Fetal Growth Retardation Research Articles

Fetal growth restriction: features of anamnesis, outcomes of pregnancy and childbirth

Background. Fetal growth restriction (FGR) is a serious medical and social problem, which is associated with high perinatal morbidity and mortality, as well as long-term consequences for offspring. To date, there are no absolute instrumental tests for accurately predicting the condition of the fetus, which justifies the relevance of this study.Objective. To study the features of the anamnesis, the course of pregnancy, and the outcome of childbirth in women with fetal growth restriction.Materials and methods. A retrospective cohort study was conducted using a continuous sample of 200 women who were delivered at the Clinic of the South Ural State Medical University (Chelyabinsk) in 2022. All the women were divided into two groups: group 1 - 30 women with FGR, group 2 - 170 women without FGR. The outcomes of pregnancy and childbirth were studied (the results were obtained by means of a questionnaire, analysis of medical documentation: the book of a pregnant woman, the history of childbirth).Results. There was a low effectiveness of the prognosis of FGR both according to the results of the analysis of anamnestic risk factors and according to laboratory and instrumental screening programs at 11-13,6 weeks of gestation. A low percentage of coverage with drug prevention was registered in the high-risk group of FGR (55%). We found that FGR is associated with other placental disorders, which more often began in the second trimester with changes in uterine and fetal blood flow and progressed as the gestation period increased. Fetal growth restriction is associated with severe preeclampsia, high incidence of premature birth, cesarean section, hypotrophy and severe asphyxia of newborns.Conclusion. The absence of significant anamnestic risk factors, the low effectiveness of predicting fetal growth retardation based on the results of programmatic screening at 11-13,6 weeks require the development of new modern methods for predicting pathology. Research should focus on the development of new fetal diagnostic tools that can improve the accuracy of predicting critical fetal conditions, as well as on the introduction of innovative therapeutic measures aimed at improving placental hemodynamics, which will further optimize the timing of delivery.

COVID-19 AND PREGNANCY

Physiological changes that occur during pregnancy may alter the response to COVID-19 infection. Pregnancy is considered a risk factor for infectious diseases, but the increased risk of complications with COVID-19 is controversial. Since the beginning of the pandemic, the impact of the disease on the condition of the mother and fetus has been questioned. The aim of the study. To assess the impact of the SARS-CoV-2 virus on the course of pregnancy, fetal growth depending on the period of pregnancy, when the disease occurred in a pregnant woman in a mild and moderate form. Materials and methods. Two groups were formed: 1st main group 60 pregnant women suffering from COVID-19 in different stages of pregnancy, 2nd control group 20 healthy pregnant women without COVID-19 infection. A general clinical, bacterioscopic, bacteriological, immunoenzymatic, ultrasound examination was performed. Statistical analysis was performed according to generally accepted methods of variational statistics. Approval of the scientific work was obtained from the Bioethics Commission of the Bukovyna State Medical University (Ukraine). The work is a part of the research work "Prevention, diagnostics and treatment of disorders of perinatal period and reproductive system of women and adolescent girls" (No. 201110H, state registration No. 0111U006499). Research results. A significant decrease in free estriol was revealed by 3.82±0.29 (p<0.01) in the main group when infected in the first trimester of pregnancy with the subsequent development of fetal growth retardation syndrome in 14.29% in the first trimester and in 12.5% ​​in in the third trimester of pregnancy, intrauterine infection of the fetus in 25%. Infection with SARS-CoV-2 in the third trimester of pregnancy led to a decrease in fetal growth and the birth of children with a weight of 2962.55±56.73 (p<0.05). Conclusions. The most favorable period for infection with SARS-CoV-2 during pregnancy is the second trimester (50%), however, a decrease in the hormone-producing function of the placenta is observed during infection in the first trimester, which leads to the development of fetal growth retardation, however, the weight at birth does not differ from the control group , unlike infection in the third trimester, where there is a significant decrease in fetal growth, the study is important for timely prevention of complications.

