Placental Blood Research Articles

Umbilical Vein Pulse Wave Spectral Analysis: A Possible Method for Placental Assessment Through Evaluation of Maternal and Fetal Flow Components.

Placental blood flow analysis is complicated by having both maternal and fetal flow components. Using the Fast Fourier Transform (FFT) of the umbilical venous pulse wave spectra (PW) envelope, we could simultaneously assess maternal/fetal blood flow in the placenta and investigate if normal and intrauterine growth restriction (IUGR)/pre-eclamptic pregnancies could be distinguished. This retrospective study included normal gestations (N=11) and gestations with IUGR, pre-eclampsia, or both (N=13). Umbilical vein PW were acquired and spectral envelopes were identified as a function of time and analyzed by FFT. Base-10 logarithms of the ratios of the maternal/fetal spectral peaks (LRSP) were compared in normal and IUGR/pre-eclamptic populations (two-tailed t-test). Body mass index (BMI), gestational age at scan time, placental position, and weight-normalized umbilical vein blood volume flow (two-tailed t-test, analysis of variance [ANOVA] analysis) were tested. P < .05 was considered significant. The LRSP for normal and IUGR/pre-eclamptic pregnancies were 0.141 ± 0.180 and -0.072 ± 0.262 (mean ± standard deviation), respectively (P=.033). We detected differences between normal gestations and combinations of LRSP and weight-normalized umbilical venous blood flows. Placental effects based on LRSPs and blood flow may act synergistically in cases with both pre-eclampsia and IUGR (P=.014). No other significant associations were seen. In this preliminary study, we showed that umbilical venous flow contains markers related to placental maternal/fetal blood flow, which can be used to assess IUGR and pre-eclampsia. When coupled with umbilical cord blood flow, this new marker may potentially identify the primary causes of the two conditions.

Prevalence of Malaria and Associated Factors among Delivering Mothers in Northwest Ethiopia.

Background Malaria is one of the leading causes of morbidity and mortality especially in pregnant women and under-five-year-old children. However, data on the prevalence among delivering mothers, potential fetal transmission, and associated birth outcomes is lacking in Ethiopia. Objective To assess the prevalence of Plasmodium infection from peripheral, placental, and cord blood samples among delivering mothers in Kuch health center, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted among 218 delivering mothers from February to May 2021 in Kuch health center. Data on sociodemographic characteristics and clinical and obstetric history of mothers were collected using a structured questionnaire. Giemsa stained blood films from maternal capillary and placental and umbilical cord blood were examined for plasmodium infection. Data were analyzed using Statistical Package for the Social Sciences version 23 software package. Results The prevalence of maternal, placental, and umbilical cord malaria was 6.4% (14/218), 2.3% (5/218), and 0.5% (1/218), respectively. Plasmodium falciparum and Plasmodium vivax accounted 3.7% (8/218) and 2.8% (6/218), respectively, in maternal peripheral blood but only Plasmodium falciparum was detected in placental and umbilical cord blood samples. Maternal malaria had significant association with primigravida (χ2 = 12.611, p = 0.002) and low birth weight (χ2 = 8.381, p = 0.004). Placental malaria was also significantly associated with low birth weight (χ2 = 32.255, p ≤ 0.001). Conclusion The prevalence of malaria among delivering mothers was considerable. Maternal peripheral malaria had a significant association with gravidity and birth weight. Placental and umbilical cord malaria also had a significant association with birth weight. Pregnant mothers should be examined for malaria and receive appropriate treatment to prevent adverse birth outcomes.

In utero exposure to parabens and early childhood BMI z-scores - Associations between placental ethyl paraben, longitudinal BMI trajectories and cord blood metabolic biomarkers.

