Fetal Protection Research Articles

Protection of rat fetuses by quercetin against caffeine- induced cleft palate

Caffeine at high doses is a known rodent teratogen and it induces limb malformations along with cleft palate in various strains of rats and mice. The teratogenic effects of some drugs can be prevented by the application of antioxidant drugs and stimulation of the maternal immune system. Also, there are some evidence that quercetin is an antioxidant. Therefore, in this study, the prophylactic effect of quercetin on teratogenic effects of caffeine was evaluated. This study was performed on 26 pregnant rats that were divided into four groups. Control group received normal saline and test groups received caffeine (80 mg/kg), caffeine (80 mg/kg) plus quercetin (75 mg/kg), and quercetin (10 mg/kg), intraperitoneally at 9 to 11th days of gestation, respectively. Fetuses were collected at the 20th day of gestation and after determination of weight and length; they were stained by Alizarin red - Alcian blue method. Cleft palate incidence was 33.33% in fetuses of rats that received only caffeine and incidence was 1.49% in the group that received caffeine plus quercetin (75 mg/kg). The means of weight and length of fetuses from rat that received quercetin were significantly greater than those that received only caffeine. It is concluded that quercetin decreased cleft palate induced by caffeine, but this subject needs more detailed evaluation. Key words: Caffeine, quercetin, pregnancy, cleft palate, teratogenicity, fetus, rat.

Pattern of community acquired pneumonia in pregnant ladies in Ain Shams University hospitals

Back groundCommunity acquired pneumonia (CAP) is recognized as a common problem that carries a substantial morbidity and mortality. The burden of disease falls mainly on people at the extremes of age and while the occurrence of CAP in young adults is uncommon. Nevertheless, pneumonia in young adults can be severe and fatal. Pneumonia in the pregnant patient is the most frequent cause of fatal non-obstetric infection. Aim of the workThe aim of this study was to assess the pattern of community acquired pneumonia among pregnant ladies in Ain Shams University hospitals. Patients and methodThe present study included 168 pregnant ladies with community acquired pneumonia, who were selected from out patient’s clinics of obstetrics and gynecology department, Ain Shams University (ASUH). ResultsThe present study included 168 pregnant ladies with community acquired pneumonia, who were selected from out patient’s clinics of obstetrics and gynecology department, Ain Shams University (ASUH). Their ages ranged from 18–42years old with mean age of 25.32years old (±4.20 SD). ConclusionMorbidity and mortality in pregnant patients with pneumonia continue to present a significant challenge. Early recognition of the diseases process and prompt treatment are required to ascertain an optimal outcome. The treatments in the gravid patients generally follow standard guide lines for the treatment of pneumonia in adults. Concern for fetal outcome should not delay treatment as improvement in maternal oxygenation and status is the best way to ensure fetal protection.

Reproductive and economic impact following controlled introduction of cattle persistently infected with bovine viral diarrhea virus into a naive group of heifers

The reproductive impact following controlled introduction of animals persistently infected (PI) with bovine viral diarrhea virus (BVDV) was evaluated in BVDV-naive heifers. Heifers were randomly allocated into two groups: an unexposed control herd (n = 34) and a herd exposed to five persistently infected (PI) animals for 7 mo, beginning 50 days before the breeding season (n = 34). Initiation of the BVDV-challenge was timed to mimic either direct contact with PI calves born in the previous calving season or accidental introduction of PI herd additions prior to the breeding season. The PI animals represented BVDV Types 1a (n = 3), 1b (n = 1) and 2 (n = 1). Two BVDV-free, seropositive bulls were used in each group for 78 days breeding seasons. In both groups, 33 of 34 heifers became pregnant, with similar distribution of fetal ages. Two heifers in each group aborted (etiology undetermined). In addition, one calf was born dead and one calf died 3 days post-partum in the BVDV-exposed group. One calf in the unexposed group died 4 mo post-partum. No calves, including the stillborn calf and the two calves that died prior to weaning, were persistently infected with BVDV. In summary, introduction of PI cattle to a group of BVDV-naive heifers 50 days prior to the breeding season did not negatively impact reproductive performance. To the contrary, the active immunity that developed following field exposure to BVDV provided effective reproductive and fetal protection during the breeding season and subsequent gestations, despite continuous exposure to PI animals until approximately midgestation. Although BVDV can have potentially devastating reproductive effects, timing of infection is a critical determinant in the outcome of a BVDV infection. A controlled breeding season with introduction of herd additions at less critical reproductive time points can mitigate the negative reproductive health consequences of BVDV.

