Stages Of Gestation Research Articles

Features of the state of extraembryonic structures in miscarriage early terms of pregnancy

Background. Despite the modern achievements of medicine, miscarriage remains the main problem of obstetrics and gynecology science and practice. Purpose – to assess the features of the state of extraembryonic structures in case of miscarriage in the early stages of gestation. Materials and Methods. Under observation were 32 patients (main group) with a verified threat of pregnancy termination with bleeding in the embryonic period of gestation (up to 10 weeks) and 20 women (control group) with a physiological course of early pregnancy. The exclusion criteria from the study were patients with induced pregnancy, multiple pregnancies, anomalies of the development of female genital organs. All patients underwent a standard clinical and laboratory examination. During the ultrasound examination, both the state of the embryo and the state of extraembryonic structures were evaluated: the volume of the fertilized egg (V f/e), the average internal diameter of the yolk sac, the nature of vascularization of the corpus luteum, the state of hemodynamics in the myometrium. During transvaginal ultrasound, the chorionic volume (Vc) was calculated and its vascularization index (VI) was evaluated using a special three-dimensional VOCAL program. Results. Analysis of embryo biometrics in the studied groups did not reveal any significant difference. When assessing the state of extra-embryonic structures, we found that the volume of the fertilized egg and the average internal diameter of the yolk sac in women with miscarriage in the embryonic period of gestation was significantly lower. The volume of the corpus luteum of the ovary in the main group was equal to 3.0±0.3 cm3 in the control group – 5.3±0.61 cm3 , (p < 0.05). Vascularization of the corpus luteum in patients with bleeding in early pregnancy was also reduced. In patients with threatened termination of pregnancy with bleeding, Vc was 32.5±2.08 cm3 in control 71.6±2.4 cm3 . The vascularization index of the chorion in pregnant women of the main group was equal to 9.5±1.2, while in women with a physiological course of gestation it was 19.1±1.7 (p<0.05). When evaluating the hemodynamics in the myometrium, it was also established that the resistance index in the uterine and spiral arteries in the patients of the main group was significantly higher compared to the pregnant women of the control group. Conclusions. When there is a threat of pregnancy termination with bleeding in the embryonic period of intrauterine development of the child, significant changes occur in extraembryonic structures. A decrease in the volume of the fertilized egg, the average internal diameter of the yolk sac, blood flow disorders in the corpus luteum and myometrium, a decrease in vascularization of the chorion and its hypoplasia create a high risk of developing placental dysfunction and worsen the prognosis of pregnancy.

Differential Development of the Chordae Tendineae and Anterior Leaflet of the Bovine Mitral Valve.

There is increasing evidence that some adult mitral valve pathologies may have developmental origins involving errors in cell signaling and protein deposition during valvulogenesis. While early and late gestational stages are well-documented in zebrafish, chicks, and small mammalian models, longitudinal studies in large mammals with a similar gestational period to humans are lacking. Further, the mechanism of chordae tendineae formation and multiplication remains unclear. The current study presents a comprehensive examination of mitral anterior leaflet and chordae tendineae development in a bovine model (a large mammal with the same gestational period as humans). Remarkably distinct from small mammals, bovine development displayed early branched chordae, with increasing attachments only until birth, while the anterior leaflet grew both during gestation and postnatally. Chordae also exhibited accelerated collagen deposition, maturation, and crimp development during gestation. These findings suggest that the bovine anterior leaflet and chordae tendineae possess unique processes of development despite being a continuous collagenous structure and could provide greater insight into human valve development.

Assessment of the impact of COVID-19 experienced at different stages of gestation on perinatal outcomes and structural changes in the placenta

