplinary support is available. Input from a hematologist, interventional radiologist, intensive care physician, urology surgeon, and/or other specialist are desirable. Apart from hysterectomy, various forms of conservative management can also be considered when the diagnosis is made prior to delivery. Fertility can therefore be preserved. After delivery, with or without hysterectomy performed, psychological support to the mothers and their families is essential. PMID:23239929

  6. mRNA related to insulin family in human placenta

    International Nuclear Information System (INIS)

    Younes, M.A.; D'Agostino, J.B.; Frazier, M.L.; Besch, P.K.

    1986-01-01

    The authors have previously reported that human term placenta contains mRNA displaying sequence homology to a rat preproinsulin I cDNA clone (p119). When placental poly(A + ) RNA was analyzed for homology to p119 by RNA/DNA blot hybridization, prominent hybridization was observed which was found by densitometric analysis to be three-fold higher than control. To further characterize this insulin-like message, a cDNA library was generated (approx.7000 transformants) using normal term cesarean-sectioned tissue to prepare placental poly(A + ) RNA templates. Five hundred transformants were initially screened by colony hybridization using a 32 P-labeled rat preproinsulin I cDNA as probe. Of the ten initial positives obtained, three were found to be true positives based on Southern hybridization analyses of the recombinant plasmids. Using Taq I digested pBr322 as a size marker, the cDNAs were found to be approximately 300 bp in length. Preliminary DNA sequencing using the Sanger dideoxy chain termination method has revealed that one of these clones displays significant homology to the 5' region of human insulin-like growth factors I and II

  7. mRNA related to insulin family in human placenta

    Energy Technology Data Exchange (ETDEWEB)

    Younes, M.A.; D' Agostino, J.B.; Frazier, M.L.; Besch, P.K.

    1986-03-01

    The authors have previously reported that human term placenta contains mRNA displaying sequence homology to a rat preproinsulin I cDNA clone (p119). When placental poly(A/sup +/) RNA was analyzed for homology to p119 by RNA/DNA blot hybridization, prominent hybridization was observed which was found by densitometric analysis to be three-fold higher than control. To further characterize this insulin-like message, a cDNA library was generated (approx.7000 transformants) using normal term cesarean-sectioned tissue to prepare placental poly(A/sup +/) RNA templates. Five hundred transformants were initially screened by colony hybridization using a /sup 32/P-labeled rat preproinsulin I cDNA as probe. Of the ten initial positives obtained, three were found to be true positives based on Southern hybridization analyses of the recombinant plasmids. Using Taq I digested pBr322 as a size marker, the cDNAs were found to be approximately 300 bp in length. Preliminary DNA sequencing using the Sanger dideoxy chain termination method has revealed that one of these clones displays significant homology to the 5' region of human insulin-like growth factors I and II.

  8. Decreased placental and maternal serum TRAIL-R2 levels are associated with placenta accreta.

    Science.gov (United States)

    Oztas, Efser; Ozler, Sibel; Ersoy, Ali Ozgur; Ersoy, Ebru; Caglar, Ali Turhan; Uygur, Dilek; Yucel, Aykan; Ergin, Merve; Danisman, Nuri

    2016-03-01

    TNF-related apoptosis-inducing ligand receptor-2 (TRAIL-R2) is produced both by decidual and trophoblast cells during pregnancy and known to participate in apoptosis. In this study, we aimed to determine and to compare maternal serum and placental TRAIL-R2 levels in patients with placenta accreta, non-adherent placenta previa and in healthy pregnancies. We also aimed to analyze the association of placenta accreta with the occurrence of previous C-sections. A total of 82 pregnant women were enrolled in this case-control study (27 placenta accreta patients, 26 non-adherent placenta previa patients and 29 age-, and BMI-matched healthy, uncomplicated pregnant controls). TRAIL-R2 levels were studied in both maternal serum and placental tissue homogenates. Determining the best predictor(s) which discriminate placenta accreta was analyzed by multiple logistic regression analyses. Adjusted odds ratios and 95% confidence intervals were also calculated. Both placental and serum TRAIL-R2 levels were significantly lower in placenta accreta group (median 34.82 pg/mg and 19.85 pg/mL, respectively) when compared with both non-adherent placenta previa (median 39.24 pg/mg and 25.99 pg/mL, respectively) and the control groups (median 41.62 pg/mg and 25.87 pg/mL, respectively) (p Placental TRAIL-R2 levels and previous cesarean section were found to be significantly associated with placenta accreta (OR: 0.934 95% CI 0.883-0.987, p = 0.016 and OR:7.725 95% CI: 2.717-21.965, p Placental and serum TRAIL-R2 levels were positively correlated. Decreased levels of placental TRAIL-R2 and previous history of cesarean section were found to be significantly associated with placenta accreta, suggesting a possible role of apoptosis in abnormal trophoblast invasion. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. [Severe Adverse Pregnancy Outcomes in Placenta Previa and Prior Cesarean Delivery].

    Science.gov (United States)

    Zhou, Mi; Chen, Meng; Zhang, Li; He, Guo-Lin; He, Lei; Wei, Qiang; Li, Tao; Liu, Xing-Hui

    2017-09-01

    To investigate the severe adverse pregnancy outcomes in pregnancies with placenta previa and prior cesarean delivery and its risk factors. This retrospective casecontrol study reviewed all pregnancies with placenta previa and prior cesarean delivery delivered by repeat cesarean section in our institution between January 2005 and June 2015,and investigated the incidence of severe adverse pregnancy outcome. A composite of severe adverse pregnancy outcomes (including transfusion of 10 units or more red blood cells,maternal ICU admission,unanticipated injuries,repeat operation,hysterectomy,and maternal death) and other maternal and neonatal outcomes were described. Univariate and multivariable logistic regression analysis were used to quantify the effects of risk factors on severe adverse pregnancy outcomes. There were 478 women with placenta previa and prior cesarean delivery in our hospital over the last decade. The average age of them was 32.5±4.8 years old,most women were beyond 30 years old,the average gravidity and parity were 4 and 1,131 cases (27.4%) had severe adverse pregnancy outcomes. Transfusion of 10 units or more red blood cells happened in 75 cases (15.7%,75/478); 44 cases (9.2%,44/478) necessitated maternal ICU admission; unanticipated bladder injury occurred in 11 cases,but non ureter or bowel injury happened; All 4 repeat operations were due to delayed hemorrhage after conservative management during cesarean delivery,and an emergent hysterectomy was performed for all of the 4 cases. Hysterectomy (107 cases,22.4%) was the most common severe adverse pregnancy outcome. Among all 311 morbidly adherent placenta cases finally confirmed by pathological or surgical findings or both,only 172 (55.3%) were suspected before delivery. Multivariable logistic regression analysis showed that the risk of severe adverse pregnancy outcomes was significantly increased by pernicious placenta previa (i.e. anterior placenta overlying the prior cesarean scar),suspicion of

  10. Dianthus chinensis L.: The Structural Difference between Vascular Bundles in the Placenta and Ovary Wall Suggests Their Different Origin.

    Science.gov (United States)

    Guo, Xue-Min; Yu, Ying-Ying; Bai, Lan; Gao, Rong-Fu

    2017-01-01

    Dianthus chinensis is a perennial herbaceous plant with great ornamental, botanical, ecological, and medicinal value. The pistil of D. chinensis is composed of two fused carpels with free central placenta and two separate styles. The placenta is a columnar structure extending about two-thirds the length of the maturing fruit, which is typical of the Caryophyllaceous. Traditionally, free central placenta is thought to have evolved from axial placenta by septal disappearance, and axial placenta to have occurred through fusion of conduplicate carpels with marginal placenta. However, the traditional opinion is becoming more and more inconsistent with the new data gained in recent research of angiosperm systematics. To clarify the origin of D. chinensis pistil, the present anatomical study was carried out. The results show that the vascular system of placenta is independent to that of the ovary wall in D. chinensis . Moreover, in the central part of placenta there are one or two amphicribral bundles, and correspondingly numerous ones in the pistil which supply the ovules/seeds. It is obvious that the central amphicribral bundles in placenta are comparable to the counterparts in branches but not to those in leaves or their derivatives. Therefore, it is reasonable to deduce that the placenta of D. chinensis was not derived from conduplicate carpels through fusion of collateral vascular bundles, and actually a floral axis with ovules/seeds laterally adhering. On the contrary, the ovary wall was the lateral appendages of the floral axis. The result of the present study is completely in agreement with Unifying Theory, in which the placenta is taken as an ovule-bearing branch. Except for D. chinensis , the similar vascular organization has been observed in placenta of numerous isolated taxa. But till now, it is uncertain that whether this vascular organization pattern is popular in the whole angiosperms or not. More intensive and extensive investigations are needed.

  11. Evaluation of glycosaminoglycans and heparanase in placentas of women with preeclampsia.

    Science.gov (United States)

    Famá, Eduardo Augusto Brosco; Souza, Renan Salvioni; Melo, Carina Mucciolo; Melo Pompei, Luciano; Pinhal, Maria Aparecida Silva

    2014-11-01

    Preeclampsia is a multisystem disorder whose etiology remains unclear. It is already known that circulation of soluble fms-like tyrosine kinase-1 (sFlt-1) is directly involved in pre-eclampsia development. However, the molecular mechanisms involved with sFlt-1 shedding are still unidentified. We identified, quantified glycosaminoglycans and determined the enzymatic activity of heparanase in placentas of women with preeclampsia, in order to possibly explain if these compounds could be related to cellular processes involved with preeclampsia. A total of 45 samples collected from placentas, 15 samples from placentas of preeclampsia women and 30 samples from non-affected women. Heparan sulfate and dermatan sulfate were identified and quantified by agarose gel electrophoresis, whilst hyaluronic acid was quantified by an ELISA like assay. Heparanase activity was determined using biotynilated heparan sulfate as substrate. The results showed that dermatan sulfate (P=0.019), heparan sulfate levels (P=0.015) and heparanase activity (P=0.006) in preeclampsia were significantly higher than in the control group. There was no significant difference between the groups for hyaluronic acid expression in placentas (P=0.110). The present study is the first to demonstrate directly the increase of heparan sulfate in human placentas from patients with preeclampsia, suggesting that endogenous heparan sulfate could be involved in the release of sFlt-1 from placenta, increasing the level of circulating sFlt-1. Alterations of extracellular matrix components in placentas with preeclampsia raise the possibility that heparan sulfate released by heparanase is involved in mechanisms of preeclampsia development. Published by Elsevier B.V.

  12. Measurement of elasticity of normal placenta using the Virtual Touch quantification technique

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Size; Nan, Ruixia; Cui, Xiao Jing; Liang, Xian; Zhao, Yanan [Dept. of Ultrasound, Affiliated Hospital of Hainan Medical College, Haikou (China); Li, Yueping [Dept. of Obstetrics and Gynecology, Affiliated Hospital of Hainan Medical College, Haikou (China)

    2016-07-15

    The aim of this study was to measure the elasticity of normal placentas using the Virtual Touch quantification (VTQ) technique. This study was approved by the Institutional Ethics Committee. Fifty randomly selected, healthy pregnant women in their second trimester and 50 randomly selected, healthy pregnant women in their third trimester with a single fetus were included, and their placentas underwent VTQ through shear wave velocity (SWV) measurements. The measurements were performed at different locations to sample different areas of the placenta. Measurements were performed 3-4 times in each location, the mean shear wave velocities were calculated without the highest and lowest values of measurements in each region, and the results were compared. The SWV of the placenta was 0.983±0.260 m/sec, and the minimal and maximal speed was 0.63 m/sec and 1.84 m/sec, respectively. There was no significant difference between the second and third trimester of VTQ of the placenta in terms of SWV (0.978±0.255 m/sec vs. 0.987±0.266 m/sec, P=0.711). The maternal age between second and third trimester was 27.9±4.3 years and 29.2±4.4 years, respectively; there was no significant difference between them (P=0.159). The results of this study show that the SWV of normal placenta tissue is 0.983±0.260 m/sec, it has little variation between the second and third trimesters, and the VTQ technique may potentially play an additional role in placenta evaluation.

  13. Measurement of elasticity of normal placenta using the Virtual Touch quantification technique

    International Nuclear Information System (INIS)

    Wu, Size; Nan, Ruixia; Cui, Xiao Jing; Liang, Xian; Zhao, Yanan; Li, Yueping

    2016-01-01

    The aim of this study was to measure the elasticity of normal placentas using the Virtual Touch quantification (VTQ) technique. This study was approved by the Institutional Ethics Committee. Fifty randomly selected, healthy pregnant women in their second trimester and 50 randomly selected, healthy pregnant women in their third trimester with a single fetus were included, and their placentas underwent VTQ through shear wave velocity (SWV) measurements. The measurements were performed at different locations to sample different areas of the placenta. Measurements were performed 3-4 times in each location, the mean shear wave velocities were calculated without the highest and lowest values of measurements in each region, and the results were compared. The SWV of the placenta was 0.983±0.260 m/sec, and the minimal and maximal speed was 0.63 m/sec and 1.84 m/sec, respectively. There was no significant difference between the second and third trimester of VTQ of the placenta in terms of SWV (0.978±0.255 m/sec vs. 0.987±0.266 m/sec, P=0.711). The maternal age between second and third trimester was 27.9±4.3 years and 29.2±4.4 years, respectively; there was no significant difference between them (P=0.159). The results of this study show that the SWV of normal placenta tissue is 0.983±0.260 m/sec, it has little variation between the second and third trimesters, and the VTQ technique may potentially play an additional role in placenta evaluation

  14. LABOUR TERMINATION AND PERINATAL OUTCOME IN PREGNANT WOMEN WITH PLACENTA ABRUPTION WITH PPROM AND PROM

    Directory of Open Access Journals (Sweden)

    Ranko Kutlesic

    2007-10-01

    Full Text Available Placenta abruption is an obstetric accident which endangers life and health of both mother and embryo. It is one of the most serious obstetric complications, whose incidence ranges from 4.9-12.9 per 1,000 labours, and according to frequency, it represents the second cause of perinatal death. Retrospective analysis included the interval from 1996 to 2005. Total number of labours was analyzed and it was 32358. In addition, the number of labours complicated by placenta abruption was analyzed, and it was 119 or 0.37%. It analyzed the incidence of placenta abruption according to age of pregnancy and the integrity of embryonic membranes. It is established that there is no statistically significant difference in the incidence of placenta abruption appearing in pregnant women, with and without the disruption of embryonic membranes. The age of pregnant women was also analyzed, and it was found out that the pregnant women with placenta abruption and PPROM were 5 years older than those with placenta abruption without PPROM, and that this difference was very significant. Disruption duration was analyzed as well as the time from the first uterus bleeding to labour. The difference between PPROM and PROM duration was statistically significant, as well as the difference in duration between spontaneous and artificial rupture of embryonic membranes. The way of labour termination was analyzed in pregnant women with verified placenta abruption. In 80% of pregnant women, the labour was terminated by Caesarian section, and only 20% by vaginal labour. Also, the perinatal outcome was analyzed, according to Apgar score in the first and fifth minute. Apgar score showed that out of the total number of abruptions, 7 neonatuses was born dead (11.66%, 13 (21.66% was born in good condition (Apgar score>7, 26 (43.33% was marked with 4-7, while 14 (23.33% was in hard asphyxia (Apgar score 1-5.

  15. Measurement of elasticity of normal placenta using the Virtual Touch quantification technique

    Directory of Open Access Journals (Sweden)

    Size Wu

    2016-07-01

    Full Text Available Purpose: The aim of this study was to measure the elasticity of normal placentas using the Virtual Touch quantification (VTQ technique. Methods: This study was approved by the Institutional Ethics Committee. Fifty randomly selected, healthy pregnant women in their second trimester and 50 randomly selected, healthy pregnant women in their third trimester with a single fetus were included, and their placentas underwent VTQ through shear wave velocity (SWV measurements. The measurements were performed at different locations to sample different areas of the placenta. Measurements were performed 3-4 times in each location, the mean shear wave velocities were calculated without the highest and lowest values of measurements in each region, and the results were compared. Results: The SWV of the placenta was 0.983±0.260 m/sec, and the minimal and maximal speed was 0.63 m/sec and 1.84 m/sec, respectively. There was no significant difference between the second and third trimester of VTQ of the placenta in terms of SWV (0.978±0.255 m/sec vs. 0.987±0.266 m/sec, P=0.711. The maternal age between second and third trimester was 27.9±4.3 years and 29.2±4.4 years, respectively; there was no significant difference between them (P=0.159. Conclusion: The results of this study show that the SWV of normal placenta tissue is 0.983±0.260 m/sec, it has little variation between the second and third trimesters, and the VTQ technique may potentially play an additional role in placenta evaluation.

  16. Placenta Increta after First-Trimester Dilatation and Curettage Manifesting as an Unusual Uterine Mass: Magnetic Resonance Findings

    Energy Technology Data Exchange (ETDEWEB)

    Ju, W.; Kim, S.C. [Dept. of Obstetrics and Gynecology, and Medical Research Inst., School of Medicine, Ewha Womens Univ., Seoul (Korea)

    2007-10-15

    Placenta increta during the first trimester of pregnancy is extremely rare. Only a few cases of placenta accreta during the latter half of pregnancy manifesting as a uterine mass have been published. This report describes a case of placenta increta that caused prolonged bleeding after a first-trimester abortion, and was identified by magnetic resonance imaging (MRI) as a heterogeneous mass in the myometrium. This is the first report of a placenta increta detected as a uterine mass after first-trimester dilatation and curettage, and its MRI findings.

  17. Paciente con esquizofrenia tratado con ziprasidona + clozapina

    Directory of Open Access Journals (Sweden)

    Pol Yanguas E.

    2013-05-01

    Full Text Available P es un paciente diagnosticado de esquizofrenia, sigue en un piso tutelado un programa de rehabilitación, está medicado con clozapina 500 mg/día y ziprasidona 280 mg/ día. Padece hipercolesterolemia, tabaquismo y sus hábitos alimenticios no son buenos. La medicación que utiliza desde 2007 hasta ahora se refleja en la tabla 1. El último tratamiento se le introdujo el 7 de agosto de 2012, habiendo presentado un electro cardiograma (ECG normal, pero con ligera taquicardia ventricular y prolactinemia de 44,8 ng/ml (valores normales: 2-18 ng/ml.

  18. Pregnancy Complications: Placental Accreta, Increta and Percreta

    Science.gov (United States)

    ... Careers Archives Health Topics Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ... Report Cards Careers Archives Pregnancy Before or between pregnancies Nutrition, weight & fitness Prenatal care Is it safe? Labor & ...

  19. Aspectos morfológicos da placenta da preguiça, Bradypus variegatus Shinz, 1825

    Directory of Open Access Journals (Sweden)

    Marleyne José Afonso Accyoli Lins Amorin

    2003-01-01

    Full Text Available Estudaram-se os aspectos morfológicos da placenta e das membranas fetais de 03 placentas de bichos-preguiça (Bradypus variegatus, adultas e prenhes, originárias da Zona da Mata do Estado de Pernambuco. Essas estruturas foram obtidas de 03 fêmeas doadas pela Universidade Federal de Pernambuco, das quais duas encontravam-se congeladas e a terceira foi colhida mediante realização de cirurgia cesariana, onde mãe e feto foram preservados. Depois de descongeladas, as placentas foram fixadas em solução aquosa de formol 10,00%. Da placenta obtida da cesariana colheram-se pequenos fragmentos da região placentária e do funículo umbilical, os quais foram fixados em paraformoldeido 4,00%, tampão fosfato pH 7,4. Os fragmentos passaram pela rotina histológica, onde foram coradas em Hematoxilina e Eosina e Tricrômio de Masson. A placenta da preguiça é corioamniótica, com o cório viloso constituindo os lobos placentários, que se localizam na região fúndica do útero, e o cório liso relacionando-se com a face interna do útero. Nas placentas de final de prenhez os lobos aglomeram-se e fundem-se aumentando de tamanho, formando uma massa principal discóide, caracterizando uma placenta zonária discoidal, que se une ao feto pelo funículo umbilical, constituído por duas artérias e uma veia umbilical. Os resultados histológicos demonstraram que a placenta desses animais é labiríntica e endoteliocorial. Assim, a placenta da preguiça pode ser classificada como labiríntica, endoteliocorial, múltipla, discóide (a termo e corioamniótica.

  20. A placenta clinic approach to the diagnosis and management of fetal growth restriction.

    Science.gov (United States)

    Kingdom, John C; Audette, Melanie C; Hobson, Sebastian R; Windrim, Rory C; Morgen, Eric

    2018-02-01

    Effective detection and management of fetal growth restriction is relevant to all obstetric care providers. Models of best practice to care for these patients and their families continue to evolve. Since much of the disease burden in fetal growth restriction originates in the placenta, the concept of a multidisciplinary placenta clinic program, managed primarily within a maternal-fetal medicine division, has gained popularity. In this context, fetal growth restriction is merely one of many placenta-related disorders that can benefit from an interdisciplinary approach, incorporating expertise from specialist perinatal ultrasound and magnetic resonance imaging, reproductive genetics, neonatal pediatrics, internal medicine subspecialties, perinatal pathology, and nursing. The accurate diagnosis and prognosis for women with fetal growth restriction is established by comprehensive clinical review and detailed sonographic evaluation of the fetus, combined with uterine artery Doppler and morphologic assessment of the placenta. Diagnostic accuracy for placenta-mediated fetal growth restriction may be enhanced by quantification of maternal serum biomarkers including placenta growth factor alone or combined with soluble fms-like tyrosine kinase-1. Uterine artery Doppler is typically abnormal in most instances of early-onset fetal growth restriction and is associated with coexistent preeclampsia and underlying maternal vascular malperfusion pathology of the placenta. By contrast, rare but potentially more serious underlying placental diagnoses, such as massive perivillous fibrinoid deposition, chronic histiocytic intervillositis, or fetal thrombotic vasculopathy, may be associated with normal uterine artery Doppler waveforms. Despite minor variations in placental size, shape, and cord insertion, placental function remains, largely normal in the general population. Consequently, morphologic assessment of the placenta is not currently incorporated into current screening

  1. Porcine placenta mitigates protein-energy malnutrition-induced fatigue.

    Science.gov (United States)

    Han, Na-Ra; Kim, Kyu-Yeop; Kim, Myong-Jo; Kim, Min-Ho; Kim, Hyung-Min; Jeong, Hyun-Ja

    2013-01-01

    Fatigue can be caused by a deficiency of nutrition or immune function. The goal of this study was to identify the effects of porcine placenta extract (PPE) and its constituents, amino acids (glutamic acid, glycine, arginine, and proline), on protein-energy malnutrition (PEM)-induced fatigue. Mice were administered a PEM diet and came to immunodeficient status. Simultaneously, the mice were administered PPE or amino acids and a forced swimming test (FST) was performed. We analyzed the levels of fatigue-related factors in serum, splenocytes, and muscles. In the FST, PPE or amino acids significantly decreased immobility times compared with the PEM diet. PPE or amino acids also significantly decreased the serum levels of fatigue-related factors after the FST. Additionally, PPE significantly decreased the levels of fatigue-related muscle parameters after the FST. In this in vitro study, PPE increased the mRNA and protein expression of Ki-67 and promoted the proliferation of splenocytes. PPE or amino acids significantly increased the levels of intracellular calcium and the translocation into the nucleus of nuclear factor of activated T-cells cytoplasmic in stimulated splenocytes. PPE or amino acids significantly decreased the production of fatigue-related inflammatory cytokines in the stimulated splenocytes. Additionally, the translocated levels of nuclear factor-κB in the nucleus and the degradation of the inhibitory protein, IκBα, in the cytosol were inhibited by PPE or amino acids. These results demonstrate that PPE and its constituents regulate PEM-induced fatigue through improving levels of immunity and decreasing fatigue-related factors. PPE may be a potential agent for a recovery from fatigue. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. The sonographic appearance and obstetric management of placenta accreta

    Directory of Open Access Journals (Sweden)

    Cheung CS

    2012-11-01

    Full Text Available Charleen Sze-yan Cheung, Ben Chong-pun ChanDepartment of Obstetrics and Gynaecology, Queen Mary Hospital, Hong KongAbstract: Placenta accreta is a condition of abnormal placental implantation in which the placental tissue invades beyond the decidua basalis. It may invade into or even through the myometrium and adjacent organs, such as the urinary bladder. The incidence has been rising in recent years. It is one of the important obstetric complications nowadays, leading to significant maternal morbidity and mortality. In the past, this condition was often diagnosed at the time of delivery when massive and unexpected hemorrhage occurred. Hysterectomy, associated with significant physical and psychological consequences, was usually the only management option. As more obstetricians have become aware of this condition, early identification with antenatal imaging diagnostic technology has become possible. Ultrasound scan plays an important role in the antenatal diagnosis. Various sonographic features with different specificity and sensitivity have been described in the literature. In equivocal cases, magnetic resonance imaging may be helpful. With such information, more accurate counseling can be offered to the mothers and their families before delivery. The delivery can also be arranged at a favorable time and in an institution where multidisciplinary support is available. Input from a hematologist, interventional radiologist, intensive care physician, urology surgeon, and/or other specialist are desirable. Apart from hysterectomy, various forms of conservative management can also be considered when the diagnosis is made prior to delivery. Fertility can therefore be preserved. After delivery, with or without hysterectomy performed, psychological support to the mothers and their families is essential.Keywords: ultrasonography, hemorrhage, hysterectomy

  3. Increased autophagy in placentas of intrauterine growth-restricted pregnancies.

    Directory of Open Access Journals (Sweden)

    Tai-Ho Hung

    Full Text Available Unexplained intrauterine growth restriction (IUGR may be a consequence of placental insufficiency; however, its etiology is not fully understood. We surmised that defective placentation in IUGR dysregulates cellular bioenergic homeostasis, leading to increased autophagy in the villous trophoblast. The aims of this work were (1 to compare the differences in autophagy, p53 expression, and apoptosis between placentas of women with normal or IUGR pregnancies; (2 to study the effects of hypoxia and the role of p53 in regulating trophoblast autophagy; and (3 to investigate the relationship between autophagy and apoptosis in hypoxic trophoblasts.Compared with normal pregnant women, women with IUGR had higher placental levels of autophagy-related proteins LC3B-II, beclin-1, and damage-regulated autophagy modulator (DRAM, with increased p53 and caspase-cleaved cytokeratin 18 (M30. Furthermore, cytotrophoblasts cultured under hypoxia (2% oxygen in the presence or absence of nutlin-3 (a p53 activity stimulator had higher levels of LC3B-II, DRAM, and M30 proteins and increased Bax mRNA expression compared with controls cultured under standard conditions. In contrast, administration of pifithrin-α (a p53 activity inhibitor during hypoxia resulted in protein levels that were similar to those of the control groups. Moreover, cytotrophoblasts transfected with LC3B, beclin-1, or DRAM siRNA had higher levels of M30 compared with the controls under hypoxia. However, transfection with Bcl-2 or Bax siRNA did not cause any significant change in the levels of LC3B-II in hypoxic cytotrophoblasts.Together, these results suggest that there is a crosstalk between autophagy and apoptosis in IUGR and that p53 plays a pivotal and complex role in regulating trophoblast cell turnover in response to hypoxic stress.

  4. The association between uterine leiomyoma and placenta abruption: A meta-analysis.

    Science.gov (United States)

    Jenabi, Ensiyeh; Ebrahimzadeh Zagami, Samira

    2017-11-01

    Some epidemiological studies have found that uterine leiomyoma can increase the risk of placenta abruption. To date, the meta-analysis has not been performed for assessing the relationship between uterine leiomyoma and placenta abruption. This meta-analysis was conducted to estimate the association between uterine leiomyoma and the risk of placenta abruption. A literature search was conducted out in major databases PubMed, Web of Science, and Scopus from the earliest possible year to October 2016. The heterogeneity across studies was explored by Q-test and I 2 statistic. The publication bias was assessed by Begg's and Egger's tests. The results were showed using odds ratio (OR) estimate with its 95% confidence intervals (CI) using a random-effects model. The literature search included 953 articles until October 2016 with 232,024 participants. Based on OR estimates obtained from case-control and cohort studies, there was significant association between uterine leiomyoma and placenta abruption (2.63; 95% CI: 1.38, 3.88). We showed based on reports in observational studies that uterine leiomyoma is a risk factor for placenta abruption.

  5. Participation in environmental health research by placenta donation - a perception study.

    Science.gov (United States)

    Lind, Uffe; Mose, Tina; Knudsen, Lisbeth E

    2007-11-22

    Much environmental health research depends on human volunteers participating with biological samples. The perception study explores why and how people participate in a placenta perfusion study in Copenhagen. The participation implies donation of the placenta after birth and some background information but no follow up. Nineteen semi-structured qualitative interviews were conducted with participants in the placenta perfusion study after donation of placenta. Observation studies were made of recruitment sessions. The interviewed participants are generally in favour of medical research. They participated in the placenta perfusion study due to a belief that societal progress follows medical research. They also felt that participating was a way of giving something back to the Danish health care system. The participants have trust in medical science and scientists, but trust is something which needs to be created through "trust-work". Face-to-face interaction, written information material and informed consent forms play important parts in creating trusting relationships in medical research. Medical research ethics do not only amount to specific types of written information material but should also be seen as a number of trust making performances involving researchers as well as research participants.

  6. Organochlorine pesticide residues in human breast milk and placenta in Tohoku, Japan

    Energy Technology Data Exchange (ETDEWEB)

    Nakai, K.; Suzuki, K.; Oka, T.; Sugawara, N.; Ohba, T.; Kameo, S.; Satoh, H. [Environmental Heath Sciences, Tohoku Univ. Graduate School of Medicine, Sendai (Japan); Nakamura, T.; Saitoh, Y. [Miyagi Prefectural Inst. of Piblic Health and Environment (Japan); Okamura, K. [Dept. of Obstetrics, Tohoku Univ. Graduate School of Medicine, Sendai (Japan)

    2004-09-15

    Recently, we have started a birth cohort study to examine the effects of exposure to persistent organochemical pollutants and heavy metals on neurodevelopment in Japanese children, The Tohoku Study of Child Development. In this cohort study, biological samples, including maternal peripheral blood, cord blood, placenta, cord tissue, and breast milk have been collected from more than six hundred mother-infant pairs for chemical determinations. The growth of infants has been monitored using neurodevelopmental tests, including the Brazelton Neonatal Behavioral Assessment Scale, the Bayley Scale of Infant Development, the Kyoto Scale of Psychological Development, and others. Exposures to dioxin and related compounds, polychlorinated biphenyls, methylmercury, and several heavy metals were assessed. Additionally, since perinatal exposure to organochlorine pesticides may affect the neurodevelopment of children, we examined the effects of those pesticides in the cohort study. In the present study, several organochlorine pesticides were analyzed in human breast milk and placenta from 20 mothers to identify the major pesticide compounds found in the cohort subjects. The relationship between pesticides in breast milk and the placenta was analyzed to examine the utilization of the placenta as the material for exposure assessment. Some information regarding the factors affecting the contamination of breast milk and the placenta with organochlorine pesticides are also discussed.

  7. Metabolic development of the porcine placenta in response to alterations in maternal or fetal homeostasis

    International Nuclear Information System (INIS)

    Namsey, T.G.; kasser, T.R.; Hausman, G.J.; Martin, R.J.

    1986-01-01

    Porcine placenta has been utilized as a model for elucidating contributions of both fetal and maternal tissues to metabolic activity of the placenta in response to a variety of stresses. Alloxan diabetes, food restriction and genetic obesity all produced alterations in placental metablolism with differences in responses of fetal and maternal placentas. Further analysis of nutrient untilization by the placenta produced dramatic differences in the partitioning of substrates by fetal and maternal tissues during placental development. Metabolic activity of maternal tissue contributed to overall placental metabolic activity to a greater degree than fetal tissue. However, experiments with in utero fetal decapitation indicated that some of differences between fetal and maternal placental metabolic activity may be due to the influence of fetal regulatory mechanisms. Maternal endometrium plays a critical role in metabolic response of uteroplacenta and thus availability of nutrients to the fetus and fetal placenta. Differences in metabolic development of fetal and maternal tissues suggested that regulation of placental metabolism may originate from fetal as well as maternal sources

  8. Growth and maturation of villi in placentae from well-controlled diabetic women

    DEFF Research Database (Denmark)

    Mayhew, T M; Sørensen, Flemming Brandt; Klebe, J G

    1994-01-01

    Placentae from controls and two groups of diabetic women (one White classes A, B, C and the other classes D, F/R) were collected at 37-42 weeks of gestation. Tissue sections were analysed using stereological methods in order to quantify the growth and maturational status of villi. Birth and place......Placentae from controls and two groups of diabetic women (one White classes A, B, C and the other classes D, F/R) were collected at 37-42 weeks of gestation. Tissue sections were analysed using stereological methods in order to quantify the growth and maturational status of villi. Birth...... with group, mode of delivery and sex of newborn as the principal effects. Mean weights were similar in controls and diabetic groups. Diabetic placentae had a more voluminous fetal capillary bed of greater length, diameter and surface area. In addition, the diffusion distances across fetal plasma (erythrocyte...... on the fetal side of the diabetic placenta. They show that changes can affect the placentae of appropriate-for-age as well as large-for-age babies and provide no evidence that they increase with the severity and duration of diabetes....

  9. Rising frequency of placenta previa and associated morbidity in women with previous casearean section

    International Nuclear Information System (INIS)

    Akhter, F.; Nawaz, Q.; Mushtaq, Q.U.A.

    2015-01-01

    To determine rising frequency of placenta previa and its associated morbidity in women with previous caesarean section. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted in the Department of Obstetrics and Gynecology at CMH Kohat from Jul 2010 to Jun 2011. Patients and Methods: This study included all pregnant women undergoing repeat caesarean sections. Of these, total 74 patients were admitted with placenta previa. The frequency and associated morbidity were determined. Results: In our study 74 patients with placenta previa were included. 71.62% were less than 35 yrs of age, while 28.38% were equal to or more than 35 years. The gestational age at presentation was 24-36 weeks in 74.3% and 37 + weeks in 5.7% at presentation, 89% patients were symptomatic and 11% were asympyomatic. The morbidities observed were placenta accrete 47%, urinary tract trauma in 63.51%, caesarean hysterectomy in 62.16%, post operative febrile morbidity in 77.03%, maternal mortality was nil, paralytic ileus in 28.38%, PPH in 82.43%, surgical site infection in 16.21%. Conclusion: Frequency of placenta previa and its associated morbidity was raised due to repeated caesarean section rate which must be reduced to decrease maternal morbidity and mortality. (author)

  10. Uterine artery embolization for the management of secondary postpartum haemorrhage associated with placenta accreta

    International Nuclear Information System (INIS)

    Li, X.; Wang, Z.; Chen, J.; Shi, H.; Zhang, X.; Pan, J.; Liu, W.; Yang, N.; Jin, Z.; Lang, J.

    2012-01-01

    Aim: To evaluate the efficacy and safety of uterine artery embolization for the management of secondary postpartum haemorrhage associated with placenta accreta. Materials and methods: Between January 2005 and August 2011, 45 women with placenta accreta, which was discovered during delivery, were managed conservatively in Peking Union Medical College Hospital. They did not experience severe bleeding during delivery. Ten patients (mean age 31 ± 6.4 years) developed secondary postpartum haemorrhage and underwent uterine artery embolization. The complications, control of haemorrhage, and outcome of the placenta left inside the uterus were retrospectively reviewed. Results: All patients underwent transcatheter embolization of bilateral uterine arteries. The median time between delivery and uterine artery embolization was 11 days (range 3–76 days). The technical success rate of embolization was 100%. Bleeding was controlled in all patients during follow-up (11 ± 6.9 months; range 3–24 months), and no further bleeding occurred. One patient developed lower-extremity deep venous thrombosis after uterine artery embolization, and no other major complications occurred. The placentae that were left inside the uteri gradually decreased in size during follow-up, except in one case. Nine patients resumed normal menstruation. One patient subsequently became pregnant and had an uneventful intrauterine pregnancy carried to term. Conclusion: Uterine artery embolization is safe and effective for the management of secondary postpartum haemorrhage associated with placenta accreta.

  11. Analysis of placenta vascularization in patients with uterine altered artery Doppler flow velocity exams.

    Science.gov (United States)

    Gilio, Daniel Bruno; Miranda Corrêa, Rosana Rosa; Souza de Oliveira Guimarães, Camila; Peres, Luiz Cesar; Marques Salge, Ana Karina; Cavellani, Camila Lourencini; de Paula Antunes Teixeira, Vicente; Costa da Cunha Castro, Eumenia

    2009-08-01

    One of the frequent questions in obstetric practice is to determine placental vascular changes that may account for abnormal Doppler flow velocity alterations in maternal uterine vessels from women and fetuses without pregnancy pathology. A retrospective morphometric study was realized using 27 placentas from patients submitted for Doppler flow velocity exam during pregnancy. The placentas were morphologically examined using hematoxylin-eosin staining. Measurements of villi were made with the use of a video camera coupled to a common light microscope and a computer with automatic image analyzing software. Of the 27 placentas, 13 (48%) were of patients showing unaltered Doppler and 14 (52%) showing altered Doppler. The number of stem villi vessels was significantly larger in the placentas of patients with Doppler exam alterations (P = 0.003). This group also presented greater stem villi vessel thickness, although without significant difference. The number of intermediary and terminal villi vessels was greater in the placentas of patients with altered Doppler exams (P < 0.001), and a greater terminal villi area was observed in these cases (P < 0.001). The morphological proof that uterine artery Doppler flow velocity exam alterations are associated with placental vascular alterations demonstrates the importance of this exam during prenatal care, even in the absence of maternal-fetal alterations.

  12. Histological features of the placenta and their relation to the gross and data from Thoroughbred mares

    Directory of Open Access Journals (Sweden)

    Fernanda M. Pazinato

    Full Text Available Abstract: The placenta is a transitory organ that originates from maternal and fetal tissues, the function of which is transporting nutrients from the mother to the fetus. The aim of this study was describe the histological features of placentas in healthy Thoroughbred mares at foaling and evaluate their relation with the gross placental and data of these mares. For this study 188 Thoroughbred mares were used. It was performed clinical observation for signs of placentitis during daily health checks and ultrasonic examination monthly to assess the fetus and placenta. All of the mares that exhibited clinical signs of placentitis were treated during gestation. The parturition was assisted, the placentas were grossly evaluated and samples were collected immediately after expulsion. The following data were considered for each mare: age, gestational age, number of parturition, time for placental expulsion, umbilical-cord length, placental weight and clinical signs of placentitis. Histological evaluation of the placentas revealed extensive cytoplasmic vacuolization of the epithelial areolar cells, presence of inflammatory infiltrates and hypoplasia-atrophy of the microcotyledons. Most of the gross placental findings were consistent with the histological results. In conclusion the mares with a vacuolated placental chorionic epithelium were older and had experienced a larger number of births. Great part of the mares with inflammatory infiltrates did not showed any clinical signs of placentitis during gestation.

