Placental Surface Research Articles

Placental surface area mediates the association between FGFR2 methylation in placenta and full-term low birth weight in girls

BackgroundFibroblast growth factor receptor 2 (FGFR2) gene encodes a protein of the fibroblast growth factor receptor family. FGFR2 gene expression is associated with the regulation of implantation process of placenta which plays a vital role in fetal growth. DNA methylation is widely known as a mechanism of fetal growth. However, it is unclear whether and how DNA methylation of FGFR2 gene in the placenta is associated with full-term low birth weight. This case-control study aims to explore the links between FGFR2 methylation in placenta and full-term low birth weight and to further examine the mediation effect of placental surface area on this association.ResultsWe conducted analyses for each of the five valid CpG sites at FGFR2 in 165 mother-baby pairs (86 FT-LBW vs. 79 FT-NBW) and found that per one standard deviation increase in the DNA methylation of CpG 11 at FGFR2 was associated with 1.64-fold higher risk of full-term low birth weight (OR = 1.64, 95% CI = [1.07, 2.52]) and 0.18 standard deviation decrease in placental surface area (β = − 0.18; standard error = 0.08, p = 0.02). The mediation effect of placental surface area on the association between DNA methylation and full-term low birth weight was significant in girls (OR = 1.38, 95% CI = [1.05, 1.80]) but not in boys. The estimated mediation proportion was 48.38%.ConclusionOur findings suggested that placental surface area mediated the association between DNA methylation of FGFR2 in placenta and full-term low birth weight in a sex-specific manner. Our study supported the importance of placental epigenetic changes in placental development and fetal growth.

Umbilical cord blood PBDEs concentrations in relation to placental size at birth

Previous studies have linked prenatal polybrominated diphenyl ether (PBDE) exposure to adverse birth outcomes. Reductions in placental size might mediate those adverse effects. We examined whether umbilical cord blood PBDEs concentrations were associated with placental size at birth. A total of 121 mother-newborn pairs residing in Wenzhou were enrolled in this study. Concentrations of 19 PBDEs in umbilical cord blood were determined by gas chromatography tandem mass spectrometry (GC-MS). Placental length, breadth and surface area was measured by medical professionals after delivery. BDE-206, 207, 208, 209 and the total of 19 PBDE congeners concentrations were negatively associated with placental length, breadth and surface area. Our results suggest that prenatal PBDEs exposure may suppress placental growth, resulting in reduced placental size.

Histopathological Evaluation of Benign Proliferative Breast Lesions

Introduction :Placental Neoplasms are classified in to two categories based on their origin: Trophoblastic and non trophoblastic. Non trophoblastic tumors are common and benign ones include chorioangioma and teratoma. Chorioangioma of placenta is the commonest benign tumor of the placenta. It consists of a benign angioma arising from the chorionic tissue. It has been found to be associated with many serious complications such as nonimmune hydrops, congenital abnormalities, hemolytic anemia, polyhydramnios, IUGR, and IUFD. Methods: A 21 years old pregnant female 2nd gravida with 32 weeks of gestation presented to Ob/Gy department at L.G. Hospital with complaints of abdominal distension for 2 weeks associated with lower abdominal pain for 2 days. She had a history of one full term normal delivery without significant peripartum events. General examination was unremarkable. P/A was grossly enlarged with Fundal height more than gestational age, fetal heart rate was 144 /min. Per vaginal examination revealed 2 cm dilated and early effaced cervix with intact membrane. USG revealed a single live fetus with 32 weeks of gestation and without structural malformations and hydrops AFI of 42 cm hyperechoic mass of 8.5 *6.5cm on placental surface, near cord insertion with hypervascularity, separate from placental tissue suggestive of placental chorioangioma. Estimated fetal weight was 1.6kg. After a course of dexamethasone, therapeutic amniocentesis was done; She developed gross polyhydramnios after 4 days of amniocentesis followed by spontaneous preterm normal labor and delivered 1.7kg live baby without peripartum complications. Histopathological analysis of the mass revealed proliferation of capillary sized vascular channels with endothelial cells, hemorrhagic and focal area of calcifications. The neonate was admitted to NICU and was discharged after a week without complications.  Conclusion :This case illustrates the prompt and accurate diagnosis of placental chorioangioma can help apply timely interventions improving patient outcome.