Parabens are used as antimicrobial preservatives in personal care products. Few studies have dealt with adverse health outcomes, transplacental transfer, and obesogenic effects of prenatal exposure to parabens. We examined the association between placental paraben levels and cord blood metabolic biomarkers, considering modulating effects of maternal pre-pregnancy BMI and underlying epigenetic mechanisms, and investigated longitudinal effects of in utero paraben exposure on early childhood trajectories of BMI z-scores. Placental concentrations of four parabens [methyl (MeP), ethyl (EtP), propyl (PrP), and butyl (BuP)] were measured by ultra-performance liquid chromatography/tandem mass spectrometry in 229 placentas of the ENVIRONAGE birth cohort. The association with cord blood metabolic biomarkers [glucose, insulin, γ-glutamyltransferase (GGT), high-density and low-density lipoprotein (HDL and LDL)] was analyzed in multiple regression models with two different sets of, a priori selected potential confounders, additionally stratified for different maternal BMI groups and assessed by causal mediation analysis. The association between placental paraben concentration and differential DNA methylation of CpGs annotated to GGT and longitudinal measurements of BMI z-scores were investigated with adjusted linear mixed models. The geometric means of placental MeP, EtP, PrP, and BuP levels above the limit of detection (LOD) were 4.42, 1.32, 1.51, and 0.35ng/g respectively, with only EtP showing sufficient (88%) measurements above LOD for further analyses. An interquartile ratio (IQR) increase in placental EtP was associated with an increase of 12.61 % (95% CI: 1.80 24.57) in the geometric mean of cord GGT activity, and with a decrease of -3.64 % (95% CI: -6.80 to -0.39) in the geometric mean of cord glucose. Placental EtP levels were significantly associated with hypermethylation of cg08612779 annotated to GGT7 after correcting for multiple testing (ß = 0.0017, p=0.049). An interquartile ratio (IQR) increment in placental EtP was associated with a decrease in longitudinal BMI z-score of 0.27 points (95% CI: -0.46 to -0.088). Prenatal EtP exposure may affect early childhood BMI. The association of placental EtP with cord blood GGT and glucose levels provides a starting point for further research on mechanisms of paraben-related metabolic processes in utero.

Elevated expression of galectin-3, thioredoxin and thioredoxin interacting protein in preeclampsia.

Preeclampsia (PE) is a pregnancy-related syndrome characterized by the onset of hypertension and proteinuria that can lead to end-organ dysfunction. Galectin-3 (Gal-3) is involved in cell growth, differentiation, inflammation and fibrosis. Thioredoxin (TXN) acts as antioxidant enzyme in several cellular processes, regulating inflammation and inhibiting apoptosis. TXNIP is an endogenous inhibitor of TXN. We evaluated changes in the inflammatory response of Gal-3, TXN, and TXNIP at the level of maternal blood, placenta, and umbilical cord blood of women with PE. Ten women with PE and 20 with normal pregnancy (NP) were recruited during admission for delivery. Blood samples were obtained from parturients and umbilical cords, and placental tissue for analysis. Gal-3 and TXNIP mRNA expression were higher in maternal plasma in PE group compared to NP and were lower in cord blood plasma and placentas in the PE group. In the PE group, TXN/TXNIP mRNA ratio was higher in cord blood plasma (2.07) compared to maternal plasma (1.09). TXN/TXNIP placental protein ratio was similar between PE (0.89) and NP (0.79). ELISA demonstrated that Gal-3 levels in maternal serum were significantly higher in the PE vs. the NP group. Pro-inflammatory changes were expressed by high Gal-3 and TXNIP mRNA in maternal blood of PE women, but not in their placental and cord blood samples. These findings may imply that the placenta has a role in protecting the fetus from the damages of inflammatory response, which is more common in PE than in NP.

MRI characterization of hemodynamic patterns of human fetuses with cyanotic congenital heart disease.

