Early Pregnancy Period Research Articles

Changes in the expression and distribution of junction and polarity proteins in the porcine endometrium during early pregnancy period

The maternal endometrium undergoes transformations during early pregnancy period to regulate the paracellular permeability across the epithelium and to enable adhesion between the trophoblast and endometrial epithelial cells. These transformations, under the influence of ovarian hormones, are associated with a partial loss in polarity of epithelial cell that is regulated by tight junctions (TJ), adherens junctions (AJ) and associated polarity protein complexes. This study examined the change in expression and distribution of proteins associated with TJs, AJs and apical partition defective (PAR) complex in porcine endometrium on Days 10, 13 and 16 of estrous cycle and pregnancy. Moreover, effect of hormones, progesterone (P4) and 17-β estradiol (E2) on polar phenotype of endometrial epithelial cells was also investigated in vitro. There was pregnancy induced increase in gene and protein expression of TJ associated claudin-1 (CLDN1) on Day 13 of pregnancy as compared to corresponding day of estrous cycle and a decrease in TJ protein, zona occludens-1 (ZO-1) and PAR complex associated PAR6 expression levels on Day 16 of pregnancy (P < 0.05). Immunofluorescence studies revealed that on Days 10 and 13, TJ proteins occludin (OCLN) and ZO-1were primarily present in the apical region of lateral epithelial membrane. On Day 16 of pregnancy, whereas, OCLN redistributed into cytoplasm, ZO-1 decreased apically but was found to localize in the basal epithelium. The AJ proteins cadherin and β-catenin were located at the apical epithelium on Day 10 of estrous cycle and pregnancy and Day 13 of estrous cycle. On Days 13 and 16 of pregnancy both proteins were expressed in the lateral membrane and co-localization between these proteins was observed on Day 16. On Day 10, PAR complex proteins PAR3, cell division control protein 42 (CDC42) and atypical protein kinase C (aPKC) ζ were observed in apical epithelium and in lateral membrane and CDC42 was also present in the cytoplasm of epithelium. Pregnancy induced redistribution of aPKCζ to cytoplasm and CDC42 to apical surface of luminal epithelium was observed on Days 13 and 16. The in vitro P4 and E2 treatment of epithelial cells mimicked in vivo results. These results indicate that P4 and E2 regulate alterations in epithelium that may facilitate embryo implantation and given the role of cadherin, catenin and CDC42 in embryo invasion, change in distribution of these proteins may limit the invasiveness of porcine conceptuses into the stroma.

Risk of venous thromboembolism in Chinese pregnant women: Hong Kong venous thromboembolism study.

BackgroundPrevious Caucasian studies have described venous thromboembolism in pregnancy; however, little is known about its incidence during pregnancy and early postpartum period in the Chinese population. We investigated the risk of venous thromboembolism in a “real-world” cohort of pregnant Chinese women with no prior history of venous thromboembolism.MethodsIn this observational study, 15,325 pregnancies were identified in 14,162 Chinese women at Queen Mary Hospital, Hong Kong between January 2004 and September 2016. Demographic data, obstetric information, and laboratory and imaging data were retrieved and reviewed.ResultsThe mean age at pregnancy was 32.4±5.3 years, and the median age was 33 years (interquartile range, 29–36 yr). Pre-existing or newly diagnosed diabetes mellitus was present in 627 women (4.1%); 359 (0.7%) women had pre-existing or newly detected hypertension. There was a small number of women with pre-existing heart disease and/or rheumatic conditions. Most deliveries (86.0%) were normal vaginal; the remaining were Cesarean section 2,146 (14.0%). The incidence of venous thromboembolism was 0.4 per 1,000 pregnancies, of which 83.3% were deep vein thrombosis and 16.7% were pulmonary embolism. In contrast to previous studies, 66.7% of venous thrombosis occurred in the first trimester.ConclusionChinese women had a substantially lower risk of venous thromboembolism during pregnancy and the postpartum period compared to that of Caucasians. The occurrence of pregnancy-related venous thromboembolism was largely confined to the early pregnancy period, probably related to the adoption of thromboprophylaxis, a lower rate of Cesarean section, and early mobilization.

