Intrauterine Fetal Development Research Articles

Study of triglyceride changes during pregnancy and neonatal birth weight and adverse outcomes.

Changes of maternal triglyceride concentrations are closely associated with intrauterine fetal growth and development, but the effect of mid- to late-term triglyceride changes on birth weight is uncertain. This study investigated the association between changes in triglycerides in mid to late in pregnant women gestational age ≥ 35 weeks on neonatal birth weight and adverse outcomes. This cohort study was based on 931 pregnant women with a singleton delivery at gestational age ≥ 35 weeks from January 1, 2022 to December 31, 2022 at Nanjing Lishui People's Hospital (NJLSPH) in China, with all maternal triglyceride concentrations measured at mid-term and late-term before delivery. The primary outcomes were neonatal birth weight and the risk of macrosomia. Late term triglyceride levels were positively associated with birth weight (β = 126.40, 95% CI: 61.95, 190.84, p < .001) and risk of macrosomia (OR = 2.11, 95% CI: 1.12, 3.98, p = .022). Late mid-term triglyceride was positively associated with birth weight (β = 27.58, 95% CI: 9.67, 45.50, p = .003), and no correlation with risk of macrosomia (OR = 1.12, 95% CI: 0.95, 1.31, p = .178). Mid-term triglyceride was not associated with birth weight (β = 45.79, 95% CI: -28.73, 120.30, p = .229) and risk of macrosomia (OR = 1.83, 95% CI: 0.89, 3.78, p = .101). Late triglyceride levels were associated with birth weight and risk of macrosomia, while late to mid-term triglyceride were associated with birth weight but not with risk of macrosomia. This suggests that maternal triglyceride changes may affect fetal growth and development, and more studies focusing on the effects of gestational triglyceride profiles are warranted.

Ethanol consumption during gestation promotes placental alterations in IGF-1 deficient placentas

Background During pregnancy, the placenta is an extremely important organ as it secretes its own hormones, e.g. insulin-like growth factor 1 (IGF-1), to ensure proper intrauterine fetal growth and development. Ethanol, an addictive and widely used drug, has numerous adverse effects during pregnancy, including fetal growth restriction (FGR). To date, the molecular mechanisms by which ethanol triggers its toxic effects during pregnancy, particularly in the placenta, are not entirely known. For this reason, a murine model of partial IGF-1 deficiency was used to determine ethanol alterations in placental morphology and AAH expression. Methods Heterozygous (HZ, Igf1+/- ) female mice were given 10% ethanol during 14 days as an acclimation period and throughout pregnancy. HZ female mice given water were used as controls. At gestational day 19, pregnant dams were sacrificed, placentas were collected and genotyped for subsequent studies. Results IGF-1 deficiency and ethanol consumption during pregnancy altered placental morphology, and decreased placental efficiency and aspartyl/asparaginyl β-hydroxylase (AAH) expression in placentas from all genotypes. No differences were found in Igf1, Igf2, Igf1r and Igf2r mRNA expression in placentas from all groups. Conclusions IGF-1 deficiency and ethanol consumption throughout gestation altered placental development, suggesting the crucial role of IGF-1 in the establishment of an adequate intrauterine environment that allows fetal growth. However, more studies are needed to study the precise mechanism to stablish the relation between both insults.

Epigenetic mechanisms of intrauterine fetal senescence: little-known effects of hyperhomocysteinemia during pregnancy

