Later Stages Of Pregnancy Research Articles

Trends in the Prevalence and Progression of Diabetic Retinopathy Associated with Hyperglycemic Disorders during Pregnancy in Japan.

The aim of this study was to determine the prevalence and progression of diabetic retinopathy (DR) with hyperglycemic disorders during pregnancy (HDPs) in Japan between 2013 and 2018 using two cohorts. The patients with HDPs were classified as those with pre-existing DM (pexD), gestational DM (GDM), and overt DM (ODM). Cohort 1 was obtained from the health claims database whose diseases were classified by the International Classification of Diseases-10. Cohort 2 was derived from a retrospective, multicenter analysis of the medical records of 225 patients from 10 ophthalmological institutions. In Cohort 1, there were 5268 patients with an HDP prevalence of 8.4%. Among them, 73 of 1139 patients had pexD (6.4%) and 61 of 4129 patients with GDM (1.5%) had DR; the overall prevalence of DR was 2.5%. In Cohort 2, 36 of 225 patients (16.0%) had DR, and 149 patients were followed at the early and late stages of pregnancy. Moreover, 10 of the 102 patients with pexD (9.8%) and two of five patients with ODM (40.0%) had a progression of DR. In conclusion, the prevalence and progression of DR in patients with pexD is lower than previously reported. More attention should be given to pexD and ODM.

Influence of Pregnancy Stages on Thyroid Status and Blood Metabolites in Desert Ewes Raised under Range Conditions in West Kordufan State, Sudan

This study aimed to evaluate the influence of the stages of pregnancy in two ecotypes of sheep, located in different grazing areas on thyroid status and certain blood metabolites. Eighty clinically healthy ewes (40 Hamari and 40 Kabashi ecotype) aged 2-5 years were used in the study. For each ecotype, the ewes were divided into four groups according to the reproductive status. Group (A): 10 ewes non-pregnant non-lactating (dry) served as the control. Group (B): 10 ewes in the early stage of pregnancy (first trimester). Group (C): 10 ewes in mid-stage of pregnancy (second trimester). Group (D): 10 ewes in the late stage of pregnancy (third trimester). Blood samples were used to measure serum levels of thyroid stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), plasma glucose concentration and serum triglyceride levels. The study detected that Hamari ecotype was supplied with salt and minerals block during watering by its owners. The results showed that in both ecotypes, the serum TSH levels were significantly (P<0.05) higher during the early stage of pregnancy then, it decreased significantly (P<0.01) as the pregnancy advanced. While serum T4 levels were higher during the early stage of pregnancy, then it decreased significantly (P<0.01) during the late pregnancy in both ecotypes. Serum T3 level was significantly (P<0.001) higher in both ecotypes during early and mid-pregnancy, then declined to the lowest value during the late stage. The plasma glucose level was significantly (P<0.001) lower during mid and late pregnancy in both ecotypes. There was a significant (P<0.05) decrease in serum triglyceride level when pregnancy advanced in both ecotypes. Kabashi ecotype showed significantly higher serum triglyceride levels in the control group (P<0.001) during early pregnancy stage (P<0.01) and mid pregnancy stage (P<0.05) compared to the values of serum triglyceride levels in Hamari ecotypes. This study indicated that pregnancy altered thyroid status in both ecotypes, however, the influence of pregnancy on the thyroid status was less in the Hamary ecotype which supplemented by mineral and salt blocks. Therefore, supplementation with minerals during pregnancy might enhance the metabolic profile on the natural pasture grazing.

Congenital herpes simpleх: modern approach to prevention, diagnosis, and treatment