Relationship of foetal number and parity in Barbari goats to plasma profile of caprine pregnancy-associated glycoprotein (caPAG) during gestation and the early postpartum period

This study was conducted to characterise pregnancy-associated glycoprotein (caPAG) in peripheral plasma during gestation and postpartum periods of nulliparous and multiparous does with one or two foetuses using a caPAG specific two-step sandwich ELISA system. Earliest time-points for detection of pregnancy and foetal number with appropriate cut-off values were identified. Plasma samples from 15 pregnant (multiparous: n = 8; nulliparous: n = 7; during pregnancy and postpartum period) and six non-pregnant (during oestrous cycle) goats were collected and analysed. Mean caPAG concentration was greater than the threshold for pregnancy detection (S-N = 0.40) on d22, peaked on d45 and remained unchanged until parturition. From d45 until parturition, caPAG concentration in multiparous does with two foetuses was 1.4 to 1.8 fold greater (P < 0.001) than those with one foetus. For the ELISA, 0.83 (S-N) was the most appropriate cut-off to differentiate does with two from those with a single foetus with an overall sensitivity and accuracy of 88.9% and 84.7%, respectively. Circulating caPAG concentration in multiparous goats was greater (P < 0.05) compared with nulliparous goats during the early pregnancy and postpartum periods. After parturition, caPAG concentrations markedly decreased and were basal within 14 days postpartum. In conclusion, using the caPAG specific ELISA, results indicated there were unique gestational and postpartum profiles for caPAG concentrations that are affected by number of foetuses and parity of the doe. The marked decrease in concentration of caPAG following parturition indicates there would not be compromising of the detection of subsequent pregnancies in goats using this technique.

The effect of dexamethasone on mucosal immunity of uterine tissue during pregnancy in rat

Disturbances in early pregnancy immunity affect embryo development, endometrial receptivity, placental development, fetal growth and lead to subfertility, dexamethasone is a synthetic glucocorticoid used for treatment of various complications. Immune cells and cytokines were examined during the early pregnancy in twenty-four female rats and six male rats for mating. Rats were grouped into two group control and dexamethasone treated by a dose of 50µgm/kgm body weight daily starting from one week before mating and persisted for one week after pregnancy. Blood samples were collected from each rat at 5hrs and at 1,3,7 day of pregnancy. Extracted RNA was subjected to real time PCR to determine mRNA levels for immune related genes interleukin1a(IL1A) and interleukin 10(IL10). Histopathological examination was done to uterus in order to detect leukocyte infiltration in uterine tissue. Results showed that significant increase in white blood cell count mainly eosinophil at 5hrs and lymphocyte at three and seven day of pregnancy of dexamethasone treated group. Moreover, TNF, C-reactive protein and progesterone were increased mainly at seven day of pregnancy of dexamethasone treated group. Similarly, interleukin 1alpha and interleukin 10 significantly increased at 5hrs and one day of pregnancy of dexamethasone treated group. In contrast, serum levels of total antioxidant capacity and estrogen were decreased significantly at 5hrs and seven day in dexamethasone treated group. Histopathological examination of uterus revealed leukocytic infiltration especially neutrophil and few eosinophils at five hours and one day of gestation then eosinophil become absent at 3day and seven day of dexamethasone group. Epithelial height and uterine gland diameter significantly increased at 5hrs, three day and seven days of gestation of dexamethasone treated group. The present investigation demonstrated that using of dexamethasone by dose of 50µgm/kgm during early pregnancy had a conflicting impact on some immune cytokines and parameters and may reflect a harmful response of immune system toward early period of pregnancy

Association of maternal disease and medication use with the risk of congenital heart defects in offspring: a case-control study using logistic regression with a random-effects model.

Objective To examine the association between maternal diseases and congenital heart defects (CHDs) and to evaluate whether those associations vary with corresponding medication use. Methods A multi-hospital case-control study conducted from February 2010 to December 2014 analysed 916 controls and 1236 cases. Participating mothers were asked whether they suffered from influenza, common cold, herpes and threatened abortion or had used corresponding medication during the periconception period or the early pregnancy period. We used a random-effects logistic regression model to compute the odds ratios (ORs), adjusted odds ratios (AORs) and 95% confidence intervals (CIs) while controlling for potential confounders. Results Compared with the results for mothers with no exposure, there were significant associations between maternal diseases with medication non-use and CHDs in the aggregate, including influenza (AOR, 1.83; 95% CI, 1.13-2.95), common cold (AOR, 2.05; 95% CI, 1.60-2.64) and herpes (AOR, 7.00; 95% CI, 2.15-22.84). There was no significant association between medication users and offspring with any subtype of CHDs, except that maternal common cold with medication use slightly increased the risk of the specific subtype, namely, isolated cardiac defects. However, an association was observed between maternal threatened abortion and medication and isolated cardiac defects (AOR, 1.33; 95% CI, 1.01-1.75). Conclusion Maternal influenza, common cold, herpes and threatened abortion from 3 months before pregnancy through the first trimester were associated with an increased risk of congenital heart disease in offspring. The teratogenic effect of these conditions may be attenuated by medication use, except for threatened abortion.