  13. Primary observation of clinical curative effect of superselective uterine artery embolization for treatment of placenta increta

    International Nuclear Information System (INIS)

    Wang Changfu; Zhang Heping; Zhang Hongxia; Jin Haiying; Wang Binjie; He Xiang; Zhang Jie; Li Changbo

    2008-01-01

    Objective: To explore the curative effect on superselective uterine artery embolization for treatment of placenta increta. Methods: Pelvic arteriography was performed to confirm bleeding vessels. Then a 5 F Cobra catheter was inserted superselectively into uterine artery ipsilateral to bleeding, through which methotrexatum (MTX) and gelatin sponge were injected for embolization. After the procedure, bleeding, blood pressure, dischargement of placenta tissue, uterine recuperation, and plasma β-HCG were monitored. Results: Bleeding vessels were confirmed in all of the 5 cases of placenta increta. Uterine artery embolization was successful at sole procedure. The operation time was 25.0 to 60.0 min, with the mean time (37.4 ± 5.8) min. Vaginal bleeding stoped in 3.0 to 12.0 minutes after embolization and the mean time was (5.7 ± 2.4) min. Blood pressure returned to normal after operation and vital signs were stable. Placenta tissue discharged on the 5th day to the 4th week after embolization and the mean time was 17 d. The uterus recuperated and blood β-HCG recovered simutaneously. The menstruation and ovulation during follow-up returned to normal. Conclusion: Superselective uterine artery embolization for treatment of placenta increta has advantages such as short operation time, minimal invasion, definite curative effect and reservation of uterus, which is worthy in clinical application. (authors)

  14. Differential Expression of Growth-, Angiogenesis- and Invasion-Related Factors in The Development of Placenta Accreta

    Directory of Open Access Journals (Sweden)

    Jenn-Jhy Tseng

    2006-06-01

    Full Text Available Placenta accreta is the major cause of maternal death complicated by massive peripartum hemorrhage. Its development is traditionally considered to be related to a decidual defect caused by previous cesarean deliveries or uterine curettages. Usually, placental villi firmly adhere to the superficial myometrium and deeply invade, or even penetrate, the uterine wall. Abnormal uteroplacental neovascularization is another characteristic. Therefore, we hypothesized that placenta accreta develops as a result of abnormal expressions of growth-, angiogenesis- and invasion-related factors in trophoblast populations. We have found, in pregnancies complicated by placenta accreta: upregulated epidermal growth factor receptor and downregulated c-erbB-2 oncoprotein in syncytiotrophoblasts; downregulated vasculoendothelial growth factor receptor-2 expression in syncytiotrophoblasts and increased vasculoendothelial growth factor in placental lysates; and downregulated Tie-2 expression in syncytiotrophoblasts and enhanced angiopoietin-2 level in placental lysates. However, matrix metalloproteinase expression was not upregulated, so the association of these invasion-related molecules with placenta accreta is less likely. Taken together, these findings imply that complex factors, either alone or in combination, might be responsible for the development of placenta accreta. Further studies are needed to understand the signaling pathways and possible genetic events.

  15. 3'-Azido-3'-deoxythymidine (AZT) induces apoptosis and alters metabolic enzyme activity in human placenta

    International Nuclear Information System (INIS)

    Collier, Abby C.; Helliwell, Rachel J.A.; Keelan, Jeffrey A.; Paxton, James W.; Mitchell, Murray D.; Tingle, Malcolm D.

    2003-01-01

    The anti-HIV drug 3'-azido-3'-deoxythymidine (AZT) is the drug of choice for preventing maternal-fetal HIV transmission during pregnancy. Our aim was to assess the cytotoxic effects of AZT on human placenta in vitro. The mechanisms of AZT-induced effects were investigated using JEG-3 choriocarcinoma cells and primary explant cultures from term and first-trimester human placentas. Cytotoxicity measures included trypan blue exclusion, MTT, and reactive oxygen species (ROS) assays. Apoptosis was measured with an antibody specific to cleaved caspase-3 and by rescue of cells by the general caspase inhibitor Boc-D-FMK. The effect of AZT on the activities of glutathione-S-transferase, β-glucuronidase, UDP-glucuronosyl transferase, cytochrome P450 (CYP) 1A, and CYP reductase (CYPR) in the placenta was assessed using biochemical assays and immunoblotting. AZT increased ROS levels, decreased cellular proliferation rates, was toxic to mitochondria, and initiated cell death by a caspase-dependent mechanism in the human placenta in vitro. In the absence of serum, the effects of AZT were amplified in all the models used. AZT also increased the amounts of activity of GST, β-glucuronidase, and CYP1A, whereas UGT and CYPR were decreased. We conclude that AZT causes apoptosis in the placenta and alters metabolizing enzymes in human placental cells. These findings have implications for the safe administration of AZT in pregnancy with respect to the maintenance of integrity of the maternal-fetal barrier

  16. Residential proximity to major roads and placenta/birth weight ratio.

    Science.gov (United States)

    Yorifuji, Takashi; Naruse, Hiroo; Kashima, Saori; Murakoshi, Takeshi; Tsuda, Toshihide; Doi, Hiroyuki; Kawachi, Ichiro

    2012-01-01

    Exposure to air pollution has been demonstrated to increase the risk of preterm birth and low birth weight. We examined whether proximity to major roads (as a marker of exposure to air pollution) is associated with increased placenta/birth weight ratio (as a biomarker of the placental transport function). Data on parental characteristics and birth outcomes were extracted from the database maintained by a major hospital in Shizuoka Prefecture, Japan. We restricted the analysis to mothers who delivered liveborn single births from 1997 to 2008 (n = 14,189). Using geocoded residential information, each birth was classified according to proximity to major roads. We examined the association between proximity to major roads and the placenta/birth weight ratio, using multiple linear regression. Proximity to major roads was associated with higher placenta/birth weight ratio. After adjusting for potential confounders, living within 200 m of a major road increased the ratio by 0.48% (95% CI = 0.15 to 0. 80). In addition, proximity to major roads was associated with lower placenta weight and birth weight. These observed associations were stronger among participants living closer to major roads. Exposure to traffic-related air pollution is associated with higher placenta/birth weight ratio. Impaired placental oxygen and nutrient transport function might be a mechanism for explaining the observed association between air pollution and low birth weight as well as preterm birth. Copyright © 2011 Elsevier B.V. All rights reserved.

  17. The placenta shed from goats with classical scrapie is infectious to goat kids and lambs.

    Science.gov (United States)

    Schneider, David A; Madsen-Bouterse, Sally A; Zhuang, Dongyue; Truscott, Thomas C; Dassanayake, Rohana P; O'Rourke, Katherine I

    2015-08-01

    The placenta of domestic sheep plays a key role in horizontal transmission of classical scrapie. Domestic goats are frequently raised with sheep and are susceptible to classical scrapie, yet potential routes of transmission from goats to sheep are not fully defined. Sparse accumulation of disease-associated prion protein in cotyledons casts doubt about the role of the goat's placenta. Thus, relevant to mixed-herd management and scrapie-eradication efforts worldwide, we determined if the goat's placenta contains prions orally infectious to goat kids and lambs. A pooled cotyledon homogenate, prepared from the shed placenta of a goat with naturally acquired classical scrapie disease, was used to orally inoculate scrapie-naïve prion genotype-matched goat kids and scrapie-susceptible lambs raised separately in a scrapie-free environment. Transmission was detected in all four goats and in two of four sheep, which importantly identifies the goat's placenta as a risk for horizontal transmission to sheep and other goats.

  18. Impact of maternal diabetes type 1 on proliferative potential, differentiation and apoptotic activity in villous capillaries of term placenta.

    Science.gov (United States)

    Jirkovská, Marie; Kučera, Tomáš; Dvořáková, Veronika; Jadrníček, Martin; Moravcová, Milena; Žižka, Zdeněk; Krejčí, Vratislav

    2016-04-01

    Maternal diabetes mellitus changes morphology and impairs function of placental capillaries. Here, quantitative parameters characterizing cell proliferation using detection of Ki67, differentiation reflected by nestin expression and apoptosis in placental capillary bed with active caspase 3 as a marker were compared in normal term placentas and placentas from pregnancies complicated by Type 1 maternal diabetes mellitus. Specimens of sixteen diabetic placentas and eight control placentas were collected by systematic uniform random sampling. Immunohistochemical detections of Ki67, nestin, and active caspase 3 were performed in histological sections of five haphazardly chosen blocks per placenta. Twenty fields of view per section, i.e. one hundred fields of view per placenta, were used for analysis of proliferation as well as of apoptosis, and in approximately 70 capillary cross-sections per placenta the nestin-positive segments of their circumference were measured. The percentage of Ki67-positive cells counted in the capillary wall was significantly lower in diabetic group. The counts of Ki67-labelled nuclei per villous area unit were significantly lower in cytotrophoblast and capillary wall of terminal villi in diabetic placenta. The proportion of nestin-labeled segments of capillary circumference was significantly higher in placentas of diabetic group. No differences in the numbers of apoptotic cells were found between studied groups. The results show that the term placenta in Type 1 diabetes has lower potential to enlarge the surface area of structures involved in maternofetal transport, and that the villous capillary bed displays delayed differentiation. Those factors may participate in decreased ability of diabetic placenta to comply with fetal requirements in the final stage of pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Endoplasmic reticulum stress is induced in the human placenta during labour.

    Science.gov (United States)

    Veerbeek, J H W; Tissot Van Patot, M C; Burton, G J; Yung, H W

    2015-01-01

    Placental endoplasmic reticulum (ER) stress has been postulated in the pathophysiology of pre-eclampsia (PE) and intrauterine growth restriction (IUGR), but its activation remains elusive. Oxidative stress induced by ischaemia/hypoxia-reoxygenation activates ER stress in vitro. Here, we explored whether exposure to labour represents an in vivo model for the study of acute placental ER stress. ER stress markers, GRP78, P-eIF2α and XBP-1, were significantly higher in laboured placentas than in Caesarean-delivered controls localised mainly in the syncytiotrophoblast. The similarities to changes observed in PE/IUGR placentas suggest exposure to labour can be used to investigate induction of ER stress in pathological placentas. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  20. GATM, the human ortholog of the mouse imprinted Gatm gene, escapes genomic imprinting in placenta

    Directory of Open Access Journals (Sweden)

    Toshinobu Miyamoto

    2005-03-01

    Full Text Available The GATM gene encodes L-arginine:glycine amidinotransferase, which catalyzes the conversion of L-arginine into guanidinoacetate, the rate-limiting step in the synthesis of creatine. Since, deficiencies in creatine synthesis and transport lead to certain forms of mental retardation in human, the human GATM gene appears to be involved in brain development. Recently it has been demonstrated that the mouse Gatm is expressed during development and is imprinted with maternal expression in the placenta and yolk sac, but not in embryonic tissues. We investigated the imprinting status of the human GATM by analyzing its expression in four human placentas. GATM was biallelically expressed, thus suggesting that this gene escapes genomic imprinting in placentas, differently from what has been reported in mouse extra-embryonic tissues.

  1. Morphology, histochemistry and glycosylation of the placenta and associated tissues in the European hedgehog (Erinaceus europaeus)

    DEFF Research Database (Denmark)

    Jones, Carolyn J P; Carter, A M; Allen, W R

    2016-01-01

    glycosylated. Yolk sac inner and outer endoderm expressed similar glycans except for N-acetylgalactosamine residues in endodermal acini. DISCUSSION: New features of near-term hedgehog placenta and associated tissues are presented, including their glycosylation, and novel yolk sac acinar structures......INTRODUCTION: There are few descriptions of the placenta and associated tissues of the European hedgehog (Erinaceus europaeus) and here we present findings on a near-term pregnant specimen. METHODS: Tissues were examined grossly and then formalin fixed and wax-embedded for histology...... and immunocytochemistry (cytokeratin) and resin embedded for lectin histochemistry. RESULTS: Each of four well-developed and near term hoglets displayed a discoid, haemochorial placenta with typical labyrinth and spongy zones. In addition there was a paraplacenta incorporating Reichert's membrane and a largely detached...

  2. Flame retardants in placenta and breast milk and cryptorchidism in newborn boys

    DEFF Research Database (Denmark)

    Main, Katharina Maria; Kiviranta, Hannu; Virtanen, Helena Eeva

    2007-01-01

    of PBDEs in breast milk was significantly higher in boys with cryptorchidism than in controls (sum of BDEs 47, 153, 99, 100, 28, 66, and 154: median, 4.16 vs. 3.16 ng/g fat; p luteinizing hormone (p ..., 1997-2001, all boys were examined for cryptorchidism. We analyzed whole placentas (for 95 cryptorchid/185 healthy boys) and individual breast milk samples (62/68) for 14 PBDEs and infant serum samples for gonadotropins, sex-hormone binding globulin, testosterone, and inhibin B. RESULTS: In 86 placenta-milk...... pairs, placenta PBDE concentrations in fat were lower than in breast milk, and a larger number of congeners were nondetectable. There was no significant difference between boys with and without cryptorchidism for individual congeners, the sum of 5 most prevalent, or all 14 congeners. The concentration...

  3. Estudio del placentoma de poblaciones de mabuya con énfasis en el análisis de células invasoras

    Directory of Open Access Journals (Sweden)

    Simón Halcón Vieira Samper

    2007-01-01

    células invasivas comparten rasgos ultraestructurales con las células del corion, pero con particularidades que les permiten cumplir funciones específicas. Prolongaciones de estas células entran en contacto con capilares uterinos y forman un extenso sistema de membranas dobles muy próximas entre sí, que encapsulan el capilar. Este hallazgo proporciona bases para proponer una nueva clasificación de la placenta de estas lagartijas al evidenciarse una relación muy estrecha entre los tejidos embrionarios y la circulación materna.

  4. Effects of environmental pollution with aromatic hydrocarbons on endocrine and metabolic functions of the human placenta.

    Science.gov (United States)

    Wierzba, Waldemar; Radowicki, Stanisław; Bojar, Iwona; Pinkas, Jarosław

    2018-03-14

    Phenol and 1-hydroxypyrene are biological markers of exposure to polycyclic aromatic hydrocarbons (PAH) that have certain negative effects on parenchymal organs such as the human placenta. The literature presents only few reports regarding the effects of elevated PAH levels on the functions of the human placenta. The aim of the work is to assess the effects of elevated PAH levels in excreted urine on the endocrine and metabolic functions of the human placenta obtained from a normal pregnancy. Tissue material from 50 afterbirths from Płock constituted a study group, whereas 50 afterbirths from Kutno constituted a control group. Immunohistochemical reactions with the peroxidase method using LSAB kits (DAKO, Denmark) were performed. The extent and intensity of reactions were analysed. The levels of phenols and 1-hydroxypyrene in the excreted urine of pregnant women (undergoing delivery) were detected using gas chromatography and colorimetry. The statistical analysis used the PQStat v.1.6.2 software; moreover, t-student and chi-square tests were used. Differences were considered to be significant at the significance level of 95% (p<0.05). The levels of phenol and 1-hydroxypyrene in the excreted urine were demonstrated to be statistically significantly higher in patients living in the area of Płock. Statistically lower expression of placental glutathione transferase and lower immunohistochemical demonstration of the placental phosphatase activity were observed in placentas from Płock. It has been demonstrated that the expression of the oestrogen receptor activity and placental gonadotropin is significantly higher in placentas from areas not contaminated with aromatic hydrocarbons (Kutno). The course of pregnancy in the environment with elevated levels of aromatic hydrocarbons leads to impaired placental functioning and reduced endocrine and metabolic activity of the placenta.

  5. Structure and Steroidogenesis of the Placenta in the Antarctic Minke Whale (Balaenoptera bonaerensis)

    Science.gov (United States)

    SASAKI, Motoki; AMANO, Yoko; HAYAKAWA, Daisuke; TSUBOTA, Toshio; ISHIKAWA, Hajime; MOGOE, Toshihiro; OHSUMI, Seiji; TETSUKA, Masafumi; MIYAMOTO, Akio; FUKUI, Yutaka; BUDIPITOJO, Teguh; KITAMURA, Nobuo

    2012-01-01

    Abstract There are few reports describing the structure and function of the whale placenta with the advance of pregnancy. In this study, therefore, the placenta and nonpregnant uterus of the Antarctic minke whale were observed morphologically and immunohistochemically. Placentas and nonpregnant uteri were collected from the 15th, 16th and 18th Japanese Whale Research Programme with Special Permit in the Antarctic (JARPA) and 1st JARPA II organized by the Institute of Cetacean Research in Tokyo, Japan. In the macro- and microscopic observations, the placenta of the Antarctic minke whale was a diffuse and epitheliochorial placenta. The chorion was interdigitated to the endometrium by primary, secondary and tertiary villi, which contained no specialized trophoblast cells such as binucleate cells, and the interdigitation became complicated with the progress of gestation. Furthermore, fetal and maternal blood vessels indented deeply into the trophoblast cells and endometrial epithelium respectively with fetal growth. The minke whale placenta showed a fold-like shape as opposed to a finger-like shape. In both nonpregnant and pregnant uteri, many uterine glands were distributed. The uterine glands in the superficial layer of the pregnant endometrium had a wide lumen and large epithelial cells as compared with those in the deep layer. On the other hand, in the nonpregnant endometrium, the uterine glands had a narrower lumen and smaller epithelial cells than in the pregnant endometrium. In immunohistochemical detection, immunoreactivity for P450scc was detected in most trophoblast cells, but not in nonpregnant uteri, suggesting that trophoblast epithelial cells synthesized and secreted the sex steroid hormones and/or their precursors to maintain the pregnancy in the Antarctic minke whale. PMID:23269486

  6. Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

    Directory of Open Access Journals (Sweden)

    Hee Young Cho

    Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

  7. DNA methylation of amino acid transporter genes in the human placenta.

    Science.gov (United States)

    Simner, C; Novakovic, B; Lillycrop, K A; Bell, C G; Harvey, N C; Cooper, C; Saffery, R; Lewis, R M; Cleal, J K

    2017-12-01

    Placental transfer of amino acids via amino acid transporters is essential for fetal growth. Little is known about the epigenetic regulation of amino acid transporters in placenta. This study investigates the DNA methylation status of amino acid transporters and their expression across gestation in human placenta. BeWo cells were treated with 5-aza-2'-deoxycytidine to inhibit methylation and assess the effects on amino acid transporter gene expression. The DNA methylation levels of amino acid transporter genes in human placenta were determined across gestation using DNA methylation array data. Placental amino acid transporter gene expression across gestation was also analysed using data from publically available Gene Expression Omnibus data sets. The expression levels of these transporters at term were established using RNA sequencing data. Inhibition of DNA methylation in BeWo cells demonstrated that expression of specific amino acid transporters can be inversely associated with DNA methylation. Amino acid transporters expressed in term placenta generally showed low levels of promoter DNA methylation. Transporters with little or no expression in term placenta tended to be more highly methylated at gene promoter regions. The transporter genes SLC1A2, SLC1A3, SLC1A4, SLC7A5, SLC7A11 and SLC7A10 had significant changes in enhancer DNA methylation across gestation, as well as gene expression changes across gestation. This study implicates DNA methylation in the regulation of amino acid transporter gene expression. However, in human placenta, DNA methylation of these genes remains low across gestation and does not always play an obvious role in regulating gene expression, despite clear evidence for differential expression as gestation proceeds. Copyright © 2017. Published by Elsevier Ltd.

  8. Impact of antenatal diagnosis and management strategies in morbidly adherent placenta

    International Nuclear Information System (INIS)

    Choudry, A.; Choudry, H.; Shukr, I.; Ahmad, S

    2011-01-01

    Objectives: To study the pattern, demography and management options in placenta accreta in a tertiary care centre. Duration and settings: January 1, 2004 to August 15, 2008 at Military Hospital, Rawalpindi and between Sep 1, 2008 to Oct 30, 2009 at Combined Military Hospital, Multan. Patients and Methods All cases of placenta accreta seen during the study period were included in the study. Placenta accreta was defined as placenta being adherent to uterine wall without easy separation. Patient's demography, presence or absence of prenatal diagnosis and the management strategy i.e. conservative or otherwise was documented on a proforma. Success or failure of surgical approach used was noted. Assessment of maternal morbidity in the form of amount of blood/blood product transfused and early and late complications was made and compared with other cases that were antenatally diagnosed or were undiagnosed. Results: A total of 28 cases were analyzed during study period. The incidence of placenta accreta was 6.3/10000. Mean maternal age was 30.7 years. Placenta praevia obstetrical hysterectomy was performed in 17(61%) cases and had to be backed up by internal iliac artery ligation in 7(25%) Requirement for blood transfusion in antenatally diagnosed cases was almost 50% less than those of undiagnosed cases and the same was true for fresh frozen plasma (3.75 +- 4.18 versus 6.75 +- 5.41), platelet transfusion (P=0.04), stay in intensive care unit (1.56 +- 1.82 versus 3.41 +- 3.28)and use of mechanical ventilation (7% versus 11%). There was no mortality in this series. Conclusions: Intra-operative internal iliac artery ligation reduces blood loss before and after hysterectomy and should be done in cases with placents accreta to reduce morbidity and mortality. (author)

  9. Role of the placenta in fetal programming: underlying mechanisms and potential interventional approaches.

    Science.gov (United States)

    Jansson, Thomas; Powell, Theresa L

    2007-07-01

    Adverse influences during fetal life alter the structure and function of distinct cells, organ systems or homoeostatic pathways, thereby 'programming' the individual for an increased risk of developing cardiovascular disease and diabetes in adult life. Fetal programming can be caused by a number of different perturbations in the maternal compartment, such as altered maternal nutrition and reduced utero-placental blood flow; however, the underlying mechanisms remain to be fully established. Perturbations in the maternal environment must be transmitted across the placenta in order to affect the fetus. Here, we review recent insights into how the placenta responds to changes in the maternal environment and discuss possible mechanisms by which the placenta mediates fetal programming. In IUGR (intrauterine growth restriction) pregnancies, the increased placental vascular resistance subjects the fetal heart to increased work load, representing a possible direct link between altered placental structure and fetal programming of cardiovascular disease. A decreased activity of placental 11beta-HSD-2 (type 2 isoform of 11beta-hydroxysteroid dehydrogenase) activity can increase fetal exposure to maternal cortisol, which programmes the fetus for later hypertension and metabolic disease. The placenta appears to function as a nutrient sensor regulating nutrient transport according to the ability of the maternal supply line to deliver nutrients. By directly regulating fetal nutrient supply and fetal growth, the placenta plays a central role in fetal programming. Furthermore, perturbations in the maternal compartment may affect the methylation status of placental genes and increase placental oxidative/nitrative stress, resulting in changes in placental function. Intervention strategies targeting the placenta in order to prevent or alleviate altered fetal growth and/or fetal programming include altering placental growth and nutrient transport by maternally administered IGFs (insulin

  10. Validation of the Ultra Micro Elisa for certification of human placenta as a source of pharmaceuticals and cosmetics

    International Nuclear Information System (INIS)

    Trujillo Alfonso, Maydelin; Rodriguez Garcia, Sisley; Perez Guevara, Maria Teresa

    2014-01-01

    The Viral Control Laboratory of the Placenta Derivatives Production Plant certifies the human placenta as pharmaceutical and cosmetic raw material by means of the microultra analytic system. To validate the Ultra Micro System for determination of hepatitis B surface antigen, antibodies to Hepatitis C Virus, and Immunodeficiency Human Virus Type 1 and 2 in umbilical cord serum samples

  11. Parturition in gilts: duration of farrowing, birth intervals and placenta expulsion in relation to maternal, piglet and placental traits

    NARCIS (Netherlands)

    Rens, van B.T.T.M.; Lende, van der T.

    2004-01-01

    Large White×Meishan F2 crossbred gilts (n=57) were observed continuously during farrowing while the placentae of their offspring were labeled in order to examine the duration of farrowing and placenta expulsion in relation to maternal-, piglet- and placental traits and the duration of birth interval

  12. Noninvasive monitoring of placenta-specific transgene expression by bioluminescence imaging.

    Directory of Open Access Journals (Sweden)

    Xiujun Fan

    Full Text Available BACKGROUND: Placental dysfunction underlies numerous complications of pregnancy. A major obstacle to understanding the roles of potential mediators of placental pathology has been the absence of suitable methods for tissue-specific gene manipulation and sensitive assays for studying gene functions in the placentas of intact animals. We describe a sensitive and noninvasive method of repetitively tracking placenta-specific gene expression throughout pregnancy using lentivirus-mediated transduction of optical reporter genes in mouse blastocysts. METHODOLOGY/PRINCIPAL FINDINGS: Zona-free blastocysts were incubated with lentivirus expressing firefly luciferase (Fluc and Tomato fluorescent fusion protein for trophectoderm-specific infection and transplanted into day 3 pseudopregnant recipients (GD3. Animals were examined for Fluc expression by live bioluminescence imaging (BLI at different points during pregnancy, and the placentas were examined for tomato expression in different cell types on GD18. In another set of experiments, blastocysts with maximum photon fluxes in the range of 2.0E+4 to 6.0E+4 p/s/cm(2/sr were transferred. Fluc expression was detectable in all surrogate dams by day 5 of pregnancy by live imaging, and the signal increased dramatically thereafter each day until GD12, reaching a peak at GD16 and maintaining that level through GD18. All of the placentas, but none of the fetuses, analyzed on GD18 by BLI showed different degrees of Fluc expression. However, only placentas of dams transferred with selected blastocysts showed uniform photon distribution with no significant variability of photon intensity among placentas of the same litter. Tomato expression in the placentas was limited to only trophoblast cell lineages. CONCLUSIONS/SIGNIFICANCE: These results, for the first time, demonstrate the feasibility of selecting lentivirally-transduced blastocysts for uniform gene expression in all placentas of the same litter and early

  13. Glucocorticoid stimulates expression of corticotropin-releasing hormone gene in human placenta

    International Nuclear Information System (INIS)

    Robinson, B.G.; Emanuel, R.L.; Frim, D.M.; Majzoub, J.A.

    1988-01-01

    Primary cultures of purified human cytotrophoblasts have been used to examine the expression of the corticotropin-releasing hormone (CRH) gene in placenta. The authors report here that glucocorticoids stimulate placental CRH synthesis and secretion in primary cultures of human placenta. This stimulation is in contrast to the glucocorticoid suppression of CRH expression in hypothalamus. The positive regulation of CRH by glucocorticoids suggests that the rise in CRH preceding parturition could result from the previously described rise in fetal glucocorticoids. Furthermore, this increase in placental CRH could stimulate, via adrenocorticotropic hormone, a further rise in fetal glucocorticoids, completing a positive feedback loop that would be terminated by delivery

  14. Combined measurement of maternal serum FE3 and HPL for determination of fetus-placenta function

    International Nuclear Information System (INIS)

    Peng Yangshui; Li Gefang; Xia Dingwen

    2003-01-01

    Objective: To investigate the clinical application of combined measurement of maternal serum FE 3 and HPL for determination of fetus-placenta function. Methods: Maternal serum FE 3 and HPL levels were measured with RIA in 86 complicated and 39 non-complicated pregnant women. Results: Serum FE 3 contents in pregnant women complicated with hypertensive syndrome, intrauterine fetal distress, gestation above 33 wks complicated with diabetes and 3rd grade placenta were significantly lower than those in non-complicated ones (p 3 and HPL could improve the early diagnosis of high-risk pregnancies

  15. The human placenta from heavy smokers: evaluation of vasoactive peptides by immunohistochemistry

    DEFF Research Database (Denmark)

    Clausen, H V; Larsen, L Grupe; Jørgensen, A

    2007-01-01

    The study aimed to demonstrate the expression of nitric oxide converting enzyme, nitric oxide synthase (e-NOS), and endothelin-1 (Et-1) in formalin-fixed paraffin-embedded placental tissue, and to demonstrate a difference in staining intensity between heavy smokers and non-smokers. Term placentas...... from pregnancies from otherwise healthy women smoking 15 or more cigarettes per day (heavy smokers) and term placentas from a matching group of non-smokers were included. The antibodies for Et-1 and e-NOS are recommended for cryostat sections. We evaluated the antibodies on paraffin-embedded tissue...

  16. Quantitative assay for the measurement of immune responses directed against the human placenta

    Energy Technology Data Exchange (ETDEWEB)

    Davies, M; Sutcliffe, R G [Glasgow Univ. (UK)

    1982-02-12

    A quantitative in vitro immune assay based on the classical chromium release assay has been developed to detect immune responses directed against alien antigens expressed by the developing foetus and present on the maternal-facing surface of the human placenta. A plasma membrane fraction from the surface of the placenta was prepared and the vesicles thus formed were radiolabelled with /sup 51/Cr. The /sup 51/Cr-labelled vesicles, by various criteria, were found to be suitable for use as targets in a release assay. Further, by means of experimentally immunised animals, the target membranes were shown to be capable of detecting both cellular and humoral anti-placental activity.

  17. Efeitos da betametasona sobre os fetos e placentas da rata albina Effects of betamethasone on the fetuses and placentas of female albino rats

    Directory of Open Access Journals (Sweden)

    Eduardo de Souza

    2001-03-01

    Full Text Available Objetivos: analisar os efeitos da betametasona sobre o binômio materno-fetal da rata albina. Métodos: utilizamos 60 ratas albinas prenhes divididas ao acaso em três grupos numericamente iguais. As ratas do grupo I foram tratadas com betametasona na dose de 1 mg/kg de peso em 0,5 ml de água destilada, por via intramuscular no 11º, 12º, 18º e 19º dia de prenhez; as do grupo II receberam 0,5 ml de água destilada, por via intramuscular no 11º, 12º, 18º e 19º dia de prenhez, e as do grupo III não receberam qualquer fármaco ou veículo. O ganho de peso das matrizes foi avaliado nos dias 0, 7, 14 e 20 de prenhez, sendo que no 20º dia todos os animais foram sacrificados por decapitação. Foram quantificados o número de implantações, de reabsorções, de fetos, de placentas, de malformações maiores, de mortalidade materna e fetal, assim como o peso dos fetos e das placentas. Resultados: nossos resultados revelaram que as matrizes tratadas com betametasona apresentaram menor ganho de peso. Quanto aos fetos e as placentas do grupo tratado, observamos que os pesos foram inferiores aos dos outros grupos. A média de peso dos fetos foi de 3,20 g contra 3,75 g no grupo controle. A média de peso das placentas foi de 0,36 g no grupo tratado com betametasona contra 0,48 g no grupo controle. Todas estas diferenças foram estatisticamente significantes. Conclusões: a betametasona apresenta efeito negativo sobre o ganho de peso das matrizes, fetos e placentas, quando administrada de forma repetitiva a partir da segunda metade da prenhez.Purpose: to analyze the effect of betamethasone on the pregnancy of rats. Methods: thirty pregnant rats were divided into three groups of ten animals each. Group I -- the animals received betamethasone IM (1 mg/kg body weight, in 0.5 ml distilled water on the 11th, 12th, 18th and 19th day of pregnancy. Group II -- the rats received distilled water (0.5 ml IM on the 11th, 12th, 18th and 19th day of pregnancy

  18. Uterine and placenta characteristics during early vascular development in the pig from day 22 to 42 of gestation.

    Science.gov (United States)

    Wright, Elane C; Miles, Jeremy R; Lents, Clay A; Rempel, Lea A

    2016-01-01

    Insufficient placenta development is one of the primary causes of fetal death and reduced fetal growth after 35 days of gestation. Between day 22 and 42 the placenta consists of a central highly vascular placenta (HVP), adjacent to the fetus, a less vascular placenta (LVP), on either side of the fetus, and necrotic tips (NT). The objective of this study was to comprehensively evaluate uterine-placenta characteristics during early gestation in the gilt and determine time points and physiological changes. Gilts (n=25) were artificially inseminated at first detection of estrus (day 0) and 24h later, and harvested at 22, 27, 32, 37 or 42 days of gestation. Litter size, 12.1±3.4, was similar for all days of gestation. Fetal and placenta weight increased with day of gestation. The greatest increase in placenta weight occurred between 37 and 42 days of gestation. The LVP zones had no measurable fold formation until day 27. Necrotic tips became apparent after 27 days of gestation. Unoccupied areas of the uterus developed folds with changes in endometrial cell size and morphology from day 32 to 42 of gestation. Limited changes occurred in either fetal growth or placenta weight from day 27 through 32 of gestation; however, significant morphological changes occur at the maternal-fetal interface, demonstrating the dynamic architecture of the developing porcine placenta during early gestation. This work establishes fundamental time points in placenta development corresponding to fetal growth and microfold formation that may influence fetal growth and impact fetal survival. Published by Elsevier B.V.

  19. Treatment of retained placenta with misoprostol: a randomised controlled trial in a low-resource setting (Tanzania

    Directory of Open Access Journals (Sweden)

    Fauteck Heiner

    2009-10-01

    Full Text Available Abstract Background Retained placenta is one of the common causes of maternal mortality in developing countries where access to appropriate obstetrical care is limited. Current treatment of retained placenta is manual removal of the placenta under anaesthesia, which can only take place in larger health care facilities. Medical treatment of retained placenta with prostaglandins E1 (misoprostol could be cost-effective and easy-to-use and could be a life-saving option in many low-resource settings. The aim of this study is to assess the efficacy and safety of sublingually administered misoprostol in women with retained placenta in a low resource setting. Methods Design: Multicentered randomised, double-blind, placebo-controlled trial, to be conducted in 5 hospitals in Tanzania, Africa. Inclusion criteria: Women with retained placenta, at a gestational age of 28 weeks or more and blood loss less than 750 ml, 30 minutes after delivery of the newborn despite active management of third stage of labour. Trial Entry & Randomisation & Study Medication: After obtaining informed consent, eligible women will be allocated randomly to the treatment groups using numbered envelopes that will be randomized in variable blocks containing identical capsules with either 800 microgram of misoprostol or placebo. The drugs will be given sublingually. The women, maternal care providers and researchers will be blinded to treatment allocation. Sample Size: 117 women, to show a 40% reduction in manual removals of the placenta (p = 0.05, 80% power. The randomization will be misoprostol: placebo = 2:1 Primary Study Outcome: Expulsion of the placenta without manual removal. Secondary outcome is the number of blood transfusions. Discussion This is a protocol for a randomized trial in a low resource setting to assess if medical treatment of women with retained placenta with misoprostol reduces the incidence of manual removal of the placenta. Clinical Trial Registration Current

  20. Videojuego con Realidad Virtual

    OpenAIRE

    González Mora, César

    2017-01-01

    El objetivo del proyecto es el desarrollo de un videojuego deportivo que utilice realidad mixta. El videojuego se podrá utilizar con dispositivos de tipo cardboard, y utilizará realidad aumentada para la interacción del jugador con el videojuego. En el desarrollo se utilizará el motor Unity para conseguir una aplicación multiplataforma, y la librería Vuforia para implementar realidad mixta.

  1. Sistemas integrados con Arduino

    OpenAIRE

    EL YAKOUTI, MOHAMMED

    2017-01-01

    Design of a robot prototype remotely controllable from Bluetooth using Arduino. Control and testing of sensors and events interacting with Arduino and Bluetooth. Diseño de un prototipo de robot controlable remotamente con Bluetooth utilizando Arduino. Control y verificación de los sensores y eventos que interactúan mediante el Arduino y el Bluetooth. El Yakouti, M. (2017). Sistemas integrados con Arduino. http://hdl.handle.net/10251/89274. TFGM

  2. Investigando con personas con dificultades de aprendizaje

    Directory of Open Access Journals (Sweden)

    Borja González Luna

    2013-12-01

    Full Text Available El artículo muestra los orígenes de lo que Walmsley (2008 denomina «investigación inclusiva». Para comprender qué se entiende por investigación inclusiva tenemos que remontarnos a los debates epistemológicos sobre las metodologías cuantitativas y cualitativas, acontecidos en la década de los 90, en torno a la revista Disability & Society. A partir de una síntesis de dichos debates, focalizados en el ámbito de la «discapacidad intelectual y del desarrollo», se exponen dos estrategias de colaboración con dicha población: a una aproximación etnográfica (de trabajo grupal, y b una aproximación biográfica (de trabajo individual. A continuación se esboza un posible diseño de trabajo de campo que intenta superar el paradigma cualitativo «clásico» con el objetivo de incluir a dicho colectivo más allá del rol de «sujetos de la investigación». Para finalizar se recoge el debate sobre la accesibilidad de los resultados de la investigación a los participantes en dichas investigaciones, y con ello la necesaria innovación en el ámbito de las «devoluciones» de los resultados, cuando se trata de incluir a personas que presentan limitaciones para la comprensión del lenguaje abstracto oral y/o escrito.

  3. Does the presence of placental basal plate myometrial fibres increase the risk of subsequent morbidly adherent placenta: a case-control study.

    Science.gov (United States)

    Miller, E S; Linn, R L; Ernst, L M

    2016-12-01

    Antenatal diagnosis of morbidly adherent placenta has been shown to improve outcomes, but existing predictors lack sensitivity. Our objective was to determine whether the presence of myometrial fibres attached to the placental basal plate (BPMYO) in an antecedent pregnancy is associated with subsequent morbidly adherent placenta. A case-control study. Departments of Obstetrics and Gynecology and Pathology, Northwestern University, Chicago, IL, USA. Women who had at least two pregnancies with placental pathological evaluation. Cases were defined as women with evidence of morbidly adherent placenta (both clinically and pathologically) in their most recent pregnancy whereas women without evidence of morbidly adherent placenta served as controls. Pathological specimens of placentas from previous pregnancies were evaluated for BPMYO. The presence of BPMYO on a previous placenta was evaluated to determine whether it could be used to improve the antenatal diagnosis of morbidly adherent placenta. Of the 25 cases of morbidly adherent placenta, 19 (76%) had BPMYO present on their previous placenta compared with 41 (41%) of controls (odds ratio 4.8, 95% CI 1.8-13.0). Adding BPMYO to a regression including other risk factors for morbidly adherent placenta (i.e. maternal age, number of previous caesarean sections, placenta praevia, previous multiple gestation, any previous curettage, and ultrasonographic suspicion of placenta accreta) significantly improved the sensitivity of antenatal diagnosis of morbidly adherent placenta (61% versus 39%, P placental pathology is associated with an increased risk of morbidly adherent placenta in a subsequent pregnancy. These findings may shed light on the pathophysiology of accreta and inform future research on predictors of accreta. Previous basal plate myometrium improves the ability to detect subsequent morbidly adherent placenta. © 2015 Royal College of Obstetricians and Gynaecologists.