Among the classic pathogens of congenital infection, herpes simplex viruses type 1 and type 2 play important role. Neonatal herpes develops as a result of antenatal transmission of HSV. The greatest risk occurs with the primary infection of a woman in the late stages of pregnancy. In 85% of cases, genital and neonatal herpes is associated with HSV-2.The purpose of study: to identify the relationship between early manifestations of neonatal herpes and genital herpes during pregnancy for early diagnosis and etiological therapy of the newborn.Materials and methods. The analysis of current clinical recommendations and international consensuses of professional communities in Russia, the USA, and a number of European countries in the management of pregnant women was carried out. The five medical histories of newborn infants with a diagnosis of congenital herpetic infection were analyzed. In the clinical guidelines for the management of normal pregnancy, routine screening of pregnant women for HSV is omitted, however, examination is recommended for symptoms of genital herpes. For the prevention of neonatal herpes, antiviral drugs and caesarean section are used. Congenital herpes develops rarely, proceeds severely with significant residual manifestations in children. Antiviral therapy (Acyclovir) is used for herpetic infection in newborns: with systemic and local infection (eye damage). The analysis showed: despite the recurrent course of genital herpes in 4 out of 5 women during pregnancy, none of the pregnant women had a laboratory examination for HSV, pregnant women did not receive systemic etiological therapy and all deliveries were natural. The absence of preventive measures contributed to the early, during the first three days of life, the development of severe forms of neonatal herpes. In respect that the lack of significant clinical specificity and delayed manifestation, an antenatal anamnesis is important diagnostic criterion for neonatal herpes.

Methods of detection and isolation of trophoblast cells from trans-cervical specimens – a historical overview

Abstract Trophoblast cells can be detected and isolated from the cervical epithelial cells obtained via various techniques of trans-cervical samples collection such as a mucus aspiration, endocervical lavage, or standard cervical brushing in the early first trimester, even from the 5 weeks’ gestation. Isolated fetal cells can be used in the early prediction of fetal sex, prenatal diagnostics of the most common aneuploidies, and any other genetic abnormalities. Nevertheless, the collection of trophoblastic cells has limited efficacy compared to currently used methods of detection of free fetal DNA in maternal circulation or other protocols of invasive prenatal diagnostics available at later stages of pregnancy. In the past years, trans-cervical cell samples were collected mainly in women before planned pregnancy termination. The early trophoblastic cells isolation from women in ongoing pregnancies opens new perspectives for further studies focused on the elucidation of pathophysiology of numerous pregnancy-related complications.

The association of prenatal exposure to benzophenones with gestational age and offspring size at birth.

In recent decades, emerging environmental pollutants such as endocrine-disrupting chemicals (EDCs) have become a particular concern. This study examined the association of maternal exposure to benzophenones as one of the EDCs with gestational age and evaluated their effects on birth outcomes including birth weight, birth length, head circumference, and Ponderal Index. We assessed 166 pregnant mothers of the PERSIAN cohort population of Isfahan, Iran, in the 1st and 3rd trimesters of pregnancy and their infants at birth. Four common benzophenones (BPs) including 2,4-dihydroxy benzophenone (BP-1), 2-hydroxy-4-methoxy benzophenone (BP-3), 4-hydroxy benzophenone (4-OH-BP), and 2,2′-dihydroxy-4-methoxy benzophenone (BP-8) were measured in maternal urine samples. The median urinary concentrations of 4-OH-BP, BP-3, BP-1, and BP-8 in the 1st trimester were 6.62, 7.5, 4.39, and 1.32 µg/g creatinine and those in the 3rd trimester were 3.15, 16.98, 9.95, and 1.04 µg/g creatinine, respectively. BP-3 was the predominant metabolite in both trimesters. There was a significant correlation between BP-3, BP-1, and 4-OH-BP levels (p < 0.05) but not BP-8. BP-1 showed a significant positive association with gestational age (GA) in all infants in the 1st trimester, but a negative association was observed between BP-3 and BP-1 levels and GA in girls. Classification of infants’ birth weight for different GAs represented that the majority of them were appropriate for GA. However, boys’ weights were heavier than girls. Also, birth outcomes of preterm (< 37 weeks) infants were noticeably lower than term infants (37–42 weeks). This study demonstrated that benzophenone derivatives especially BP-3 can affect the duration of pregnancy and consequently fetal growth in the early and late stages of pregnancy. This is more pronounced in girls; however, more investigations in a different population are needed to prove the results. Therefore, the application of these compounds as a UV protector requires precise regulation to reduce exposure, especially in pregnant women.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11356-021-17634-9.