MicroRNA-145 targets Smad1 in endometrial stromal cells and regulates decidualization in rat.

Decidualization of endometrial stromal cells is the pre-requisite for the embryo implantation and establishment of pregnancy. Although known to be regulated by several factors, the process of regulation of decidualization by miRNAs is largely unknown. Previous reports suggest that the upregulated expression of miR-145 is associated with repeated implantation failure. The current study was aimed to identify and validate the role of miR-145 in regulating stromal cell decidualization and the mechanism involved therein. Expression of miR-145 was found to be downregulated during the decidualization period of early pregnancy and also in artificially induced decidualization in rat uterus. During in vitro decidualization in rat endometrial stromal cells (ESCs), the overexpression of mimic miR-145 attenuated the progression of decidualization. Biochemical marker alkaline phosphatase and protein markers (insulin-like growth factor binding protein, cyclin D3) were also suppressed in miR-145 mimic-transfected cells as compared to normal decidualized cells. Bioinformatic analysis and luciferase reporter assay confirmed that Smad1 is the direct target of miR-145. Differentiation of ESCs was inhibited in miR-145 mimic-transfected cells which occurred via downregulating the target Smad1 along with its downstream p-Smad1/5/8 and Wnt-4. Pre-treatment of ESCs with Smad1 siRNA resulted in downregulated expression of p-Smad1/5/8, Wnt-4, Cox-2, and VEGF. In addition, miR-145 overexpression resulted in the loss of angiogenic factors Cox-2, MMP-9, and VEGF, indicating suppression of the process of angiogenesis. Migration of human umbilical vein endothelial cells was also attenuated in the presence of conditioned media obtained from miR-145-transfected decidualizing cells. In conclusion, the study demonstrated the role of miR-145 in regulation of progression of decidualization which is mediated through inhibition of Smad1. KEY MESSAGES: MiR-145 expression is downregulated during decidualization in the rat uterus. Overexpression of miR-145 inhibited the decidualization progression. MiR-145 suppressed the migration and invasion of HUVECs. MiR-145 downregulated Smad1 which suppresses Smad1/5/8, Wnt-4, MMP-9, Cox-2, and VEGF.

Thyroid hormone profiles and TSH evaluation during early pregnancy and the transition period in dairy cows

The thyroid hormone axis is one important endocrine system within a complex system of various factors and hormones necessary to establish and maintain pregnancy in cattle and in metabolic adaptations towards lactation. Pregnancy and lactation occur contemporaneously in dairy cows, and have major impacts on thyroid hormones as well as status of the hypothalamus-pituitary thyroid axis influences pregnancy and lactation. As especially the thyroid hormone axis with special focus to TSH is not well studies in the past, the aim of the study was to examine the thyroid hormone axis, especially in heifers during adaptation to the first lactation, to verify the association between lactation and thyroid hormones. Secondly, the early pregnancy period was the focus of the present investigation. To determine thyroid hormone patterns and especially thyroid-stimulating hormone (TSH) during the transition period, 12 primiparous Holstein Friesian cows and 41 pregnant and 34 non-pregnant pluriparous cows were sampled. During the transition period, thyroxin (T4) concentrations decreased after calving in primiparous cows, and the milk yield [kg] was negatively correlated with triiodothyronine (T3) and T4 concentrations. In pregnant and non-pregnant pluriparous cows, T3, T4, TSH and free T4 (fT4) decreased between the day of ovulation (day 0) and day 18. From day 18 of gestation to day 100 after AI, an increase in TSH and fT4 and a decrease in Reverse T3 (rT3) was observed in the pregnant cows. In conclusion, the results of the present study confirm that regulative processes within the thyroid hormone metabolism occur during early lactation. For the first time it could be shown in dairy cows that TSH and fT4 increased during early pregnancy whereas rT3 decreased indicating also in bovine species a TSH stimulatory effect by pregnancy.

