Placental Cord Research Articles

Maternal-fetal interface: The contribution of histopathological analysis, molecular detection and indirect immunofluorescence of Treponema pallidum pallidum in placental tissue and umbilical cord

Treponema pallidum can be transmitted to the fetus through the placenta and cause congenital syphilis (CS). Despite that, few studies have focused on the diagnostic approaches used to analyse congenital syphilis. The aim of this study is to compare the diagnosis methods of CS based on the nested PCR-polA (nPCR), direct immunofluorescence (IF), and histopathology of diverse types of biological specimens obtained from the maternal-fetal interface. A cohort of 103 women and their new-born infants was investigated through the analysis of tissue (placenta and umbilical cord), peripheral blood from the mother and infant, and total blood from the umbilical cord by the methods. The women were determined as having syphilis or not based on a clinical-serological diagnosis. Overall, 29.1% of the women investigated were diagnosed as having syphilis, with 70% being classified as recent cases, and 30% as being in the latent phase. The IF and nPCR procedures were equally effective for the detection of T. pallidum in the tissue of the placenta and umbilical cord, with a positive correlation being observed between the histopathological triad for CS and the identification of the spirochetes. The nPCR was more sensitive for the detection of the treponeme in the samples from the neonates and the umbilical cord. Equivalent results were obtained for the detection of T. pallidum using the nPCR and IF approaches. These techniques provided a valuable addition to the serological diagnosis and histopathological findings, and presented considerable potential for the epidemiological monitoring of SC.

The Metabolic Signatures of Surviving Cotwins in Cases of Single Intrauterine Fetal Death During Monochorionic Diamniotic Pregnancy: A Prospective Case-Control Study.

Introduction: Single intrauterine fetal death (sIUFD) in monochorionic diamniotic (MCDA) twin pregnancy may be associated with adverse clinical outcomes and possible metabolic changes in the surviving co-twin. Metabolomic profiling has not been undertaken before in these complex twin pregnancies. Methods: In this prospectively collected case-control study, three cross-cohort comparisons were made between sIUFD MCDA (n = 16), uncomplicated MCDA (n = 16, eight pairs), and uncomplicated singleton pregnancies (n = 8). To identify major sources of variation within the sIUFD MCDA cohort, a secondary comparison was conducted between spontaneous sIUFD (n = 8) and sIUFD in MCDA twins due to selective termination of a single abnormal fetus by radiofrequency ablation (RFA) (n = 8). Metabolomics analysis of placental tissue and umbilical cord plasma was performed using LC-MS profiling. The underlying metabolic networks and pathways were analyzed by web-based platforms. Associations and statistical correlations of all identified differential metabolites with neonatal birthweight and birth length were assessed by multivariable linear regression, adjusted for maternal age and gestation. Results: Across four comparisons, 131 and 111 differential metabolites were identified in placental tissue and cord plasma, respectively, with the highest variation seen between the spontaneous vs. single-induced IUFD in MCDA twins by RFA in the cord plasma. Conversely, the number of viable fetuses and the presence of sIUFD in MCDA twins had the highest impact on metabolite variation in placental tissue. Compounds correlated with fetal growth including placental acylcarnitines and gangliosides, along with specific amino acids (e.g., histidinyl-hydroxyproline), xenobiotics and biliverdin in cord plasma. Conclusion: sIUFD in MCDA twin pregnancy correlates with distinctive metabolic signatures, mostly in fatty acyls and complex lipids, in placental tissue and cord plasma of the surviving cotwin. Some metabolites are also associated with fetal growth.

