Fetal Placenta Research Articles

Correlation of metabolic characteristics with maternal, fetal and placental asprosin in human pregnancy

ObjectiveAsprosin is a recently discovered hormone associated with obesity and diabetes mellitus. Little is known about asprosin’s role during pregnancy, but a contribution of asprosin to pregnancy complications resulting from maternal obesity and gestational diabetes mellitus (GDM) is conceivable. We assessed the potential effects of obesity, GDM and other clinical parameters on maternal and fetal umbilical plasma asprosin concentrations and placental asprosin expression.DesignThe Cologne-Placenta Cohort Study comprises 247 female patients, from whom blood and placentas were collected at the University Hospital Cologne.MethodsWe studied the maternal and fetal umbilical plasma and placentas of pregnant women with an elective, primary section. Sandwich ELISA measurements of maternal and fetal umbilical plasma and immunohistochemical stainings of placental tissue were performed to determine the asprosin levels. Also, the relation between asprosin levels and clinical blood parameters was studied.ResultsThere was a strong correlation between the maternal and fetal plasma asprosin levels and both increased with GDM in normal-weight and obese women. Asprosin immunoreactivity was measured in cultivated placental cells and placental tissue. BMI and GDM were not but pre-pregnancy exercise and smoking were correlated with maternal and/or fetal asprosin levels. Placental asprosin levels were associated with maternal but not with fetal plasma asprosin levels and with BMI but not with GDM. Placental asprosin was related to maternal insulin levels and increased upon insulin treatment in GDM patients.ConclusionsAsprosin could potentially act as a biomarker and contribute to the clinical manifestation of pregnancy complications associated with maternal obesity.

Maternal microbiota-derived metabolic profile in fetal murine intestine, brain and placenta

BackgroundThe maternal microbiota affects the development of the offspring by microbial metabolites translocating to the fetus. To reveal the spectrum of these molecular mediators of the earliest host-microbe interactions, we compared placenta, fetal intestine and brain from germ-free (GF) and specific pathogen free (SPF) mouse dams by non-targeted metabolic profiling.ResultsOne hundred one annotated metabolites and altogether 3680 molecular features were present in significantly different amounts in the placenta and/or fetal organs of GF and SPF mice. More than half of these were more abundant in the SPF organs, suggesting their microbial origin or a metabolic response of the host to the presence of microbes. The clearest separation was observed in the placenta, but most of the molecular features showed significantly different levels also in the fetal intestine and/or brain. Metabolites that were detected in lower amounts in the GF fetal organs included 5-aminovaleric acid betaine, trimethylamine N-oxide, catechol-O-sulphate, hippuric and pipecolic acid. Derivatives of the amino acid tryptophan, such as kynurenine, 3-indolepropionic acid and hydroxyindoleacetic acid, were also less abundant in the absence of microbiota. Ninety-nine molecular features were detected only in the SPF mice. We also observed several molecular features which were more abundant in the GF mice, possibly representing precursors of microbial metabolites or indicators of a metabolic response to the absence of microbiota.ConclusionsThe maternal microbiota has a profound impact on the fetal metabolome. Our observations suggest the existence of a multitude of yet unidentified microbially modified metabolites which pass through the placenta into the fetus and potentially influence fetal development.

Clinical and genomic data of sars-cov-2 detected in maternal–fetal interface during the first wave of infection in Brazil

Brazil has the highest SARS-CoV-2 case-fatality rate in pregnant women in the Americas. In this study, clinical and virological findings of five mildly symptomatic pregnant women and their infected fetuses/newborns treated at a referral hospital for COVID19-pregnant women in Midwestern Brazil are reported. Mother and fetal samples were tested by RT-qPCR, ECLIA and Illumina MiSeq sequencing. From the five cases, one resulted in spontaneous abortion, one was stillborn, two were preterm births and one full-term birth. Maternal and fetal placenta, newborn and stillborn secretions were SARS-CoV-2+; one neonate developed ground-glass opacities in his lungs. One neonate's umbilical cord was IgG+ and all were IgM negative upon hospital discharge. Genomes recovered from two placentas belong to the B.1.1.28 and B.1.1.33 lineages and present nonsynonymous mutations associated with virus fitness and infectivity; other not frequently reported mutations (B.1.1.33: NSP3 V2090G, M A2S and ORF3ab S253P and Y264N; B.1.1.28: NSP3 E995D, NSP12 R240K, NSP14H1897Y and in ORF7b V21F) were found in proteins involved in viral replication, viral induction of apoptosis, viral interference on interferon and on NF-Κβ pathways. Phylogeny indicates the south of Brazil as the possible origin of these lineages circulating in Mato Grosso State. These findings contribute to describe SARS-CoV-2 infection and outcomes in pregnant women and their fetuses, at any stage of gestation and even in mild symptomatic cases.