Case Study of a Very Early Diagnosed and Successfully Treated Heterotopic Pregnancy

Spontaneous heterotopic pregnancy (HP) is rare and defined as combination of intrauterine and ectopic embryo implantation in one pregnancy. Most cases present with acute abdominal pain with hemoperitoneum. During the early stages of pregnancy, a HP diagnosis is uncommon. In the following, we present a case report of spontaneous HP, which was diagnosed before tubal rupture, and discuss methods of early diagnosis. A 27-year-old woman was admitted to the clinic complaining of vaginal spotting. An ultrasonography revealed two corpus luteum cysts, as well as a six-week intrauterine pregnancy together with a right tubal pregnancy with no pelvic free fluid. A laparoscopic right salpingectomy was performed. The pregnancy continued with no complications and ended after a gestation period of 38 weeks and four days with a vaginal delivery. In conclusion, it could be beneficial to use a vaginal ultrasound for examining not only uterus but also both adnexal regions at the early pregnancy period.

Maternal use of thyroid hormone replacement therapy before, during, and after pregnancy: agreement between self-report and prescription records and group-based trajectory modeling of prescription patterns.

PurposeA reliable definition of exposure and knowledge about long-term medication patterns is important for drug safety studies during pregnancy. Few studies have investigated these measures for thyroid hormone replacement therapy (THRT). The purpose of this study was to 1) calculate the agreement between self-report and dispensed prescriptions of THRT and 2) classify women with similar adherence patterns to THRT into disjoint longitudinal trajectories.MethodsOur analysis used data from the Norwegian Mother and Child Cohort Study (MoBa), a prospective population-based cohort study. MoBa was linked to prescription records from the Norwegian Prescription Database (NorPD). We estimated Cohen’s kappa coefficients (k) and approximate 95% CIs for agreement between self-report and prescription records for the 6-month period prior to pregnancy and for each pregnancy trimester. Using group-based trajectory models (GBTMs), we estimated adherence trajectories among women who self-reported and had a THRT prescription.ResultsThere were 56,148 women in MoBa, who had both a record in NorPD and available prescription history up to 1 year prior to pregnancy. Of these, 1,171 (2.1%) self-reported and received a prescription for THRT. Agreement was “perfect” in the 6-month period prior to pregnancy (k=0.86; CI 0.85–0.88), in the first (k=0.83; CI 0.82–0.85) and in the second trimesters (k=0.89; CI 0.87–0.90), while this was moderate (k=0.57; CI 0.54–0.59) in the third trimester. Among the subset of the 1,171 women, we identified four disjoint GBTM adherence groups: Constant-High (50.2%), Constant-Medium (32.9%), Increasing-Medium (11.0%), and Decreasing-Low (5.8%).ConclusionAgreement between self-report and prescription records was high for THRT in the early pregnancy period. Based on our GBTM results, about one in two women with hypothyroidism had adequate adherence to prescribed THRT throughout pregnancy. Given the potential consequences, evidence of low adherence in 5.8% of pregnant women with hypothyroidism is of concern.

Activation of CCL20 and its receptor CCR6 promotes endometrium preparation for implantation and placenta development during the early pregnancy period in pigs

The success of implantation and placentation during early pregnancy depends on the intrauterine environment of diverse histotrophs, including nutrients, growth factors, cytokines, and chemokines. Here, we determined the functional role and signal transduction of CC-motif chemokine 20 (CCL20) in the porcine endometrium during pregnancy. The expression of CCL20 and its receptor CCR6 was abundant in the glandular epithelium (GE) and luminal epithelium (LE) of the porcine endometrium during early pregnancy. Administration of CCL20 to porcine endometrial LE cells increased cellular proliferation with strong PCNA expression by activation of PI3K and MAPK signaling. Blocking PI3K and MAPK decreased the CCL20-mediated elevated proliferation of pLE cells. Moreover, the proliferation of pLE cells was enhanced by inhibiting the LPS-induced cytokines and tunicamycin-induced endoplasmic reticulum (ER) stress response proteins. Overall, these results suggest that CCL20 may improve the endometrial receptivity through inducing proliferative signal transduction in the porcine endometrium during the early gestational period.

Correlation of two radioimmunoassay systems for measuring plasma pregnancy-associated glycoproteins concentrations during early pregnancy and postpartum periods in water buffalo.