BACKGROUND: At the beginning of the pandemic COVID-19, the attention of obstetricians and gynecologists was focused on studying the impact of SARS-CoV-2 on obstetric and perinatal outcomes. Currently, the dynamics of mutations in genes encoding SARS-CoV-2 proteins determines the emergence of a large number of new strains of the virus that are highly virulent. Given this fact, the problem of assessing the impact of COVID-19 on pregnancy outcomes also remains relevant.
 AIM: The aim of this study was to assess the impact of the novel coronavirus infection (COVID-19) transmitted at different stages of gestation on perinatal outcomes and structural changes in the placenta.
 MATERIALS AND METHODS: In 2022–2023, a prospective analysis of 113 cases of childbirth in women who had the novel coronavirus infection during pregnancy was carried out in obstetric institutions in Novosibirsk. The total sample of subjects was divided into three study groups using cluster analysis. Group 1 included 25 women who had SARS-CoV-2 at a gestation period of up to 16 weeks; Group 2 consisted of 61 patients who underwent COVID-19 at gestation period of 17 to 34 weeks; and Group 3 comprised 27 pregnant women in whom COVID-19 was detected after 34 weeks of pregnancy. The control group included 65 pregnant women who had a negative smear test result for SARS-CoV-2. Pathological examination of the placenta included macro- and microscopic studies. Statistical processing of the results was carried out using the IBM SPSS Statistics Version 25.0 program.
 RESULTS: The most common fetal distress was observed in patients of Groups 1 and 2 (p = 0.002). We found an inverse correlation between the gestational age at which a woman suffered coronavirus infection and the volumetric density of capillaries and intervillous fibrinoid, as well as the percentage of formation of the syncytial-capillary membrane and villi with symplastic buds. On the contrary, a direct correlation between the gestational age and the volumetric density of connective tissue was found. Intervillusitis was more often observed in the placentas of women of Groups 1 and 2. Histitocytic infiltration was characteristic of the placentas of patients of Group 2.
 CONCLUSIONS: The frequency of adverse perinatal outcomes and the intensity of structural changes in the placenta depend on the gestation period in which the patient suffered the novel coronavirus infection. The most significant structural changes in the placenta were detected in patients of Group 2.

Noninvasive Tracking of Embryonic Cardiac Dynamics and Development with Volumetric Optoacoustic Spectroscopy.

Noninvasive monitoring of cardiac development can potentially prevent cardiac anomalies in adulthood. Mouse models provide unique opportunities to study cardiac development and disease in mammals. However, high-resolution noninvasive functional analyses of murine embryonic cardiac models are challenging because of the small size and fast volumetric motion of the embryonic heart, which is deeply embedded inside the uterus. In this study, a real time volumetric optoacoustic spectroscopy (VOS) platform for whole-heart visualization with high spatial (100µm) and temporal (10ms) resolutions is developed. Embryonic heart development on gestational days (GDs) 14.5-17.5 and quantify cardiac dynamics using time-lapse-4D image data of the heart is followed. Additionally, spectroscopic recordings enable the quantification of the blood oxygenation status in heart chambers in a label-free and noninvasive manner. This technology introduces new possibilities for high-resolution quantification of embryonic heart function at different gestational stages in mammalian models, offering an invaluable noninvasive method for developmental biology.

Prevalence, Pattern and Outcome of Congenital Anomalies in Patients Admitted at a Tertiary Level Hospital in Bangladesh

Congenital anomalies are a major public health concern globally, contributing significantly to perinatal and neonatal mortality. Understanding their prevalence, patterns, and outcomes are essential for effective healthcare planning and interventions. This cross-sectional observational study aimed to investigate the distribution and immediate outcomes of congenital anomalies among infants delivered at Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur, Bangladesh. Study population comprised admitted pregnant mothers who delivered infants with congenital anomalies from January to December 2022. Data were collected from medical records, including parity, gestational age at delivery, mode of delivery and outcomes of congenital anomalies. Total 3461 deliveries occurred during this period, of which 88 had congenital anomalies with a prevalence of 2.54%. Among the 88 infants with congenital anomalies, the most prevalent anomalies were Anencephaly and Hydrocephalus, affecting the central nervous system. Anencephaly had a 100% mortality rate, emphasizing its severity and poor prognosis. Anencephaly was more common in infants delivered between 12 to 28 weeks. Early gestational stages play critical role in its pathogenesis. Hydrocephalus showed a relatively higher proportion of live births. Vaginal delivery was the predominant mode of delivery for most congenital anomalies. Public health efforts targeting early detection, appropriate care and support for affected families can potentially reduce the impact of congenital anomalies on maternal and neonatal health. Bangabandhu Sheikh Mujib Med. Coll. J. 2024;3(1):27-31

Serum Ferritin Level and Total Iron Binding Capacity Relationship with Iron Deficiency Anemia During Pregnancy and Labour