Intrauterine growth restriction modifies the normal gene expression in kidney from rabbit fetuses

The aim of this work was to study the effect of intrauterine growth restriction (IUGR) on fetal kidneys. The IUGR was induced by uteroplacental vessels ligature in a model of pregnant rabbit. We centralized the study in the gene expression of essential proteins for fetal kidney development and kidney protection against hypoxia, osmotic stress, and kidney injury. The gene expression of HIF-1α, NFAT5, IL-1β, NGAL, and ATM were studied by qRT-PCR and Western blot in kidneys from control and IUGR fetuses. Experimental IUGR fetuses were significantly smaller than the control animals (39 vs. 48g, p<0.05). The number of glomeruli was decreased in IUGR kidneys, without morphological alterations. IUGR increased the gene expression of HIF-1α, NFAT5, IL-1β, NGAL, and ATM (p<0.05) in kidneys of fetuses undergoing IUGR, suggesting that fetal blood flow restriction produce alterations in gene expression in fetal kidneys.

Blockage of Heme Oxygenase-1 Abrogates the Protective Effect of Regulatory T Cells on Murine Pregnancy and Promotes the Maturation of Dendritic Cells

Regulatory T cells (Treg) play an important role in fetal protection. They expand during normal pregnancy and protect fetal antigens from maternal effector cells. Their effect is associated with the up-regulation of tolerance-associated molecules at the fetal-maternal interface. Among these, Heme Oxygenase-1 (HO-1, coded by Hmox1) is of special importance as its blockage correlates with increased abortion rates and its up-regulation positively affects pregnancy outcome. Here, we aimed to investigate whether the protective effect of Treg is mediated by HO-1 in a mouse model. HO-1 blockage by Zinc Protoporhyrin (ZnPPIX) abrogated the protective effect of Treg transfer. We found that HO-1 is important in maintaining maternal dendritic cells (DCs) in an immature state, which contributes to the expansion of the peripheral Treg population. This brings to light one essential pathway through which Treg mediates the semi-allogeneic fetus tolerance.

Response to Letter Regarding Article, “Management of Severe Mitral Stenosis During Pregnancy”

HomeCirculationVol. 126, No. 1Response to Letter Regarding Article, “Management of Severe Mitral Stenosis During Pregnancy” Free AccessReplyPDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReplyPDF/EPUBResponse to Letter Regarding Article, “Management of Severe Mitral Stenosis During Pregnancy” Rebecca S. Norrad, MBBS, BSc (Hon) and Omid Salehian, MSc, MD, FRCPC, FACC, FAHA Rebecca S. NorradRebecca S. Norrad Search for more papers by this author and Omid SalehianOmid Salehian Search for more papers by this author Originally published3 Jul 2012https://doi.org/10.1161/CIRCULATIONAHA.112.110841Circulation. 2012;126:e16We appreciate the interest shown by Dr Harikrishnan and colleagues in our article.1 We agree with them that percutaneous balloon mitral valvuloplasty in pregnant women should be reserved for those patients in whom aggressive medical therapy fails and in patients for whom the benefits of intervention outweighs its risks. Certainly decreasing the heart rate is the main goal of medical therapy in patients with symptomatic mitral stenosis. Our patient was on very high dose of metoprolol (100 mg TID) and continued to be significantly symptomatic despite complete bed rest. In our experience, further addition of atrioventricular nodal blocking agents such as digoxin would not provide significant reduction in heart rate to provide adequate improvement in valve hemodynamics and symptoms.We also agree with the importance of reduction in radiation exposure and fetal protection during the procedure. In our institution, it is routine practice to minimize fluoroscopy time, and to provide lead shielding to cover the lower abdominal segment, as well, which would not be readily visible on fluoroscopy images performed during balloon inflation. However we do routinely perform invasive hemodynamics during our valve procedures, because, in certain cases, important information can be obtained with no increase in fluoroscopy time.With respect to anticoagulation in patients with rheumatic mitral stenosis, current American College of Chest Physicians guidelines2 recommend use of systemic anticoagulation if the left atrial diameter exceeds 55 mm, even if the patient is in sinus rhythm (albeit a grade 2C recommendation). Furthermore, American College of Chest Physicians guidelines for the antithrombotic therapy in pregnancy3 recommend the use of low-molecular-weight heparin over unfractionated heparin during pregnancy because of its improved safety profile. Needless to say, anticoagulation therapy during pregnancy needs to be individualized based on the overall risk/benefit assessment, patient preferences, and availability of resources, among other things.Finally, by virtue of the fact that this article was published in the Images in Cardiovascular Medicine section of the Circulation, it is by no means meant to be comprehensive. Many areas in the care of patients with rheumatic heart disease were not covered. This case was presented to highlight some of the challenges in taking care of these patients during pregnancy.Rebecca S. Norrad, MBBS, BSc (Hon)Omid Salehian, MSc, MD, FRCPC, FACC, FAHA Division of Cardiology Department of Medicine McMaster University Hamilton, Ontario, CanadaDisclosuresNone.