This is the first time that PAG determination using two different antisera raised against PAG molecules purified from both caprine (RIA-706) and bubaline placentas (RIA-860) is reported in water buffalo. Ninety-eight buffalo cows, belonging to a buffalo herd subjected to a synchronization and artificial insemination (AI) programme, were enrolled in this study. Blood samples were taken on days 0 (AI), 23, 25, 28, 30 and 45. Pregnancy was confirmed by ultrasonography on days 28 and 45. The blood of 20 buffaloes that had calved was tested every five days from the day of calving until day 50 postcalving. Differences in PAG concentrations were observed between pregnant and nonpregnant buffaloes starting from day 23 post AI using both RIA-706 and RIA-860 (p<0.001). However, estimated mean concentrations of PAG measured by RIA-706 were higher than RIA-860 (p<0.001) and Bland-Altman analysis showed biases ranged from 0.0ng/ml at day 23 to 0.79ng/ml at day 28 post AI. Moreover, RIA-706 showed greater sensitivity and accuracy both at 23 and 25days of pregnancy. RIA-706 and RIA-860 decreased below 1ng/ml from 40 and 30days postpartum, respectively, suggesting that PAG are better recognized by the antisera raised against the caprine PAG in the postpartum period also. This is essential when using PAG as an appropriate marker of early pregnancy after postpartum for detecting new pregnancies. The results of this study show that the ability of RIA systems to recognize early PAG could be improved using antisera raised against PAG molecules isolated from caprine placenta.

Neonatal lactocrine deficiency affects the adult porcine endometrial transcriptome at pregnancy day 13.

Reproductive performance of female pigs that do not receive sufficient colostrum from birth is permanently impaired. Whether lactocrine deficiency, reflected by low serum immunoglobulin immunocrit (iCrit), affects patterns of endometrial gene expression during the periattachment period of early pregnancy is unknown. Here, objectives were to determine effects of low iCrit at birth on the adult endometrial transcriptome on pregnancy day (PxD) 13. On the first day of postnatal life, gilts were assigned to high or low iCrit groups. Adult high (n=8) and low (n=7) iCrit gilts were bred (PxD 0), and humanely slaughtered on PxD 13 when tissues and fluids were collected. The endometrial transcriptome was defined for each group using mRNAseq and microRNAseq. Reads were mapped to the Sus scrofa 11.1 genome build. Mature microRNAs were annotated using miRBase 21. Differential expression was defined based on fold change (≥±1.5). Lactocrine deficiency did not affect corpora lutea number, uterine horn length, uterine wet weight, conceptus recovery, or uterine luminal fluid estrogen content on PxD 13. However, mRNAseq revealed 1157 differentially expressed endometrial mRNAs in high versus low iCrit gilts. Differentially expressed genes had functions related to solute transport, endometrial receptivity, and immune response. Six differentially expressed endometrial microRNAs included five predicted to target 62 differentially expressed mRNAs, affecting similar biological processes. Thus, lactocrine deficiency on the first day of postnatal life can alter uterine developmental trajectory with lasting effects on endometrial responses to pregnancy as reflected at the level of the transcriptome on PxD 13.

Epidemiological Survey of Toxoplasmosis among Aborted Women in Garmian district, Kurdistan Region, Iraq

Toxoplasmosis is a zoonotic infection that caused by an obligated intracellular parasite Toxoplasma gondii of many types of tissues, including nervous, muscular and intestinal epithelial tissue. Congenital toxoplasmosis is most severe condition when occurs in early period of pregnancy. The main aim of this study is to determine prevalence of toxoplasmosis among aborted women in Garmian region by using both Latex Agglutination Test (LAT) and Enzyme Linked Immunosorbent Assay (ELISA). The study was carried out in Kalar General Hospital to detect Toxoplasma antibodies among 350 samples, in which 250 samples were from aborted women and 100 samples were from normal birth women as a control. Participants’ age was range from &lt; 18 to &gt; 35 years old. The data were collected form 15th January 2009 to 25th June 2010 by using a special questionnaire form to obtain full information from each participant. For statistical analysis of the data, Statistical Package for Social Sciences (SPSS) version 22 was used. The study showed that (112) cases out of 250 were seropositive for Toxoplasma gondii by using LAT, (65) cases for IgG and (50) cases for IgM by using ELISA. In the abortion group, it showed (87) cases out of 150 were seropositive by using LAT, (51) cases for IgG and (40) cases for IgM (26.6%), whereas in normal birth group (control), it showed (25) case out of 100 were seropositive by using LAT, (14) case for IgG and (10) case for IgM by using ELISA. A High seropositivity percentage was recorded among housewives (35.2%) than teachers and employees (29.4%), (28.5%) respectively. Furthermore, a higher percentage of Toxoplasma seropositivity was recorded in rural area than urban area. The aborted women who were in contact with soil showed the higher rate of Toxoplasma seropositivity (38.7%) than those were not in contact with soil (25%). This study concluded that the prevalence of toxoplasmosis was higher in Garmian region and especially among those women who have lower education level and who live in rural areas.