Eccentric placentae have reduced surface area and are associated with lower birth weight in babies small for gestational age.

Placental structure and function determine birth outcomes. Placental mass does not always correlate with fetal birth weight (BW) in uncomplicated pregnancies which raises the possibility of other variables such as placental shape and cord insertion being the determinants of placental efficiency. In total, 160 women with singleton pregnancy, recruited into a pregnancy cohort were studied. Placental weight (PW) was measured and other data were obtained from clinical records. Birth outcomes were classified as small for gestational age (SGA) and appropriate for gestational age (AGA) based on fetal gender, gestational age (GA) and BW. High-resolution images of the chorionic plate were recorded. The shape of the placenta and the insertion of the cord were measured using eccentricity index (EI) and cord centrality index (CCI). Only placentae with eccentrically inserted cords (n=136) were included. The mean BW and PW were 2942 (±435) g and 414 (±82) g with average GA of 38.6 weeks. The mean CCI and EI was 0.483 (±0.17) and 0.482 (±0.16). Neither of these correlated with placental efficiency. However, EI showed negative correlation with placental surface area and breadth. Upon sub-grouping the cohort into SGA (n=32) and AGA (n=104), the SGA babies with the highest EI (third tertile) had significantly lower BW than those with the least eccentric placentae (first tertile). Although eccentric-shaped placentae were present in both SGA and AGA groups, the effect on BW was observed only in the SGA group.

664: Acute inflammation during ascending intra-uterine infection simultaneously progress in both extra-placental membranes and chorionic plate: evidence of anatomic connection between extra-placental membranes and chorionic plate

Extra-placental membranes (EPM) and fetal placental surface, that is, chorionic plate (CP), are continuous, and most processes are likely to be seen in both. However, there is no information about whether acute inflammatory processes simultaneously progress in both EPM and CP during ascending intra-uterine infection (AIUI). The objective of the study is to examine this issue. Study population included 179 singleton early preterm-births due to PTL and preterm-PROM. We examined the frequency of inflammation in sub-chorionic fibrin (SCF) and connective tissue (CT) within CP according to the progression of inflammation in EPM(i.e., inflammation-free chorio-decidua [CD] or inflammation restricted to decidua, inflammation restricted to membrane trophoblast (MT) of chorion, inflammation restricted to CT of chorion, and inflammation in amnion), and the frequency of inflammation in MT of chorion, CT of chorion, and amnion within EPM according to the progression of inflammation in CP(i.e., inflammation-free CP, inflammation restricted to SCF of CP, and inflammation in CT of CP). Acute inflammation in EPM and CP was defined according to the previously reported criteria. 1) Inflammation-free CD or inflammation restricted to decidua, inflammation restricted to MT of chorion, inflammation restricted to CT of chorion, and inflammation in amnion were present in 53%, 17%, 17% and 12% of cases; 2) Inflammation-free CP, inflammation restricted to SCF of CP, and inflammation in CT of CP were present in 75%, 10% and 16% of cases; 3) Inflammation in SCF (Fig.1.a) and CT (Fig.1.b) within CP was more frequent according to the progression of inflammation in EPM; 4) Inflammation in MT of chorion (Fig.2.a), CT of chorion (Fig.2.b) and amnion (Fig.2.c) within EPM more developed according to the progression of inflammation in CP. Inflammation in SCF and CT within CP is more frequent according to the progression of inflammation in EPM, and inflammation in MT of chorion, CT of chorion, and amnion within EPM more develops according to the progression of inflammation in CP. This finding suggests that acute inflammatory processes simultaneously progress in both EPM and CP during AIUI.View Large Image Figure ViewerDownload Hi-res image Download (PPT)

Ultrasound features of placental changes and their obstetric correlates among HIV patients and controls at Aminu Kano Teaching Hospital, Kano

