Physiological Gestation Research Articles

Changes in coagulogram parameters and acid-base composition of blood in pregnant women with moderate and severe preeclampsia

Objective: to conduct a comparative analysis of coagulogram and acid-base composition of blood in pregnant women with moderate and severe preeclampsia (PE) and to assess the impact of the detected disorders on pregnancy outcomes. Material and methods. Group 1 consisted of patients with moderate PE (n=33), group 2 — with severe PE (n=34), and group 3 —women with physiological gestation (n=39). Parameters of coagulogram, acid-base composition of capillary blood of pregnant women (pH, pC02, p02, HC03-act) were determined on the RAPIDLAB 1265 device. Results. An increase in the level of fibrinogen was revealed in group 1 — by 9.9% relative to the indicator of group 3 (p=0.10), in group 2 — by 28.2% (p=0.002) against the background of a shortening of the APTT, respectively by 6.8% (p=0.003) and 9.9% (p<0.001) and a decrease in the number of platelets — by 11.9% (p=0.03) and 27.3% (p<0.001). Changes in the acid-base composition of capillary blood in PE were established: a decrease in HC03-act and p02 with an increase in pC02, which reflect the tendency to develop metabolic acidosis and respiratory alkalosis, more pronounced in group 2. Conclusions. PE is associated with disorders of blood coagulation potential and changes in blood gas composition, more pronounced in severe PE, which contributes to an increase in the frequency of premature birth (with moderate PE — up to 75.8%, severe — up to 100%) and cesarean section (respectively, by 7.7 and 18 times). The measurement of pC02 and p02 levels should be classified as informative and promising tests in terms of differential diagnosis of the severity of PE.

DETERMINISTIC BEHAVIORAL AND ANAMNESTIC RISK FACTORS INDUCING MISCARRIAGE (according to the results of a sociological study)

Background. Every year there are 23 million miscarriages and approximately 15 million premature babies are born in the world. Prematurity induces an increase in the hospitalization of newborns, creates a significant economic burden on families and the burden on health care systems, and increases the risk of developing psychological and mental disorders, which determines this pathology as a priority in the search for ways to solve it.
 Aim: to establish the most significant behavioral risk factors for miscarriage, which are actually modifiable, which will be one of the key elements in solving the problem of preventing miscarriage.
 Materials and methods. During the scientific study, two groups of women were formed. The study group consisted of 403 women after spontaneous abortion, premature birth or threatened miscarriage, and the control group included 402 women with a physiological gestation course and parturient women with a full-term pregnancy.
 Results. According to the results of the study, theку was a significant impact of an external stress factor during pregnancy, noted by 23.08% [19.1-27.31] and 3.73% [2.10-5.80] of the respondents of the study and control groups, respectively (p <0.01), as well as nervous system overload at the workplace, noted by 42.43% [37.65-47.29] and 29.35% [25.01-33.9] of women, respectively (p<0.01).
 The negative impact of physical activity such as running or jogging, as well as professional sports, which were indicated by 17.87% [14.28-21.75] and 8.71% [6.15-11.66], and 6 .20% [4.06-8.76] and 2.24% [1.02-3.91] of the respondents of the study and control groups, respectively (p<0.01), have been proven.
 It was established that the proportion of females who drank wine was 39.70% [34.98-44.52] in the study group, while they were 17.66% [14.09-21.54] (p<0.01) in the control group, and the share of women who drank low-alcohol beverages was twice as prevalent in the control group, 13.93% [10.72-17.48] compared to 7.20% [4.88-9.92] in the study group (p<0.01).
 The preventive effect of additional intake of micronutrients, namely folic acid and iodine, was noted. 37.47% [32.81-42.25] of women in the study group took folic acid at 400 μg per day from the moment they found out about their pregnancy until the end of the 16th week of pregnancy, which was 1.4 times less than in the control group, accounting for 51.00% [46.11-55.87] (p<0.01). Only a quarter of 25.06% [20.96-29.41] women of the study group and almost half of 45.27% [40.44-50.15] women of the control group (p<0.01) took iodine supplements containing 200 μg of iodine per day from the beginning to the end of pregnancy.
 The expediency of limiting sexual life during critical periods of pregnancy, namely during the 8-12, 18-22, and 28-32 weeks of pregnancy, was proven, as noted by 31.27% [26.84-35.87] of the respondents of the study group and 47.26% [42.4-52.15] of subjects in the control group (p<0.05).
 Conclusion. Based on the results of the study, the most significant behavioral risk factors were established, which are mainly manageable and modifiable. The obtained results will be used in the formation of groups with an increased risk of miscarriage among women of reproductive age and in the development of a personalized risk-oriented model for the prevention of miscarriage.

