Disease In Pregnant Women Research Articles

Evaluation of a new mouthwash formulated with Chlorhexidine and Cymenol after a scaling and root planing treatment in grade I and II periodontal patients.

Periodontal disease (PD) is a chronic inflammatory disease of multifactorial origin that affects the supporting tissues of the tooth. According to WHO in 2022, severe periodontal disease will affect around 19% of the adult population worldwide. Its risk factors include the presence of periodontopathogenic bacteria in biofilm and the susceptibility of the host's immune system, among others. Preterm birth is defined as birth occurring before 37 weeks of gestational age. It also has a multifactorial origin and it's associated with risk factors such as intrauterine and extrauterine infections. There is a possibility that periodontal disease in pregnant women increases the risk of preterm birth through hematogenous pathways or the presence and intervention of inflammatory mediators. Through a systematic review of existing scientific articles from 2014 to 2024, five randomized clinical trials were selected, including a total of 1984 pregnant patients diagnosed with periodontal disease. Half of these patients received non-surgical treatment, while the other half did not, aiming to evaluate a possible association between periodontal disease and/or its treatment and the occurrence of preterm birth. The risk of bias was assessed using the Cochrane "RoB 2" tool, and finally, a meta-analysis was conducted to compare the results obtained in the selected studies. Four articles showed a trend favoring non-surgical periodontal treatment as a preventive measure for preterm birth. These articles accounted for 92.2% of the total weight, while the remaining 7.85% corresponded to the single article that did not favor the treatment. However, none of the articles showed statistically significant results. There is no demonstrated association between periodontal disease in pregnant women and the incidence of preterm birth. On the other hand, there is a slightly favorable trend towards non-surgical periodontal treatment during pregnancy as a measure to reduce the incidence of preterm birth, but it's not statistically significant. To obtain a definitive answer, more randomized clinical trials following similar study and design parameters are needed.

Manifestations of COVID-19 in pregnant women with focus on gastrointestinal symptoms: a systematic review.

This review study was conducted to evaluate the symptoms of COVID-19 in pregnant women with a focus on gastrointestinal symptoms. COVID-19 is a fatal respiratory disease caused by a novel coronavirus that quickly became a pandemic. Although the main symptoms of this disease include respiratory symptoms, gastrointestinal manifestations have also been observed in some patients suffering from COVID-19. Pregnant women are among the most vulnerable groups in the community to infectious diseases. Scientific databases were searched for articles published up to May 8, 2020. Any type of study investigating the manifestations of COVID-19 in pregnant women was included. Symptoms of the disease in pregnant women with an emphasis on gastrointestinal symptoms were assessed. The search resulted in 852 titles and abstracts, which were narrowed down to 43 studies involving 374 women. The most common symptoms of patients were fever (59.1%) and cough (48.4%), respectively. Gastrointestinal symptoms included diarrhea (4.5%), abdominal pain (1.6%), nausea (0.8%), and loss of appetite (0.3%), respectively. In studies on pregnant women with gastrointestinal symptoms, 13 fetal abortions occurred, most of which were induced abortions due to the risks posed by COVID-19.In thirty cases, and infected pregnant women reported a history of chronic pregnancy-related diseases. COVID-19 in pregnant women, similar to the general population, can present with gastrointestinal manifestations. The gastrointestinal tract can be a potential route for infection with the novel coronavirus.

COVID-19 in pregnant women of Siberia and the Far East. Article

The purpose of the study was to conduct a comparative assessment of the incidence and characteristics of the course of the NCI COVID-19 in pregnant women in the Siberian Federal District and Far Eastern Federal District. Materials and methods. The analysis of operational information on the incidence of NCI COVID-19 and the features of the course in pregnant women, women in childbirth and puerperas provided by the chief obstetrician-gynecologists of the Siberian Federal District and the Far Eastern Federal District on May 25, 2020 is carried out. Results. The results of the study showed that the proportion of pregnant women among patients with COVID-19 in the Siberian Federal District and the Far Eastern Federal District is 0.82 %. Pneumonia was registered in almost every third patient (28.4 %), but the disease, on the whole, was characterized by a milder course than in the general population of patients: a severe form of the disease was diagnosed in 3.6 % of women, hospitalization in RAO was performed in 1.9 % of cases, mechanical ventilation was required by 0.6 % of patients. There were no cases of maternal and perinatal mortality. Conclusion. The course of the disease in pregnant women in the Siberian Federal District and the Far Eastern Federal District was characterized by a milder course relative to the general patient population. However, final conclusions can only be drawn after the pandemic is over.