Fetal heart rate evolution patterns in cerebral palsy associated with umbilical cord complications: a nationwide study

BackgroundThe aim of the present study was to clarify fetal heart rate (FHR) evolution patterns in infants with cerebral palsy (CP) according to different types of umbilical cord complications.MethodsThis case–control study included children born: with a birth weight ≥2000 g, at gestational age ≥33 weeks, with disability due to CP, and between 2009 and 2014. Obstetric characteristics and FHR patterns were compared among patients with CP associated with (126 cases) and without (594 controls) umbilical cord complications.ResultsThere were 32 umbilical cord prolapse cases and 94 cases with coexistent antenatal umbilical cord complications. Compared with the control group, the persistent non-reassuring pattern was more frequent in cases with coexistent antenatal umbilical cord complications (p = 0.012). A reassuring FHR pattern was observed on admission, but resulted in prolonged deceleration, especially during the first stage of labor, and was significantly identified in 69% of cases with umbilical cord prolapse and 35% of cases with antenatal cord complications, compared to 17% of control cases (p < 0.001).ConclusionHypercoiled cord and abnormal placental umbilical cord insertion, may be associated with CP due to acute hypoxic-ischemic injury as well as sub-acute or chronic adverse events during pregnancy, while umbilical cord prolapse may be characterized by acute hypoxic-ischemic injury during delivery.

Probable Mode of Action of &lt;i&gt;Sita kasmaryadi&lt;/i&gt; Herbal Decoction in Placental Compliance – A Review

The occurrence of IUGR (Intra uterine growth retardation) is estimated to be approximately 5% in the population and it is considered as the third leading cause for perinatal mortality in India. Despite plentiful management options, none is effectively proved in improving placental circulation and foetal weight gain. Indian medicine practices a herbal decoction with &lt;em&gt;Glycyrrhiza glabra&lt;/em&gt; Linn., &lt;em&gt;Gmelina arborea Roxb&lt;/em&gt;. ex. &lt;em&gt;Smith&lt;/em&gt; and sugar. The pharmacological potentials of this decoction was attempted to explore here in this review based on available researches. Thorough internet search was performed to derive the data. Recent researches on detailed chemical composition and its possible pharmacological action also had been detailed. It is an effective formulation in improving placental and umbilical cord circulation, aids in improving foetoplacental circulation to a greater extent with negligible side effects.

Impact of placental malaria on maternal, placental and fetal cord responses and its role in pregnancy outcomes in women from Blue Nile State, Sudan

BackgroundThe sequestration of Plasmodium falciparum infected cells in the placenta results in placental malaria (PM). It activates the mother's immune cells and induces secretion of inflammatory cytokines, which might influence pregnancy outcomes. This study aims to investigate the cytokines (levels IL-4, IL-6, IL-10, IL-17A, and INF γ) in maternal peripheral, placental, and umbilical cord blood in response to PM and the extent to which this may influence maternal haemoglobin levels and birth weight.MethodsA total of 185 consenting Sudanese women from Blue Nile State were enrolled at delivery time in a cross-sectional study conducted between Jan 2012-Dec 2015. Malaria infection in the collected maternal peripheral, placental, umbilical cord samples was determined microscopically, and ELISA was used to measure the plasma levels IL-4, IL-6, IL-10, IL-17A, and INF γ in the collected positive and negative malaria samples.ResultsElevated levels of IL-4 and IL-10 and reduced levels of IL-6 were detected in the malaria positive samples in comparison to the negative ones in the three types of the samples investigated. Maternal, IL-4 and IL-10 were significantly higher in the samples collected from the PM infected group compared to the non-infected control (P < 0.001). While the absence of PM was significantly associated with the IL-6 and maternal IFN-γ levels, maternal IL-17A, placental and umbilical cord IFN-γ levels showed no significant difference (P = 0.214, P = 0.065, P = 0.536, respectively) due to infection. Haemoglobin level and birth weight were increased in the group with high levels of IL-6 and IL-17A, but not in the group with IL-4 and IL-10 levels. While significantly negative correlation was found between IFN-γ levels and birth weight for all three types of samples, only maternal peripheral IFN-γ level was significantly positively correlated with maternal haemoglobin (r = 0.171, P = 0.020).ConclusionThese results suggest that PM induces mother’s immune response and impairs her cytokine profile, which might alter maternal haemoglobin levels and the baby's birth weight.