Assessment of lead and mercury levels in maternal blood, fetal cord blood and placenta in pregnancy with intrauterine growth restriction

Introduction: Many studies reported that prenatal exposure to lead and mercury are correlated with reduced birth weight and size, and these metals can cause adverse effects on neurodevelopment. In this study, it was aimed to investigate and compare the lead and mercury levels in maternal blood, cord blood, and placenta in pregnant women with IUGR fetuses diagnosed using abnormal Doppler findings and pregnant women with healthy fetuses.
 Material: This study included 75 patients, comprising 41 in IUGR group and 34 in control group. Maternal venous blood, fetal cord blood and placental samples were taken during delivery period.
 Results: Mercury levels in maternal blood and fetal cord blood, and lead levels in the placenta were found to be significantly higher in the IUGR group than in healthy subjects. Correlation analysis revealed that measurement values of body weight, body height, and head circumference of fetus might be lower when mercury level was measured higher in maternal blood and fetal cord blood. Furthermore, fetal body weight and fetal body height also would be lower when lead level measured in placenta was higher. Logistic Regression analysis results revealed that mercury levels measured in fetal cord blood could be used as the best marker in predicting low fetal weight, low fetal body height, and low fetal head circumference.
 Conclusion: In conclusion, it was thought with this study results that in order to identify the etiology and to give therapeutic prenatal care of the IUGR in a fetus diagnosed as idiopathic IUGR it would be appropriate to measure the level of lead and especially mercury in the fetal cord blood during the prenatal follow-up period.

Characterization of the Microbiota Associated With 12-Week-Old Bovine Fetuses Exposed to Divergent in utero Nutrition.

A recent study reported the existence of a diverse microbiota in 5-to-7-month-old calf fetuses, suggesting that colonization of the bovine gut with so-called “pioneer” microbiota may begin during mid-gestation. In the present study, we investigated 1) the presence of microbiota in bovine fetuses at early gestation (12 weeks), and 2) whether the fetal microbiota is influenced by the maternal rate of gain or dietary supplementation with vitamins and minerals (VTM) during early gestation. Amniotic and allantoic fluids, and intestinal and placental (cotyledon) tissue samples obtained from fetuses (n = 33) on day 83 of gestation were processed for the assessment of fetal microbiota using 16S rRNA gene sequencing. The sequencing results revealed that a diverse and complex microbial community was present in each of these fetal compartments evaluated. Allantoic and amniotic fluids, and fetal intestinal and placenta microbiota each had distinctly different (0.047 ≥ R2 ≥ 0.019, P ≤ 0.031) microbial community structures. Allantoic fluid had a greater (P < 0.05) microbial richness (number of OTUs) (Mean 122) compared to amniotic fluid (84), intestine (63), and placenta (66). Microbial diversity (Shannon index) was similar for the intestinal and placental samples, and both were less diverse compared with fetal fluid microbiota (P < 0.05). Thirty-nine different archaeal and bacterial phyla were detected across all fetal samples, with Proteobacteria (55%), Firmicutes (16.2%), Acidobacteriota (13.6%), and Bacteroidota (5%) predominating. Among the 20 most relatively abundant bacterial genera, Acidovorax, Acinetobacter, Brucella, Corynebacterium, Enterococcus, Exiguobacterium, and Stenotrophomonas differed by fetal sample type (P < 0.05). A total of 55 taxa were shared among the four different microbial communities. qPCR of bacteria in the intestine and placenta samples as well as scanning electron microscopy imaging of fetal fluids provided additional evidence for the presence of a microbiota in these samples. Minor effects of maternal rate of gain and VTM supplementation, and their interactions on microbial richness and composition were detected. Overall, the results of this study indicate that colonization with pioneer microbiota may occur during early gestation in bovine fetuses, and that the maternal nutritional regime during gestation may influence the early fetal microbiota.