Prematurity and growth retardation: different causes of fetal coagulation disorders

prematurity and fetal growth retardation complicates in general one in five pregnancies. The combination of prematurity with severe growth retardation and hypoxia worsens the prognosis due to increase of periventricular hemorrhage incidence, and later coronary heart disease, hypertension, stroke, miscarriage and fetal growth retardation in own pregnancies in adulthood. The causes of impaired blood coagulation and fibrinolysis in retardated and premature newborns remain poorly understood. The goal of the study - to compare the parameters of blood acid-base and gases balance, coagulation and fibrinolysis in prematurity and growth retardation. Material and methods. Newborns of three clinical groups were examined. 24 full-term newborns with a postnatal diagnosis of I-II growth retardation stage constituted group I. 18 newborns of group II were born prematurely, corresponding to pregnancy term of 28-34 weeks. Control group III consisted of 20 full-term healthy infants. The birth took place without emergency interventions and without perinatal losses. Blood samples of the umbilical cord artery were obtained immediately after it was clamped. The parameters of blood acid-base and gas compositionof mothers and newborns blood and the fetal kinetic characteristics of blood coagulation and fibrinolysis were compared. Results. Newborns of group I had a pH of 7.27±0.012, in group II - 7.33±0.022, in group III - 7.30±0.024, which corresponded to the difference between maternal and fetal values of 0.10; 0.07 and 0.13. The pH difference in growth retarded fetuses is higher than in premature fetuses, closely to that of full-term fetuses, despite the lowest pH. Parameters of pO2 and pCO2 in labor do not have an indicative difference in newborns of all groups. Thromboelastometric parameters of the premature infants blood indicate low density and accelerated clot lysis, but while growth retarded fetuses accelerated formation and incomplete clot lysis. That is because of notable predominance of endothelial origin procoagulant factors in growth retarded fetuses. Indicators of acid-base and gas balance in newborns with growth retardation are shifted towards acidosis, in contrast to anthropometrically similar premature infants, whose indicators are higher than full-term fetuses ones.

Features of mental state and reproductive function in dynamics inmentally ill women with infertility

Women suffering from a mental disorder are faced with the problem of pregnancy and the realisation of their reproductive rights throughout their lives. The presence of a mental disorder largely determines the onset, course and outcome of pregnancy. A deterioration in mental health is often accompanied by an impairment of menstrual and reproductive function, and an improvement contributes to their recovery.Objective: to analyse individual indicators of reproductive function in women with various mental disorders and infertility in dynamics according to the follow-up data.Material and methods. The study included 120 women with various mental disorders and infertility, who were observed for 2 years by a psychiatrist and a gynaecologist on the background of treatment of the existing disorders.Results. In 70% of cases, mentally ill women have primary infertility, with idiopathic infertility predominating (63.3%), especially in the context of secondary infertility (77.8%; p<0.05). Treatment of infertility by gynaecologists and mental disorders by psychiatrists leads to the normalization of the menstrual cycle and the onset of pregnancy. Pregnancy is usually accompanied by obstetric and somatic complications (fetal growth retardation and miscarriage, placental disorders, hypertension, oedema, lipid metabolism disorders, gestational diabetes mellitus). Reproductive function is impaired mostly in patients with schizophrenia and affective disorders, they account for 80.8% of observed infertility. Fertility is lowest in patients with paranoid schizophrenia: pregnancy occurred in 12.9% of patients, none of them gave birth. In schizoaffective disorder, 43.75% of women became pregnant, but only 20% gave birth. In bipolar affective disorder (BAD) type I, pregnancy occurred in 87.5% of patients (of which 57.1% resulted in a childbirth), in bipolar disorder type II – in 43.75% (of which 42.8% resulted in a childbirth), and in recurrent depressive disorder – in 60% (of which 50% resulted in a childbirth). In these disorders, the duration of infertility correlates with the duration of the disease (p<0.05). In neurotic disorders, fertility suffers to a lesser extent: pregnancy with recovery or significant improvement of the mental condition occurred in 75–100% of cases, but only 66.7% of cases resulted in a child birth. Childbirth was mainly performed by caesarean section.Conclusion. Reproductive function in mentally ill women depends largely on the type of mental disorder, the characteristics of its course, the efficacy of psychopharmacotherapy, the quality of remission and the degree of social and family adaptation, which must be taken into account in the diagnosis and treatment of infertility.