Background: Iron deficiency anemia (IDA) is a prevalent condition globally, impacting maternal and fetal health outcomes significantly. The condition is especially concerning during pregnancy, given its association with complications such as preterm labor and increased maternal and neonatal morbidity and mortality rates. Objective: The study aimed to assess the prevalence of IDA among pregnant women and its correlation with fetal-maternal complications, as well as to evaluate the effectiveness of current healthcare interventions in managing the condition. Methods: A cross-sectional study was conducted at Shikhzayad Women Hospital, Larkana, over six months from January 1, 2022, to July 1, 2022. Fifty pregnant women with IDA at various gestational stages were selected and evaluated for serum ferritin and total iron-binding capacity (TIBC). The severity of anemia and its correlation with feto-maternal complications were analyzed using SPSS version 25. Results: Out of the 50 women studied, 6 had mild anemia, 37 had moderate anemia, and 7 had severe anemia. Serum ferritin levels showed that 10 participants had levels between 5-10 mg/L, 20 had levels between 10-50 mg/L, 10 had levels between 50-150 mg/L, and 10 had normal levels (150-300 mg/L). Elevated TIBC levels (400-600 ug/ml) were observed in 30 women. Feto-maternal complications included emergency cesarean sections (28 cases), postpartum hemorrhage (8 cases), disseminated intravascular coagulation (6 cases), cardiac failure (4 cases), and maternal death (4 cases). Pregnancy outcomes were reported as 5 first-trimester abortions, 2 second-trimester abortions, 4 preterm deliveries, 15 cases of intrauterine growth restriction (IUGR), 9 intrauterine deaths (IUD), and 5 neonatal deaths (NND). Conclusion: IDA remains a significant determinant of adverse maternal and neonatal outcomes. This study underscores the urgent need for enhanced preventive strategies, including iron supplementation and dietary education. Further large-scale research is required for a comprehensive understanding of IDA's impact and the development of targeted interventions.

A longitudinal and cross-sectional study of placental circulation between normal and placental insufficiency pregnancies

IntroductionTo longitudinally and cross-sectionally study the differences in the uterine artery pulsatility index (UTPI), umbilical artery pulsatility index (UAPI) and placental vascularization indices (PVIs, derived from 3-dimensional power Doppler) between normal and placental insufficiency pregnancies throughout gestation. MethodsUTPI, UAPI and PVI were measured 6 times at 4- to 5- week intervals from 11 to 13+6 weeks–36 weeks. Preeclampsia (PE) and fetal growth restriction (FGR) were defined as placental insufficiency. Comparisons of UTPI, UAPI and PVI between normal and insufficiency groups were performed by one-way repeated measures analysis of variance. ResultsA total of 125 women were included: monitored regularly from the first trimester to 36 weeks of gestation: 109 with normal pregnancies and 16 with placental insufficiency. Longitudinal study of the normal pregnancy group showed that UTPI and UAPI decreased significantly every 4 weeks, while PVIs increased significantly every 8 weeks until term. In the placental insufficiency group however, this decrease occurred slower at 8 weeks intervals and UTPI stabilized after 24 weeks. No significant difference was noted in PVIs throughout pregnancy. Cross-sectional study from different stages of gestation showed that UTPI was higher in the insufficiency group from 15 weeks onward and PVIs were lower after 32 weeks. DiscussionCompared to high-risk pregnancies with normal outcome, UTPI and UAPI needed a longer time to reach a significant change in those with clinical confirmation of placental insufficiency pregnancies and no significant change was found in PVI throughout gestation. UTPI was the earliest factor in detecting adverse outcome pregnancies.

Fetal Left Ventricle Function Evaluated by Two-Dimensional Speckle-Tracking Echocardiography across Clinical Stages of Severity in Growth-Restricted Fetuses.

Fetal growth restriction (FGR) can result in adverse perinatal outcomes due to cardiac dysfunction. This study used 2D speckle-tracking echocardiography to assess left ventricle (LV) longitudinal strain across FGR severity stages. A prospective longitudinal cohort study measured global (GLS) and segmental LV longitudinal strain in FGR fetuses, with evaluations conducted at various time points. FGR was classified into subtypes based on published criteria using fetal weight centile and Doppler parameters. A linear mixed model was employed to analyze repeated measures and compare Z-score measurements between groups throughout gestational age. The study included 40 FGR fetuses and a total of 107 evaluations were performed: 21 from small for gestational age (SGA), 74 from the FGR stage I, and 12 from the FGR stage ≥ II. The results indicate that SGA and stage I FGR fetuses exhibit higher LV GLS than stages ≥ II. Throughout gestation, SGA and FGR stage I fetuses showed similar behavior with consistently better LV GLS values when compared to FGR stages ≥ II. No significant differences were observed in LV GLS strain behavior between SGA and FGR stage I. In conclusion, all FGRs show signs of early cardiac dysfunction, with severe cases demonstrating significantly a lower LV GLS when compared to mild cases, suggesting deterioration of cardiac dysfunction with progression of fetal compromise.