The features of the prevention of preeclampsia in pregnant women with gestational endotheliopathy in the first trimester

The objective: to evaluate the clinical effectiveness of L-arginine in the prevention of preeclampsia and reduction of other perinatal risks in patients with preclinical gestational endotheliopathy (GE).Materials and methods. A comparative clinical study was performed at the clinical base of the Department of Obstetrics and Gynecology N. 1 of the Vinnytsya National Pirogov Memorial Medical University. 116 pregnant women with preclinical GE (main group), which was diagnosed by laboratory and instrumental research (microalbuminuria and endothelium-dependent vasodilatation), took part in the study. The patients of the main group were divided into clinical subgroups: 31 pregnant women with GE in subgroup A received acetylsalicylic acid (ASA) at a dose of 75 mg per or per day; 33 patients with preclinical GE from subgroup B received L-arginine at a dose of 4-4.2 g per or per day; 52 pregnant women with preclinical GE who refused prophylactic treatment were included in the subgroup C. The control group involved 58 pregnant women with a physiological gestation and without GE.The clinical effectiveness of the therapy was assessed by comparing the number of cases of perinatal pathology in the I, II and III trimesters.Results. The use of L-arginine as an alternative preventive therapy for the development of preeclampsia and other perinatal pathology made possible to reduce the rate of preeclampsia significantly (RR 0.19, 95% CI: 0.05-0.77; p=0.02) and placental hyperplasia/hypoplasia (RR 0.17, 95% CI: 0.04-0.68; p=0.01), compared to patients who did not receive any preventive treatment. In pregnant women with early-onset gestational endotheliopathy who received L-arginine, placental dysfunction was not diagnosed in the II and III trimesters of pregnancy and there were no cases of fetal growth retardation. The use of L-arginine was not associated with side effects and/or adverse reactions in the proposed dose and frequency of administration and can be considered beneficial for the mother and the fetus.Conclusions. Prescribing ASA and L-arginine drugs for pregnant women with a moderate degree of perinatal risk (preclinical GE) made possible not only to prolong pregnancy, but also to prevent the development of severe perinatal pathology. A more pronounced clinical effectiveness of the course prescription of solution of L-arginine per or (daily dose of L-arginine - 4.0-4.2 g) in pregnant women with preclinical form of GE may be associated with the endotheliotropic protective effect of the drug.The appropriateness of using L-arginine during pregnancy is still debated, and further researches are needed to determine the optimal dosage, initial period for using and duration for the best prophylactic or therapeutic effect.

Adipokines in Pregnancy: A Systematic Review of Clinical Data.

Adipokines are signaling proteins involved in metabolic, endocrinological, vascular and immunogenic processes. Associations of various adipokines with not only insulin resistance but also with increased insulin sensitivity, increased systolic blood pressure, and atherosclerosis highlight the significance of adipokines in several components of metabolic syndrome and metabolic diseases in general. As pregnancy presents a unique metabolic state, the role of adipokines in pregnancy, and even in various pregnancy complications, appears to be key to elucidating these metabolic processes. Many studies in recent years have attempted to clarify the role of adipokines in pregnancy and gestational pathologies. In this review, we aim to investigate the changes in maternal adipokine levels in physiological gestation, as well as the association of adipokines with pregnancy pathologies, such as gestational diabetes mellitus (GDM) and preeclampsia (PE). Furthermore, we will analyze the association of adipokines in both maternal serum and cord blood with parameters of intrauterine growth and various pregnancy outcomes.