Possibilities of an experimental approach in creating fetal growth restriction in animal models

The literature review was compiled to assess which animal models of intrauterine development disorders most adequately reflect the pathological processes in the clinic. Intrauterine growth restriction associated with placental insufficiency is an urgent scientific and practical problem of modern obstetrics and perinatology. According to World Health Organization, this complication occurs in 10% of pregnant women. The etiology and mechanisms of this pathology have been the focus of research for more than decades. Nevertheless, the methods of predicting and preventing this pathology are not very effective, as consensus in diagnostic approaches is only being formed, and there are practically no methods of correction. The results of experimental studies have made a significant contribution to the understanding of the pathophysiological foundations of the placental insufficiency and intrauterine growth restriction development. For this purpose, various laboratory animals are used, most often rats (Rattus norvegicus), chinchillas (Chinchilla lanigera), mice (Mus musculus), rabbits (Oryctolagus cuniculus), and guinea pigs (Cavia porcellus). Each of the above types of experimental animals has its own advantages for studying intrauterine growth restriction. There are three main methods used to simulate intrauterine growth restriction in animals: the surgical method (ligation of blood vessels), the method of placing in a chamber with a reduced oxygen concentration, and the method of lowering the caloric content and amount of food. Various models of intrauterine growth restriction have been proposed over a long study of the problem. However, these data differ greatly among themselves in the literature. The task of this review was to understand the most effective models and animal species to study fetal growth retardation, as well as ways to create this pregnancy complication.

ОСОБЕННОСТИ АМИНОКИСЛОТНОГО ОБМЕНА У БЕРЕМЕННЫХ С ЗАДЕРЖКОЙ РОСТА ПЛОДА

The analysis of the metabolomic profile of amino acid metabolism was performed in 98 patients with a confirmed diagnosis of fetal growth retardation; 65 patients with physiological pregnancy. It was found that pregnant women with fetal growth retardation had statistically significantly reduced levels of glutathione (p=0,000), asparagine (p=0,01), 3-methylhistidine (p=0,005), citrulline (p=0,004), anserine (p=0,017), carnosine (p=0,002), β-aminobutyric acid (p=0,046), γ-aminobutyric acid (p=0,000), α-aminobutyric acid (p=0,032), ethanolamine (p=0,022), methionine (p=0,000), and tryptophan (p=0,031); an increase in the concentration of: cysteine acid (p=0,046), histidine (p=0,016), homoserine (p=0,004), oxylysine (p=0,000), ornithine (p=0,009) was detected. The study of the features of the metabolic profile of free amino acids in pregnant women with fetal growth retardation will allow identifying additional diagnostic biomarkers, developing effective methods of treatment and prevention

Adverse Fetomaternal Outcomes in Obese Pregnant Women with Gestational Hypertension

Objective: To determine the incidence of adverse fetomaternal outcomes of gestational hypertension in pregnant obese women. Methodology: The six-month descriptive observational study at Liaqat Memorial Hospital, Kohat, with 127obesepregnantwomenaged15-45.Participantswere selectedbasedonsingletonpregnancy more than 24 weeks gestation according to scan or LMP and a blood pressure of >140/90 mmHg on two different occasions without proteinuria, or a single reading of BP of 160/110mmHg with a BMI over 30 kg/m². Baseline data (maternal age, parity, BMI gestational age, education, socioeconomic status, family income, and residence) were collected. Fetomaternal complications were recorded by following up the patients till delivery. Results: The study included obese pregnant women with an average age of 33.2± 1.5 years and a mean BMI of 31.2 ± 5.6. Most participants had a median parity of 3, with a majority belonging to urban areas (51.1%) , having middle socioeconomic status (48.8% ). The adverse fetal outcomes ranged from preterm birth (16.4%),fetal growth restriction (12.6%),fetal hypoxia (8.9%)andlastlyperinataldeath(5.2%).Theadversematernaloutcomeswerepostpartumhemorrhage (16.4%), placental abruption (8.3%) , ecclempsia (7.2%) , HELLPsyndrome (4.1%) and maternal mortality (3.1%). Adverse maternal and fetal outcomes preterm labor postpartum hemorrhage, eclampsia, and placental abruption, fetal growth restriction and intrauterine fetal death outcomes being significantly higher in moderate gestational hypertension compared to mild gestational hypertension p=0.023, p=0.030, p=0.020, p=0.011, p=0.035 and p=0.022) respectively and adverse outcome placental abruption, eclampsia, and fetal growth restriction being significantly higher in class II obesity when compared to class I (p value= p=0.045 p=0.041 p=0.038)respectively Conclusion: Adverse fetomaternal outcomes are significantly affected by the severity of gestational hypertension andclass of obesity.Prenatal identification ofrisk factors in these women couldlowermaternal and fetal morbidity and mortality rates, underscoring the importance of an effective prenatal care system.