Особенности клинического течения артериальной гипотензии у беременных

A study was carried out of women with arterial hypotension against the background of the development of the pathological state of the fetus and newborns born to women living in two different climatic regions of Osh city and in the highlands of Chon-Alay district of Osh region. In the pathogenesis of pregnancy complications caused by arterial hypotension, the leading importance is attached to vascular disorders and microcirculation disorders, leading to systemic hemodynamic changes in the body of a pregnant woman. It was found that in mountainous terrain, arterial hypotension and exogenous hypoxia affect the “mother–placenta–fetus–newborn” system, increasing the load on the respiratory, circulatory and hematopoietic organs of the mother, and also leads to impaired placental function.

Placental Dysfunction in Assisted Reproductive Pregnancies: Perinatal, Neonatal and Adult Life Outcomes.

Obstetric and newborn outcomes of assisted reproductive technology (ART) pregnancies are associated with significative prevalence of maternal and neonatal adverse health conditions, such as cardiovascular and metabolic diseases. These data are interpreted as anomalies in placentation involving a dysregulation of several molecular factors and pathways. It is not clear which extent of the observed placental alterations are the result of ART and which originate from infertility itself. These two aspects probably act synergically for the final obstetric risk. Data show that mechanisms of inappropriate trophoblast invasion and consequent altered vascular remodeling sustain several clinical conditions, leading to obstetric and perinatal risks often found in ART pregnancies, such as preeclampsia, fetal growth restriction and placenta previa or accreta. The roles of factors such as VEGF, GATA3, PIGF, sFLT-1, sEndoglin, EGFL7, melatonin and of ART conditions, such as short or long embryo cultures, trophectoderm biopsy, embryo cryopreservation, and supraphysiologic endometrium preparation, are discussed. Inflammatory local conditions and epigenetic influence on embryos of ART procedures are important research topics since they may have important consequences on obstetric risk. Prevention and treatment of these conditions represent new frontiers for clinicians and biologists involved in ART, and synergic actions with researchers at molecular levels are advocated.

Effects of porcine reproductive and respiratory syndrome virus (PRRSV) on thyroid hormone metabolism in the late gestation fetus

Porcine reproductive and respiratory syndrome virus (PRRSV) in late gestation causes a profound suppression of circulating maternal and fetal thyroid hormone during a critical window of development. To understand this relationship, we evaluated thyroid hormone metabolism at the maternal–fetal interface and within fetal tissues, along with hormone metabolite levels in serum. Fetuses were classified using an established model based on viral load in serum and thymus, and preservation status, including uninfected (UNIF), high-viral load viable (HV-VIA), and high-viral load meconium-stained (HV-MEC), with additional controls from sham-inoculated gilts (CON). Expression of three iodothyronine deiodinases, five sulfotransferases, sulfatase, and two solute carriers known to transport thyroid hormone were evaluated in maternal endometrium and fetal placenta, liver, and kidney. Serum thyroxin (T4), reverse triiodothyronine (rT3), and diiodothyronine (T2) were evaluated via liquid chromatography tandem mass spectrometry. Significant changes in gene expression were observed in all four tissues, with the liver being the most severely impacted. We observed local and fetal specific regulation of maternal tissues through significant upregulation of DIO2 and DIO3 expression in the endometrium corresponding to infected but viable fetuses relative to uninfected and control fetuses. Expression levels of DIO2 and DIO3 were significantly higher in the resilient (HV-VIA) fetuses relative to the susceptible (HV-MEC) fetuses. A substantial decrease in serum T4 was confirmed, with no corresponding increase in rT3 or T2. Collectively, these results show that thyroid hormone metabolism is altered at the maternal–fetal interface and within the PRRSV infected fetus and is associated with fetal viability.

Testing Pharmacokinetics and Efficacy of Pravastatin Using Feto-Maternal Interface Organ-On-Chips

Pravastatin reduce pro-inflammatory mediators in feto-maternal interface (FMi) tissues and minimize PE-like symptoms in vitro and in animal models. Several questions remain regarding the drug’s pharmacokinetics (PK), metabolism, and efficacy that cannot be fully answered using traditional 2D cell culture or placental perfusion models prior to clinical trials. We used two distinct microfluidic organ-on-chip (OOC) models that are interconnected through microchannels and maintain intercellular interactions between cells to faithfully represents the human FMi to test pravastatin’s PK and cellular responses at the fetal membranes (FM) and placenta (P).