Today, a whole body of evidence base has been formed showing the negative effect of hyperhomocysteinemia (HHC) during pregnancy on the intrauterine fetal development: risk factors associated with development of congenital neural tube defects, congenital heart defects and non-syndromic oral facial clefts. In addition, numerous studies have shown that HHC is a risk factor for serious pregnancy complications such as repeated pregnancy loss, preterm birth, preeclampsia, placental abruption, intrauterine growth restriction, gestational diabetes mellitus. At the same time, despite multiple clinical and experimental studies, the significance of HHC effects continues to support the interest to this issue. In recent years, new data were revealed about littleknown phenomena pregnancy-associated maternal HHC such as "epigenetic fetal aging" and "fetal atherogenesis". Epigenetic aging is an individual indicator of aging that captures interindividual differences at disease onset throughout life occurring during intrauterine development being reveaked as DNA hypomethylation. Moderate HHC during pregnancy causes fetal DNA hypomethylation, which, according to recent research, may represent the main mechanism underlying health in childhood and adulthood. "Fetal atherogenesis" is another understudied HHC effect emphasizing that the formation of atherosclerotic plaques begins not in adulthood, but in utero. A body of studies has shown that the formation of thickening and fatty streaks in vascular intima involved in the pathogenesis of atherosclerosis begins antenatally. The discovery of new aspects of negative intrauterine HHC impact on fetal development necessitates a detailed study of HHC causes as non-modifiable (genetic defects in enzyme systems), and more importantly, conditionally modifiable causes (lack of cofactors, excessive methionine consumption, medications) for their timely leveling. It is also important to study approaches to HHC correction at the preconception stage of a female reproductive function in order to correctly "program" fetus and newborn development.

Epigenetic implications in maternal diabetes and metabolic syndrome-associated risk of orofacial clefts.

Orofacial clefts (OFCs) are one of the most common types of structural birth defects. The etiologies are complicated, involving with genetic, epigenetic, and environmental factors. Studies have found that maternal diabetes and metabolic syndrome are associated with a higher risk of OFCs in offspring. Metabolic syndrome is a clustering of several disease risk factors, including hyperglycemia, dyslipidemia, obesity, and hypertension. Metabolic disease during pregnancy can increase risk of adverse outcomes and significantly influence fetal development, including orofacial formation and fusion. An altered metabolic state may contribute to developmental disorders or congenital defects including OFCs, potentially through epigenetic modulations, such as histone modification, DNA methylation, and noncoding RNA expression to alter activities of critical morphogenetic signaling or related developmental genes. This review summarizes the currently available evidence and underlying mechanisms of how the maternal metabolic syndrome is associated with OFCs in mostly human and some animal studies. It may provide a better understanding of the interactions between intrauterine metabolic status and fetal orofacial development which might be applied toward prevention and treatments of OFCs.

Correlation between the Symptoms of Major Depression during Pregnancy, Fetal Indicators and Delivery Complications

Introduction: Studies have shown a high prevalence rate of the symptoms of major depression in the general population of women on Kosovo (43.18%), therefore research on the impact of depression during pregnancy on the intrauterine fetal development and complications during and after delivery in the population of women on Kosovo at reproductive age has scientific and professional rationale. Objective: The purpose of the study is to research correlation of major depression symptoms during pregnancy with the indicators of intrauterine fetal development and complications during delivery. Method: The research is prospective randomized and after fulfilling the selective criteria included three hundred pregnant women in the second trimester and at the beginning of the third trimester of pregnancy in the general population of women on Kosovo. Scale of the major depression symptoms was determined with the Hopkins Symptom Check List (HSCL-25). Statistical package for results analysis included software SPSS 12, ANOVA analyses, frequencies, Chi square test, and linear regression analysis. Results: Significant correlation was proven between the symptoms of major depression during early and mid-pregnancy with: uterine contractions at the beginning of labor, perineal lacerations during delivery, tachycardia in the newborn baby, duration of newborn’s stay in the neonatal intensive care unit, the woman's duration of hospital stay in the department before and after delivery, and the delayed start of breastfeeding. Findings proved that there is no significant correlation between the emotional state of pregnant women and the slowing down of the intrauterine fetal development. Discussion: Based on the study results and the data from the literature, these clinical correlations are a result of interaction between the major depression during pregnancy with neuroendocrine trajectories of pregnancy, fetus and placental functions. Conclusion: Major depression during early and mid-term pregnancy may have impact on specific clinical parameters of the childbirth and newborn baby. The obtained results suggest the need for systematic mental health support of the woman during pregnancy.

