Chronic fetal and maternal instrumentation in pregnant sheep: Effect on gestation length and birthweight

2010 ◽  
Vol 22 (2) ◽  
pp. 459 ◽  
Author(s):  
Natalee W. Bessette ◽  
Dan W. Rurak
Keyword(s):  
Preterm Birth ◽  
Linear Relationship ◽  
Severity Score ◽  
Surgical Intervention ◽  
Gestation Length ◽  
Maternal Complication ◽  
Significant Incidence ◽  
Pregnant Sheep ◽  
Fetal Complications ◽  
Potential Factors

The objective was to compare gestation length in chronically instrumented (laboratory) pregnant sheep (n = 131) and in the breeding flock (n = 476) that provided the experimental sheep. In the breeding flock, gestation length was normally distributed and varied between 141 and 151 days (mean = 147 ± 0.1 days). In the laboratory sheep, gestation length varied between 128 and 151 days (mean = 142 ± 1 day), and was bimodal, with 35.9% delivering preterm (<141 days). To examine potential factors that contributed to the preterm birth, a severity score was used, which comprised surgery characteristics, number of experiments and maternal or fetal complications. There was a significant inverse linear relationship (P < 0.001) between the total severity score and gestation length. The median values for the surgical (15 v. 12), overall complication (6 v. 2), maternal complication (2 v. 0) and fetal complication (2 v. 2) components were significantly greater in the preterm compared with the term groups. There was no relationship between fetal number and gestation length in either group. It is concluded that in chronic pregnant sheep preparations, there is a significant incidence of preterm birth and that this is associated with the severity of the surgical intervention and with several maternal and fetal complications.

National Guidance Updated on Multiple Birth Pregnancies

2019 ◽  
Vol 7 (9) ◽  
pp. 428-428
Keyword(s):  
Preterm Birth ◽  
Multiple Birth ◽  
Birth Timing ◽  
Intrapartum Care ◽  
National Guidance ◽  
Fetal Complications

The National Institute for Health and Care Excellence has reviewed the evidence and made new recommendations on fetal complications, preterm birth, timing of birth and intrapartum care for multiple birth pregnancies

Car Surfing: Case Studies of a Growing Dangerous Phenomenon

2008 ◽  
Vol 74 (3) ◽  
pp. 260-261
Author(s):  
Steven Clark ◽  
Alicia Mangram ◽  
Ernest Dunn
Keyword(s):  
Injury Severity Score ◽  
Severity Score ◽  
Injury Severity ◽  
Surgical Intervention ◽  
Ventilatory Support ◽  
Retrospective Chart Review ◽  
Severe Injuries ◽  
Revised Trauma Score ◽  
Urban Level ◽  
Trauma Score

Car surfing is a dangerous new pastime for American youth. Car surfing is an activity that is defined as standing (or lying) on a vehicle while it is being driven. This activity frequently results in severe injuries that often require significant surgical intervention. Despite its destructive nature, however, there are many Internet sites that encourage this behavior and view it as amusing. As a result, car surfing is becoming increasingly popular. We conducted a retrospective chart review of all patients injured as a result of car surfing over the last 4 years at our Urban Level II trauma center. Data collected included Injury Severity Score (ISS), Revised Trauma Score (RTS), age, gender, injury pattern, surgical intervention, and length of stay. Eight car surfers were identified. The average age was 17. The average Revised Trauma Score was 6.8 with an average Injury Severity Score of 16.9. Five patients were admitted to the intensive care unit. Four of these five patients needed to be intubated for ventilatory support. Five of the eight patients had significant intracranial injuries. Two patients had epidural hematomas that required evacuation. Two other patients had subdural hematomas that were treated nonoperatively, and one patient had a subarachnoid hemorrhage that was also treated nonoperatively. Four of the eight patients required surgical intervention. There were no deaths in this study. Car surfing leads to severe injuries that can result in significant morbidity. American youth have access to Internet sites that project this activity as an acceptable behavior. Five of our eight patients had a significant intra-cranial injury. Trauma surgeons need to be more aware of this injury phenomenon.

scholarly journals Uterine Deletion of Trp53 Compromises Antioxidant Responses in the Mouse Decidua

Endocrinology ◽  
2012 ◽  
Vol 153 (9) ◽  
pp. 4568-4579 ◽  
Author(s):  
Kristin E. Burnum ◽  
Yasushi Hirota ◽  
Erin S. Baker ◽  
Mikihiro Yoshie ◽  
Yehia M. Ibrahim ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Antioxidant Enzymes ◽  
Preterm Birth ◽  
Global Health ◽  
P53 Protein ◽  
Terminal Differentiation ◽  
Down Regulation ◽  
Antioxidant Responses ◽  
Global Health Issue ◽  
Potential Factors