The Clinical Features and Outcomes of Four Neonates Born to Mothers with a Severe Form of COVID-19 and a Positive RT-PCR for SARS Co-V2 in Douala Gynaeco-Obstetric and Pediatric Hospital in Cameroon

Background: A novel viral respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is responsible for a worldwide pandemic. The effects of this new disease in pregnant women and newborns are actually not well known. Methods: We investigated the clinical features and outcomes of four neonates born to mothers with a severe form of COVID-19 and a positive RT-PCR for SARS Co-V2 in Douala Gynaeco-Obstetric and Pediatric Hospital (Cameroon) from April 20 to June 5, 2020. Results: All four mothers were symptomatic and had a positive RT-PCR for SARS CoV-2 from nasopharyngeal swab on admission. All of them delivered prematurely through cesarean section because of severe respiratory distress and one died shortly after delivery. The four premature male infants were born between 30 weeks and 35 weeks 2 days of gestation and had birth weights ranging from 1090 g to 2950 g. All infants had 1-minute Apgar scores that ranged from 7 to 8 and 5-minute Apgar scores varying between 8 and 9. They were isolated from their mothers immediately after birth and received formula feeding. Three of the four infants were tested using nasopharyngeal swab specimens for RT-PCR 24 to 48 hours after birth and were negative for COVID-19. All the infants were treated in a dedicated area at the neonatal care unit and presented with mild respiratory distress on admission with a Silverman score that varied between 2 and 4/10. During their hospitalization, all the infants also presented with jaundice and underwent phototherapy. Three of them had anemia with hemoglobin levels ranging from 105 to 123 g/L requiring for blood transfusion. The hospital stay varied between 3 and 48 days. Three infants were discharged healthy and one died. Conclusion: This case series suggests the possibility of poor maternal and neonatal outcomes in case of severe COVID-19 in mothers. It also suggests that severe COVID-19 in pregnant women may be a risk factor for prematurity for the newborns. It is crucial to screen pregnant women, to implement infection prevention, control measures and to provide close monitoring of neonates born to mothers with a severe form of COVID-19.

An Evaluation of Knowledge, Attitude, and Practices of Obstetricians and Midwives Concerning Oral Health of Pregnant Women in Birjand in 2019

Background: Periodontal disease in pregnant women usually occurs due to physiological changes during pregnancy and is associated with adverse prenatal and perinatal outcomes. However, pregnant women are reluctant to visit a dentist because of unreliable information or perceived hazards of dental procedures for the mother and fetus. Therefore, it is vital to examine the knowledge and practice of obstetricians and midwives and their attitude towards oral health of pregnant women as they are closely connected with these women. Methods: In this study, 90 obstetricians and midwives from Birjand were randomly selected. The data for their knowledge, attitude, and practice were collected through self-report. The scale developed by Malek Mohammadi et al, with a high reliability of 80%, was used for data collection. Data analysis was performed using SPSS version 22.0. Results: Most of the participants (65.6%) worked in the hospital setting, and an average period of 10.32±8.24 years had passed from the subjects’ graduation. Of them, 82.2% provided care services for more than 40 hours per week for an average number of 31.3±67.6 patients. The mean score of knowledge, attitude, and practice were 6.27±1.33, 19.43±2.10, and 4.32±1.35, respectively. All participants considered it important to observe oral health during pregnancy, and 91.1% referred their patients to the dentist. Most of the participants (37.78%) obtained their information from continuous medical education programs. Conclusions: The results of this survey showed that the attitude and practice of obstetricians and midwives were satisfactory given their level of knowledge about the importance of oral health during pregnancy. However, they were still far from standard guidelines. Therefore, it is recommended that their knowledge and skills should be increased to obtain optimal care during pregnancy.