Trimester-specific reference intervals for thyroid function parameters in pregnant Caucasian women using Roche platforms: a prospective study

BackgroundStandard thyroid function parameters reference intervals (RI) are unsuitable during pregnancy, potentially resulting in incongruous treatments that may cause adverse effects on pregnancy outcomes. We aimed at defining trimester-specific TSH, FT4 and FT3 RI, using samples longitudinally collected from healthy Caucasian women.Materials and methodsBlood samples from 150 healthy Caucasian women, who had a physiological gestation and a healthy newborn at term, were collected in each trimester and at around six months post-partum. They showed mild iodine deficiency. After excluding women with overt TSH abnormalities (> 10 mU/L) and/or TPO antibodies, data from 139 pregnant women were analyzed by means of widely used Roche platforms, and TSH, FT4 and FT3 trimester-specific RI were calculated. Post-partum data were available for 55 subjects.ResultsSerum TSH RI were 0.34–3.81 mU/L in the first trimester, and changed slightly to 0.68–4.07 U/L and 0.63–4.00 mU/L in the second and third trimester, respectively. Conversely, both FT4 and FT3 concentrations progressively decreased during pregnancy, the median values in the third trimester being 14.8% and 13.2% lower, respectively, than in the first trimester. Thyroid function parameters in the first trimester were similar to those measured after the end of pregnancy.ConclusionsThis study calculates trimester-specific RI for thyroid function parameters in pregnancy, and proposes the reference limits that should be adopted when using Roche platforms in Caucasian women.

МОРФОЛОГИЧЕСКИЕ АСПЕКТЫ НЕСОСТОЯТЕЛЬНОСТИ ПЛОДНЫХ ОБОЛОЧЕК ПРИ НЕДОНОШЕННОЙ БЕРЕМЕННОСТИ ПО ДАННЫМ СКАНИРУЮЩЕЙ ЭЛЕКТРОННОЙ МИКРОСКОПИИ

Abstract. Currently, one of the most significant pathologies in obstetric practice is rupture of amniotic fluid in preterm pregnancy, which in more than 50% of cases precedes premature termination of pregnancy. This study is devoted to the study of the morphological foundations of the formation of insolvency of the membranes in preterm pregnancy. Using a Hitachi S-4500 scanning electron microscope at a magnification of 130 and 900 times, the ultrastructure of two fetal membranes (smooth chorion and amnion) was studied during physiological gestation and during pregnancy complicated by premature rupture of the fetal membranes with an anhydrous interval of not more than 6 hours and the absence of clinical and laboratory signs of the inflammatory process. The material was taken during a caesarean section. Tissue samples with dimensions of 1-4 mm are stained according to the Kranovsky method. It has been established that during a physiologically proceeding pregnancy, the outer layer of the amnion is represented by a cubic epithelium, which has a brush border on the apical part of the stellate shape. Amnion cells are tightly adjacent to each other. The inner layer of the amnion is represented by mesenchymal epithelium. The study of the ultrastructure of the smooth chorion during physiological pregnancy showed that its outer surface, in contact with the decidua, consists of tightly contacting cells with stellate microvilli. The inner surface of the smooth chorion, adjacent to the amnion, is represented by spongy tissue. The study of the ultrastructure of the fetal membranes during preterm pregnancy, complicated by prenatal rupture of amniotic fluid, made it possible to establish that the morphological basis of the failure of the fetal membranes is damage to the brush border of the amniotic epithelium and an increase in intercellular gaps in the amniotic membrane, which indicates the inferiority of the fetal membranes already at the stage of their formation.

The percentage of CD39+ monocytes is higher in pregnant COVID-19+ patients than in nonpregnant COVID-19+ patients.