To characterize, using magnetic resonance imaging (MRI), the distribution of blood flow and oxygen transport in human fetuses with subtypes of congenital heart disease (CHD) that present with neonatal cyanosis. Blood flow was measured in the major vessels of 152 late-gestation human fetuses with CHD and 40 gestational-age-matched normal fetuses, using cine phase-contrast MRI. Oxygen saturation (SaO2 ) was measured in the major vessels of 57 fetuses with CHD and 40 controls. Compared with controls, we found lower combined ventricular output in fetuses with single-ventricle physiology, with the lowest being observed in fetuses with severe forms of Ebstein's anomaly. Obstructive lesions of the left or right heart were associated with increased flow across the contralateral side. Pulmonary blood flow was reduced in fetuses with Ebstein's anomaly, while those with Ebstein's anomaly and tricuspid atresia had reduced umbilical flow. Flow in the superior vena cava was elevated in fetuses with transposition of the great arteries, normal in fetuses with hypoplastic left heart, tetralogy of Fallot or tricuspid atresia and reduced in fetuses with Ebstein's anomaly. Umbilical vein SaO2 was reduced in fetuses with hypoplastic left heart or tetralogy of Fallot. Ascending aorta and superior vena cava SaO2 were reduced in nearly all CHD subtypes. Fetuses with cyanotic CHD exhibit profound changes in the distribution of blood flow and oxygen transport, which result in changes in cerebral, pulmonary and placental blood flow and oxygenation. These alterations of fetal circulatory physiology may influence the neonatal course and help account for abnormalities of prenatal growth and development that have been described in newborns with cyanotic CHD. © 2021 International Society of Ultrasound in Obstetrics and Gynecology.

Aldosterone and renin concentrations were abnormally elevated in a cohort of normotensive pregnant women.

During pregnancy, the renin-angiotensin-aldosterone system (RAAS) undergoes major changes to preserve normal blood pressure (BP) and placental blood flow and to ensure a good pregnancy outcome. Abnormal aldosterone-renin metabolism is a risk factor for arterial hypertension and cardiovascular risk, but its association with pathological conditions in pregnancy remains unknown. Moreover, potential biomarkers associated with these pathological conditions should be identified. To study a cohort of normotensive pregnant women according to their serum aldosterone and plasma renin levels and assay their small extracellular vesicles (sEVs) and a specific protein cargo (LCN2, AT1R). A cohort of 54 normotensive pregnant women at term gestation was included. We determined the BP, serum aldosterone, and plasma renin concentrations. In a subgroup, we isolated their plasma sEVs and semiquantitated two EV proteins (AT1R and LCN2). We set a normal range of aldosterone and renin based on the interquartile range. We identified 5/54 (9%) pregnant women with elevated aldosterone and low renin levels and 5/54 (9%) other pregnant women with low aldosterone and elevated renin levels. No differences were found in sEV-LCN2 or sEV-AT1R. We found that 18% of normotensive pregnant women had either high aldosterone or high renin levels, suggesting a subclinical status similar to primary aldosteronism or hyperreninemia, respectively. Both could evolve to pathological conditions by affecting the maternal vascular and renal physiology and further the BP. sEVs and their specific cargo should be further studied to clarify their role as potential biomarkers of RAAS alterations in pregnant women.

Ocular drug delivery system &amp;#40;ODDS&amp;#41;: Exploration the challenges and approaches to improve ODDS

The remarkable life structures and physiology of the eye presents huge difficulties to researchers in the field of visual medication conveyance frameworks. Nearby infusion is the most fitting and proper medication organization technique for the treatment of foremost front sickness. There are two kinds of hindrances in ophthalmic medication conveyance frameworks: static boundaries and dynamic obstructions. Static lamellae contain corneal, dermal, retinal, and retinal vessels while dynamic lamellae contain placental blood stream, conjunctiva, tear evacuation, and lymphatic seepage. These limitations influence the bioavailability of the medication. This article examines the limits of customary ophthalmic practice and the central point affecting the pharmacokinetics of the eye. Likewise, eye salves, gels, prodrugs, intranasal infusions, thickeners, entrance energizers, liposomes, microparticles, nanoparticles, visual infusions, inserts, nanoparticles, nanostructures, microemulsions, gels and periocular infusions. It guarantees the bioavailability of the medication and the controlled and constant control of the medication in the foremost and back alveoli.