Background: One of the serious health problems in the world today is the human immunodeficiency virus (HIV)/acquired immune deficiency syndrome pandemic, with Nigeria having the second largest number of new cases. During pregnancy, HIV-infected women face more adverse effects than uninfected women. This study aimed at evaluating ultrasound features of placentas of HIV-positive women and controls to demonstrate a difference in vasculoplacental complications between the two groups. Methods: A comparative study was conducted among HIV-positive women and their matched controls. Informed consent was obtained and a pretested interviewer-administered questionnaire was used. The women had ultrasound assessment of the placenta and an obstetric ultrasound scan. Results: There were no differences in placental surface area (t = −1.122, df = 6, P = 0.305, 95% confidence interval: −17.46 to 15.56) and placental thickness (t = 1.846, df = 58, P = 0.07, 95% confidence interval: −0.405 to 9.99). Calcifications were found but not related to HIV status. The most common complication among the HIV-infected women was miscarriage. No complications were recorded among the controls. Conclusion: There was no difference in the vasculopathological changes detectable by ultrasound scan in the placentas of HIV-infected and uninfected pregnant women.

Maternal parity affects placental development, growth and metabolism of foals until 1 year and a half

Primiparous mares are known to produce smaller foals than multiparous mares. This difference seems to be partly explained by the reduced exchange surface and volume of the placental villi in primiparous compared to multiparous placentas. The effect of maternal parity on foals' post-natal growth, metabolism and sexual maturation, however, has been given little consideration. The objectives of this work were to analyse placental biometry and structure at term, growth of foals and yearlings, their metabolism and testicular maturation at one year of age.Twenty multiparous mares (M), aged over 6 years and 12 primiparous mares (P), aged up to 5 years were artificially inseminated with the same stallion and monitored the same way until foaling. At birth, foals and placentas were measured and placentas were sampled above at the umbilical cord insertion, as well as in the pregnant and the non-pregnant horn to perform stereological analyses. Foals were weighed and measured until 540 days of age. At 120 and 360 days of age, an Intravenous Glucose Tolerance Test was performed on foals and yearlings. At 360 days of age, the males were castrated and testicular maturation analysed by RT-qPCR.At birth, P dams produced lighter and smaller foals and placentas. The foal birth weight to placental surface ratio was lower in the P compared to the M group. P Foals remained lighter than M foals until 360 days of age and smaller until at least 540 days of age. At 120 days of age, P foals had a higher glucose tolerance than M foals, and then may be less mature than M foals in terms of the control of their glucose homeostasis. At 360 days of age, the testicles of prepubertal P stallions were less mature in the P vs the M group.In conclusion, primiparous dams produce intrauterine growth restricted, less mature and smaller foals compared to multiparous dams with altered metabolism and growth until at least 540 days of age. These differences could affect the sport career of these foals, especially if it begins at an early age.

Autism risk classification using placental chorionic surface vascular network features

BackgroundAutism Spectrum Disorder (ASD) is one of the fastest-growing developmental disorders in the United States. It was hypothesized that variations in the placental chorionic surface vascular network (PCSVN) structure may reflect both the overall effects of genetic and environmentally regulated variations in branching morphogenesis within the conceptus and the fetus’ vital organs. This paper provides sound evidences to support the study of ASD risks with PCSVN through a combination of feature-selection and classification algorithms.MethodsTwenty eight arterial and 8 shape-based PCSVN attributes from a high-risk ASD cohort of 89 placentas and a population-based cohort of 201 placentas were examined for ranked relevance using a modified version of the random forest algorithm, called the Boruta method. Principal component analysis (PCA) was applied to isolate principal effects of arterial growth on the fetal surface of the placenta. Linear discriminant analysis (LDA) with a 10-fold cross validation was performed to establish error statistics.ResultsThe Boruta method selected 15 arterial attributes as relevant, implying the difference in high and low ASD risk can be explained by the arterial features alone. The five principal features obtained through PCA, which accounted for about 88% of the data variability, indicated that PCSVNs associated with placentas of high-risk ASD pregnancies generally had fewer branch points, thicker and less tortuous arteries, better extension to the surface boundary, and smaller branch angles than their population-based counterparts.ConclusionWe developed a set of methods to explain major PCSVN differences between placentas associated with high risk ASD pregnancies and those selected from the general population. The research paradigm presented can be generalized to study connections between PCSVN features and other maternal and fetal outcomes such as gestational diabetes and hypertension.