Maternal and developmental toxicity of Bisphenol-A in SWR/J mice

Bisphenol-A (BPA), an organic compound with two phenol functional groups, is a widely used industrial plasticizer with known estrogenic properties. It is used in the manufacture of epoxy resins and polycarbonate plastics. This study was designed to evaluate and assess the possible toxicity arising from the oral administration of BPA to pregnant mice. Pregnant SWR/J mice (15 mice/group) were administrated oral doses of BPA (125, 250 and 500 mg/kg/day) over the course of five-day intervals during gestation (D1-5, D6-10 and D11-15), while control groups received only corn oil. The results indicated that BPA was associated with a reduction in the body weight of the pregnant mice from around 2–3 days after administration until the end of gestation. The greatest effects were evident when the BPA was given during the later stages of pregnancy, and with higher doses. They also showed marked reduction in food intake and, to a lesser extent, in water intake. Furthermore, doses of BPA induced a reduction in implantation sites, lower foetal body weight and increased mortality rates. Abortion and foetal resorption rates were not affected by BPA administration, however. The above findings were concluded by discussing the possible mechanisms involved in producing these effects.

VP31.18: Perinatal outcome of COVID‐19 infection in the first and second half of pregnancy

The COVID-19 pandemic has affected millions of people around the world, and pregnant women are one of the groups most at risk. In this study, we examined the symptoms, tests, and pregnancy outcomes of pregnant patients with COVID-19 hospitalised in the Infectious Diseases Center of Razi Hospital, Iran, Ahvaz Jundishapur University of Medical Sciences. This is a descriptive and retrospective study conducted on 54 pregnant patients with COVID-19 in Iran, Ahvaz. In this study all hospitalised COVID-19 positive pregnant patients from February 23, 2019 to June 15, 2020 were included using the census method. In this study, 54 pregnant patients with Covid-19 were studied, of whom 42 were over 20 weeks of gestational age and 12 patients were under 20 weeks. The mean length of hospitalisation was 6 days in the first group and 4 days in the second group. In the first group, 12 patients (28.6%) were admitted to the ICU, while only 2 patients (16.7%) from the other group were admitted to the ICU. There were 4 maternal deaths and 3 fetal deaths. Severe pre-eclampsia with severe thrombocitopenia Fetal Growth restriction Dichorionic twin pregnancy HELLP Syndrome Preterm premature rupture of membranes Disseminated intravascular coagulation According to our study, it seems that with advanced gestational age, especially after the first half of pregnancy, the severity of this disease, which leads to longer hospitalisation and calls for intensive care units increases. Maternal and fetal mortality rates also increase at later stages of pregnancy. Besides, no vertical transmission of the virus was observed in any of the newborns, but the vertical transmission is still possible according to previous studies.

Deep Investigating the Changes of Gut Microbiome and Its Correlation With the Shifts of Host Serum Metabolome Around Parturition in Sows.

Parturition is a crucial event in the sow reproduction cycle, which accompanies by a series of physiological changes, including sex hormones, metabolism, and immunity. More and more studies have indicated the changes of the gut microbiota from pregnancy to parturition. However, what bacterial species and functional capacities of the gut microbiome are changed around parturition has been largely unknown, and the correlations between the changes of gut bacterial species and host metabolome were also uncovered. In this study, by combining 16S rRNA gene and shotgun metagenomic sequencing data, and the profiles of serum metabolome and fecal short-chain fatty acids (SCFAs), we investigated the changes of gut microbiome, serum metabolite features and fecal SCFAs from late pregnancy (LP) to postpartum (PO) stage. We found the significant changes of gut microbiota from LP to PO stage in both 16S rRNA gene sequencing and metagenomic sequencing analyses. The bacterial species from Lactobacillus, Streptococcus, and Clostridium were enriched at the LP stage, while the species from Bacteroides, Escherichia, and Campylobacter had higher abundances at the PO stage. Functional capacities of the gut microbiome were also significantly changed and associated with the shifts of gut bacteria. Untargeted metabolomic analyses revealed that the metabolite features related to taurine and hypotaurine metabolism, and arginine biosynthesis and metabolism were enriched at the LP stage, and positively associated with those bacterial species enriched at the LP stage, while the metabolite features associated with vitamin B6 and glycerophospholipid metabolism had higher abundances at the PO stage and were positively correlated with the bacteria enriched at the PO stage. Six kinds of SCFAs were measured in feces samples and showed higher concentrations at the LP stage. These results suggested that the changes of gut microbiome from LP to PO stage lead to the shifts of host lipid, amino acids and vitamin metabolism and SCFA production. The results from this study provided new insights for the changes of sow gut microbiome and host metabolism around parturition, and gave new knowledge for guiding the feeding and maternal care of sows from late pregnancy to lactation in the pig industry.