The Association Between Placental Residual Blood Volume and Two Placental Transfusion Methods After Delivery at Term.

Background: Despite reports of the beneficial effects, such as increasing hemoglobin level and iron store in the neonatal period, of delayed cord clamping, or umbilical cord milking after delivery in healthy term-born infants, the duration of delayed clamping or rounds of milking in most previous reports were determined arbitrarily and varied widely across different studies.Methods: We prospectively recruited 80 women with normal singleton pregnancies at 38–40 weeks' gestation. Participants were classified according to the mode of delivery and randomly assigned to either collecting blood from the placenta by umbilical cord drainage (CD) or cord milking (CM), with the placenta left in the uterus. The volume of blood collected, the duration of CD, and the number of rounds of CM were recorded.Results: Collected placental residual blood volume positively correlated with birth weight, placental weight, and length of the cord. When 80% of the total placental residual blood volume collected was set as the threshold, more than 80% of women who delivered vaginally reached this level within 60 s of CD or seven repetitions of CM. This amount of blood could be obtained within 120 s of CD or after seven repetitions of CM in more than 80% of women who underwent cesarean delivery.Conclusion: In most women, regardless of birth weight and placental weight, more than 80% of placental residual blood volume could be collected by CD within 60 s after vaginal delivery, 120 s after cesarean delivery, and seven repetitions of CM in both vaginal and cesarean deliveries.

MicroRNA signatures associated with fetal growth restriction: a systematic review.

Placental-origin microRNA (miRNA) profiles can be useful toward early diagnosis and management of fetal growth restriction (FGR) and associated complications. We conducted a systematic review to identify case-control studies that have examined miRNA signatures associated with human FGR. We systematically searched PubMed and ScienceDirect databases for relevant articles and manually searched reference lists of the relevant articles till May 18th, 2021. Of the 2133 studies identified, 21 were included. FGR-associated upregulation of miR-210 and miR-424 and downregulation of a placenta-specific miRNA cluster miRNA located on C19MC (miR-518b, miR-519d) and miR-221-3p was reported by >1 included studies. Analysis of the target genes of these miRNA as well as pathway analysis pointed to the involvement of angiogenesis and growth signaling pathways, such as the phosphatidylinositol 3-kinase- protein kinase B (PI3K-Akt) pathway. Only 3 out of the 21 included studies reported FGR-associated miRNAs in matched placental and maternal blood samples. We conclude that FGR-associated placental miRNAs could be utilized to inform clinical practice towards early diagnosis of FGR, provided enough evidence from studies on matched placental and maternal blood samples become available.Prospective Register of Systematic Reviews (PROSPERO) registration number: CRD42019136762.

Impact of COVID-19 on Pregnancy and Maternal Health: An Update

The current pandemic caused by the novel coronavirus disease 2019 (COVID-19) is spreading at an accelerated rate globally. Global concerns were raised following its discovery in December 2019, as previous similar diseases. Diseases such as the severe acute respiratory syndrome-related coronavirus (SARS-CoV) and the Middle East respiratory syndrome-related coronavirus (MERS-CoV) are known to lead to adverse outcomes in pregnant women and those in early maternal stages, with significantly higher rates of complication and mortality compared to other groups of individuals. The anatomical, physiological, and immunological changes that occur during pregnancy lead to higher risks associated with respiratory infections for pregnant women, as they can directly affect the well-being of pregnant women and infants. Vertical transmission of COVID-19 from mother to child was a concern, as such transmission could endanger a child. Three mechanisms of vertical transmission have been suggested: intrauterine transmission, placental blood transmission, and intrapartum transmission. This review discusses the impact and pathogenicity of COVID-19 on the well-being of pregnant and early maternal women, both the clinical aspect, health aspects, and diagnostic and therapeutic options. It will also discuss the adverse outcomes among pregnant women and newborn infants who contract the disease and the different mechanisms of vertical transmission from infected mother to child. The diagnostic and therapeutic approaches of COVID- 19 that have been recently used have also been highlighted, in addition to the challenges faced by pregnant women who have contracted the virus during the pandemic.