Prevalence of placental malaria among asymptomatic pregnant women in Wolkite health center, Gurage zone, Southern Ethiopia

BackgroundPlacental malaria (PM) is a major public health problem associated with adverse pregnancy outcomes such as low birth weight (LBW), preterm delivery and maternal anemia. The present study is aimed to determine the prevalence of placental malaria among asymptomatic pregnant women in Wolkite health center, Gurage zone, Southern Ethiopia.MethodFacility-based cross-sectional study was carried out from June 2019 to August 2019. A total of 230 pregnant women were involved in the study where socio-demographic data, medical and obstetric history were collected using pretested structured questionnaires. Blood samples were collected at delivery from maternal capillary, placenta and umbilical cord for the detection of malarial parasite. Maternal hematocrit was determined to screen for anemia.ResultIn this study, the prevalence of placental malaria, peripheral malaria and umbilical cord malaria was 3.9% (9/230), 15.2% (35/230) and 2.6% (6/230) respectively. Plasmodium falciparum and Plasmodium vivax were detected by microscopy. All babies with positive umbilical cord blood films were born from a mother with placental malaria. Maternal anemia was recorded in 58.3% of the women. In univariate analysis, placental malaria was significantly associated with LBW (p < 0.001) unlike parity and maternal anemia.ConclusionPlacental malaria among asymptomatic pregnant women is low in Wolkite health centre, Gurage zone in Southern Ethiopia. Moreover, placental malaria was strongly associated with LBW. Thus, further strengthening the existing prevention and control activities and screening of asymptomatic pregnant women as part of routine antenatal care service is very essential.

Mechanisms of Early Adversity Associated Increases In Risk For Psychiatric Disorders

Overall Abstract Early adverse exposures, such as maternal stress or toxins during pregnancy and childhood adversity are thought to result in long-lasting consequences on many systems, including the brain and ultimately in an increased risk for psychiatric disorders. The impact of these environmental risk factors is moderated by genetic variation. The biological mechanisms underlying this increased risk are still unclear. This symposium will focus on potential mechanisms mediating these lasting effects and their moderation by genetic variation, with epigenetics, specifically DNA methylation as main candidate. The developing brain is highly sensitive to environmental exposures during the in utero period and three of the presentations will focus on how environmental factors during pregnancy alter risk for psychiatric symptoms as well as brain structure and function and have lasting influences on the epigenome at birth. Prenatal exposures such as cigarette smoke, heavy metals, and folic acid are associated with changes in DNA methylation measured in infants at birth Kelly Bakulski (University of Michigan) will report on data generated in an autism enriched-risk birth cohort that examines the sensitivity of DNA methylation at birth, measured in placental tissue and cord blood, to in utero environmental exposures and the development of autism spectrum disorder or related traits by age three. Margit Burmeister (University of Michigan) will present a study of iron deficiency in newborns in China, demonstrating the detrimental effects of pre-and postnatal iron deficiency with regards to brain structure and function. This is complemented by genome-wide epigenetic analyses that investigate the impact of iron deficiency in the presence of lead exposure and pesticides. Another set of pregnancy-related risk factors associated with increased risk for emotional and behavioral problems in children are stress and depression during pregnancy. Katri Raikkonen (University of Helsinki, Finland) will present data from a large prospective study of pregnancy risk factors and their effects on cord blood DNA methylation and child behavior up to 3.5 years of age. Maternal depression during pregnancy was related to significant changes in a recently established epigenetic predictors of gestational age, with increasing depression, associated with more “immature” epigenetic age. This epigenetic marker was then in turn predicting total behavioral, emotionally reactive, and withdrawn problems in boys. Finally, risk for psychiatric symptoms following exposure to childhood adversity is moderated by genetic variation. Understanding the mechanisms of this moderation may help in targeting specific treatments to children with combined genetic and environmental risk. Sara Jaffee (University of Pennsylvania) showed that 8- to 11-year-old children from the UK who carried two copies of the serotonin transporter polymorphism had elevated levels of internalizing and externalizing problems following exposure to adverse life events because of their coping strategies. Influencing the coping styles of these children may be an effective treatment strategy in this subgroup of children. At the end of the symposium, Elisabeth Binder (MPI of Psychiatry, Munich) will comment of common mechanisms emerging from the data presented in the individuals talk and how a better understanding of these factors will aid biology-based diagnoses of psychiatric disorders and individualized treatment approaches.