DWI in Brains of Fetuses with Congenital Heart Disease: A Case-Control MR Imaging Study.

Abnormal ADC values are seen in ischemic brain lesions such as acute or chronic hypoxia. We aimed to assess whether ADC values in the developing brain measured by in utero DWI were different in fetuses with congenital heart disease compared with healthy controls. In utero DWI was performed in 50 fetuses with congenital heart disease and 100 healthy controls at a similar gestational age. Pair-wise ADC values of the ROIs were manually delineated on each side of the frontal and periatrial WM and in the basal ganglia, thalamus, and cerebellar hemisphere, as well as a single measurement in the pons. Fetuses with congenital heart disease had significantly lower ADC values in frontal and periatrial WM and the pons than controls (all P < .05) in the early stages of pregnancy. However, ADC values in the thalamus were higher for fetuses with congenital heart disease than for controls (gestational age, ≥26 weeks). For ADC values in the cerebellar hemisphere, there was no obvious significance between cases and controls (P = .07) in the late stages of pregnancy. Basal ganglia ADC values were consistently not significantly different between the 2 groups during the early and late stages of pregnancy (P = .47; .21). Abnormal brain diffusivity can be detected using in utero DWI in fetuses with congenital heart disease. Abnormal ADC values found at a mean gestational age of 26 weeks suggest structural changes, which may provide an early indicator of the impact of congenital heart disease on the developing brain.

EARLY PREGNANCY OUTCOMES AFTER IVF AND SLEEP DISORDERED BREATHING

While sleep disordered breath (SDB) is associated with multiple medical comorbidities and adverse late stage pregnancy complications such as preeclampsia and gestational diabetes, there is little understanding of its impact on early pregnancy outcomes after IVF. Patients between 18 to 45 years old undergoing autologous IVF and anticipating an embryo transfer were eligible for participation in this single-arm prospective observational study. Women with current treatment of obstructive sleep apnea were excluded. Demographics, medical history, and sleep surveys including the STOP-BANG Questionnaire, Epworth Sleepiness Survey, Pittsburgh Sleep Quality Index, and the Insomnia Severity Index were collected. Participants completed a single night of home sleep monitoring prior to IVF with a novel sensor system composed of two wireless patches located at the suprasternal notch and the index finger (ANNE Sleep, Sibel Health), which collected continuous measurements of heart rate, respiratory rate, peripheral arterial tonometry, temperature, blood pressure, and pulse oxygenation. Sleep nights were reviewed for SDB determined by an apnea hypopnea index (AHI), defined as the average number of apneic events per hour based on American Academy of Sleep Medicine scoring guidelines. IVF cycle and early pregnancy outcomes were followed to at least 12 weeks. The primary exposure was SDB (AHI 5 events/hr) and the primary outcome was rate of clinical pregnancy (defined as intrauterine gestational sac with a yolk sac) after IVF. Continuous variables were compared using Student’s t-test or Mann–Whitney U test based on normality, while χ2 or Fisher’s exact tests were used to compare categorical variables by SDB exposure. Logistic regression assessed predictors of clinical pregnancy after adjusting for confounders. A total of 30 subjects were recruited from an academic fertility center. The overall rate of SDB was 58%. Participants with SDB had a mean AHI of 13.4 compared to 2.7 events/hr (p<0.01), were younger, and more likely to have ovulatory dysfunction. There were otherwise no significant differences in body mass index (BMI), parity, IVF cycle stimulation parameters, embryological yield, or sleep survey results. Clinical pregnancy occurred in only 38% of women with SDB vs 64% in those without (p=0.18). After adjusting for age, BMI, and ovulatory dysfunction, SDB was an independent risk factor for reduced clinical pregnancy rates (aOR 0.13, 95% CI: 0.02-0.83, p=0.03). Though SDB occurred more frequently among women with ovulatory dysfunction (88% vs 46%, p=0.04), SDB remained a risk factor for unsuccessful pregnancy after IVF, independent of underlying infertility diagnosis. Sleep disordered breathing of any severity is associated with an 87% (95% CI: 0.02-0.83) lower likelihood of clinical pregnancy after IVF.