  4. The placenta and foetal membranes of the lesser yellow house bat ...

    African Journals Online (AJOL)

    1988-06-05

    Jun 5, 1988 ... A discoidal hemodichorial placenta is present in $cotophilus borbonicus. Evidence is presented which suggests that histotrophic nutrition, in addition to hemotrophic nutrition, occurs. The foetal trophospongium phagocytoses cell debris and glandular secretions derived from the maternal endometrium ...

  5. Role of Doppler US and MRI in diagnosis of placenta accreta ...

    African Journals Online (AJOL)

    The aim of this work is to evaluate the role of Doppler US and MRI in the diagnosis of placenta accreta. Patients and methods: During period between 2012 to 2013, 120 pregnant patients with previous cesarean section were investigated by ultrasound and Doppler and then in suspected cases MRI was obtained (10 cases).

  6. The evolution of the placenta drives a shift in sexual selection in livebearing fish

    NARCIS (Netherlands)

    Pollux, B.J.A.; Meredith, R.W.; Springer, M.S.; Garland, T.; Reznick, D.N.

    2014-01-01

    The evolution of the placenta from a non-placental ancestor causes a shift of maternal investment from pre- to post-fertilization, creating a venue for parent–offspring conflicts during pregnancy1, 2, 3, 4. Theory predicts that the rise of these conflicts should drive a shift from a reliance on

  7. How Prenatal Depression, Anxiety, and Stress May Affect Child Outcome: The Placenta and Child Development

    Science.gov (United States)

    Glover, Vivette; O'Connor, T. G.; O'Donnell, K.; Capron, Lauren

    2014-01-01

    There is good evidence that if a woman is depressed, anxious, or stressed while she is pregnant, then there is an increased risk that her child will have emotional, behavioral, or cognitive problems. Her own biology must cause these effects, but it is not known how. One important line of research suggests that the function of the placenta changes…

  8. Glycosylation at the fetomaternal interface in hemomonochorial placentae from five widely separated species of mammal

    DEFF Research Database (Denmark)

    Jones, Carolyn J. P.; Carter, Anthony M.; Aplin, John D.

    2007-01-01

    sapiens) and guinea pig (Cavia porcellus)--in order to assess whether evolutionary convergence to the hemomonochorial state is accompanied by a similar convergence of glycan expression. Placentae from 2 E. telfairi, 3 C. crocuta, 1 D. novemcinctus, 4 womenand 1 C. porcellus were fixed and processed...

  9. Enantiomeric ratios as an indicator of exposure processes for persistent pollutants in human placentas

    DEFF Research Database (Denmark)

    Shen, Heqing; Virtanen, H E; Main, Katharina M

    2006-01-01

    The enantiomeric ratios (ER) of alpha-HCH and o,p'-DDT ((+)-isomer concentration/(-)-isomer concentration) and o,p'-DDD (first eluting enantiomer/second enantiomer) were investigated in 112 human placentas from Finnish boys collected 1997-2001. Both o,p'-DDD and alpha-HCH showed changes in their ER...

  10. Application of fluorescent in situ hybridisation for demonstration of Coxiella burnetti in placentas from ruminant abortions

    DEFF Research Database (Denmark)

    Jensen, Tim Kåre; Montgomery, Donald L.; Jaeger, Paula T.

    2007-01-01

    A fluorescent in situ hybridisation (FISH) assay targeting 16S ribosomal RNA was developed for detection of the zoonotic bacterium Coxiella burnetii in formalin-fixed, paraffin-embedded tissue, and applied on placentas from ruminant abortions. The applicability of the FISH assay was compared...

  11. Differential transferrin expression in placentae from normal and abnormal pregnancies: a pilot study

    Czech Academy of Sciences Publication Activity Database

    Králová, Alena; Světlíková, M.; Madar, J.; Ulčová-Gallová, Z.; Bukovský, A.; Pěknicová, Jana

    2008-01-01

    Roč. 6, č. 27 (2008), s. 1-16 ISSN 1477-7827 R&D Projects: GA MŠk OE 211 Institutional research plan: CEZ:AV0Z50520701 Keywords : transferrin * monoclonal antibody * human placentae Subject RIV: EB - Genetics ; Molecular Biology Impact factor: 2.634, year: 2008

  12. Generation of functional islets from human umbilical cord and placenta derived mesenchymal stem cells.

    Science.gov (United States)

    Kadam, Sachin; Govindasamy, Vijayendran; Bhonde, Ramesh

    2012-01-01

    Bone marrow-derived mesenchymal stem cells (BM-MSCs) have been used for allogeneic application in tissue engineering but have certain drawbacks. Therefore, mesenchymal stem cells (MSCs) derived from other adult tissue sources have been considered as an alternative. The human umbilical cord and placenta are easily available noncontroversial sources of human tissue, which are often discarded as biological waste, and their collection is noninvasive. These sources of MSCs are not subjected to ethical constraints, as in the case of embryonic stem cells. MSCs derived from umbilical cord and placenta are multipotent and have the ability to differentiate into various cell types crossing the lineage boundary towards endodermal lineage. The aim of this chapter is to provide a detailed reproducible cookbook protocol for the isolation, propagation, characterization, and differentiation of MSCs derived from human umbilical cord and placenta with special reference to harnessing their potential towards pancreatic/islet lineage for utilization as a cell therapy product. We show here that mesenchymal stromal cells can be extensively expanded from umbilical cord and placenta of human origin retaining their multilineage differentiation potential in vitro. Our report indicates that postnatal tissues obtained as delivery waste represent a rich source of mesenchymal stromal cells, which can be differentiated into functional islets employing three-stage protocol developed by our group. These islets could be used as novel in vitro model for screening hypoglycemics/insulin secretagogues, thus reducing animal experimentation for this purpose and for the future human islet transplantation programs to treat diabetes.

  13. A danish national cohort study on neonatal outcome in singleton pregnancies with placenta previa

    DEFF Research Database (Denmark)

    Nørgaard, Lone N; Pinborg, Anja; Lidegaard, Ojvind

    2012-01-01

    . Main outcome measures. Gestational age, birthweight, Apgar score after 5min, stillbirth, neonatal mortality and admittance to neonatal intensive care unit. Results. The incidence of placenta previa in Denmark was 0.54% in 2006. Neonates born after pregnancies with placenta previa had a higher risk...... of being born at a gestational age below 37 weeks (OR 8.6; 95% CI 7.5-9.9), having Apgar score =7 at 5 min (OR 2.7; 95% CI 2.0-3.7), being transferred to neonatal intensive care unit (OR 4.3; 95% CI 3.8-4.9) and for stillbirth and neonatal mortality combined (OR 1.8; 95% CI 1.1-3.0), compared to neonates...... born in pregnancies without placenta previa. No increased risk of being small-for-gestational age was found (OR 1.0; 95% CI 1.0-1.2). Conclusion. When adjusting for confounders neonates born after pregnancies with placenta previa had a significantly higher risk of being born preterm, having a low Apgar...

  14. Comparative transcriptome and secretome analysis of wood decay fungi Postia placenta and Phanerochaete chrysosporium

    Science.gov (United States)

    Amber J. Vanden Wymelenberg; Jill Gaskell; Michael Mozuch; Grzegorz Sabat; John Ralph; Oleksandr Skyba; Shawn D Mansfield; Robert A. Blanchette; Diego Martinez; Igor Grigoriev; Philip J Kersten; Daniel Cullen

    2010-01-01

    Cellulose degradation by brown rot fungi, such as Postia placenta, is poorly understood relative to the phylogenetically related white rot basidiomycete, Phanerochaete chrysosporium. To elucidate the number, structure, and regulation of genes involved in lignocellulosic cell wall attack, secretome and transcriptome analyses were performed on both wood decay fungi...

  15. Cow placenta extract promotes murine hair growth through enhancing the insulin - like growth factor-1

    Directory of Open Access Journals (Sweden)

    Dongliang Zhang

    2011-01-01

    Full Text Available Background: Hair loss is seen as an irreversible process. Most research concentrates on how to elongate the anagen, reduce the negative factors of obstructing hair growth and improve the hair number and size. Aim: In our experiment, we tried to prove that the cow placenta extract can promote hair growth by elongating hair shaft and increasing hair follicle number. Materials and Methods: Cow placenta extract (CPE, water and minoxidil applied separately on the back of depilated B57CL/6 mice for the case, negative and positive control respectively. We checked the proliferation of cells which are resident in hair sheath, and the expression of a few growth factors which stimulate hair growth. Results: Result shows that placenta extract more efficiently accelerates cell division and growth factor expression, by raising the insulin-like growth factor (IGF-1 mRNA and protein level to increase HF size and hair length. Conclusions: The extract is not a purified product; so, it is less effective than minoxidil, which is approved by the US FDA for the treatment of male pattern baldness. If refinement is done, the placenta extract would be a good candidate medicine for hair loss.

  16. The Effects of the Hominis Placenta Herbal acupuncture on Sleep pattern disturbance

    Directory of Open Access Journals (Sweden)

    Youn Hyoun-min

    2005-02-01

    Full Text Available Objective : This study has been designed and performed to identify the effects of Hominis Placenta herbal acupuncture which is usually used in reducing sleep pattern disturbances. Methods : The study subjects studied included 48 patients who were admitted in hospital located in Pusan, and they were classified into 2 groups : 25 patients in the experimental group who injected Hominis Placenta herbal acupuncture and 23 patients in the control group who were treated by acupuncture. The both group injected on GB20, GB12 and HT7 for 5 days without medicine. The sleep pattern disturbance score was measured by using 15 questions according to Korean Sleep Scale A(Oh, Jin Joo. Song, Mi Soon. Kim, Shin Mi. 1998. Results & conclusions : The sleep pattern disturbance score of the experimental group who injected Hominis Placenta herbal acupuncture was significantly lower than that of the control group. (t= 7.00 p= .00 These results provided that Hominis Placenta herbal acupuncture of GB20, GB12 and HT7 was effective for relieving sleep pattern disturbances, it is need more sample's number and more treatmentt's duration.

  17. Velamentous and Furcate Cord Insertion with Placenta Accreta in an IVF Pregnancy with Unicornuate Uterus

    Directory of Open Access Journals (Sweden)

    Mehmet Tunç Canda

    2013-01-01

    Full Text Available Velamentous and furcate cord insertion with concomitant placenta accreta is a very rare and life-threatening event of pregnancy for both the mother and the fetus. Obstetricians should be cautious about umbilical cord insertion and placental adherence abnormalities in pregnancies conceived by assisted reproductive technologies (ART particularly in women with Müllerian anomalies.

  18. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta.

    Science.gov (United States)

    Riteau, Anne-Sophie; Tassin, Mikael; Chambon, Guillemette; Le Vaillant, Claudine; de Laveaucoupet, Jocelyne; Quéré, Marie-Pierre; Joubert, Madeleine; Prevot, Sophie; Philippe, Henri-Jean; Benachi, Alexandra

    2014-01-01

    To evaluate the accuracy of ultrasonography and magnetic resonance imaging (MRI) in the diagnosis of placenta accreta and to define the most relevant specific ultrasound and MRI features that may predict placental invasion. This study was approved by the institutional review board of the French College of Obstetricians and Gynecologists. We retrospectively reviewed the medical records of all patients referred for suspected placenta accreta to two university hospitals from 01/2001 to 05/2012. Our study population included 42 pregnant women who had been investigated by both ultrasonography and MRI. Ultrasound images and MRI were blindly reassessed for each case by 2 raters in order to score features that predict abnormal placental invasion. Sensitivity in the diagnosis of placenta accreta was 100% with ultrasound and 76.9% for MRI (P = 0.03). Specificity was 37.5% with ultrasonography and 50% for MRI (P = 0.6). The features of greatest sensitivity on ultrasonography were intraplacental lacunae and loss of the normal retroplacental clear space. Increased vascularization in the uterine serosa-bladder wall interface and vascularization perpendicular to the uterine wall had the best positive predictive value (92%). At MRI, uterine bulging had the best positive predictive value (85%) and its combination with the presence of dark intraplacental bands on T2-weighted images improved the predictive value to 90%. Ultrasound imaging is the mainstay of screening for placenta accreta. MRI appears to be complementary to ultrasonography, especially when there are few ultrasound signs.

  19. Decreased oxidative stress may contribute to the disease process in placenta accreta

    Science.gov (United States)

    Öztaş, Efser; Özler, Sibel; Ergin, Merve; Erel, Özcan; Gümüş Güler, Başak; Çağlar, Ali Turhan; Yücel, Aykan; Uygur, Dilek; Danışman, Nuri

    2017-08-23

    Background/aim: The main aim of this study was to investigate serum total oxidant status (TOS), total antioxidant status (TAS), oxidative stress index (OSI), and arylesterase levels in pregnant women with placenta accreta and to compare those with age-matched healthy pregnant women. Materials and methods: A total of 27 pregnant women who had clinically and pathologically proven placenta accreta and 30 age- and BMI- matched healthy pregnant women were enrolled in this case control study. Maternal serum TOS, TAS, OSI, and arylesterase levels were evaluated using logistic regression analysis to determine if there was an association with abnormal placental invasion or not. Results: Decreased OSI (OR= 0.999, 95%CI: 0.998-1.000, P = 0.035) and increased arylesterase levels (OR= 0.981, 95%CI: 0.970-0.993, P = 0.001) were significantly associated with the presence of placenta accreta. Maternal serum TOS, TAS, OSI, and arylesterase levels were not predictive for adverse perinatal outcomes (P > 0.05). Conclusions: Decreased OSI and increased arylesterase levels are significantly associated with placenta accreta and may contribute to the abnormal invasion process.

  20. Biological Activities of Hominis Placenta Herbal Acupuncture prepared by Hydrochloric Acid Hydrolysis

    Directory of Open Access Journals (Sweden)

    Geun-young Seo

    2010-06-01

    Full Text Available Reactive Oxygen Species(ROS are continuously produced at a high rate as a by-product of aerobic metabolism. Since tissue damage by free radical increases with age, the reactive oxygen species(ROS such as hydrogen peroxide(H2O2, nitric oxide(NO. Several lines of evidence provided that ROS appears to cause to develop aging-related various diseases such as cancer, arthritis, cardiovascular disease. In this study, we have conducted to investigate the biological activities of Hominis Placenta Herbal Acupuncture by measuring total polyphenol content, DPPH radical scavenging, ABTS radical scavenging, Superoxide dismutase(SOD-like activity, Nitrite scavenging ability in vitro. The total polyphenol contents of Hominis Placenta Herbal Acupuncture was 24.6㎖/㎖. Elctron donation ability on DPPH was 49.4%. The 2,2'-azinobis-3-ehtlbezothiazoline-6-sulfonic acid radical decolorization (ABTS was 50.01%, similar to the DPPH free radical scavenging. The superoxide dismutase (SOD-like activities of hominis placenta herbal acupuncture was 50.876%. The nitrite scavenging abilities at pH 1.5, pH 3.0, pH 6.0 were 52.8%, 29.4%, 15.4%, respectively; these abilities decreased as pH increased. We conclude that Hominis Placenta Herbal Acupuncture may be useful as potential sources of antioxidant.

  1. Gestation Related Gene Expression of the Endocannabinoid Pathway in Rat Placenta

    Directory of Open Access Journals (Sweden)

    Kanchan Vaswani

    2015-01-01

    Full Text Available Mammalian placentation is a vital facet of the development of a healthy and viable offspring. Throughout gestation the placenta changes to accommodate, provide for, and meet the demands of a growing fetus. Gestational gene expression is a crucial part of placenta development. The endocannabinoid pathway is activated in the placenta and decidual tissues throughout pregnancy and aberrant endocannabinoid signaling during the period of placental development has been associated with pregnancy disorders. In this study, the gene expression of eight endocannabinoid system enzymes was investigated throughout gestation. Rat placentae were obtained at E14.25, E15.25, E17.25, and E20, RNA was extracted, and microarray was performed. Gene expression of enzymes Faah, Mgll, Plcd4, Pld1, Nat1, Daglα, and Ptgs2 was studied (cohort 1, microarray. Biological replication of the results was performed by qPCR (cohort 2. Four genes showed differential expression (Mgll, Plcd4, Ptgs2, and Pld1, from mid to late gestation. Genes positively associated with gestational age were Ptgs2, Mgll, and Pld1, while Plcd4 was downregulated. This is the first comprehensive study that has investigated endocannabinoid pathway gene expression during rat pregnancy. This study provides the framework for future studies that investigate the role of endocannabinoid system during pregnancy.

  2. Draft genome sequence of a monokaryotic model brown-rot fungus Postia (Rhodonia) placenta SB12

    Science.gov (United States)

    Jill Gaskell; Phil Kersten; Luis F. Larrondo; Paulo Canessa; Diego Martinez; David Hibbett; Monika Schmoll; Christian P. Kubicek; Angel T. Martinez; Jagjit Yadav; Emma Master; Jon Karl Magnuson; Debbie Yaver; Randy Berka; Kathleen Lail; Cindy Chen; Kurt LaButti; Matt Nolan; Anna Lipzen; Andrea Aerts; Robert Riley; Kerrie Barry; Bernard Henrissat; Robert Blanchette; Igor V. Grigoriev; Dan Cullen

    2017-01-01

    We report the genome of Postia (Rhodonia) placenta MAD-SB12, a homokaryotic wood decay fungus (Basidiomycota, Polyporales). Intensively studied as a representative brown rot decayer, the gene complement is consistent with the rapid depolymerization of cellulose but not lignin.

  3. Myocytes of chorionic vessels from placentas with meconium-associated vascular necrosis exhibit apoptotic markers.

    Science.gov (United States)

    King, Erin L; Redline, Raymond W; Smith, Steven D; Kraus, Frederick T; Sadovsky, Yoel; Nelson, D Michael

    2004-04-01

    Meconium-associated vascular necrosis (MAVN) is a histological abnormality of human placental chorionic vessels that is associated with poor neonatal outcome. We tested the hypothesis that MAVN shows apoptosis in the walls of chorionic vessels. Archival placental specimens with MAVN (n = 5) were compared with specimens from uncomplicated pregnancies at term (n = 5) and from placentas with intense chorionic vasculitis associated with acute chorioamnionitis with (n = 5) or without (n = 5) a clinical history of meconium in the amniotic fluid. Sections from all placentas were processed by the TUNEL method, and 2 observers who were blinded to specimen diagnosis quantified the immunofluorescent TUNEL staining in both the amnion-facing and villous-facing walls of the larger chorionic vessels in each specimen. Compared with the other 3 groups, only the amnion-facing wall of chorionic vessels in MAVN showed a significantly greater number of apoptotic cells. This was verified by morphological criteria and caspase 3 staining. There were limited or no detectable TUNEL-stained cells in either the villous-facing walls of vessels in the MAVN specimens or in any of the vessels of the placentas from uncomplicated pregnancies. There was a negligible level of apoptosis in chorionic vessels of placentas with intense chorionic vasculitis, with or without meconium, despite the inflammatory response or presence of meconium. We conclude that apoptosis contributes to the pathophysiology of MAVN.

  4. Epoxiconazole-induced degeneration in rat placenta and the effects of estradiol supplementation.

    Science.gov (United States)

    Rey Moreno, Maria Cecilia; Fussell, Karma C; Gröters, Sibylle; Schneider, Steffen; Strauss, Volker; Stinchcombe, Stefan; Fegert, Ivana; Veras, Mariana; van Ravenzwaay, Bennard

    2013-06-01

    Epoxiconazole (CAS-No. 133855-98-8) was recently shown to cause both a marked depletion of maternal estradiol blood levels and a significantly increased incidence of late fetal mortality when administered to pregnant rats throughout gestation (GD 7-18 or 21); estradiol supplementation prevented this epoxiconazole effect in rats (Stinchcombe et al., 2013), indicating that epoxiconazole-mediated estradiol depletion is a critical key event for induction of late fetal resorptions in rats. For further elucidation of the mode of action, the placentas from these modified prenatal developmental toxicity experiments with 23 and 50 mg/kg bw/d epoxiconazole were subjected to a detailed histopathological examination. This revealed dose-dependent placental degeneration characterized by cystic dilation of maternal sinuses in the labyrinth, leading to rupture of the interhemal membrane. Concomitant degeneration occurred in the trophospongium. Both placentas supporting live fetuses and late fetal resorptions were affected; the highest degree of severity was observed in placentas with late resorptions. Placental degeneration correlated with a severe decline in maternal serum estradiol concentration. Supplementation with 0.5 and 1.0 μg of the synthetic estrogen estradiol cyclopentylpropionate per day reduced the severity of the degeneration in placentas with live fetuses. The present study demonstrates that both the placental degeneration and the increased incidence of late fetal resorptions are due to decreased levels of estrogen, since estrogen supplementation ameliorates the former and abolishes the latter. © 2013 Wiley Periodicals, Inc.

  5. Review: Public perspectives on the utilization of human placentas in scientific research and medicine.

    Science.gov (United States)

    Yoshizawa, R S

    2013-01-01

    Placental tissues are frequently utilized by scientists studying pregnancy and reproduction and in diverse fields including immunology, stem cell research, genetics, cancer research, and tissue engineering, as well as by clinicians in many therapies. Though the utilization of the human placenta in science and medicine has benefitted many people, little is known about public perspectives of this phenomenon. This review addresses placental donation, collection, and utilization in science and medicine, focusing on public perspectives. Cultural values and traditions, ethical paradigms and concerns, public understandings of science and medicine, and political considerations may impact perceptions of the utilization of the placenta in science and medicine, but systematic study is lacking. It is argued that knowledge of public views gained from empirical investigation may underpin the development of collection protocols and research projects that are more responsive to public will, spur more extensive utilization in science and medicine of this unique organ, and/or aid in the realization of the mobilization of knowledge about the placenta for clinical and educational ends. New avenues for research on public perspectives of the placenta are proposed. Copyright © 2012 Elsevier Ltd. All rights reserved.

  6. Activities of xenobiotic metabolizing enzymes in rat placenta and liver in vitro

    NARCIS (Netherlands)

    Fabian, Eric; Wang, Xinyi; Engel, Franziska; Li, Hequn; Landsiedel, Robert; Ravenzwaay, van Bennard

    2016-01-01

    In order to assess whether the placental metabolism of xenobiotic compounds should be taken into consideration for physiologically-based toxicokinetic (PBTK) modelling, the activities of seven phase I and phase II enzymes have been quantified in the 18-day placenta of untreated Wistar rats. To

  7. High activity of fatty acid oxidation enzymes in human placenta: implications for fetal-maternal disease

    NARCIS (Netherlands)

    Oey, N. A.; den Boer, M. E. J.; Ruiter, J. P. N.; Wanders, R. J. A.; Duran, M.; Waterham, H. R.; Boer, K.; van der Post, J. A. M.; Wijburg, F. A.

    2003-01-01

    As the human fetus and placenta are considered to be primarily dependent on glucose oxidation for energy metabolism, the cause of the remarkable association between severe maternal pregnancy complications and the carriage of a fetus with an inborn error of mitochondrial long-chain fatty acid

  8. An appraisal of retained placentae in ibadan: a five year review.

    Science.gov (United States)

    Obajimi, G O; Roberts, A O; Aimakhu, C O; Bello, F A; Olayemi, O

    2009-06-01

    To determine the frequency of retained placenta at the University College Hospital Ibadan (UCH). and to describe the socio-demographic characteristics of the patients and examine the risk factors predisposing to retained placenta. This is a descriptive study covering a period of 5 years from January 1(st) 2002 to December 31(st) 2006. During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births. During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were available for analysis. The mean age was 29.37 ± 4.99 years. First and second Para accounted for 52 per cent of the patients. Majority of the patient were unbooked for antenatal care in UCH with booked patients accounting for 27.8 per cent of the cases. The mean gestational age at delivery was 34.29 ± 6.02. Three patients presented to the hospital in shock of which 2 died on account of severe haemorrhagic shock. Fifty-eight patients (64.8%) presented with anaemia (packed cell volume less than 30 per cent) and 35 patients (38.8%) had blood transfusion ranging between 1-4 pints. 1 patient required hysterectomy on account of morbidly adherent placenta. Eleven patients (12.2%) had placenta retention in the past, 28 patients (31%) had a previous dilatation and curettage, 14 patients (15.5%) had previous caesarean sections and 47 patients (41.3%) had no known predisposing factors. Retained placenta still remains a potentially life threatening condition in the tropics due to the associated haemorrhage, and other complications related to its removal. The incidence and severity may be decreased by health education, women empowerment and the provision of facilities for essential obstetric services by high skilled health care providers in ensuring a properly conducted delivery with active management of the third stage of labour.

  9. Transverse uterine fundal incision for placenta praevia with accreta, involving the entire anterior uterine wall: a case series.

    Science.gov (United States)

    Kotsuji, F; Nishijima, K; Kurokawa, T; Yoshida, Y; Sekiya, T; Banzai, M; Minakami, H; Udagawa, Y

    2013-08-01

    To determine the feasibility and safety of transverse fundal incision with manual placental removal in women with placenta praevia and possible placenta accreta. Case series. Four level-three Japanese obstetric centres. Thirty-four women with prior caesarean section and placenta praevia that widely covers the anterior uterine wall, in whom placenta accreta cannot be ruled out. A transverse fundal incision was performed at the time of caesarean section and manual placental removal was attempted under direct observation. Operative fluid loss. The total volume of fluid lost during our operative procedure compares favourably with the volume lost during our routine transverse lower-segment caesarean sections performed in patients without placenta praevia or accreta. The average fluid loss was 1370 g. No patients required transfer to intensive care, and there were no cases of fetal anaemia. This procedure has the potential to reduce the heavy bleeding that arises from caesarean deliveries in women with placenta praevia and placenta accreta. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

  10. Retained placenta of dairy cows associated with managemental factors in Rajshahi, Bangladesh

    Directory of Open Access Journals (Sweden)

    K. M. Mozaffor Hossain

    2013-08-01

    Full Text Available Aim: The incidence of retained placenta of dairy cows in relation to individual animal level and farm management factors such as farm type, farm size, housing system, floor type, feed quality, time of parturition, farming experience of farmer and delivery pattern of cows was determined. Materials and Methods: A total 1205 parturated dairy cows conducted in nine upazilas and four Metro Thana of Rajshahi district during July 2010 to June 2011for attainment of the result. Individual animal and farm management factors associated with retained placenta were recorded in a structured questionnaire through face-to-face farmer's interview and reviewing farm records. The raw data were compiled and statistical SPSS program to analyze to obtained result. Results: The overall incidence of retained placenta was 13.4%. The incidence was significantly higher in Local × Sahiwal genotype (4.6% and late delivery (longer gestation period (80% than their counter groups (p<0.05. The large farm (6.0% had higher incidence and had no significant effect than medium and individual household. Similarly animals housed in Tin shed building with poor ventilation facilities (6.6%, animal housed in unscientific concrete floor (6.8%, animals mostly grassed along with small amount of straw supplied (5.4% and a farmer had less than one year farming experience (5.3% had not significant statistically show higher incidence of retained placenta. Conclusion: The local genotype; mini farm; supplied better feed quality; vast farming experience of farmer and normal delivery with eutocia had less chance of retained placenta of dairy cows. [Vet World 2013; 6(4.000: 180-184

  11. In vivo quantification of {sup 18}F-Fdg uptake in human placenta during early pregnancy

    Energy Technology Data Exchange (ETDEWEB)

    Zanotti-Fregonara, P.; Jan, S.; Trebossen, R.; Maroy, R. [CEA, DSV, I2BM, SHFJ, F-91401 Orsay (France); Champion, C. [Univ Paul Verlaine Metz, Lab Phys Mol et Collis, Inst Phys, Metz (France); Hindie, E. [Hop St Antoine, AP-HP, F-75571 Paris (France); Hindie, E. [Univ Paris 07, IMDCT, IUH, Ecole Doctorale B2T, F-75221 Paris (France)

    2008-07-01

    {sup 18}F-FDG is the most widely used PET radiopharmaceutical. Nevertheless, no data for {sup 18}F-FDG uptake in the human placenta have been reported. We recently reported on embryo dosimetry in a woman who underwent an {sup 18}F-FDG PET/CT scan during early pregnancy. In the present work we attempt an in vivo quantification of the {sup 18}F-FDG uptake by the placenta. The 27-y-old woman received 320 MBq of {sup 18}F-FDG for a follow-up study for Hodgkin's lymphoma and was later discovered to be pregnant (embryo age 8 wk). Imaging started 1 h after injection. The maximum placental tissue uptake (SUVmax) was 2.5. This value was conservatively attributed to the entire placental volume, i.e., 45 mL, a value representative of the average dimensions of a normal placenta at 8 wk. On the basis of these measurements, placenta {sup 18}F-FDG uptake in our patient was 0.19% of the injected activity. A Monte Carlo simulation was used to derive the photon dose to the embryo from the placenta (0.022 * 10{sup -2} mGy per MBq of injected {sup 18}F-FDG) and from the surrounding amniotic fluid (0.017 * 10{sup -2} mGy MBq{sup -1}). This increases our previously calculated dose (3.3 * 10{sup -2} mGy MBq{sup -1}) by only a small fraction (1.18%), which does not justify modifying the previous estimate given the overall uncertainties. (authors)

  12. Wound Healing Effects of Rose Placenta in a Mouse Model of Full-Thickness Wounds

    Directory of Open Access Journals (Sweden)

    Yang Woo Kim

    2015-11-01

    Full Text Available BackgroundRosa damascena, a type of herb, has been used for wound healing in Eastern folk medicine. The goal of this study was to evaluate the effectiveness of rose placenta from R. damascena in a full-thickness wound model in mice.MethodsSixty six-week-old C57BL/6N mice were used. Full-thickness wounds were made with an 8-mm diameter punch. Two wounds were made on each side of the back, and wounds were assigned randomly to the control and experimental groups. Rose placenta (250 µg was injected in the experimental group, and normal saline was injected in the control group. Wound sizes were measured with digital photography, and specimens were harvested. Immunohistochemical staining was performed to assess the expression of epidermal growth factor (EGF, vascular endothelial growth factor (VEGF, transforming growth factor-β1 (TGF-β1, and CD31. Vessel density was measured. Quantitative analysis using an enzyme-linked immunosorbent assay (ELISA for EGF was performed. All evaluations were performed on postoperative days 0, 2, 4, 7, and 10. Statistical analyses were performed using the paired t-test.Results On days 4, 7, and 10, the wounds treated with rose placenta were significantly smaller. On day 2, VEGF and EGF expression increased in the experimental group. On days 7 and 10, TGF-β1 expression decreased in the experimental group. On day 10, vessel density increased in the experimental group. The increase in EGF on day 2 was confirmed with ELISA.ConclusionsRose placenta was found to be associated with improved wound healing in a mouse full-thickness wound model via increased EGF release. Rose placenta may potentially be a novel drug candidate for enhancing wound healing.

  13. Comparative proteomics analysis of placenta from pregnant women with intrahepatic cholestasis of pregnancy.

    Science.gov (United States)

    Zhang, Ting; Guo, Yueshuai; Guo, Xuejiang; Zhou, Tao; Chen, Daozhen; Xiang, Jingying; Zhou, Zuomin

    2013-01-01

    Intrahepatic cholestasis of pregnancy (ICP) usually occurs in the third trimester and associated with increased risks in fetal complications. Currently, the exact cause of this disease is unknown. In this study we aim to investigate the potential proteins in placenta, which may participate in the molecular mechanisms of ICP-related fetal complications using iTRAQ-based proteomics approach. The iTRAQ analysis combined with liquid chromatography-tandem mass spectrometry (LC-MS/MS) was performed to separate differentially expressed placental proteins from 4 pregnant women with ICP and 4 healthy pregnant women. Bioinformatics analysis was used to find the relative processes that these differentially expressed proteins were involved in. Three apoptosis related proteins ERp29, PRDX6 and MPO that resulted from iTRAQ-based proteomics were further verified in placenta by Western blotting and immunohistochemistry. Placental apoptosis was also detected by TUNEL assay. Proteomics results showed there were 38 differentially expressed proteins from pregnant women with ICP and healthy pregnant women, 29 were upregulated and 9 were downregulated in placenta from pregnant women with ICP. Bioinformatics analysis showed most of the identified proteins was functionally related to specific cell processes, including apoptosis, oxidative stress, lipid metabolism. The expression levels of ERp29, PRDX6 and MPO were consistent with the proteomics data. The apoptosis index in placenta from ICP patients was significantly increased. This preliminary work provides a better understanding of the proteomic alterations of placenta from pregnant women with ICP and may provide us some new insights into the pathophysiology and potential novel treatment targets for ICP.

  14. Placenta praevia: review of clinical presentation and management in a Nigerian teaching hospital.

    Science.gov (United States)

    Ikechebelu, J I; Onwusulu, D N

    2007-01-01

    The study aims at reviewing the clinical presentation and management of placenta praevia in a tertiary health facility. This is a retrospective study of 59 cases of placenta praevia managed at the Nnamdi Azikiwe University Teaching Hospital, Nnewi from January 1997 to December 2001. The case records of 44 of the patients were obtained from the hospital medical records department and analysed. During the five year period, there were 3565 deliveries and 59 cases of placenta praevia giving an incidence of 1.65%. Thirty four (77.3%) occurred in women aged 35 years and below. The commonest was type 111 (12 cases; 27.3%) followed by type IV (10 cases; 22.7%). Previous uterine scar was associated with 22 (50.0%) cases. Age had no statistically significant effect on the prevalence. The commonest GA range at presentation (13; 29.6%) and at delivery (18; 40.9%) was 37-40 weeks. The commonest mode of presentation was antepartum haemorrhage (34; 77.3%) followed by abnormal lie and malpresentation (4 each; 9.1%). The average admission delivery interval was one week in 33 (75.0%) cases and only two (4.5%) received blood transfusion. Forty (90.9%) women had caesarean delivery while 12 (27.3%) babies were of low birth weight. There were only 2 (4.5%) fetal deaths and one (2.3%) caesarean hysterectomy. The commonest predisposing factor to placenta praevia in this study is previous uterine scar. Judicious use of caesarean section especially in the primigravida will help reduce the incidence of placenta praevia. Also a screening ultrasonography at 34-36 weeks gestation (especially in women with previously scarred uterus) is recommended.

  15. Respuesta humoral y consecuencias reproductivas en ovejas desafiadas con Brucella ovis al final de la gestación Immune response and reproductive consequences in experimentally infected ewes with Brucella ovis during late pregnancy

    Directory of Open Access Journals (Sweden)

    Fernando A Paolicchi

    2013-03-01

    Full Text Available La brucelosis ovina por Brucella ovis es una enfermedad de prevalencia alta en Argentina. Para evaluar la patogenicidad de B. ovis y la respuesta serológica durante el último mes de gestación, 6 ovejas se distribuyeron en dos grupos: G1, ovejas preñadas, n = 4 y G2, ovejas no preñadas, n = 2. Tres ovejas del G1 (15 días preparto y una del G2 fueron inoculadas con B. ovis. Se analizaron muestras de suero mediante diferentes pruebas serológicas. Se realizó aislamiento y PCR a partir de mucus cérvico-vaginal (mcv, placenta y leche. En las muestras de placenta se realizó histopatología. Las hembras del G1 parieron corderos vivos; se detectaron anticuerpos en las ovejas desafiadas del G1 a partir de los 5 días posinoculación. El mcv de las ovejas desafiadas resultó negativo al aislamiento en ambos grupos. Las muestras de leche del G1 fueron positivas por cultivo y PCR a B. ovis. La técnica de PCR resultó positiva en las placentas de las ovejas desafiadas del G1. La histopatología reveló una placentitis necrótica supurativa en una de las ovejas desafiadas. El desafío con B. ovis preparto resultó en la invasión de la placenta y de la glándula mamaria, con la consecuente excreción de la bacteria por leche. La infección con B. ovis indujo una respuesta humoral temprana en las ovejas. La colonización de la placenta por B. ovis y la excreción de la bacteria por la leche sugieren un potencial riesgo de infección activa para los corderos y la posibilidad de que estos se comporten como portadores latentes de la infección.Ovine brucellosis by Brucella ovis is a highly prevalent disease in Argentina. This study aimed to evaluate the pathogenicity of B. ovis and the serological response in ewes during late pregnancy and in their offspring. Six adult ewes were distributed in two groupsGI (pregnant females, n = 4 and G2 (nonpregnant females, n = 2. Three pregnant ewes at 15 days prepartum and one nonpregnant eve were inoculated with B

  16. Giochiamo con i robot

    Directory of Open Access Journals (Sweden)

    Andrea Bonarini

    2009-01-01

    Full Text Available "Giochiamo con i robot" e' un laboratorio interattivo per grandi e piccini realizzato per l'edizione 2007 del Festival della Scienza di Genova. Lungo un percorso che va dalla telerobotica alla robotica evolutiva, il laboratorio sviluppa il tema di dare intelligenza ai robot. Questo percorso, le cui tappe sono le varie installazioni, si conclude nella "bottega" dove e' possibile costruire e programmare i propri robot o smontare e modificare quelli esposti durante il percorso didattico. I visitatori sono coinvolti in attivita' ludiche grazie alle quali possonoentrare in contatto con alcune delle idee potenti della robotica,

  17. disegnare con ... Alberto Pratelli

    Directory of Open Access Journals (Sweden)

    Roberto Mingucci

    2017-12-01

    Full Text Available Con questa breve intervista ad Alberto Pratelli, (non a caso scelto per aprire questa nuova rubrica intendia-mo inaugurare un dialogo con personalità significati-ve del Disegno di Architettura, che consenta riflessioni dedicate alle sue varie dimensioni, oggi più che mai da approfondire. La suggestione a farlo, viene da un’idea di Pablo Rodri-guez Navarro ed abbiamo quindi pensato di avviarla proprio in questo numero, che Pablo ha accettato di curare su un tema a lui particolarmente caro.