PSXII-13 Blood flow parameters in ovine fetuses from different sires

Abstract Placental and fetal development are influenced by paternal genes. Doppler ultrasonography was performed on pregnant ewes to examine the effect of sire on fetal and placental blood flow parameters. Twenty Suffolk ewes were randomly assigned to either a Suffolk ram or a Texel ram. Only ewes carrying twins were used for the study. Ultrasound exams were performed at 60, 90, and 120 (± 3) days post-breeding. Umbilical artery and fetal aorta blood-flow velocities, and aorta vessel diameter were measured. Blood flow velocities were used to calculate the resistance index (RI), which was used for statistical analysis (Glimmix, SAS). Gestational age and weight at birth were recorded. There were 5 Suffolk x Suffolk (SxS) and 6 Suffolk x Texel (SxT) ewes carrying twins to term. For umbilical artery RI, there was no significant (P &amp;lt; 0.05) effect of breed; there was significant effect of time (0.89 ± 0.03a; 0.63 ± 0.03b; 0.59 ± 0.03b LSM ± SE for days 60, 90, and 120 respectively); and there was no interaction. For aorta RI, there was no significant effect of breed; there was significant effect of time (0.73 ± 0.03a; 0.67 ± 0.03ab; 0.63 ± 0.03b for days 60, 90, and 120 respectively); and there was no interaction. For aorta diameter, the effect of breed approached significance (P = 0.054), SxS had a larger average diameter (0.50 ± 0.02 cm) than SxT (0.45 ± 0.01 cm); there was significant effect of time (0.24 ± 0.03a; 0.46 ± 0.02b; 0.72 ± 0.02c cm for days 60; 90; and 120 respectively); and there was no interaction. There were no significant differences between sires for weight or gestational age at birth. The results correspond with the changes in fetal and placental vascular resistance over time; however, further research is needed to expand our knowledge on the effect of sire.

T-Cell Homeostatic Imbalance in Placentas From Women With Human Immunodeficiency Virus in the Absence of Vertical Transmission.

Implementation of universal antiretroviral therapy (ART) has significantly lowered vertical transmission rates but has also increased numbers of human immunodeficiency virus (HIV)-exposed uninfected children, who remain vulnerable to morbid effects. In the current study, we investigated whether T-cell alterations in the placenta contribute to altered immune status in HIV-exposed uninfected. We analyzed T cells from term placenta decidua and villous tissue and paired cord blood from pregnant women living with HIV (PWH) who initiated ART late in pregnancy (n = 21) with pregnant women not living with HIV (PWNH) (n = 9). Placentas from PWH showed inverted CD4/CD8 ratios and higher proportions of tissue resident CD8+ T cells in villous tissue relative to control placentas. CD8+ T cells in the fetal capillaries, which were of fetal origin, were positively correlated with maternal plasma viremia before ART initiation, implying that imbalanced T cells persisted throughout pregnancy. In addition, the expanded memory differentiation of CD8+ T cells was confined to the fetal placental compartment and cord blood but was not observed in the maternal decidua. T-cell homeostatic imbalance in the blood circulation of PWH is reflected in the placenta. The placenta may be a causal link between HIV-induced maternal immune changes during gestation and altered immunity in newborn infants in the absence of vertical transmission.

Fetal Sex Does Not Impact Placental Blood Flow or Placental Amino Acid Transfer in Late Gestation Pregnant Sheep With or Without Placental Insufficiency.