Prenatal prednisone exposure impacts liver development and function in fetal mice and its characteristics.

Prednisone, a widely used glucocorticoid drug in human and veterinary medicine, has been reported to cause developmental toxicity. However, systematic studies about the effect of prednisone on fetal liver development are still unclear. We investigated the potential effects of maternal exposure to clinically equivalent doses of prednisone during different gestational stages on cell proliferation and apoptosis, cell differentiation, glucose and lipid metabolism, and hematopoiesis in the liver of fetal mice, and explored the potential mechanisms. Results showed that prenatal prednisone exposure (PPE) could suppress cell proliferation, inhibit hepatocyte differentiation, and promote cholangiocyte differentiation in the fetal liver. Meanwhile, PPE could result in the enhancement of glyconeogenesis and bile acid synthesis and the inhibition of fatty acid β-oxidation and hematopoiesis in the fetal liver. Further analysis found that PPE-induced alterations in liver development had obvious stage and sex differences. Overall, the alteration in fetal liver development and function induced by PPE was most pronounced during the whole pregnancy (GD0-18), and the males were relatively more affected than the females. Additionally, fetal hepatic insulin-like growth factor 1 (IGF1) signaling pathway was inhibited by PPE. In conclusion, PPE could impact fetal liver development and multiple functions, and these alterations might be partially related to the inhibition of IGF1 signaling pathway.

Relationship between plasma anti-Müllerian hormone concentrations in female Holstein calves immediately after birth and milk yield and composition in dams during early to mid-gestation

The energy status of dams during the early stages of gestation may affect ovarian reserve. It was hypothesized that greater milk yield and composition during the early stages of gestation may suppress the number of primordial follicles in the fetuses of dairy cattle. This study aimed to evaluate the anti-Müllerian hormone (AMH), used as an indicator of ovarian reserve, in female Holstein calves immediately after birth. It also examined the relationship between the AMH concentrations and the milk yield and composition of dams during early pregnancy. A total of 85 female Holstein calves (born to first-calving cows [nulliparous heifers], n = 31; second-calving [primiparous] cows, n = 22; and third- or subsequent-calving [multiparous] cows, n = 32) were examined. Blood samples were collected from the female calves after birth and before the first colostrum feeding for the analysis of plasma AMH concentrations. Data on daily milk yield and monthly milk composition during the 1st to 6th month of pregnancy were additionally collected from milking dams. The plasma AMH concentrations ranged from 0.106 to 1542.3 pg/mL, with an average of 291.6 ± 30.5 pg/mL. There was no significant difference observed among the plasma AMH concentrations in female calves born from nulliparous heifers, primiparous cows, multiparous cows. Primiparous cows exhibited numerous negative correlations between the plasma AMH concentrations of their female calves immediately after birth and the daily milk yield and milk composition from the 1st to the 4th month of pregnancy; there was, however, no correlation observed in multiparous cows. Overall, there were large individual variations observed in the plasma AMH concentrations immediately after birth. Both milk yield and the amount of milk components strongly influenced the plasma AMH concentrations in calves immediately after birth in primiparous cows in the growth phase. These factors, conversely, did not affect the plasma AMH concentrations of calves in multiparous cows. The results of this study suggest that high-producing pregnant primiparous cows devote more energy to their growth and lactation, potentially compromising the reproductive potential of their offspring. Thus, improving the feeding management of primiparous cows with the goal of increasing the fertility of their progeny will help high-yielding dairy cows reproduce more successfully.

Emotional temperaments in advanced pregnant goats and its relationship with the feto-maternal blood flow and placentome echotexture