Infección congénita por citomegalovirus: presentación de tres casos y revisión de la literatura

La infección perinatal más frecuente es causada por citomegalovirus (CMV), en el feto y el recién nacido esta infección es la principal causa de sordera y compromiso en el desarrollo psicomotor; el tamizaje, diagnóstico y manejo no se han protocolizado en el control prenatal. El pronóstico de estos pacientes dependerá de un manejo adecuado. Se presentan tres casos con el objetivo de revisar el diagnóstico prenatal y el manejo en el neonato.Materiales y métodos: se muestran tres casos de infección congénita por citomegalovirus diagnosticados en el Hospital Universitario Hernando Moncaleano de Neiva-Huila, centro de referencia de la región suroccidental de Colombia. Se realizó una búsqueda electrónica en las bases de datos de PudMed, Embase, Medline, Lilacs, Cochrane.Resultados: se encontraron 31 artículos, dos guías basadas en evidencia, seis revisiones sistemáticas, dos consensos de la Asociación Española de Pediatría, cuatro estudios de casos y controles, cuatro estudios de cohortes, doce revisiones narrativas, un estudio analítico de decisiones y de costos.Conclusión: el tamizaje rutinario para CMV en el control prenatal no está recomendado. Se debe hacer tamizaje en mujeres gestantes de alto riesgo. El método de tamizaje son la inmunoglobulina IgM específica y el test de avidez por IgG, si esta es baja confirma infección reciente. La prueba confirmatoria es la PCR para CMV. En recién nacidos la prueba de tamizaje es la PCR y el patrón de oro es el cultivo viral. En mujeres con infección gestacional se debe aplicar inmunoglobulina específica para protección fetal.

Xenon and Sevoflurane Provide Analgesia during Labor and Fetal Brain Protection in a Perinatal Rat Model of Hypoxia-Ischemia

It is not possible to identify all pregnancies at risk of neonatal hypoxic-ischemic encephalopathy (HIE). Many women use some form of analgesia during childbirth and some anesthetic agents have been shown to be neuroprotective when used as analgesics at subanesthetic concentrations. In this study we sought to understand the effects of two anesthetic agents with presumptive analgesic activity and known preconditioning-neuroprotective properties (sevoflurane or xenon), in reducing hypoxia-induced brain damage in a model of intrauterine perinatal asphyxia. The analgesic and neuroprotective effects at subanesthetic levels of sevoflurane (0.35%) or xenon (35%) were tested in a rat model of intrauterine perinatal asphyxia. Analgesic effects were measured by assessing maternal behavior and spinal cord dorsal horn neuronal activation using c-Fos. In separate experiments, intrauterine fetal asphyxia was induced four hours after gas exposure; on post-insult day 3 apoptotic cell death was measured by caspase-3 immunostaining in hippocampal neurons and correlated with the number of viable neurons on postnatal day (PND) 7. A separate cohort of pups was nurtured by a surrogate mother for 50 days when cognitive testing with Morris water maze was performed. Both anesthetic agents provided analgesia as reflected by a reduction in the number of stretching movements and decreased c-Fos expression in the dorsal horn of the spinal cord. Both agents also reduced the number of caspase-3 positive (apoptotic) neurons and increased cell viability in the hippocampus at PND7. These acute histological changes were mirrored by improved cognitive function measured remotely after birth on PND 50 compared to control group. Subanesthetic doses of sevoflurane or xenon provided both analgesia and neuroprotection in this model of intrauterine perinatal asphyxia. These data suggest that anesthetic agents with neuroprotective properties may be effective in preventing HIE and should be tested in clinical trials in the future.