  18. Caracterización del canal epitelial de sodio en sinciciotrofoblasto de placenta humana preeclamptica Characterization of the epithelial sodium channel in human pre-eclampsia syncytiotrophoblast

    Directory of Open Access Journals (Sweden)

    Silvana del Mónaco

    2006-02-01

    Full Text Available El sinciciotrofoblasto (SCT de placenta humana regula la transferencia de solutos y agua entre la sangre fetal y materna. En el presente trabajo observamos que el canal de sodio ENaC (asociado a cuadros como el síndrome de Liddle y pseudohipoaldosteronismo está presente en la membrana apical del SCT y que la subunidad a del canal tiene una expresión reducida en placentas con hipertensión gestacional (preeclampsia. Realizamos estudios a nivel de expresión de ARN (RT-PCR y a nivel proteico (western blot e inmunohistoquímica. En la línea celular BeWo (modelo de SCT humano el canal se encuentra presente y la expresión del mismo es regulada por las hormonas aldosterona, vasopresina, estradiol y progesterona. Analizamos la actividad del ENaC por electrofisiología y observamos corrientes sensibles a amiloride (10 µM cuando las células BeWo se cultivaron 12 horas con aldosterona (100 nM. Esta corriente presentó una magnitud 20 veces mayor que las corrientes basales, un potencial de reversión cercano a 3 mV y una conductancia de 127 ± 26 pS/pF entre los pulsos de -60 y -140 mV aplicados. Las características de esta corriente son similares a las producidas por ENaC en otros tejidos y evidencian la presencia de un canal funcional. El papel del ENaC en el SCT es poco comprendido, aunque la diferencia de expresión en la preeclampsia podría tener consecuencias para el transporte placentario de agua y iones. Nuestros datos son un aporte para futuros estudios de los mecanismos involucrados en la patofisiología de la preeclampsia.The syncytiotrophoblast (SCT, a multinucleated epithelium forming the outer layer of chorionic villi, acts in human placenta as a transporting barrier regulating the transference of nutrients, solutes and water between maternal and fetal blood. Electrolyte homeostasis and extracellular fluid volume are maintained primarily by regulated Na+ transport. The present study was conducted to analyze the presence of the

  19. Conversando con Oriol Bohigas

    OpenAIRE

    Redondo Domínguez, Ernesto; Moya Sala, Joaquim

    2015-01-01

    [EN] Interview with Oriol Bohigas [ES] Entrevista con Oriol Bohigas Redondo Domínguez, E.; Moya Sala, J. (2015). Conversando con… Oriol Bohigas. EGA. Revista de Expresión Gráfica Arquitectónica. 20(26):22-35. doi:10.4995/ega.2015.4061 22 35 20 26

  20. DR Con o:

    African Journals Online (AJOL)

    which could fall under the Ugandan influence. The con-. flict in the ..... The Congolese people and international community within SADC, the AU ..... ments and make peace among themselves. However, one ... friends overnight.There is a great ...

  1. Development of the Human Placenta and Fetal Heart: Synergic or Independent?

    Directory of Open Access Journals (Sweden)

    Graham J. Burton

    2018-04-01

    Full Text Available The placenta is the largest fetal organ, and toward the end of pregnancy the umbilical circulation receives at least 40% of the biventricular cardiac output. It is not surprising, therefore, that there are likely to be close haemodynamic links between the development of the placenta and the fetal heart. Development of the placenta is precocious, and in advance of that of the fetus. The placenta undergoes considerable remodeling at the end of the first trimester of pregnancy, and its vasculature is capable of adapting to environmental conditions and to variations in the blood supply received from the mother. There are two components to the placental membranes to consider, the secondary yolk sac and the chorioallantoic placenta. The yolk sac is the first of the extraembryonic membranes to be vascularized, and condensations in the mesenchyme at ~17 days post-conception (p.c. give rise to endothelial and erythroid precursors. A network of blood vessels is established ~24 days p.c., with the vitelline vein draining through the region of the developing liver into the sinus venosus. Gestational sacs of early pregnancy failures often display aberrant development of the yolk sac, which is likely to be secondary to abnormal fetal development. Vasculogenesis occurs in the villous mesenchyme of the chorioallantoic placenta at a similarly early stage. Nucleated erythrocytes occupy the lumens of the placental capillaries and end-diastolic flow is absent in the umbilical arterial circulation throughout most of the first trimester, indicating a high resistance to blood flow. Resistance begins to fall in the umbilico-placental circulation around 12–14 weeks. During normal early pregnancy the placental capillary network is plastic, and considerable remodeling occurs in response to the local oxygen concentration, and in particular to oxidative stress. In pregnancies complicated by preeclampsia and/or fetal growth restriction, utero-placental malperfusion induces

  2. Roles of microRNA-34a in the pathogenesis of placenta accreta.

    Science.gov (United States)

    Umemura, Kota; Ishioka, Shin-Ichi; Endo, Toshiaki; Ezaka, Yoshiaki; Takahashi, Madoka; Saito, Tsuyoshi

    2013-01-01

    MicroRNA-34a (miR-34a) is associated with invasion and metastasis of various cancers. The trophoblastic cells of placenta accreta invade into the myometrium in a similar way to the invasion of cancers. We studied the roles of miR-34a in the pathogenesis of placenta accreta. The human choriocarcinoma cell line JAR was used for in vitro experiments as a model of trophoblasts, and placental tissues from the operative specimen of patients with or without placenta accreta were used for experiments in vivo. Morpholino antisense oligomer against miR-34a (miR-34a Morpho/AS) was added to JAR, and the expression of miR-34a and plasminogen activator inhibitor-1 (PAI-1) was determined by real time PCR. The effects of antisense, interleukin (IL)-6 and IL-8 in the process of invasion were studied with an invasion assay. Expression of miR-34a in vivo was studied with the use of fluorescent in situ hybridization (FISH). Expression of miR-34a was inhibited by 65% with the administration of antisense, and a slight increase in miR-34a expression was observed with the addition of IL-6 and IL-8. PAI-1 expression decreased with the addition of IL-6 and IL-8, and increased with the administration of antisense. There was an increase in invasive capacity through the inhibition of miR-34a expression. Strong FISH expression of miR-34a was observed in trophoblast cells of non-placenta accreta, and a clear decrease in miR-34a expression was observed in those of placenta accreta. Expression of miR-34a was downregulated in placenta accreta. In vitro experiments also showed that the invasive potential of JAR increased by suppressing miR-34a, probably through the expression of PAI-1. © 2012 The Authors. Journal of Obstetrics and Gynaecology Research © 2012 Japan Society of Obstetrics and Gynecology.

  3. Cross Talk between Adipose Tissue and Placenta in Obese and Gestational Diabetes Mellitus Pregnancies via Exosomes.

    Science.gov (United States)

    Jayabalan, Nanthini; Nair, Soumyalekshmi; Nuzhat, Zarin; Rice, Gregory E; Zuñiga, Felipe A; Sobrevia, Luis; Leiva, Andrea; Sanhueza, Carlos; Gutiérrez, Jaime Agustín; Lappas, Martha; Freeman, Dilys Jane; Salomon, Carlos

    2017-01-01

    Obesity is an important public health issue worldwide, where it is commonly associated with the development of metabolic disorders, especially insulin resistance (IR). Maternal obesity is associated with an increased risk of pregnancy complications, especially gestational diabetes mellitus (GDM). Metabolism is a vital process for energy production and the maintenance of essential cellular functions. Excess energy storage is predominantly regulated by the adipose tissue. Primarily made up of adipocytes, adipose tissue acts as the body's major energy reservoir. The role of adipose tissue, however, is not restricted to a "bag of fat." The adipose tissue is an endocrine organ, secreting various adipokines, enzymes, growth factors, and hormones that take part in glucose and lipid metabolism. In obesity, the greater portion of the adipose tissue comprises fat, and there is increased pro-inflammatory cytokine secretion, macrophage infiltration, and reduced insulin sensitivity. Obesity contributes to systemic IR and its associated metabolic complications. Similar to adipose tissue, the placenta is also an endocrine organ. During pregnancy, the placenta secretes various molecules to maintain pregnancy physiology. In addition, the placenta plays an important role in metabolism and exchange of nutrients between mother and fetus. Inflammation at the placenta may contribute to the severity of maternal IR and her likelihood of developing GDM and may also mediate the adverse consequences of obesity and GDM on the fetus. Interestingly, studies on maternal insulin sensitivity and secretion of placental hormones have not shown a positive correlation between these phenomena. Recently, a great interest in the field of extracellular vesicles (EVs) has been observed in the literature. EVs are produced by a wide range of cells and are present in all biological fluids. EVs are involved in cell-to-cell communication. Recent evidence points to an association between adipose tissue

  4. Cross Talk between Adipose Tissue and Placenta in Obese and Gestational Diabetes Mellitus Pregnancies via Exosomes

    Directory of Open Access Journals (Sweden)

    Nanthini Jayabalan

    2017-09-01

    Full Text Available Obesity is an important public health issue worldwide, where it is commonly associated with the development of metabolic disorders, especially insulin resistance (IR. Maternal obesity is associated with an increased risk of pregnancy complications, especially gestational diabetes mellitus (GDM. Metabolism is a vital process for energy production and the maintenance of essential cellular functions. Excess energy storage is predominantly regulated by the adipose tissue. Primarily made up of adipocytes, adipose tissue acts as the body’s major energy reservoir. The role of adipose tissue, however, is not restricted to a “bag of fat.” The adipose tissue is an endocrine organ, secreting various adipokines, enzymes, growth factors, and hormones that take part in glucose and lipid metabolism. In obesity, the greater portion of the adipose tissue comprises fat, and there is increased pro-inflammatory cytokine secretion, macrophage infiltration, and reduced insulin sensitivity. Obesity contributes to systemic IR and its associated metabolic complications. Similar to adipose tissue, the placenta is also an endocrine organ. During pregnancy, the placenta secretes various molecules to maintain pregnancy physiology. In addition, the placenta plays an important role in metabolism and exchange of nutrients between mother and fetus. Inflammation at the placenta may contribute to the severity of maternal IR and her likelihood of developing GDM and may also mediate the adverse consequences of obesity and GDM on the fetus. Interestingly, studies on maternal insulin sensitivity and secretion of placental hormones have not shown a positive correlation between these phenomena. Recently, a great interest in the field of extracellular vesicles (EVs has been observed in the literature. EVs are produced by a wide range of cells and are present in all biological fluids. EVs are involved in cell-to-cell communication. Recent evidence points to an association between

  5. fertilizada con diferentes abonos

    Directory of Open Access Journals (Sweden)

    Jorge Alberto Elizondo-Salazar

    2007-01-01

    Full Text Available Producción y calidad de la biomasa de morera (Morus alba fertilizada con diferentes abonos. Se llevó a cabo un experimento en la Estación Experimental “Alfredo Volio Mata” de la Universidad de Costa Rica con el fi n de evaluar la aplicación de 150 kg de N/ha/año proveniente de dos abonos orgánicos: lombriabono y compostaje; y de un fertilizante químico, sobre la producción y calidad de la biomasa de morera. El periodo experimental comprendió un ciclo de 12 meses, iniciando en julio del 2003 y fi nalizando en julio del 2004. Se utilizó una plantación de morera de 12 años de establecida con una densidad de siembra de 27.777 plantas/ ha. Se empleó un diseño de bloques completos al azar con cuatro tratamientos: dos abonos orgánicos, nitrato de amonio (33,5% N y un control. Las plantas se podaron a 0,6 m sobre el nivel del suelo al inicio del ensayo. Durante el periodo experimental, las plantas fueron podadas consecutivamente cada 90 días. Las hojas y los tallos fueron separados y analizados para determinar el contenido de materia seca y proteína cruda. La producción de materia seca fue 23% superior y el contenido de proteína cruda fue signifi cativamente mayor con el nitrógeno químico, mientras que el contenido de materia seca fue menor. No se encontraron diferencias signifi cativas entre el tratamiento control y los tratamientos orgánicos.

  6. Suppression by ellagic acid of 60Co-irradiation-induced lipid peroxidation in placenta and fetus of rats

    International Nuclear Information System (INIS)

    Oku, Hirotsugu

    1992-01-01

    The effect of ellagic acid, a component of Eucalyptus maculata, on lipid peroxidation was examined in placenta and fetus of pregnant rats irradiated with 60 Co. The increase in lipid peroxide levels by the irradiation of the placenta and fetus brain as well as those of the serum and organs of mother was suppressed by treatment of the mother rats with ellagic acid. This suppressing effect found in placenta and fetus was significantly correlated with that found in mother rats. Moreover, ellagic acid suppressed the morphological changes such as degeneration in the endothelial cells of placenta and liver cells of fetus caused by the irradiation and improved the survival rate after the irradiation. These suppressing effects of ellagic acid were approximately the same as those of α-tocopherol. (author)

  7. The interleukin 2 gene is expressed in the syncytiotrophoblast of the human placenta

    International Nuclear Information System (INIS)

    Boehm, K.D.; Kelley, M.F.; Ilan, J.; Ilan, J.

    1989-01-01

    The lymphokine interleukin 2 is an important immune system regulatory glycopolypeptide. It is produced by antigen- or mitogen-stimulated T lymphocytes and is required for the proliferation or clonal expansion of activated T lymphocytes. In this report, it is demonstrated by RNA transfer blot hybridization that the poly(A) + RNA population of the human placenta contains a 0.85-kilobase RNA transcript that specifically hybridizes to a human interleukin 2 cDNA probe. By using hybridization histochemistry in situ, it is further shown that interleukin 2 RNA transcripts are localized, primarily, to the syncytial (syncytiotrophoblast) layer of the human placenta. Possible roles for syncytiotrophoblast-produced interleukin 2 are suggested and discussed

  8. Mercury accumulation in placenta and foetal membranes. A study of dental workers and their babies

    Energy Technology Data Exchange (ETDEWEB)

    Wannag, A; Skjaerasen, J

    1975-01-01

    To investigate the hazards of exposure to levels of elementary mercury lower than the present TLV value (0.05 mg/m/sup 3/) a group of dental workers and a nonexposed group were studied. The amount of mercury in blood from mothers and babies at the time of delivery was similar. The exposed group had increased mercury content in placenta and fetal membranes. Mercury accumulation in these organs might serve as a protection for the fetus against mercury exposure. Since exposure to sub-TLV concentrations of elemental mercury during pregnancy will not be reflected in blood mercury content at the time of delivery, the amount of mercury in placenta and fetal membranes might serve as a biological indicator of such exposure.

  9. [Imbalance of system of glutamin - glutamic acid in the placenta and amniotic fluid at placental insufficiency].

    Science.gov (United States)

    Pogorelova, T N; Gunko, V O; Linde, V A

    2014-01-01

    Metabolism of glutamine and glutamic acid has been investigated in the placenta and amniotic fluid under conditions of placental insufficiency. The development of placental insufficiency is characterized by the increased content of glutamic acid and a decrease of glutamine in both placenta and amniotic fluid. These changes changes were accompanied by changes in the activity of enzymes involved in the metabolism of these amino acids. There was a decrease in glutamate dehydrogenase activity and an increase in glutaminase activity with the simultaneous decrease of glutamine synthetase activity. The compensatory decrease in the activity of glutamine keto acid aminotransferase did not prevent a decrease in the glutamine level. The impairments in the system glutamic acid-glutamine were more pronounced during the development of premature labor.

  10. Proteome Differences in Placenta and Endometrium between Normal and Intrauterine Growth Restricted Pig Fetuses.

    Directory of Open Access Journals (Sweden)

    Fang Chen

    Full Text Available Uteroplacental tissue plays a key role in substance exchanges between maternal and fetal circulation, and, therefore, in the growth and development of fetuses. In this study, proteomics and western blotting were applied to investigate the changes of proteome in the placenta and endometrium of normal and intrauterine growth restriction (IUGR porcine fetuses during mid to late pregnancy (D60, 90, and 110 of gestation. Our results showed that proteins participating in cell structure, energy metabolism, stress response, cell turnover, as well as transport and metabolism of nutrients were differentially expressed in placenta and endometrium between normal and IUGR fetuses. Analysis of functions of these proteins suggests reductions in ATP production and nutrients transport, increases in oxidative stress and apoptosis, and impairment of cell metabolism in IUGR fetuses. Collectively, our findings aid in understanding of the mechanisms responsible for uteroplacental dysfunction in IUGR fetus, and are expected to provide new strategies to reduce fetal growth restriction in pigs and other mammals.

  11. Associations between congenital cryptorchidism in newborn boys and levels of dioxins and PCBs in placenta

    DEFF Research Database (Denmark)

    Virtanen, H E; Koskenniemi, J J; Sundqvist, E

    2012-01-01

    In animal studies, exposure to dioxins has been associated with disrupted development of the male reproductive system, including testicular maldescent. Some polychlorinated biphenyls (PCBs) have also dioxin-like effects. In addition, one previous case-control study has reported an association...... between congenital cryptorchidism and colostrum PCB levels. We performed a case-control study to evaluate whether congenital cryptorchidism in boys was associated with increased levels of dioxins or PCBs in placenta reflecting foetal exposure. In addition, associations between placenta levels...... controls) and 168 Danish (39 cases, 129 controls)] were analysed for 17 toxic polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) and 37 PCBs (including 12 dioxin-like PCBs). Infant serum samples taken at 3 months were analysed for reproductive hormones. No significant differences between cases...

  12. Growth and development of the placenta in the capybara (Hydrochaeris hydrochaeris)

    DEFF Research Database (Denmark)

    Kanashiro, Claudia; Santos, Tatiana C; Miglino, Maria Angelica

    2009-01-01

    BACKGROUND: The guinea pig is an attractive model for human pregnancy and placentation, mainly because of its haemomonochorial placental type, but is rather small in size. Therefore, to better understand the impact of body mass, we studied placental development in the capybara which has a body mass...... around 50 kg and a gestation period of around 150 days. We paid attention to the development of the lobulated arrangement of the placenta, the growth of the labyrinth in the course of gestation, the differentiation of the subplacenta, and the pattern of invasion by extraplacental trophoblast. METHODS...... found in smaller hystricognath rodents including the guinea pig. These features apparently do not dependent on body size. Clearly, placentation in hystricognaths adheres to an extraordinarily stable pattern suggesting they can be used interchangeably as models of human placenta....

  13. Concentration of perfluorinated compounds and cotinine in human foetal organs, placenta, and maternal plasma

    DEFF Research Database (Denmark)

    Mamsen, Linn Salto; Jönsson, Bo A.G.; Lindh, Christian H.

    2017-01-01

    levels. Foetal exposure has previously been estimated from umbilical cord plasma, but the actual concentration in foetal organs has never been measured. Objectives The concentrations of 5 PFASs and cotinine – the primary metabolite of nicotine – were measured in human foetuses, placentas, and maternal...... plasma to evaluate to what extent these compounds were transferred from mother to foetus and to determine if the PFAS concentrations were associated with maternal cigarette smoking. Methods Thirty-nine Danish women who underwent legal termination of pregnancy before gestational week 12 were included; 24...... ratio for all five PFASs and cotinine. Smokers presented 99 ng/g cotinine in plasma, 108 ng/g in placenta, and 61 ng/g in foetal organs. No correlation between the maternal cotinine concentrations and PFAS concentrations was found. Conclusions PFASs were transferred from mother to foetus, however...

  14. Placenta expresses anti-Müllerian hormone and its receptor: Sex-related difference in fetal membranes.

    Science.gov (United States)

    Novembri, R; Funghi, L; Voltolini, C; Belmonte, G; Vannuccini, S; Torricelli, M; Petraglia, F

    2015-07-01

    Anti-Müllerian hormone (AMH) is a member of the transforming growth factor-β superfamily, playing a role in sexual differentiation and recruitment. Since a correlation exists between AMH serum levels in cord blood and fetal sex, the present study aimed to identify mRNA and protein expression of AMH and AMHRII in placenta and fetal membranes according to fetal sex. Placenta and fetal membranes samples (n = 40) were collected from women with singleton uncomplicated pregnancies at term. Identification of AMH protein in placenta and fetal membranes was carried out by immunohistochemistry and AMH and AMHRII protein localization by immunofluorescence, while mRNA expression was assessed by quantitative real-time PCR. AMH and AMHRII mRNAs were expressed by placenta and fetal membranes at term, without any significant difference between males and females. Placental immunostaining showed a syncytial localization of AMH without sex-related differences; while fetal membranes immunostaining was significantly more intense in male than in female fetuses (p membranes. The present study for the first time demonstrated that human placenta and fetal membranes expresses and co-localizes AMH and AMHRII. Although no sex-related difference was found for the mRNA expression both in placenta and fetal membranes, a most intense staining for AMH in male fetal membranes supports AMH as a gender specific hormone. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Gadd45 α expression in preeclampsia placenta and the effect of Gadd45 α on trophoblast HTR8/Svneo

    Directory of Open Access Journals (Sweden)

    Li Wang

    2016-01-01

    Full Text Available Objective: To study the expression of Gadd45 α in preeclampsia placenta and the regulating effect of Gadd45 α knockdown on trophoblast HTR8/Svneo. Methods: Preeclampsia placenta tissue and normal placenta tissue were collected, and mRNA contents and protein contents of Gadd45 α were detected by fluorescent quantitative PCR and Western blotting respectively; trophoblast cells HTR8/Svneo were cultured and after transfection of Gadd45 α siRNA, cell invasion ability and expression of invasion-assiotiated molecules were detected. Results: mRNA content and protein content of Gadd45 α in preeclampsia placenta tissue were higher than those in normal placenta tissue; after transfection of Gadd45 α siRNA, mRNA content and protein content of Gadd45 α in HTR8/Svneo cells significantly decreased, and the number of invasive cells as well as expression of MMP1, MMP2, MMP3 and MMP9 significantly increased. Conclusion: The expression of Gadd45 α in preeclampsia placenta abnormally increases; inhibting the expression of Gadd45 α in trophoblasts HTR8/Svneo can promote invasion and increase the expression of MMPs molecules.

  16. Expression of β human chorionic gonadotropin in the placenta of gestational diabetic mothers: an immunohistochemistry and ultrastructural study.

    Science.gov (United States)

    Sak, Muhammed Erdal; Deveci, Engin; Evsen, Mehmet Siddik; Kalkanhi, Sevgi; Baran, Ozlem; Ozekinci, Selver; Seker, Uğur

    2013-02-01

    To investigate morphologic differences of the placenta in pregnancies complicated by gestational diabetes compared to nondiabetic pregnancies. This was a comparative morphological study of the placentas from 20 women with gestational diabetes and 20 healthy pregnancies at 28-35 weeks of gestation. The presence of lesions such as fibrinoid necrosis, villous edema, syncytial knot and vascular lesions like chorangiosis was apparent, mainly in the diabetes group. There was an apparent decrease in the intensity of the human chorionic gonadotropin (hCG) immunostaining in the syncytiotrophoblast from the 28th to 35th weeks of gestation in the placentas of the healthy control group. No hCG immunostaining was observed in the villous or intervillous areas of any of the placentas. In diabetic placentas the expression of hCG was homogeneous with a moderate to intense immunoreactivity in the syncytiotrophoblast. Several syncytiotrophoblast cells showed dilations of both rough and smooth endoplasmic reticulum and loss and alteration of microvilli, and large vacuoles were observed just below the plasma membrane, as well as irregularities in the mitochondria. Syncytial cells play an important role in the placental transition. Increased expression of beta-hCG, deterioration, degeneration of organelles and cell structure and the basal membrane disorder in chorionic vessels were seen in placentas with gestational diabetes. These changes can affect placental transfer. However, further studies are needed to clarify this issue.

  17. Distribution of calcium, iron, copper, and zinc in two portions of placenta of teenager and adult women.

    Science.gov (United States)

    de Moraes, Milena Lima; de Faria Barbosa, Renata; Santo, Raquel Espírito; da Silva Santos, Flávia; de Almeida, Lívia Belcastro; de Jesus, Edgar Francisco Oliveira; de Carvalho Sardinha, Fátima Lucia; do Carmo, Maria das Graças Tavares

    2011-12-01

    The placenta is fundamental for fetal development. The aim of this study was to determine Ca, Fe, Cu, and Zn content in the fetal and maternal portions of the placentas of teenage and adult women. Measurement of the minerals was conducted using Synchrotron radiation total reflection X-ray fluorescence. Forty samples from the fetal portion of teenagers and adults and 40 samples from the maternal portion of teenagers and adults were analyzed. There were significant differences in the Ca and Cu concentrations of the placenta's maternal portion when compared to the fetal portion, for both teenagers and adults. There were differences in Fe and Zn concentrations only when comparing the maternal portion of placenta with the fetal portion of the adults. These results suggest important differences in mineral content based on the placental portion. No significant difference was observed between the minerals studied of the maternal portion of teenagers and adults; however, in the fetal portion, mineral concentrations were greater in adults than in teenagers. Therefore, the mineral concentration of the fetal portion of the placenta is influenced by the mother's age. If there is mineral's competition between the mother and fetus during pregnancy in adolescence due to the importance of these minerals in growth and development, then the mechanism and reason for it should be elucidated in future research. In addition, we believe that further research should be carried out on transporters of these minerals in the same portions of the placentas analyzed by our group, in teenagers and adults.

  18. Grey-scale and colour Doppler ultrasound versus magnetic resonance imaging for the prenatal diagnosis of placenta accreta.

    Science.gov (United States)

    Rezk, Mohamed Abd-Allah; Shawky, Mohamed

    2016-01-01

    To assess the effectiveness of grey-scale and colour Doppler ultrasound (US) versus magnetic resonance imaging (MRI) for the prenatal diagnosis of placenta accreta. A prospective observational study including a total of 74 patients with placenta previa and previous uterine scar (n = 74). Grey-scale and colour Doppler US was done followed by MRI by different observers to diagnose adherent placenta. Test validity of US and MRI were calculated. Maternal morbidity and mortality were also assessed. A total of 53 patients confirmed to have placenta accreta at operation. The overall sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of US was 94.34, 91.67, 96.15 and 88% compared to 96.08, 87.50, 94.23 and 91.3% for MRI, respectively. The most relevant US sign was turbulent blood flow by colour Doppler, while dark intra-placental band was the most sensitive MRI sign. Venous thromboembolism (1.3%), bladder injury (29.7%), ureteric injury (18.9%), postoperative fever (10.8%), admission to ICU (50%) and re-operation (31.1%). Placenta accreta can be successfully diagnosed by grey-scale and colour Doppler US. MRI would be more likely suggested for either posteriorly or laterally situated placenta previa in order to exclude placental invasion.

  19. The Placental Secretome: Identifying Potential Cross-Talk Between Placenta and Islet β-Cells

    Directory of Open Access Journals (Sweden)

    Robert Drynda

    2018-02-01

    Full Text Available Background/Aims: Insulin-secreting islet β-cells adapt to the insulin resistance associated with pregnancy by increasing functional β-cell mass, but the placental signals involved in this process are not well defined. In the current study, we analysed expression of G-protein coupled receptor (GPCR mRNAs in mouse islets and islet GPCR ligand mRNAs in placenta during pregnancy to generate an atlas of potential interactions between the placenta and β-cells to inform future functional studies of islet adaptive responses to pregnancy. Methods: Quantative RT-PCR arrays were used to measure mRNA expression levels of: (i 342 GPCRs in islets from non-pregnant mice, and in islets isolated from mice on gestational days 12 and 18; (ii 126 islet GPCR ligands in mouse placenta at gestational days 12 and 18. Results: At gestational day 12, a time of rapid expansion of the β-cell mass, 189 islet GPCR mRNAs were quantifiable, while 79 of the 126 known islet GPCR ligand mRNAs were detectable in placental extracts. Approximately half of the quantifiable placental GPCR ligand genes were of unknown function in β-cells. The expression of some islet GPCR and placental ligand mRNAs varied during pregnancy, with altered expression of both GPCR and ligand mRNAs by gestational day 18. Conclusion: The current study has revealed numerous potential routes for interaction between the placenta and islets, and offers an atlas to inform further functional studies of their roles in adaptive responses to pregnancy, and in the regulation of the β-cell mass.

  20. Iron-59 transfer across the placenta at late pregnancy in rat

    International Nuclear Information System (INIS)

    Zylicz, E.

    1976-01-01

    The transfer of 59 Fe from mother to foetus in relation to the time of gestation was examined 24 hours after injecting 5 μCi of 59 Fe-citrate. The radioactivity of foetuses, placentae and some mother organs between 15th and 21st days of gestation was determined. A striking daily foetal 59 Fe increment with a concomitant decrease of 59 Fe level in maternalorgans was observed from 16th day of pregnancy. (author)

  1. Alcohol, Methamphetamine, and Marijuana Exposure Have Distinct Effects on the Human Placenta.

    Science.gov (United States)

    Carter, R Colin; Wainwright, Helen; Molteno, Christopher D; Georgieff, Michael K; Dodge, Neil C; Warton, Fleur; Meintjes, Ernesta M; Jacobson, Joseph L; Jacobson, Sandra W

    2016-04-01

    Animal studies have demonstrated adverse effects of prenatal alcohol exposure on placental development, but few studies have examined these effects in humans. Little is known about effects of prenatal exposure to methamphetamine, marijuana, and cigarette smoking on placental development. Placentas were collected from 103 Cape Coloured (mixed ancestry) pregnant women recruited at their first antenatal clinic visit in Cape Town, South Africa. Sixty-six heavy drinkers and 37 nondrinkers were interviewed about their alcohol, cigarette smoking, and drug use at 3 antenatal visits. A senior pathologist, blinded to exposure status, performed comprehensive pathology examinations on each placenta using a standardized protocol. In multivariable regression models, effects of prenatal exposure were examined on placental size, structure, and presence of infections and meconium. Drinkers reported a binge pattern of heavy drinking, averaging 8.0 drinks/occasion across pregnancy on 1.4 d/wk. 79.6% smoked cigarettes; 22.3% used marijuana; and 17.5% used methamphetamine. Alcohol exposure was related to decreased placental weight and a smaller placenta-to-birthweight ratio. By contrast, methamphetamine was associated with larger placental weight and a larger placenta-to-birthweight ratio. Marijuana was also associated with larger placental weight. Alcohol exposure was associated with increased risk of placental hemorrhage. Prenatal alcohol, drug, and cigarette use were not associated with chorioamnionitis, villitis, deciduitis, or maternal vascular underperfusion. Alcohol and cigarette smoking were associated with a decreased risk of intrauterine passing of meconium, a sign of acute fetal stress and/or hypoxia; methamphetamine, with an increased risk. This is the first human study to show that alcohol, methamphetamine, and marijuana were associated with distinct patterns of pathology, suggesting different mechanisms mediating their effects on placental development. Given the growing

  2. Angiogenic factor imbalance precedes complement deposition in placentae of the BPH/5 model of preeclampsia.

    Science.gov (United States)

    Sones, Jennifer L; Merriam, Audrey A; Seffens, Angelina; Brown-Grant, Dex-Ann; Butler, Scott D; Zhao, Anna M; Xu, Xinjing; Shawber, Carrie J; Grenier, Jennifer K; Douglas, Nataki C

    2018-05-01

    Preeclampsia (PE), a hypertensive disorder of pregnancy, is a leading cause of maternal and fetal morbidity and mortality. Although the etiology is unknown, PE is thought to be caused by defective implantation and decidualization in pregnancy. Pregnant blood pressure high (BPH)/5 mice spontaneously develop placentopathies and maternal features of human PE. We hypothesized that BPH/5 implantation sites have transcriptomic alterations. Next-generation RNA sequencing of implantation sites at peak decidualization, embryonic day (E)7.5, revealed complement gene up-regulation in BPH/5 vs. controls. In BPH/5, expression of complement factor 3 was increased around the decidual vasculature of E7.5 implantation sites and in the trophoblast giant cell layer of E10.5 placentae. Altered expression of VEGF pathway genes in E5.5 BPH/5 implantation sites preceded complement dysregulation, which correlated with abnormal vasculature and increased placental growth factor mRNA and VEGF 164 expression at E7.5. By E10.5, proangiogenic genes were down-regulated, whereas antiangiogenic sFlt-1 was up-regulated in BPH/5 placentae. We found that early local misexpression of VEGF genes and abnormal decidual vasculature preceded sFlt-1 overexpression and increased complement deposition in BPH/5 placentae. Our findings suggest that abnormal decidual angiogenesis precedes complement activation, which in turn contributes to the aberrant trophoblast invasion and poor placentation that underlie PE.-Sones, J. L., Merriam, A. A., Seffens, A., Brown-Grant, D.-A., Butler, S. D., Zhao, A. M., Xu, X., Shawber, C. J., Grenier, J. K., Douglas, N. C. Angiogenic factor imbalance precedes complement deposition in placentae of the BPH/5 model of preeclampsia.

  3. Topological properties and spatial organization of villous capillaries in normal and diabetic placentas

    Czech Academy of Sciences Publication Activity Database

    Jirkovská, Marie; Kubínová, Lucie; Janáček, Jiří; Moravcová, M.; Krejčí, V.; Karen, Petr

    2002-01-01

    Roč. 39, č. 3 (2002), s. 268-278 ISSN 1018-1172 R&D Projects: GA ČR GA304/97/0420; GA ČR GA304/01/0257 Institutional research plan: CEZ:AV0Z5011922 Keywords : diabetic placentas * vascular topology * confocal microscopy Subject RIV: EA - Cell Biology Impact factor: 2.458, year: 2002

  4. Comparative Proteomics Analysis of Placenta from Pregnant Women with Intrahepatic Cholestasis of Pregnancy

    OpenAIRE

    Zhang, Ting; Guo, Yueshuai; Guo, Xuejiang; Zhou, Tao; Chen, Daozhen; Xiang, Jingying; Zhou, Zuomin

    2013-01-01

    INTRODUCTION: Intrahepatic cholestasis of pregnancy (ICP) usually occurs in the third trimester and associated with increased risks in fetal complications. Currently, the exact cause of this disease is unknown. In this study we aim to investigate the potential proteins in placenta, which may participate in the molecular mechanisms of ICP-related fetal complications using iTRAQ-based proteomics approach. METHODS: The iTRAQ analysis combined with liquid chromatography-tandem mass spectrometry (...

  5. MEASURES TO IMPROVE THE OUTCOME OF ABRUPTIO PLACENTA IN A TERTIARY REFERRAL CENTRE

    Directory of Open Access Journals (Sweden)

    Vijaya

    2015-12-01

    Full Text Available AIM To analyze the outcome of 135 patients admitted with Abruptio Placenta during a period of 9 months managed at Tertiary Referral Centre, Modern Govt. Maternity Hospital, Petalburz, Hyderabad, Telangana State. MATERIALS AND METHODS A study of 135 cases of Abruptio Placenta over a period of 9 months at a tertiary level referral centre. They were analyzed regarding age, parity, socio economic status, period of gestation, antenatal care, management of Abruption and maternal and fetal outcome, and the measures to improve the condition were analyzed. RESULTS Abruptio placenta is a dreadful threat to maternal and fetal life. In our study unbooked cases were 110(81.48%, Hypertension is the main risk factor almost in 90(66.66% cases, 65% of them were between 28-36 weeks of GA, and 6 were grandmultis, 6 cases ended up with HELLP syndrome with DIC. All these 6 cases were near misses, 5 unbooked cases had eclampsia. One case of unbooked eclampsia had abruption DIC and could not be saved as it was the late referral. Total number of vaginal deliveries were 66(48.88% and total no. of abdominal deliveries were 67(49.62% in this LSCS 66 and one hysterotomy. IUD at the time of admission total were 100(74%. CONCLUSION To improve the outcome in Abruptio Placentae Good antenatal care, Educating the patient, Strengthening the Primary Health Centers in identifying the risk factors like Pre-eclampsia thereby avoiding eclampsia. Regular antenatal checkups timely delivery and availability of blood and blood products with good Neonatal care unit will help in improving the outcome of Abruptio.

  6. Is thrombophilia a risk factor for placenta-mediated pregnancy complications?

    DEFF Research Database (Denmark)

    Hoffmann, Elise; Hedlund, Elisabeth; Perin, Trine

    2012-01-01

    PURPOSE: To determine if thrombophilia is a risk factor for placenta-mediated pregnancy complications (PMPC) (i.e., preeclampsia, intrauterine growth restriction (IUGR), placental abruption, intrauterine fetal death and recurrent pregnancy loss). METHODS: A 5-year retrospective cohort study....... Ongoing pregnancies in women with an antecedent PMPC with thrombophilia were compared with the pregnancies in similar women without thrombophilia. The main outcome measures were mean birth weight deviations, corrected for gestational age, and recurrence of PMPC. Low-molecular-weight heparin (LMWH...

  7. Fetal blood vessel count increases in compensation of hypoxia in premature placentas

    Directory of Open Access Journals (Sweden)

    K. Kartini

    2015-04-01

    Full Text Available Background Prematurity refers to live births before 37 weeks of gestation, wherein the baby is born before the body and its organ systems achieve perfect maturity, and this disorder is still a global problem. The high incidence of prematurity is a problem in developing and also in developed countries. Certain conditions accompanying pregnancies like preeclampsia, infection, and placental insufficiency, may trigger uterine hypoxia, causing premature birth. The placental condition is related to the intra-uterine fetal condition. In prolonged placental hypoxia, there occurs a compensatory mechanism, i.e. an increase in placental angiogenesis. This study aimed to evaluate the effect of hypoxia on fetal blood vessel count as compensatory mechanism for tissue hypoxia. Methods An observational-analytical cross-sectional design using paraffin blocks of conserved premature placentas, comprising 31 samples of hypoxic premature placentas and 28 samples of non-hypoxic premature placentas, selected using non-random consecutive sampling. The samples were made into slides and stained with hematoxylin-eosin for assessment of histological structure, including fetal blood vessel count and integrity, villus conditions, syncytiotrophoblastic nuclear changes, and syncytiotrophoblastic nuclear aggregation. Mann-Whitney test was used to compare the difference of blood vessel count between groups. Results Assessment of histological structure showed a significant increase in fetal blood vessel count in the hypoxic group [8.00 (5-15] as compared with the non-hypoxic group [7.50 (3-15]. Conclusion The hypoxia in premature placentas caused an increase in the number of fetal blood vessels as a form of compensation for disturbed oxygen homeostasis.

  8. Fetal blood vessel count increases in compensation of hypoxia in premature placentas

    Directory of Open Access Journals (Sweden)

    K Kartini

    2016-02-01

    Full Text Available BACKGROUND Prematurity refers to live births before 37 weeks of gestation, wherein the baby is born before the body and its organ systems achieve perfect maturity, and this disorder is still a global problem. The high incidence of prematurity is a problem in developing and also in developed countries. Certain conditions accompanying pregnancies like preeclampsia, infection, and placental insufficiency, may trigger uterine hypoxia, causing premature birth. The placental condition is related to the intra-uterine fetal condition. In prolonged placental hypoxia, there occurs a compensatory mechanism, i.e. an increase in placental angiogenesis. This study aimed to evaluate the effect of hypoxia on fetal blood vessel count as compensatory mechanism for tissue hypoxia. METHODS An observational-analytical cross-sectional design using paraffin blocks of conserved premature placentas, comprising 31 samples of hypoxic premature placentas and 28 samples of non-hypoxic premature placentas, selected using non-random consecutive sampling. The samples were made into slides and stained with hematoxylin-eosin for assessment of histological structure, including fetal blood vessel count and integrity, villus conditions, syncytiotrophoblastic nuclear changes, and syncytiotrophoblastic nuclear aggregation. Mann-Whitney test was used to compare the difference of blood vessel count between groups. RESULTS Assessment of histological structure showed a significant increase in fetal blood vessel count in the hypoxic group [8.00 (5-15] as compared with the non-hypoxic group [7.50 (3-15]. CONCLUSION The hypoxia in premature placentas caused an increase in the number of fetal blood vessels as a form of compensation for disturbed oxygen homeostasis.