Pregnant sheep have been used to model complications of human pregnancies including placental insufficiency and intrauterine growth restriction. Some of the hallmarks of placental insufficiency are slower uterine and umbilical blood flow rates, impaired placental transport of oxygen and amino acids, and lower fetal arterial concentrations of anabolic growth factors. An impact of fetal sex on these outcomes has not been identified in either human or sheep pregnancies. This is likely because most studies measuring these outcomes have used small numbers of subjects or animals. We undertook a secondary analysis of previously published data generated by our laboratory in late-gestation (gestational age of 133 ± 0days gestational age) control sheep (n = 29 male fetuses; n = 26 female fetuses; n = 3 sex not recorded) and sheep exposed to elevated ambient temperatures to cause experimental placental insufficiency (n = 23 male fetuses; n = 17 female fetuses; n = 1 sex not recorded). The primary goal was to determine how fetal sex modifies the effect of the experimental insult on outcomes related to placental blood flow, amino acid and oxygen transport, and fetal hormones. Of the 112 outcomes measured, we only found an interaction between fetal sex and experimental insult for the uterine uptake rates of isoleucine, phenylalanine, and arginine. Additionally, most outcomes measured did not show a difference based on fetal sex when adjusting for the impact of placental insufficiency. Exceptions included fetal norepinephrine and cortisol concentrations, which were higher in female compared to male fetuses. For the parameters measured in the current analysis, the impact of fetal sex was not widespread.

A clinical and in-silico study exploring the association of CASP-3, NF-kB, miR-187, and miR-146 in pre-eclampsia

ABSTRACT Introduction Apoptosis is involved in pathogenesis of Pre-eclampsia (PE), further research is needed to determine its molecular mechanism. Methods The study recruited two groups (controls; 09, PE; 11). Biochemical tests, RT-PCR and ELISA were employed for analysis of genes and MicroRNAs (miRNA). Bioinformatics tools were employed for interactomics analysis. Results There was increased apoptosis in maternal placental tissue (MPT) and Maternal Blood Cells (MBC) as demonstrated by expression of CASP3 and NF-κB1. miR-146-5p and 187-5p were downregulated in MBC and MPT but upregulated in fetal placental tissue (FPT).. Discussion An increased apoptosis in MBC and MPT is a significant contributory factor for PE in pregnancy, while FPT is immune to the aforementioned effects.

Impact of calcium nitrate supplementation on the oxygen-carrying capacity of lactating sows and their offspring.

Calcium nitrate supplementation has recently been suggested to provide potential benefits to sows and, in particular, their offspring when administered at a level of 1,200 ppm in feed shortly before farrowing through lactation. More specifically, nitrate supplementation has been suggested as one opportunity for improved placental and/or fetal blood flow and has been hypothesized in previous work to be important to the swine industry in light of the global trend toward larger litter sizes. The benefit is likely manifested through exposure to the nitrate moiety, but interestingly, nitrate has historically been considered a compound of concern for swine. High levels of nitrate once metabolized to nitrite can interfere with the oxygen-carrying capacity of hemoglobin, resulting in increased methemoglobin and, subsequently, methemoglobinemia (MetHb) if the animal is deprived of significant amounts of oxygen; however, the level of nitrate exposure necessary to induce MetHb in sows is not clearly defined. This work was undertaken to examine methemoglobin levels in sows and piglets exposed to the potentially beneficial levels of 1,200 and 6,000 ppm nitrate added to their diets over the course of the periparturient period. Other oxygen capacity blood variables were evaluated (e.g., hemoglobin, hematocrit, and various measures of hemoglobin and red blood cell volumes and concentrations), as well as performance endpoints (weight changes and feed intake) and general observations over the 27-d period. No evidence of treatment-related toxicity manifestation was observed at these supplemental levels. Nearly all oxygen-related variables were affected by time (independent of treatment), indicating adaptive general effects of farrowing. These findings support the hypothesis that MetHb is not a concern up to at least 6,000 ppm supplemental nitrate exposure, even in combination with additional nitrate in the sow’s daily diet. This work is important to help swine producers understand that consideration of nitrate benefit should outweigh concern for risk of nitrate-induced toxicity.