Synchronized Activity of Organic Cation Transporter 3 (Oct3/Slc22a3) and Multidrug and Toxin Extrusion 1 (Mate1/Slc47a1) Transporter in Transplacental Passage of MPP+ in Rat

The aim of the present study was to investigate the expression, localization, and function of organic cation transporter 3 (Oct3, Slc22a3) and multidrug and toxin extrusion protein 1 (Mate1, Slc47a1) in the rat placenta. Using qRT-PCR and Western blotting techniques, we demonstrated abundant Oct3 and Mate1 mRNA and protein expression achieving significantly higher levels than those in the maternal kidney (positive control). Immunohistochemical visualization revealed preferential localization of Oct3 on the basolateral, i.e., fetus facing side of the placenta, whereas Mate1 positivity was located in the labyrinth area predominantly on the apical, i.e., maternal side of the placenta. To investigate the role of these transporters in the transplacental pharmacokinetics, the in situ method of dually perfused rat term placenta was employed in open- and closed-circuit arrangements; 1-methyl-4-phenylpyridinium (MPP(+)) was used as a model substrate of both Oct3 and Mate1. We provide evidence that Oct3 and Mate1 cause considerable asymmetry between maternal-to-fetal and fetal-to-maternal transport of MPP(+) in favor of fetomaternal direction. Using closed-circuit experimental setup, we further describe the capacity of Oct3 and Mate1 to transport their substrate from fetus to mother even against a concentration gradient. We conclude that Oct3, in a concentration-dependent manner, takes up MPP(+) from the fetal circulation into the placenta, whereas Mate1, on the other side of the barrier, is responsible for MPP(+) efflux from placenta to the maternal circulation. These two transport proteins, thus, form an efficient transplacental eliminatory pathway and play an important role in fetal protection and detoxication.

Morbidité materno-fœtale des extractions instrumentales : forceps versus spatules. À propos d’une série de 77 cas

ObjectiveTo compare the early feto-maternal morbidity after assisted vaginal delivery using forceps versus spatulas. Patients and methodsIt is a retrospective comparative study conducted in a third level maternity carrying on cephalic instrumental non premature deliveries by forceps or spatulas, on singleton pregnancies. Forty assisted vaginal deliveries using forceps and 40 others using spatulas were registered, over a period of 4.5 months. Feto-maternal lesions were analyzed. ResultsCharacteristics of the population of forceps and spatulas groups were alike (Body Mass Index: 25.9 versus 26.7kg/m2, P=0.79; parity: 0.6 versus 0.4, P=0.20; fetal weight: 3306g versus 3295g, P=0.91). The characteristics of labor were also similar, except for the left transverse fetal position more important in spatulas group (10.8% – 4/37 – versus 0%; P=0.03). More fetus had no lesion in the spatulas group (85.7% – 30/35 – versus 60.5% - 23/38), P=0.02). The episiotomy rate was higher in the forceps group: 32/40 (80.0%) versus 13/37 (35.1%); P=0.0001. Discussion and conclusionThese results are similar to those from the literature, which evoke a fetal protection by spatulas. However, this is biased by the fact that the two instruments are not always used in the same conditions. Besides, spatulas do not appear to be more deleterious to maternal perinea. Therefore, perpetuation and teaching the use of these two instruments seem essential.

Pregnancy and substance use – the Norwegian z 10–3 solution.1 Ethical and clinical reflections related to incarceration of pregnant women to protect the foetus from harmful substances