Relationship Between Nuchal Fold Thickness and Fetal Heart Disease in Pregnant Women Referred to a Pediatric Hospital in Bandar Abbas During 2018-2019

Background: Congenital heart disease (CHD) is of the most common congenital anomalies. Most of the major cardiac defects can be diagnosed by fetal echocardiography at 20 weeks of gestation. Evaluation of nuchal thickness can be the first stage of screening in the diagnosis of CHD. Therefore, this study aimed to investigate the relationship between nuchal translucency (NT) and CHD in pregnant women. Materials and Methods: The current study is an analytical-descriptive study conducted on fetuses of 44 pregnant women. Abdominal sonography of the participants at 10-14 weeks of gestation was performed, and they referred to a pediatric hospital in Bandar Abbas in order to undergo fetal echocardiography at 17-18 weeks of gestation. Results: The mean age of the participants was 28±6 years. Out of 44 pregnant women, fetal heart disease was diagnosed in 4 pregnancies (9%), one of whom was reported as 2.5≤NT<3.5 and three cases were reported as 3.5≤NT. Out of 40 women with no fetal heart disease, two cases had NT≥3.5, 12 cases had 2.5≤NT<3.5 and 26 cases had NT>2.5. Conclusion: The results of this study showed that 6.8% of the cases of CHD had an increase in the thickness of NT (NT≥3.5) at 10-14 weeks of gestation. The sensitivity of this screening method was 75% at 18-20 weeks of gestation which is low for general population. Therefore, NT cannot be regarded as the only or main screening tool for CHD.

CHARACTERISTICS OF PREGNANT MOTHER THAT VOLUNTARY COUNSELING AND TESTING EXAMINATION IN PUSKESMAS CIJERUK, BOGOR DISTRICT

Voluntary Counseling and Testing (VCT) is an effort to reduce the incidence of HIV in pregnant women. The author conducted research on VCT with characteristics of maternal age, gestational age, parity, education, and occupation. The purpose of this study was to determine the characteristics of pregnant women undergoing a VCT examination. This research was conducted in November-December 2018, the population in this study were all pregnant women who did VCT examination as many as 130. The number of mothers who did VCT based on age 20 years-35 years was 102 (78.5%). The number of mothers who did VCT based on the age of trimester 1 pregnancy was 122 people (93.8%). The number of mothers doing VCT based on primipara/grande multiparity was 80 people (61.5%). The number of mothers undergoing VCT was based on higher education 100 people (76.9%). The number of mothers who do VCT based on work does not work as many as 130 people (100%). Judging from the results of research based on the theory that many are appropriate and some are not appropriate both from age, gestational age, parity, education, and employment. Thus, the most variable is jobs as many as 130 people (100%). All health workers, especially midwives, should further improve counseling services on VCT testing for pregnant women and especially in matters relating to HIV disease in pregnant women and to reduce maternal mortality and infant mortality rates, especially in West Java.

Screening for Chagas disease in pregnancy and newborns in Andalusia (Spain)

To determine the current state of the implementation of Chagas screening in pregnancy and newborns at risk in the eight Andalusian provinces. An observational, cross-sectional and descriptive study was carried out through a survey reviewed and validated by experts from the Andalusian Group of Pediatric Infectious Diseases and Immunology. Eighteen pediatric infectious disease specialists from Andalusian referral hospitals (fourteen public and four private) participated. The Chagas screening during pregnancy was known by seventeen specialists (94%), and systema-tically applied in seven hospitals (38.9%) by gynecologists or midwives. The protocol for following-up newborns at risk was known by sixteen specialists (88.9%) and applied in ten hospitals (55.5%), two of which did not study siblings and relatives of these newborns. Only two cases of vertical transmission of Chagas (11.1%) were detected; it happened in two hospitals applying systematically the Chagas screening to pregnant woman at risk, the same ones that also diagnosed two cases in siblings of newborns at risk. In Andalusia screening of Chagas disease in pregnant women and newborns at risk is not carried out in a systematic and uniform way in all the reference hospitals, so an underdiagnosis of congenital Chagas disease is highly probable. The training of professionals involved in assisting pregnant women and their offspring, and the unification of the follow-up criteria for newborns at risk would be essential for carrying out both a correct diagnosis and an early treatment of these cases.