P-gp expression inhibition mediates placental glucocorticoid barrier opening and fetal weight loss

BackgroundPrenatal adverse environments can cause fetal intrauterine growth retardation (IUGR) and higher susceptibility to multiple diseases after birth, related to multi-organ development programming changes mediated by intrauterine overexposure to maternal glucocorticoids. As a glucocorticoid barrier, P-glycoprotein (P-gp) is highly expressed in placental syncytiotrophoblasts; however, the effect of P-gp on the occurrence of IUGR remains unclear.MethodsHuman placenta and fetal cord blood samples of IUGR fetuses were collected, and the related indexes were detected. Pregnant Wistar rats were administered with 30 mg/kg·d (low dose) and 120 mg/kg·d (high dose) caffeine from gestational day (GD) 9 to 20 to construct the rat IUGR model. Pregnant mice were administered with caffeine (120 mg/kg·d) separately or combined with sodium ferulate (50 mg/kg·d) from gestational day GD 9 to 18 to confirm the intervention target on fetal weight loss caused by prenatal caffeine exposure (PCE). The fetal serum/placental corticosterone level, placental P-gp expression, and related indicator changes were analyzed. In vitro, primary human trophoblasts and BeWo cells were used to confirm the effect of caffeine on P-gp and its mechanism.ResultsThe placental P-gp expression was significantly reduced, but the umbilical cord blood cortisol level was increased in clinical samples of the IUGR neonates, which were positively and negatively correlated with the neonatal birth weight, respectively. Meanwhile, in the PCE-induced IUGR rat model, the placental P-gp expression of IUGR rats was decreased while the corticosterone levels of the placentas/fetal blood were increased, which were positively and negatively correlated with the decreased placental/fetal weights, respectively. Combined with the PCE-induced IUGR rat model, in vitro caffeine-treated placental trophoblasts, we confirmed that caffeine decreased the histone acetylation and expression of P-gp via RYR/JNK/YB-1/P300 pathway, which inhibited placental and fetal development. We further demonstrated that P-gp inducer sodium ferulate could reverse the inhibitory effect of caffeine on the fetal body/placental weight. Finally, clinical specimens and other animal models of IUGR also confirmed that the JNK/YB-1 pathway is a co-regulatory mechanism of P-gp expression inhibition, among which the expression of YB-1 is the most stable. Therefore, we proposed that YB-1 could be used as the potential early warning target for the opening of the placental glucocorticoid barrier, the occurrence of IUGR, and the susceptibility of a variety of diseases.ConclusionsThis study, for the first time, clarified the critical role and epigenetic regulation mechanism of P-gp in mediating the opening mechanism of the placental glucocorticoid barrier, providing a novel idea for exploring the early warning, prevention, and treatment strategies of IUGR.

MiRNA changes in the mouse placenta due to bisphenol A exposure.

Aim: To determine small RNA expression changes in mouse placenta inducedby bisphenol A (BPA) exposure. Methods: Exposing female mice to BPA two weeks prior to conception through gestational day 12.5; whereupon fetal placentas were collected, frozen in liquid nitrogenand stored at -80°C. Small RNAs were isolated and used for small RNA-sequencing. Results: 43 small RNAs were differentially expressed. Target mRNAs wereclosely aligned to those expressed by thymus and brain, and pathway enrichment analyses indicated thatsuch target mRNAs regulate neurogenesis and associated neurodevelopment processes. Conclusions: BPA induces several small RNAs in mouse placenta that might provide biomarkers for BPA exposure. Further, the placenta might affect fetal brain development through thesecretion of miRNAs.

The Sexually Dimorphic Nature of the Human Placenta: A Literature Review

Introduction: Neonatal growth is dependent on the ability of the mother’s placenta to deliver nutrients. As such, placental health is an important aspect of obstetric care. Existing literature has suggested an association between fetal sex and placental growth and development; however, no centralized study has been conducted. This paper aims to conduct a narrative review that summarizes findings from published literature on the effects of fetal sex on the growth and development of the placenta through three facets: placental function, structure, and outcome. Methods: Databases including Medline, Embase, and EMCare in Ovid, CINAHL, Web of Science, and Scopus were searched using keywords for the concepts of fetal sex and placenta. These were searched in combination with keywords relevant to placental function, placental structure, and pregnancy outcomes, using Boolean operators “OR/AND/NOT” as necessary. Studies written in English and published in peer reviewed journals were considered, with an emphasis on those published between 2017-2021. Results: Sexual dimorphism is evident in the fetal responses to stressful maternal environmental conditions, onset by conditions such as asthma and obesity. Sex-specific differences have also been observed in complications of pregnancy, including gestational diabetes mellitus (GDM), preeclampsia, preterm delivery, stillbirth, and insufficient uteroplacental circulation. Discussion: Despite the placentas from male and female births being categorized together in previous literature, this review highlights the sexually dimorphic nature of the ephemeral organ. Knowledge of fetal sex as early as possible during the pregnancy will help clinicians take proactive measures to optimize the health of the mother and the fetus. Conclusion: This study provides a holistic review of the effects of placental development among the fetal sexes, a critical aspect to monitor for effective obstetric care. Hence, further research into the sexually dimorphic nature is warranted.

