Detachment Of Placenta Research Articles

Comparison of vascular cell adhesion molecule 1 (VCAM-1) during pregnancy, after placental detachment and during puerperium between normal and pregnancy with COVID-19.

Pregnant women have a number of physiological changes that lower the immune responses to avoid embryonic rejection, which increases the risk of problems after contracting coronavirus disease 2019 (COVID-19). Multiple inflammatory cytokines are dysregulated in this process and expressed inappropriately during systemic inflammatory responses associated with COVID-19. The aim of the study was to compare the levels of vascular cell adhesion molecule 1 (VCAM-1), a marker of endothelial damage in pregnancies with and without COVID-19. A cohort prospective study was conducted at H. Adam Malik General Hospital and the Universitas Sumatera Utara Hospital, Indonesia. Pregnant women without COVID-19 and pregnant women with moderate and severe degrees of COVID-19 were recruited. The level of VCAM-1 was measured at three different time points (during pregnancy, within an hour of placental detachment, and 24 hours postpartum). The ANOVA and Student t-test were used to compare the VCAM-1 levels among different time points and between groups, respectively. The mean VCAM-1 levels at the hospital admission, one hour of placental detachment and 24 hours postpartum in non-COVID-19 and COVID-19 pregnancies were 591.29 vs 1176.27 pg/mL; 558.2 vs 1136.2 pg/mL; and 508.59 vs 985.2 pg/mL, respectively. There was a significant different in VCAM-1 levels in normal pregnancy at the time of hospital admission, one hour after detachment of the placenta and 24 hours postpartum (p=0.04). The mean VCAM-1 levels in pregnant women with COVID-19 also had significant differences between three time points (p=0.033). The levels of VCAM-1 were statically higher among pregnancy in the COVID-19 group compared to the non-COVID-19 group during hospital admission (p=0.023), one hour after placenta detachment (p=0.040) and 24 hours postpartum (p=0.043). The results suggested the usefulness of identifying the VCAM-1 level as a marker of endothelial dysfunction in pregnancy with COVID-19.

Marginal umbilical cord insertions in a bipartite placenta responsible for placenta abruption: a case report

Hemorrhage is one of the major causes of maternal death. Main causes of APH are placenta previa, placenta abruption and uterine rupture. Rare causes of placenta abruption include marginal and velamentous umbilical cord insertions. We hereby present a case of placenta abruption due to marginal umbilical cord insertions occurring on a bipartite placenta. A 40-year-old nulliparous African woman, 35 weeks pregnant consulted for dark red pervaginal bleeding, which occurred recently. Past history was unremarkable. Her pregnancy was well followed up. A recent ultrasound scan revealed a fundal inserted placenta. Physical examination revealed a fundal height of 37 cm, no uterine activity, normal fetal heart tones and a blood-stained vulva. Our diagnosis was a mild placenta abruption. An obstetrical ultrasound carried out revealed a normal pregnancy and a retroplacental blood clot of 11mm. A safe baby was born through an emergency cesarean section which revealed a normally inserted bipartite placenta with a 10% placenta detachment located on one placenta half and two cords inserted marginally. The postoperative period was uneventful and she was discharged five days after cesarean section. This case report shows that marginal cord insertion, which can lead to placenta abruption, can be also observed on a bipartite placenta.

UTERINE INVERSION DURING CESAREAN SECTION: A RARE PRESENTATION

INTRODUCTION: Uterine inversion is the collapse of uterine fundus into the endometrial cavity resulting in turning the uterus partially or completely inside out. Uterine inversion during cesarean section is an extremely rare obstetric complication and the exact incidence is not known. CASE DESCRIPTION: We report complete inversion of uterus in 38-year-old female, Gravida 2 Para 1+0, 38+0 weeks gestational age, admitted for elective lower segment cesarean section due to previous 1 scar. Delivery of the baby was uneventful. Complete inversion of uterus through uterine incision was noticed immediately after detachment of placenta. Oxytocin infusion was discontinued immediately, and uterine inversion was reversed manually by exteriorizing uterus and then making a fist and applying force on the fundus. Uterus was closed back in two layers, but it remained relaxed despite, massaging, oxytocin and sublingual misoprostol; therefore, modified B-lynch sutures were applied. This helped the patient to be prevented from any further complications. She was discharged as planned and was stable on follow up visits. CONCLUSION: Uterine inversion was promptly identified and corrected without any major complications.