A Preliminary Clinical Report of 183 Units of Placental Umbilical Cord Whole Blood Transfusion in HIV-Positive Patients with Anemia and Emaciation

A Preliminary Clinical Report of 183 Units of Placental Umbilical Cord Whole Blood Transfusion in HIV-Positive Patients with Anemia and Emaciation

Placental Histopathology Differences and Neonatal Outcome in Dichorionic-Diamniotic as Compared to Monochorionic-Diamniotic Twin Pregnancies.

We aimed to compare the differences in placental histopathology lesions and pregnancy outcome in dichorionic-diamniotic (DCDA) versus uncomplicated monochorionic-diamniotic (MCDA) twin gestations. Maternal characteristics, neonatal outcome, and placental histopathology reports of all twin deliveries between 24 and 41 weeks were reviewed. Excluded were pregnancies complicated by twin-to-twin transfusion syndrome, twin anemia-polycythemia sequence, selective intrauterine growth restriction, placenta previa, intrauterine fetal death, and malformation. Placental lesions were classified to maternal/fetal vascular malperfusion lesions. Umbilical cord abnormalities included hypo-/hypercoiling and abnormal insertion. Composite adverse neonatal outcome was defined as 1 or more early complications. Small for gestational age (SGA) was defined as birth weight ≤10th percentile. The DCDA group (n = 362) was characterized by higher rates of assisted reproductive techniques ( P < .001) and nulliparity ( P = .03) as compared to the MCDA group (n = 65). Gestational age at delivery was similar between groups. Placental maternal vascular malperfusion lesions were more common in placentas from DCDA group (38.2% vs 23.1%; P = .016), while fetal vascular malperfusion lesions and abnormal cord insertion were more common in placentas from MCDA group ( P = .027; P< .001). The SGA and composite adverse neonatal outcome were more common in the MCDA group ( P = .031 and P = .038, respectively). By multivariate regression analysis, composite adverse neonatal outcome was found to be independently associated with the MCDA group, adjusted odds ratio (aOR) = 1.2, 95% confidence interval (CI) = 1.04 to 1.89, P = .041, and with placental fetal malperfusion lesions aOR = 1.3, 95% CI = 1.1 to 2.09, P = .038. Placental pathology differs between MCDA and DCDA twin pregnancies. Adverse neonatal outcome in uncomplicated MCDA twins, as compared to DCDA twins, could be related to increased placental fetal malperfusion lesions and abnormal cord insertion.

Study of Correlation of Neonatal Outcomes with Gross Abnormalities of Placenta and Umbilical Cord

Introduction: Perinatal outcome of new-borns is greatly influenced by abnormalities of placenta and umbilical cord. In most of the deliveries, whether home or institutional, the placenta and umbilical cords are discarded without examination. Due to paucity of information on abnormalities of placenta and cord, there is hardly any correlation with foetal outcomes. The aim was to study the correlation between the foetal outcome and the different types of abnormalities of placenta and umbilical cord.Materials and Methods: A prospective, cross-sectional, descriptive, randomised study was conducted from January 2016 to December 2016 in a tertiary care hospital in North India. The study was carried out on 1000 term singleton newborns. The placenta and umbilical cords were obtained from both normal and caesarean section deliveries. A proforma was used to gather data from the patients and new-borns. Statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 20 (SPSS Inc, Chicago, IL, IBM version) along with Microsoft Excel (2010 version).Results: One thousand placentae and umbilical cords were examined of which high placental weight/birth weight ratio, gross anomalies of placenta (infarctions, calcifications and retro placental haematoma), marginal (battledore and velamentous) umbilical cord insertions, long umbilical cords and single umbilical artery were associated with negative foetal outcomes.Conclusions: There was a high incidence of adverse foetal outcome with placental and umbilical cord abnormalities. Education of our health personnel dealing with deliveries on the importance of proper examination of the placenta and umbilical cords should be emphasised and instituted upon.