Current medical guidelines consider pregnant women with COVID-19 to be a high-risk group. Since physiological gestation downregulates the immunological response to maintain "maternal-fetal tolerance", SARS-CoV-2 infection may constitute a potentially threatening condition to both the mother and the fetus. To establish the immune profile in pregnant COVID-19+ patients, a cross-sectional study was conducted. Pregnant women with COVID-19 (P-COVID-19+; n = 15) were analyzed and compared with nonpregnant women with COVID-19 (NP-COVID-19+; n = 15) or those with physiological pregnancy (P-COVID-19-; n = 13). Serological cytokine and chemokine concentrations, leucocyte immunophenotypes, and mononuclear leucocyte responses to polyclonal stimuli were analyzed in all groups. Higher concentrations of serological TNF-α, IL-6, MIP1b and IL-4 were observed within the P-COVID-19+ group, while cytokines and chemokines secreted by peripheral leucocytes in response to LPS, IL-6 or PMA-ionomicin were similar among the groups. Immunophenotype analysis showed a lower percentage of HLA-DR+ monocytes in P-COVID-19+ than in P-COVID-19- and a higher percentage of CD39+ monocytes in P-COVID-19+ than in NP-COVID-19+. After whole blood polyclonal stimulation, similar percentages of T cells and TNF+ monocytes between groups were observed. Our results suggest that P-COVID-19+ elicits a strong inflammatory response similar to NP-COVID19+ but also displays an anti-inflammatory response that controls the ATP/adenosine balance and prevents hyperinflammatory damage in COVID-19.

MODERN DIAGNOSIS OF PLACENTAL DYSFUNCTION AND ITS COMPLICATIONS

The aim of the study was to improve the modern diagnosis of placental dysfunction and its complications. Materials and methods. The study involved a prospective survey of 70 pregnant women divided into the main group (pregnant women with placental dysfunction) (n = 50) and the control group (n = 20). The main group was divided into subgroups of pregnant women with placental dysfunction and fetal growth retardation (n = 30) and pregnant women with placental dysfunction without fetal growth retardation (n = 20). The control group comprised 20 pregnant women with physiological gestation. Apart from history taking, the study comprised obstetric and general clinical examination, evaluation of endothelium- dependent vasodilation, serum concentrations of soluble forms of vascular and platelet- endothelial molecules of cell adhesion 1, indicators of athrombogenicity of the vascular growth wall, uterine-placental-fetal blood circulation, pathomorphological and histometric examination of the placenta. Results. Based on the obtained clinical-morphological and endotheliotropic criteria, a personalized clinical algorithm for managing pregnant women with placental dysfunction was developed and implemented. Conclusions. Assessment of pregnancy results in a prospective clinical study showed that the proposed algorithm for personalization of the risk of perinatal abnormalities not only helped to avoid antenatal mortality, but also to prevent intranatal and early neonatal losses in patients with placental dysfunction and fetal growth retardation.

Maternal and Neonatal Evaluation of Derived Reactive Oxygen Metabolites and Biological Antioxidant Potential in Donkey Mares and Foals.

Simple SummaryThe aim of the study was to measure the concentrations of derived reactive oxygen metabolite (d-ROMs) and the biological antioxidant potential (BAP) of donkey mares and foals in order to evaluate the maternal and neonatal oxidative status at delivery and to verify the protective role of the placenta against fetal oxidative stress. A total of 15 Amiata jennies and 17 foals (four foals were born from twin foaling) were included. Immediately after delivery, maternal and foal venous blood samples were drawn from the jugular vein and from one of the two umbilical arteries. Plasma samples were evaluated for d-ROMs and BAP. Lactate was also assessed from whole blood. Statistical analysis was performed. Blood lactate was higher in foals than in their dams. Our results support the hypothesis that the placenta may be a protective barrier against oxidative damage and that the antioxidant system is not well formed at birth in donkey foals.Our aim was to measure the concentrations of derived reactive oxygen metabolite (d-ROMs) and biological antioxidant potential (BAP) of donkey mares and foals at delivery and to verify the protective role of the placenta against fetal oxidative stress. A total of 15 Amiata jennies with a physiological gestation length and delivery were included together with 17 foals (two twin foalings). After delivery, maternal and foal venous blood samples were collected along with blood from the artery. Circulating lactate and plasma d-ROMs and BAP were evaluated. The Wilcoxon test for paired data was applied to verify differences in d-ROMs and BAP values, while the Spearman test was used to evaluate correlations. A significantly higher d-ROMs concentration was found in jennies compared to their foals, and to the umbilical artery blood. The BAP was higher in jennies than in their foals, but no differences were observed in the umbilical artery blood. No difference was found between foals and their umbilical cord. Blood lactate was higher in foals than in their dams. Positive correlations were found between mares and umbilical cord for BAP and d-ROMs, and between mares and foals and umbilical cord for BAP. In conclusion, the placenta may be a protective factor for the fetus. As with equine foals, the antioxidant system of donkey foals does not seems to be effective at birth.