Preterm birth is a global health issue impacting millions of mothers and babies. However, the etiology of preterm birth is not clearly understood. Our recent finding that premature decidual senescence with terminal differentiation is a cause of preterm birth in mice with uterine Trp53 deletion, encoding p53 protein, led us to explore other potential factors that are related to preterm birth. Using proteomics approaches, here, we show that 183 candidate proteins show significant changes in deciduae with Trp53 deletion as compared with normal deciduae. Functional categorization of these proteins unveiled new pathways that are influenced by p53. In particular, down-regulation of a cluster of antioxidant enzymes in p53-deficient deciduae suggests that increased oxidative stress could be one cause of preterm birth in mice harboring uterine deletion of Trp53.

scholarly journals Evolutionary transcriptomics implicates HAND2 in the origins of implantation and regulation of gestation length

eLife ◽  
2021 ◽  
Vol 10 ◽  
Author(s):  
Mirna Marinić ◽  
Katelyn Mika ◽  
Sravanthi Chigurupati ◽  
Vincent J Lynch
Keyword(s):  
Preterm Birth ◽  
Menstrual Cycle ◽  
Cell Types ◽  
Estrogen Signaling ◽  
Gestation Length ◽  
Stromal Fibroblasts ◽  
Extravillous Cytotrophoblasts ◽  
Length Regulation ◽  
Blastocyst Implantation ◽  
Maternal Fetal Interface

The developmental origins and evolutionary histories of cell types, tissues, and organs contribute to the ways in which their dysfunction produces disease. In mammals, the nature, development and evolution of maternal-fetal interactions likely influence diseases of pregnancy. Here we show genes that evolved expression at the maternal-fetal interface in Eutherian mammals play essential roles in the evolution of pregnancy and are associated with immunological disorders and preterm birth. Among these genes is HAND2, a transcription factor that suppresses estrogen signaling, a Eutherian innovation allowing blastocyst implantation. We found dynamic HAND2 expression in the decidua throughout the menstrual cycle and pregnancy, gradually decreasing to a low at term. HAND2 regulates a distinct set of genes in endometrial stromal fibroblasts including IL15, a cytokine also exhibiting dynamic expression throughout the menstrual cycle and gestation, promoting migration of natural killer cells and extravillous cytotrophoblasts. We demonstrate that HAND2 promoter loops to an enhancer containing SNPs implicated in birth weight and gestation length regulation. Collectively, these data connect HAND2 expression at the maternal-fetal interface with evolution of implantation and gestational regulation, and preterm birth.

scholarly journals Uncommon etiology of a common presentation

2021 ◽  
Vol 8 (3) ◽  
pp. 585
Author(s):  
Akila Venkatkrishnan ◽  
Suresh Chelliah ◽  
Meganathan Pachamuthu ◽  
Sathia Dev Jayabalan
Keyword(s):  
Bowel Obstruction ◽  
Severity Score ◽  
Rare Case ◽  
Surgical Intervention ◽  
Common Cause ◽  
Documented Case ◽  
Common Presentation

Intussusception is the most common cause of bowel obstruction in infants. The authors present a rare case of intussusception in a SARS-CoV-2 positive infant, and a severity score of 5 on HRCT. This is the first documented case of survival in SARS-CoV-2 patient where intussusception was the primary manifestation, which required surgical intervention.  

scholarly journals Pregnancy outcome and its relationship to progression of renal failure in autosomal dominant polycystic kidney disease.

1994 ◽  
Vol 5 (5) ◽  
pp. 1178-1185
Author(s):  
A B Chapman ◽  
A M Johnson ◽  
P A Gabow
Keyword(s):  
Kidney Disease ◽  
Polycystic Kidney Disease ◽  
Autosomal Dominant ◽  
Chronic Hypertension ◽  
Complication Rates ◽  
Polycystic Kidney ◽  
Maternal Complications ◽  
Maternal Complication ◽  
Fetal Complications ◽  
Autosomal Dominant Polycystic Kidney