The current study aimed to investigate the effect of xylazine sedation (non-sedated versus sedated conditions) and animal temperament on the fetal and maternal hemodynamics during the late stage of gestation in goats. In addition, it aimed to study the concentrations of cortisol and the echotexture of the placentome. Fourteen goats were assigned into two equal groups (n = 7, each) based on the animal’s emotional temperament (calm versus nervous groups). All goats were examined for assessment of the blood flow within the fetal aorta (FA), umbilical artery (UMA), and middle uterine artery (MUA) using color-pulsed Doppler ultrasonography. Goats were exposed to light sedation using the recommended dose of xylazine (0.05 mg/Kg Bw) intramuscularly. Goats in each group were reassessed for the studied parameters after sedation. Blood samples were drawn to determine the concentrations of cortisol. Placentome echotexture pixel intensity (PXI) was evaluated using computer image analysis software. Results revealed the significant impact of the xylazine sedation on the Doppler indices of the blood flow within the measured arteries (FA, UMA, and MUA), the PXI of placentome echotexture, and cortisol concentrations. The emotional temperament of goats had significant effects on the blood flow parameters of the MUA and UMA, concentrations of cortisol, and the PXI of the placentome. The interaction effect (sedation x temperament) was noticed in the measured parameters of the UMA blood flow, fetal heart rate, and cortisol concentrations. In conclusion, xylazine sedation and emotional temperaments induced alterations in the echotexture of the placentomes as well as the hemodynamic parameters of late-stage pregnant goats without affecting the pregnancy outcomes.

Color Doppler ultrasound in high-low risk pregnancies and its relationship to fetal outcomes: a cross-sectional study.

To calculate the multivessel color Doppler indices in high-risk and low-risk pregnancies and relate these to fetal outcomes. The investigation involved 60 patients who were pregnant. The patients were separated into groups according to assessment of low and high risk. The patients underwent color Doppler ultrasonography to detect the maternal and fetal blood vessels, and the measured Doppler indices were then analyzed for any association with fetal outcomes. The gestational stages (in weeks) of the participants at the respective times of investigation and delivery were 32.06 ± 2.98 and 36.2 ± 1.78 in the low-risk group and 29.21 ± 1.95 and 29.83 ± 1.86 in the high-risk group. The pulsatility index (PI), resistive index (RI), and systolic/diastolic ratio (SD) decreased with gestation length in the low-risk group, whereas in the high-risk group, these values increased in the uterine and umbilical arteries. With increased gestational stage, MCA-PSV (peak systolic velocity) in the middle cerebral artery (MCA) increased, while PI decreased. Pulsatile and reversal flow of the uterine vein, the vein of Galen, and the umbilical vein were noted in high-risk pregnancies, and these negatively affected the fetal outcome. The fetal venous parameters were more specific and sensitive for predicting an unfavorable fetal outcome than the arterial factors, with a greater negative predictive value. The results of our study indicate that abnormal Doppler indices of the blood vessels in high-risk pregnant patients will result in adverse clinical outcomes. Therefore, the patients can be monitored and managed accordingly using Doppler ultrasonography.

Longitudinal skeletal growth and growth plate morphological characteristics of chondro-tissue specific CUL7 knockout mice

Background3 M syndrome is first reported in 1975，which characterized by severe pre- and postnatal growth retardation, skeletal malformation and facial dysmorphism. These three genes (CUL7, OBSL1 and CCDC8) have been identified to be respond for 3 M syndrome, of which CUL7 is accounting for approximately 70%. To date, the molecular mechanism underlying the pathogenesis of 3 M syndrome remains poorly understood. Previous studies showed that no Cul7-/- mice could survive after birth, because of growth retardation at late gestational stage and respiratory distress after birth. The establishment of the animal model of cartilage specific Cul7 knockout mice (Cul7fl/fl;Col2a1-CreERT2 mice) has confirmed that Cul7fl/fl;Col2a1-CreERT2 mice can be selective in a time- and tissue-dependent manner, which can provide an experimental basis for further research on severe genetic diseases related to growth plates. ObjectiveTo establish a model of Cul7fl/fl;Col2a1-CreERT2 mice based on Cre/LoxP system, and to further observe its phenotype and morphological changes in growth plate. MethodsThe Cul7fl/fl;Col2a1-CreERT2 mice were taken as the experimental group, while the genotype of Cul7fl/+;Col2a1-CreERT2 mice were used as the control group. The gross morphological features and X-ray films of limbs in the two groups were observed every week for 3–6 consecutive weeks, and the length of the mice from nose to the tail, the length of femur and tibia were recorded. In the meantime, The histological morphology of tibial growth plates was compared between the two groups. ResultsA preliminary model of Cul7fl/fl;Col2a1-CreERT2 mice was established. The Cul7fl/fl;Col2a1-CreERT2 mice had abnormally short and deformed limbs (P<0.05), increased thickness of growth plate, the disorderly arranged chondrocyte columns, decreased number of cells in the proliferation zone, changes in the shape from flat to round, obviously expanded extracellular matrix, and disordered arrangement, thickening and loosening of bone trabecula at the proximal metaphysis of the femur. ConclusionsThe knockout of Cul7 gene may affect both the proliferation of chondrocytes and the endochondral osteogenesis, confirming that Cul7 is essential for the normal development of bone in the body.