Differential expression of markers of oxidative stress and apoptosis in relation to serum ferritin levels in patients with pre-eclampsia

&lt;p&gt;&lt;strong&gt;Background and Objective:&lt;/strong&gt; Pre-eclampsia (PE) is a hypertensive gestational disease appearing during second trimester of pregnancy. Free radicals are released by the placenta in this condition that may cause oxidative damage. This study was designed to determine the serum ferritin (SF) levels in maternal blood, fetal umbilical cord blood and placenta and the changes associated with oxidative stress as well as cell apoptosis to understand the pathogenesis of PE.&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This cross-sectional analytical study recruited 60 pregnant females with severe PE and assigned into early and late onset PE groups. Another n = 60 cases of normal pregnant females with similar gestational weeks were selected in the control group. Maternal serum and fetal umbilical cord blood ferritin levels were determined by automatic biochemical immunoassay system. Reverse transcription real-time fluorescence, Western blot and colorimetry were used to determine mRNA expression levels of ferritin and ferritin heavy chain, relative expression of ferritin and superoxide dismutase, malondialdehyde (MDA), and glutathione peroxidase (GSH-Px) levels, respectively.&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Results:&lt;/strong&gt; Mean age was 30.89 &amp;plusmn; 5.65 and 31.79 &amp;plusmn; 5.06 years in early and late onset PE groups respectively. Serum uric acid and creatinine levels of both PE groups were significantly higher than the normal pregnant females. SF levels were also higher in the participants of PE groups. However, the mRNA and ferritin protein levels in placental tissue were significantly lower in PE groups while comparing to controls. The cleaved caspase-3 protein, GSH-Px and MDA levels were significantly higher in both PE groups (p &amp;lt; 0.05).&lt;/p&gt;&#x0D; &lt;p&gt;&lt;strong&gt;Conclusion:&lt;/strong&gt; The alterations in factors related to oxidative stress and cell apoptosis in placental tissue may be helpful to understand the pathogenesis of PE and may provide potential biomarkers for the diagnosis of PE.&lt;/p&gt;

Interleukin-15 in Outcomes of Pregnancy.

Interleukin-15 (IL-15) is a pleiotropic cytokine that classically acts to support the development, maintenance, and function of killer lymphocytes. IL-15 is abundant in the uterus prior to and during pregnancy, but it is subject to tight spatial and temporal regulation. Both mouse models and human studies suggest that homeostasis of IL-15 is essential for healthy pregnancy. Dysregulation of IL-15 is associated with adverse outcomes of pregnancy. Herein, we review producers of IL-15 and responders to IL-15, including non-traditional responders in the maternal uterus and fetal placenta. We also review regulation of IL-15 at the maternal–fetal interface and propose mechanisms of action of IL-15 to facilitate additional study of this critical cytokine in the context of pregnancy.

PSII-B-28 Investigation of the presence of bacterial microbiota in 12-week-old bovine fetuses