The role of dermatopontin in cell adhesion in bovine placenta during early-mid pregnancy and parturition – Pilot study

Dermatopontin (DPT) is a small protein molecule thought to have a role in the formation of the extracellular architecture and adhesion. The aim of the study was to confirm the presence of DPT and to examine its role in placental cell adhesion during pregnancy, at parturition and postpartum in cows.Placental tissue samples were obtained at abattoir from healthy pregnant cows (n = 6) while parturient samples were collected during caesarian section and retrospectively divided into released up to 6 h (R; n = 5) and not released up to 6 h (NR; n = 4) foetal membranes. Maternal epithelial cells were isolated from pregnant samples and were used for the examination of the influence of DPT (5, 50 and 100 ng/mL) on cell adhesion. Parturient samples were manually divided into maternal and foetal part and individually homogenized for Western blotting and ELISA analysis.Western blotting confirmed the presence of DPT in examined tissues. ELISA test showed significant (p < 0.05) decrease in DPT concentration within examined pregnancy period with higher concentrations in maternal part (p < 0.05). Moreover, at parturition DPT concentration further decreased in maternal (p < 0.05) but increased (p < 0.05) in fetal part. The examination of not released samples showed opposite relationship in comparison to parturient samples – the increase in maternal (p < 0.05) and the decrease in fetal (p < 0.05) part of placenta. DPT facilitated the adhesion of epithelial cells in examined periods of pregnancy in increasing manner with pregnancy course.The presence of DPT in bovine placenta during pregnancy and parturition was confirmed. This protein may influence cell adhesion during attachment and detachment of placenta. Further studies on mechanisms of action of DPT in bovine placenta are necessary.

Pregnancy and childbirth with Shereshevsky–Turner syndrome, established at 12 years of age

The article presents a personal observation of the course of pregnancy and childbirth in a patient with a typical form of gonadal dysgenesis (ShereshevskyTurner syndrome, karyotype 45,X0/46,XY in the ratio of clones 1:1). The diagnosis was established at 12 years of age during an examination for growth retardation and lack of signs of puberty. Given the presence of a 46,XY clone in the karyotype, a high risk of malignization of dysgenetic gonads, laparoscopy and gonadectomy were performed at 12 years of age. Pregnancy occurred after preparation of the endometrium with estrogens and progestogens, as a result of the first in vitro fertilization attempt with a donor egg and her husbands sperm, occurred against the background of hormonal support with the threat of termination of pregnancy and hypercoagulation. At 34 weeks, there was a premature detachment of placenta, in connection with which she was delivered by cesarean section.

Therapeutic Implications of Inherited Thrombophilia in Pregnancy.

Inherited (hereditary) thrombophilia is a genetic disorder that affects coagulation, being responsible for more than 60% of idiopathic (spontaneous or unprovoked) thromboembolic events. Association of inherited thrombophilia with pregnancy increases the risk of thromboembolic disease, and it may be related to many complications, such as preeclampsia, recurrent miscarriage intrauterine growth restriction, early detachment of placenta, and prematurity. Interpretation of a positive test for thrombophilia in pregnant women is difficult because they have many natural changes in the coagulation system. Genetic diagnosis of thrombophilia, after a thrombotic event or during a pregnancy complication, has a major importance, not only to define its etiology but also to determine the duration of anticoagulant treatment and risk stratification for prophylaxis treatment. Literature search was performed using electronic database (PubMed) between April 1981 and November 2018. We used different keywords and MeSH terms to generate the most relevant results related to the inherited thrombophilia and its impact on pregnancy. Screening for inherited thrombophilia in young women is recommended in case of personal history of venous thromboembolism, first-degree relatives with a history of high-risk thrombophilia, or personal history of second-trimester miscarriage. Decision to recommend thromboprophylaxis with anticoagulant treatment in pregnant women with inherited thrombophilia is determined by history of venous thromboembolism, type and associated risk of inherited thrombophilia, and presence of additional risk factors. Low-molecular-weight heparins are the preferred agents for prophylaxis in pregnancy, while the doses vary depending on thrombophilia type, personal history, and associated risk factors. Association between 2 procoagulant conditions, inherited thrombophilia and pregnancy, has an important impact for the mother and fetus. This review will summarize the impact of each inherited prothrombotic factor on cardiovascular and pregnancy outcomes and will discuss the role of anticoagulation treatment for women diagnosed with inherited thrombophilia.