The effect of pregnancy on renal disease has not been defined in autosomal dominant polycystic kidney disease (ADPKD). Therefore, fetal and maternal complication rates in ADPKD women as compared with those in unaffected family members (NADPKD) were assessed. Two hundred thirty-five ADPKD and 108 NADPKD women with 605 and 244 pregnancies, respectively, were studied. Overall, fetal complication rates were similar between ADPKD and NADPKD women (32.6 versus 26.2%). Fetal complications were more common in ADPKD women when they were older than 30 yr. Increased fetal prematurity rates were found in preeclamptic ADPKD women as compared with normotensive ADPKD women (28 versus 10%; P < 0.01). More maternal complications occurred in ADPKD as compared with NADPKD women (35 versus 19%; P < 0.001), with preexisting hypertension being the most important risk factor for a maternal complication to occur. Normotensive ADPKD women who developed preeclampsia were more likely to develop chronic hypertension as compared with those without preeclampsia (89 versus 58%; P < 0.01). Hypertensive ADPKD women with four or more pregnancies had lower creatinine clearances than age-adjusted hypertensive ADPKD women with fewer than four pregnancies (49 +/- 5 versus 66 +/- 3 mL/min per 1.73 m2; P < 0.01). Therefore, normotensive ADPKD women usually have successful, uncomplicated pregnancies. However, hypertensive ADPKD women are at high risk for fetal and maternal complications and measures should be taken to prevent the development of preeclampsia in these women.

scholarly journals Evolutionary transcriptomics implicates HAND2 in the origins of implantation and regulation of gestation length

2020 ◽  
Author(s):  
Mirna Marinić ◽  
Katelyn Mika ◽  
Sravanthi Chigurupati ◽  
Vincent J. Lynch
Keyword(s):  
Preterm Birth ◽  
Menstrual Cycle ◽  
Target Genes ◽  
Cell Types ◽  
Estrogen Signaling ◽  
Gestation Length ◽  
Distal Enhancer ◽  
Stromal Fibroblasts ◽  
Organ Systems ◽  
Maternal Fetal Interface

AbstractThe developmental origins and evolutionary histories of cell types, tissues and organ systems contribute to the ways in which their dysfunction leads to disease. In mammals for example, the nature and extent of maternal-fetal interactions, how those interactions develop, and their evolutionary history likely influence diseases of pregnancy such as infertility and preterm birth. Here we show genes that evolved to be expressed at the maternal-fetal interface in Eutherian (‘Placental’) mammals play essential roles in the evolution of pregnancy and are associated with immune system disorders and preterm birth. Among these genes is the transcription factor HAND2, which suppresses estrogen signaling, an innovation of Eutherians, thereby allowing blastocyst implantation. We found that HAND2 is dynamically expressed in the decidua throughout the menstrual cycle and pregnancy, gradually decreasing to reach a low at term. HAND2 regulates a small but distinct set of target genes in endometrial stromal fibroblasts including the cytokine IL15, which was also dynamically expressed throughout the menstrual cycle and gestation, and promoted the migration of natural killer cells and extravillous cytotrophoblasts. Remarkably, we found that the HAND2 promoter loops to a distal enhancer containing SNPs implicated in the regulation of gestation length and birth weight. Collectively, these data connect HAND2 expression at the maternal-fetal interface with the evolution of implantation and gestation length regulation, and preterm birth.

scholarly journals To study the feto-maternal outcome in cases with previous surgical intervention for first trimester abortion on subsequent pregnancy and to compare with cases without history of previous abortion

2020 ◽  
Vol 9 (10) ◽  
pp. 4227
Author(s):  
Kritika Tanwar ◽  
Bani Sarkar ◽  
Anjali Chauhan
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Surgical Intervention ◽  
First Trimester ◽  
Subsequent Pregnancy ◽  
P Value ◽  
Trimester Abortion ◽  
Increased Risk ◽  
History Of ◽  
Surgical Abortion

Background: To study the Feto-maternal outcome in cases with previous surgical intervention for first trimester abortion on subsequent pregnancy and to compare with cases without history of previous abortion.Methods: A cross sectional observational study was conducted over a period of two years. Study included 80 consenting females at 28 weeks POG. Females with history of prior surgical abortion just before the present pregnancy were included as cases (n=40) and rest as controls (n=40). Detailed obstetric history was taken, subjects were then followed till delivery and feto-maternal outcomes such as period of gestation, mode of delivery birth weight, Apgar score, increased NICU stay at the time of delivery were recorded and analyzed.Results: We observed that the women with history of induced surgical abortion were at increased risk of Pre term birth (52.5%, p value0.006), Cesarean section (40%, p value 0.012), Low birth weight (47.5%, p value <0.001), increased NICU stay (32.5%, p value 0.027) compared to primi-gravida controls.Conclusions: We concluded that women with previous history of induced surgical abortions were at increased risk of preterm birth, very preterm birth and low birth weight babies, NICU stay in the subsequent pregnancies. The risk of caesarean was found to be increased in women with previous induced abortions exposing the women to the morbidity associated with the C-section. Hence patient with prior history of surgical first trimester abortion needs more vigilant monitoring during antenatal period in subsequent pregnancy.