АНАЛИЗ ТЕЧЕНИЯ БЕРЕМЕННОСТИ У ЖЕНЩИН С АНТЕНАТАЛЬНОЙ ГИБЕЛЬЮ ПЛОДА

A retrospective analysis of the course of pregnancy and childbirth was conducted in 194 patients with antenatal fetal death and 110 patients with live birth. It was established that unfavorable anamnestic risk factors for antenatal fetal death are: pregnancy outside marriage, smoking, spontaneous termination of a previous pregnancy, extragenital pathology (diseases of the cardiovascular and urinary systems, obesity). Risk factors for intrauterine fetal death on the part of the mother include: threatened termination of pregnancy, acute respiratory diseases, hypertensive conditions, anemia, placental insufficiency, premature placental abruption, oligohydramnios, polyhydramnios; from the fetus: congenital malformations, fetal growth retardation.

Insights into fetomaternal outcomes in pre-eclampsia: A tertiary care center descriptive study

Preeclampsia and eclampsia remain significant challenges in both maternal and perinatal health worldwide, with a pronounced impact in regions such as India, where access to comprehensive maternal care can be limited. The objective of this study was to examine the outcomes for both mothers and babies, along with the complications linked to severe cases of preeclampsia and eclampsia, within a tertiary healthcare facility situated in South India. : Sixty-five pregnant women diagnosed with severe preeclampsia or eclampsia were enrolled in this descriptive observational study conducted at a tertiary care teaching hospital, Chennai, spanning from March 2023 to December 2023. Inclusion criteria comprised women with singleton pregnancies exhibiting severe preeclampsia (defined by blood pressure ≥160/110 mmHg and 1+ or more albuminuria) or eclampsia. Exclusion criteria included chronic hypertension, multiple pregnancies, chronic renal disease, connective tissue disorder, neurological complications, and refusal of consent. Data on sociodemographic variables, obstetric characteristics, maternal symptoms, and complications were collected using a structured questionnaire. Maternal and fetal well-being were assessed through biochemical, radiological, and nonstress tests.: The results revealed that 80% of the study population with severe preeclampsia or eclampsia fell within the age group of 21-30 years, with 49.2% aged between 26-30 years. Majority (60%) were primigravida. Common maternal symptoms included headache (60%), oedema (76.9%), with fewer experiencing epigastric pain (3.1%) and vaginal bleeding (15.4%). Complications observed were HELLP syndrome (12.35%), placental abruption (7.7%), and eclampsia (10.8%). Perinatal outcomes included intrauterine fetal death (4.6%), fetal growth retardation (23.1%), low birth weight (30.8%), respiratory distress syndrome (4.6%), and stillbirth (1.5%), with 35.4% being normal births.This study emphasises the substantial impact of severe preeclampsia and eclampsia on the health of both mothers and fetuses, underscoring the importance of thorough antenatal care, prompt identification of risk factors, and timely interventions to minimise negative consequences. There is a clear call for additional research to investigate and implement effective strategies for prevention and management, aiming to decrease the morbidity and mortality rates associated with these hypertensive disorders during pregnancy.