Developing a serocorrelate of protection against invasive group B streptococcus disease in pregnant women: a feasibility study.

Group B streptococcus is the leading cause of infection in infants. Currently, intrapartum antibiotic prophylaxis is the major strategy to prevent invasive group B streptococcus disease. However, intrapartum antibiotic prophylaxis does not prevent maternal sepsis, premature births, stillbirths or late-onset disease. Maternal vaccination may offer an alternative strategy. Multivalent polysaccharide protein conjugate vaccine development is under way and a serocorrelate of protection is needed to expedite vaccine licensure. The ultimate aim of this work is to determine the correlate of protection against the major group B streptococcus disease-causing serotypes in infants in the UK. The aim of this feasibility study is to test key operational aspects of the study design. Prospective cohort study of pregnant women and their infants in a 6-month period (1 July to 31 December 2018). Five secondary and tertiary hospitals from London and South England. National iGBS disease surveillance was conducted in all trusts in England and Wales. Pregnant women aged ≥ 18 years who were delivering at one of the selected hospitals and who provided consent during the study period. There were no exclusion criteria. No interventions were performed. (1) To test the feasibility of collecting serum at delivery from a large cohort of pregnant women. (2) To test the key operational aspects for a proposed large serocorrelates study. (3) To test the feasibility of collecting samples from those with invasive group B streptococcus. A total of 1823 women were recruited during the study period. Overall, 85% of serum samples were collected at three sites collecting only cord blood. At the two sites collecting maternal, cord and infant blood samples, the collection rate was 60%. A total of 614 women were screened for group B streptococcus with a colonisation rate of 22% (serotype distribution: 30% III, 25% Ia, 16% II, 14% Ib, 14% V and 1% IV). A blood sample was collected from 34 infants who were born to colonised women. Maternal and infant blood and the bacterial isolates for 15 newborns who developed invasive group B streptococcal disease during the study period were collected (serotype distribution: 29% III, 29% II, 21% Ia, 7% Ib, 7% IV and 7% V). Recruitment and sample collection were dependent on the presence of research midwives rather than the whole clinical team. In addition, individualised consent limited the number of women who could be approached each day, and site set-up for the national surveillance study and the limited time period of this feasibility study limited recruitment of all eligible participants. We have verified the feasibility of collecting and processing rectovaginal swabs and blood samples in pregnant women, as well as samples from those with invasive group B streptococcal disease. We have made recommendations for the recruitment of cases within the proposed GBS3 study and for controls both within GBS3 and as an extension of this feasibility study. A large case-control study comparing specific immunoglobulin G levels in mothers whose infants develop invasive group B streptococcal disease with those in colonised mothers whose infants do not develop invasive group B streptococcal disease is recommended. Current Controlled Trials ISRCTN49326091; IRAS project identification number 246149/REC reference number 18/WM/0147. This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 23, No. 67. See the NIHR Journals Library website for further project information.

Evaluation of caries risk factors associated with pregnancy

Tooth decay is a serious public health problem, and identifying risk factors to the disease in pregnant women is essential. The use of the Cariogram, could contribute to implementing preventive measures to improve women’s health during pregnancy. The purpose of this study was to determine the risk to dental caries in pregnant women. The Cariogram presents the results of the five risk factors of caries, and it was observed that the patients have a 42% of chance to avoid new carious lesions and 58% could present lesions, which could be caused by 40% related to diet and bacteria. Conclusion: To date, existing studies are not sufficient to ultimately identify main caries risk factors associated with dental decay in pregnant women.

Virus-like Particle Vaccine Containing Toxoplasma gondii Rhoptry Protein 13 Induces Protection against T. gondii ME49 Infection in Mice.