Abstract A recent study reported the existence of a diverse microbiota in 5-to-7-month-old calf fetuses, suggesting that colonization of the bovine gut with so-called “pioneer” microbiota may begin during mid-gestation. In the present study, we investigated the microbiota in bovine fetuses at early gestation. Amniotic and allantoic fluids, and intestinal and placental (cotyledon) tissue samples harvested from fetuses (n = 33) on day 83 of gestation were processed for the assessment of fetal microbiota using 16S rRNA gene sequencing. The sequencing results revealed that a diverse and complex microbial community was present in allantoic and amniotic fluids, and fetal intestine and placenta on day 83 of gestation in beef cattle. Microbial community structure was significantly different between allantoic and amniotic fluid, and intestinal and placental microbiota (0.047 ≥ R2 ≥ 0.019, P ≤ 0.031). Allantoic fluid had a greater (P &amp;lt; 0.05) microbial richness (number of OTUs) (122 ± 10) compared to amniotic fluid (84 ± 6), intestine (63 ± 7) and placenta (66 ± 6). Microbial diversity (Shannon index) was similar for the intestinal and placental samples, and both were less diverse compared to the fetal fluid microbiota (P &amp;lt; 0.05). At the phylum level, 39 different archaeal and bacterial phyla were detected across all fetal samples, with Proteobacteria (55%), Firmicutes (16.2%), Actinobacteria (13.6%) and Bacteroidetes (5%) predominating. Among the 20 most relatively abundant bacterial genera, Acidovorax, Acinetobacter, Brucella, Corynebacterium, Enterococcus, Exiguobacterium and Stenotrophomonas differed by fetal sample type (P &amp;lt; 0.05). A total of 55 taxa were shared among the four different microbial communities. qPCR of bacteria in the intestine and placenta samples as well as scanning electron microscopy imaging of fetal fluids provided additional evidence for the presence of a microbiota in these samples. Overall, the results of this study indicate that colonization with pioneer microbiota may occur during early gestation in bovine fetuses.

Nutrition for pregnant women: debunking the myths!

The basis of the normal course of pregnancy is a healthy lifestyle, including nutrition as the main component. It is necessary that the diet of a pregnant woman is balanced and contains the optimal amount of not only macro-, but also micronutrients. Vitamins and minerals obtained from food play an important role in the course of many metabolic processes that ensure the growth and development of fetal tissues, and, prevent intrauterine malformations. They are fundamental to ensuring the normal course and outcome of pregnancy. Additional intake of micronutrients is aimed at ensuring the increased physiological needs of a pregnant woman’s body associated with fetal growth, placenta formation, and restructuring of the mother’s body. In recent years, many myths have arisen about the nutrition of pregnant women, in our article we will discuss the most common.

Phoenixin-20 ameliorates gestational diabetes mellitus (GDM) symptoms and placental insults in an experimental mouse model

Background and purposeGestational diabetes mellitus (GDM) is a complication commonly observed in pregnancy, closely associated with increased oxidative stress, inflammatory response, and endoplasmic reticulum (ER) stress. Phoenixin-20 (PNX-20) is a newly reproductive hormone from the hypothalamus that has displayed pleiotropic effects. The promising inhibitory effects of PNX-20 on inflammation have recently been widely reported. The present study aims to investigate the protective effect of PNX-20 on GDM induced placental insults. MethodsA GDM model was established on C57BLKsJ db/+ mice. The expression level of GPR173 was evaluated using RT-PCR and western blotting analysis. The serum level of glucose, insulin, lipid profiles, and oxidative stress indicators were detected with commercial kits. Fetal analysis was performed to evaluate the reproductive ability. ELISA was used to detect the production of inflammatory factors. The expressions of p-eIF-2α, ATF4, and GRP78 were evaluated with western blotting assay. ResultsFirstly, we found that GPR173 is expressed in the placenta tissue. Secondly, the elevated blood glucose level and lipid level, declined serum insulin level, fetus alive ratio, fetal and placenta weight, and shorten crown-rump length, were observed in the placenta tissue of GDM mice, which were reversed by treatment with PNX-20. Thirdly, the excessively released inflammatory factors and activated oxidative stress in GDM mice were alleviated by the administration of PNX-20. Lastly, the activated eIF-2α/ATF4 ER stress signaling pathway in GDM mice was dramatically suppressed by PNX-20. ConclusionOur data revealed a protective property of PNX-20 against placental insults resulted from GDM.

Pattern of Blood Transfusion among Women Undergoing Caesarean Section in a Tertiary Health Care Centre