Growth factor dysregulation and placental dysfunction

The article is devoted to the study of angiogenic and antiangiogenic vascular growth factors in placental dysfunction, which is of great importance in obstetrics and perinatology. The study of growth factors as predictors of the development of placental dysfunction makes it possible to determine in advance the development of many obstetric pathologies, including preeclampsia and fetal growth retardation, which is of great practical importance. The authors conducted an immunological study of pregnant women with placental dysfunction and pregnant women with a physiological pregnancy. Purpose of the study: to study serum growth factors in women with placental dysfunction. We examined 47 pregnant women with a gestation period of 26-40 weeks, with a diagnosis of placental dysfunction, who were under observation in the obstetric department of the city maternity complex No. 3 of the city of Tashkent. The control group consisted of 35 women with a physiological pregnancy. All women underwent an immunological blood test: cellular and humoral immunity, as well as cytokines (VEGF-A, PlGF, sFlt-1, sFlt-1/PlGF) were studied. Based on the results obtained, the authors suggest that an increased level of soluble sFlt-1 and a simultaneous decrease in the levels of VEGF-A and PlGF in pregnant women at 26-40 weeks of gestation may portend the development of pregnancy complications, including preeclampsia and fetal growth restriction, and increase the risk of premature birth. Ddelivery due to impaired placental blood flow and oxygen deficiency for the fetus, lead to deterioration of microcirculation, and insufficient levels of VEGF-A and PlGF can contribute to vascular endothelial dysfunction, which can also contribute to the development of preeclampsia. The studied angiogenic and antiangiogenic vascular growth factors are important indicators and can serve as markers for predicting pregnancy complications for active medical intervention in maintaining the health of both mother and child.

Co-infection of Plasmodium and soil-transmitted helminth among pregnant women in Abaya district, South Ethiopia: A community-based study

ObjectivesCo-infection of malaria with helminths poses significant risks, including fetomaternal hemorrhage, fetal growth retardation, spontaneous abortion, and preterm delivery. However, there is a lack of community studies to demonstrate the prevalence of co-infection of helminths with Plasmodium and soil-transmitted helminths (STH) and associated factors among pregnant women in Ethiopia. MethodsA community-based cross-sectional study was conducted among 287 randomly selected pregnant women in the Abaya district from September to December 2022. Data were collected using a standardized questionnaire. Blood and stool samples were collected from each pregnant woman and data analysis was performed using SPSS. Logistic regression analysis was used to identify associated factors. ResultsThe co-infection prevalence of Plasmodium and STH was 19.5% (95% confidence interval [CI]: 14.92-24.08%), where STHs were 40.6% (95% CI: 34.9-46.3%) and Plasmodium was 32.4% (95% CI: 27-37.8%). Hookworm and Plasmodium falciparum were the most commonly identified parasite species. Factors significantly associated with co-infection with Plasmodium and STH included the habit of eating soil (adjusted odds ratio [AOR] = 2.70, 95% CI: 1.36-5.34), not using insecticide-treated bed nets (AOR = 3.47, 95% CI: 1.76-6.85), living near stagnant water (AOR = 2.23, 95% CI: 1.07-4.64), and rural residence (AOR = 2.23, 95% CI: 1.07-5.97). ConclusionsInterventions should prioritize enhancing sanitation, educating pregnant women on the use of insecticide-treated bed nets, avoiding eating soil, and eliminating stagnant water near homes. More research should be conducted on the area using more advanced methods.

Obstetric and neonatal outcomes of immune thrombocytopenic purpura in pregnancy and the role of delta hemoglobin index: A case-control study from a tertiary center.