Toxoplasma gondii can infect humans worldwide, causing serious diseases in pregnant women and immunocompromised individuals. T. gondii rhoptry protein 13 (ROP13) is known as one of the key proteins involved in host cell invasion. In this study, we generated virus-like particles (VLPs) vaccine expressing T. gondii rhoptry ROP13 and investigated VLPs vaccine efficacy in mice. Mice immunized with ROP13 VLPs vaccine elicited significantly higher levels of T. gondii-specific IgG, IgG1, IgG2a, and IgA antibody responses following boost immunization and challenge infection, whereas antibody inductions were insignificant upon prime immunization. Differing immunization routes resulted in differing antibody induction, as intranasal immunization (IN) induced greater antibody responses than intramuscular immunization (IM) after boost and challenge infection. IN immunization induced significantly higher levels of IgG and IgA antibody responses from feces, antibody-secreting cells (ASCs), CD4+ T, CD8+ T cells and germinal center B cell responses in the spleen compared to IM immunization. Compared to IM immunization, IN immunization resulted in significantly reduced cyst counts in the brain as well as lesser body weight loss, which contributed to better protection. All of the mice immunized through either route survived, whereas all naïve control mice perished. These results indicate that the ROP13 VLPs vaccine could be a potential vaccine candidate against T. gondii infection.

The Prevalence and Types of Hypertensive Diseases in Pregnant Women Admitted to Department of Obstetrics and Gynecology in Tanta University Hospitals

AbstractBackground: Hypertensive disorders of pregnancy are used as an umbrella term that includes chronic and gestational hypertension, preeclampsia and eclampsia, representing a major cause of maternal and perinatal morbidity and mortality, considered to be the most common medical problem encoun-tered during pregnancy, and so this study was done to find the prevalence and types and the proper methods of treatment of each type of hypertension in pregnant women admitted to Department of Obstetrics, Tanta University Hospital.Aim of Study: The aim of this study is to find the prevalence and types of hypertension in pregnant women admitted to Department of Obstetrics, Tanta University Hospital.Patients and Methods: This prospective, randomized, comparative study included Seven hundred and fifty (750) pregnant women in the Department of Obstetrics and Gyne-cology in Tanta University Hospital during the period between December 2016 and December 2017. In this study, hypertensive pregnant females were categorized in to 4 major groups: Chronic hypertension, gestational hypertension, pre-eclampsia, eclampsia and no cases of superimposed pre-eclampsia on top of chronic hypertension were encountered. Informed consents were obtained from all study participants.Results: Number of patients examined in this study was 750 pregnant women, 179 were hypertensive (23.86%). Chron-ic hypertension 15 cases (8.37%), gestational hypertension 61 cases (34.07%), pre-eclampsia 90 cases (50.27%) and eclampsia 13 cases (7.26%), according to the clinical charac-teristics, the mean age was significally higher in chronic hypertensive group (40.53±5.3 years), and was significally lower in eclamptic patients (23.31±4.33 years), the highest gravidity was recorded in chronic hypertension (3.20±0). The body mass index was similar in all the studied groups. Blood pressure was highest in preeclampsia, according to methods of delivery in different studied groups, assisted and spontaneous vaginal delivery were highest in gestational hypertension (23%) and (13.1%) respectively and Caesarian section was highest in eclampsia (84.6%) and lowest in chronic hyperten-sion (60%), the gestational age of the studied groups was showing that prematurity was encountered in 61.54% of cases of eclampsia and was lowest (0%) in chronic hypertension; this was due to induction of labor, the main cause of death in this study is prematurity. The mean APGAR score in the present study was highest in chronic hypertension group (7.40 ±1.88) and lowest in eclamptic group (5.08±1.19) after one minute of delivery and after 5 minutes APGAR score was highest in pre-eclamptic (8.80±1.52) and lowest in eclamptic group (7.23±1.88). The respiratory distress syndrome, Neonatal Intensive Care Unit and neonatal mortality were highest in eclampsia group (3 8.5%, 30.8% and 23.1% respectively) and lowest in chronic hypertension group (0% in all), a comparison between 2 forms of pre-eclampsia (mild and severe) showed that all the parameters including blood pressure, hematocrit value, creatinine, uric acid levels and liver enzymes were higher in severe preeclampsia compared to the mild form. C.S was 100% in severe pre-eclampcia and 73.01% in mild pre-eclampcia, the respiratory distress syndrome, Neonatal Intensive Care Unit and neonatal mortality were significally higher in severe pre-eclampcia than mild pre-eclampcia, gestational age and birth weight were significally higher in severe pre-eclampcia than mild pre-eclampcia, Intra Uterine Growth Restrictions (I.U.G.R) were found only among the severe pre-eclampcia group (18.52%).Conclusions: From this study we can reach the following conclusions:1-High blood pressure complicates 23.9% of all pregnant women.2-The incidence of chronic hypertension in the present study is 8.37%, gestational hypertension is 34.1%, pre-eclampsia is 50.3% and eclampsia is 7.3%.3-The worst prognosis was found among the eclamptic group.4-Chronic hypertension when perfectly managed doesn't develop into superimposed pre-eclampsia.5-No cases of secondary chronic hypertension were encoun-tered in the study denoting that it is rare with pregnancy. The cause of secondary hypertension may compromise her fertility.6-Neonatal complications were most common with pre-eclampsia and eclampsia.