Placental alterations in structure and function in intra‐uterine growth‐retarded horses

Following embryo transfer (ET), the size and breed of the recipient mare can affect fetal development and subsequent post natal growth rate and insulin sensitivity in foals. To investigate placental adaptation in pregnancies where increased or restricted fetal growth was induced through ET between Pony, Saddlebred and Draught horses. In vivo experiment. Control Pony (P, n=21) and Saddlebred (S, n=28) pregnancies were obtained by artificial insemination. Increased pregnancies were obtained by transferring Pony (P-D, n=6) and Saddlebred (S-D, n=8) embryos into Draught mares. Restricted pregnancies were obtained by transferring Saddlebred embryos into Pony mares (S-P, n=6). Placental weight and surface were recorded and samples collected for stereology and analysis of expression of genes involved in placental growth, vascularisation and nutrient transport. Data were analysed by linear model. S-P foals were growth retarded when compared with controls despite increased gestational length. Placental weight was reduced but placental surface density and volume fraction were increased. Placental expression of genes involved in growth and development and nutrient transfer was strongly reduced. In contrast, placental size and weight were increased in enhanced growth P-D and S-D foals. The trophoblastic surface density and the allantoic vessels surface density were decreased in P-D and S-D, respectively, both with very few modifications in gene expression. Control embryos were produced by artificial insemination whereas experimental embryos were produced by ET. Placental structure and gene expression are modified after ET into a smaller or larger breed than that of the embryo. These adaptations contribute to the observed phenotype of foal growth restriction or enhanced growth at birth.

The use of Invos™ somatic oximetry to measure variations in placental tissue oxygenation in laboring healthy term parturients with epidural analgesia: an observational study.

PurposeNear-infrared spectroscopy provides a non-invasive continuous real-time monitoring of tissue oxygen saturation. As uterine contractions during labor may be associated with a transient uteroplacental hypoperfusion, this prospective, observational study investigates the ability of near-infrared spectroscopy to detect variation in uteroplacental oximetry during uterine contractions.Patients and methodsFour Invos™ oximetry probes (Medtronic®, Minneapolis, MN, USA) per subjects were applied on the placental surface (PLA), the abdomen (MYO), the forearm (ARM) and the leg (LEG), of twenty healthy laboring parturients with epidural analgesia. Measurements of mean tissue oxygen saturation and area under the curve (AUC) were made during 60 minutes. The primary outcome was the difference of the AUC measurements between the PLA probe and the MYO probe.ResultsThe AUC values for the PLA and MYO probes were not different. The mean saturation values recorded by the PLA probe were not different from the other probes.ConclusionThe Invos monitor was unable to detect variations in uteroplacental saturation during labor in healthy parturients.

Enhancing placental chorionic surface vasculature from barium-perfused images with directional and multiscale methods

Enhancing placental chorionic surface vasculature from barium-perfused images with directional and multiscale methods

Exposure to fine particulate matter in the air alters placental structure and the renin-angiotensin system.

Transforming growth factor beta 1 (TGFβ1), the uteroplacental renin-angiotensin system (RAS) and vascular endothelial growth factor A (VEGF-A) participate in the placentation process. The aim of this study was to investigate the effects of exposure to pollutants on the placenta.MethodsFemale Wistar rats were exposed to filtered air (F) or to concentrated fine particulate matter (P) for 15 days. After mating, the rats were divided into four groups and again exposed to F or P (FF, FP, PF, PP) beginning on day 6 of pregnancy. At embryonic day 19, the placenta was collected. The placental structure, the protein and gene expression of TGFβ1, VEGF-A, and its receptor Flk-1 and RAS were evaluated by indirect ELISA and quantitative real-time PCR.ResultsExposure to P decreased the placental mass, size, and surface area as well as the TGFβ1, VEGF-A and Flk-1 content. In the maternal portion of the placenta, angiotensin II (AngII) and its receptors AT1 (AT1R) and AT2 (AT2R) were decreased in the PF and PP groups. In the fetal portion of the placenta, AngII in the FP, PF and PP groups and AT2R in the PF and PP groups were decreased, but AT1R was increased in the FP group. VEGF-A gene expression was lower in the PP group than in the FF group.ConclusionsExposure to pollutants before and/or during pregnancy alters some characteristics of the placenta, indicating a possible impairment of trophoblast invasion and placental angiogenesis with possible consequences for the maternal-fetal interaction, such as a limitation of fetal nutrition and growth.