  9. The human TRPV6 channel protein is associated with cyclophilin B in human placenta.

    Science.gov (United States)

    Stumpf, Tobias; Zhang, Qi; Hirnet, Daniela; Lewandrowski, Urs; Sickmann, Albert; Wissenbach, Ulrich; Dörr, Janka; Lohr, Christian; Deitmer, Joachim W; Fecher-Trost, Claudia

    2008-06-27

    Transcellular calcium transport in the kidney, pancreas, small intestine, and placenta is partly mediated by transient receptor potential (TRP) channels. The highly selective TRPV6 calcium channel protein is most likely important for the calcium transfer in different specialized epithelial cells. In the human placenta the protein is expressed in trophoblast tissue, where it is implicated in the transepithelial calcium transfer from mother to the fetus. We enriched the TRPV6 channel protein endogenously expressed in placenta together with annexin A2 and cyclophilin B (CypB), which is a member of the huge immunophilin family. In the human placenta TRPV6 and CypB are mainly located intracellularly in the syncytiotrophoblast layer, but a small amount of the mature glycosylated TRPV6 channel protein and CypB is also expressed in microvilli apical membranes, the fetomaternal barrier. To understand the role of CypB on the TRPV6 channel function, we evaluated the effect of CypB co-expression on TRPV6-mediated calcium uptake into Xenopus laevis oocytes expressing TRPV6. A significant increase of TRPV6-mediated calcium uptake was observed after CypB/TRPV6 co-expression. This stimulatory effect of CypB was reversed by the immunosuppressive drug cyclosporin A, which inhibits the enzymatic activity of CypB. Cyclosporin A had no significant effect on TRPV6 and CypB protein expression levels in the oocytes. In summary, our results establish CypB as a new TRPV6 accessory protein with potential involvement in TRPV6 channel activation through its peptidyl-prolyl cis/trans isomerase activity.

  10. Anthroposophic lifestyle influences the concentration of metals in placenta and cord blood

    International Nuclear Information System (INIS)

    Fagerstedt, Sara; Kippler, Maria; Scheynius, Annika; Gutzeit, Cindy; Mie, Axel; Alm, Johan; Vahter, Marie

    2015-01-01

    Allergic diseases develop in genetically susceptible individuals in a complex interplay with the environment, usually early in life. We have previously shown that the anthroposophic lifestyle is associated with reduced risk of allergic disease in children, but details on the influencing environmental factors are largely unknown. This study aims to elucidate if anthroposophic lifestyle influences fetal exposure to selected toxic and essential elements. Randomly selected non-smoking mothers with (n=40) and without (n=40) anthroposophic lifestyle from the prospective birth cohort ALADDIN were included. Concentrations of 12 toxic and essential elements were analyzed in full term placentas and in the erythrocyte fractions of maternal peripheral blood and of umbilical cord blood, using inductively coupled plasma mass spectrometry. Cadmium concentrations in maternal blood and placenta were significantly higher in mothers with an anthroposophic lifestyle (p<0.001), while concentrations in cord blood were generally low, irrespective of lifestyle. Cobalt concentrations were higher in both maternal blood, placenta and cord blood in the anthroposophic group. Lead concentrations were higher in maternal blood and cord blood, but not placenta, of mothers with anthroposophic lifestyle. Analysis of covariance, including lifestyle, parity, maternal age, gestational age, vegetarian diet, use of herbal medicine and occupation in the model, showed that mainly the anthroposophic lifestyle was significantly associated with cadmium concentrations. In conclusion, women with an anthroposophic lifestyle had higher concentrations of cadmium, cobalt and lead concentrations. Cadmium concentrations might have been influenced by a diet rich in vegetables and/or low iron status of the mothers. - Highlights: • Toxic elements in mother–newborn pairs in relation to anthroposophic lifestyle. • Anthroposophic lifestyle was associated with higher levels of cadmium, cobalt and lead. • A diet rich

  11. Smoking specifically induces metallothionein-2 isoform in human placenta at term

    International Nuclear Information System (INIS)

    Ronco, Ana Maria; Garrido, Fernando; Llanos, Miguel N.

    2006-01-01

    Recently, we reported the presence of higher levels of metallothionein (MT) in placentas of smokers compared to non-smokers. In the present study, we designed experiments to separate and evaluate two isoforms of MT (MT-1 and MT-2) in placentas of smokers and non-smokers. Metallothionein was extracted and separated by ion-exchange high performance liquid chromatography (HPLC), previous saturation with cadmium chloride. Two peaks eluting at 6 and 12.5 min, corresponding to MT-1 and MT-2, respectively, were obtained. Metallothionein present in both peaks was identified by Western blot analysis using a monoclonal antibody directed against MT-1 and MT-2. Each isoform concentration was calculated after measuring its cadmium content by atomic absorption spectrometry with inductively coupled-plasma. In placentas of smokers, MT-2 levels increased by seven-fold compared to non-smokers, whereas MT-1 was not changed. Total placental cadmium and zinc concentrations, determined by atomic absorption spectrometry and neutron activation analysis, respectively, were higher in smokers. Metallothioneins levels were clearly in excess to bind all cadmium ions present in placentas. However, most of placental zinc remains unbound to MTs, although as much as twice zinc ions could be bound to MT in smokers. In conclusion, MT-2 is the main isoform induced by smoking, suggesting that this isoform could be involved in placental cadmium and zinc retention. This fact, which could contribute to reduce the transference of zinc to the fetus, may be associated to detrimental effects on fetal growth and development

  12. The Placenta in Twin-to-Twin Transfusion Syndrome and Twin Anemia Polycythemia Sequence.

    Science.gov (United States)

    Couck, Isabel; Lewi, Liesbeth

    2016-06-01

    Twin-to-twin transfusion syndrome (TTTS) and twin anemia polycythemia sequence (TAPS) are complications unique to monochorionic twin pregnancies and their shared circulation. Both are the result of the transfusion imbalance in the intertwin circulation. TTTS is characterized by an amniotic fluid discordance, whereas in TAPS, there is a severe discordance in hemoglobin levels. The article gives an overview of the typical features of TTTS and TAPS placentas.

  13. Non- Surgical Approach in a Case of Placenta Accreta Complicated by a Pulmonary Embolus

    OpenAIRE

    İncebiyik, Adnan; Yalcin, Funda; Hilali, Nese Gul; Camuzcuoglu, Aysun; Camuzcuoglu, Hakan; Vural, Mehmet

    2015-01-01

    Placenta accreta, which is a serious complication of pregnancy that can be treated with a spectrum of treatment methods ranging from medical treatment to hysterectomy, is characterized by the abnormal adherence of the placental tissue to the uterine wall. The presence of a simultaneous pulmonary embolus necessitates more conservative treatment approaches due to anticoagulant treatment and limited lung capacity of the patient. In this case report, a case with these risk factors that was treate...

  14. High-intensity focused ultrasound treatment of placenta accreta after vaginal delivery: a preliminary study.

    Science.gov (United States)

    Bai, Y; Luo, X; Li, Q; Yin, N; Fu, X; Zhang, H; Qi, H

    2016-04-01

    To evaluate the safety and efficiency of high-intensity focused ultrasound (HIFU) in the treatment of placenta accreta after vaginal delivery. Enrolled into this study between September 2011 and September 2013 were 12 patients who had been diagnosed with placenta accreta following vaginal delivery and who had stable vital signs. All patients were treated using an ultrasound-guided HIFU treatment system. As indication of the effectiveness of the treatment we considered decreased vascular index on color Doppler imaging, decrease in size of residual placenta compared with pretreatment size on assessment by three-dimensional ultrasound with Virtual Organ Computer-aided Analysis, reduced signal intensity and degree of enhancement on magnetic resonance imaging and avoidance of hysterectomy following treatment. To assess the safety of HIFU treatment, we recorded side effects, hemorrhage, infection, sex steroid levels, return of menses and subsequent pregnancy. Patients were followed up in this preliminary study until December 2013. The 12 patients receiving HIFU treatment had an average postpartum hospital stay of 6.8 days and an average period of residual placental involution of 36.9 days. HIFU treatment did not apparently increase the risk of infection or hemorrhage and no patient required hysterectomy. In all patients menstruation recommenced after an average of 80.2 days, and sex steroid levels during the middle luteal phase of the second menstrual cycle were normal. Two patients became pregnant again during the follow-up period. This preliminary study suggests that ultrasound-guided HIFU is a safe and effective non-invasive method to treat placenta accreta patients after vaginal delivery who have stable vital signs and desire to preserve fertility. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2015 ISUOG. Published by John Wiley & Sons Ltd.

  15. Accuracy of ultrasonography and magnetic resonance imaging in the diagnosis of placenta accreta.

    Directory of Open Access Journals (Sweden)

    Anne-Sophie Riteau

    Full Text Available PURPOSE: To evaluate the accuracy of ultrasonography and magnetic resonance imaging (MRI in the diagnosis of placenta accreta and to define the most relevant specific ultrasound and MRI features that may predict placental invasion. MATERIAL AND METHODS: This study was approved by the institutional review board of the French College of Obstetricians and Gynecologists. We retrospectively reviewed the medical records of all patients referred for suspected placenta accreta to two university hospitals from 01/2001 to 05/2012. Our study population included 42 pregnant women who had been investigated by both ultrasonography and MRI. Ultrasound images and MRI were blindly reassessed for each case by 2 raters in order to score features that predict abnormal placental invasion. RESULTS: Sensitivity in the diagnosis of placenta accreta was 100% with ultrasound and 76.9% for MRI (P = 0.03. Specificity was 37.5% with ultrasonography and 50% for MRI (P = 0.6. The features of greatest sensitivity on ultrasonography were intraplacental lacunae and loss of the normal retroplacental clear space. Increased vascularization in the uterine serosa-bladder wall interface and vascularization perpendicular to the uterine wall had the best positive predictive value (92%. At MRI, uterine bulging had the best positive predictive value (85% and its combination with the presence of dark intraplacental bands on T2-weighted images improved the predictive value to 90%. CONCLUSION: Ultrasound imaging is the mainstay of screening for placenta accreta. MRI appears to be complementary to ultrasonography, especially when there are few ultrasound signs.

  16. Estimation of placenta function using T2* measurements during hyper- and normoxia

    DEFF Research Database (Denmark)

    Peters, David Alberg; Sørensen, Anne Nødgård; Fründ, Ernst Torben

    2012-01-01

    MR imaging is becoming widely used for pre natal diagnosis1. Conventional pre natal imaging focuses on structural changes, but recently several groups have begun to investigate changes in the MR signal during oxygen breathing. The main focus has been changes in the BOLD signal2,3 in organs such a...... such as liver, brain, lungs and heart. In this study we invenstigate the feasibility of pre- and post-oxygen T2* measurements to evaluate the function of the placenta....

  17. Anthroposophic lifestyle influences the concentration of metals in placenta and cord blood

    Energy Technology Data Exchange (ETDEWEB)

    Fagerstedt, Sara [The Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm (Sweden); Kippler, Maria [Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm (Sweden); Scheynius, Annika; Gutzeit, Cindy [Department of Medicine Solna, Translational Immunology Unit, Karolinska Institutet and University Hospital, Stockholm (Sweden); Mie, Axel [The Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm (Sweden); Alm, Johan [The Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Stockholm (Sweden); Sachs' Children and Youth Hospital, Södersjukhuset, Stockholm (Sweden); Vahter, Marie, E-mail: marie.vahter@ki.se [Institute of Environmental Medicine, Karolinska Institutet, Box 210, 171 77 Stockholm (Sweden)

    2015-01-15

    Allergic diseases develop in genetically susceptible individuals in a complex interplay with the environment, usually early in life. We have previously shown that the anthroposophic lifestyle is associated with reduced risk of allergic disease in children, but details on the influencing environmental factors are largely unknown. This study aims to elucidate if anthroposophic lifestyle influences fetal exposure to selected toxic and essential elements. Randomly selected non-smoking mothers with (n=40) and without (n=40) anthroposophic lifestyle from the prospective birth cohort ALADDIN were included. Concentrations of 12 toxic and essential elements were analyzed in full term placentas and in the erythrocyte fractions of maternal peripheral blood and of umbilical cord blood, using inductively coupled plasma mass spectrometry. Cadmium concentrations in maternal blood and placenta were significantly higher in mothers with an anthroposophic lifestyle (p<0.001), while concentrations in cord blood were generally low, irrespective of lifestyle. Cobalt concentrations were higher in both maternal blood, placenta and cord blood in the anthroposophic group. Lead concentrations were higher in maternal blood and cord blood, but not placenta, of mothers with anthroposophic lifestyle. Analysis of covariance, including lifestyle, parity, maternal age, gestational age, vegetarian diet, use of herbal medicine and occupation in the model, showed that mainly the anthroposophic lifestyle was significantly associated with cadmium concentrations. In conclusion, women with an anthroposophic lifestyle had higher concentrations of cadmium, cobalt and lead concentrations. Cadmium concentrations might have been influenced by a diet rich in vegetables and/or low iron status of the mothers. - Highlights: • Toxic elements in mother–newborn pairs in relation to anthroposophic lifestyle. • Anthroposophic lifestyle was associated with higher levels of cadmium, cobalt and lead. • A diet rich

  18. Cesárea prévia como fator de risco para o descolamento prematuro da placenta Previous cesarean section as a risk factor for abruptio placentae

    Directory of Open Access Journals (Sweden)

    Fábio Roberto Cabar

    2004-10-01

    Full Text Available OBJETIVO: investigar a relação entre o antecedente de cesárea e a ocorrência do descolamento prematuro da placenta (DPP. MÉTODOS: estudo retrospectivo em que foram avaliados os dados referentes a 6495 partos realizados no período entre abril de 2001 e janeiro de 2004. Foram adotados como critérios de inclusão: diagnóstico de DPP confirmado por exame da placenta após o parto, gestação única, peso do recém-nascido superior a 500 g e idade gestacional acima de 22 semanas e ausência de história de trauma abdominal na gestação atual. Para cada caso de DPP incluído no estudo foram selecionados cinco controles, obedecendo ao seguinte pareamento: paridade, idade gestacional (30 semanas, diagnóstico materno de síndrome hipertensiva na gestação índice, antecedente de cicatriz uterina prévia não relacionada à operação cesariana, diagnóstico de rotura prematura de membranas ou diagnóstico de polidrâmnio. A análise univariada das variáveis contínuas foi realizada utilizando-se o teste t de Student e as variáveis categóricas foram avaliadas por meio de teste exato de Fisher ou teste de chi2, com níveis descritivos (p menores que 0,05 considerados significantes. RESULTADOS: 34 casos de pacientes com diagnóstico de DPP preencheram os critérios de inclusão (incidência de 0,52%. Para o grupo controle foram selecionadas 170 pacientes que obedeceram aos critérios de pareamento propostos. No grupo de pacientes com DPP, 26,5% apresentavam antecedente de parto cesárea (9 casos, ao passo que, no grupo controle, esse antecedente foi observado em 21,2% das pacientes (36 casos. Não houve diferença estatisticamente significativa na incidência de cesárea prévia entre os dois grupos estudados (p=0,65, OR=1,34, IC 95%=0,53-3,34. CONCLUSÃO: o aspecto abordado neste estudo, isto é, a associação do DPP em pacientes com cicatriz uterina de cesárea, não pôde ser confirmado com a presente casuística.PURPOSE: to study the

  19. The first trimester human placenta is a site for terminal maturation of primitive erythroid cells.

    Science.gov (United States)

    Van Handel, Ben; Prashad, Sacha L; Hassanzadeh-Kiabi, Nargess; Huang, Andy; Magnusson, Mattias; Atanassova, Boriana; Chen, Angela; Hamalainen, Eija I; Mikkola, Hanna K A

    2010-10-28

    Embryonic hematopoiesis starts via the generation of primitive red blood cells (RBCs) that satisfy the embryo's immediate oxygen needs. Although primitive RBCs were thought to retain their nuclei, recent studies have shown that primitive RBCs in mice enucleate in the fetal liver. It has been unknown whether human primitive RBCs enucleate, and what hematopoietic site might support this process. Our data indicate that the terminal maturation and enucleation of human primitive RBCs occurs in first trimester placental villi. Extravascular ζ-globin(+) primitive erythroid cells were found in placental villi between 5-7 weeks of development, at which time the frequency of enucleated RBCs was higher in the villous stroma than in circulation. RBC enucleation was further evidenced by the presence of primitive reticulocytes and pyrenocytes (ejected RBC nuclei) in the placenta. Extravascular RBCs were found to associate with placental macrophages, which contained ingested nuclei. Clonogenic macrophage progenitors of fetal origin were present in the chorionic plate of the placenta before the onset of fetoplacental circulation, after which macrophages had migrated to the villi. These findings indicate that placental macrophages may assist the enucleation process of primitive RBCs in placental villi, implying an unexpectedly broad role for the placenta in embryonic hematopoiesis.

  20. Differential transferrin expression in placentae from normal and abnormal pregnancies: a pilot study

    Directory of Open Access Journals (Sweden)

    Bukovsky Antonin

    2008-07-01

    Full Text Available Abstract Background The placenta is an important site for iron metabolism in humans. It transfers iron from the mother to the fetus. One of the major iron transport proteins is transferrin, which is a blood plasma protein crucial for iron uptake. Its localization and expression may be one of the markers to distinguish placental dysfunction. Methods In the experimental study we used antibody preparation, mass spectrometric analysis, biochemical and immunocytochemical methods for characterization of transferrin expression on the human choriocarcinoma cell line JAR (JAR cells, placental lysates, and cryostat sections. Newly designed monoclonal antibody TRO-tf-01 to human transferrin was applied on human placentae from normal (n = 3 and abnormal (n = 9 pregnancies. Results Variations of transferrin expression were detected in villous syncytiotrophoblast, which is in direct contact with maternal blood. In placentae from normal pregnancies, the expression of transferrin in the syncytium was significantly lower (p Conclusion These observations suggest that in the case of abnormal pregnancies, the fetus may require higher levels of transferrin in order to prevent iron depletion due to the stress from the placental dysfunction.

  1. Evaluation of the maternal-fetal transfer of granisetron in an ex vivo placenta perfusion model.

    Science.gov (United States)

    Julius, Justin M; Tindall, Andrew; Moise, Kenneth J; Refuerzo, Jerrie S; Berens, Pamela D; Smith, Judith A

    2014-11-01

    The objective of this study was to estimate maternal-fetal transplacental passage of granisetron in an ex vivo placental perfusion model. Term human placentas (N=8) were collected immediately after delivery. A single cotyledon from each placenta was perfused granisetron concentration to mimic systemic maternal peak plasma concentrations following either IV (50ng/mL) or transdermal administration (5ng/mL). To assess drug transfer and accumulation, samples were collected from maternal and fetal compartments. In the 50ng/mL open model, the mean transport fraction was 0.21±0.08 with clearance index of 0.53±0.66. Fetal peak concentrations achieved was 5.6±6.6ng/mL with mean accumulation of 5.35±6.4ng/mL. No drug was detected in the fetal compartment with the 5ng/mL models. Transplacental passage of granisetron was inconsistent at the 50ng/mL concentration that achieved with IV dosing. However, there consistently was no detectable passage in all the placentas evaluated of the granisetron at 5ng/mL concentration that would be achieved after transdermal patch administration. Copyright © 2014 Elsevier Inc. All rights reserved.

  2. Retrotransposon hypomethylation in melanoma and expression of a placenta-specific gene.

    Directory of Open Access Journals (Sweden)

    Erin C Macaulay

    Full Text Available In the human placenta, DNA hypomethylation permits the expression of retrotransposon-derived genes that are normally silenced by methylation in somatic tissues. We previously identified hypomethylation of a retrotransposon-derived transcript of the voltage-gated potassium channel gene KCNH5 that is expressed only in human placenta. However, an RNA sequence from this placental-specific transcript has been reported in melanoma. This study examined the promoter methylation and expression of the retrotransposon-derived KCNH5 transcript in 25 melanoma cell lines to determine whether the acquisition of 'placental' epigenetic marks is a feature of melanoma. Methylation and gene expression analysis revealed hypomethylation of this retrotransposon in melanoma cell lines, particularly in those samples that express the placental KCNH5 transcript. Therefore we propose that hypomethylation of the placental-specific KCNH5 promoter is frequently associated with KCNH5 expression in melanoma cells. Our findings show that melanoma can develop hypomethylation of a retrotransposon-derived gene; a characteristic notably shared with the normal placenta.

  3. The Clinical Study about Honilirls Placenta Herbal Acupuncture on Bell's Palsy

    Directory of Open Access Journals (Sweden)

    Lee Chae-Woo

    2005-12-01

    Full Text Available Objectives : This study has been designed and performed to identify the effect on Bell's palsy according to the injection of herbal medicine induced from the Hominis Placenta. Methods : We measured the facial palsy changes of the patients who were admitted for Bell's palsy in the Oriental Medical hospital of Dongeui medical center from 03-01-2004 to 07-31-2004. Bell's palsy patients were divided into two groups. One group(A group was injected with Hominis Placenta herbal acupuncture. The other group(B group was injected with normal saline. Then effects of these treatment was evaluated by Yanagihara's unweighted grading system. Results : A group was marked more higher than B group in treatment outcome. we discovered that it is significant differences between two groups after 4 week. Conclusions : These results provided that A group is more effective than B group. For clearly proving the effect of Hominis Placenta herbal acupuncture on Bell's palsy, it is need more sample's number and more treatment's duration.

  4. Differential Proteome Analysis of the Preeclamptic Placenta Using Optimized Protein Extraction

    Directory of Open Access Journals (Sweden)

    Magnus Centlow

    2010-01-01

    Full Text Available The human placenta is a difficult tissue to work with using proteomic technology since it contains large amounts of lipids and glycogen. Both lipids and glycogen are known to interfere with the first step in the two-dimensional polyacrylamide gel electrophoresis (2D-PAGE, the isoelectric focusing. In order to gain the best possible protein separation on 2D-PAGE, an optimized sample preparation protocol for placental proteins was developed. Two different buffers, urea/CHAPS and Hepes, were used for solubilization in combination with six different precipitation methods. The removal of glycogen from the samples by centrifugation was crucial for the final proteome maps. Solubilization with urea/CHAPS in combination with dichloromethane/methanol or acidified acetone proved to be the best precipitation procedures. When applied to clinical placenta samples apolipoprotein A1 was found to be accumulated in the preeclamptic placenta, where it may either have a nutritional effect or act as a modifier of signal transduction.

  5. Symbol "&" suture to control atonic postpartum hemorrhage with placenta previa accreta.

    Science.gov (United States)

    Li, Guang Tai; Li, Xiao Fan; Liu, Ya Jing; Li, Wei; Xu, Hong Mei

    2015-02-01

    To evaluate the efficacy and safety of a symbol "&" compression suture technique in controlling severe atonic postpartum hemorrhage with placenta previa accreta during cesarean delivery. Nine women with heavy postpartum bleeding from uterine inertia and placenta previa percret, which did not react to conventional initial management protocols, were underwent the suture in the shape of symbol "&" in China Meitan General Hospital. The suture procedure was to staple the anterior and posterior walls (of the lower uterine segment as well as corpus uterus) together using number 1 chromic catgut, with a cross at about 2 cm above the upper boundary of lower uterine segment. Symbol "&" compression suture was capable of stanching the postpartum hemorrhage immediately in all nine women. None of these patients developed complications related to this method. Subsequent pregnancies after the suture were occurred in two women and delivered with repeat cesarean section. Symbol "&" compression suture is a simple, safe and highly effective technique to control the treatment-resistant uterine atonic bleeding, particularly in previous cesarean scar at lower segment and placenta previa accreta.

  6. Comparative Methylation of ERVWE1/Syncytin-1 and Other Human Endogenous Retrovirus LTRs in Placenta Tissues

    Science.gov (United States)

    Gimenez, Juliette; Montgiraud, Cécile; Oriol, Guy; Pichon, Jean-Philippe; Ruel, Karine; Tsatsaris, Vassilis; Gerbaud, Pascale; Frendo, Jean-Louis; Evain-Brion, Danièle; Mallet, François

    2009-01-01

    Human endogenous retroviruses (HERVs) are globally silent in somatic cells. However, some HERVs display high transcription in physiological conditions. In particular, ERVWE1, ERVFRDE1 and ERV3, three proviruses of distinct families, are highly transcribed in placenta and produce envelope proteins associated with placenta development. As silencing of repeated elements is thought to occur mainly by DNA methylation, we compared the methylation of ERVWE1 and related HERVs to appreciate whether HERV methylation relies upon the family, the integration site, the tissue, the long terminal repeat (LTR) function or the associated gene function. CpG methylation of HERV-W LTRs in placenta-associated tissues was heterogeneous but a joint epigenetic control was found for ERVWE1 5′LTR and its juxtaposed enhancer, a mammalian apparent LTR retrotransposon. Additionally, ERVWE1, ERVFRDE1 and ERV3 5′LTRs were all essentially hypomethylated in cytotrophoblasts during pregnancy, but showed distinct and stage-dependent methylation profiles. In non-cytotrophoblastic cells, they also exhibited different methylation profiles, compatible with their respective transcriptional activities. Comparative analyses of transcriptional activity and LTR methylation in cell lines further sustained a role for methylation in the control of functional LTRs. These results suggest that HERV methylation might not be family related but copy-specific, and related to the LTR function and the tissue. In particular, ERVWE1 and ERV3 could be developmentally epigenetically regulated HERVs. PMID:19561344

  7. Nursing care for patients with placenta previa undergoing interventional therapy in the second trimester of pregnancy

    International Nuclear Information System (INIS)

    Pan Suzhao; Lu Aijin; Wang Xuezhen

    2009-01-01

    Objective: To discuss the nursing care for patients with placenta previa,who receive uterine arterial catheterization and embolization in the second trimester of pregnancy. Methods: By using superselective catheterization with Seldinger technique, bilateral uterine artery angiography and embolization were performed in 16 patients with placenta previa in the second trimester of pregnancy. Two to four hours after the procedure, rivanol intra-amniotic injection was employed to induce the abortion. Close perioperative observation and careful nursing were carried out. Results: The fetus with its subsidiary tissue was delivered in a mean time of 4.5 hours after the operation in 15 cases. No postpartum hemorrhage occurred. Induced abortion failed in one case with 26 weeks pregnancy because of a scar uterus and cervical dystocia. Hysterotomy was performed 6 days later, blood loss during the operation was about 100 ml. No nursing care related complications occurred in all 16 patients. Conclusion: Uterine arterial embolization is very helpful in making the induced abortion for the treatment of bleeding placenta previa in the second trimester of pregnancy. Strengthening of perioperative care can improve successful rate of interventional therapy and prevent the occurrence of complication. (authors)

  8. Maternal–Fetal Nutrient Transport in Pregnancy Pathologies: The Role of the Placenta

    Directory of Open Access Journals (Sweden)

    Kendra Elizabeth Brett

    2014-09-01

    Full Text Available Appropriate in utero growth is essential for offspring development and is a critical contributor to long-term health. Fetal growth is largely dictated by the availability of nutrients in maternal circulation and the ability of these nutrients to be transported into fetal circulation via the placenta. Substrate flux across placental gradients is dependent on the accessibility and activity of nutrient-specific transporters. Changes in the expression and activity of these transporters is implicated in cases of restricted and excessive fetal growth, and may represent a control mechanism by which fetal growth rate attempts to match availability of nutrients in maternal circulation. This review provides an overview of placenta nutrient transport with an emphasis on macro-nutrient transporters. It highlights the changes in expression and activity of these transporters associated with common pregnancy pathologies, including intrauterine growth restriction, macrosomia, diabetes and obesity, as well as the potential impact of maternal diet. Molecular signaling pathways linking maternal nutrient availability and placenta nutrient transport are discussed. How sexual dimorphism affects fetal growth strategies and the placenta’s response to an altered intrauterine environment is considered. Further knowledge in this area may be the first step in the development of targeted interventions to help optimize fetal growth.

  9. Role of carbon source in the shift from oxidative to hydrolytic wood decomposition by Postia placenta.

    Science.gov (United States)

    Zhang, Jiwei; Schilling, Jonathan S

    2017-09-01

    Brown rot fungi initiate wood decay using oxidative pretreatments to improve access for cellulolytic enzymes. These pretreatments are incompatible with enzymes, and we recently showed that Postia placenta overcomes this issue by delaying glycoside hydrolase (GH) gene upregulation briefly (wood wafers and spatially mapped expression (via quantitative PCR) of twelve ORs and GHs targeted using functional genomics analyses. By layering expression patterns over solubilized sugar data (via HPLC) from wood, we observed solubilization of wood glucose, cellobiose, mannose, and xylose coincident with the OR-GH transition. We then tested effects of these soluble sugars, plus polymeric carbon sources (spruce powder, cellulose), on P. placenta gene expression in liquid cultures. Expression of ORs was strictly (aox1, cro5) or progressively repressed over time (qrd1, lcc1) by all soluble sugars, including cellobiose, but not by polymeric sources. Simple sugars repressed hemicellulase gene expression over time, but these sugars did not repress cellulases. Cellulase genes were upregulated, however, along with hemicellulases in the presence of soluble cellobiose and in the presence of polymeric carbon sources, relative to starvation (carbon-free). This verifies an inducible cellulase system in P. placenta that lacks carbon catabolite repression (CCR), and it suggests that brown rot fungi use soluble sugars, particularly cellobiose, to cue a critical oxidative-hydrolytic transition. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. pacientes con falla cardiaca

    Directory of Open Access Journals (Sweden)

    Diana Marcela Achury Saldaña

    2007-01-01

    Full Text Available Objetivo: determinar la adherencia al tratamiento de pacientes con falla cardiaca hospitalizados, al aplicar un plan educativo quefomenta el autocuidado.Método: estudio cuasiexperimental (entrevistas enfermera-paciente realizado entre diciembre de 2004 y mayo de 2006, con unamuestra de 50 pacientes seleccionados por conveniencia. Se diseñó un instrumento para evaluar los comportamientos de los pacientes,con base en algunos resultados de la adherencia y sus respectivos indicadores de la taxonomía NOC (Nursing out comes classification. Laadherencia al tratamiento fue medida en dos momentos: el primero durante la hospitalización, seguido de la aplicación del plan educativoantes del alta, que proporcionaba información en el manejo de su enfermedad desde una dimensión física, psicológica y social quepromueve el autocuidado; y el segundo un mes después del alta en su domicilio.Resultados: diferencias estadísticamente significativas (P=0,0001 que demuestran cómo mediante la capacitación al paciente enel manejo de su tratamiento farmacológico y no farmacológico, el establecimiento de una sana relación entre el profesional de enfermeríay el paciente, y la participación de la familia, se logra una total adherencia al tratamiento.Conclusiones: para lograr una adherencia total del paciente con falla cardiaca al tratamiento es necesario un proceso educativo y unseguimiento continuo y personalizado que motive permanentemente al paciente y se le reconozca el papel protagónico en su cuidado y manejo de la enfermedad.

  11. Post-implantation mortality of in vitro produced embryos is associated with DNA methyltransferase 1 dysfunction in sheep placenta.

    Science.gov (United States)

    Ptak, Grazyna Ewa; D'Agostino, Antonella; Toschi, Paola; Fidanza, Antonella; Zacchini, Federica; Czernik, Marta; Monaco, Federica; Loi, Pasqualino

    2013-02-01

    Is DNA methyltransferase 1 (DNMT1) dysfunction involved in epigenetic deregulation of placentae from embryos obtained by assisted reproduction technologies (ARTs)? DNMT1 expression in growing placentae of in vitro produced (IVP) embryos is compromised and associated with pregnancy loss. DNMT1 maintains the methylation profile of genes during cell division. The methylation status of genes involved in placenta development is altered in embryos obtained in vitro. Disturbances in the epigenetic regulation of gene expression during placentogenesis could be involved in the frequent developmental arrest and loss of IVP embryos. Forty sheep were naturally mated (Group 1, CTR). IVP blastocysts (2-4 per ewe) were surgically transferred to the remaining 46 recipient sheep 6 days after oestrus (Group 2). Twenty-one recipients from Group 1 and 27 recipients from Group 2 were allowed to deliver in order to compare embryo survival in both groups at term (150 days). From the remaining recipients (n = 38), fetuses and placentae of both groups were recovered by paramedian laparotomy at Days 20, 22, 24, 26 and 28 of gestation. Immediately after collection, early placental tissues (chorion-allantois) were snap frozen in liquid nitrogen and DNMT1 expression and activity was evaluated. mRNA levels (for DNMT1, HDAC2, PCNA, DMAP1, MEST, IGF2, CDKN1C, H19) and the methylation status of H19 were also analyzed. Furthermore, embryo size and survival rate were measured. Our study shows that DNMT1 expression was reduced in early placentae from sheep IVP embryos. This reduction was associated with growth arrest and subsequent death of the sheep embryos. Conversely, normal levels of DNMT1 and its cofactors were observed in placentae from IVP embryos that survived this developmental bottleneck. Although DNA methylation machinery was severely compromised in IVP placentae only up to Day 24, the low DNMT1 enzymatic activity that persisted after this stage in IVP placentae was not lethal for the

  12. Cadmium-induced teratogenicity: Association with ROS-mediated endoplasmic reticulum stress in placenta

    International Nuclear Information System (INIS)

    Wang, Zhen; Wang, Hua; Xu, Zhong Mei; Ji, Yan-Li; Chen, Yuan-Hua; Zhang, Zhi-Hui; Zhang, Cheng; Meng, Xiu-Hong; Zhao, Mei; Xu, De-Xiang

    2012-01-01

    The placenta is essential for sustaining the growth of the fetus. An increased endoplasmic reticulum (ER) stress has been associated with the impaired placental and fetal development. Cadmium (Cd) is a potent teratogen that caused fetal malformation and growth restriction. The present study investigated the effects of maternal Cd exposure on placental and fetal development. The pregnant mice were intraperitoneally injected with CdCl 2 (4.5 mg/kg) on gestational day 9. As expected, maternal Cd exposure during early limb development significantly increased the incidences of forelimb ectrodactyly in fetuses. An obvious impairment in the labyrinth, a highly developed tissue of blood vessels, was observed in placenta of mice treated with CdCl 2 . In addition, maternal Cd exposure markedly repressed cell proliferation and increased apoptosis in placenta. An additional experiment showed that maternal Cd exposure significantly upregulated the expression of GRP78, an ER chaperone. Moreover, maternal Cd exposure induced the phosphorylation of placental eIF2α, a downstream molecule of PERK signaling. In addition, maternal Cd exposure significantly increased the level of placental CHOP, another target of PERK signaling, indicating that the unfolded protein response (UPR) signaling was activated in placenta of mice treated with CdCl 2 . Interestingly, alpha-phenyl-N-t-butylnitrone, a free radical spin-trapping agent, significantly alleviated Cd-induced placental ER stress and UPR. Taken together, these results suggest that reactive oxygen species (ROS)-mediated ER stress might be involved in Cd-induced impairment on placental and fetal development. Antioxidants may be used as pharmacological agents to protect against Cd-induced fetal malformation and growth restriction. -- Highlights: ► Cd induces fetal malformation and growth restriction. ► Cd induced placental ER stress and UPR. ► PBN alleviates Cd-induced ER stress and UPR in placenta. ► ROS-mediated ER stress might

  13. Transfer of PAMAM dendrimers across human placenta: prospects of its use as drug carrier during pregnancy.

    Science.gov (United States)

    Menjoge, Anupa R; Rinderknecht, Amber L; Navath, Raghavendra S; Faridnia, Masoud; Kim, Chong J; Romero, Roberto; Miller, Richard K; Kannan, Rangaramanujam M

    2011-03-30

    Dendrimers offer significant potential as nanocarriers for targeted delivery of drugs and imaging agents. The objectives of this study were to evaluate the transplacental transport, kinetics and biodistribution of PAMAM dendrimers ex-vivo across the human placenta in comparison with antipyrine, a freely diffusible molecule, using dually perfused re-circulating term human placental lobules. The purpose of this study is to determine if dendrimers as drug carriers can be used to design drug delivery systems directed at selectively treating either the mother or the fetus. The transplacental transfers of fluorescently (Alexa 488) tagged PAMAM dendrimer (16 kDa) and antipyrine (188 Da) from maternal to fetal circulation were measured using HPLC/dual UV and fluorescent detector (sensitivity of 10 ng/mL for dendrimer and 100 ng/mL for antipyrine respectively). C(max) for the dendrimer-Alexa (DA) in maternal perfusate (T(max)=15 min) was 18 times higher than in the fetal perfusate and never equilibrated with the maternal perfusate during 5.5 h of perfusion (n=4). DA exhibited a measurable but low transplacental transport of 2.26±0.12 μg/mL during 5.5h, where the mean transplacental transfer was 0.84±0.11% of the total maternal concentration and the feto-maternal ratio as percent was 0.073%±0.02. The biochemical and physiological analysis of the placentae perfused with DA demonstrated normal function throughout the perfusion. The immunofluorescence histochemistry confirmed that the biodistribution of DA in perfused placenta was sparsely dispersed, and when noted was principally seen in the inter-villous spaces and outer rim of the villous branches. In a few cases, DA was found internalized and localized in nuclei and cytoplasm of syncytiotrophoblast and inside the villous core; however, DA was mostly absent from the villous capillaries. In conclusion, the PAMAM dendrimers exhibited a low rate of transfer from maternal to the fetal side across the perfused human placenta

  14. Mercury toxicokinetics of the healthy human term placenta involve amino acid transporters and ABC transporters

    International Nuclear Information System (INIS)

    Straka, Elisabeth; Ellinger, Isabella; Balthasar, Christina; Scheinast, Matthias; Schatz, Jasmin; Szattler, Tamara; Bleichert, Sonja; Saleh, Leila; Knöfler, Martin; Zeisler, Harald; Hengstschläger, Markus; Rosner, Margit; Salzer, Hans; Gundacker, Claudia

    2016-01-01

    Highlights: • It is known that MeHg is able to pass the placenta and to affect fetal brain development. • Uptake and efflux transporters were examined in human primary trophoblast cells and BeWo cells. • Involvement in mercury transfer was assessed by measurement of cellular mercury content upon siRNA mediated gene knockdown. • Localization of transporters was determined by immunofluorescence microscopy. • LAT1 and rBAT at the apical membrane of the syncytiotrophoblast (STB) are involved in MeHg uptake. • MRP1 located at basal membrane of STB mediates mercury efflux. - Abstract: Background: The capacity of the human placenta to handle exogenous stressors is poorly understood. The heavy metal mercury is well-known to pass the placenta and to affect brain development. An active transport across the placenta has been assumed. The underlying mechanisms however are virtually unknown. Objectives: Uptake and efflux transporters (17 candidate proteins) assumed to play a key role in placental mercury transfer were examined for expression, localization and function in human primary trophoblast cells and the trophoblast-derived choriocarcinoma cell line BeWo. Methods: To prove involvement of the transporters, we used small interfering RNA (siRNA) and exposed cells to methylmercury (MeHg). Total mercury contents of cells were analyzed by Cold vapor-atomic fluorescence spectrometry (CV-AFS). Localization of the proteins in human term placenta sections was determined via immunofluorescence microscopy. Results: We found the amino acid transporter subunits L-type amino acid transporter (LAT)1 and rBAT (related to b 0,+ type amino acid transporter) as well as the efflux transporter multidrug resistance associated protein (MRP)1 to be involved in mercury kinetics of trophoblast cells (t-test P < 0.05). Conclusion: The amino acid transporters located at the apical side of the syncytiotrophoblast (STB) manage uptake of MeHg. Mercury conjugated to glutathione (GSH) is

  15. Cementos con cenizas volantes

    Directory of Open Access Journals (Sweden)

    Ossa M., Mauricio

    1984-03-01

    additions of 20 and 30% .