Preliminary results of the placental decorin profile in bovine pregnancy and parturition

Decorin is a small leucine-rich proteoglycan which is involved in multiple biological functions mainly as a structural and signaling molecule. Due to its biological properties in connective tissue, decorin may participate in remodeling of ECM during attachment and detachment of placenta within the course of pregnancy and at parturition in cows. The aim of the study was to detect the presence of decorin protein in bovine placental tissues and to evaluate its profile during pregnancy and at parturition. Placental tissues from healthy pregnant cows (2–5 month) were collected in abattoir (n = 10), while parturient tissues were obtained during caesarian section at physiological term (n = 6). Maternal and fetal parts were separated manually and subjected to homogenization and to quantitative ELISA and verification by Western blotting with anti-decorin antibodies. ELISA test showed that the concentration of decorin during pregnancy was higher in the fetal part of placenta compared with the maternal part (p < 0.001). Similar pattern was noted regarding to maternal and fetal samples derived from parturient cows. Our preliminary results demonstrate that the concentration of decorin is gestation time-dependent in healthy bovine placenta. Possible confirmation of the involvement of decorin in early pregnancy attachment and detachment of the placenta during parturition requires further research.

Factores relacionados a partos por cesárea en el Hospital II EsSalud de Huánuco

Introducción: El objetivo del presente estudio fue determinar la frecuencia de las cesáreas en el Hospital II EsSalud - Huánuco e identificar los factores relacionados a su ocurrencia. Métodos: Diseño descriptivo transversal. La variable dependiente fue “tipo de parto” y las variables independientes incluyeron características clínicas y no clínicas. Para la obtención de los datos se utilizaron las historias clínicas. Se realizó un análisis bivariado de las variables clínicas, usando la prueba chi-cuadrado y la prueba exacta de Fisher; además, se asoció con razón de prevalencia (RP); el análisis estadístico de la variable no clínica se realizó con la correlación de Pearson. Resultados: La tasa de cesárea obtenida fue de 37,16%, encontrándose asociación entre cesárea y las variables cesárea previa [p=0,000; RP: 2,81 (IC: 2,12-3,72)], presentación fetal [p=0,034; RP: 2,14 (IC: 1,37-3,34)], desprendimiento prematuro de placenta [p=0,039; RP: 2,61 (IC: 1,73-3,94)], sufrimiento fetal agudo [p=0,000; RP: 2,68; (IC: 1,99-3,60)], ruptura prematura de membrana [p=0,011; RP: 1,76 (IC: 1,20-2,58)], placenta previa (p=0,013; RP: 2,71 (IC: 1,92-3,82)] y disturbio de líquido amniótico (p=0,012; RP: 1,90 (IC: 1,26-2,88)]; no siendo estadísticamente significativas las variables macrosomía fetal, hipertensión inducida por el embarazo, tratamiento por infertilidad, embarazo múltiple y condilomatosis. La variable no clínica “médico” no fue significativa. Conclusiones: La tasa de cesárea en el Hospital II EsSalud- Huánuco fue de 37,16%; los factores relacionados a cesárea fueron cesárea previa, presentación fetal, desprendimiento prematuro de placenta, sufrimiento fetal agudo, ruptura prematura de membrana, placenta previa y disturbio de líquido amniótico.