Three Dimensional Power Doppler Ultrasound in Assessment of Placental Volume and Blood Flow and its Correlation with Severity of Pre-Eclampsia

Three Dimensional Power Doppler Ultrasound in Assessment of Placental Volume and Blood Flow and its Correlation with Severity of Pre-Eclampsia

Norepinephrine versus Ephedrine Boluses To Treat Spinal-Induced Hypotension in Cesarean Deliveries

Abstract Corresponding Background Cesarean sections normally require an anesthetic block at T4 level, so hypotension is reported to occur in up to 80% of spinal anesthesia cases. When maternal hypotension associated with spinal anesthesia for cesarean section is severe and sustained, it can lead to serious maternal complications as well as impairment of the uterine and placental blood flow with consecutive fetal hypoxia, acidosis, and neurological injury. Aim of the Work to compare the administration of intermittent i.v. boluses of norepinephrine and ephedrine to counterbalance the hypotensive effect of spinal anesthesia during cesarean delivery. The results of the study showed that compared with ephedrine, norepinephrine maintained maternal blood pressure and uterine artery blood flow. Further, it was associated with lower numbers of hypotension and hypertension episodes and less frequency of bradycardia and tachycardia during cesarean delivery. Furthermore, the numbers of boluses of vasopressors used during spinal anesthesia were lower in norepinephrine compared with the use of ephedrine. Conclusion Norepinephrine can be used as an alternative vasopressor to maintain maternal blood pressure during spinal anesthesia for cesarean delivery, with no adverse effect on neonatal outcome.

Asemptomatik gebe kadınlarda COVID-19 taraması: Hangisi daha iyi; rektal mi orofaringeal / nazofaringeal sürüntü mü?

Aim: The aim of the study was to evaluate the incidence of asymptomatic COVID-19 disease in pregnant women withrectal and oropharyngeal/nasopharyngeal swab to compare the efficacy of two samples.Material and Method: This prospective cohort study included 234 asymptomatic pregnant women who had undergoneplanned cesarean section between May 7 and September 24, 2020 in obstetrics unit of a tertiary care center, in Ankara,Turkey. The oropharyngeal/nasopharyngeal swab, rectal swab, placental, amniotic fluid, and cord blood samples wereobtained from all participants. The placental, amniotic fluid, and cord blood samples were tested when any of theoropharyngeal/nasopharyngeal or rectal samples were positive. The real-time reverse transcriptase-polymerase chainreaction (RT-PCR) test was performed to detect SARS-CoV-2 virus in the samples.Results: The incidence of the asymptomatic COVID-19 disease was 0.42% (1/234) in the study population. One of 234oropharyngeal/nasopharyngeal swabs was positive, while none of the rectal swabs including the one positive withoropharyngeal/nasopharyngeal swab were positive for SARS-CoV-2 virus. The RT-PCR test results of the placental,amniotic fluid, and cord blood samples of the COVID-positive case were negative.Conclusion: The incidence of asymptomatic COVID-19 disease in pregnant women who had undergone elective cesareandelivery was low, in Ankara, Turkey. In asymptomatic pregnant women, oropharyngeal/nasopharyngeal swab was foundto be more useful in detecting COVID-19 disease compared to rectal swab. No evidence was found about the intrauterinetransmission of asymptomatic disease.

Comparison of prenatal functional markers of retardation of fetal growth and delayed fetal development with expression of vascular growth factors in the placenta