The effect of organic quail egg supplementation on the blood lipid profile of white mice (Rattus Norvegicus L.) during the lactation period

Background: Quail eggs contain a considerable amount of complete nutritional sources such as carbohydrates, proteins, fats, and micronutrients. However, they also have a high cholesterol level, which can potentially cause atherosclerosis and chronic heart diseases. The response of the body to foods containing is influenced by factors such as ethnicity, genetics, and hormonal and nutrient status of the consumer. The cholesterol level of quail eggs can be reduced by manipulating the feed using supplemental organic feed. Organic quail eggs have been believed to correct the lipid profile of white mice during the lactation phase. Purpose: The aim of this study was to analyze the effect of feed containing organic quail eggs on the blood lipid profile of white mice (Rattus norvegicus L.) during the lactation phase. Materials and Methods: This experimental study was conducted using a completely randomized design with four experiments and five repetitions. Experimental mice: T0 mice were used as control; T1 mice were supplemented with quail eggs produced by quails that were fed with standard feed; T2 mice were supplemented with eggs produced by quails fed with standard organic feed; and T3 mice were supplemented with eggs produced by quails fed with organic feed with the addition of cassava leaf flour, mackerel flour, and turmeric powder. Quail egg supplementation was administered to the mice from the early pregnancy period till the end of the lactation phase. The acquired data were analyzed using ANOVA. SPSS version 16.0 software for Windows was used for data analyses. Results and summary: Feeding the white mice with different compositions of organic quail egg supplements had no effect on the consumption of feed and water, body weight, and lipid profile (including total cholesterol, LDL, HDL, and triglyceride) during the lactation phase (P > 0.05).

Frequency and Determinants of Maternal Anaemia in Early Postpartum Period

Objective: To determine the frequency and risk factors of maternal anaemia after delivery.&#x0D; Methods: A cross-sectional study was carried out in two private tertiary care hospitals of Karachi over a period of six month from April to October 2017. A sample of 300 postpartum women was recruited in the study by convenient sampling.&#x0D; Inclusions criteria were women more than 24 hours or up to one week following delivery of babies of more than 28 weeks of gestation and all booked cases of hospitals that consented to take part in re- search study. Exclusion criteria were women who had no antenatal visits and haemoglobin estima- tion in third trimester of pregnancy.&#x0D; Data was collected using predesigned questionnaire after taking informed consent. Haemoglobin lev- els were noted in early pregnancy, third trimester and postpartum period.&#x0D; Results: The study group comprises of 135 (47.9%) women with postpartum anaemia, whereas 147 (52.1%) women had normal level of haemoglobin. A total of 72 (25.5%) women had a rise in haemo- globin,192 (62%) women had low and 18 (6.4%) women had unchanged postpartum haemoglobin as compared to the third trimester haemoglobin level.&#x0D; The mean age of the study group was 27.59 ± 4.221. Inadequate iron intake was noted in 66 (48.9%) women in the anaemic group, whereas it was found in 51 (34.7%) women in the non-anaemic group (p-value=0.000, OR=0.083). Anaemia was diagnosed during pregnancy in 105 (77.8%) women in anaemic group, whereas 33 (22.4%) women had anaemia during pregnancy in non-anaemic post- partum group (p-value=0.000, OR=0.083). Caesarean section was performed in 84 (62.3%) women with postpartum anaemia (p-value=0.010, OR=0.537). A total of 27 (20%) women with postpartum anaemia had episiotomy during normal vaginal or instrumental deliveries (p-value=0.042, OR=1.765).&#x0D; Conclusion: Frequency of early postpartum anaemia is high. Anaemia during pregnancy, inadequate iron intake, vaginal delivery with episiotomy and caesarean section were significant risk factors.

Characteristics of bioelectrical activity of oviducts and uterus during early pregnancy in sows recorded by telemetry method.