The Relationship between Pregnancy-related Anxiety and Maternal-fetal Attachment among Primigravida

BACKGROUND: Many studies support the hypothesis that pregnancy-related anxiety (PRA) is strongly linked to postpartum depression, preterm births, low birth weight, fetal growth restriction, pregnancy complications, and negative infant outcomes. PRA has also been associated with mother-fetal bond during pregnancy that a special relationship between the mother and infant and growth beyond before the infant is born. Although extensive studies on PRA and maternal-fetal attachment (MFA) have been carried out, little attention on these issues is done in the Indonesian context. AIM: To fill such a gap, the present study aimed to investigate the relationship between maternal PRA and MFA. METHODS: Expectant mothers who visit their antenatal care in the primary health community services at Yogyakarta participated in this study. They were recruited using a purposive sampling technique based on the criteria: (a) The 1st time pregnancy, (b) in the late stage of pregnancy, (c) have no complication, (d) mother at any age range, and (e) mother at any education level. G-power 3.1.9.2 with effect size 0.15 has used to determine the number of samples, 84 people. Statistical analysis Pearson correlation has been applied and calculates the t relationship between two variables. General linier model analysis conducted the contribution of demographic variables to PRA and MFA. RESULTS: There is a significant relationship between maternal anxiety during pregnancy and MFA (p &lt; 0.001) and a significant correlation between PRA and maternal age. However, there were no correlation between MFA and demographic variables. IMPLICATION FOR PRACTICE: Findings study provides the crucial information as the new approach to enhance the quality of care of mother’s and infant’s health during pregnancy as well as to promote maternal mental health.

National population prevalence of antibodies to SARS-CoV-2 among pregnant women in Scotland during the second wave of the COVID-19 pandemic: a prospective national serosurvey

ObjectivesThis study aimed to determine SARS-CoV-2 seroprevalence among pregnant women in the Scottish population during the second wave of the COVID-19 pandemic. Study designProspective national serosurvey. MethodsWe tested 13,428 residual samples retrieved from pregnant women participating in the first trimester combined ultrasound and biochemical screening for fetal trisomy across Scotland for SARS-CoV-2 antibodies over a 6-month period from November 2020 to April 2021. Seroprevalence estimates were adjusted for the sensitivity and specificity of the assays and weighted to reference populations. ResultsSeroprevalence rates in the antenatal samples significantly increased from 5.5% (95% confidence interval [CI] 4.7%–6.5%) in the 5-week period up to and including International Organization for Standardization (ISO) Week 51 (w/b Monday 14 December 2020) to 11.3% (95% CI 10.1%–12.6%) in the 5-week period up to and including ISO Week 14 (w/b Monday 5 April 2021). Increasing seroprevalence trends across the second wave were observed among all age groups. ConclusionsBy the end of the second wave of the COVID-19 pandemic, approximately one in 10 women tested around the end of the first trimester of pregnancy had antibodies to SARS-CoV-2, suggesting that the vast majority were still susceptible to COVID-19 as they progressed to the later stages of pregnancy, when risks from infection are elevated for both mother and baby.

STUDY OF THE INFLUENCE OF HORMONAL FUNCTION IMPAIREMENT OF THE PLACENTA ON THE STATE OF FETUS AND NEWBORN IN WOMEN WITH NODULAR GOITER