To evaluate the effect of idiopathic thrombocytopenic purpura (ITP) on pregnancies and the role of the delta hemoglobin indices in the evaluation of treatment effectiveness. This case-control study was conducted with 23 ITP and 115 low-risk pregnancies. Obstetric outcomes (fetal growth retardation (FGR), preterm delivery) and neonatal outcomes (weights, APGAR scores, NICU admissions, thrombocytopenia) were recorded. ITP group was subgrouped based on the platelet ratio at the admission for delivery and evaluated the impact of platelet ratios on blood loss amounts at delivery by using delta hemoglobin indices. Eleven patients received treatment during pregnancy. The gestational age at birth and fetal APGAR scores were lower, and the preterm delivery and FGR rates were higher in the ITP group. Four newborns (17.4%) had thrombocytopenia. There were two postpartum hemorrhages. Newborn platelet counts did not correlate with maternal platelet counts. The study showed no difference in delta hemoglobin counts between the ITP and control groups. ITP is associated with an increased risk of maternal and fetal complications. The presented study showed by using the delta hemoglobin indices that, hemorrhagic complications could be prevented with appropriate management. Neonatal thrombocytopenia should be considered for all ITP patients.

Effect of basic periodontal treatment on CRP in elderly pregnant women with periodontal disease

Periodontal disease is a chronic infectious disease, which is common and frequent disease in pregnant women. It is an infectious disease caused by a variety of microorganisms, and the physiological changes in pregnant women after pregnancy can promote the occurrence and development of periodontal disease. Women no less than 35 years old are at an increased risk of maternal and fetal complications in pregnancy, older pregnant women with periodontal disease are prone to preterm birth, fetal growth retardation, premature rupture of membranes, and the incidence of neonatal low birth weight is significantly higher than that in older women with healthy oral health, i.e., these risks are increased with age. CRP is an acute-phase protein produced by liver organs, which is produced by hepatocytes under the promotion of inflammatory factors, and serves as the most direct and sensitive marker of inflammatory response. Studies have shown that basic periodontal treatment relieve periodontal tissue inflammation in pregnant women with periodontitis, while significantly reducing their serum CRP concentration, thereby decreasing the occurrence of adverse pregnancy outcomes. The objective of this study is to investigate the effect of basic periodontal treatment on CRP in elderly pregnant women with periodontal disease.

Innovative study of the fetal heart in monochorionic multiple births

Introduction. Fetal echocardiography is currently one of the main methods of prenatal diagnosis. However, in recent years, attention has shifted towards the use of ultrasound to assess fetal myocardial function.The aim of this study is compare global longitudinal deformation of the myocardium of the left (LV) and right ventricles (RV) of the heart in fetuses with uncomplicated singleton pregnancy, in fetuses from monochorionic twins with transfusion syndrome, selective growth retardation and in uncomplicated monochorionic multiple pregnancy.Material and methods. A prospective cohort study was conducted which included 60 pregnant patients: Group I — patients with an uncomplicated singleton pregnancy (n=25); Group II — 35 patients with monochorionic diamniotic twins, whose pregnancy in 10 cases was complicated by feto-fetal transfusion syndrome (stages I-III according to Quintero R.A.), in 10 cases — selective growth retardation of the second fetus and in 15 cases monochorionic twins without complications. The following parameters were determined: global longitudinal deformation (GLD) of the myocardium of the ventricles of fetal hearts using the speckle tracking method of ejection fraction (EF), end-diastolic and end-systolic volumes of the ventricles of the heart.Results. Significant differences were established in GLD of RV and LV between singleton and monochorionic multiple pregnancies (LV: -21.2 ± 2.03 versus -23.41 ± 0 .25, p = 0.003); RV: — 20.3 ± 2.5 versus -23.3 ± 2.5, p = 0.013). Significant differences were revealed in GLD of the LV and RV in recipient fetuses before and after laser coagulation of placental anastomoses (LPCA) [LV in recipients before LCPA (- 20.4 ± 2.98) versus LV recipient after LCPA (-24.2 ± 3.3), p = 0.018], [RV in recipients before LKPA (- 20.4 ± 2.8) vs. RV in recipients after laser coagulation of placental anastomoses (-23.7 ± 3.4, p = 0.012].Conclusion. Assessment of the cardiac function of fetuses from monochorionic twins using the echocardiographic speckle tracking technique makes it possible to identify early changes in fetal myocardial function in twins from monochorionic diamniotic twins, as well as to carry out reliable testing monitoring changes in cardiac function over time.