Clinical management and progress in sudden sensorineural hearing loss during pregnancy.

Sudden sensorineural hearing loss (SSNHL) is a relatively rare, but distressing, disease in pregnant women. Little is known about the causes, clinical manifestations, treatments, and prognosis of SSNHL. Some hypotheses have been proposed to explain the pathophysiological mechanism of SSNHL, but most of them have not been identified. This article reviews the existing literature to present a summary of this clinical problem. Most patients suffer from SSNHL in the second or third trimester, and show moderate to profound hearing loss. The interval between the initial treatment and onset of hearing loss is less than 10 days in most patients. Some patients with SSNHL show tinnitus, vertigo, or dizziness, and fullness of the ear. Although some patients have a tendency for self-cure, treatment with intravenous dextran 40 combined with intratympanic corticosteroids is probably a safe and effective therapeutic strategy for pregnant patients with SSNHL. Further clinical research is necessary to identify the best therapeutic strategy for these patients.

TSHβX1 Splice Variant Expression and D2 Thr92Ala Polymorphism Analysis in Pregnant Women with Thyroid Diseases

Thyroid diseases are pathologies that frequently affect pregnant women. The objective was to find out whether the expression of TSHβX1 splice variant and D2 Thr92Ala polymorphism in the DIO2 gene are associated with thyroid disease in pregnant women. It was a comparative, prospective clinical, and cross-sectional study. Ninety-two pregnant patients, of which 38 were normothyroid and 54 had thyroid disease, were included. The expression of the TSHβX1 splice variant was quantified by real-time PCR and the D2 Thr92Ala (rs225014 CT) polymorphism was genotyped using TaqMan probes. The TSHβX1 splice variant was detected in both groups without significant differences in the relative expression. The T allele was associated with the thyroid dysfunction (OR = 2.117, p = 0.0339). We confirmed the presence of the predicted TSHβX1, and our results suggest that 92Thr (rs225017T) allele is a risk factor to thyroid dysfunction in pregnant women.

Advances in non-invasive prenatal gene detection technologies

Non-invasive prenatal testing is a novel detection method which uses sequencing of maternal plasma cell-free DNA in order to screen genetic disease for pregnant women. Compared to traditional prenatal pregnancy tests and disease diagnosis techniques, this technology is non-invasive, convenient, accurate and so on. Since the discovery of cell-free DNA in the peripheral maternal plasma in 1997, non-invasive prenatal genetic testing has been widely used in clinical pregnancy tests and related medical research with the development of high-throughput gene sequencing,it has meaningful achievements in the detection of fetal aneuploidy and enormous challenges in the detection of complex genetic diseases. This article reviews the development of non-invasive prenatal genetic testing technology. Key words: Genetic testing; Prenatal diagnosis; Chromosome aberrations; Genetic diseases,inborn

Differential microRNA expression profile in the plasma of preeclampsia and normal pregnancies.