The thyroid gland pathology is one of the most common in the world and is on the samelevel with diabetes mellitus and diseases of the cardiovascular system in its importance.Extragenital pathology, in particular, nodular goiter in pregnant women acts as anadditional stress factor that can negatively affect hormonal relationships in the motherplacenta-fetus system and contribute to an increase in the frequency of complications ofpregnancy, childbirth, and impairment of the fetus and newborn condition.The aim of this work – to study the disturbance effect in the hormonal function of theplacenta on the condition of the fetus and newborn from women with nodular goiter.Material and methods. The analysis of the state of the fetus and newborn of 20 apparentlyhealthy women (control group) and 54 women with nodular goiter (main group). Of these,30 newborns from women with grade I nodular goiter were included into group I, and24 newborns from women with grade II nodular goiter were included into group II. Theintrauterine fetus state was judged about according to the data of cardiotocography, fetalbiophysical profile (FBP), ultrasound examination, and Doppler results. The functionalstate of the fetoplacental complex was assessed by determining the serum concentrationof estradiol (Е2), estriol Е3), progesterone, placental lactogen, as well as the results ofhistological examination of the placentas.Results. The study of the placenta hormonal function, the results of ultrasound diagnosticsand histological examination of the placentas indicate the presence of placentaldysfunction in pregnant women with nodular goiter, that affected the condition of thefetus and newborn. Thus, the cardiotocographic index in fetuses from pregnant women,suffering from nodular goiter, is significantly less than in healthy pregnant women(p&lt;0.05). The average PPI score in women with nodular goiter is also significantly lowerthan in the control group (p&lt;0.05). Doppler data indicate a change in the parameters of the maternal hemodynamics, that led to a violation of the uteroplacental blood flow, thedevelopment of fetal hypoxia.Conclusions. The presence of nodular goiter in the mother is a risk factor for placentaldysfunction. Starting from the second trimester of pregnancy, there are significant changesin the content of placental hormones in the blood. A decrease in the concentration ofprogesterone in the blood serum in pregnant women with nodular goiter, in the latestages of pregnancy, can serve as a marker of the threat of termination of pregnancyand premature birth. A decrease in the content of estradiol and placental lactogen inthe maternal blood serum can be used as a marker of fetal distress in pregnant womenwith nodular goiter. The condition of the fetus and newborn is in direct proportion to thedegree of manifestation of the nodular goiter and the functional state of the placenta.

Use of Recombinant Endolysin to Improve Accuracy of Group B Streptococcus Tests.

ABSTRACTGroup B Streptococcus (GBS) causes serious neonatal infection via vertical transmission. The prenatal GBS screening test is performed at the late stage of pregnancy to avoid risks of infection. In this test, enrichment culture is performed, followed by GBS identification. Selective medium is used for the enrichment; however, Enterococcus faecalis, which is a potential contaminant in swab samples, can interfere with the growth of GBS. Such bacterial contamination can lead to false-negative results. Endolysin, a bacteriophage-derived enzyme, degrades peptidoglycan in the bacterial cell wall; it is a promising antimicrobial agent for selectively eliminating specific bacterial genera/species. In this study, we used the recombinant endolysin EG-LYS, which is specific to E. faecalis; the endolysin potentially enriched GBS in the selective culture. First, in the false-negative model (coculture of GBS and E. faecalis, which disabled GBS detection in the subsequent GBS identification test), EG-LYS treatment at 0.1 mg/ml improved GBS detection. Next, we used 548 vaginal swabs to test the efficacy of EG-LYS treatment in improving GBS detection. EG-LYS treatment (0.1 mg/ml) increased the GBS-positive ratio to 17.9%, compared to 15.7% in the control (phosphate-buffered saline [PBS] treatment). In addition, there were an increased number of GBS colonies under EG-LYS treatment in some samples. The results were supported by the microbiota analysis of the enriched cultures. In conclusion, EG-LYS treatment of the enrichment culture potentially improves the accuracy of the prenatal GBS screening test.IMPORTANCE Endolysin is a bacteriophage-derived enzyme that degrades the peptidoglycan in the cell wall of host bacteria; it could be used as an antimicrobial agent for selectively eliminating specific bacterial genera/species. Group B Streptococcus (GBS) causes neonatal infection via vertical transmission; prenatal GBS screening test, in which enrichment culture is followed by bacterial identification, is used to detect the presence of GBS in pregnant women. However, the presence of commensal bacteria such as Enterococcus faecalis in clinical specimens can inhibit GBS growth in the selective enrichment culture, resulting in false-negative result. Here, we demonstrated that the application of originally isolated endolysin in the enrichment culture improved the test accuracy by inhibiting unwanted E. faecalis growth and therefore avoiding false-negative results, not only in experimental settings, but also in tests using vaginal swabs.

Maintaining exceptionality: Interrogating gestational limits for abortion

Gestational limits on abortion are often seen as a condition for decriminalisation. Focusing on the final reports of three institutional law reform inquiries into abortion in Australia, this article argues that gestational limits were recommended through foreclosing the subject position of the unwillingly pregnant woman who experiences gestational time as a threat to her bodily integrity and imagined future. Structural features of law reform commissions tethered models of decriminalisation to the era of criminalisation. Abortion was also rendered meaningful in the reports through discursive tropes that centred foetal viability and constructed later abortion in terms of a delay that required explanation, with the medico-judicial categories used to explain this delay – which distinguished between ‘medical’ and ‘psychosocial’ abortions – recentring the decision-making authority of doctors. Gestational limits on abortion rearticulate the exceptionality of abortion, reinscribing the illegitimacy of abortion and the people who have them, at least at later stages of pregnancy.