scholarly journals Microalbuminuria as a Predictor of Pregnancy Induced Hypertension

2014 ◽  
Vol 9 (2) ◽  
pp. 42-45
Author(s):  
G Kour ◽  
S Kour
Keyword(s):  
Predictive Value ◽  
Pregnancy Induced Hypertension ◽  
Negative Group ◽  
Positive Group ◽  
Maternal Complication ◽  
A Value ◽  
Induced Hypertension ◽  
Fetal Complications

Aims: This study was done to find out predictive value of   microalbuminuria between 24-34 weeks of gestation in the development of pregnancy-induced hypertension, maternal and fetal complications. Methods: Urinary microalbuminuria was measured by turbidometry in 200 normo-tensive women between 24-34 weeks of gestation. Microalbuminuria was defined as a value of ≥ 20 mg albumin per gram of creatinine in a spot sample of urine. The women were divided into two groups as microalbuminuria positive and microalbuminuria negative. They were followed up to delivery and were evaluated for the development of pregnancy-induced hypertension, maternal and fetal complications. Results: Out of 200 women microalbuminuria was positive in 32 (16%) patients.  Sixteen (50%) in the microalbuminuria group developed hypertension as compared to seven (4.1%) in the microalbuminuria negative group (p<0.0001). Also 13 (40%) in the microalbuminuria positive group developed a maternal complication as compared to 11 (6.5%) in the microalbuminuria negative group (p<0.0001). Nineteen women (59%) in the microalbuminuria group had a fetal complication as compared to 10 women (5.9%) in the microalbuminuria negative group (p<0.0001). Conclusions: Presence of urinary microalbuminuria between 24-34 weeks of gestation can predict development of pregnancy-induced hypertension, maternal and fetal complications. DOI: http://dx.doi.org/10.3126/njog.v9i2.11761    

scholarly journals Evaluation of the Patients with Antenatal Hydronephrosis Diagnosed Ureteropelvic Junction Obstruction with the Hydronephrosis Severity Score

2021 ◽  
Author(s):  
Gökçen Erfidan ◽  
Eren Soyaltın ◽  
Tunç Özdemir ◽  
Secil Arslansoyu Çamlar ◽  
Demet Alaygut ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Severity Score ◽  
Ureteropelvic Junction Obstruction ◽  
Surgical Intervention ◽  
Outlet Obstruction ◽  
Case Series ◽  
Horseshoe Kidney ◽  
Ureteropelvic Junction ◽  
Ureterovesical Junction ◽  
Antenatal Hydronephrosis

Objective: Ureteropelvic junction obstruction is the main cause of obstructive antenatal hydronephrosis. Although surgery is the traditional treatment modality, there is still no consensus on surgical indications. We aimed to analyse the patients referred as antenatal hydronephrosis and diagnosed with ureteropelvic junction obstruction with Hydronehprosis Severity Score that has been developed by Babu at al. Method: The patients who were admitted with antenatal hydronephrosis in 2013-2018 and diagnosed as ureteropelvic junction obstruction and followed up in our clinic for at least one year were evaluated. The cases with unilateral hydronephrosis were included. Those with vesicoureteral reflux, horseshoe kidney, hydroureter, ureterovesical junction obstruction were excluded. Renal ultrasonography and nuclear scintigraphy results were re-evaluated. They were grouped as mild (0-4), moderate (5-8) and severe (9-12) based on scoring of three parameters; differantial renal function, drainage curve pattern and US grade. Clinical outcomes were also classified in three groups; resolution (grade 1-no hydronephrosis), persistance (grade 2-3 hydronephrosis) and surgical intervention. The relation between the scores and clinical outcomes were analysed. Results: A total of 57 patients were evaluated. 2 with horseshoe kidney, 4 with vesicoureteralreflux, 7 with bilateral hydronephrosis, 4 with ureteric outlet obstruction, 12 with incomplete records were excluded. Finally, 28 patients were included. Hydronephrosis was resolved in 4 (14.2%), persisted in 5 (17.8%) and surgical intervention was required in 19 (67.8%) patients. 1/5 patients with mild, 15/20 patients with moderate and 3/3 patients with severe HSS underwent surgery. 77.2% of the patients with a total score of ≥6 initially required surgical intervention at their follow-up. Conclusion: HSS may provide a significant predictive value for surgical intervention for the patients classified as “mild” or “severe” at the initial evaluation. In the “moderate” group, the risk increases in the patients with HSS≥6. Existing data should be evaluated with larger case series.

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