The effects of prenatal azithromycin exposure on offspring ovarian development at different stages, doses, and courses

Azithromycin, a commonly used macrolide antibiotic for treating chlamydial infections during pregnancy, has sparked investigations into its potential effects on offspring development. Despite these inquiries, there remains uncertainty about the specific impact of prenatal azithromycin exposure (PAzE) on offspring ovarian development and the precise "effect window". Pregnant mice, following clinical guidelines for azithromycin dosing, were orally administered azithromycin at different gestational stages [(gestational day, GD) 10–12 or GD 15–17], doses (50, 100, or 200 mg/kg·d), and courses (single or multiple). On GD 18, we collected offspring blood and ovaries to examine changes in fetal serum estradiol (E2) levels, fetal ovarian morphology, pre-granulosa cell function, and oocyte development. Multiple courses of PAzE resulted in abnormal fetal ovarian morphological development, disorganized germ cell nests, enhanced ovarian cell proliferation, and reduced apoptosis. Simultaneously, multiple courses of PAzE significantly increased fetal serum E2 levels, elevated ovarian steroidogenic function (indicated by Star, 3β-hsd, and Cyp19 expression), disrupted oocyte development (indicated by Figlα and Nobox expression), and led to alterations in the MAPK signal pathway in fetal ovaries, particularly in the high-dose treatment group. In contrast, a single course of PAzE reduced fetal ovarian cell proliferation, decreased steroidogenic function, and inhibited oocyte development, particularly through the downregulation of Mek2 expression in the MAPK signal pathway. These findings suggest that PAzE can influence various aspects of fetal mouse ovarian cell development. Multiple courses enhance pre-granulosa cell estrogen synthesis function and advance germ cell development, while a single terminal gestation dose inhibits germ cell development. These differential effects may be associated with changes in the MAPK signal pathway.

The iron status of rural Nigerian women in the second and third trimesters of pregnancy: implications for the iron endowment and subsequent dietary iron needs of their babies.

The aim of the study was to determine the iron status of rural-dwelling pregnant Nigerian women in the second and third trimesters, and to predict their risk of giving birth to babies with suboptimal iron endowment. This was a prospective cohort study conducted between April and August 2021. A total of 174 consecutive and consenting pregnant rural dwellers, who met the inclusion criteria, were recruited by convenience sampling from the antenatal clinic of a public hospital in Nsukka, a semirural town in south-east Nigeria. The study participants were aged 21-40 years, and their iron status was determined by measuring blood haemoglobin (Hb) and serum ferritin (SF) concentration. Hb concentration was determined by the cyanmethemoglobin method and the SF concentration was determined by enzyme immunoassay method. Almost half (47.7%) of the participants had Hb concentrations below 11 g/dL, while about two out of every five (40.8%) had SF concentrations less than 15 &micro;g/L. The prevalence of iron deficiency, iron deficiency anaemia (IDA) and non-iron deficiency anaemia were 40.8%, 23.6% and 24.7%, respectively. The mean SF levels varied with maternal age, gestation stage, pregnancy intervals and the intake of iron supplements. The mean SF concentration was higher in the second trimester than in the third. The mean SF concentration &plusmn; standard deviation (37.10&plusmn;3.02 &micro;g/L) was higher in the group that took iron supplements than in the group that did not (20.76&plusmn;2.11 &micro;g/L). However, two out of five participants in both groups had SF concentrations less than 15.0 &micro;g/L. The prevalence of IDA was quite high among the participants in both trimesters even with the widespread intake of the recommended oral iron supplements. About four out of 10 of the participants had SF concentrations of less than 15 &micro;g/L and were thus judged at risk of giving birth to babies with poor iron deposits. Therefore, more effective strategies are needed to monitor and prevent IDA among pregnant women in rural populations of Nigeria and, by inference, other parts of tropical Africa.