The incidence of fetal growth retardation: trends over the decade

The incidence of fetal growth retardation: trends over the decade

PREVENTION OF FETAL GROWTH RETARDATION

Fetal growth restriction (FGR) has been a frequently encountered pathology in obstetrics and affects 5-10% of pregnancies. It has been one of the three main causes of perinatal deaths, after premature births and fetal malformations. In approximately one third of cases with FGR, cause or pathology was not found, which made it difficult to prevent or treat them effectively. Mostly, FGR was a consequence of insufficiency of uteroplacental circulation, placental and fetoplacental function. The term SGA (small for gestational age) has to do with constitutional growth rates and the statistical determination within which the newborn is considered smaller for gestational age. Whereas the term FGR (fetal growth retardation) refers to delayed growth below the 10th percentile as a pathological phenomenon. The current management of FGR consists of fetal surveillance to detect a decline in the baby’s health and deliver when this can be safely done. Therefor Doppler ultrasound was considered the chosen technique. The use of low-dose aspirin for preventing FGR and preeclampsia (PE) has been one of the most important research topics for the last 10 years. Several national protocols recommend the treatment with low-dose aspirin (100-150mg daily) for high-risk pregnancies, starting around 12-16 weeks of gestation. It favors placentation by its proangiogenic, antithrombotic and anti-inflammatory effects.

P215 EFFECT OF OXYGEN LOADING MODEL ON RETINOPATHY OF PREMATURITY IN INTRAUTERINE GROWTH RETARDED MICE

Background and Objective: Fetal growth retardation (IUGR) not only induces various complications in newborns, but is also known to be associated with the future development of lifestyle-related diseases and conditions. Therefore, the neonatal treatment often struggles between life-sustaining and oxygen administration. We have previously reported that IUGR mice born from mothers raised on a low-protein diet show enhanced vascular remodeling. The mechanism is influenced by an increased inflammatory response associated with a decreased angiogenic response due to hypoxic loading in a femoral artery cuff implantation model. Based on this, we hypothesized that in IUGR mice, the reduced angiogenic response in retinopathy of prematurity may work to suppress the onset of the disease. To test this hypothesis, we examined the effects of oxygen loading on the retinal neovasculature using the mouse oxygen-induced retinopathy of prematurity (OIR) model. Methods The OIR model was created in newborns born from mothers raised on a normal protein diet (20%) and in IUGR newborns born from mothers raised on a low protein diet (8%). Specifically, the newborns were exposed to 75% hyperoxia for 5 days starting at 7 days of age, and retinal neovascularization was histologically evaluated 5 days later at 17 days of age for comprehensive transcriptome analysis. Results: Compared to normal birth weight OIR mice, retinal neovascularization was significantly suppressed in OIR mice with FGR. Retinal RNA sequencing revealed decreased expression of angiogenic factors that trigger pathological retinal neovascularization, such as the mitogen-activated protein kinase pathway (MAPK) pathway and corresponding upstream signaling pathways. Conclusions Our findings suggest that IUGR neonates have a weaker response to retinal oxygen stress and consequently are likely to have reduced retinopathy of prematurity. These results indicate that the risk of developing retinopathy of prematurity is attenuated in IUGR neonates compared to mature neonates with normal birth weight.

Association between the dysregulation of gene expression in placenta and the pathogenesis of fetal growth retardation.

Association between the dysregulation of gene expression in placenta and the pathogenesis of fetal growth retardation.