    Casi la generalidad de los estudios realizados sobre cementos con adición de cenizas volantes se refieren a sus características y comportamiento en pastas, morteros y hormigones, siempre en relación con aquéllos del cemento portland. Esta vez, se desarrolló un trabajo experimental orientado a relacionar entre sí los cementos con adiciones de cenizas volantes y de puzolana natural. Para ello se fabricaron a escala de laboratorio cementos de ambos tipos, empleando como materias primas comunes clinker y yeso y, como variables, diferentes porcentajes de las dos adiciones, que cumplieron previamente los requisitos normalizados en cuanto a sus actividades puzolánicas. La calidad de los cementos fabricados resultó adecuada y concordante con la del cemento portland-puzolánico obtenido a escala industrial con los mismos clinker, yeso y puzolana natural de este estudio. Posteriormente, se determinaron las características de los cementos experimentales y se confeccionaron morteros normales para la realización de ensayos físicos y mecánicos. Los resultados de ensayos indicaron que los cementos con adición de cenizas volantes (CCV requieren menos agua para consistencia normal, presentan tiempos de fraguado mayores y expansiones en autoclave menores que los cementos con adición de puzolana (CP. Los calores de hidratación a 7 y 28 días de edad fueron aproximadamente similares para ambos tipos de cemento. En morteros normales, los cementos CCV mostraron menor retracción de secado, mayor retentividad y mayor fluidez (para igual cantidad de agua que los cementos CP. En los ensayos de exudación se observó que ésta depende más de la finura que el tipo de adición. Finalmente, los ensayos mecánicos señalaron que las resistencias a compresión y flexotracción de los morteros con cementos CCV son menores a edades inferiores que 14 días (del orden de 5 a 10% a un día de edad, pero que a partir de entonces pasan a ser mayores que las de

  16. Maternal obesity alters brain derived neurotrophic factor (BDNF) signaling in the placenta in a sexually dimorphic manner.

    Science.gov (United States)

    Prince, Calais S; Maloyan, Alina; Myatt, Leslie

    2017-01-01

    Obesity is a major clinical problem in obstetrics being associated with adverse pregnancy outcomes and fetal programming. Brain derived neurotrophic factor (BDNF), a validated miR-210 target, is necessary for placental development, fetal growth, glucose metabolism, and energy homeostasis. Plasma BDNF levels are reduced in obese individuals; however, placental BDNF has yet to be studied in the context of maternal obesity. In this study, we investigated the effect of maternal obesity and sexual dimorphism on placental BDNF signaling. BDNF signaling was measured in placentas from lean (pre-pregnancy BMI 30) women at term without medical complications that delivered via cesarean section without labor. MiRNA-210, BDNF mRNA, proBDNF, and mature BDNF were measured by RT - PCR, ELISA, and Western blot. Downstream signaling via TRKB (BDNF receptor) was measured using Western blot. Maternal obesity was associated with increased miRNA-210 and decreased BDNF mRNA in placentas from female fetuses, and decreased proBDNF in placentas from male fetuses. We also identified decreased mature BDNF in placentas from male fetuses when compared to female fetuses. Mir-210 expression was negatively correlated with mature BDNF protein. TRKB phosphorylated at tyrosine 817, not tyrosine 515, was increased in placentas from obese women. Maternal obesity was associated with increased phosphorylation of MAPK p38 in placentas from male fetuses, but not phosphorylation of ERK p42/44. BDNF regulation is complex and highly regulated. Pre-pregnancy/early maternal obesity adversely affects BDNF/TRKB signaling in the placenta in a sexually dimorphic manner. These data collectively suggest that induction of placental TRKB signaling could ameliorate the placental OB phenotype, thus improving perinatal outcome. Copyright © 2016 Elsevier Ltd. All rights reserved.

  17. /sup 125/I-human epidermal growth factor specific binding to placentas and fetal membranes from varoius pregnancy states

    Energy Technology Data Exchange (ETDEWEB)

    Hofmann, G.E.; Siddiqi, T.A.; Rao, Ch. V.; Carman, F.R.

    1988-01-01

    Specific binding of /sup 125/I-human epidermal growth factor (hEGF) to homogenates of term human placentas and fetal membranes from normal and appropriate for gestational age (N = 20), intrauterine growth retarded (N = 9), twin (N = 11), White class AB diabetic (N = 12), and large for gestational age (N = 13) pregnancies was measured. In all pregnancy states, placentas bound approximately four times more /sup 125/I-hEGF than did fetal membranes (P<0.0001). There was no significant differnce in /sup 125/I-hEGF binding to fetal membranes from the various pregnancy states (P<0.05). /sup 125/I-hEGF specific binding to placentas from intrauterine growth retarded or twin pregnancies was significantly greater compared with placentas from normal and appropriate for gestational age pregnancies (P<0.05). The binding to placentas from pregnancies complicated by White class AB diabetes or large for gestational age infants, on the other hand, was not significantly different from that to placentas from normal and appropriate for gestational age pregnancies. /sup 125/I-hEGF specific binding did not differ between placentas from intrauterine growth retarded or twin pregnancies (P<0.05). Placental and fetal membrane /sup 125/I-hEGF binding did not vary with fetal sex, maternal race, placental weight, or gestational age between 37 to 42 weeks (P<0.05). Placental but not fetal membrane /sup 125/I-hEGF binding increased with increasing infant weight when appropriate for gestational age and large for gestational age infants were included (P<0.05, r = 0.38, N = 32) but not for intrauterine growth retarded, appropriate for gestational age, or large for gestational age infants alone.

  18. Innate immune function in placenta and cord blood of hepatitis C--seropositive mother-infant dyads.

    Science.gov (United States)

    Hurtado, Christine Waasdorp; Golden-Mason, Lucy; Brocato, Megan; Krull, Mona; Narkewicz, Michael R; Rosen, Hugo R

    2010-08-30

    Vertical transmission accounts for the majority of pediatric cases of hepatitis C viral (HCV) infection. In contrast to the adult population who develop persistent viremia in approximately 80% of cases following exposure, the rate of mother-to-child transmission (2-6%) is strikingly low. Protection from vertical transmission likely requires the coordination of multiple components of the immune system. Placenta and decidua provide a direct connection between mother and infant. We hypothesized that innate immune responses would differ across the three compartments (decidua, placenta and cord blood) and that hepatitis C exposure would modify innate immunity in these tissues. The study was comprised of HCV-infected and healthy control mother and infant pairs from whom cord blood, placenta and decidua were collected with isolation of mononuclear cells. Multiparameter flow cytometry was performed to assess the phenotype, intracellular cytokine production and cytotoxicity of the cells. In keeping with a model where the maternal-fetal interface provides antiviral protection, we found a gradient in proportional frequencies of NKT and gammadelta-T cells being higher in placenta than cord blood. Cytotoxicity of NK and NKT cells was enhanced in placenta and placental NKT cytotoxicity was further increased by HCV infection. HCV exposure had multiple effects on innate cells including a decrease in activation markers (CD69, TRAIL and NKp44) on NK cells and a decrease in plasmacytoid dendritic cells in both placenta and cord blood of exposed infants. In summary, the placenta represents an active innate immunological organ that provides antiviral protection against HCV transmission in the majority of cases; the increased incidence in preterm labor previously described in HCV-seropositive mothers may be related to enhanced cytotoxicity of NKT cells.

  19. Effects of indomethacin, NS-398 (a selective prostaglandin H synthase-2 inhibitor) and protein synthesis inhibitors on prostaglandin production by the guinea-pig placenta.

    Science.gov (United States)

    Aitken, H; Poyser, N L

    2001-01-01

    The outputs of PGF(2 alpha), PGE2 and 6-keto-PGF(1 alpha)were similar from the day 22 guinea-pig placenta and sub-placenta in culture, except for PGE2 output from the sub-placenta which was lower. Between days 22 and 29 of pregnancy, the outputs of PGF(2 alpha), PGE2 and 6-keto-PGF(1 alpha)during the initial 2 h culture period increased 6.9-, 1.1- and 3.2-fold, respectively, from the placenta, and 2.1-, 1.4- and 2.2-fold, respectively, from the sub-placenta. Therefore, there was a relatively specific increase in PGF(2 alpha)production by the guinea-pig placenta between days 22 and 29 of pregnancy. The output of PGFM from the cultured placenta also increased between days 22 and 29, indicating that the increase in PGF(2 alpha)output was due to increased synthesis rather than to decreased metabolism. By comparing the amounts of prostaglandins produced by tissue homogenates during a 1 h incubation period, it appears that there is approximately a 2-fold increase in the amount of prostaglandin H synthase (PGHS) present in the guinea-pig placenta between days 22 and 29. NS-398 (a specific inhibitor of PGHS-2) and indomethacin (an inhibitor of both PGHS-1 and PGHS-2) both inhibited prostaglandin production by homogenates of day 22 and day 29 placenta. Indomethacin was more effective than NS-398, except for their actions on PGF(2 alpha)production by the day 29 placenta where indomethacin and NS-398 were equiactive. Indomethacin and NS-398 were both very effective at inhibiting the outputs of PGF(2 alpha), PGE2 and 6-keto-PGF(1 alpha)from the day 22 and day 29 placenta and sub-placenta in culture, indicating that prostaglandin production by the guinea-pig placenta and sub-placenta in culture is largely dependent upon the activity of PGHS-2. The high production of PGF(2 alpha)by the day 29 placenta is not dependent on the continual synthesis of fresh protein(s), as inhibitors of protein synthesis did not reduce PGF(2 alpha)output from the day 29 guinea-pig placenta in culture

  20. competencia con China

    Directory of Open Access Journals (Sweden)

    Elena de la Paz Hernández Águila

    2007-01-01

    Full Text Available El artículo ofrece un diagnóstico del desempeño de la industria mexicana del calzado desde la década de los ochenta hasta la actualidad. Analiza la problemática que ha enfrentado esta rama industrial a partir del proceso de apertura comercial y de la competencia en su mercado interno con productos provenientes de países asiáticos, particularmente China. Problematiza al respecto los retos y las perspectivas que a mediano plazo enfrentará este sector empresarial y sobre las posibilidades de competir en el mercado globalizado.

  1. Construir con Madera

    OpenAIRE

    Olabe-Velasco, F. (Fermín); Val-Hernández, Y. (Yolanda); Varela-de-la-Cruz, P. (Perla); Cabrero-Ballarín, J.M. (José Manuel)

    2010-01-01

    Guía divulgativa ‘Construir con madera’, elaborada por la Cátedra Madera de la Universidad de Navarra y el Gobierno de Navarra. La publicación pretende explicar de forma sencilla los beneficios y posibilidades de este material en la construcción, tanto en lo que respecta a su resistencia, comportamiento frente al fuego, durabilidad, capacidad de aislamiento, propiedades acústicas, estética, respeto al medio ambiente y sostenibilidad como fuente de energía. A modo de ejemplo, en la ...

  2. Entrevista con Giovanni Levi

    Directory of Open Access Journals (Sweden)

    Monica Oliveira

    2017-06-01

    Full Text Available En esta entrevista, Giovanni Levi - como un conocedor del tema de Familia - realiza una importante evaluación sobre el actual estado de las investigaciones realizadas en el Brasil y em el exterior. Con estilo franco, agudo y lucido critica las visiones tradicionales y sus ilusiones ypropone nuevos conceptos y métodos. La historia de la familia debería ceder espacio para el estudio de las redes relacionales o de los mundos relacionales. De la misma forma, la historia cuantitativa debería abrir espacio para el estudio de las cualidades. Ya con relación a la historia de las elites, tan estudiada y reproducida en una diversidad de trabajos, que deberíase mirar en otra perspectiva. Es decir, no mirar a las reglas sociales predeterminadas, sino a los desvíos y a las variaciones. Levi defiende que los historiadores deben trascender a los documentos que se encuentran fácilmente y que pueden fortalecer perspectivas deformadas y esequilibradas de la sociedad. Para él, los historiadores deben esforzarse por estudiar a aquellos grupos que dejaron pocos rastros documentales. En ese esfuerzo existiría una nueva mirada sobre la historia de la familia.

  3. Entrevista con Patricia Ariza

    Directory of Open Access Journals (Sweden)

    Esperanza Londoño La Rotta

    2017-01-01

    Full Text Available Pensamiento, Palabra y Obra entrevista a una artista, feminista y activista política, quien como mujer y artista ha permitido pensar el arte más allá de un simple espectáculo. Toda una vida dedicada al teatro y a darle voz, a través de sus obras, a víctimas del conflicto colombiano, defensora de derechos humanos; además de hacer evidente en su vida y a través de la plataforma “Artistas por la paz”, las múltiples relaciones que se pueden establecer entre el arte, la construcción de paz y la resolución de conflictos. Hablamos en su casa, en medio del calor de la bienvenida con Patricia Ariza, directora del festival alternativo de teatro, de Mujeres en Escena y de la Corporación Colombiana de Teatro, entre otras muchas actividades que voluntariamente su espíritu libertario ha asumido. Esta entrevista se realizó antes del 2 de octubre, pero con la revisión de los acuerdos que propició el plebiscito ganado por una ínfima minoría por el no, sigue siendo vigente este planteamiento.

  4. 125I-human epidermal growth factor specific binding to placentas and fetal membranes from varoius pregnancy states

    International Nuclear Information System (INIS)

    Hofmann, G.E.; Siddiqi, T.A.; Rao, Ch. V.; Carman, F.R.

    1988-01-01

    Specific binding of 125 I-human epidermal growth factor (hEGF) to homogenates of term human placentas and fetal membranes from normal and appropriate for gestational age (N = 20), intrauterine growth retarded (N = 9), twin (N = 11), White class A/B diabetic (N = 12), and large for gestational age (N = 13) pregnancies was measured. In all pregnancy states, placentas bound approximately four times more 125 I-hEGF than did fetal membranes (P 125 I-hEGF binding to fetal membranes from the various pregnancy states (P 125 I-hEGF specific binding to placentas from intrauterine growth retarded or twin pregnancies was significantly greater compared with placentas from normal and appropriate for gestational age pregnancies (P 125 I-hEGF specific binding did not differ between placentas from intrauterine growth retarded or twin pregnancies (P 125 I-hEGF binding did not vary with fetal sex, maternal race, placental weight, or gestational age between 37 to 42 weeks (P 125 I-hEGF binding increased with increasing infant weight when appropriate for gestational age and large for gestational age infants were included (P<0.05, r = 0.38, N = 32) but not for intrauterine growth retarded, appropriate for gestational age, or large for gestational age infants alone. (author)

  5. Altered protein expression in gestational diabetes mellitus placentas provides insight into insulin resistance and coagulation/fibrinolysis pathways.

    Directory of Open Access Journals (Sweden)

    Bin Liu

    Full Text Available OBJECTIVE: To investigate the placental proteome differences between pregnant women complicated with gestational diabetes mellitus (GDM and those with normal glucose tolerance (NGT. METHODS: We used two-dimensional electrophoresis (2DE to separate and compare placental protein levels from GDM and NGT groups. Differentially expressed proteins between the two groups were identified by MALDI-TOF/TOF mass spectrometry and further confirmed by Western blotting. The mRNA levels of related proteins were measured by realtime RT-PCR. Immunohistochemistry (IHC was performed to examine the cellular location of the proteins expressed in placenta villi. RESULTS: Twenty-one protein spots were differentially expressed between GDM and NGT placenta villi in the tested samples, fifteen of which were successfully identified by mass spectrometry. The molecular functions of these differentially expressed proteins include blood coagulation, signal transduction, anti-apoptosis, ATP binding, phospholipid binding, calcium ion binding, platelet activation, and tryptophan-tRNA ligase activity. Both protein and mRNA levels of Annexin A2, Annexin A5 and 14-3-3 protein ζ/δ were up-regulated, while the expression of the Ras-related protein Rap1A was down-regulated in the GDM placenta group. CONCLUSION: Placenta villi derived from GDM pregnant women exhibit significant proteome differences compared to those of NGT mothers. The identified differentially expressed proteins are mainly associated with the development of insulin resistance, transplacental transportation of glucose, hyperglucose-mediated coagulation and fibrinolysis disorders in the GDM placenta villi.

  6. Reorganization of Extracellular Matrix in Placentas from Women with Asymptomatic Chagas Disease: Mechanism of Parasite Invasion or Local Placental Defense?

    Directory of Open Access Journals (Sweden)

    Juan Duaso

    2012-01-01

    Full Text Available Chagas disease, produced by the protozoan Trypanosoma cruzi (T. cruzi, is one of the most frequent endemic diseases in Latin America. In spite the fact that in the past few years T. cruzi congenital transmission has become of epidemiological importance, studies about this mechanism of infection are scarce. In order to explore some morphological aspects of this infection in the placenta, we analyzed placentas from T. cruzi-infected mothers by immunohistochemical and histochemical methods. Infection in mothers, newborns, and placentas was confirmed by PCR and by immunofluorescence in the placenta. T. cruzi-infected placentas present destruction of the syncytiotrophoblast and villous stroma, selective disorganization of the basal lamina, and disorganization of collagen I in villous stroma. Our results suggest that the parasite induces reorganization of this tissue component and in this way may regulate both inflammatory and immune responses in the host. Changes in the ECM of placental tissues, together with the immunological status of mother and fetus, and parasite load may determine the probability of congenital transmission of T. cruzi.

  7. Maternal plasma levels of cell-free β-HCG mRNA as a prenatal diagnostic indicator of placenta accrete.

    Science.gov (United States)

    Zhou, J; Li, J; Yan, P; Ye, Y H; Peng, W; Wang, S; Wang, X Tong

    2014-09-01

    Several biomarkers, including maternal serum creatinine kinase and α-fetoprotein, have been described as potential tools for the diagnosis of placental abnormalities. This study aimed to determine whether maternal plasma mRNA levels of the β subunit of human chorionic gonadotropin (β-HCG) could predict placenta accreta prenatally. Sixty-eight singleton pregnant women with prior cesarean deliveries (CDs) were classified into three groups: normal placentation (35 women, control group); placenta previa alone (21 women, placenta previa group); and both placenta previa and placenta accreta (12 women, placenta previa/accreta group). Maternal plasma concentrations of cell-free β-HCG mRNA were measured by real-time reverse-transcription polymerase chain reaction and were expressed as multiples of the median (MoM). Cell-free β-HCG mRNA concentrations (MoM, range) were significantly higher in women with placenta accreta (3.65, 2.78-7.19) than in women with placenta previa (0.94, 0.00-2.97) or normal placentation (1.00, 0.00-2.69) (Steel-Dwass test, P accreta group, the concentration of cell-free β-HCG mRNA was significantly higher among women who underwent CDs with hysterectomy (4.41, 3.49-7.19) than among women whose CDs did not result in hysterectomy (3.20, 2.78-3.70) (Mann-Whitney U test, P = 0.012). An increased level of cell-free β-HCG mRNA in the maternal plasma of women with placenta accreta may arise from direct uteroplacental transfer of cell-free placental mRNA molecules. The concentration of cell-free β-HCG mRNA in maternal plasma may be applicable to the prenatal diagnosis of placenta accreta, especially to identify women with placenta accreta likely to require hysterectomy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Maternal obesity modulates intracellular lipid turnover in the human term placenta.

    Science.gov (United States)

    Hirschmugl, B; Desoye, G; Catalano, P; Klymiuk, I; Scharnagl, H; Payr, S; Kitzinger, E; Schliefsteiner, C; Lang, U; Wadsack, C; Hauguel-de Mouzon, S

    2017-02-01

    Obesity before pregnancy is associated with impaired metabolic status of the mother and the offspring later in life. These adverse effects have been attributed to epigenetic changes in utero, but little is known about the role of placental metabolism and its contribution to fetal development. We examined the impact of maternal pre-pregnancy obesity on the expression of genes involved in placental lipid metabolism in lean and obese women. Seventy-three lean and obese women with healthy pregnancy were recruited at term elective cesarean delivery. Metabolic parameters were measured on maternal venous blood samples. Expression of 88 genes involved in lipid metabolism was measured in whole placenta tissue. Proteins of genes differently expressed in response to maternal obesity were quantified, correlated with maternal parameters and immunolocalized in placenta sections. Isolated primary trophoblasts were used for in vitro assays. Triglyceride (TG) content was increased in placental tissue of obese (1.10, CI 1.04-1.24 mg g -1 , Pwomen. Among target genes examined, six showed positive correlation (Pobese vs lean women. CGI-58 protein levels correlated positively with maternal insulin levels and pre-pregnancy body mass index (R=0.63, Ptreatment of cultured trophoblast cells. Pre-gravid obesity significantly modifies the expression of placental genes related to transport and storage of neutral lipids. We propose that the upregulation of CGI-58, a master regulator of TG hydrolysis, contributes to the turnover of intracellular lipids in placenta of obese women, and is tightly regulated by metabolic factors of the mother.

  9. A 3D co-culture microtissue model of the human placenta for nanotoxicity assessment.

    Science.gov (United States)

    Muoth, Carina; Wichser, Adrian; Monopoli, Marco; Correia, Manuel; Ehrlich, Nicky; Loeschner, Katrin; Gallud, Audrey; Kucki, Melanie; Diener, Liliane; Manser, Pius; Jochum, Wolfram; Wick, Peter; Buerki-Thurnherr, Tina

    2016-10-06

    There is increasing evidence that certain nanoparticles (NPs) can overcome the placental barrier, raising concerns on potential adverse effects on the growing fetus. But even in the absence of placental transfer, NPs may pose a risk to proper fetal development if they interfere with the viability and functionality of the placental tissue. The effects of NPs on the human placenta are not well studied or understood, and predictive in vitro placenta models to achieve mechanistic insights on NP-placenta interactions are essentially lacking. Using the scaffold-free hanging drop technology, we developed a well-organized and highly reproducible 3D co-culture microtissue (MT) model consisting of a core of placental fibroblasts surrounded by a trophoblast cell layer, which resembles the structure of the in vivo placental tissue. We could show that secretion levels of human chorionic gonadotropin (hCG) were significantly higher in 3D than in 2D cell cultures, which indicates an enhanced differentiation of trophoblasts grown on 3D MTs. NP toxicity assessment revealed that cadmium telluride (CdTe) and copper oxide (CuO) NPs but not titanium dioxide (TiO 2 ) NPs decreased MT viability and reduced the release of hCG. NP acute toxicity was significantly reduced in 3D co-culture MTs compared to 2D monocultures. Taken together, 3D placental MTs provide a new and promising model for the fast generation of tissue-relevant acute NP toxicity data, which are indispensable for the safe development of NPs for industrial, commercial and medical applications.

  10. Abnormal regulation for progesterone production in placenta with prenatal cocaine exposure in rats.

    Science.gov (United States)

    Wu, L; Yan, J; Qu, S C; Feng, Y Q; Jiang, X L

    2012-12-01

    Cocaine abuse in pregnant women is currently a significant public hygiene problem and is tightly associated with elevated risk for preterm delivery. Placental steroidogenesis especially progesterone production was essential for success and maintenance of pregnancy in humans and rodents. In the present study, we determined the impact of prenatal cocaine exposure on pathways of placental progesterone synthesis in rats. Pregnant rats were treated cocaine twice daily (15 mg/kg/day) during the third trimester, and the maternal and fetal plasma progesterone and pregnenolone concentrations were detected. We also examined both the protein and mRNA expression of some key enzymes and regulators for progesterone production in placenta. Results showed that, after maternal cocaine use during pregnancy, progesterone and pregnenolone concentrations in both maternal and fetal rats were significantly decreased. Although prenatal cocaine exposure had no effects on placental 3β-hydroxysteroid dehydrogenase type 1 (3βHSD1) expression, protein and mRNA expression of the cholesterol side-chain cleavage enzyme (P450scc/CYP11a) in placenta was significantly inhibited. Moreover, protein and mRNA expressions of MLN64 that regulating cholesterol transport and activating protein 2γ (AP2γ/Tfap2c) that controlling P450scc/CYP11a gene expression in placenta were both decreased following maternal cocaine use in pregnancy. Collectively, this study suggested that prenatal cocaine exposure could insult the placental progesterone production in rats possibly associated with the high risk for preterm delivery. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Rab11 family expression in the human placenta: Localization at the maternal-fetal interface

    Science.gov (United States)

    Artemiuk, Patrycja A.; Hanscom, Sara R.; Lindsay, Andrew J.; Wuebbolt, Danielle; Breathnach, Fionnuala M.; Tully, Elizabeth C.; Khan, Amir R.; McCaffrey, Mary W.

    2017-01-01

    Rab proteins are a family of small GTPases involved in a variety of cellular processes. The Rab11 subfamily in particular directs key steps of intracellular functions involving vesicle trafficking of the endosomal recycling pathway. This Rab subfamily works through a series of effector proteins including the Rab11-FIPs (Rab11 Family-Interacting Proteins). While the Rab11 subfamily has been well characterized at the cellular level, its function within human organ systems is still being explored. In an effort to further study these proteins, we conducted a preliminary investigation of a subgroup of endosomal Rab proteins in a range of human cell lines by Western blotting. The results from this analysis indicated that Rab11a, Rab11c(Rab25) and Rab14 were expressed in a wide range of cell lines, including the human placental trophoblastic BeWo cell line. These findings encouraged us to further analyse the localization of these Rabs and their common effector protein, the Rab Coupling Protein (RCP), by immunofluorescence microscopy and to extend this work to normal human placental tissue. The placenta is a highly active exchange interface, facilitating transfer between mother and fetus during pregnancy. As Rab11 proteins are closely involved in transcytosis we hypothesized that the placenta would be an interesting human tissue model system for Rab investigation. By immunofluorescence microscopy, Rab11a, Rab11c(Rab25), Rab14 as well as their common FIP effector RCP showed prominent expression in the placental cell lines. We also identified the expression of these proteins in human placental lysates by Western blot analysis. Further, via fluorescent immunohistochemistry, we noted abundant localization of these proteins within key functional areas of primary human placental tissues, namely the outer syncytial layer of placental villous tissue and the endothelia of fetal blood vessels. Overall these findings highlight the expression of the Rab11 family within the human

  12. [The composition of the gastrointestinal bacterial flora of mouse embryos and the placenta tissue bacterial flora].

    Science.gov (United States)

    Lei, D; Lin, Y; Jiang, X; Lan, L; Zhang, W; Wang, B X

    2017-03-02

    Objective: To explore the composition of the gastrointestinal bacterial flora of mouse embryos and the placenta tissue bacterial flora. Method: Twenty-four specimens were collected from pregnant Kunming mouse including 8 mice of early embryonic (12-13 days) gastrointestinal tissues, 8 cases of late embryonic (19-20 days)gastrointestinal tissues, 8 of late pregnancy placental tissues.The 24 samples were extracted by DNeasy Blood & Tissue kit for high-throughput DNA sequencing. Result: The level of Proteobacteria, Bacteroidetes, Actino-bacteria and Firmicutes were predominantin all specimens.The relative content of predominant bacterial phyla in each group: Proteobacteria (95.00%, 88.14%, 87.26%), Bacteroidetes(1.71%, 2.15%, 2.63%), Actino-Bacteria(1.16%, 4.10%, 3.38%), Firmicutes(0.75%, 2.62%, 2.01%). At the level of family, there were nine predominant bacterial families in which Enterobacteriaeae , Shewanel laceae and Moraxellaceae were dominant.The relative content of dominant bacterial family in eachgroup: Enterobacteriaeae (46.99%, 44.34%, 41.08%), Shewanellaceae (21.99%, 21.10%, 19.05%), Moraxellaceae (9.18%, 7.09%, 5.64%). From the species of flora, the flora from fetal gastrointestinal in early pregnancy and late pregnancy (65.44% and 62.73%) were the same as that from placenta tissue in the late pregnancy.From the abundance of bacteria, at the level of family, the same content of bacteria in three groups accounted for 78.16%, 72.53% and 65.78% respectively. Conclusion: It was proved that the gastrointestinal bacterial flora of mouse embryos and the placenta tissue bacterial flora were colonized. At the same time the bacteria are classified.

  13. Permeability of human placenta and fetal membranes to thyrotropin-stimulating hormone in vitro.

    Science.gov (United States)

    Bajoria, R; Fisk, N M

    1998-05-01

    We determined the placental transfer of TSH in an in vitro model of dually perfused isolated lobule in 28 human term placentas by adding varying concentrations (5-60 microIU mL(-1)) of TSH as a single bolus dose to the closed maternal circulation. Transmembrane transfer of TSH was also studied by adding 45 microIU mL(-1) to the maternal or fetal compartment of a dual chamber of fetal membranes in culture. Passage of freely diffusible markers creatinine and antipyrine were also studied in this model. TSH concentration was measured by third generation chemiluminescence assay with a sensitivity of 10 mIU mL(-1). In the perfusion experiments, at physiologic concentrations the slow decline of TSH in the maternal circulation was associated with a small linear increase in fetal levels to 0.11 +/- 0.04% of initial dose at 2 h. The placental transfer rate was 0.08 microIU min(-1). Increasing maternal concentrations of TSH were associated with proportional increases in transfer rate (y = 0.002x; R2 = 0.99) and placental uptake (y = 0.01x; R2 = 0.97). The placental permeability of TSH was 2.4 x 10(-4) mL min(-1) g(-1) and was proportional to its coefficients of diffusion in water and molecular size. The transmembrane transfer and permeability of TSH was comparable to those of the placenta. We conclude that TSH crosses the human term placenta and fetal membranes sparingly.

  14. Increase in perivillous fibrinoid material in placentas from pregnancies with preeclampsia

    OpenAIRE

    Souza, Diego Agra de; Bezerra, Antonio Fernando de Sousa; Wanderley, David Campos; Souto, Claudia Maria Barbosa

    2011-01-01

    INTRODUÇÃO: A pré-eclâmpsia responde por alta morbimortalidade no Brasil e no mundo. A sua etiologia ainda não foi totalmente esclarecida. Entre as alterações placentárias na pré-eclâmpsia citam-se: infartos, aumento de nós sinciciais, hipotrofia vilositária, espessamento da membrana basal trofoblástica e deposição de material fibrinoide. OBJETIVO: Analisar quantitativamente imagens do material fibrinoide perivilositário presente em placentas de gestações com e sem pré-eclâmpsia. MATERIAL E M...

  15. Prophylactic interventions after delivery of placenta for reducing bleeding during the postnatal period.

    Science.gov (United States)

    Yaju, Yukari; Kataoka, Yaeko; Eto, Hiromi; Horiuchi, Shigeko; Mori, Rintaro

    2013-11-26

    There are several Cochrane systematic reviews looking at postpartum haemorrhage (PPH) prophylaxis in the third stage of labour and another Cochrane review investigating the timing of prophylactic uterotonics in the third stage of labour (i.e. before or after delivery of the placenta). There are, however, no Cochrane reviews looking at the use of interventions given purely after delivery of the placenta. Ergometrine or methylergometrine are used for the prevention of PPH in the postpartum period (the period after delivery of the infant) after delivery of the placenta in some countries. There are, furthermore, no Cochrane reviews that have so far considered herbal therapies or homeopathic remedies for the prevention of PPH after delivery of the placenta. To assess the effectiveness of available prophylactic interventions for PPH including prophylactic use of ergotamine, ergometrine, methylergometrine, herbal therapies, and homeopathic remedies, administered after delivery of the placenta, compared with no uterotonic agents as well as with different routes of administration for prevention of PPH after delivery of the placenta. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (30 April 2013), The Food and Drug Administration (FDA) (USA),  Medicines and Healthcare Products Regulatory Agency (MHRA) (UK), European Medicines Agency (EMA) (EU), Pharmaceuticals and Medical Devices Agency (PMDA) (Japan),  Therapeutic Goods Administration (TGA) (Australia), ClinicalTrials.gov, Current Controlled Trials, WHO International Clinical Trials Registry Platform (ICTRP), University Hospital Medical Information Network Clinical Trials Registry (UMIN-CTR; Japan), Japan Pharmaceutical Information Center Clinical Trials Information (Japic-CTI; Japan), Japan Medical Association Clinical Trial Registration (JMACCT CTR; Japan) (all on 30 April 2013) and reference lists of retrieved studies All randomised or quasi-randomised controlled trials comparing prophylactic

  16. CONGENITAL MALFORMATIONS OF THE FETUS, INCOMPATIBLE WITH LIFE, STRUCTURE, THEIR COMBINATION WITH CHANGES IN THE PLACENTA

    Directory of Open Access Journals (Sweden)

    Екатерина Валерьевна Коломбет

    2018-01-01

    Conclusion. The structure of the detection of congenital fetal malformations, in the groups studied in the place I have malformations of the cardiovascular system, on the II – defects of the central nervous system, on III – multiple malformations. Often met with malformations of the umbilical cord than the placenta. On the I place among the signs of the pathological structure of the umbilical cord was a thin umbilical cord, on II – the false nodes of the umbilical cord, on III – the true ones.

  17. [Biochemical changes in the placenta of white rats treated with basfungin].

    Science.gov (United States)

    Markova, E

    1976-01-01

    The author carried out experiments on white rats and discussed the role of the placental insufficiency in the perinatal pathology under the action of fungicide basfugine. After administration of the preparation singly at the critical 13th day of embriogenesis and repeatedly during the course of the gestation the author examined biochemically the activity of the following enzymes: glucose-6-phosphatdehydrogenase, lactatdehydrogenase and thermostable alkaline phosphatase. Basfungine, administered in effective teratogenic doses, inhibited the activity of the indicated enzymes in the placenta, manifesting in this way its functional insufficiency, which was most probably the substantial moment in the pathogenesis of the induced anamaly in the fetal development.

  18. Effect of zeranol on expression of apoptotic and cell cycle proteins in murine placentae

    International Nuclear Information System (INIS)

    Wang, Yanfei; Li, Lu; Wang, C.C.; Leung, Lai K.

    2013-01-01

    Highlights: • Zeranol administered at 1–100 mg/kg/day demonstrated an increasing trend of fetal resorption and early delivery in mice. • Placental expression of Cdk2 and 4, Cyclin D1 and Bcl-xL were reduced mostly in mice treated with ≥10 mg zeranol/kg/day. • Increased pErk-1 and 2 were also observed in the placentae of zeranol-treated mice. - Abstract: Mycotoxins are chemicals produced by fungus and many of them are toxic to humans. Zeranol is a mycotoxin used to promote growth in cattle in North America; yet such a practice draws concern about the residual compound in meat in European countries. In the present study, the toxicity of zeranol was tested in a mouse model for reproduction. Pregnant ICR mice were given p.o. daily doses of zeranol at 0, 1, 10, 100 mg/kg for 4 days (from E13.5 to E16.5). Increased rates of fetal resorption at late gestation (E17.5) and preterm birth (< E18.5) were observed in mice treated with zeranol. The apparent factors causing these perinatal conditions were subsequently investigated. Perturbation of cell death or proliferation-related proteins might deter the growth and maintenance of the placentae, and the subsequent fetal resorption and preterm birth. Placental tissue isolated from pregnant mice at E17.5 showed that the expressions of Cdk2 and 4, Cyclin D1 and Bcl-xL were reduced in zeranol-treatment groups. The downregulations might signify growth or maintenance failure in the placentae. Furthermore, reduction in the signaling proteins Erk-1/2 in the placentae could trigger the decrease in the cell cycle/apoptosis proteins. In addition, relaxin is associated with preterm labor. An increase in placental Relaxin-1 expression could also contribute to early delivery in this study. Result of the current study suggested that exposure to zeranol might introduce adverse effect in pregnancy

  19. Presence of IgE cells in human placenta is independent of malaria infection or chorioamnionitis

    DEFF Research Database (Denmark)

    Rindsjö, E; Hulthén Varli, I; Ofori, M F

    2006-01-01

    We have shown previously that numerous IgE(+) macrophage-like cells are present in the villous stroma of full term placenta and that there was no difference in the amount of IgE(+) cells between allergic and non-allergic mothers. The presence of such an abundant number of IgE(+) cells...... from Ghana with and without malaria parasites. The immunohistochemical staining pattern for IgE looked similar to our previous study, with the IgE located on Hofbauer-like cells. We could not find any difference in the amount or distribution of IgE(+) cells between malaria-infected and non...

  20. Proteomic analysis of proteins differentially expressed in conidia and mycelium of the entomopathogenic fungus Aschersonia placenta

    Czech Academy of Sciences Publication Activity Database

    Qiu, J.; Su, Y.; Gelbič, Ivan; Qiu, Y.; Xie, X.; Guan, X.

    2012-01-01

    Roč. 58, č. 12 (2012), s. 1327-1334 ISSN 0008-4166 Grant - others:National Natural Science Foundation of China(CN) 30500005; National Natural Science Foundation of China(CN) 31070026; National Natural Science Foundation of China(CN) 31170025; Fujian Province University(CN) JK2011013; Fujian Provincial Science Foundation(CN) 2010J06007; Chinese National Programs(CN) 2011AA10A203; Fujian Provincial Science Foundation(CN) 0b08b005 Institutional research plan: CEZ:AV0Z50070508 Keywords : entomopathogenic fungus * Aschersonia placenta * fungal developmental stages Subject RIV: CE - Biochemistry Impact factor: 1.199, year: 2012

  1. Transplacental transfer of monomethyl phthalate and mono(2-ethylhexyl) phthalate in a human placenta perfusion system

    DEFF Research Database (Denmark)

    Mose, Tina; Knudsen, Lisbeth E; Hedegaard, Morten

    2007-01-01

    The transplacental passage of monomethylphtalate (mMP) and mono (2-ethylhexyl) phthalate (mEHP) was studied using an ex vivo placental perfusion model with simultaneous perfusion of fetal and maternal circulation in a single cotyledon. Umbilical cord blood and placental tissue collected both before...... plasma samples. mMP and possibly other short-chained phthalate monoesters in maternal blood can cross the placenta by slow transfer, whereas the results indicate no placental transfer of mEHP. Further studies are recommended....