The Impact of Unspecified Anxiety during Pregnancy on the Fetus Development and Childbirth Complications

Introduction: The high levels of chronic psychosocial stress and traumatic experiences faced by the general population of Kosovo in recent decades resulted in a high prevalence of unspecified anxiety (45.17%) among women at the reproductive age. On this psychological ground there are objective hypotheses that fetal growth and childbirth process may be affected. Objective: The purpose of the study is to research the correlation of unspecified anxiety during pregnancy with the intrauterine development of the fetus and complications during childbirth. Method: The research is prospective randomized and after fulfilling the selective criteria included three hundred (300) pregnant women in the second trimester and at the beginning of the third trimester of pregnancy in the general population of women on Kosovo. Scale of unspecified anxiety was determined with the Hopkins Symptom Check List (HSCL-25). Statistical package for results analysis included software SPSS 12, ANOVA analyses, frequencies, Chi square test, and linear regression analysis. Results: Findings proved that there is no significant correlation between the emotional state of pregnant women and the slowing down of the intrauterine fetal development. However, the study proved the significant correlation between the degree of unspecified anxiety during early and mid-term pregnancy with the degree of cervix effacement at the beginning of the birth act, and with tachycardia in the newborn baby. Discussion: Based on the study results and the data from the literature, these clinical correlations occur based on the interference of unspecified anxiety during pregnancy with neuroendocrine trajectories of pregnancy, fetus and placental functions. Conclusion: Unspecified anxiety during early and mid-term pregnancy may initiate cervix effacement and may cause fetal tachycardia at birth. The obtained results suggest the need for greater care for the emotional state of the woman during pregnancy.

Birth weight, adult body size, and risk of colorectal cancer

BackgroundEvidence suggests that birth weight may be associated with colorectal cancer (CRC) risk later in life. Whether the association is mediated by adult body size remains unexamined. MethodCox proportional hazards models (Hazard Ratio (HR) and 95 % Confidence Intervals (CI)) were used to evaluate the association between self-reported birth weight (<6 lbs, 6-<8 lbs, ≥8 lbs) and CRC risk among 70,397 postmenopausal women from the Women’s Health Initiative. Further, we assessed whether this association was mediated by adult body size using multiple mediation analyses. ResultsCompared with birth weights of 6-< 8 lbs, birth weight ≥ 8 lbs was associated with higher CRC risk in postmenopausal women (HR = 1.31, 95 % CI 1.16–1.48). This association was significantly mediated by adult height (proportion mediated =11.4 %), weight (11.2 %), waist circumference (10.9 %), and body mass index at baseline (4.0 %). The joint effect of adult height and weight explained 21.6 % of this positive association. ConclusionOur data support the hypothesis that the intrauterine environment and fetal development may be related to the risk of developing CRC later in life. While adult body size partially explains this association, further investigation is required to identify other factors that mediate the link between birth weight and CRC.

The Benefit of Amniotic Membrane as A Surgical Wound Dressing for Post Cesarean Section

The amniotic membrane is a layer that directly covers the amniotic cavity derived from trophoblast cells with various types of pluripotent cells so that it has clinical potential. This membrane is essential for intrauterine fetal growth and development. The amniotic membrane has been widely studied to have various functions, one of which is in the process of wound healing, both acute and chronic. One type of acute wound that begins to use the amniotic membrane as a dressing material is a cesarean section wound. In cesarean section, there is an acute wound due to the incision of the abdominal wall and uterus. The process of wound healing, especially in the epithelial part, is the same as other acute wound healing, which consists of the process of migration, proliferation and cross-linking between cells in the epithelium. In general, the amniotic membrane has clinical potential, especially in wound healing. This relates to the various substrates and the molecules contained therein. In some clinical studies also found a positive effect on wound healing. However, specifically discussing its clinical effectiveness in caesarean section wounds is still limited. Therefore, in this literature, we will discuss the use of the amniotic membranes in wound healing for cesarean sections.

Placental teratoma: A case report of an unusual entity

Teratomas are tumors of totipotent embryonic germ cells. The common sites of occurrence apart from the genital organs are mediastinal, retroperitoneal, presacral and paracoccygeal regions. It is extremely uncommon to encounter teratomas in the placenta resulting from an aberrant migration of germ cells during the early phase of intrauterine fetal development. Placental teratomas affect females of childbearing age group, without producing adverse fetal and maternal outcomes. However, they are of considerable interest since placental teratomas are sometimes considered an extreme form of fetus acardius amorphous. In the absence of clear differentiating criteria between these two entities, rendering a definitive diagnosis remains a daunting task for pathologists.