Outcome of Pregnancy In Myomatous Uterus in the Gynecology-Obstetrics Department of the Ignace Deen Hospital of the Conakry University Hospital Centre, Guinea

Introduction: the association of myoma and pregnancy is a frequent entity, often prone to obstetric complications. The aim of this study was to analyse the impact of myoma on pregnancy, childbirth and the post-partum period. Patients and methods: this was a prospective descriptive and analytical study conducted over a 6-month period from 6 September 2022 to 5 March 2023 in the gynaecology and obstetrics department of Ignace Deen Hospital. It concerned pregnant women with uterine myomas who had agreed to take part in the study. Results: the frequency of pregnancy in a myomatous uterus was 5.58%. The average age of the pregnant women was 28, with extremes of 21 and 40. The most common age group was 31-35. Nearly 70% (69.86%) of the cases of fibroids associated with pregnancy were discovered by ultrasound. The location of the myomas was interstitial in 47.95% of cases. Medium-sized fibroids (6-10 cm) dominated our series (53.42% of cases). Of the 146 cases collected, 72% gave birth in the department, 77.78% by caesarean section. The indication for caesarean section Dystocic presentations (54.76%) were the major indication in more than half the cases. Over 70% of pregnant women gave birth without complications. These were dominated in the mother by miscarriage (20.93%) and premature delivery (16.27%). Fetal asphyxia (4.65%) and intrauterine growth retardation (4.65%) in the fetus. The study reported a significant association between size, location and the occurrence of obstetric complications (P value: 0.034; 0.009). Conclusion: the association of fibroma and pregnancy is a frequent entity and constitutes a high risk for the mother and the foetus. Morbidity is related to the location of the myoma and changes according to the term of the pregnancy. If pregnancy is to have a successful outcome, it is essential that pregnant women are aware of the importance of antenatal monitoring, with a view to early detection and appropriate management of any complications.

CHARACTERISTICS OF RISK FACTORS FOR THE DEVELOPMENT OF PRIMARY PLACENTAL DYSFUNCTION IN WOMEN WITH A THREAT OF ABORTION IN THE FIRST TRIMESTER OF PREGNANCY

The aim of the study – to optimize the prediction of primary placental dysfunctiondevelopment by determining the risk factors for its development in women with a threatof miscarriage in the early stages of pregnancy.Materials and methods. A prospective analysis of the somatic, reproductive and obstetricanamnesis of 40 pregnant women with threatened abortion in the 1st trimester ofpregnancy and clinical manifestations of placental dysfunction (PD) was carried out –the main group, 60 pregnant women with threatened abortion without PD (comparisongroup). The control group consisted of 50 women with the physiological course of the firsttrimester of pregnancy. Results. Among those with symptoms of threat of termination of pregnancy in the earlystages of pregnancy and PD, the number of women of borderline reproductive age (≤18years and ≥40 years), with obesity (BMI > 30) and a combination of several co-morbidextragenital pathologies was significantly higher than in the comparison group and inthe control group. In the anamnesis of pregnant women of the main group, gynecologicaldiseases, early pregnancy losses (spontaneous miscarriages and non-developingpregnancies) were significantly more often detected. In the first trimester of pregnancyvaginal bleeding, chorionic detachment, retrochorionic hematoma, and low chorionicposition were diagnosed significantly more often in women of the main group. In 7.5 % ofcases, in the first trimester of pregnancy, pregnant women with a threat of abortion andPD had an acute respiratory viral infection.The relationship between the development of primary PD and the frequency of gestationalcomplications associated with the placenta (PE (20.0 %), Abruptio placentae (17.5 %),fetal growth retardation syndrome (10.0 %) and fetal distress (27.5 %)) was established.Every third pregnancy ended in premature birth (32.5 %). The percentage of deliveries byCS in the main group was 62.5 %. Complications of pregnancy and childbirth, associatedwith impaired placental function, led to a high frequency of births of babies in a state ofmoderate and severe asphyxia (15.0 % and 5.0 %, respectively) and stillbirths.Conclusions. The conducted studies confirmed that the development of placentaldysfunction from the early stages of pregnancy in women with a threat of abortion isthe cause of the complicated course of pregnancy and childbirth, which lead to adverseperinatal consequences. Risk factors for the development of placental dysfunctionin pregnant women with threatened abortion are the borderline reproductive age ofthe mother, obesity, a combination of several co-morbid extragenital pathologies,gynecological diseases and early reproductive losses in the anamnesis. Also, the riskfactors for impaired placental formation are detachment of the chorion, retrochorialhematoma, and acute respiratory viral infections in the early stages of pregnancy.