  2. Comparision hexachlorobenzene residues in placentas from Finland and Denmark (1997-2001)

    Energy Technology Data Exchange (ETDEWEB)

    Shen, H.; Schramm, K.W. [GSF-National Research Center for Environment and Health, Inst. for Ecological Chemistry (Germany); Main, K.; M. Ida Schmidt; Boisen, K.; Chellakooty, M.; Damgaard, I.; Skakkebaek, N. [Univ. Dept. of Growth and Reproduction, Copenhagen (Denmark); Kaleva, M.; Virtanen, H.; Haavisto, A.M.; Toppari, J. [Dept. of Paediatrics and Physiology, Univ. of Turku, Turku (Finland)

    2004-09-15

    Hexachlorobenzene (HCB) continues to be released in to the environment as an industry byproduct, although it has been banned as fungicide in most countries in the 1970s. The high persistence and bioaccumulation along the food chain cause that humans are almost exclusively exposed through their diet. Here we present the fetus exposure as the first step to investigate the possible relationship between the male reproductive system toxicity and environmental exposure of this compound. The two-cohort male placenta samples originate from Denmark and Finland, which have different incidences of male urogenital disorders.

  3. Metodologia para estudo do volume e densidade absoluta da placenta humana de termo

    Directory of Open Access Journals (Sweden)

    Del Nero Ulisses

    2002-01-01

    Full Text Available OBJETIVO: comparar duas metodologias para o cálculo do volume placentário em gestações normais de termo: a do princípio de Arquimedes e a do volume do cilindro, para estimar a densidade absoluta da placenta. Definir a metodologia mais adequada para o cálculo do volume e densidade placentários, que se relacione com o peso e classificação do recém-nascido. MÉTODOS: foram estudadas 50 placentas provenientes de gestações de termo sem complicações e calculados o volume e a densidade absoluta placentários: a pelo princípio de Arquimedes e b na suposição de que a placenta seria uma secção de cilindro com duas alturas diferentes do bolo placentário: com a altura média e com a altura da média aritmética do centro e extremidades. As densidades absolutas placentárias foram calculadas pelo quociente entre o peso ao ar da placenta e os diferentes volumes. RESULTADOS: a maioria das gestantes eram multíparas, idade média de 25,4 anos, volume placentário médio entre 547,8 e 610 cmsuperscript three e densidade média entre 0,94 e 1,14 g/cmsuperscript three, dependendo da metodologia empregada. CONCLUSÕES: a metodologia mais adequada para estimar o volume placentário no termo foi a do princípio de Arquimedes, pela melhor correlação com o peso dos recém-nascidos, o índice placentário e a classificação do peso dos recém-nascidos em relação à idade gestacional.

  4. preescolares desnutridos con madres con obesidad y sin obesidad

    Directory of Open Access Journals (Sweden)

    Viridiana Vanessa Conzuelo-González

    2009-01-01

    Full Text Available El primer objetivo fue conocer cuántos menores de cinco años con diferentes grados de desnutrición tienen una madre con sobrepeso/obesidad/ en una comunidad indígena que vive en extrema pobreza y bajo condiciones de migración masculina internacional. El segundo fue comparar tres variables socionutricionales (ingreso familiar, educación de la madre y adecuación nutrimental de la dieta diaria entre estos hogares y los hogares con desnutrición infantil y madres sin obesidad. Se realizó un estudio transversal (2006-2007, en la comunidad mazahua de San Francisco Tepeolulco, Municipio de Temascalcingo; que incluyó a 85 hogares integrados por preescolares con desnutrición inscritos al programa Oportunidades. Se determinó el estado nutrición de los preescolares con indicadores antropométricos y se obtuvo el IMC de las madres de estos infantes. Se aplicó una encuesta socionutricional, incluida el recordatorio de 24 horas, y complementado con la observación participante (cualitativa. Se encontró que 83% de las madres mazahuas presentaron sobrepeso u obesidad. El estado de nutrición de los preescolares con madres con obesidad presentó un porcentaje mayor de desnutrición (76%. En la variable género, se encontró que 54% de los niños con madres con obesidad tenía baja talla. Al relacionar el nivel educativo de la madre, esta variable resultó ser estadísticamente significativa (p=0.015, donde el analfabetismo está más relacionado con la desnutrición infantil que tienen madres de bajo y/o peso normal. La elevada prevalencia de hogares conformados con preescolares con desnutrición y madres con obesidad, es un síntoma más de la pobreza en zonas indígenas en México, con bajo índice de desarrollo humano.

  5. Changes in the blood indicators and body condition of high yielding Holstein cows with retained placenta and ketosis

    Directory of Open Access Journals (Sweden)

    Zenon Nogalski

    2012-01-01

    Full Text Available The aim of this study was to determine the effect of changes in body condition in the dry period and the early lactation period on the incidence of retained placenta and ketosis in 94 high-yielding Holstein-Friesian cows. Body condition scoring was performed every two weeks from the beginning of the dry period until week 18 of lactation. Blood for the measuring of indicators of metabolism was sampled in weeks 1 and 2 ante partum and in weeks 1, 2, 3, 7 and 15 post partum. Retained placenta was reported in 11 cows, and ketosis was diagnosed in 18 animals. One week ante partum, the serum profile of cows diagnosed with ketosis during lactation revealed 0.52 mmol/l β-hydroxybutyric acid and 0.29 mmol/l non-esterified fatty acids on average. One week post partum, the serum profile of cows with ketosis revealed 1.59 mmol/l β-hydroxybutyric acid and 1.09 mmol/l non-esterified fatty acids and cows with retained placenta 1.65 and 1.41, respectively. From the week 5 ante partum to the point of lowest body condition the average body condition loss reached 1.4 points in cows with retained placenta, 1.1 points in cows with ketosis, and 0.8 points in healthy cows. Retained placenta and ketosis increased significantly conception rates by 0.47 and 0.50, respectively. Our results show that monitoring changes in the body condition and non-esterified fatty acids and β-hydroxybutyric acid blood levels in high-yielding cows in the transition period, followed by taking relevant disease-control measures, may be effective in reducing the incidence of retained placenta and ketosis in dairy cattle herds.

  6. Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case-control study.

    Science.gov (United States)

    Farquhar, Cynthia M; Li, Zhuoyang; Lensen, Sarah; McLintock, Claire; Pollock, Wendy; Peek, Michael J; Ellwood, David; Knight, Marian; Homer, Caroline Se; Vaughan, Geraldine; Wang, Alex; Sullivan, Elizabeth

    2017-10-05

    Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. Case-control study. Sites in Australia and New Zealand with at least 50 births per year. Cases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls. Data were collected using the Australasian Maternity Outcomes Surveillance System. Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). The incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Incidence, risk factors and perinatal outcomes for placenta accreta in Australia and New Zealand: a case–control study

    Science.gov (United States)

    Farquhar, Cynthia M; Li, Zhuoyang; McLintock, Claire; Pollock, Wendy; Peek, Michael J; Ellwood, David; Knight, Marian; Vaughan, Geraldine; Wang, Alex; Sullivan, Elizabeth

    2017-01-01

    Objective Estimate the incidence of placenta accreta and describe risk factors, clinical practice and perinatal outcomes. Design Case–control study. Setting Sites in Australia and New Zealand with at least 50 births per year. Participants Cases were women giving birth (≥20 weeks or fetus ≥400 g) who were diagnosed with placenta accreta by antenatal imaging, at operation or by pathology specimens between 2010 and 2012. Controls were two births immediately prior to a case. A total of 295 cases were included and 570 controls. Methods Data were collected using the Australasian Maternity Outcomes Surveillance System. Primary and secondary outcome measures Incidence, risk factors (eg, prior caesarean section (CS), maternal age) and clinical outcomes of placenta accreta (eg CS, hysterectomy and death). Results The incidence of placenta accreta was 44.2/100 000 women giving birth (95% CI 39.4 to 49.5); however, this may overestimated due to the case definition used. In primiparous women, an increased odds of placenta accreta was observed in older women (adjusted OR (AOR) women≥40 vs accreta were more likely to have a caesarean section (AOR: 4.6, 95% CI 2.7 to 7.6) to be admitted to the intensive care unit (ICU)/high dependency unit (AOR: 46.1, 95% CI 22.3 to 95.4) and to have a hysterectomy (AOR: 209.0, 95% CI 19.9 to 875.0). Babies born to women with placenta accreta were more likely to be preterm, be admitted to neonatal ICU and require resuscitation. PMID:28982832

  8. A comparison of cell-free placental messenger ribonucleic acid and color Doppler ultrasound for the prediction of placental invasion in patients with placenta accreta

    Directory of Open Access Journals (Sweden)

    Elham Naghshineh

    2015-01-01

    Conclusions: Cell-free mRNA is an acceptable, easy made, functional test with sensitivity, specificity, PPV and NPV more than Doppler ultrasound for diagnosis and prediction of incidence of placenta accrete and we recommend the use of cell-free mRNA test for diagnosis of placenta accreta.

  9. Transport of benzo[alpha]pyrene in the dually perfused human placenta perfusion model: effect of albumin in the perfusion medium

    DEFF Research Database (Denmark)

    Mathiesen, Line; Rytting, Erik; Mose, Tina

    2009-01-01

    compared to other species; since it is available without major ethical obstacles, we have used the human placenta perfusion model to study transport from mother to foetus. Placentas were donated after births at Rigshospitalet in Copenhagen from pregnant mothers who signed an informed consent. Ba...

  10. NAA for study of organohalogen levels in placenta, umbilical cord and hair of mothers with disabled newborns

    International Nuclear Information System (INIS)

    Zhang, H.; Chai, Z.F.; Chinese Academy of Sciences, Beijing; Wang, J.B.

    2008-01-01

    The concentrations of extractable organohalogens (EOX) and extractable persistent organohalogens (EPOX) in placenta, umbilical cord and hair of mothers delivering disabled or normal newborns as well as the compositions of EPOCl in three analyzed matrices were determined by a combination of NAA, gas chromatography and chemical separation. The results indicated that both EOX and EPOX decreased in the order: hair > umbilical cord > placenta. Organochlorines were the major fraction of organohalogens. More than 77% of EPOCl were unidentified. High organohalogens exposure may induce adverse health effects, and hair, as a biomonitor for organohalogens assessment, is more recommendable. (author)

  11. Placentação em cutias (Dasyprocta aguti, CARLETON, M.D.): aspectos morfológicos

    OpenAIRE

    Rodrigues, Rosângela Felipe; Miglino, Maria Angelica; Ferraz, Rosa Helena dos Santos; Morais-Pinto, Luciano de

    2003-01-01

    A cutia é um roedor silvestre, encontrado no sul da América Central e em regiões tropicais da América do Sul, principalmente nas regiões norte, nordeste e sudeste do Brasil. Estes animais fornecem proteína de origem animal e por isso, apresentam importância sócio-econômica para as regiões do norte e nordeste do Brasil. Para o presente trabalho foram utilizadas sete placentas de cutias (Dasyprocta aguti), em diferentes fases da gestação. Nos aspectos morfológicos a placenta da cutia apresenta ...

  12. Caracterização das áreas hemófagas da placenta bovina Characterization of hemophagous areas of the bovine placenta

    Directory of Open Access Journals (Sweden)

    Susana M.M. Cazerta

    2007-06-01

    Full Text Available A região específica da interface materno-fetal corresponde à zona arcada do placentônio ovino e caprino. Em pequenos ruminantes esta área é também caracterizada por sangue materno extravasado (áreas hemófagas. É possível que o ferro seja transferido para o feto por eritrofagocitose trofoblástica nestas áreas. Para investigar as áreas hemófagas na placenta bovina, foram analisados placentônios de 34 vacas zebuínas gestantes (dois a três, quatro a seis, sete a oito, e nove meses de prenhez. O material foi fixado com solução aquosa de formaldeído a 10% e paraformaldeído a 4%, em tampão fosfato, pH 7,4, 0,1M, sendo processado e corado para microscopia de luz e histoquímica. Os hematomas placentários foram observados entre o epitélio uterino e trofoblástico, a partir de três meses de prenhez. A presença de eritrócitos nas células trofoblásticas elucidou a eritrofago-citose. A reação histoquímica de Perl's permitiu provar a existência de ferro férrico no trofoblasto. A reação de PAS foi po-sitiva, marcando substância mucóide nas células epiteliais e, principalmente, nas células binucleadas do epitélio fetal. Baseando-se nas características histológicas e histoquímicas, inferimos que as áreas hemófagas são sítios importantes para a transferência de ferro na placenta bovina.The specific region of maternal fetal interface needs to be clarified and corresponds to the "arcade zone" of sheep and goat placentomes. In small ruminants that area is also characterized by macroscopic blood extravasation (hemophagous areas. This occurs possibly because the iron is transferred to the embryo by trophoblastic erytrophagocytosis in these hemophagous placental areas. In order to investigate the hemophagous placental areas in cattle, placentomes of 34 pregnant Bos indicus cows (2-3, 4-6, 7-8 and 9 months of gestation were analyzed. They were fixed by perfusion with 10% formaldehyde aqueous solution and 4

  13. Inter-individual variation of selenium in maternal plasma, cord plasma and placenta

    International Nuclear Information System (INIS)

    Lee, Anne M.; Huel, Guy; Godin, Jean; Hellier, Georgette; Sahuquillo, Josiane; Moreau, Thierry; Blot, Phillipe

    1994-01-01

    Selenium (Se) in high doses has been known to cause injury to the fetus and newborn. The major difficulty in assessing the effects of selenium on human reproduction stems from the need for a suitable means of estimating maternal and fetal exposure. The present investigation, therefore, examines the respective reliability of maternal plasma, cord plasma and placenta as epidemiological indicators as well as inter-individual variation of this trace element. An unselected population of 128 pregnancies was studied. Obstetrical characteristics were noted. Selenium concentrations were determined for maternal plasma, cord plasma, and placental tissue by fluorometric analysis. Maternal plasma selenium concentrations (Se-Bm) were significantly greater than fetal concentrations (Se-Bc). Placental selenium (Se-Pl) levels were four times that of fetal levels. Variability of Se-Bc is best explained by placental concentrations. Maternal weight and ethnic origin are significantly correlated with Se-Bc. Female newborn have higher selenium levels than male newborn. The present study demonstrates the significance of the placenta as an indicator of fetal selenium exposure

  14. Modulation of cholesterol transport by maternal hypercholesterolemia in human full-term placenta.

    Directory of Open Access Journals (Sweden)

    Ran Zhang

    Full Text Available The significance of maternal cholesterol transporting to the fetus under normal as well as pathological circumstances is less understood. The objective of this study was to observe the effects of maternal hypercholesterolemia on placental cholesterol transportation. Human full-time placenta, maternal and venous cord blood were sampled at delivery from the pregnant women with serum total cholesterol (TC concentrations at third trimester higher than 7.25 mM (n = 19 and the pregnant women with normal TC concentrations (n = 19. Serum lipids and expression of genes related to cholesterol transportation were measured by western blot or real-time PCR. The results indicated that serum TC, high density lipoprotein cholesterol (HDL-C, and low density lipoprotein cholesterol (LDL-C levels were significantly increased, in pregnancies, but decreased in cord blood in hypercholesterolemic group compared to the matched control group. All the subjects were no-drinking, non-smoker, and gestational disease free. The mRNA expression of lipoprotein receptors, including LDLR and VLDLR were significantly increased, while the protein expression of PCSK9 was significantly increased in hypercholesterolemic placenta. In conclusion, maternal hypercholesterolemia might decrease the transportation of cholesterol from mother to fetus because of the high levels of PCSK9 protein expression.

  15. [Influence of valproic acid (depakine I.V.) on human placenta metabolism--experimental model].

    Science.gov (United States)

    Semczuk-Sikora, Anna; Rogowska, Wanda; Semczuk, Marian

    2003-08-01

    The pregnancy in women with epilepsy is associated with an increased incidence of congenital malformations in offspring. Currently, anti-epileptic drugs (AEDs) are concerned to be a major etiologic factor of abnormal fetal development but the pathomechanism of teratogenicity of AEDs is complex and not well understood. The purpose of this study was to evaluate an influence of one of the AED-valproic acid (VPA) on placental metabolism (glucose consumption and lactate production). Term human placental cotyledons were perfused in vitro using a recycling perfusion of maternal and fetal circulations. A total 18 placentas were perfused either with 75 micrograms/ml of VPA (therapeutic dose) or with 225 micrograms/ml of VPA (toxic dose). Eight placentas were perfused with a medium without VPA and served as controls. During 2.5 h of experiment, both maternal and fetal glucose consumption and lactate production were measured every 30 minutes. The introduction of different concentrations of VPA into the perfusion system did not effect placental glucose consumption and lactate production rates in both maternal and fetal compartments. The teratogenic effect of valproic acid is not associated with metabolic disturbances of glucose or lactate in the placental tissue.

  16. Evaluation of cell proliferation and apoptosis in placentas of rats with severe diabetes

    Directory of Open Access Journals (Sweden)

    Marilza Vieira Cunha Rudge

    2012-04-01

    Full Text Available The aim of this work was to analyze the cell proliferation and apoptosis indexes on the 18th and 21st days of pregnancy of diabetic rats and to correlate with maternal glycemia and perinatal outcomes. Placentas from 20 Wistar rats were collected and divided into four experimental groups: control and diabetic of 18 and 21 days of pregnancy. The cell proliferation was analyzed using the PCNA expression and apoptosis by the TUNEL method. It was observed that PCNA and TUNEL indexes decreased from day 18 to 21 of pregnancy in the placentas of diabetic rats and these values were lower than control groups. Diabetic dams presented higher percentage of small for pregnancy age (SPA fetuses. However, there was no difference between the PCNA and TUNEL indexes in SPA and N-SPA fetuses in all the groups and these indexes were not correlated to maternal glycemic. Thus, placental cell proliferation and apoptosis did not interfere in the intrauterine growth restriction.

  17. We can Diagnose it if we Consider it. Diagnostic Pitfall for Placenta: Placental Mesenchymal Dysplasia

    Directory of Open Access Journals (Sweden)

    Havva Serap TORU

    2018-01-01

    Full Text Available Placental mesenchymal dysplasia is an increasingly recognizable abnormality. Early cases have been confused with partial hydatidiform mole. Placental mesenchymal dysplasia is probably under-diagnosed because of being an unfamiliar clinical entity and also mistaken for gestational trophoblastic disease due to the similar sonographic findings of two entities. In this report, we describe the clinical, gross, and histopathological findings of placental mesenchymal dysplasia in two cases. The 33-week-preterm baby of a 26-year-old woman with cardiovascular disease and 342 gram placenta and the 19-week fetus with trisomy 21 of a 40 year-old woman were terminated. Macroscopically thick-walled vessels and microscopically hydropic villous with peripherally localized thick-walled vessels without trophoblastic cell proliferation were observed in both cases. These two cases represent a rare placental anomaly that is benign but it is challenging to distinguish placental mesenchymal dysplasia from an incomplete mole. Placental mesenchymal dysplasia should be included in the differential diagnosis of sonographic findings that show a normal appearing fetus and a placenta with cystic lesions. Placental mesenchymal dysplasia is associated with pregnancy-related hypertension. In conclusion, the most important point is “you can diagnose it if you consider it”.

  18. Acardiac twin with externalized intestine adherent to placenta: unusual manifestation of omphalocele.

    Science.gov (United States)

    Emery, Shawn Clark; Vaux, Keith K; Pretorius, Dolores; Masliah, Eliezer; Benirschke, Kurt

    2004-01-01

    TRAP (twin reversed arterial perfusion) syndrome produces an acardiac twin (acardiac monster, acardius, acardiacus, chorioangiopagus parasiticus, etc.). Acardiacs result from monozygotic multiple births in which three anatomic anomalies occur: (1) a fetus' cardiac development is disturbed; (2) artery-artery anastomosis carries blood from a normal ("pump") twin to the acardiac; (3) vein-vein anastomosis carries blood from the acardiac back to the normal twin. Whether reversal of blood flow in the acardiac results from or causes cardiac dysmorphogenesis has not been resolved. Acardiac twins demonstrate a complex constellation of malformations usually thought to result from reversed blood flow; omphalocele is particularly common. We report monochorionic monoamnionic male twins in which an acardiac twin demonstrated externalized intestines adherent to the placenta. The twins were delivered from a 30-year-old primigravida mother by cesarean section without maternal complications at 33 w. The mother has no significant past medical history. The macerated acardius had a 4-cm long attenuated umbilical cord with indeterminate number of vessels. Structures rostral to the thorax were absent save for one poorly developed hand and arm. The abdomen contained loose mesenchyme and no organs. The entire intestine (21 cm) along with two testes was located in a sac on the surface of the placenta. No histopathologic anomalies of formed structures were identified aside from spatial relationships and incomplete development. The normal twin required no intensive care and is doing well. To our knowledge, this is the first report of externalized intestine, which may represent an unusual consequence of omphalocele.

  19. Regulation of MT1-MMP/MMP-2/TIMP-2 axis in human placenta

    Directory of Open Access Journals (Sweden)

    Vincent ZL

    2015-10-01

    Full Text Available Zoë L Vincent,1,2 Murray D Mitchell,l,3 Anna P Ponnampalam1,2 1Liggins Institute, 2Gravida: National Centre for Growth and Development, University of Auckland, Auckland, New Zealand; 3University of Queensland Centre for Clinical Research, Brisbane, QLD, Australia Abstract: Matrix metalloproteinases (MMPs and specific endogenous tissue inhibitors of metalloproteinases (TIMPs mediate rupture of the fetal membranes in both physiological and pathological conditions. MMPs and TIMPs are subject to regulation by DNA methylation in human malignancies and pre-eclampsia. To determine if membrane type 1 MMP (MT1-MMP, MMP2, and TIMP2 are regulated by DNA methylation in human placentas, we employed an in vitro model where human placental tissues were collected at term gestation and cultured with methylation inhibiting agent 5-aza-2′deoxycytidine (AZA and lipopolysaccharide. The results suggest that DNA methylation is not directly involved in the regulation of MT1-MMP in placental tissue; however, remodeling of chromatin by a pharmacologic agent such as AZA potentiates an infection-related increase in MT1-MMP. MT1-MMP is a powerful activator of MMP2 and this action, coupled with either no change or a decrease in TIMP2 concentrations, favors a gelatinolytic state leading to extracellular matrix degradation, which could predispose fetal membranes to rupture prematurely during inflammation. Keywords: placenta, epigenetic regulation, DNA methylation, MMPs, labor

  20. Safe spinal anesthesia in a woman with chronic renal failure and placenta previa

    Directory of Open Access Journals (Sweden)

    Beyazit Zencirci

    2010-05-01

    Full Text Available Beyazit ZencirciKahramanmaras, TurkeyBackground: Chronic renal failure is strongly associated with poor pregnancy outcome. Women dependent on hemodialysis before conception rarely achieve a successful live birth.Case presentation: A 31-year-old multiparous Turkish woman was scheduled for cesarean section under spinal anesthesia at 37 weeks and five days’ gestation because of hemorrhage due to secondary placenta previa. Spinal anesthesia with 8 mg of hyperbaric bupivacaine was successfully performed. Invasive blood pressure, central venous pressure, and heart rate were stable during the surgery. The mother returned to regular hemodialysis on the first postoperative day.Conclusion: Pregnancy is uncommon in women with chronic renal failure requiring chronic dialysis. Rates of maternal hypertension, pre-eclampsia, anemia, and infection in the pregnant chronic dialysis patient are high. However, our findings suggest that with careful, close, and effective monitoring preoperatively and intraoperatively, spinal anesthesia can be safely performed for cesarean section in patients undergoing hemodialysis.Keywords: chronic renal failure, pregnancy, spinal anesthesia, hemodialysis, placenta previa

  1. Prophylactic balloon occlusion of internal iliac arteries in women with placenta accreta: Literature review and analysis

    Energy Technology Data Exchange (ETDEWEB)

    Dilauro, M.D.; Dason, S. [McMaster University, Michael G. DeGroote School of Medicine (Canada); Athreya, S., E-mail: sathreya@stjoes.ca [Diagnostic Imaging, St Joseph' s Healthcare Hamilton, Ontario (Canada)

    2012-06-15

    Aim: To review the literature on the use of prophylactic balloon occlusion alone and in conjunction with arterial embolization of the internal iliac arteries in women with placenta accreta. Materials and methods: The PubMed, MEDLINE, CINAHL, EMBASE, and Cochrane Library databases were searched for keywords related to this technique and its use in the avoidance of caesarean hysterectomy. The relevant published articles were selected and then searched for further references. Results: The literature search found 15 case reports and five studies for a total of 20 articles. The use of balloon catheters to prevent post-partum haemorrhage in women with placenta accreta is controversial with some investigators reporting reduced blood loss and transfusion requirements while others reporting no benefit. This procedure does not appear to reduce operative time or hospital stay. Some groups have described catheter-related complications, such as maternal thromboembolic events and the need for stent placement and/or arterial bypass. Thus far, there is no reported maternal or foetal mortality related to this procedure. Conclusion: Current evidence is based upon case reports and small retrospective studies. Larger studies or randomized controlled trials are essential in order to demonstrate the safety and efficacy of bilateral iliac balloon occlusion. The creation of a data registry would also facilitate the reporting of this technique.

  2. Simultaneous detection of periodontal pathogens in subgingival plaque and placenta of women with hypertension in pregnancy.

    Science.gov (United States)

    Swati, P; Thomas, Betsy; Vahab, Saadi Abdul; Kapaettu, Satyamoorthy; Kushtagi, Pralhad

    2012-03-01

    There are many studies documenting increased prevalence of periodontal infection in women with preeclampsia. But, very few studies have attempted to establish causal relationship between the two. To find out causal circumstantial evidence by isolating specific periodontal pathogens in oral and placental samples. Antenatal periodontal screening and subgingival plaque collection was carried out in ten women with hypertension in pregnancy and ten normotensive controls on their hospital admission at term for cesarean delivery. Placental biopsy was obtained after aseptic placental collection at the time of elective cesarean delivery. Subgingival plaque and placental biopsy were studied for Porphyromonas gingivalis, Fusobacterium nucleatum, Treponema denticola, Prevotella intermedia and Aggregatibacter actinomycetemcomitans using quantitative polymerase chain reaction technique. Periodontist and laboratory personnel were unaware of case or control status. Periodontal status was not informed to the obstetrician recruiting the cases and laboratory. Microbiology report was not revealed till end of the study. Periodontal pathogens were found to be high in the group with hypertension than the controls. P gingivalis was found in all the samples from subgingival plaque and placenta, irrespective of the periodontal disease status. In cases with hypertension, periodontal pathogens are present in higher proportion in subgingival plaque and placenta.

  3. IFN-γ expression in placenta is associated to resistance to Chlamydia abortus after intragastric infection.

    Science.gov (United States)

    del Rio, L; Barberá-Cremades, M; Navarro, J A; Buendía, A J; Cuello, F; Ortega, N; Gallego, M C; Salinas, J; Caro, M R

    2013-03-01

    Intragastric infection mimics the natural route of infection of Chlamydia abortus (etiological agent of ovine enzootic abortion). In the mouse model, intragastric experimental infection induces very mild signs of infection followed by late term abortions, as it is shown by the natural ovine host. In order to evaluate the immune mechanisms associated to the dissemination of the pathogen from the gastrointestinal tract, we have administered an intragastric dose of C. abortus to pregnant mice. Systemic and local expression of cytokines, tissue colonization and excretion of bacteria after parturition were monitored during pregnancy. Susceptible CBA/J mice showed a higher bacterial colonization of the placenta and excretion of live bacteria after parturition that were related to a higher local IL-10 expression. By contrast, resistant C57BL/6 mouse strain had higher local IFN-γ mRNA expression in the placenta just before parturition and a transient bacterial colonization of the reproductive tract, with no excretion of C. abortus after parturition. In summary, intragastric infection not only mimics the natural route of infection of C. abortus, but can also be useful in order to understand the immunopathogenesis of chlamydial abortion in the mouse. Copyright © 2013 Elsevier Ltd. All rights reserved.

  4. Glycine uptake by microvillous and basal plasma membrane vesicles from term human placentae.

    Science.gov (United States)

    Dicke, J M; Verges, D; Kelley, L K; Smith, C H

    1993-01-01

    Like most amino acids, glycine is present in higher concentrations in the fetus than in the mother. Unlike most amino acids, animal studies suggest fetal concentrations of glycine are minimally in excess of those required for protein synthesis. Abnormal glycine utilization has also been demonstrated in small-for-gestational age human fetuses. The mechanism(s) of glycine uptake in the human placenta are unknown. In other mammalian cells glycine is a substrate for the A, ASC and Gly amino acid transport systems. In this study human placental glycine uptake was characterized using microvillous and basal plasma membrane vesicles each prepared from the same placenta. In both membranes glycine uptake was mediated predominantly by the sodium-dependent A system. Competitive inhibition studies suggest that in microvillous vesicles the small percentage of sodium-dependent glycine uptake not inhibited by methylaminoisobutyric acid (MeAIB) shares a transport system with glycine methyl ester and sarcosine, substrates of the Gly system in other tissues. In addition there are mediated sodium-independent and non-selective transport mechanisms in both plasma membranes. If fetal glycine availability is primarily contingent upon the common and highly regulated A system, glycine must compete with many other substrates potentially resulting in marginal fetal reserves, abnormal utilization and impaired growth.

  5. Effect of Docosahexaenoic Acid on Apoptosis and Proliferation in the Placenta: Preliminary Report

    Directory of Open Access Journals (Sweden)

    Ewa Wietrak

    2015-01-01

    Full Text Available Introduction. Observational studies confirm a higher incidence of preeclampsia in patients with low erythrocyte concentrations of omega-3 fatty acids. Observations point to an association of disorders of pregnancy, such as intrauterine growth restriction (IUGR and preeclampsia, with excessive apoptosis. One potential mechanism of action of docosahexaenoic acid (DHA promoting a reduction in the risk of pathological pregnancy may be by influencing these processes in the placenta. Materials and Methods. We investigated 28 pregnant women supplemented with a fish oil product containing 300 mg DHA starting from pregnancy week 20 until delivery (DHA group. The control group consisted of 50 women who did not receive such supplementation (control group. We determined the expression of Ki-67 and p21 as markers of proliferation and caspase 3 activity as a marker of apoptosis and DHA levels in umbilical cord blood. Results. Caspase 3 activity was significantly lower in the DHA group in comparison to the control group. Umbilical cord blood DHA concentration was higher in the DHA group. The expression of the proteins p21 and Ki-67 did not differ significantly between the groups. Conclusions. We observed an association between DHA supplementation and inhibition of placental apoptosis. We did not find an association between DHA and proliferation process in the placenta.

  6. On opportunity for emergency cesarean hysterectomy and pregnancy outcomes of patients with placenta accreta.

    Science.gov (United States)

    Kong, Xiang; Kong, Yan; Yan, Jin; Hu, Jin-Ju; Wang, Fang-Fang; Zhang, Lei

    2017-09-01

    Effective diagnosis and clinical management of placenta accreta (PA) in China are not clear. The purpose of the study was to analyze the risk factors and diagnosis of PA, maternal and neonatal outcomes in patients with PA. It was a retrospective study of cases with PA, confirmed by histologically and/or clinically suspected during 3 years in 2 tertiary referral hospitals. The incidence rate of patients with PA, who had history of artificial abortion, cesarean section (CS), and placenta previa (PP) was 94%, 70%, and 72%, respectively. In 29 patients of scheduled CS group, 12 cases were performed with cesarean hysterectomy. Mean estimated blood loss (EBL) was 1.5 L, and 17 babies were admitted to neonatal intensive care unit (NICU). In the 18 cases of emergency CS group, 6 cases were performed cesarean hysterectomy. Mean EBL was 2.4 L, and 16 babies were admitted to NICU. The difference of mean EBL, cases of fetal admitted to intensive care unit in 2 groups was significant difference (P emergency CS. Emergency peripartum hysterectomy is a feasible method under the circumstances of heave, fast bleeding, and the failure of conservative surgery.

  7. Efficient production of Aschersonia placenta protoplasts for transformation using optimization algorithms.

    Science.gov (United States)

    Wei, Xiuyan; Song, Xinyue; Dong, Dong; Keyhani, Nemat O; Yao, Lindan; Zang, Xiangyun; Dong, Lili; Gu, Zijian; Fu, Delai; Liu, Xingzhong; Qiu, Junzhi; Guan, Xiong

    2016-07-01

    The insect pathogenic fungus Aschersonia placenta is a highly effective pathogen of whiteflies and scale insects. However, few genetic tools are currently available for studying this organism. Here we report on the conditions for the production of transformable A. placenta protoplasts using an optimized protocol based on the response surface method (RSM). Critical parameters for protoplast production were modelled by using a Box-Behnken design (BBD) involving 3 levels of 3 variables that was subsequently tested to verify its ability to predict protoplast production (R(2) = 0.9465). The optimized conditions resulted in the highest yield of protoplasts ((4.41 ± 0.02) × 10(7) cells/mL of culture, mean ± SE) when fungal cells were treated with 26.1 mg/mL of lywallzyme for 4 h of digestion, and subsequently allowed to recover for 64.6 h in 0.7 mol/L NaCl-Tris buffer. The latter was used as an osmotic stabilizer. The yield of protoplasts was approximately 10-fold higher than that of the nonoptimized conditions. Generated protoplasts were transformed with vector PbarGPE containing the bar gene as the selection marker. Transformation efficiency was 300 colonies/(μg DNA·10(7) protoplasts), and integration of the vector DNA was confirmed by PCR. The results show that rational design strategies (RSM and BBD methods) are useful to increase the production of fungal protoplasts for a variety of downstream applications.

  8. Variable Methylation Potential in Preterm Placenta: Implication for Epigenetic Programming of the Offspring.

    Science.gov (United States)

    Khot, Vinita V; Chavan-Gautam, Preeti; Mehendale, Savita; Joshi, Sadhana R

    2017-06-01

    Children born preterm are reported to be at increased risk of developing noncommunicable diseases in later life. Altered placental DNA methylation patterns are implicated in fetal programming of adult diseases. Our earlier animal studies focus on micronutrients (folic acid, vitamin B 12 ) and long-chain polyunsaturated fatty acids (LCPUFAs) that interact in the 1 carbon cycle, thereby influencing methylation reactions. Our previous studies in women delivering preterm show altered plasma levels of micronutrients and lower plasma LCPUFA levels. We postulate that alterations in the micronutrient metabolism may affect the regulation of enzymes, methionine adenosyltransferase ( MAT2A), and SAH-hydrolase ( AHCY), involved in the production of methyl donor S-adenosylmethionine (SAM), thereby influencing the methylation potential (MP) in the placenta of women delivering preterm. The present study, therefore, examines the mRNA, protein levels of enzymes ( MAT2A and AHCY), SAM, S-adenosylhomocysteine (SAH) levels, and global DNA methylation levels from preterm (n = 73) and term (n = 73) placentae. The enzyme messenger RNA (mRNA) levels were analyzed by real-time quantitative polymerase chain reaction, protein levels by enzyme-linked immunosorbent assay, and SAM-SAH levels by high-performance liquid chromatography. The mRNA levels for MAT2A and AHCY are higher ( P programming of the developing fetus.

  9. Formaldehyde Crosses the Human Placenta and Affects Human Trophoblast Differentiation and Hormonal Functions.

    Directory of Open Access Journals (Sweden)

    Guillaume Pidoux

    Full Text Available The chorionic villus of the human placenta is the source of specific endocrine functions and nutrient exchanges. These activities are ensured by the syncytiotrophobast (ST, which bathes in maternal blood. The ST arises and regenerates throughout pregnancy by fusion of underlying cytotrophoblasts (CT. Any anomaly of ST formation or regeneration can affect pregnancy outcome and fetal growth. Because of its direct interaction with maternal blood, the ST is sensitive to drugs, pollutants and xenohormones. Ex vivo assays of perfused cotyledon show that formaldehyde, a common pollutant present in furniture, paint and plastics, can accumulate in the human placenta and cross to the fetal compartment. By means of RT-qPCR, immunoblot and immunocytochemistry experiments, we demonstrate in vitro that formaldehyde exerts endocrine toxicity on human trophoblasts, including a decrease in the production of protein hormones of pregnancy. In addition, formaldehyde exposure triggered human trophoblast fusion by upregulating syncitin-1 receptor expression (ASC-type amino-acid transporter 2: ASCT2. Moreover, we show that formaldehyde-exposed trophoblasts present an altered redox status associated with oxidative stress, and an increase in ASCT2 expression intended to compensate for this stress. Finally, we demonstrate that the adverse effects of formaldehyde on trophoblast differentiation and fusion are reversed by N-acetyl-L-cysteine (Nac, an antioxidant.

  10. Frequency, Risk Factors, and Adverse Fetomaternal Outcomes of Placenta Previa in Northern Tanzania

    Directory of Open Access Journals (Sweden)

    Elizabeth Eliet Senkoro

    2017-01-01

    Full Text Available Background and Objective. Placenta previa (PP is a potential risk factor for obstetric hemorrhage, which is a major cause of fetomaternal morbidity and mortality in developing countries. This study aimed to determine frequency, risk factors, and adverse fetomaternal outcomes of placenta previa in Northern Tanzania. Methodology. A retrospective cohort study was conducted using maternally-linked data from Kilimanjaro Christian Medical Centre birth registry spanning 2000 to 2015. All women who gave birth to singleton infants were studied. Adjusted odds ratios (ORs with 95% confidence intervals for risk factors and adverse fetomaternal outcomes associated with PP were estimated in multivariable logistic regression models. Result. A total of 47,686 singleton deliveries were analyzed. Of these, the frequency of PP was 0.6%. Notable significant risk factors for PP included gynecological diseases, alcohol consumption during pregnancy, malpresentation, and gravidity ≥5. Adverse maternal outcomes were postpartum haemorrhage, antepartum haemorrhage, and Caesarean delivery. PP increased odds of fetal Malpresentation and early neonatal death. Conclusion. The prevalence of PP was comparable to that found in past research. Multiple independent risk factors were identified. PP was found to have associations with several adverse fetomaternal outcomes. Early identification of women at risk of PP may help clinicians prevent such complications.