Birth weight, umbilical and placental traits in relation to neonatal loss in cloned pigs

Cloned piglets generated through somatic cell nuclear transfer (SCNT) have a high rate of neonatal death. Postnatal loss is associated with low birth weight, umbilical status and placental parameters in fertilisation-derived piglets. To investigate whether or not this relationship also exists in cloned piglets, birth weight, umbilical status, placental parameters, placental morphology and gene expression pattern were compared among four piglet groups, namely, SCNT-derived male piglets that died within 4 days (SCNT-DW4), SCNT-derived male piglets that survived over 4 days (SCNT-SO4), artificial insemination (AI)-generated male piglets that died within 4 days (AI-DW4) and AI-generated male piglets that survived over 4 days (AI-SO4). Results showed that the occurring frequency of abnormal umbilical cord in SCNT-DW4 piglets was significantly higher than that in AI-SO4 piglets but was similar to that in SCNT-SO4 and AI-DW4 piglets. The birth weight, placental surface area and placental weight of AI-SO4, AI-DW4 and SCNT-SO4 groups were similar but were significantly higher than those in SCNT-DW4 group. SCNT-SO4 placentas exhibited mild but SCNT-DW4 placentas showed severe morphological abnormalities compared with AI-SO4 placentas. The expression profiles of imprinting, angiopoiesis, nutrient transport, apoptosis and oxidative stress-related genes in SCNT-DW4 placentas were erroneous compared with those in SCNT-SO4 and AI-SO4 placentas, which both had similar gene expression patterns. These results indicate that birth weight, umbilical status, placental parameters, placental morphology and gene expression were associated with neonatal death of cloned piglets. The high loss of cloned piglets during neonatal age may be caused by severe deficiency of extra-embryonic development during prenatal stage.

Rapid conceptus elongation in the pig: An interleukin 1 beta 2 and estrogen-regulated phenomenon.

Establishment and maintenance of pregnancy in the pig involves activating many physiological, cellular, and molecular signaling pathways between the developing conceptus and hormonally regulated maternal endometrium. Rapid elongation of the pig trophoblast allows for the establishment of sufficient placental surface area for the transport of nutrients to the fetus throughout pregnancy. Estrogens secreted by the conceptus during elongation act on uterine epithelia to induce secretion of uterine factors required for conceptus development and for preventing endocrine secretion of prostaglandin F2α, which would cause luteolysis. Thus, trophoblast expansion within the uterine lumen during early gestation is an essential process for implantation and maintenance of pregnancy in species with an epitheliochorial form of placentation. In the pig, rapid conceptus elongation involves the unique expression of interleukin-1 beta 2 (IL1B2), which establishes pro-inflammatory effects that may be tempered by the spatiotemporal secretion of estrogen from the conceptuses. The present review provides current information on pig conceptus remodeling and signaling via estrogen and IL1B2 pathways, as well as endometrial responses to those conceptus factors leading to establishment of pregnancy.

Effects of season on placental, foetal and neonatal development in horses

Seasonal changes in metabolic rate have been shown in horses and we hypothesized that this leads to the birth of smaller foals early in the year. Mares and their foals were assigned to three groups by day of foaling within the year (e.g. 1 January = day 1): Group 1 (n = 10) day 40–65, group 2 (n = 8) day 67–92, group 3 (n = 9) day 94–121. Groups did not differ with regard to parity. In foals, height at withers and body weight were determined on days 1–5 and weekly until 12 weeks of age. Chest circumference, distances fetlock to carpus, carpus to elbow, poll to nose and crown-rump length were determined on day 5 and weekly until 12 weeks of age. Placental weight (p < 0.05) and surface (p < 0.01) were lower in mares of group 1 than in groups 2 and 3. Foal weight and length measurements increased over time (p < 0.001). Height at withers was consistently lower in group 1 than in groups 2 and 3 (p < 0.05) while foal weight did not differ among groups. Fetlock to carpus, carpus to elbow (both p < 0.01) and poll to nose length (p < 0.05) were lower in group 1 than in groups 2 and 3. Neither gestation length nor sex ratio of foals differed among groups. In conclusion, foetal size is reduced when the final growth phase coincides with the winter months. This also impacts neonatal growth during the first three months of life.