Imaging modalities for confirming pulmonary embolism during pregnancy: results from a multicenter international study.

We explored the variations in use of imaging modalities for confirming pulmonary embolism (PE) according to the trimester of pregnancy. We included all pregnant patients with confirmed acute PE from RIETE, a prospective registry of patients with PE (03/2001-02/2020). Imaging modalities included computed tomography pulmonary angiography (CTPA), ventilation-perfusion (V/Q) scan, or presence of signs of acute PE along with imaging-confirmed proximal deep vein thrombosis (pDVT) without pulmonary vascular imaging. We compared the imaging modalities to postpartum patients with PE, and other non-pregnant women with PE. There were 157 pregnant patients (age: 32.7 ± 0.5), 228 postpartum patients (age: 33.9 ± 0.5), and 23,937 non-pregnant non-postpartum women (age: 69.5 ± 0.1). CTPA was the most common modality for confirming PE, from 55.7% in first trimester to 58.3% in second trimester, and 70.0% in third trimester. From first trimester to third trimester, V/Q scanning was used in 21.3%, 16.7%, and 18.3% of cases, respectively. Confirmed pDVT along with the presence of signs/symptoms of PE was the confirmatory modality for PE in 21.3% of patients in first trimester, 19.4% in second trimester, and 6.7% in third trimester. The proportion of postpartum patients confirmed with CTPA (85.5%) was comparable to that of non-pregnant non-postpartum women (83.2%). From the first trimester of pregnancy to postpartum period, there was a linear increase in the proportion of patients with PE diagnosed with CTPA (p = 0.039). CTPA was the primary modality for confirming PE in all trimesters of pregnancy, although its proportional use was higher in later stages of pregnancy. • Computed tomography pulmonary angiography (CTPA) was the primary modality of diagnosis in all trimesters of pregnancy among patients with confirmed pulmonary embolism, even in the first trimester. • From the first trimester of pregnancy to postpartum period, there was a linear increase in the proportion of patients with pulmonary embolism who were diagnosed based on CTPA. • In the postpartum period, use of CTPA as the modality to confirm pulmonary embolism was comparable to non-pregnant patients.

Effects of Pparγ1 deletion on late-stage murine embryogenesis and cells that undergo endocycle

Peroxisome proliferator-activated receptor (PPAR) γ1, a nuclear receptor, is abundant in the murine placenta during the late stage of pregnancy (E15–E16), although its functional roles remain unclear. PPARγ1 is encoded by two splicing isoforms, namely Pparγ1canonical and Pparγ1sv, and its embryonic loss leads to early (E10) embryonic lethality. Thus, we generated knockout (KO) mice that carried only one of the isoforms to obtain a milder phenotype. Pparγ1sv-KO mice were viable and fertile, whereas Pparγ1canonical-KO mice failed to recover around the weaning age. Pparγ1canonical-KO embryos developed normally up to 15.5 dpc, followed by growth delays after that. The junctional zone of Pparγ1canonical-KO placentas severely infiltrated the labyrinth, and maternal blood sinuses were dilated. In the wild-type, PPARγ1 was highly expressed in sinusoidal trophoblast giant cells (S-TGCs), peaking at 15.5 dpc. Pparγ1canonical-KO abolished PPARγ1 expression in S-TGCs. Notably, the S-TGCs had unusually enlarged nuclei and often occupied maternal vascular spaces, disturbing the organization of the fine labyrinth structure. Gene expression analyses of Pparγ1canonical-KO placentas indicated enhanced S-phase cell cycle signatures. EdU-positive S-TGCs in Pparγ1canonical-KO placentas were greater in number than those in wild-type placentas, suggesting that the cells continued to endoreplicate in the mutant placentas. These results indicate that PPARγ1, a known cell cycle arrest mediator, is involved in the transition of TGCs undergoing endocycling to the terminal differentiation stage in the placentas. Therefore, PPARγ1 deficiency, induced through genetic manipulation, leads to placental insufficiency.