Aims This article highlights ethical and clinical dilemmas of incarceration of pregnant drug addicts mandated by z 10–3 of the Norwegian Municipal Health and Care Services act. Material The material consists of two cases, Siri and Anna, and the ethical dilemmas posed by the use of z 10–3 in these cases. Methods Semi-structured in-depth individual interviews were conducted, audio-recorded and transcribed word for word. Transcripts were coded according to converging interests and possible ethical dilemmas and described in a case format. The practical and experiential consequences of the law are discussed in relation to the four main bioethical principles: respect for autonomy, non-maleficence, beneficence and social justice. These are supplemented by the principles of relational ethics. Results The application of z 10–3 may lead to situations which distort the psychological preparation for parenthood and strains the helping relationship. The four principles approach seems to be an insufficient tool in grasping the complexity of the situation. Conclusions Interventions to protect the foetus from the pregnant woman's use of substances demand elevated professional awareness of ethical and relational challenges and dilemmas. Relational ethics provides a framework to enhance reflexivity and a trusting therapeutic alliance. The potential for psychological change during pregnancy should be invested in. Hence, we suggest that during incarceration according to z 10–3, foetal protection and the promotion of parental competences should be given equal priority.

Sertraline Alters Multidrug Resistance Phosphoglycoprotein Activity in the Mouse Placenta and Fetal Blood–Brain Barrier

Phosphoglycoprotein (P-gp) is highly expressed in the placental syncytiotrophoblast and prevents xenobiotics from entering the fetus. In tumor cells, P-gp-mediated substrate efflux is inhibited by selective serotonin reuptake inhibitors (SSRIs). However, nothing is known regarding the effects of SSRIs on P-gp function in the placenta or fetal tissues. We hypothesized that the SSRI sertraline would decrease P-gp-mediated drug efflux at the placenta and fetal blood-brain barrier (BBB)-increasing P-gp substrate transfer from the mother to the fetus and fetal brain. In contrast to our hypothesis, this study presents the novel findings that sertraline (4 hours exposure) increases placental P-gp-mediated efflux (P < .001), resulting in decreased drug transfer to the fetus. Meanwhile, sertraline decreases fetal (P < .001) and maternal (P < .05) BBB P-gp-mediated efflux, resulting in increased drug transfer into the fetal and maternal brain from the circulation. This suggests that P-gp regulation by sertraline is tissue specific. These findings have important clinical implications with respect to fetal protection during maternal drug therapy in pregnancy.

Placental drug transporters and their role in fetal protection

The human placenta has a number of protective mechanisms that help to prevent potentially harmful compounds from entering the fetal compartment. Two important transporter proteins are phospho-glycoprotein (P-gp) and breast cancer resistance protein (BCRP) which are mainly expressed in the syncytiotrophoblast where they actively extrude a wide range of xenobiotics. The expression profile of these transporters varies with advancing gestation. P-gp has been shown to decline near term, leaving the fetus susceptible to potentially teratogenic drugs commonly administered to pregnant women (i.e. synthetic glucocorticoids, selective serotonin reuptake inhibitors, glyburide, antiretrovirals, etc.). Drug transporter expression is regulated by a number of transcription factors, and steroid hormones present during pregnancy, such as progesterone, estrogen and corticosteroids. Drug transporter levels have also been found to be altered in pathological pregnancies (preterm, pre-eclampsia, growth restriction and infection). Genetic variation in the genes that encode these drug transporters can significantly alter transporter function and may play a significant role in determining the susceptibility of a fetus to maternally-administered therapeutic drugs. Understanding the regulation of placental drug transporters in normal and pathological pregnancies is critical to further our knowledge of fetal development, and may lead to the development of more selectively-targeted maternal and fetal drug treatments.

Pre and Post-Natal Exposure to Air Pollution is Public Health Problem

3in concentration of PM 10 and 22% in the deaths of neonates by respiratory diseases. The maternal exposure to O 3 in the second and to CO in third month of pregnancy caused a loss in weight of babies [7-10]. Moreover, the pregnant women who inhaled NO 2 during gestational period present an increase of 25% premature delivery [11]. The mechanism that was suggested to clarify the association between CO and the low weight of neonates would be the competition between this gas and O 2 for the sites in hemoglobin, which would decrease the transport of O 2 to the tissues and harm the fetal development. In terms of the association between O 3 and the decrease in neonate weight, animal studies suggested that this effect would be modulated by maternal inflammatory process. The prematurity could be explained through oxidation of proteins and lipids by NO 2 and the decrease of antioxidant protection of fetus and mother. Experimental studies demonstrated that inhalation of NO 2 during gestational period induced the oxidation of lipids, which are components of placenta, and increased the lethality in post-implatantion period of embryo [12]. Gilboa et al. [13] showed the existence of a positive association between the exposure to CO and the Fallot Tetrology (odds ratio: 2,04); between PM 10 and atrial septus defects (odds ratio: 2,27) and between SO 2 and ventricular septus defects (odds ratio: 2,16). Ritz et al. [14] found CO and O 3 inhaled during the second month of pregnancy, which is a critical period for heart development, caused congenital cardiac malformation. Considering the studies which were presented in this editorial, the mechanisms that are involved in injuries caused to air pollution in pre and post-natal periods are not well known. Therefore, there is a necessity to study more and to increase our knowledge about this subject to determine the effects of pollutant inhalation during the gestational period in adult age. Moreover, these kinds of studies are important to create public health policies to decrease the emission of pollutants in atmosphere.