Protective Effect of the c-mpl Agonist Romiplostim on Megakaryocytopoiesis of Human CD34+Hematopoietic Progenitor Cells Exposed to Ionizing Radiation

A thrombopoiesis-stimulating protein, the myeloproliferative leukemia virus protooncogene (Mpl) ligand romiplostim (RP), is currently approved as a therapeutic agent for idiopathic thrombocytopenic purpura in many countries. Although the action of the initial MPL ligand thrombopoietin (TPO) on human megakaryocytic regeneration from irradiated human hematopoietic stem cells has been examined, there are few reports on the action of RP. In the present study, freshly prepared nonirradiated and 2-Gy X-irradiated human CD34 positive (CD34+) cells from placental umbilical cord blood were cultured with a combination of RP and various cytokines. As a result, the effect of RP on cell proliferation of nonirradiated CD34+ cells was found to be comparable to that of TPO. However, the stimulating activity of RP on megakaryocytic progenitor-derived colony formation was markedly lower compared with TPO. Regarding the action of RP with various cytokines, the present results showed that a combination of RP with interleukin-3 (IL-3) or IL-3 plus stem cell factor (SCF) showed a high regenerative effect on cell proliferation, megakaryopoiesis, thrombopoiesis, and megakaryocyte colony formation from X-irradiated CD34+ cells. The present study showed that human recombinant RP has potential effects on human megakaryocytic regeneration from X-irradiated human CD34+ cells and synergistically acts with IL-3 and IL-3 plus SCF, just as observed with TPO.

Intrauterine Deaths in North-Eastern Hungary with National and International Comparison

Objective: Demographic analysis of intrauterine deaths in North-Eastern Hungary with national and international comparison. Materials and Methods: The authors collected data from the National Bureau of Statistics’ 1996-2014 database to assess frequency, gestational age, maternal age and education for six counties of the region. 722 individual cases were analyzed. A regional survey was initiated to collect more detailed data on living environment in the region between 2010 and 2014 through community midwifery services records. Results: Data over 20 years showed most intrauterine deaths (Perinatal mortality, Late fetal death, Stillbirth] occurred between 24th and 36th weeks of which 35% occurred in the North-Eastern region of Hungary. The causes of intrauterine deaths were placental abruption, cord accident, placental insufficiency, malformations and intrauterine infection. Detailed analysis regarding attendance at either the Obstetricians or the community midwifery services, the patient’s medical history and the patients’ compliance were reported, compliance in 1% completely lacked. Gravidity and multiparity were associated risk factors. A significant proportion was associated with teenage pregnancy, low maternal education, smoking risks, unemployment, dependence on social support, unhygienic environment and smaller accommodations. Lack of cooperation during antenatal care was significant. Conclusion: Frequency and distribution of intrauterine deaths in North-Eastern Hungary show a similar picture as those of socio-economic indices. The unfavorable trend came to an end in 2015, however the national statistics did not show any improvement. The solution to the problem seems to be independent of the service provision, therefore, socio-economic development of affected counties is warranted, and financial incentives and/or government aid provided during pregnancy may improve future perinatal outcomes.

Placental umbilical cord whole blood transfusion to combat anemia in the background of severe malaria

Placental umbilical cord whole blood transfusion to combat anemia in the background of severe malaria

The effect of aspartame ingestion in pregnant female albino rats on placental and fetal weights, umbilical cord length, and histology of fetal pancreas

Background and aim Sugar is one of the commonest causes of weight gain and diabetes. Aspartame is one of the most commonly used artificial sweeteners worldwide to replace sugar. This study aimed to study the effects of aspartame in pregnant female albino rats on fetal and placental weights, length of umbilical cord, and possible histological changes in fetal pancreas. Materials and methods Thirty-six adult female albino rats and nine adult male albino rats weighing between 220 and 250 g were used. Each four female rats were housed with one male rat to allow mating. Pregnant rats were divided into three groups (n=12 each): control group (group І), low-dose-treated group (group ІІ), and high-dose-treated group (group ІІІ). The low-dose-treated group received 14 mg/kg aspartame and the high-dose-treated group received 40 mg/kg aspartame daily from the first day of pregnancy to the 20th day of pregnancy. Results This study showed a highly significant reduction of maternal weight gain, placental weight, fetal weight, and umbilical cord length in both aspartame-treated groups. Fetal pancreas showed histopathological changes in both aspartame-treated groups as evidenced by light and electron microscopy. All the results in this study were dose related. Conclusion The use of aspartame during pregnancy might reduce fetal and placental weights and umbilical cord length and alter the histology of fetal pancreas.