Роль COVID-19 в развитии плацентарных нарушений у беременных пациенток

Introduction. The coronavirus disease pandemic (COVID-19) is a leading global health and economic concern. The danger to the mother and fetus during pregnancy from infection with SARS-CoV2 is still being studied. New evidence suggests that SARS-CoV-2 infection causes oxidative stress during pregnancy and immune system activation, leading to cytokine storm and subsequent tissue damage. Objective. To establish the pathogenetic role of oxidative stress in the occurrence and severity of COVID-19 and, more importantly, pregnancy outcomes in female patients. Results. A systematic review of the scientific literature in the following databases was performed: PubMed, ResearchGate, Medscape, Cochrane Library. Key searches included the words: pregnancy, oxidative stress, placenta, cytokine storm. Based on a review of the literature, the following conclusion was reached: morphofunctional placental changes resulting from oxidative stress in SARS-CoV-2-infected mothers may result from disorders of the mother-placenta-fetal system caused by systemic viral exposure, resulting in a pathogenetic vicious circle involving systemic inflammation that exacerbates oxidative stress in both the placenta and systemically in the woman. Conclusion. This review highlights the general characteristics of oxidative stress in pregnant women with COVID-19. A better understanding of the mechanisms of SARS-CoV-2 infection and its impact on placental function is critical because the association of pregnancy complications and COVID-19 can lead to potential risk of intrauterine fetal development.

Prenatal exposure to heavy metal mixtures and anthropometric birth outcomes: a cross-sectional study

BackgroundNumerous studies have suggested significant associations between prenatal exposure to heavy metals and newborn anthropometric measures. However, little is known about the effect of various heavy metal mixtures at relatively low concentrations. Hence, this study aimed to investigate associations between prenatal exposures to a wide range of individual heavy metals and heavy metal mixtures with anthropometric measures of newborns.MethodsWe recruited 975 mother–term infant pairs from two major hospitals in Israel. Associations between eight heavy metals (arsenic, cadmium, chromium, mercury, nickel, lead, selenium, and thallium) detected in maternal urine samples on the day of delivery with weight, length, and head circumference at birth were estimated using linear and Bayesian kernel machine regression (BKMR) models.ResultsMost heavy metals examined in our study were observed in lower concentrations than in other studies, except for selenium. In the linear as well as the BKMR models, birth weight and length were negatively associated with levels of chromium. Birth weight was found to be negatively associated with thallium and positively associated with nickel.ConclusionBy using a large sample size and advanced statistical models, we could examine the association between prenatal exposure to metals in relatively low concentrations and anthropometric measures of newborns. Chromium was suggested to be the most influential metal in the mixture, and its associations with birth weight and length were found negative. Head circumference was neither associated with any of the metals, yet the levels of metals detected in our sample were relatively low. The suggested associations should be further investigated and could shed light on complex biochemical processes involved in intrauterine fetal development.

Hubungan Antara Paritas Dengan Tingkat Kecemasan Ibu Hamil Di Griya Arin, Yogyakarta

Approximately 10% of pregnant women experience depression and this condition is higher in developing countries, reaching 15.6% during pregnancy and 19.8% after delivery. Mothers who experience anxiety during pregnancy will affect the intrauterine environment and fetal development. The majority of Primigravida mothers do not have experience and how to handle pregnancy until the delivery process goes smoothly, causing anxiety when compared to multigravidas. The purpose of this study was to determine the relationship between parity and anxiety levels. To determine the relationship between parity and the anxiety level of pregnant women with TM II and III. The type of research used is an analytic survey with a cross sectional approach. The population in this study were all pregnant women with TM II and III at Griya Arin using a purposive random sampling technique with a total of 30 respondents. The data analysis used was the Spearman rho correlation nonparametric statistical test.The parity of most pregnant women in the multigravida pregnancy category was 60% (18 people), while the anxiety level of most pregnant women was in the moderate category, namely 73.3% (22 people). There is a parity relationship with the level of anxiety in pregnant women at Griya Arin Yogyakarta with a p-value of 0.039 and an odds ratio of 1.000 . There is a relationship between parity and the level of anxiety in pregnant women at Griya Arin Yogyakarta.