Association of Placental Jets and Mega-Jets With Reduced Villous Density

Spiral arteries (SAs) lie at the interface between the uterus and placenta, and supply nutrients to the placental surface. Maternal blood circulation is separated from the fetal circulation by structures called villous trees. SAs are transformed in early pregnancy from tightly coiled vessels to large high-capacity channels, which is believed to facilitate an increased maternal blood flow throughout pregnancy with minimal increase in velocity, preventing damage to delicate villous trees. Significant maternal blood flow velocities have been theorized in the space surrounding the villi (the intervillous space, IVS), particularly when SA conversion is inadequate, but have only recently been visualized reliably using pulsed wave Doppler ultrasonography. Here, we present a computational model of blood flow from SA openings, allowing prediction of IVS properties based on jet length. We show that jets of flow observed by ultrasound are likely correlated with increased IVS porosity near the SA mouth and propose that observed mega-jets (flow penetrating more than half the placental thickness) are only possible when SAs open to regions of the placenta with very sparse villous structures. We postulate that IVS tissue density must decrease at the SA mouth through gestation, supporting the hypothesis that blood flow from SAs influences villous tree development.

Placental recess accompanied by a T2 dark band: a new finding for diagnosing placental invasion.

Our aim was to assess the usefulness of a new magnetic resonance imaging (MRI) finding, the placental recess, for diagnosing placental invasion. This retrospective study included 51 patients (mean age 34.1years, range 26-43years) with suspected placental invasion who underwent cesarean section. Preoperative MRI was performed using a 1.5-T unit and included axial, sagittal, and coronal T2-weighted imaging (T2WI) with half-Fourier fast spin-echo sequences. Overall, 9 patients showed placental invasion, and 42 did not. Placental recess was defined as a placental deformity with contraction of the placental surface and outer rim of the uterus accompanied by a T2 dark band. Two radiologists independently assessed the presence of the placental recess and conventional findings including uterine bulging, abnormal placental vascularity, placental heterogeneous intensity on T2-weighted imaging (T2WI), and the T2 dark band. Fisher's two-sided exact test was used to compare findings between patients with and without placental invasion. Interobserver reliability was assessed using the kappa statistic. MRI features had interobserver reliability of>0.40. Placental recess yielded the highest kappa value (0.898). Significant differences were identified between patients with and without placental invasion regarding abnormal placental vascularity, placental heterogeneous intensity, a T2 dark band, and the placental recess on T2WI (p=0.0282, 0.0003, 0.0003,<0.0001, respectively). The placental recess had sensitivity, specificity, positive and negative predictive values, and accuracy of 56, 100, 100, 91, and 92%, respectively. The placental recess was useful for diagnosing placental invasion, with high interobserver variability and accuracy.

Environmental and maternal factors associated with gross placental morphology in dairy cattle.

This article reports on a study of gross placental morphology of 282 expelled placentas from 89 primi- and 193 multiparous Holstein dams immediately after calving and examines associations with environmental factors such as typical herd features and season of calving, and maternal factors such as age at calving, level of milk yield at conception and cumulative amount of milk produced during gestation. The highest correlation between calf measurements and placental characteristics was found between the weight of the calf and the total cotyledonary surface (r=.643; p<.001), confirming the high importance of the cotyledonary surface available for nutrient transfer to the developing foetus. Younger age in adolescent and smaller heart girth in multiparous dams were associated with a higher cotyledon number, suggesting placental compensation in dams with lower capacities in terms of dry matter intake. No significant association between milk yield during gestation in multiparous animals and gross placental morphometrics could be detected, indicating that factors such as the amount of milk produced during gestation affect placental development less than foetal weight close to term. Therefore, placental growth may be sustained at the expense of other tissues in an attempt to maintain pregnancy and minimize the adverse consequences for the foetus. This study offers evidence concerning factors affecting the placental surface size for nutrient transfer from dam to calf in dairy cattle based on gross morphometrics, but needs confirmation from studies in which this surface size is more profoundly assessed by measuring the branches present in the cotyledonary villi.