Preeclampsia is a common disease in pregnant women that can only be diagnosed from 20 weeks after fertilization. Developing early diagnosis markers is urgent and would be helpful in selecting appropriate treatment strategies. The present study aimed to identify the differential expression profiles of microRNAs in the plasma between patients with preeclampsia and normal pregnancies using microarray methods. Using quantitative polymerase chain reaction (qPCR), the differentially expressed microRNAs (miRNAs or miRs) identified from the microarray analysis were validated. A total of 3 miRNAs, including hsa-miR-1304-5p, hsa-miR-320a and hsa-miR-5002-5p, were upregulated in the plasma of patients with preeclampsia pregnancies. Examination of the functions of these miRNAs demonstrated that they were involved in cell proliferation, indicating that preeclampsia affected this pathway. In addition, 26 downregulated miRNAs were identified by microarray methods. The functions of these miRNAs included immune regulation, vascular development, cancer pathology and pathology of other disease (tuberculosis, oligozoospermia, psoriasis and Alzheimer's disease). Using qPCR, the most differentially expressed miRNAs were confirmed to be hsa-miR-1304-5p, hsa-miR-320a and hsa-miR-5002-5p, which were upregulated, as well as hsa-miR-188-3p, hsa-miR-211-5p, hiv1-miR-TAR-3p, hsa-miR-4432 and hsa-miR-4498 that were significantly downregulated in the plasma of preeclampsia patients. The present findings may be useful in the development of early diagnosis markers and treatment targets for preeclampsia.

Imitators of severe preeclampsia: on differential diagnosis and multidisciplinary management

Preeclampsia (PE) is not only a disease of pregnant women, but also a disease with lifelong consequences for mother and child. Making an early diagnosis and differential diagnosis of PE is crucial yet challenging, since PE can be mistaken for other internal diseases or surgical conditions. Despite the variety of clinical symptoms of thrombotic microangiopathy that may manifest in a non-typical picture of PE, progressive multiple organ failure develops in all cases. It seems promising to study the role of matrix metalloproteinases and determine the genetic predisposition to early and severe PE. The forecast and prevention attempts must begin from the fertile cycle. A better knowledge of biochemical and genetic markers along with the clinical and instrumental tests will reduce the morbidity and mortality in PE patients.

Detection of benzodiazepines and antidepressants consumption during pregnancy: Maternal hair vs. meconium