Clinical case of successful correction of aortic coarctation with hypoplasia of the distal aortic arch in a premature infant with very low birth weight

Congenital heart disease is considered to be one of the most common diseases among congenital defects. Aortic coarctation belongs to the groupof common congenital heart defects. In the overwhelming majority of cases, it is combined with hypoplasia of the aortic arch and requires urgent surgical intervention. The absence of timely diagnosis of pathology and necessary therapy may lead to congestive heart failure, cardiogenic shock and death. Although the results of treatment of congenital heart defects in newborns have improved significantly in recent years, children with low weight are remainedto be difficult category of patients. Prematurity and low birth weight are risk factors for increased mortality and development of recoarctation in infants who have undergone surgical correction. We represent the case of successful correction of aortic coarctation with hypoplasia of the distal aortic arch in a prematured baby with very low birth weight. The diagnosis was made prenatally. The mother was recommended to be monitored at Рerinatal Сenter, Penza, where at the 35th week, an early delivery was performed because of lack of water and intrauterine fetal development delay. The body weight at birth was 1330 grams. On the same day, the child was admitted to the Federal Center of Cardiovascular Surgery, Penza, where he received the necessary surgical care. The results of dynamic observation of the patient showed the absence of recoarctation and arterial hypertension. Despite the fact that low body weight and prematurity are significant risk factors for complication and an unfavourable outcome, modern medical technologies and accumulated experience have allowed to carry out surgical correction timely and then to do successful postoperative treatment and nursing of the child with coarctation and hypoplasia of the aortic arch.

Iodine content of frequently used prenatal and adult multivitamins in Switzerland.

Iodine is essential for the biosynthesis of thyroid hormones, which are crucial for intrauterine growth and fetal neurocognitive development. Iodine requirements increase during pregnancy and lactation. The World Health Organization and the Swiss Confederation recommend a total daily iodine intake of 250 µg of iodine during preconception, pregnancy and lactation. To assure this goal, several professional organizations recommend complementing the nutritional iodine intake with supplements containing 150 μg of iodine daily. Prenatal and adult multivitamins widely available in Switzerland were compiled to determine their iodine content. Obstetricians verified that the list includes the most frequently prescribed supplements in Switzerland. A total of 44 adult multivitamin supplements were identified, 23 of which are specifically intended for women planning pregnancy, pregnant, or breastfeeding. Seven out of 23 (30.4%) prenatal multivitamins products, and 12/21 (57.1%) adult multivitamins contained no iodine. Among all the products, only 18/44 (40.9%) contain 150 µg of iodine or more. Several widely used products contain no or insufficient amounts (<150 ug) of iodine. Providers need to be informed about the variability in iodine content of supplements and established recommendations, and manufacturers of prenatal supplements should assure that their products contain iodine in adequate amounts.

Antenatal Classes in the Context of Prenatal Anxiety and Depression during the COVID-19 Pandemic.

Perinatal maternal anxiety and depression negatively affect intrauterine fetal development, birth outcome, breastfeeding initiation, duration, and milk composition. Antenatal classes potentially reduce the anxiety of pregnant women and may thus contribute to healthy infant development. The study investigates the relationship between participation in online or in-person antenatal classes and levels of anxiety and depression in Polish women during the COVID-19 pandemic. The study group included 1774 adult, non-smoking pregnant women. We compared the state anxiety (STAI-State) and depression levels (EPDS) in women who (i) attended antenatal classes in-person, (ii) attended online classes, and (iii) did not attend any of them. The statistical analyses included a GLM model and trend analysis, while controlling for maternal trait anxiety, age, pregnancy complications, trimester of pregnancy, previous pregnancies, and COVID-19 infections. We observed statistically significant differences in the level of anxiety (and depression). Women who did attend antenatal classes in person had the lowest levels of anxiety and depression. Considering the importance of maternal mental well-being on fetal development, birth outcome, and breastfeeding, in-person participation in antenatal classes should be recommended to pregnant women.