What is the central question of this study? The aim of present study was to record and analyse the myoelectrical activity in the female pig reproductive tract (uterus and oviduct) during early pregnancy. What is the main finding and its importance? Understanding the contractile activity of the uterus and oviducts is indispensable for understanding the physiological mechanisms as well as all irregularities associated with the period of conception and early pregnancy. The aim of the present study was to record the myoelectrical activity of the reproductive tract in sows during the oestrous phase and early pregnancy via a telemetry recording system. In a total of eight non-pregnant pigs, the bioelectrical activity was recorded through three silicone electrodes sutured on the oviduct (isthmus and ampulla) and the uterine horn. Blood samples were collected to monitor the concentrations of progesterone (P4) and luteinizing hormone (LH). The oestrous cycle was synchronized with equine chorionic gonadotrophin (eCG) and human chorionic gonadotrophin (hCG), and the animals were subjected to artificial insemination. Analysis of the EMG activity of the oviduct and uterus in the oestrous phase and in early stages of pregnancy suggests explicitly that telemetry could enable in vivo assessment of myoelectrical activity of parts of the reproductive system in sows. Off-line analysis of the duration of EMG activity bursts in the uterus, isthmus and ampulla were significantly higher during early pregnancy (phases II and III) than in the oestrous phase. The EMG signals demonstrated low mean amplitudes of activity in the oviduct and uterus during early pregnancy (phases I-III). Significant differences between the root mean square signals were observed in the isthmus and ampulla both during oestrus and in early pregnancy (phase I; P<0.01). During the oestrous phase, the P4 concentration was estimated at <1ngml-1 , whereas the LH concentration was >4ngml-1 . In contrast, during early pregnancy, the P4 and LH concentrations were estimated at >4 and <1ngml-1 , respectively.

Profile of MicroRNA Expression in Endometrial Cell during In Vitro Culture According to Progesterone Concentration.

Artificial uterus using endometrium implant can be a novel treatment strategy for infertile women with refractory endometrial dysfunction. At early pregnancy, the function of uterine endometrial cells for the communication between the conceptus of pre-implantation period and maternal reproductive system is essential. MicroRNA (miR) expression profile of endometrial cells according to progesterone, a crucial pregnancy-maintaining hormone, provides important data for in vitro endometrial cell culture strategy that is useful for engineering artificial uteri using endometrial implants. The present study aimed to evaluate the miR expression profile of in vitro cultured endometrial cells under hormonal milieu mimicking early pregnancy period in terms of progesterone concentration. We cultured murine uterine endometrial cells, human uterine endometrial carcinoma cells, and immortalized human uterine endometrial cells using different progesterone concentrations, and analyzed the expression of miRs critical for early pregnancy. The expression of miR-20a, -21, -196a, -199a, and -200a was differently regulated according to progesterone concentration in different endometrial cell lines. The analysis of candidate target genes showed that the expression of phosphatase and tensin homolog, mucin 1 (MUC1), progesterone receptor, transforming growth factor β receptor II, matrix metallopeptidase-9 was up-regulated by progesterone treatment in mouse and human endometrial cell lines. These results indicate that physiological concentration range (10-7 and 10-9 M) of progesterone affect the survival and target gene expression via modulating miR expression. Taken together, progesterone can be a crucial factor in regulating miR expression on in vitro cultured endometrial cells.

Validity of New Ballard Score Untill 7th Day of Postnatal Life In Preterm Neonate

Background: Premature infant mortality &amp; morbidity is influenced by intrauterine growth &amp; maturation. In our perspective unavailability of accurate LMP from mother, early USG report or home delivered preterm baby that admitted after 4th day of postnatal age create great dilemma regarding the assessment of gestational age (GA).Objective: To validate the New Ballard Score (NBS) until 7th day of postnatal age in preterm neonate.Methods: This observational cross sectional study was conducted in pediatric ward, Rajshahi Medical College Hospital from 1st January 2009 to 31st December 2009. A total of 129 preterm neonate, GA ranging from 29wk to 35 wk, without any medical problem were included in this study. Accurate documentation of LMP of mother and USG during early pregnancy period were available for each study sample. GA of the babies were determined by NBS on 1st, 5th and 7th postnatal age and compaired with LMP &amp; USG based GA. Various raw score was obtained from broken total score in D1 compared with D5 &amp; D7. LMP based GA also compared with USG based GA.Results: Total NBS of D1 were tested with D5 &amp; D7 for level of agreement &amp; degree of correlation. For D1 with D5, r value was 0.97 and for D1 with D7, r value was 0.681. So, NBS of D1 positively correlated with NBS of D5 and D7. The total physical score also positively correlated with D1 versus D5 &amp; D7 (r value 0.975 &amp; 0.796). The total neurological score positively correlated with D1 versus D5 &amp; D7 (r value 0.893 &amp; 0.630). Neurological score were more significant than physical score. All p values were statistically significant (p value ?0.001). GA by NBS &amp; LMP was positively correlated (r=0.94) as well as GA by NBS &amp; USG (r=0.94). GA by NBS did not differ more than 2 weeks from LMP or USG based GA of any particular subjects.Conclusions: The tendency of over estimates the GA by NBS increased from Day 1 to Day 5 to Day 7. But the GA calculated from LMP &amp; USG did not differ more than 2 weeks from GA by NBS. Thus NBS can be used as a clinical tool to detect GA up to Day 7 of postnatal life.Bangladesh J Child Health 2017; VOL 41 (1) :24-27