Myo-Inositol as a Key Supporter of Fertility and Physiological Gestation.

Pregnancy is a complex process, featuring several necessary changes in women’s physiology. Most women undergo healthy pregnancies; even so, several women experience reduced fertility or pathologies related to the pregnancy. In the last years, researchers investigated several molecules as promoters of fertility. Among all, myo-inositol (myo-ins) represents a safe compound that proved useful in issues related to fertility and pregnancy. In fact, myo-ins participates in several signaling processes, including the pathways of insulin and gonadotropins, and, therefore, it is likely to positively affect fertility. In particular, several clinical trials demonstrate that its administration can have therapeutic effects in infertile women, and that it can also be useful as a preventive treatment during pregnancy. Particularly, myo-ins could prevent the onset of neural tube defects and the occurrence of gestational diabetes mellitus, promoting a trouble-free gestation. Due to the safety and efficiency of myo-ins, such a treatment may also substitute several pharmaceuticals, which are contraindicated in pregnancy.

Violation of the balance of free metals and metal-containing proteins in amniotic fluid in placental insufficiency.

The content of metal ions and proteins containing or binding these metals in amniotic fluid during different periods of physiological pregnancy and placental insufficiency (PI) was studied. The content of zinc, copper, magnesium, iron, zinc-α-2-glycoprotein, ferritin, ceruloplasmin and the activity of Ca2+, Mg2+-ATPase were estimated using spectrophotometric methods, immunoturbometric and enzyme immunoassay methods. It was found that in PI in both trimesters there is a decrease in the content of zinc, copper, iron and an increase in the level of copper. The indices of ceruloplasmin, ferritin, Ca2+, Mg2+-ATPase in PI are lower, and zinc-α-2-glycoprotein is higher than in similar periods of physiological gestation. A close correlation of different directions has been established between the level of metals and the corresponding proteins. The revealed violations obviously play a certain pathogenetic role in the development of PI, and the indicators of the ratio between metals can serve as markers for predicting the state of newborns.

Features of violation of maturation of the chorionic tree of the placenta at immaturity of the placental bed of the uterus on the background of iron deficiency anemia in pregnant women in terms of chronic insufficiency of manure

The authors of the article investigated the quantitative parameters of the placental chorion tree during physiological pregnancy and gestation against the background of iron deficiency anemia. It has been established that iron deficiency anemia in pregnant women inhibits the development of the placental chorionic tree, which is explained by the formation of chorionic villi (through trophoblastic and free processes) and violation of the transition of terminal villi to terminal "specialized" villi. The diagnosis of chronic placental insufficiency during pregnancy on the background of iron deficiency anemia can be verified morphologically based on quantitative indicators of assessment of the structure of the placental chorionic tree - the percentage of terminal villi should be higher than 43% and the percentage of terminal "specialized" villi lower than 15%.