Reproductive Choices and Informed Consent: Fetal Interests, Women's Identity, and Relational Autonomy

In this Article, I describe and examine the severe shortcomings in women's autonomy in the context of reproductive choices in the medical arena. The reproductive choices I explore are those choices that involve gestation: abortion, fertility treatments, and interventions during pregnancy. Due to state and medical interests in the fetus, I describe how information conveyed to patients making reproductive choices is biased towards fetal interests, relies on female stereotypes, and is still conveyed with the objective authority of the medical profession. Moreover, reproductive choices implicate women's values and identity interests that reach beyond medical concerns, which are not part of the informed consent doctrine at all. The narrow, individualistic informed consent torts doctrine intended to protect patient autonomy does not do enough in this context to balance bias nor does it mandate discussion of important identity interests and values. Accordingly, I argue that when faced with reproductive choices, women are not provided the balanced and comprehensive information needed to promote their autonomy. In response to the breakdown in patient autonomy I describe, instead of leaving women alone to make choices or regulating in order to protect them from their choices, a broader framework for supporting reproductive choices should be established. In light of the interdependence of woman and fetus, as well as the broader social context shaping these decisions, I argue that a more contextual, relational perspective of autonomy should be the goal of informed consent in the context of reproductive choices. I suggest a number of reforms that aim to optimize patient autonomy from a relational perspective. I suggest a broad, deliberative doctor-patient consultation and legal reforms that create more balance between the pull towards intervention and fetal protection on the one hand, and non-intervention and protection of women's personal identity interests on the other.

Indoleamine 2,3-Dioxygenase Expression in Human Cancers: Clinical and Immunologic Perspectives

Indoleamine 2,3-dioxygenase (IDO) is a tryptophan-catabolizing enzyme with immune-regulating activities in many contexts, such as fetal protection, allograft protection, and cancer progression. Clinical trials are currently evaluating IDO inhibition with 1-methyltryptophan in cancer immunotherapy. However, the exact role of tryptophan catabolism by IDO in human cancers remains poorly understood. Here, we review several studies that correlate IDO expression in human cancer samples and tumor-draining lymph nodes, with relevant clinical or immunologic parameters. IDO expression in various histologic cancer types seems to decrease tumor infiltration of immune cells and to increase the proportion of regulatory T lymphocytes in the infiltrate. The impact of IDO on different immune cell infiltration leads to the conclusion that IDO negatively regulates the recruitment of antitumor immune cells. In addition, increased IDO expression correlates with diverse tumor progression parameters and shorter patient survival. In summary, in the vast majority of the reported studies, IDO expression is correlated with a less favorable prognosis. As we may see results from the first clinical trials with 1-methyltryptophan in years to come, this review brings together IDO studies from human studies and aims to help appreciate outcomes from current and future trials. Consequently, IDO inhibition seems a promising approach for cancer immunotherapy.

Patient and radiographer perspectives of two lead shielding devices for foetal dose reduction in CT scanning

Aim In many UK hospitals pregnant patients undergoing chest CT scans have lead shielding placed over their abdomen/pelvis in order to reduce foetal radiation dose. In the majority of cases conventional lead aprons are used even though these are not designed for the task. The purpose of the study was to compare these aprons with a new shielding device, from both patient and radiographer perspectives. Materials & methods The study was performed using 35 volunteer radiographers who alternately acted as both radiographer and pregnant patient; pregnancy was simulated at the time of the study. In both roles the volunteers experienced the two products and then completed a questionnaire to determine the relative merits of the products in terms of weight, manoeuvrability and fit to patient shape. The study received local ethics committee approval (09/H1304/33). Results Both patients and radiographers showed a strong preference for the new shielding device with average favourable ratings of 83% for radiographers and 72% for patients compared with 27% and 17% for the lead aprons. The new device was particularly favoured in terms of manoeuvrability (97% vs. 46%), fit to patient shape (91% vs. 17%) and the perceived weight reduction on the patient’s abdomen. Conclusions A new shielding device for foetal radiation protection in all stages of pregnancy has been evaluated and has been shown to be preferred by both patients and radiographers when compared to conventional lead aprons.