The most common mental diseases in pregnant women are depression and anxiety disorders (estimated prevalence 6.5–12.9% and 15.6%, respectively [1] , [2] ). The drugs used in their treatment (antidepressants and benzodiazepines) can produce serious obstetric complications, as well as deleterious effects in fetal development and later in life [1] . The aim of this study was to compare maternal hair and meconium for detecting in utero drug exposure to benzodiazepines and antidepressants. Maternal hair and meconium samples were collected after delivery from 145 mother–newborn dyads. Samples were analyzed for the determination of benzodiazepines (alprazolam, clonazepam, bromazepam, diazepam, nordiazepam, lorazepam, lormetazepam, oxazepam, flunitrazepam, 7-aminoflunitrazepam, triazolam, and zolpidem), antidepressants (amitriptyline, clomipramine, fluoxetine, paroxetine, venlafaxine, citalopram), and 6 metabolites by LC-MS/MS. Hair samples were segmented in 3 segments corresponding with the 3 trimesters ( n = 99), but if the amount of hair was not enough a 8-cm segment was employed ( n = 46). Maternal hair results (LOQ = 5–20 pg/mg) and meconium Results (LOQ = 5–20 ng/g) were compared. Forty-nine hair samples (33.8%) tested positive, 23 (15.9%) for benzodiazepines (19 segmented and 4 non-segmented) and 33 (22.8%) for antidepressants (23 segmented and 10 non-segmented). Specifically, the most frequently detected compounds in hair were nordiazepam ( n = 13, > LOD-224.6 pg/mg), citalopram ( n = 11, 30.2–7166.1 pg/mg), diazepam ( n = 10, 6.6–879.5 pg/mg), amitriptyline ( n = 8, 11.3–556.5 pg/mg), and venlafaxine ( n = 8, 14.4–659.1 pg/mg). Twenty-eight meconium samples (19.3%) tested positive, 24 (16.6%) for benzodiazepines and 8 (5.5%) for antidepressants. The most frequently detect compounds in meconium were nordiazepam ( n = 16, > LOD-125.1 ng/g), diazepam ( n = 12, > LOD-68.6 ng/g), citalopram ( n = 5, > LOD-2729.5 ng/g) and its metabolite desmethylcitalopram ( n = 4, > LOD-1286.1 ng/g), and alprazolam ( n = 3, 5.7–42.2 ng/g). The overall agreement between maternal hair and meconium results was 66.9%, but this value increased to 70.2% when only the hair results corresponding with the third trimester were compared with meconium. This good agreement was due to the high percentage of negative results ( n = 84), but if only positive results were analyzed the percentage decreased to 19.7% and 42.6%, respectively. A better correlation was found between positive results in both specimens for benzodiazepines (39.1%) than antidepressants (18.2%). Moreover, when hair samples were positive in the three trimesters ( n = 15), meconium was positive in 7 cases, and in the remaining cases the concentration in hair was decreasing along pregnancy, except in one case. Surprisingly, when benzodiazepines were administrated during delivery ( n = 15), in 6 cases meconium tested positive at low concentrations (1.1–8.6 ng/g). Maternal hair was more sensitive than meconium to detect consumption during pregnancy, while meconium was able to detect consumption during the third trimester and also during delivery.

Features of etiology, pathogenesis, treatment and prophylaxis of periodontal diseases in pregnant women in the context of iron deficiency anemia (review of the literature)

An important task of modern dentistry is the study of dental morbidity in pregnant women with somatic pathology. This is due to many factors, including a significant prevalence of periodontal diseases among the population, infection impact on the body of the pregnant woman and the fetus, an increase in the frequency of somatic diseases in pregnant women.The aim of the retrospective literary research was to study modern scientific trends regarding the peculiarities of etiology, pathogenesis, treatment and prophylaxis of periodontal diseases in pregnant women with iron deficiency anemia.The collection of scientific publications (30 sources), including 19 domestic and 11 foreign professional sources, has been analyzed on the current issue of modern dentistry: periodontal diseases in pregnant women with iron deficiency anemia. The aspects of high prevalence of periodontal diseases among this contingent of patients, their polyethiologic origin, complex mechanism of development, peculiarities of treatment and prevention have been considered. According to the authors' researches, it was found that catarrhal gingivitis is the most common clinical form of the inflammatory process in the 1st trimester, gingivitis of pregnant women develops as a catarrhal or hypertrophic inflammation, rarely - ulcerous-necrotic gingival lesion in the 2nd trimester. The clinical picture of hypertrophic gingivitis in pregnant women is to be seen in its most clinical manifestation in the 3rd trimester and in the immediate prenatal period. Taking into account the fact that to date, in the majority of women, the actual consumption of macro- and micronutrients and vitamins with food is much lower than the level that provides a favorable course of pregnancy and lactation, the use of vitamin-mineral complexes are obligatory in pregnant women with periodontal disease and concomitant iron deficiency anemia. At the initial stages of generalized periodontitis, vitamin therapy is most effective. Today, foreign authors refer to the concept of micronutrient programming of the future baby's development during pregnancy, which is the applicability of multivitamin complexes. The main task of dentists and obstetrician-gynecologists is to create a conscious awareness of the importance of timely dental care in pregnant women by forming a positive motivation among expecting mothers to seek dental care. From these data, the optimal periods of dental examinations and differential approach to medical preventive measures can be determined.

Modern approach to pharmacotherapy of gastroesophageal reflux disease in pregnant women

Modern approach to pharmacotherapy of gastroesophageal reflux disease in pregnant women