MORPHOLOGICAL COMPOSITION OF BLOOD AND BIOCHEMICAL PROCESSES IN THE ORGANISM OF FEMALE RATS F1 UNDER LONG-TERM EXPOSURE OF CITRIC ACID

The paper considers the effect on rats of long-term feeding of an aqueous solution of citric acid (C6H12O6 x H2O, "chemically pure.") in the amount of 8 mg/l. The study was performed on 10 laboratory female rats F1 of the Wistar line, obtained from F0 females. Two groups were set up: control and experimental, 5 animals in each. Animals were under standard conditions with natural light regime day/night, aqueous solutions of citrate, water, and feed received ad libitum. Were determined the morphological composition and biochemical parameters of the blood of female F1 rats. The results of the study indicate the absence of an unfavorable effect of citric acid on red blood cells. Concerning white blood, there is a decrease in the number of leukocytes, which may be due to the development of an adaptive response of the body to citric acid or the inhibition of citric acid's immune response to long-term adaptive action. There is a significant increase in the relative content of eosinophils in females F1, which probably may be due to the action of citric acid. The analysis of the obtained results of blood biochemical parameters indicates a certain tendency to decrease, in terms of control, the content of serum iron, as well as its total and unsaturated Fe-binding capacity. Ferrum saturation of serum transferrin was present at the level of animals in the control group. Analysis of the study results indicates no changes in control in the activity of enzymes: Alkaline phosphatase ALT and AST, also have no statistically significant confirmation of differences in the control group. The level of urea was statistically not significantly higher in terms of control. Thus, long-term watering of citric acid to female rats in the generation F0 and F1 during their physiological and sexual gestation and pregnancy reveal un-favorable effects in female rats F1. However, there was distinguished the adaptive immune-biological response of the animals organism. The immunological response was supported by a decrease in the number of leukocytes and a significant increase in the relative content of eosinophils. The results of biochemical studies of serum indicate the absence of statistically significant differences in animals of the control group.

«Беременность – естественная модель метаболического синдрома»: результаты динамического исследования физиологической гестации

«Беременность – естественная модель метаболического синдрома»: результаты динамического исследования физиологической гестации

EVALUATION OF HORMONAL ASPECTS BY CERVICAL INSUFFICIENCY IN WOMEN WITH HISTORY OF INFERTILITY

Introduction. Today, the frequency of infertility is increasing worldwide. Infertility, associated with anovulation, is especially challenging for the medical correction especially. The leading aspect of this problem is hormonal disorders in the body of a woman. The aim of this study was to assess the level of estradiol and progesterone in the blood serum of pregnant women with cervical insufficiency and infertility associated with anovulation in the history. Materials and methods. The main group included 30 pregnant women with the II trimester of pregnancy, who had cervical insufficiency and infertility associated with anovulation in the past medical history. They got pregnant after assisted reproductive technologies. The control group included 30 pregnant women without cervical insufficiency and with physiological gestation. Estradiol and progesterone levels in blood serum were determined at 20-22 and 30-32 weeks of gestation. Results. The average age of the women in the basic group was statistically higher relative to the control one – 31.30±1.16 and 27.30±0.92 years, respectively (p=0.02). There was no difference in the number of pregnancies in women between both groups. In the main group, 73.33% of the persons were primagravida, 10.00 % of patients had two pregnancies, and 16.67 % - three pregnancies. 56.67 % of the women in the control group were primagravida, 26.67 % had two pregnancies, 16.66 % - three pregnancies. Although primaparas predominated in both groups, the number of such women was in 1.47 times higher in the main group (93.33 %) than in control (63.33 % of patients; χ2=6.28, p=0.01); 6.67 % and 26.67 % women had two labors respectively and 10.00 % of healthy patients - three labors. The concentration of estradiol at the 20-22 and 30-32 weeks of pregnancy in women of the main group almost corresponded to physiological parameters. However, the progesterone level in women with cervical insufficiency and a history of infertility was by 13.44 % lower than in healthy pregnant women at 20-22 weeks, and by 17.02% at 30-32 weeks (p=0.003). Conclusions. In pregnant women with cervical insufficiency and infertility associated with anovulation, the level of estradiol in the II and III trimesters of gestation mainly corresponds to the level of physiological pregnancy. However, they have the decrease in progesterone concentration in the III trimester of pregnancy relative to healthy pregnant women (p<0.003).