Guyton perspective in managing peripartum cardiomyopathy patient with pulmonary edema: a case report

BackgroundPeripartum cardiomyopathy (PPCM) is a potentially life-threatening pregnancy-related condition characterized by left ventricular dysfunction and heart failure, typically occurring in the peripartum period. Individuals with a history of preeclampsia and hypertension are particularly prone to developing PPCM. Recent research suggests that the condition may be triggered by vascular dysfunction influenced by maternal hormones in the late stages of gestation. The onset of left heart failure results in decreased cardiac output, leading to insufficient perfusion, which in turn, contributes to pulmonary edema and exacerbates tissue hypoxia. This cardiovascular response activates the neurohumoral system, causing peripheral vasoconstriction and elevating both mean capillary filling pressure (MCFP) and central venous pressure (CVP). Early administration of furosemide reduces volume overload due to negative cumulative fluid balance gaining and vasodilation, which increases the velocity of intravascular refilling and causes interstitial edema to resolve. This will decrease interstitial fluid pressure, resulting in decreased mechanical compression to systemic capillary and systemic vein pressure, thus decreasing MCFP and CVP subsequently. Reduced CVP also contributes to increased venous return by decreasing the gradient pressure between MCFP and CVP, resulting in increased cardiac output (CO) and improved tissue oxygenation.CaseA 33-year-old Asian woman, para 3 at full term pregnancy, admitted to the intensive care unit (ICU) after c-section and tubectomy due to shortness of breath and palpitation. Based on history taking, physical examination and echocardiography the patient fulfilled the criteria of PPCM which was also complicated by pulmonary edema. Despite impending respiratory failure, the patient rejected intubation and continuous positive airway pressure (CPAP), and was given oxygen supplementation through nasal cannula. Furosemide was given rapidly continued by maintenance dose and CVP was monitored. Antihypertensive drug, anticoagulants, and bromocriptine were also administered. After achieving negative cumulative fluid balance the patient’s symptoms resolved and was discharged one week later.ConclusionThere is a correlation between negative cumulative fluid balance and reduced central venous pressure after early furosemide therapy. Suspicion for PPCM should not be lowered in the presence of preeclampsia, it could delay appropriate treatment and increase the mortality.

The hormonal control of parturition.

Parturition is a complex physiological process that must occur in a reliable manner and at an appropriate gestation stage to ensure a healthy newborn and mother. To this end, hormones that affect the function of the gravid uterus, especially progesterone (P4), 17β-estradiol (E2), oxytocin (OT), and prostaglandins (PGs), play pivotal roles. P4 via the nuclear P4 receptor (PR) promotes uterine quiescence and for most of pregnancy exerts a dominant block to labor. Loss of the P4 block to parturition in association with a gain in prolabor actions of E2 are key transitions in the hormonal cascade leading to parturition. P4 withdrawal can occur through various mechanisms depending on species and physiological context. Parturition in most species involves inflammation within the uterine tissues and especially at the maternal-fetal interface. Local PGs and other inflammatory mediators may initiate parturition by inducing P4 withdrawal. Withdrawal of the P4 block is coordinated with increased E2 actions to enhance uterotonic signals mediated by OT and PGs to promote uterine contractions, cervix softening, and membrane rupture, i.e., labor. This review examines recent advances in research to understand the hormonal control of parturition, with focus on the roles of P4, E2, PGs, OT, inflammatory cytokines, and placental peptide hormones together with evolutionary biology of and implications for clinical management of human parturition.

Effects of Defoliation at Different Fertility Stages on Material Accumulation, Physiological Indices and Yield of Cotton