PEDIATRIC HEALTHCARE SERVICE FOR AS A PART OF INDONESIAN FUTURE

Continuing and accelerating child health are issues stated in Sustainable Development Goals (SDG) by United Nation (UN). Targets in improving child health in SDG are by decreasing neonatal and pediatric mortality. Reducing risk and prevention of neonatal mortality may be achieved by monitoring intrauterine fetal development. High burden of pediatric mortality may be seen in pediatric genetic, neoplasm and infectious disease. In this COVID-19 pandemic era, SARS-COV2 infection in children add more challenge in improving child health. In this issue, we proudly present articles on pediatric genetic, neoplasm and infectious disease especially in clinical manifestation, diagnostic and therapeutic challenge.

Ethanol consumption during gestation promotes placental alterations in IGF-1 deficient mice

Background: During pregnancy, the placenta is an extremely important organ as it secretes its own hormones, e.g. insulin-like growth factor 1 (IGF-1), to ensure proper intrauterine fetal growth and development. Ethanol, an addictive and widely used drug, has numerous adverse effects during pregnancy, including fetal growth restriction (FGR). To date, the molecular mechanisms by which ethanol triggers its toxic effects during pregnancy, particularly in the placenta, are not entirely known. For this reason, a murine model of partial IGF-1 deficiency was used to determine ethanol alterations in placental morphology and AAH expression. Methods: Heterozygous (HZ, Igf1+/-) female mice were given 10% ethanol during 14 days as an acclimation period and throughout pregnancy. HZ female mice given water were used as controls. At gestational day 19, pregnant dams were sacrificed, placentas were collected and genotyped for subsequent studies. Results: IGF-1 deficiency and ethanol consumption during pregnancy altered placental morphology, and decreased placental efficiency and aspartyl/asparaginyl β-hydroxylase (AAH) expression in placentas from all genotypes. No differences were found in Igf1, Igf2, Igf1r and Igf2r mRNA expression in placentas from all groups. Conclusions: IGF-1 deficiency and ethanol consumption throughout gestation altered placental development, suggesting the crucial role of IGF-1 in the establishment of an adequate intrauterine environment that allows fetal growth. However, more studies are needed to study the precise mechanism to stablish the relation between both insults.

THE RELATIONSHIP BETWEEN PLACENTAL GROWTH RATES AND THE BIRTH WEIGHT IN DICHORIONIC DIAMNIOTIC TWINS

Relevance. Birth weight is one of the main indicators of intrauterine fetal development. The condition of the placenta reflects the influence of the maternal environment on the fetus. It is important to find out which placental growth parameters significantly affect the mass of dichorionic diamniotic (DHDA) twins.&#x0D; Objective: to investigate the relationship between indicators of placental growth and birth weight of dichorionic diamniotic twins.&#x0D; Materials and methods. One hundred thirty-five DCDA twin pairs were studied during 2016-2020: 68 pairs were opposite-sex, 32 – same-sex females and 35 – same-sex males. The gestational age ranged from 29 to 39.5 weeks, averaging 36,4 ± V1,74 weeks. The influence of such parameters as maximum and minimum placental diameters, as well as perimeter, area, circularity (Circ), roundness, thickness, mass (PM), volume (V), displacement of the umbilical cord insertion site from the placental disc centre along its maximum (XCD) and the minimum axis (YCD).&#x0D; Results. A strong positive correlation was found between PM and birth weight in the whole cohort of DCDA twins (r = 0.7059, p &lt; 0.0001). It was strongest in the same-sex female group (r = 0.7886, p &lt; 0.0001), then in the opposite-sex pairs (r = 0.7093, p &lt; 0.0001), slightly weaker – in the same-sex male couples (r = 0.6065, p &lt; 0.0001). The birth weight and PM correlated with almost all indicators that characterize the placental shape. The strongest correlation was with V (rV_BW = 0.66, p &lt; 0.0001; rV_PM = 0.59, p &lt; 0.0001) and the area*Circ (rS*Circ_BW = 0.64; p &lt; 0.0001; rS*Circ_PM = 0.62; p &lt; 0.0001). The multiple regression analysis of the effect of different morphometric parameters of the placentas on the birth weight has demonstrated the statistical significance of the following parameters: XCD, PM, V, YCD and Circ. The general regression model for the whole DCDA group: birth weight = 2242,3 + 0,8*МП + V – 10,0* XCD (R2 = 0,7002). Similar equations were calculated for different types of DCDA tweens. Thus, morphometric measures account for the 67-85% variances of the birth weight of the DCDA tweens.&#x0D; Conclusion. In the DCDA pairs, placental mass strongly positively correlated with birth weight. Both indicators are in strong relationship with V and their area*Circ. The closer the placental shape is to the circle, the higher its functional ability. Deterioration of the latter may be due to the far fixation of the umbilical cord from the center of the placental disc. The displacement along the maximum axis has a stronger impact comparing to the displacement relative to the minimum axis. The multiple regression analysis has revealed that statistical significance had XCD and PM or V in the whole types of twins. Proposed models demonstrate that 67-85% of the variability of birth weight may be accounted for by the three or four simple placental measures