Are concentrations of alkaline earth elements in maternal hair associated with risk of neural tube defects?

The relationship between maternal intake of alkaline earth elements (AEEs) during the period of neural tube closure and the risk of neural tube defects (NTDs) is still unclear. We propose that AEE deficiency during the early period of pregnancy is associated with an elevated risk of NTDs in the offspring. In this study, we recruited 191 women with NTD-affected pregnancies (cases) and 261 women who delivered healthy infants (controls). The concentrations of four AEEs (Ca, Mg, Sr, Ba) in maternal hair sections that grew during early pregnancy were analyzed. Information on the dietary habits of the mothers was also collected by questionnaire. Higher concentrations of the four AEEs in hair had protective effects against the risk of total NTDs, with odds ratios with 95% confidence interval (comparing groups separated by each median level) of 0.44 (0.28–0.68) for Mg, 0.56 (0.36–0.87) for Ca, 0.45 (0.28–0.70) for Sr, and 0.41 (0.26–0.65) for Ba. Significant negative dose-response trends were identified for the relationships between the four AEE concentrations in maternal hair and the risks of anencephaly and spina bifida, but not for encephalocele. The frequencies of maternal consumption of fresh green vegetables, fresh fruit, and meat or fish were positively correlated with the concentrations of AEEs in hair. We concluded that the maternal intake of AEEs may play an important role in preventing NTD formation in offspring, and that this intake is related to maternal dietary habits of consuming fresh green vegetables, fresh fruit, and fish or meat.

A comparison between the effects of ginger, pyridoxine (vitamin B6) and placebo for the treatment of the first trimester nausea and vomiting of pregnancy (NVP)

Introduction: Nausea and vomiting of pregnancy (NVP) are one of the most common complains of the early pregnancy period and are bothersome for pregnant women. Some prefer to use herbal medicine instead of chemical agents.Objective: The purpose of the present study was to compare the effects of ginger, pyridoxine (vitamin B6), and placebo for the treatment of NVP.Method: The study was performed as a triple blind clinical trial on pregnant women suffering mild to moderate NVP between 6 and 16 weeks of pregnancy. In these women ginger, 500 mg twice daily, vitamin B6 40 mg twice daily and placebo twice daily were administered for 4 d. Rhodes questionnaire was used for evaluation of the severity of symptoms. The severity of NVP was evaluated 24 h before entering the study and up to 4 d after using medications and results were compared among the three groups.Results: Seventy-seven women finished the study (28 in the Ginger group, 26 in the B6 group, and 23 in the placebo group). The women of the three groups did not have significant differences according to age, gestational age, parity, and severity of each symptom before treatment and educational status. Total score of Rhodes questionnaire for nausea was decreased significantly in three groups after treatment. (p < .001, p = .012, and p = .03 for ginger, vitamin B6, and placebo, respectively.) Also total score of Rhodes questionnaire for vomiting was decreased in three groups (p = .03 for ginger, p = .02 for B6, and p = .04 for placebo). Ginger and vitamin B6 could reduce the severity of all items of Rhodes questionnaire significantly; however, placebo was significantly effective only on the frequency of nausea, intensity of vomiting and frequency of retching. Ginger and vitamin B6 were more effective than placebo (p = .039 and p = .007, respectively); however, total score of Rhodes did not show significant difference between ginger and vitamin B6 (p = .128). Ginger was more effective for nausea (intensity and distress) and distress of vomit.Conclusion: Ginger is more effective than placebo for the treatment of mild to moderate NVP and is comparable with vitamin B6.Trial registration number and registry website: IRCT2015020320923N1