67 MATERNAL OBESITY AT CONCEPTION AND INSULIN SENSITIVITY IN LATE GESTATION ALTERS PLACENTAL STRUCTURE BUT NOT FETAL BIOMETRY AT BIRTH IN THE HORSE

Obesity is a major health issue in the horse industry, often associated with insulin resistance. This study aimed to analyse effects of maternal obesity at insemination and insulin resistance during late gestation on term placenta and foals at term. A total of 24 multiparous saddlebred mares were allocated to 1 of 2 groups at insemination: group obese (O) had a body condition score (BCS, French scale 1–5) &gt;4 (N = 15), and group normal (N) had a BCS = 4 (N = 9). From insemination until the sixth month of gestation, all the mares had access to pasture. From wintering, they were housed in box stalls and fed the same amount of energy, proteins, and fibre as a percentage of their body weight. During all the gestation, BCS, basal blood glucose, insulin, triglycerides, and nonesterified fatty acid plasma concentrations were measured each month. At 300 days of gestation, a frequent sampling glucose tolerance test, enabling the simultaneous evaluation of insulin sensitivity (IS) and glucose tolerance, was performed. At birth, placentas and foals were measured. Placentas were sampled around the umbilical cord to perform structural and functional analyses by stereology and RT-qPCR. Results were analysed using a type 3 ANOVA taking into account mare group and foal sex. Effects were considered significant when P &lt; 0.05. At 300 days of gestation, the frequent sampling glucose tolerance test indicated that half of the O mares were insulin resistant (IS &lt;1; N = 8), whereas the other half were insulin sensitive (IS &gt;1; N = 7). Based on these results, O mares were subdivided in 2 groups: obese resistant and obese sensitive (OS). Obese resistant mares were 61% less insulin sensitive than N mares and 59% less insulin sensitive than OS mares (P &lt; 0.0001, P &lt; 0.01, respectively). There was no difference for IS between N and OS mares. All analyses were thus performed comparing the 3 groups. In the N group, 3 mares were insulin resistant (one-third of the mares of the N group). Feed intake during wintering was not different between groups. Mares of both O groups maintained a high BCS (&gt;4) during pregnancy, whereas N mares lost BCS down 2.75 at birth (&lt;0.001). Basal glucose, insulin, triglycerides, and nonesterified fatty acid plasma were not different during gestation. At birth, no difference was observed for placental weight, surface and volume, nor for foal weight and withers height. The volume of allantoic vessels was reduced in placentas of OS mares compared with those of OR (P = 0.03; 78%) and N mares (P = 0.005; 65%). Moreover, placentas from OS mares had an increased volume of haemotrophic trophoblast (P = 0.03) and microcotyledonary vessels (P = 0.03) compared with N mares. No difference of expression was observed for 11 genes related to nutrient transfer, vascularization, growth, and development. Mare that are obese at insemination and insulin sensitive in late gestation appear to develop placental structural adaptations during gestation, possibly to increase fetoplacental exchanges, compared with obese, insulin resistant mares and lean mares. The monitoring of foal development (growth, metabolism, and osteoarticular status) is ongoing.

Evaluation of clinical efficacy and safety of carboprost tromethamine injection combined with low B-Lynch suture for intractable postpartum hemorrhage placenta previa

Objective To investigate clinical efficacy and safety of carboprost tromethamine injection combined with low B-Lynch suture for intractable postpartum hemorrhage placenta previa. Methods 125 cases of intractable postpartum hemorrhage placenta previa were divided into two groups according to treatment(n=62) with the observation group(n=63), the control group was administered oxytocin, and the line in the placental separation surface 8 interrupted suture; the observation group was used carboprost tromethamine injection combined with low B-Lynch suture.Clinical efficacy, blood loss, bleeding, postoperative bleeding 2h, 24h after blood loss, transfusion rate and index sex hormone levels were compared before and after treatment. Results (1)After treatment, total effective rate of the control group and observation group was 77.42%(48/62) and 95.24%(60/63) respectively.There was a statistically significant difference between the two groups(P 0.05), and after treatment, the index level differences were not statistically significant(P>0.05); (4)the two groups during treatment, liver and kidney functions were normal, three cases of the control group and two cases of the observation group occured nausea and vomiting. Conclusion Carboprost tromethamine injection combined with low B-Lynch suture has significant effect, a small amount of bleeding, high security for intractable postpartum hemorrhage placenta previa, which should be promoted. Key words: Placenta previa; Intrctable postpartum hemorrhage; Carboprost tromethamine injection; Lower B-Lynch suture technique; Hormone