  11. Meeting report of the first conference of the International Placenta Stem Cell Society (IPLASS)

    Science.gov (United States)

    Parolini, O.; Alviano, F.; Betz, A.G.; Bianchi, D.W.; Götherström, C.; Manuelpillai, U.; Mellor, A.L.; Ofir, R.; Ponsaerts, P.; Scherjon, S.A.; Weiss, M.L.; Wolbank, S.; Wood, K.J.; Borlongan, C.V.

    2012-01-01

    The International Placenta Stem Cell Society (IPLASS) was founded in June 2010. Its goal is to serve as a network for advancing research and clinical applications of stem/progenitor cells isolated from human term placental tissues, including the amnio-chorionic fetal membranes and Wharton's jelly. The commitment of the Society to champion placenta as a stem cell source was realized with the inaugural meeting of IPLASS held in Brescia, Italy, in October 2010. Officially designated as an EMBO-endorsed scientific activity, international experts in the field gathered for a 3-day meeting, which commenced with “Meet with the experts” sessions, IPLASS member and board meetings, and welcome remarks by Dr. Ornella Parolini, President of IPLASS. The evening's highlight was a keynote plenary lecture by Dr. Diana Bianchi. The subsequent scientific program consisted of morning and afternoon oral and poster presentations, followed by social events. Both provided many opportunities for intellectual exchange among the 120 multi-national participants. This allowed a methodical and deliberate evaluation of the status of placental cells in research in regenerative and reparative medicine. The meeting concluded with Dr. Parolini summarizing the meeting's highlights. This further prepared the fertile ground on which to build the promising potential of placental cell research. The second IPLASS meeting will take place in September 2012 in Vienna, Austria. This meeting report summarizes the thought-provoking lectures delivered at the first meeting of IPLASS. PMID:21575989

  12. Activation of type III interferon genes by pathogenic bacteria in infected epithelial cells and mouse placenta.

    Directory of Open Access Journals (Sweden)

    Hélène Bierne

    Full Text Available Bacterial infections trigger the expression of type I and II interferon genes but little is known about their effect on type III interferon (IFN-λ genes, whose products play important roles in epithelial innate immunity against viruses. Here, we studied the expression of IFN-λ genes in cultured human epithelial cells infected with different pathogenic bacteria and in the mouse placenta infected with Listeria monocytogenes. We first showed that in intestinal LoVo cells, induction of IFN-λ genes by L. monocytogenes required bacterial entry and increased further during the bacterial intracellular phase of infection. Other Gram-positive bacteria, Staphylococcus aureus, Staphylococcus epidermidis and Enterococcus faecalis, also induced IFN-λ genes when internalized by LoVo cells. In contrast, Gram-negative bacteria Salmonella enterica serovar Typhimurium, Shigella flexneri and Chlamydia trachomatis did not substantially induce IFN-λ. We also found that IFN-λ genes were up-regulated in A549 lung epithelial cells infected with Mycobacterium tuberculosis and in HepG2 hepatocytes and BeWo trophoblastic cells infected with L. monocytogenes. In a humanized mouse line permissive to fetoplacental listeriosis, IFN-λ2/λ3 mRNA levels were enhanced in placentas infected with L. monocytogenes. In addition, the feto-placental tissue was responsive to IFN-λ2. Together, these results suggest that IFN-λ may be an important modulator of the immune response to Gram-positive intracellular bacteria in epithelial tissues.

  13. Localization of the placenta on gamma chamber with 113m In-lambratene

    International Nuclear Information System (INIS)

    Shejretova, E.; Blazheva, P.; Kovacheva, S.; Tsanev, Ts.

    1977-01-01

    The authors describe their experience in applying the radioisotopic method for localization of the placenta on gamma chamber by means of 113m In-lambratene (113m In-cysteamine). This complex is chosen due to its valuable physical characteristics of 113m In as shortliving, with whom lambratene is labelled, with proven irradiation protective properties, with the purpose of lowering irradiation load of the fetus. The authors use unique apparatus, gamma chamber Pho-Gamma HP and conventional scanner during injection of 2 mCi 113m In-lambratene. The authors examined 81 women, 42 of whom were pregnant at 6 to 10 months of gestation and 39 women from the third to the fifth month of gestation because of bleedings, Rh isoimmunization with forthcoming amniocentesis, and state after cesarian section for the first group and impending interruption of pregnancy for the second group. The diagnosis of the placenta localization was supported by cesarian section, delivery and interruption of pregnancy. There was 100% coincidence of the diagnosis. (author)

  14. A potential pro-anagogic cell therapy with human placenta-derived mesenchymal cells

    International Nuclear Information System (INIS)

    Nishishita, Toshihide; Ouchi, Kunie; Zhang, Xiaohong; Inoue, Mariko; Inazawa, Takeshi; Yoshiura, Kenta; Kuwabara, Koichiro; Nakaoka, Takashi; Watanabe, Nobukazu; Igura, Koichi; Takahashi, Tsuneo A.; Yamashita, Naohide

    2004-01-01

    Recently several strategies to treat ischemic diseases have been proposed but the ideal way has to be determined. We explored whether human placenta-derived mesenchymal cells (hPDMCs) can be used for this purpose because placenta is very rich in vessels. First, production of human vascular endothelial growth factor (hVEGF) from hPDMCs was examined. The amount of hVEGF secreted by hPDMCs was similar to the amount produced by HeLa cells. hVEGF was barely detected in human umbilical vein endothelial cells (hUVECs) or human peripheral blood mononuclear cells. hVEGF secreted from hPDMCs stimulated the proliferation of hUVECs, indicating its biological activity. Transplantation of hPDMCs to the ischemic limbs of NOD/Shi-scid mice significantly improved the blood flow of the affected limbs. Blood vessel formation was more prominently observed in the limbs of treated mice as compared to the control mice. Real-time RT-PCR revealed that hPDMCs produced hVEGF for at least 7 days after transplantation. Thus, transplantation of hPDMCs could potentially be a promising treatment for human ischemic diseases

  15. Immunohistochemical distribution of early pregnancy factor in ovary, oviduct and placenta of pregnant gilts.

    Science.gov (United States)

    Grosso, M C; Bellingeri, R V; Motta, C E; Alustiza, F E; Picco, N Y; Vivas, A B

    2015-01-01

    Early pregnancy factor (EPF) is an immunosuppressant that promotes maternal immune system tolerance of the allogenic fetus. Little is known about localization of this factor in different tissues and nothing has been reported about localization in swine reproductive and placental tissues. We determined the concentration of EPF in serum of gilts and porcine placenta conditioned medium (PPCM). We also analyzed the expression of EPF in different reproductive tissues of pregnant gilts at 10, 30, 60 and 90 days of pregnancy. EPF concentration in serum and PPCM was determined by western blot and densitometry. EPF expression in reproductive tissue was assessed by immunohistochemistry. The highest concentration of EPF was observed at 30 days in serum and PPCM; the concentration was higher in PPCM than in serum at the stages we evaluated. All reproductive tissues from the gestational stages analyzed showed specific labeling of EPF, but this labeling did not appear in non-pregnant gilts. At 30 days pregnancy, the EPF expression in the ovary was predominantly in follicular lutein cells, probably owing to its function as a luteotrophic factor. In the oviduct, EPF was expressed in unciliated secretory epithelial cells and in the cilia of ciliated cells. In the placenta, EPF was expressed in the fetal portion (mesoderm chorioallantois and epithelium of endoderm). EPF acts as an autocrine and paracrine growth factor for the trophoblast during the peri-implantation period.

  16. The expression and function of fatty acid transport protein-2 and -4 in the murine placenta.

    Directory of Open Access Journals (Sweden)

    Takuya Mishima

    Full Text Available The uptake and trans-placental trafficking of fatty acids from the maternal blood into the fetal circulation are essential for embryonic development, and involve several families of proteins. Fatty acid transport proteins (FATPs uniquely transport fatty acids into cells. We surmised that placental FATPs are germane for fetal growth, and are regulated during hypoxic stress, which is associated with reduced fat supply to the fetus.Using cultured primary term human trophoblasts we found that FATP2, FATP4 and FATP6 were highly expressed in trophoblasts. Hypoxia enhanced the expression of trophoblastic FATP2 and reduced the expression of FATP4, with no change in FATP6. We also found that Fatp2 and Fatp4 are expressed in the mouse amnion and placenta, respectively. Mice deficient in Fatp2 or Fatp4 did not deviate from normal Mendelian distribution, with both embryos and placentas exhibiting normal weight and morphology, triglyceride content, and expression of genes related to fatty acid mobilization.We conclude that even though hypoxia regulates the expression of FATP2 and FATP4 in human trophoblasts, mouse Fatp2 and Fatp4 are not essential for intrauterine fetal growth.

  17. [Leonardo da Vinci and his studies on the human fetus and the placenta].

    Science.gov (United States)

    Cataldi, L; Fanos, V

    2000-01-01

    To review the accuracy of Leonardo's anatomical studies of the female external genitalia and the foetus, particularly those concerning the umbilical cord with its blood vessels. The anatomical drawings of Leonardo da Vinci which are now stored in the Windors Castle near London were reviewed and the accuracy of the details of the genital apparatus and foetus was evaluated. A written comment characterizes many of his drawings. He described accurately the position of the uterine blood vessels and the relationship between the pelvic organs. However his drawing and description of the female external genitalia and human placenta was incorrect because his understanding of it was inadequate. He believed that the human placenta had cotyledons like that of the ungulate uterus (drown side A of sheet 19). At the top of that sheet some Leonardo's details of the anatomic relationship are shown. In our opinion, Leonardo's misunderstanding is probably because he was only able to perform one anatomical dissection of a pregnant women and foetus and therefore his knowledge was limited. The resulting documentation of the pregnant women and foetus was therefore heavily supplemented with his enormous experience in animal anatomy.

  18. autorregulado con estudiantes universitarios

    Directory of Open Access Journals (Sweden)

    Jairo Andrés Montes

    2005-01-01

    Full Text Available El propósito del presente estudio es describir la forma en la que se presentan los procesos de aprendizaje autorregulado con un grupo de estudiantes (22 estudiantes de tercer semestre de Psicología de la PUJ, Cali, en el evento de preparación para la presentación un examen. Asimismo se describen las correlaciones que ocurren entre las distintas fases de dicho proceso de autorregulación del aprendizaje. Para conseguir los objetivos propuestos se ha hecho uso de una observación de desempeño en tiempo real, es decir, de la observación durante una sesión de preparación de examen de los estudiantes, en la cual se emplearon protocolos verbales para dar cuenta de lo que «pasaba por su mente» mientras estudiaban. Una entrevista semi-estructurada y una prueba objetiva. Los resultados fueron analizados a la luz del modelo mixto de procesamiento de información y constructivismo abordado por Winne(1998. Como resultado se encontró una relación significativa entre los niveles de desempeño en el proceso de ARR y el resultado del examen. Igualmente se encontraron bajos niveles de regulación en una parte importante de la muestra y un desfase significativo entre conocimiento declarativo de ARR y desempeño en el mismo

  19. ABRUPTIO PLACENTAE*

    African Journals Online (AJOL)

    1971-05-01

    May 1, 1971 ... Artificial rupture of membranes and the administration of Syntocinon 5 U in an intravenous drip formed a basic part of the therapy. Prolongation of the interval between artificial rupture of the membranes and delivery. 'Date received: 24 .... rhage is due to atony of the uterine muscle which is caused by the ...

  20. ABRUPTIO PLACENTAE*

    African Journals Online (AJOL)

    1971-05-01

    May 1, 1971 ... 1968) 1 228 patients presented with this complication and were treated in the .... The external blood loss was not marked, but all com- plained of ... patients, internal version and breech extraction was per- formed because of ...

  1. Early growth response protein 1 (EGR1) regulates pro-inflammatory gene expression in response to palmitate and TNF alpha in human placenta cells and is induced in obese placenta

    Science.gov (United States)

    Maternal obesity has been hypothesized to induce a pro-inflammatory response in the placenta. However, the specific factors contributing to this pro-infalmmatory response are yet to be determined. Our objective was to examine the effects of palmitic acid (PA), tumor necrosis factor alpha (TNF alph...

  2. Puentes con vigas pretensadas

    Directory of Open Access Journals (Sweden)

    Editorial, Equipo

    1965-07-01

    Full Text Available This paper describes one of the three bridges which Hidrocivil, S. A., has built in Catalonia (northern Spain, over the river Ripoll. The other two bridges are very similar to this one, both in construction and design, and show only minor adjustments to the local topography. The contracting firm proposed several alterations in the prefabrication and constructional procedure, in relation to the initial project, and these changes were accepted. The main feature of these projects is the use of prestressed beams, built at the workshop in sections, and joined together by means of sixty 7 mm cables in each beam. As the shear forces are more acute at the joints, the end of each section has a kind of diaphragm, to provide a large contact area, and hence greater surface to transmit the shear forces. The methods of construction are also of interest. Briefly, they involve building the bridge piles, and use these to support a provisional structure with transversal movement. This provisional structure, in turn, served as platform for two bridge cranes, which lifted the girders to their final location. After the first span was completed, the deck was concreted and the auxiliary structure pushed forward to the next span, to repeat the same operations. This arrangement saved the use of provisional framework.En este trabajo se describe uno de los tres puentes que Hidrocivil, S. A., ha construido.—previo concurso— en la región catalana; concretamente, el que salva el río Ripoll. Los otros dos no han sido objeto de descripción general por ser muy similares, en lo que a ejecución y concepción se refiere, con la única variante que presentan las características topográficas locales. La empresa propuso ciertas variantes— que fueron aceptadas— en la prefabricación y métodos de construcción. El interés de estas obras se centra en el empleo de vigas pretensadas, prefabricadas en taller por trozos, y solidarizados en el mismo mediante las operaciones

  3. Violencia con el anciano

    Directory of Open Access Journals (Sweden)

    Rita Campillo Motilva

    2002-08-01

    Full Text Available La violencia doméstica es tan antigua como la humanidad misma y se reconocen la violencia infantil, contra la mujer y al anciano, fundamentalmente; siendo este último grupo una población en ascenso por las mayores expectativas de vida de los últimos años. Como resultado de ello, el número de casos de abuso en el anciano se incrementará y el impacto de este abuso sobre la salud debe ser considerado de forma adecuada. La gama de maltratos es variadísima e incluye el abuso físico, emocional, financiero, sexual, por negligencia, negación a brindarle ayuda y otras formas más. Los ancianos con deterioro cognitivo son los más vulnerables. El médico en la atención primaria de salud es un pilar importante en la prevención y educación de este problema.Domestic violence is as old as humanity itself. Child, women and elderly abuse are mainly recognized. The elderly group is increasing due to the higher life expectancy experimented during the last years. As a result, the number of battered elderly will grow and the impact of this abuse on health should be adequately considered. The range of abuse is very wide and it includes physical, emotional, financial and sexual abuse, negligence, rejection to give assistance and others. The elderly with cognitive deterioration are the most vulnerable. The physician at the primary health care level is an important milestone in the prevention and education of this problem.

  4. Arf and RhoA regulate both the cytosolic and the membrane-bound phospholipase D from human placenta

    DEFF Research Database (Denmark)

    Vinggaard, Anne Marie; Hansen, Harald S.; Provost, J.J.

    1997-01-01

    placenta, which is stimulated by PIP, but not by oleate. Here we show that oleic acid and a-linolenic acid both dose-dependently inhibited solubilized membrane PLD (65% inhibition at 4 mM), whereas stearic acid (4 mM) had no effect. Thus, the presence of double bonds in the fatty acid is important...

  5. Energy Balance Regulating Neuropeptides Are Expressed through Pregnancy and Regulated by Interleukin-6 Deficiency in Mouse Placenta.

    Science.gov (United States)

    Pazos, Patricia; Lima, Luis; Diéguez, Carlos; García, María C

    2014-01-01

    The placenta produces a number of signaling molecules including metabolic and reproductive hormones as well as several inflammatory mediators. Among them, Interleukin-6 (IL-6), a well-known immune and metabolic regulator, acts peripherally modulating metabolic function and centrally increasing energy expenditure and reducing body fat. IL-6 interacts with key hypothalamic neuropeptidergic systems controlling energy homeostasis such as those producing the orexigenic/anabolic: neuropeptide Y (NPY) and agouti-related peptide (AgRP) and anorectic/catabolic neuropeptides: proopiomelanocortin (POMC) and cocaine and amphetamine regulated transcript (CART). Human and rat placenta have been identified as source of these neuropeptides, but their expression and regulation in murine placental tissues remain unknown. Therefore, placental mRNA levels of IL-6, NPY, AgRP, POMC, and CART at different pregnancy stages (gestational days 13, 15, and 18) were analyzed by real time PCR, as were the effect of IL-6 deficiency (IL-6 knockout mice) on their placental expression. Our results showed that placenta-derived neuropeptides were regulated by gestational age and IL-6 throughout the second half of mouse pregnancy. These data suggest that IL-6 may participate in the fine tune control of energy balance during pregnancy by extending its action as a metabolic signal to the main organ at the fetomaternal interface: the placenta.

  6. Energy Balance Regulating Neuropeptides Are Expressed through Pregnancy and Regulated by Interleukin-6 Deficiency in Mouse Placenta

    Directory of Open Access Journals (Sweden)

    Patricia Pazos

    2014-01-01

    Full Text Available The placenta produces a number of signaling molecules including metabolic and reproductive hormones as well as several inflammatory mediators. Among them, Interleukin-6 (IL-6, a well-known immune and metabolic regulator, acts peripherally modulating metabolic function and centrally increasing energy expenditure and reducing body fat. IL-6 interacts with key hypothalamic neuropeptidergic systems controlling energy homeostasis such as those producing the orexigenic/anabolic: neuropeptide Y (NPY and agouti-related peptide (AgRP and anorectic/catabolic neuropeptides: proopiomelanocortin (POMC and cocaine and amphetamine regulated transcript (CART. Human and rat placenta have been identified as source of these neuropeptides, but their expression and regulation in murine placental tissues remain unknown. Therefore, placental mRNA levels of IL-6, NPY, AgRP, POMC, and CART at different pregnancy stages (gestational days 13, 15, and 18 were analyzed by real time PCR, as were the effect of IL-6 deficiency (IL-6 knockout mice on their placental expression. Our results showed that placenta-derived neuropeptides were regulated by gestational age and IL-6 throughout the second half of mouse pregnancy. These data suggest that IL-6 may participate in the fine tune control of energy balance during pregnancy by extending its action as a metabolic signal to the main organ at the fetomaternal interface: the placenta.

  7. Is there any difference between preeclamptic and healthy pregnant women regarding the presence of periopathogenic bacteria in the placenta?

    Directory of Open Access Journals (Sweden)

    Fateme Mostajeran

    2013-01-01

    Full Text Available Background: Preeclampsia is an important cause of maternal morbidity and mortality with unclear cause. It is believed that inflammation plays an important role in the pathogenesis of preeclampsia. Periodontal disease is a chronic inflammatory infectious condition which commonly involves humans. Recently, chronic infection was linked to atherosclerosis. Atherosclerosis shares some histopathologic features with uteroplacental atherosis of preeclamptic women. This study was aimed to investigate the presence of periopathogenic bacteria in the placental tissue of preeclamptic women, and compare it with women with normal pregnancy. Methods: Samples were obtained from 23 placentas of preeclamptic women and from 23 age-matched healthy pregnant women. Qualitative polymerase chain reaction was performed to detect the presence of five periopathogenic bacteria. Results: There was no significant difference between the two groups regarding the relative frequency of women with different types of periopathogenic bacterial infection of the placenta. In addition, there was no significant difference in the number of women with any type of infection of the placenta (regardless of the type of periopathogenic bacteria [14 (61% mothers with placental infection in the case group vs. 18 (78% mothers in the control group, P value = 0.16]. Conclusions: This study did not show any significant difference between preeclamptic women and healthy women with normal pregnancy regarding the periopathogenic bacterial profile of the placenta.

  8. Capsaicin Synthesis Requires in Situ Phenylalanine and Valine Formation in in Vitro Maintained Placentas from Capsicum chinense

    Directory of Open Access Journals (Sweden)

    Fray M. Baas-Espinola

    2016-06-01

    Full Text Available Capsaicinoids (CAP are nitrogenous metabolites formed from valine (Val and phenylalanine (Phe in the placentas of hot Capsicum genotypes. Placentas of Habanero peppers can incorporate inorganic nitrogen into amino acids and have the ability to secure the availability of the required amino acids for CAP biosynthesis. In order to determine the participation of the placental tissue as a supplier of these amino acids, the effects of blocking the synthesis of Val and Phe by using specific enzyme inhibitors were analyzed. Isolated placentas maintained in vitro were used to rule out external sources′ participation. Blocking Phe synthesis, through the inhibition of arogenate dehydratase, significantly decreased CAP accumulation suggesting that at least part of Phe required in this process has to be produced in situ. Chlorsulfuron inhibition of acetolactate synthase, involved in Val synthesis, decreased not only Val accumulation but also that of CAP, pointing out that the requirement for this amino acid can also be fulfilled by this tissue. The presented data demonstrates that CAP accumulation in in vitro maintained placentas can be accomplished through the in situ availability of Val and Phe and suggests that the synthesis of the fatty acid chain moiety may be a limiting factor in the biosynthesis of these alkaloids.

  9. EphA2 is a biomarker of hMSCs derived from human placenta and umbilical cord

    Directory of Open Access Journals (Sweden)

    Shih-Pei Shen

    2015-12-01

    Conclusion: EphA2 can be used to distinguish and isolate MSCs from a primary culture of placenta-derived cells. EphA2-sorted MSCs exhibited superior responsiveness to TNF-α signaling in an inflammatory environment compared with unsorted MSCs or MSC-like cells.

  10. Early changes of placenta-derived messenger RNA in maternal plasma – potential value for preeclampsia prediction?

    Directory of Open Access Journals (Sweden)

    Surugiu Sebastian

    2015-12-01

    Full Text Available Objective: the pourpose of the study was to determine if there are any differences between placenta derived plasmatic levels of messenger RNA in normal and future preeclamptic pregnancies and if these placental transcripts can predict preeclampsia long before clinical onset

  11. Significant alteration of gene expression in wood decay fungi Postia placenta and Phanerochaete chrysosporium by plant species

    Science.gov (United States)

    Amber Vanden Wymelenberg; Jill Gaskell; Michael Mozuch; Sandra Splinter BonDurant; Grzegorz Sabat; John Ralph; Oleksandr Skyba; Shawn D. Mansfield; Robert A. Blanchette; Igor Grigoriev; Philip J. Kersten; Daniel Cullen

    2011-01-01

    Identification of specific genes and enzymes involved in conversion of lignocellulosics from an expanding number of potential feedstocks is of growing interest to bioenergy process development. The basidiomycetous wood decay fungi Phanerochaete chrysosporium and Postia placenta are promising in this regard because they are able to utilize a wide range of simple and...

  12. Microarray-Based Analysis of Methylation of 1st Trimester Trisomic Placentas from Down Syndrome, Edwards Syndrome and Patau Syndrome

    DEFF Research Database (Denmark)

    Hatt, Lotte; Aagaard, Mads M; Bach, Cathrine

    2016-01-01

    Methylation-based non-invasive prenatal testing of fetal aneuploidies is an alternative method that could possibly improve fetal aneuploidy diagnosis, especially for trisomy 13 (T13) and trisomy 18(T18). Our aim was to study the methylation landscape in placenta DNA from trisomy 13, 18 and 21 pre...

  13. Prognostic impact of placenta growth factor and vascular endothelial growth factor A in patients with breast cancer

    DEFF Research Database (Denmark)

    Maae, Else; Olsen, Dorte Aalund; Steffensen, Karina Dahl

    2012-01-01

    Placenta growth factor (PlGF) and vascular endothelial growth factor A (VEGF-A) are angiogenic growth factors interacting competitively with the same receptors. VEGF-A is essential in both normal and pathologic conditions, but the functions of PlGF seem to be restricted to pathologic conditions s...

  14. Utility of diffusion-weighted MR imaging in the diagnosis of placenta accreta spectrum abnormality.

    Science.gov (United States)

    Sannananja, Bhagya; Ellermeier, Anna; Hippe, Daniel S; Winter, Thomas C; Kang, Stella K; Lee, Susanna I; Kilgore, Mark R; Dighe, Manjiri K

    2018-04-17

    The aim of this study was to evaluate the utility of added DWI sequences as an adjunct to traditional MR imaging in the evaluation of abnormal placentation in patients with suspicion for placenta accreta spectrum abnormality or morbidly adherent placenta (MAP). The study was approved by local ethics committee. The subjects included pregnant women with prenatal MRI performed between July 2013 to July 2015. All imaging was performed on a Philips 1.5T MR scanner using pelvic phased-array coil. Only T2-weighted and diffusion-weighted imaging (DWI) series were compiled for review. Two randomized imaging sets were created: set 1 included T2-weighted series only (T2W); set 2 included T2W with DWI series together (T2W + DWI). Three radiologists, blinded to history and pathology, reviewed the imaging, with 2 weeks of time between the two image sets. Sensitivity, specificity, and overall accuracy for MAP were calculated and compared between T2W only and T2W + DWI reads. Associations between imaging findings and invasion on pathology were tested using the Chi-squared test. Confidence scores, inter-reader agreement, and systematic differences were documented. A total of 17 pregnant women were included in the study. 8 cases were pathologically diagnosed with MAP. There were no significant differences in the diagnostic accuracy between T2W and T2W + DWI in the diagnosis of MAP in terms of overall accuracy (62.7% for T2W vs. 68.6% for T2W + DWI, p = 0.68), sensitivity (70.8% for T2W vs. 95.8% for T2W + DWI, p = 0.12), and specificity (55.6% for T2W vs. 44.4% for T2W + DWI, p = 0.49). There was no significant difference in the diagnostic confidence between the review of T2W images alone and the T2W + DWI review (mean 7.3 ± 1.8 for T2W vs. 7.5 ± 1.8 for T2W + DWI, p = 0.37). With the current imaging technique, addition of DWI sequence to the traditional T2W images cannot be shown to significantly increase the accuracy or

  15. Assessment of ABCG2-mediated transport of pesticides across the rabbit placenta barrier using a novel MDCKII in vitro model

    International Nuclear Information System (INIS)

    Halwachs, Sandra; Schäfer, Ingo; Kneuer, Carsten; Seibel, Peter; Honscha, Walther

    2016-01-01

    In humans, the ATP-binding cassette efflux transporter ABCG2 contributes to the fetoprotective barrier function of the placenta, potentially limiting the toxicity of transporter substrates to the fetus. During testing of chemicals including pesticides, developmental toxicity studies are performed in rabbit. Despite its toxicological relevance, ABCG2-mediated transport of pesticides in rabbit placenta has not been yet elucidated. We therefore generated polarized MDCK II cells expressing the ABCG2 transporter from rabbit placenta (rbABCG2) and evaluated interaction of the efflux transporter with selected insecticides, fungicides, and herbicides. The Hoechst H33342 accumulation assay indicated that 13 widely used pesticidal active substances including azoxystrobin, carbendazim, chlorpyrifos, chlormequat, diflufenican, dimethoate, dimethomorph, dithianon, ioxynil, methiocarb, propamocarb, rimsulfuron and toclofos-methyl may be rbABCG2 inhibitors and/or substrates. No such evidence was obtained for chlorpyrifos-methyl, epoxiconazole, glyphosate, imazalil and thiacloprid. Moreover, chlorpyrifos (CPF), dimethomorph, tolclofos-methyl and rimsulfuron showed concentration-dependent inhibition of H33342 excretion in rbABCG2-transduced MDCKII cells. To further evaluate the role of rbABCG2 in pesticide transport across the placenta barrier, we generated polarized MDCKII-rbABCG2 monolayers. Confocal microscopy confirmed correct localization of rbABCG2 protein in the apical plasma membrane. In transepithelial flux studies, we showed the time-dependent preferential basolateral to apical (B > A) directed transport of [ 14 C] CPF across polarized MDCKII-rbABCG2 monolayers which was significantly inhibited by the ABCG2 inhibitor fumitremorgin C (FTC). Using this novel in vitro cell culture model, we altogether showed functional secretory activity of the ABCG2 transporter from rabbit placenta and identified several pesticides like the insecticide CPF as potential rbABCG2 substrates

  16. Assessment of ABCG2-mediated transport of pesticides across the rabbit placenta barrier using a novel MDCKII in vitro model

    Energy Technology Data Exchange (ETDEWEB)

    Halwachs, Sandra [Institute of Pharmacology, Pharmacy and Toxicology, Faculty of Veterinary Medicine, Universität Leipzig, Leipzig (Germany); Schäfer, Ingo [Molecular Cell Therapy, Center for Biotechnology and Biomedicine, Faculty of Medicine, Universität Leipzig, Leipzig (Germany); Kneuer, Carsten [Federal Institute for Risk Assessment (BfR), Pesticide Safety, Max-Dohrn-Straße 8-10, D-10589 Berlin (Germany); Seibel, Peter [Molecular Cell Therapy, Center for Biotechnology and Biomedicine, Faculty of Medicine, Universität Leipzig, Leipzig (Germany); Honscha, Walther, E-mail: honscha@vetmed.uni-leipzig.de [Institute of Pharmacology, Pharmacy and Toxicology, Faculty of Veterinary Medicine, Universität Leipzig, Leipzig (Germany)

    2016-08-15

    In humans, the ATP-binding cassette efflux transporter ABCG2 contributes to the fetoprotective barrier function of the placenta, potentially limiting the toxicity of transporter substrates to the fetus. During testing of chemicals including pesticides, developmental toxicity studies are performed in rabbit. Despite its toxicological relevance, ABCG2-mediated transport of pesticides in rabbit placenta has not been yet elucidated. We therefore generated polarized MDCK II cells expressing the ABCG2 transporter from rabbit placenta (rbABCG2) and evaluated interaction of the efflux transporter with selected insecticides, fungicides, and herbicides. The Hoechst H33342 accumulation assay indicated that 13 widely used pesticidal active substances including azoxystrobin, carbendazim, chlorpyrifos, chlormequat, diflufenican, dimethoate, dimethomorph, dithianon, ioxynil, methiocarb, propamocarb, rimsulfuron and toclofos-methyl may be rbABCG2 inhibitors and/or substrates. No such evidence was obtained for chlorpyrifos-methyl, epoxiconazole, glyphosate, imazalil and thiacloprid. Moreover, chlorpyrifos (CPF), dimethomorph, tolclofos-methyl and rimsulfuron showed concentration-dependent inhibition of H33342 excretion in rbABCG2-transduced MDCKII cells. To further evaluate the role of rbABCG2 in pesticide transport across the placenta barrier, we generated polarized MDCKII-rbABCG2 monolayers. Confocal microscopy confirmed correct localization of rbABCG2 protein in the apical plasma membrane. In transepithelial flux studies, we showed the time-dependent preferential basolateral to apical (B > A) directed transport of [{sup 14}C] CPF across polarized MDCKII-rbABCG2 monolayers which was significantly inhibited by the ABCG2 inhibitor fumitremorgin C (FTC). Using this novel in vitro cell culture model, we altogether showed functional secretory activity of the ABCG2 transporter from rabbit placenta and identified several pesticides like the insecticide CPF as potential rbABCG2

  17. Moléculas que participan en el transporte de hierro materno-fetal: importancia del receptor 1 de transferrina y de la ferroportina en la placenta humana = Molecules implicated in maternal-fetal iron transport across the placental barrier: Role of Transferrin Receptor 1 and Ferroportin

    Directory of Open Access Journals (Sweden)

    Corrales Agudelo, Lady Vanessa

    2011-03-01

    Full Text Available La adecuada transferencia placentaria de hierro es crucial para satisfacer los altos requerimientos del feto y promover su adecuado crecimiento y desarrollo intrauterino; de otra parte, contribuye a prevenir la ferropenia y la anemia, entidades altamente prevalentes en los lactantes durante los primeros dos años de edad, que se asocian con mayor morbilidad y mortalidad en la infancia. La placenta es un órgano capaz de realizar diferentes adaptaciones en la producción de moléculas que participan en el transporte de hierro materno-fetal en respuesta al estado de hierro celular, para proveer la mayor disponibilidad de este mineral al feto. Esta revisión, pretende acercar al lector a los mecanismos metabólicos y moleculares relacionados con la captación, el transporte y la salida de hierro por la placenta hacia el feto, así como su regulación, para proporcionar elementos que le permitan comprender en forma integrada, la importancia de un adecuado estado de hierro materno antes y durante la gestación.

  18. Calcitonin-like immunoreactivity and calcitonin gene expression in the placenta and in the mammary gland of the rat

    Energy Technology Data Exchange (ETDEWEB)

    Jousset, V; Legendre, B; Besnard, P; Segond, N; Jullienne, A

    1988-01-01

    Recently, the presence of monomeric CT in plasma and milk was reported by others in a lactating woman surgically thyroidectomized. Similarly, the placenta was thought to be a possible source of CT. Since such findings were based exclusively on immunological arguments, we have investigated the CT gene expression in these rat tissues. CT mRNAs were detected by dot-blot hybridization of total RNAs extracted from rat tissues with a /sup 32/P-labelled human CT cDNa probe. Subcellular fractions of each tissue were screened for CT-like immunoreactivity using two different antibodies. With one antibody, extracts of the mammary gland and placenta both produced full displacement of labelled human CT from the antiserum and serial dilutions of the extracts gave displacement curves parallel to that of synthetic human CT, which suggests immunological similarity. However, dilution curves were not parallel for the second antibody, and for both antisera, CT-like immunoreactivity was found in all subsellular fractions from nuclei to cytosols. Immunoprecipitation of translation products from poly (A)/sup +/RNAs of placenta showed two major bands around 30 kD. Under stringent conditions, the weak hybridization of placental RNAs seen by dot-blot under less stringent conditions disappeared. Northern analyses of total RNAs from the placenta failed to detect mRNA of 1 k base size like in thyroid glands, but hybridization under weak stringent conditions occurred with larger mRNAs (around 4.4 and 2.4 k bases). Immunoprecipitation of translation products from mRNAs of rat mammary glands showed three major bands around 46, 30 and 20 kD. Our results suggest that the CT gene is not expressed in the rat placenta and in rat mammary gland, since CT mRNAs were not detected in either tissues. (EB).

  19. Impact of targeted scanning protocols on perinatal outcomes in pregnancies at risk of placenta accreta spectrum or vasa previa.

    Science.gov (United States)

    Melcer, Yaakov; Jauniaux, Eric; Maymon, Shlomit; Tsviban, Anna; Pekar-Zlotin, Marina; Betser, Moshe; Maymon, Ron

    2018-04-01

    Placenta accreta spectrum and vasa previa (VP) are congenital disorders of placentation associated with high morbidity and mortality for both mothers and newborns when undiagnosed before delivery. Prenatal diagnosis of these conditions is essential to allow multidisciplinary management and thus improve perinatal outcomes. The objective of the study was to compare perinatal outcome in women with placenta accreta spectrum or vasa previa before and after implementation of targeted scanning protocols. This retrospective study included 2 nonconcurrent cohorts for each condition before and after implementation of the corresponding protocols (2004-1012 vs 2013-2016 for placenta accreta spectrum and 1988-2007 vs 2008-2016 for vasa previa). Clinical reports of women diagnosed with placenta accreta spectrum and vasa previa during the study periods were reviewed and outcomes were compared. In total, there were 97 cases of placenta accreta spectrum and 51 cases with vasa previa, all confirmed at delivery. In both cohorts, the prenatal detection rate increased after implementation of the scanning protocols (28 of 65 cases [43.1%] vs 31 of 32 cases [96.9%], P accreta spectrum and 9 of 18 cases [50%] vs 29 of 33 cases [87.9%], 87.9%, P accreta spectrum cohort, the estimated blood loss and the postoperative hospitalization stay decreased between periods (1520 ± 845 vs 1168 ± 707 mL, P accreta spectrum and vasa previa was associated with improved maternal and neonatal outcomes. The continuous increases in the rates of caesarean deliveries and use of assisted reproductive technology highlights the need to develop training programs and introduce targeted scanning protocols at the national and international levels. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Cigarette smoking during pregnancy regulates the expression of specific nicotinic acetylcholine receptor (nAChR) subunits in the human placenta

    Energy Technology Data Exchange (ETDEWEB)

    Machaalani, R., E-mail: rita.machaalani@sydney.edu.au [Department of Medicine, The University of Sydney, NSW 2006 (Australia); Bosch Institute, The University of Sydney, NSW 2006 (Australia); The Children' s Hospital at Westmead, NSW 2145 (Australia); Ghazavi, E. [Bosch Institute, The University of Sydney, NSW 2006 (Australia); School of Medical Sciences (Pharmacology), The University of Sydney, NSW 2006 (Australia); Hinton, T. [School of Medical Sciences (Pharmacology), The University of Sydney, NSW 2006 (Australia); Waters, K.A. [Department of Medicine, The University of Sydney, NSW 2006 (Australia); The Children' s Hospital at Westmead, NSW 2145 (Australia); Hennessy, A. [School of Medicine, University of Western Sydney, NSW 2751 (Australia); Heart Research Institute, 7 Eliza St Newtown, NSW 2042 (Australia)

    2014-05-01

    Smoking during pregnancy is associated with low birth weight, premature delivery, and neonatal morbidity and mortality. Nicotine, a major pathogenic compound of cigarette smoke, binds to the nicotinic acetylcholine receptors (nAChRs). A total of 16 nAChR subunits have been identified in mammals (9 α, 4 β, and 1 δ, γ and ε subunits). The effect of cigarette smoking on the expression of these subunits in the placenta has not yet been determined, thus constituting the aim of this study. Using RT-qPCR and western blotting, this study investigated all 16 mammalian nAChR subunits in the normal healthy human placenta, and compared mRNA and protein expressions in the placentas from smokers (n = 8) to controls (n = 8). Our data show that all 16 subunit mRNAs are expressed in the normal, non-diseased human placenta and that the expression of α2, α3, α4, α9, β2 and β4 subunits is greater than the other subunits. For mRNA, cigarette smoke exposure was associated with increased expression of the α9 subunit, and decreased expression of the δ subunit. At the protein level, expression of both α9 and δ was increased. Thus, cigarette smoking in pregnancy is sufficient to regulate nAChR subunits in the placenta, specifically α9 and δ subunits, and could contribute to the adverse effects of vasoconstriction and decreased re-epithelialisation (α9), and increased calcification and apoptosis (δ), seen in the placentas of smoking women. - Highlights: • All 16 mammalian nAChR subunits are expressed in the human placenta. • Cigarette smoking increases α9 mRNA and protein in the placenta. • Cigarette smoking decreases δ mRNA but increases δ protein in the placenta.