The use of inhibitors of fibrinolysis in the treatment of obstetric hemorrhage due to placenta detachment

The use of inhibitors of fibrinolysis in the treatment of obstetric hemorrhage due to placenta detachment

ANALISIS OF MATERNITY OBSTETRIC SERVICE INDICATORS IN RUSSIA IN 2006-2013 YEARS

The relevance of the analysis of indicators of maternity obstetric service, which is a kind of tool for shaping the health of the population, not only now, but also for the future is not in doubt. Objective. To analyze the maternity obstetric service indicators in Russia in dynamics for 2006-2015 years, according to official statistics. Materials and Methods. Official statistic data is analyzed by descriptive method of statistics. Results. The number of births in Russia has increased during the period of study for 30.1%, and was higher than the level of 1991, from 2012. An increase in the frequency of ectopic pregnancy was marked during the study period (from 1.62 to 2.6% of all reported pregnancies). Analysis of data on the incidence of pregnant women found that its high level saves over the last six years (about 80%). At the same time there is a decrease incidence of anemia among pregnant, extragenital diseases and preeclampsia. Violations of labor decreased for 18.4% in 10 years, their number in 2015 is 88.4 for 1000 labor, that is lower, than in 1991 (96.5‰). The frequency of bleeding during childbirth has decreased during the observation period by 11.4%, the number of bleeding in the 3 period of labor decreased, whereas in the postpartum period and because of the placenta detachment and because of coagulopathy- increased. The number of caesareans has increased two times over 10 years. Conclusion. Analysis has shown favorable trends reproductive situation in the country – an increase in the number of births, the decline of reproductive losses, some complications of pregnancy and childbirth. At the same time a high level of controlled disease in childbirth (bleeding, sepsis) determine ways to improve maternity obstetric service.

Effectiveness of Counseling on the Willingness to Use Intra-Uterine Device Contraceptive after Placenta Detachment among the Health Insurance Participants in Panembahan Hospital, Bantul

Background : Counseling on family planning and contraceptive use after deliverymay increase awareness of women to use contraceptives. Any use of contraceptives there are side effects, including in the use of contraceptives used in the uterus post placenta, side effects and failure was a factor that caused the acceptors are having dropped out of the methods used. This study aimed to determine the effectiveness of counseling on willingness to use intra-uterine device contraceptive after delivery. Subject and Methods : This was a qualitative study with case studies carried out in Bantul Yogyakarta. A total of 3 midwives and 3 contraceptive use in the uterus post placenta acceptor Panembahan Senopati hospital. The dependent variable was health insurance participant. The independent was contraceptive used in the uterus post placenta. The data collected by interview, observation, document. The informant was 3midwifery and 3 acceptor of post placenta. Results : Socialization and counseling is done always accompanied and informed consent when the pregnancy inspection. Midwives play a role in counseling process by involving the husband as support for potential acceptors. Such side effects are still within the limits of reasonable expulse. Contraceptives used in the uterus post placentainstallation carried out by a competent midwife by SPO. Midwives provide education and counseling reset when the client still complained of side effects. Conclusion : Socialization and counseling potential acceptors are effective to increase willingness to use intra-uterine device contraceptive among the health insurance participants. Keywords : counseling, intra-uterine device contraceptive Correspondence: Ristiana Eka Ariningtyas. STIKes Jenderal Ahmad Yani, Yogyakarta. Email: tyasarin1988@gmail.com. Mobile: 08985069979. Journal of Health Policy and Management (2016), 1(1): 8-12 https://doi.org/10.26911/thejhpm.2016.01.01.02

Clinical value of determination of markers of a thrombophylia at patients with the complicated pregnancy in the anamnesis

The results of the survey of 214 patients with the complicated pregnancy (a preeclampsia, a premature detachment of placenta, antenatal fetal death, miscarriage) in the anamnesis are presented in the article. We determined the level of molecular markers of a thrombophilia (TAT, D-dimer) and aggregation activity of platelets and carried out antithrombotic therapy to these women. It is shown that 47,7 % of such nonpregnant women and pregnant early terms have the high level of D-dimer, TAT - 46,7 %, aggregation activity of platelets - 52,6 %. Determination of the increased levels of molecular markers of a thrombophilia is the indication to application the antithrombotic therapy and allow to control efficiency of this therapy.