AIM: The study aimed to investigate and compare Doppler metric indicators in the main arteries of the functional system of the mother, placenta, and fetus as well as the parameters of the activityrest cycle in fetuses with vascular endothelial growth factor (VEGF) expression and placenta growth factor (PlGF) in the presence of physiological pregnancy and placental insufficiency to analyze morphofunctional parallels between these indicators in the third trimester of pregnancy.&#x0D; MATERIALS AND METHODS: Twenty-nine women on the 3435 weeks of pregnancy (period of physiological maturity of the activityrest cycle in the fetus) were screened. The main group consisted of 19 patients. The inclusion criteria were as follows: single-fetal pregnancy, fetometric indicators below the 10th percentile, and presence of blood flow disorders in the main vessels of the motherplacentafetus functional system. The comparison group included 10 relatively healthy women. The criteria for inclusion in the comparison group were as follows: single-fetal physiological pregnancy, fetometric indicators above the 10th percentile, and absence of Doppler disorders of placental blood flow. Fetometry and Doppler studies of the placental blood flow in the main arteries of the functional system of the mother, placenta, fetus were performed using the Voluson 730 Expert ultrasound device (GE, USA). The activityrest cycle in the fetus was evaluated using Sonicaid Team Care fetal monitor (Oxford, UK). Placental tissue was taken from the central placental area for immunohistochemical analysis of VEGF and PlGF expression with primary monoclonal antibodies of the main women group and comparison group after childbirth (1:100, Abcam, UK).&#x0D; RESULTS: A direct correlation between the expression of VEGF in the central zone of the placenta and index resistance (IR), ripple index (RI) in the uterine arteries, as well as the cerebroplacental relationship CPR (r1=0.487; p1=0.035; r2=0.487; p2=0.035; r3=0.578; p3=0.030, respectively) in women of the main group was found. A direct correlation was established between the expression of VEGF in the central zone of the placenta and IR in the umbilical artery (r=0.49; p=0.033) in patients of the main group. The analysis of the restactivity cycle in fetuses of women of the main group showed that at 3435 weeks 73% of them do not form it: the behavior of fetuses is represented only by the activated state. An inverse relationship was found between VEGF expression and the motor-cardiac reflex amplitude (r=0.866; p=0.05) as well as the heart rate oscillation amplitude (r=0.866; p=0.05) in fetuses of women of the main group.&#x0D; CONCLUSIONS: The identified morphofunctional parallels will allow to develop non-invasive pathogenetic prognostic models for prenatal diagnosis of fetal development delay with different degrees of growth restriction.

MicroRNA-3935 promotes human trophoblast cell epithelial-mesenchymal transition through tumor necrosis factor receptor-associated factor 6/regulator of G protein signaling 2 axis

BackgroundInsufficient migration and invasion during trophoblast epithelial-mesenchymal transition (EMT) results in the occurrence and development of preeclampsia (PE), and our previous study has screened 52 miRNAs, whose expression levels are altered in the placental samples from PE patients, compared with the normal group. Among those, miR-3935 is one of the miRNAs being most significantly down-regulated, indicating its involvement in PE. However, the exact effect and molecular mechanisms remain unknown.MethodsIn the present study, we investigate the roles and underlying mechanisms of miR-3935 in trophoblast EMT by use of the human extra-villous trophoblast cell line HTR-8/SVneo as well as human placental tissues and maternal blood samples obtained from 15 women with normal pregnancies and 15 women with PE. Experimental methods include transfection, quantitative reverse transcription-PCR (qRT-PCR), western blot, immunofluorescence staining, dual-luciferase assays, in vitro invasion and migration assays, RNA-Seq analysis, bisulfite sequencing and immunohistochemistry staining.ResultsMiR-3935 expression is significantly decreased in both placentas and peripheral blood specimens of PE, and functionally, miR-3935 promotes EMT of trophoblast cells. Mechanistically, TRAF6 is identified to be a direct target of miR-3935 and TRAF6 exerts its negative effect on EMT of trophoblast cells by inhibition of RGS2, which down-regulates the methylation status of promoter of CDH1 gene that encodes E-Cadherin protein through induction of ALKBH1, resulting in increase of E-Cadherin and subsequently insufficient trophoblast EMT.ConclusionsTogether these results uncover a hitherto uncharacterized role of miR-3935/TRAF6/RGS2 axis in the function of human trophoblasts, which may pinpoint the molecular pathogenesis of PE and may be a prognostic biomarker and therapeutic target for such obstetrical diseases as PE.