Fetal protection against bovine viral diarrhoea type 1 virus infection after one administration of a live-attenuated vaccine

A modified-live vaccine has been shown previously to prevent fetal infection with bovine viral diarrhoea virus (BVDV)-2 and, to some extent BVDV-1, when used in association with an inactivated vaccine in a two-step vaccination protocol. In this challenge study, the modified-live vaccine used alone was able to protect 13 heifers between 49 and 96 days of gestation at challenge from leucopenia and virus replication and, for a 4-month period, to prevent fetal infection. The efficacy of the BVDV-1f 22146/Han81 challenge was demonstrated by virus isolation from the fetuses of all nine non-vaccinated, control heifers. However, the small number of heifers tested meant that the vaccination failure rate could be as high as 10% in the field.

Fetal protection in heifers vaccinated with a modified-live virus vaccine containing bovine viral diarrhea virus subtypes 1a and 2a and exposed during gestation to cattle persistently infected with bovine viral diarrhea virus subtype 1b

To determine efficacy of a modified-live virus (MLV) vaccine containing bovine viral diarrhea virus (BVDV) 1a and 2a against fetal infection in heifers exposed to cattle persistently infected (PI) with BVDV subtype 1 b. 50 heifers and their fetuses. Susceptible heifers received a placebo vaccine administered IM or a vaccine containing MLV strains of BVDV1a and BVDV2a administered IM or SC. On day 124 (64 to 89 days of gestation), 50 pregnant heifers (20 vaccinated SC, 20 vaccinated IM, and 10 control heifers) were challenge exposed to 8 PI cattle. On days 207 to 209, fetuses were recovered from heifers and used for testing. 2 control heifers aborted following challenge exposure; both fetuses were unavailable for testing. Eleven fetuses (8 control heifers and 1 IM and 2 SC vaccinates) were positive for BVDV via virus isolation (VI) and for BVDV antigen via immunohistochemical analysis in multiple tissues. Two additional fetuses from IM vaccinates were considered exposed to BVDV (one was seropositive for BVDV and the second was positive via VI in fetal tissues). A third fetus in the SC vaccinates was positive for BVDV via VI from serum alone. Vaccination against BVDV provided fetal protection in IM vaccinated (17/20) and SC vaccinated (17/20) heifers, but all control heifers (10/10) were considered infected. 1 dose of a BVDV1a and 2a MLV vaccine administered SC or IM prior to breeding helped protect against fetal infection in pregnant heifers exposed to cattle PI with BVDV1b.

HLA-G Expression in Human Embryonic Stem Cells and Preimplantation Embryos

Human leukocyte Ag-G, a tolerogenic molecule that acts on cells of both innate and adaptive immunity, plays an important role in tumor progression, transplantation, placentation, as well as the protection of the allogeneic fetus from the maternal immune system. We investigated HLA-G mRNA and protein expression in human embryonic stem cells (hESC) derived from the inner cell mass (ICM) of blastocysts. hESC self-renew indefinitely in culture while maintaining pluripotency, providing an unlimited source of cells for therapy. HLA-G mRNA was present in early and late passage hESC, as assessed by real time RT-PCR. Protein expression was demonstrated by flow cytometry, immunocytochemistry, and ELISA on an hESC extract. Binding of HLA-G with its ILT2 receptor demonstrated the functional active status. To verify this finding in a physiologically relevant setting, HLA-G protein expression was investigated during preimplantation development. We demonstrated HLA-G protein expression in oocytes, cleavage stage embryos, and blastocysts, where we find it in trophectoderms but also in ICM cells. During blastocyst development, a downregulation of HLA-G in the ICM cells was present. This data might be important for cell therapy and transplantation because undifferentiated hESC can contaminate the transplant of differentiated stem cells and develop into malignant cancer cells.