In recent years, severe hailstorms have caused damage to cotton leaves and stalks. In order to identify the effects of cotton leaf damage on its dry matter accumulation, protective enzyme activity and yield in different periods, in this experiment, different intensities of hail were simulated by manual leaf cutting. In this study, the effects of leaf damage on dry matter accumulation, chlorophyll fluorescence, POD (peroxidase), SOD (superoxide dismutase) and MDA levels (malondialdehyde), and yield of cotton were studied in field experiments at three stages (bud, full bud and flower boll stages) and in sub-plots with different artificial defoliation intensities (0%, 25%, 50%, 75% and 100%). Removing the leaf sources had differently sized effects on the “sink” at each stage, and these are ordered as follows: flowering and boll stage &gt; full bud stage &gt; pregnancy stage. The greater the intensity of leaf removal, the greater the impact on the “sink”. Among them, after removing 50% of the leaves at the full bud stage, the total dry matter of the cotton plant increased by 12.46% compared to that of the control, and the boll formation rate per plant increased by 14.99%, resulting in overcompensation. Mo, Vj and φDo all showed a tendency to decrease and then increase with the increase in defoliation intensity at different periods of the treatment, and the lowest values of Mo, Vj and φDo, and the largest values of φpo, ψo and φEo were found in the 50% defoliation treatment at the gestational bud stage. The values of ψo and φEo were at the maximum in the 25% defoliation treatment at the full bud stage. The values of Mo and Vj in the different defoliation treatments at the bolling stage showed a tendency to increase and then decrease with the increase in defoliation intensity, with the highest values in the 25% treatment and the smallest values of φpo, ψo and φEo in the 25% defoliation treatment. The POD enzyme activity level was elevated in the defoliation treatments at the three different periods, and the highest value was observed in the 50% defoliation group at the full bud and boll stages, which is a reflection of supercompensation. The SOD enzyme activity level tended to increase with the intensity of defoliation, and defoliation at the gestational and full bud stages first enhanced and then weakened the stress on the cotton plants. The differences between treatments decreased after 12 weeks. The stress of defoliation on cotton plants was weakened at the boll stage. With the increase in defoliation intensity, the content of MDA showed a gradual increasing trend. The cotton MDA content was higher than that of the other treatments at 75% defoliation at both the post-fertilized bud and full bud stage.

Nuclear Binding Protein 2/Nesfatin-1 Affects Trophoblast Cell Fusion during Placental Development via the EGFR-PLCG1-CAMK4 Pathway.

Previous studies have shown that nuclear binding protein 2 (NUCB2) is expressed in the human placenta and increases with an increase in the syncytialization of trophoblast cells. This study aimed to investigate the role of NUCB2 in the differentiation and fusion of trophectoderm cells. In this study, the expression levels of NUCB2 and E-cadherin in the placentas of rats at different gestation stages were investigated. The results showed that there was an opposite trend between the expression of placental NUCB2 and E-cadherin in rat placentas in different trimesters. When primary human trophoblast (PHT) and BeWo cells were treated with high concentrations of Nesfatin-1, the trophoblast cell syncytialization was significantly inhibited. The effects of NUCB2 knockdown in BeWo cells and Forskolin-induced syncytialization were investigated. These cells showed a significantly decreased cell fusion rate. The mechanism underlying NUCB2-regulated trophoblast cell syncytialization was explored using RNA-Seq and the results indicated that the epidermal growth factor receptor (EGFR)-phospholipase C gamma 1 (PLCG1)-calmodulin-dependent protein kinase IV (CAMK4) pathway might be involved. The results suggested that the placental expression of NUCB2 plays an important role in the fusion of trophoblasts during differentiation via the EGFR-PLCG1-CAMK4 pathway.

Transcriptomic analysis of bovine endometrial epithelial cells in response to interferon tau and hormone stimulation.

The embryonic loss during early stage of gestation is one of the major causes of infertility for domestic ruminants, causing huge economic losses to pasture. Maternal recognition of pregnancy and implantation are the crucial process for determining the successful establishment and development of pregnancy in cattle. The research on molecular mechanisms of pregnancy recognition will facilitate illustrating the complex process of pregnancy establishment and help to improve pregnancy outcomes. In this study, we performed transcriptomic analysis of primary bovine endometrial epithelial cells (BEND) with or without IFNT and hormones intervention through RNA sequencing. We eventually identified 608 differentially expressed genes (DEGs) including 409 up-regulated genes and 199 down-regulated genes in IFNT and hormones-treated group compared with control group. Gene Ontology (GO) enrichment analysis demonstrated that the majority of DEGs were implicated in immune system process, response to external stimulus, response to cytokine, regulation of response to stress. Results from KEGG analysis showed a significant enrichment of NOD-like receptor signaling pathway, antigen processing and presentation, necroptosis, oxidative phosphorylation, RIG-I-like receptor signaling pathway. Additionally, a set of promising candidate genes, including (USP18, STAT1, PSMB8, IFIH1, MX2, IFI44, DHX58, CASP8, DRAM1, CXCR4), were characterized by constructing an integrated interaction network. Specifically, the mRNA expression of HOXA11, PTGS1 and PTGS2 were remarkably suppressed by silencing DRAM1 under IFNT and hormone administration, thus speculating that DRAM1 might play a crucial role in early pregnancy by regulating endometrial function. The results of this study depicted a relatively comprehensive transcriptional profiles of BEND in response to IFNT and hormones, which contributes to a better understanding of gene interaction network and underlying regulatory mechanisms in endometrium of ruminants during early pregnancy.