Infection as the cause of perinatal mortality in Latvia

Infection is one of the leading causes of perinatal mortality worldwide – accounting for 36% of cases. Perinatal mortality in Latvia is slowly decreasing: from 7.3 per 1000 live births in 2013 to 6.7 per 1000 live births in 2015. Intrauterine infection still is a global problem and a significant factor that affects morbidity and mortality of the mother and the child.This study includes data about the cause of death, including infections, from 417 autopsy protocols of all fetuses and neonates between 22 weeks of gestation and &lt; 7 days postpartum from 2013 to 2015.The main cause of perinatal mortality was antenatal fetal asphyxia in 50% (n=210), followed by infections – 39% (n=163), including cases of chorioamnionitis. The highest mortality rate was found in the 22nd–27th+6 (i.e. 27 full weeks and 6 days) gestational weeks – 32% of cases (n=135). Intrauterine pneumonia accounted for 24% (n=39) of all the infection caused deaths, meconium aspiration pneumonia – 0.04% (n=6), early neonatal sepsis – 0.03% (n=4) and specific infections like syphilis and cytomegalovirus – 0.02% (n=3). Histological examination of the placenta, the placental cord and fetal membranes was made in 61% (n=255) of cases, and 19.6% (n=50) of them had an infection.

P21.10: Development of vasa previa with advancing gestation from placental and umbilical cord vessels in the lower uterine segment

P21.10: Development of vasa previa with advancing gestation from placental and umbilical cord vessels in the lower uterine segment

P 29 Involvement of the placental neuropeptide system in preeclampsia

Introduction One of the causes of preeclampsia (PE) is due to an imbalance of inflammatory and anti-inflammatory proteins, as well as hyperactivity of the sympathetic nervous system. Previous studies have already revealed the involvement of the neuropeptides galanin (GAL) and oxytocin (OXT) in inflammatory processes and their modulatory role with respect to the autonomous system 1, 2. Despite those findings, evidence for a relation of these hormones in the pathogenesis of PE is missing so far. Objectives Aim of the study is to characterise the above mentioned peptide systems regarding their expression patterns in the placenta, umbilical cord and plasma of PE patients and healthy controls. Patients and methods Placental (maternal and fetal side) and umbilical cord tissues have been collected during caesarean section from control and PE patients. Furthermore blood samples have been taken at the day of the surgery and four days postpartum. Biopsies have been analysed for the expression of GAL, GAL1,3- and OXT-receptors (GAL1, GAL3, OXTR). Additionally, differentiated analysis of maternal and fetal tissue was performed to reveal potential different expression patterns. Results Preliminary results of the IHC revealed a clear expression of GAL3 in trophoblasts of PE placentas, whereas controls showed an increase expression of GAL3 on endothelial cells. Moreover an increased expression of GAL1 and GAL on endothelial cells has been detected in controls compared to PE. Different patterns were also visible regarding the OXTR with higher expression levels in controls compared to PE. Furthermore, PE placentas showed local expression differences (fetal > maternal side), which was not apparent in controls. Conclusion The different expression patterns of the GAL-system and the OXTR still have to be verified by Western Blot analyses, qPCR and IHC. However, their preliminary detection in placental tissue could be a first hint regarding the involvement of those systems in the inflammatory processes of PE.

Regulating role of fetal thyroid hormones on placental mitochondrial DNA methylation: epidemiological evidence from the ENVIRONAGE birth cohort study