Background: Cesarean section delivery causes major risk factors in terms of intraoperative performance and blood loss while blood transfusion is a promising factor in emergency care in case of blood unavailability. Women undergoing cesarean section routinely require blood cross-matching. Aim: The present study aimed to evaluate the pattern of blood transfusion among women who underwent c/section at the tertiary care center. Materials and Methods: This cross-sectional study was conducted on 745 pregnant women who underwent cesarean section at Obstetrics &amp; Gynaecology department of Quaid-e-Azam International Hospital Islamabad and PAF hospital Masroor, Karachi for duration of six months from January 2021 to June 2021. The demographic details, incidence of cesarean section, blood transfusion indications and types were recorded. Antenatal intraoperative and pre-operative details were also noted. Complications regarding blood transfusion were analyzed using multivariable analysis and EPI-statistical software v 3.5.3. Results: Of the total 745 cesarean sections, the prevalence of blood transfusion was 10.1%. About 75 women transfused 216 units of blood with packed cells tailed by Fresh Frozen Plasma (FFP). The prevalence of emergency cesarean section was 61 (81.3%) while general anesthesia was utilized in 27 (44.3%) cases. Fetal distress and placenta praevia were the common indications of cesarean section. Placenta praevia Respiratory rate (RR) was 5.01 (p&lt;0.001). Other obstetric complications and risk factors were anemia, antepartum hemorrhage, hypertension, and previous cesarean section. The cross-matched transfusion ratio was 9.93 while the transfusion index and probabilities were 0.078 and 10.1 respectively. Conclusion: Our study found a higher prevalence of blood transfusion risks among pregnant women who underwent cesarean section. It has been observed that the risk of blood transfusion increased with placenta previa, preoperative maternal anemia, placenta abruption, and second stage cesarean section. During the antenatal period, the need for blood transfusion might be reduced with an increased concentration of maternal hemoglobin. Keywords: Blood transfusion, Complications, Caesarean delivery, Transfusion index

Utility of the cerebroplacental ratio (CPR) in marijuana exposed growth restricted fetuses

Objective Fetal growth restriction (FGR) is associated with an increased risk of adverse perinatal outcomes. The cerebroplacental ratio (CPR) represents the interaction of alterations in blood flow to the fetal brain and placenta. CPR has been utilized as a superior reflection of fetal hypoxia/acidemia and therefore a better predictor of fetal morbidity. We sought to determine the role of the CPR as an adjunctive tool to identify fetuses at increased risk of adverse perinatal outcomes in a study population of marijuana (MJ) exposed FGR fetuses. Methods This was a retrospective cohort study of high-risk singleton pregnancies over a 4-year period. Self-identified daily MJ users with FGR fetuses in the 3rd trimester were isolated. Fetal biometry, amniotic fluid indices, and CPRs were calculated. A CPR <1 was considered abnormal. FGR fetuses with normal and abnormal CPRs were then compared. Results 26/192 (13.5%) of MJ exposed fetuses were diagnosed with FGR in the 3rd trimester. 12/26 (46%) had an abnormal CPR and 14 had a normal CPR (mean CPR 0.60 vs 1.57, p = .0001). The mean EFW percentile was lower in the abnormal CPR group in comparison to the group with normal CPR (3.33 vs 7.64, p = .0001). Both groups showed evidence of brain sparing with an overall mean head circumference of 17.55 in comparison to a mean abdominal circumference of 5.63. A CPR <1 was associated with more severe FGR, oligohydramnios, and abnormal UA Doppler studies. Conclusions Approximately half of the MJ exposed FGR fetuses had an abnormal CPR. In this subset of patients, >90% had severe FGR, a higher proportion had absence/reversal of end diastolic flow in the UA, and a higher proportion had oligohydramnios. This demonstrates that an abnormal CPR identifies a group of FGR fetuses at a greater risk of adverse perinatal outcomes.

Sexually Dimorphic Transcriptomic Changes of Developing Fetal Brain Reveal Signaling Pathways and Marker Genes of Brain Cells in Domestic Pigs.

In this study, transcriptomic changes of the developing brain of pig fetuses of both sexes were investigated on gestation days (GD) 45, 60 and 90. Pig fetal brain grows rapidly around GD60. Consequently, gene expression of the fetal brain was distinctly different on GD90 compared to that of GD45 and GD60. In addition, varying numbers of differentially expressed genes (DEGs) were identified in the male brain compared to the female brain during development. The sex of adjacent fetuses also influenced gene expression of the fetal brain. Extensive changes in gene expression at the exon-level were observed during brain development. Pathway enrichment analysis showed that the ionotropic glutamate receptor pathway and p53 pathway were enriched in the female brain, whereas specific receptor-mediated signaling pathways were enriched in the male brain. Marker genes of neurons and astrocytes were significantly differentially expressed between male and female brains during development. Furthermore, comparative analysis of gene expression patterns between fetal brain and placenta suggested that genes related to ion transportation may play a key role in the regulation of the brain-placental axis in pig. Collectively, the study suggests potential application of pig models to better understand influence of fetal sex on brain development.