PO-0721 Profile Of Admissions In Neonatal Intensive Care Unit Of The Teaching Hospital Alcides Carneiro – PetrÓpolis/rj-brazil

Introduction Neonatal ICU enters as a fundamental tool to quality care to sick newborns, becoming of paramount importance in reducing neonatal mortality. Knowing the population served allows appropriate care plan and strategize improvements in care for mother and newborn. Objective To identify risk factors related to admissions to Neonatal ICU of the Hospital Teaching Alcides Carneiro-RJ/Brazil Methodology A descriptive, cross-sectional study to Neonatal ICU, January 1 to March 31, 2014 Results In the period 692 children was born in the maternity ward, 78 (11.7%) admitted to the neonatal intensive care unit. The total number of hospitalizations was 83 infants, five external drives. Maternal diagnoses that contributed: infection (70.3%), hypertensive disease (28.4%), infections mandatory prenatal screening (9.45%), gestational diabetes (5.4%), Premature detachment of placenta (2.7%). The caesarean rate was 65%, with the main indications: fetal distress (29.6%), preeclampsia (24%). Regarding gestational age 61.4% were premature, 16.8% of these extremely preterm infants. We observed 50% of newborns with low birth weight, very low birth weight 7.3% and 8.5% extremely low birth weight. The admission diagnoses were: respiratory disorders (68.6%), prematurity (50.6%), infection (21.6%), asphyxia (15.6%), hyperbilirubinemia (7.2%), metabolic disorders (7.2%), congenital infection (6%). Conclusion As the only service of reference for the public health system in our county, received a maternal and child care to higher morbidity. Identify possible causes related to the hospitalisation of newborns, are preventable infections that can be diagnosed and addressed during prenatal causes rethink the health system offered to pregnant women and propose our discussion forums.

Gestational loss and growth restriction by angiogenic defects in placental growth factor transgenic mice.

Angiogenesis is an important biological process during development, reproduction, and in immune responses. Placental growth factor (PlGF) is a member of vascular endothelial growth factor that is critical for angiogenesis and vasculogenesis. We generated transgenic mice overexpressing PlGF in specifically T cells using the human CD2-promoter to investigate the effects of PlGF overexpression. Transgenic mice were difficult to obtain owing to high lethality; for this reason, we investigated why gestational loss occurred in these transgenic mice. Here, we report that placenta detachment and inhibition of angiogenesis occurred in PlGF transgenic mice during the gestational period. Moreover, even when transgenic mice were born, their growth was restricted. Conclusively, PlGF overexpression prevents angiogenesis by inhibiting Braf, extracellular signal-regulated kinase activation, and downregulation of HIF-1α in the mouse placenta. Furthermore, it affected regulatory T cells, which are important for maintenance of pregnancy.

Nitroglycerin for Management of Retained Placenta: A Multicenter Study

The primary aim was to determine if sequential administration of oxytocin and nitroglycerin is effective for management of retained placenta when performed by obstetricians with no experience of the method. Secondary aims were to examine possible adverse effects of nitroglycerin. One hundred and five women with retained placenta were randomly selected to receive either 1 mg nitroglycerin or placebo tablets sublingually if intravenous oxytocin had failed to expel the placenta. At two of the hospitals some of the midwives were familiar with the use of nitroglycerin. The other midwives and all the participating obstetricians had no clinical experience of the method. In the treatment group, detachment of placenta following nitroglycerin occurred in 37.3% of the women compared to 20.4% in the placebo group (P = 0.056). In the two hospitals with some experience of the method, placenta was removed in 9 of 19 (47.4%) women in the nitroglycerin group compared to 3 of 17 (15.0%) women in the placebo group. No adverse effects of clinical importance were registered. Although the difference between the two groups did not reach statistical significance, the higher success rate in the two hospitals with some experience could indicate that clinical experience is of importance in order to achieve placental detachment.