Analysis of L-carnitine effectiveness in complex treat-ment of pregnant women with placental insufficiency

Objective. To increase the effectiveness of treatment of placental insufficiency in pregnant women with the inclusion of L-carnitine (Inestom) in complex therapy.&#x0D; Materials and methods. A total of 76 pregnant women aged 18 to 39 years were examined at 2240 weeks of gestation. All the examined patients were divided into two groups. Patients of the first group (n = 37) received only basic treatment, which included the use of a complex of vasodilators, tocolytics, drugs that improve microcirculation and rheological properties of blood. Patients of the second group (n = 39) received L-carnitine along with basic therapy (Inestom, Help SA Pharmaceuticals, Greece).&#x0D; Results. The use of the drug Inestom as a part of the complex treatment of placental insufficiency led to the normalization of utero-placental-fetal blood flow and intrauterine fetal development in 94.7 % of pregnant women. After the course of drug therapy, there was an increase in the total score of cardiotography, which in the first group of patients was 7.08 0.06 before treatment and 7.13 0.11 after treatment (p 0.05), and in the second group 7.12 0.11 before treatment and 7.95 0.05 after (p 0.05). The results of antenatal dopplerometry showed that in pregnant women who received Inestom as a part of the complex treatment, there was a decrease in the mean values of all vascular resistance indices.&#x0D; Conclusions. The use of Inestom in the complex treatment of placental insufficiency has a positive effect on the state of hemodynamics in the "mother-placenta-fetus" system, and affects the intrauterine state of the fetus.

Prenatal High-Sucrose Diet Induced Vascular Dysfunction in Thoracic Artery of Fetal Offspring.

Maternal nutrition during pregnancy is related to intrauterine fetal development. The authors' previous work reports that prenatal high sucrose (HS) diet impaired micro-vascular functions in postnatal offspring. It is unclear whether/how prenatal HS causes vascular injury during fetal life. Pregnant rats are fed with normal drinking water or 20% high-sucrose solution during the whole gestational period. Pregnant HS increases maternal weight before delivery. Fetal thoracic aorta is separated for experiments. Angiotensin II (AII)-stimulated vascular contraction of fetal thoracic arteries in HS group is greater, which mainly results from the enhanced AT1 receptor (AT1R) function and the downstream signaling. Nifedipine significantly increases vascular tension in HS group, indicating that the L-type calcium channels (LTCCs) function is strengthened. 2-Aminoethyl diphenylborinate (2-APB), inositol 1,4,5-trisphosphate receptors (IP3Rs) inhibitor, increases vascular tension induced by AII in HS group and ryanodine receptors-sensitive vascular tone shows no difference in the two groups, which suggested that the activity of IP3Rs-operated calcium channels is increased. These findings suggest that prenatal HS induces vascular dysfunction of thoracic arteries in fetal offspring by enhancing AT1R, LTCCs function and IP3Rs-associated calcium channels, providing new information regarding the impact of prenatal HS on the functional development of fetal vascular systems.