Seasonal periodicity of melatonin exchange and hormonal status of pregnant women in dependence on fetus sex

Objective:to study melatonin metabolism and hormonal status of pregnant women in different seasons of the year, depending on the sex of the fetus. Materials and methods:538 women were examined at the time of physiological gestation of 37-40 weeks. The first group — 286 pregnant women with female fetuses and the second group — 254 pregnant with male fetuses. Estimation of the hormonal status included the determination of the level of cortisol, estradiol, adrenocorticotropic hormone, progesterone, testosterone in the blood and melatonin in the urine of pregnant women.Results:the level of 6-sulphatoxymelatonin in the morning urine, regardless of the sex of the fetus, was higher in the seasons of the year with the predominance of the dark time of the day. Absolute levels of 6-sulphatoxymelatonin in urine in all women in 37-40 weeks of gestation were the lowest in the light-saturated summer and spring months of the year, while in the winter period its parameters were maximal. Melatonin production was statistically significantly higher in pregnant women with female fetuses during the fall and winter periods of the year. Regardless of the time of the year, in pregnant women with female fetuses, the absolute levels of estradiol and progesterone were higher than in the case of the male fetus. The highest values in the case of the female fetus were noted in the spring. Testosterone production was significantly higher in pregnant women with male fetuses mainly in the spring season. Stress resistance of pregnant women was higher in the summer months. Depending on the “sex of the fetus” factor, stress hormones in the summer had the highest values in pregnant women with male fetuses.Conclusions:the sex of the fetus is a significant factor affecting the seasonal variability of melatonin production, sexual and stress hormones in pregnant women due to the formation of the specificity of the systemic signaling between the maternal and the fetal organism in the dynamics of pregnancy.

B-mode ultrasonography and ecobiometric parameters for assessment of embryonic and fetal development in sheep

The aim in this study was to evaluate the maternal-fetal development during physiological gestation in sheep by means of ultrasonography and to predict the gestational age by mathematical formulae. Thirty Santa Inês sheep were included. Evaluations were performed weekly from the 3rd to 21st gestational week. The Shapiro test was used to determine normality of the data, and Spearman test was used for determining correlations of real or transformed measurements as gestation advanced. If there was a significant difference detected, variable adjustments and gestational weeks were tested using regression models. Significance level was set at 5% and the results presented as mean ± SD. Principal components analysis (PCA) was used for data clustering and graphic analysis. The gestational vesicle, abdominal, thoracic, biparietal, ocular orbit, and placentome diameters; and the lengths of crown-to-rump, nuchal to snout, scapula, humerus, radius, metacarpus, femur, tibia, metatarsal, heart length, heart width and kidneys were measured. Using pulsed Doppler ultrasonography, heart rate (HR) was obtained. The greatest coefficients of determination (r²) were obtained for the biparietal diameter (BPD; 96.5%) and metacarpus length (MCAR; 93%), followed by the abdominal diameter (AD; 91.7%) and heart width (HTW; 90.2%). The PCA analysis indicated graphically that at week 8 to 9, there was no significant change related to technique, whereas, at weeks 19, 20, and 21 a decrease in growth was observed, with the greatest data variability at week 19. Ultrasonographic assessments indicated there were significant correlations between developmental stages of all maternal-fetal structures and the gestational age, which can be used as reference values for gestational age assessments and detection of development abnormalities.

Extra-uterine (abdominal) full term foetus in a 15-day pregnant rabbit

BackgroundWhile ectopic pregnancies account for 1–2% of all pregnancies, abdominal pregnancy is extremely rare, accounting for approximately 1% of ectopic pregnancies. Extrauterine abdominal pregnancy is defined as the implantation and development of an embryo in the peritoneal cavity. The present report is the first of an incidental case of abdominal pregnancy within four full-term foetus simultaneously with 2 weeks of physiological gestation in a healthy doe rabbit.Case presentationThe doe was born on November 3, 2014 and the first partum took place on May 18, 2015. The doe had previously delivered and weaned an average of 12.0 ± 1.41 live kits at birth (no stillbirths were recorded) during 5 consecutive pregnancies. The last mating was on December 18, 2015 and the detection of pregnancy failure post breeding (by abdominal palpation) on December 31, 2015. Then, the doe was artificially inseminated on January 27, 2016, diagnosed pregnant on February 11, 2016 and subsequently euthanized to recover the foetus. A ventral midline incision revealed a reproductive tract with 12 implantation sites with 15 days old foetus and 4 term foetus in abdominal cavity. There were two foetus floating on either side of the abdominal cavity and two suspended near the greater curvature of the stomach. They were attached to internal organs by means of one or 2 thread-like blood vessels that linked them to the abdominal surfaces.ConclusionsIn our opinion a systematic monitoring of rabbit breeding should be included to fully understand and enhance current knowledge of this phenomenon of abdominal pregnancy.