BackgroundFetal development largely depends on thyroid hormone availability and proper placental function with an important role played by placental mitochondria. The biological mechanisms by which thyroid hormones exert their effects on mitochondrial function are not well understood. We investigated the role of fetal thyroid hormones on placental mitochondrial DNA (mtDNA) content and mtDNA methylation. We collected placental tissue and cord blood from 305 mother–child pairs that were enrolled between February 2010 and June 2014 in the ENVIRONAGE (ENVIRonmental influence ON early AGEing) birth cohort (province of Limburg, Belgium). Placental mtDNA content was determined by qPCR and placental mtDNA methylation by bisulfite-pyrosequencing in two regions, i.e., the D-loop control region and 12S ribosomal RNA (MT-RNR1). The levels of free thyroid hormones (FT3, FT4) and thyroid-stimulating hormone (TSH) were measured in cord blood.ResultsCord blood FT3 and FT4 were inversely associated with placental mtDNA methylation at the MT-RNR1 (p ≤ 0.01) and D-loop (p ≤ 0.05) regions, whereas a positive association was observed for both hormones with placental mtDNA content (p ≤ 0.04). Assuming causality, we estimated that MT-RNR1 and D-loop methylation mediated, respectively, 77% [indirect effect +14.61% (95% CI 2.64 to 27.98%, p = 0.01)] and 47% [indirect effect +8.60% (95% CI 1.23 to 16.50%, p = 0.02] of the positive association between FT3 and placental mtDNA content. Mediation models with FT4 gave similar results but the estimated effect proportions were smaller compared with those of FT3 (54% and 24%, respectively).ConclusionsWe showed that epigenetic modification at specific loci of the mitochondrial genome could intervene with the thyroid-dependent regulation of mitochondrial DNA copy numbers.

Umbilical cord blood leptin concentration - What does it imply?

Objective: The significance of the placental or umbilical cord leptin levels remains unresolved in spite of their well-documented function. In the current study we investigated, whether, leptin concentration that mirrors the fetal health is influenced by type of birth, placental weight, cord length, sex, weight, pO2 and pH parameters. Methods: Umbilical cord blood samples were collected post placental delivery (n=40) from both normal and caesarian deliveries with all demographical information. Leptin concentration was determined form cord blood plasma, while fresh cord blood was used for blood gas analysis. Results: The average leptin concentrations of male and female fetal umbilical cord were 16.6 ± 1.6 and 18.2 ± 0.6 ng/ml respectively. The maximum threshold of the umbilical vein leptin concentrations were 15.3 ± 0.6 and 18.3 ± 1.2 ng/ml in male and females respectively. There was a direct relationship observed with the birthweight and leptin concentration. The mean pH 7.117 ± 0.02 and pO2 19.74 ± 2.01 mmHg did not significantly correlate with leptin levels. Discussion: Leptin concertation were significantly high in normal delivery than caesarian section. Placental weight or umbilical cord length did not affect the leptin concentration. We did not observe any significant alteration in pH or pO2 levels influencing leptin. However, the most remarkable correlation was leptin with birth weight, which explains the best utilization of the maternal fuel resources in the development of the fetus. We did observe a level in female babies. Conclusion: Overall, the placental leptin concentration mirrors the health status of the fetus and weight metabolism.

The impact of maternal parameters on intrauterine growth restriction

The incidence of fetal growth restriction is variable, being known that is more frequent in resource-limited countries. The mechanism of fetal growth restriction is considered to be multifactorial, resulting from a combination of maternal, placental and fetal factors, the uteroplacental insufficiency being the dominant cause. Our purpose in this study was to determine the impact and the incidence of various maternal factors encountered among cases with fetal growth restriction delivered at term. The studied parameters were: the birth weight, the sex of the newborn, the way of delivery, the Apgar score at one minute, the maternal age, the maternal gestation and parity, the presence of presentation dystocia, the pregnancy monitoring by specialist, the presence of infectious factor, the presence of abnormal placental insertion or umbilical cord abnormalities, the status of the fetus and the presence of pregnancy-induced hypertension, preeclampsia or eclampsia. Results. During the 3-year period of the study, there were registered 12987 births in our hospital. The incidence of newborns with low birth weight at term was 1.5%. The average weight at birth was 2302 grams, with the lowest value 1750 grams, and the female fetuses were more affected (57.6%). The incidence of placental condition within the studied group was only 2%; also, the pregnancy-induced hypertension was present only in 6% of cases. Conclusion. Fetal growth restriction requires an accurate diagnosis with a clear distinction of constitutional small fetuses from the abnormal small ones. Ultrasound monitorization is mandatory for the diagnosis and the assessment of the fetal status