Pregnancy After Kidney Transplantation: Two Transplantation Centers—Vicenza–Udine Experience

Background Pregnancy after kidney transplant has become possible thanks to the recent surgical and pharmacological breakthrough. Materials and Methods We performed a restrospective study including all childbearing women transplanted in our centers after 1997. The following variables were analyzed: type of nephropathy, patient age when dialysis started, age at transplantation, time between dialysis and transplantation and between transplantation and baby birth. We also considered immunosuppressive therapy, type of delivery, baby weight, Apgar score, and mother and baby follow-up. Results We followed up 13 pregnancies in 12 patients who were diagnosed with chronic pyelonephritys (n = 4), postpartum cortical necrosis (n = 1), immunoglobulin A GN (n = 4), diabetic nephropathy (n = 1), unknown nephropathy (n = 2). All patients received a cadaveric donor kidney. They were treated with calcium antagonists and alfamethyldopa for their high blood pressure. We observed 9 mother complications: nonnephrotic proteinuria (n = 1), urinary tract Infection (n = 1), pre-eclampsia (n = 4), internal placenta detachment (n = 1) and spontaneous abortions (n = 2); 4 fetal complications: IUGR (n = 2), acute distress respiaratory syndrome (n = 1), Klinefelter syndrome (n = 1) and preterm births (n = 4). In 2 cases the child weight was lower when compared to the gestational age, and 5 babies were admitted to the neonatal intensive care unit. The mother's follow-up showed no acute rejection episodes. Breastfeeding was discouraged due to the transmission of immunosuppressive medications into breast milk. We did not observe significant disease upon child follow-up. Conclusion Our data were in agreement with the literature confirming that pregnancy after kidney transplant though possible carries elevated risks. Patients therefore are referred to highly specialized centers where obstetricians, nephrologists, intensivists, and neonatologists provide surveillance and treatment.

COURSE OF PREGNANCY, DELIVERY AND PUERPERAL PERIOD IN PATIENTS FROM GROUP OF HIGH PERYNATAL RISK

Objective: to analyze course of pregnancy, delivery and puerperal period in patients from group of high perynatal risk. Design and subjects: a prospective study 176 pregnant women with polyhydramnion and 73 pregnant with normal amount of amniotic fluid. Results: there are an increase frequency of chronic placental insufficiency in 2,2 times, gestosis and powerless labor in 2,5 times, colpitis in 2,9 times, violations of detachment of placenta in 2,6 times and involution of uterus in 7,7 times.

ETIOLOGY AND PROGNOSIS IN 36 ACUTE RENAL FAILURE CASES RELATED TO PREGNANCY IN CENTRAL ANATOLIA

Aim: In this study, the reason of the acute renal failure (ARF) clinic features and results of it has examined as retrospectively. Methods: In this study, the etiology, clinical features and outcome of acute renal failure (ARF) evaluted retrospectively in the Anatolian region of Turkey. Above mentioned features were examined retrospectively in 36 ARF cases (mean age 31.6±6.8, range 17-46), related to pregnancy between 1997 and 2001. Results: The ARF has developed approximately on the 30 th gestational week. The reasons of ARF were; HELLP Syndrome and preclampsia (44%) in 16 cases, postpartum hemorrhage in 7 cases (19%), placenta detachment in 5 cases (14%), septic or spontaneous abortion in 5 cases (14%), and eclampsia in 3 cases. The 5 cases related to the abortion were seen (14%) in the first trimester and others were developed (86%) in the third trimester or postpartum period. In 9 cases (25%) there were intrauterine dead. In 24 of the ARF cases (67%) had hypertension at the time of the diagnosis whereas six cases (17%) had hypotension related to the vaginal bleeding. All cases had oliguria and the avarage duration was 4.8±8.7 (2-27) days. The avarage of the staying period in the hospital was 11.7±7.6 ( 4-28 )days. Hemodialysis was applied to 17 cases (47%), and not needed for 19 cases (53%). Conclusion: ARF related to the pregnancy was seen commonly in the third or the later pregnancies and the most common reasons were HELLP Syndrome, placenta detachment, and postpartum hemorrhage and resulted in a high risk condition for fetal and maternal mortality therefore, we think that the number of the pregnancies should be limited and especially multipar pregnancies must be closely controlled for ARF.