MORPHOLOGICAL RESEARCH ON FREE-RESIDUE OXIDATION PROCESSES IN CASES OF DECIDUAL CELLS OF PLACENTA IN CHORIOAMNIONOTIS AND BASAL DECIDUITIS COMBINED WITH IRON-DEFICIENCY ANEMIA IN THE PREGNANT

Background. The oxidative modification of proteins is lately pivotal to pathologists and it is a new way of research on different pathological conditions, as well as the diagnostics of inflammation processes in placenta.Objective. The study was aimed at the research of nitro peroxides and establishing the specific features of oxidative modification of proteins in inflammation of placenta with iron deficient anaemia in the pregnant.Methods. Сhemiluminescent and histochemical technique (with bromphenol blue on ‘acidic’ and ‘basic’ proteins according to Mikel Calvo) was applied.Results. The intensity of nitro peroxides glow in chorioamnionitis and basal deciduitis increased in comparison with the samples of physiological and iron deficient anaemia gestation. At the same time in chorioamnionitis the glow intensity is higher than in basal deciduitis.Due to the results of immune histochemical technique held while analysing the samples, together with chorioamnionitis and basal deciduitis the R/B increases and in basal deciduitis the rate, is probably, higher, than in chorioamnionitis. At the same time, the extent of oxidative modification of proteins in cases of inflammation with iron deficient anaemia in the pregnant is on the average higher than with no iron deficient anaemia in the pregnant.Conclusions. High level of nitro peroxides in placentae basal plate in secundines inflammation, the increase in R/B rate, in other words the prevalence of ‘acidic’ proteins over ‘basic’ ones, is evidenced due to the increase of the intensity of oxidative modification processes of proteins in cases of deciduitis.

Комплексна терапія плацентарної дисфункції у вагітних з маловоддям

The objective: to improve the treatment of placental dysfunction in pregnant women with oligohydramnios regarding their psychological condition. Patients and methods. Survey was conducted in 120 pregnant women with oligohydramnios the gestational age of 27-29 weeks (main group) and 30 physiologically healthy pregnant women (control group) on the basis of the city clinical hospital of Ivano-Frankivsk. Results. During the study of psychological features we have not yet determined significant differences in the level of personal anxiety with oligohydramnios as compared with pregnant women with physiological gestation. Also, was found the division of examined for low, medium, and high levels of this indicator between the two pregnant groups. In particular, approximately half of the individuals had an average level of personal anxiety – 14 (46.67±9.11%) and 57 healthy pregnant women (47.50±4.56%) with oligohydramnios, third – highest, respectively 11 (36.67±8.80%) and 39 (32.50±4.58%), the lowest level recorded in 5 (16.67±6.80 per cent) and 24 (20.00±3.65%) patients. A comprehensive approach to correction of the condition of water shortage has been applied in women of the main group, which included: psychological support for couples with sessions with a psychologist to control emotions. Establishing emotional contact with a woman, trust relationships, discussion of physical and emotional changes is a part of pregnancy. Conclusion. In the result of the researches, the approach proposed by us to the treatment of pregnancy with oligohydramnios, allowed to reduce the stress of compensatory mechanisms of the fetoplacental unit, which contributed to the reduction of anxiety in pregnant and have improved not only obstetric but also perinatal outcomes in women of the main group. Key words: pregnancy, placental dysfunction, oligohydramnios, Cytoflavin.