Probiotic effect on reserve mobilization in late stage pregnancy in goats

This study was carried out to evaluate a probiotic effect on the mobilisation of body reserves in goats towards the end of gestation by measuring ketone body production in blood and calculating the body condition score (BCS). Ketone body production was monitored by measuring the betahydroxybutyrate BHB levels in the blood using a portable kit (PRECISION XTRA Blood ketone test). The results revealed that the use of the probiotic SYMBIOVEBA® (association of Saccharomyces cervicae and Lactobacillus) did not decrease the formation of blood BHB in goats, and therefore did not decrease mobilization of the body reserves of goats in late pregnancy.

Influence of perceived stress on prenatal depression in Surinamese women enrolled in the CCREOH study

BackgroundPrenatal depression may have adverse health effects on mothers and their offspring. Perceived stress is an important risk factor for depression during pregnancy. Studies have shown that both perceived stress and depression may negatively influence birth outcomes. While 20% of pregnancies in Suriname, a middle-income Caribbean country located in northern South America, results in adverse birth outcomes, data on prenatal depression and its risk factors are lacking. This study aimed to assess the influence of perceived stress on depression during pregnancy in Surinamese women.MethodsSurvey data were used from 1143 pregnant women who participated in the Caribbean Consortium for Research in Environmental and Occupational Health-MeKiTamara prospective cohort study that addresses the impact of chemical and non-chemical environmental exposures in mother/child dyads in Suriname. The Edinburgh Depression Scale and Cohen Perceived Stress Scale were used to screen for probable depression (cut-off ≥ 12) and high stress (cut-off ≥ 20), respectively. The association between perceived stress and depression was examined using bivariate and multiple logistic regression analyses, adjusted for social support (including resilience) and maternal demographics.ResultsThe prevalence of high perceived stress during the first two trimesters and the third trimester were 27.2% and 24.7% respectively. 22.4% of the participants had probable depression during first or second trimester and 17.6% during the third trimester. Women experiencing high stress levels during the first two trimesters had 1.92 increased odds (95% CI 1.18–3.11, p = 0.008) of having probable depression during the third trimester of pregnancy than those with low stress levels. Pregnant women with low individual resilience during early pregnancy (52.1%) had 1.65 (95% CI 1.03–2.63, p = 0.038) increased odds of having probable depression during later stages of pregnancy compared to those with high individual resilience. Low educational level (p = 0.004) and age of the mother (20–34 years) (p = 0.023) were significantly associated with probable depression during the third trimester.ConclusionsEarly detection and management of stress and depression during pregnancy are important. Health education programs, targeting the reduction of stress during pregnancy, may help to reduce depression and its potential adverse health effects on the mother and child.

Effects of ambient temperature on the risk of preterm birth in offspring of adolescent mothers in rural henan, China

BackgroundA number of studies have explored the association between ambient temperature and preterm birth (PTB), but rarely among adolescent mothers. ObjectivesTo estimate the effects of ambient temperature on the risk of PTB and gestational age of newborns delivered by adolescent mothers in rural areas of Henan province. MethodsWe obtained 5394 medical records of adolescent mothers with results of pre-pregnancy physical examination and pregnancy outcomes from the National Free Preconception Health Examination Project (NFPHEP) in Henan province. Meteorological information was obtained from the China Meteorological Data Sharing Service System. Individual exposure levels were evaluated with an inverse distance-weighted model. A multiple logistic regression model and multiple linear regression model were used to estimate the effects of ambient temperature on the risk of PTB and gestational age, respectively. Stratified and interaction analyses were also performed. ResultsOf newborns in this study, 3.45% (186/5394) were PTB. Mean, maximum and minimum temperature during the entire pregnancy, especially the last 1–4 weeks of pregnancy, were positively associated with the risk of PTB and negatively associated with gestational age (P < 0.05). Nevertheless, a masking effect was observed that gestational age was positively associated with ambient temperature during the first trimester of pregnancy, due to the strongly inverse correlation between ambient temperature during the early and late stages of pregnancy. Stratified analyses showed that increasing temperature during the last 1–4 weeks of pregnancy increased the risk of PTB and decreased gestational age in newborns born in the cold season (P < 0.05). Furthermore, interaction analyses showed that birth season modified the effects of temperature on the gestational age (Pinteraction < 0.10). ConclusionsElevated ambient temperature can decrease gestational age and increase the risk of PTB in offspring of adolescent mothers in rural areas. The birth season may modify the effects of temperature on gestational age.