Results of the Pregnancies with HELLP Syndrome

In this study, clinical features, developing complications, and results of thirty-six patients, which were followed up in our Obstetrics and Gynecology and Nephrology departments between 1997 and 2001, with the diagnosis of HELLP syndrome were searched retrospectively. The mean age of the cases followed up with diagnosis of HELLP syndrome were 30.2 ± 5.9 (17–46) years. HELLP syndrome was diagnosed on average in the 32.6 ± 4.8th (23–41) week of gestations. Seventy percent of the cases were with severe preeclampsia and 30% of the cases were with mild preeclampsia. Eleven cases (30%) were nullipara and twenty-five cases (70%) multipara. The average of arterial systolic blood pressure of the cases were 161.6 ± 26 mmHg, and that of diastolic blood pressure was 98.5 ± 16.8 mmHg. In thirteen cases (36%) acute renal failure (ARF), six cases (17%) placenta detachment, two cases disseminate intravascular coagulation (DIC), one case Adult Respiratory Distress Syndrome (ARDS) were developed. In seven cases (19%) intrauterine dead fetuses were detected. In twenty-three cases by cesarian section (64%), in thirteen cases by induction (36%) the pregnancies were terminated in 72 h after diagnosing HELLP syndrome. Birth weights of eleven babies (30%) were below 1500 g. Five of the eleven babies were dead in the neonatal period. Six of the thirteen patients who had ARF were given hemodialysis. Two patients died because of the development of ARF + DIC and ARDS. No predicting factors for the development of HELLP syndrome could be detected, but severe preeclampsia. Therefore we think that preeclamptic pregnancies must be followed up very closely and if HELLP syndrome develops, termination of the pregnancy would be proper as soon as possible.

Placenta Detachment: Unexpected High Concentrations of 5-Hydroxytryptamine (Serotonin) in Fetal Blood and its Mitogenic Effect on Placental Cells in Bovine

The purpose of this study was twofold: (1) to determine whether there is a profile of 5-hydroxytryptamine (5-HT, serotonin) concentrations in fetal bovine blood and tissues during pregnancy, parturition and the early neonatal period and (2) to determine whether 5-HT has a ‘mitogenic’ effect on cultured placentome cells in bovine. Results revealed a 5-HT concentration profile in fetal blood. Overall concentrations of 5-HT in fetal blood were 6.6 times (P< 0.001) that of adult cows and 2.8 times (P< 0.001) that of blood collected during caesarean section (from umbilical veins) and from 18–72h old calves. Mid-term and full-term pregnancy fetuses were not statistically different from each other. Overall concentrations of 5-HT in the intestinal wall of the fetus were 4.4 times higher (P< 0.05) than in the 24h calf. Concentration of 5-HT in full-term muscle was 3.5 times higher than in mid-term muscle and 2.8 times higher than in 24h old calf muscle (P< 0.05). Concentrations of 5-HT in mid-term and full-term cotyledon were 4.4 times higher (P< 0.05) than in post partum cotyledon.Characterized trophoblast cells and a heterogeneous population of bovine cotyledon cells treated with 5-HT (2.5, 5.0 and 10.0μm) incorporated between 2.0 and 3.0 times more3[H]-thymidine than untreated controls, indicating a dose-dependent (r=0.94) positive mitogenic effect of 5-HT. Both groups of cultured cells responded equally. Five-HT treatment did not affect either cell number or cell size. It was concluded that a 5-HT concentration profile exists in fetal bovine blood and tissues and that 5-HT has the ability to act as a mitogen in bovine placental cells.