Diagnosis Of Pregnancy Research Articles

The Value of Ultrasonography in the Diagnosis of Abdominal Pregnancy.

Analyze the clinical and ultrasound characteristics of 15 cases of abdominal pregnancy (AP) to improve the ultrasonography-based diagnosis. A retrospective research of AP patients from 2010 to 2021 with pathology was performed, clinical and ultrasound characteristics were analyzed and summarized. Fifteen cases of AP occurred in early pregnancy. Most cases of AP were implanted in the pelvic cavity, with a few on the greater omentum and diaphragm, etc. Eight cases showed mixed hyperechoic, four cases had gestational sacs, and three cases exhibited mixed hypoechoic. Combined with the characteristics of AP, ultrasound can provide a valuable diagnosis.

Cell-free pregnancy-associated microRNAs in blood plasma as potential biomarker in early diagnosis of ectopic pregnancy.

Ectopic pregnancy (EP) is one of the life-threatening disorders in early pregnancy and current strategies are inadequate in its clinical management. There is a need to identify more accurate biomarkers for early diagnosis of ectopic pregnancy. This case-control study was conducted in a group of 35 women diagnosed with ectopic pregnancy and 31 women with a normal singleton pregnancy. Patients' characteristics including the level of β-hCG, age, body mass index (BMI), and gestational age have been recorded. The plasma levels of cell-free hsa-miR-411, hsa-miR-433, and hsa-miR-524 were examined by qRT-PCR using specific primers. There was no statistically significant difference in maternal age, gestational age, and BMI between the two groups. β-hCG concentrations in EP were significantly lower than normal pregnancy group. Cell-free hsa-miR-411 and hsa-miR-433 had statistically significant differences in concentrations in women with EP and normal pregnancy. hsa-miR-411 and hsa-miR-433 had better diagnostic values for discriminating EP from normal pregnancy. Moreover, hsa-miR-411 and hsa-miR-433 showed a specificity of 61% and 53%, and a sensitivity of 72% and 79%, respectively. hsa-miR-411 and hsa-miR-433 microRNAs concentrations in plasma have potential as a predicting biomarker for early diagnosis of EP. However, further research is needed before using miRNAs in clinical practice for both diagnostic and therapeutic goals.

Successful delivery in a cornual pregnancy after expectant management with traditional Chinese medicine and low-molecular-weight heparin: A case report.

Horn pregnancy is a rare subtype of ectopic pregnancy that presents a diagnosis and treatment challenge due to its nonspecific symptoms and high risk of rupture. A 32-year-old woman without vaginal pregnancy with history of right corner who presented with painless vaginal bleeding. A transvaginal ultrasound revealed a pregnancy sac implanted in the left corner of the uterus, confirming the diagnosis of a cornual pregnancy. Treatment options include pharmacological or surgical interventions, and anticipatory treatment is rarely recommended. Conservative treatment was chosen after extensive consultation, and the patient was treated with low molecular weight heparin and traditional Chinese medicine. Subsequent ultrasound tests showed stable fetal development and a successful cesarean section. This case highlights the success of combining low molecular weight heparin with traditional Chinese medicine in the treatment of cornual pregnancy. Factors affecting horn pregnancy, diagnostic challenges, and treatment considerations are discussed. Further research is necessary to determine the best management strategy and to ensure safe delivery for patients with impaired fertility but a strong desire to conceive.

Uterine cysts in mares

This work is aimed at studying the etiology, prevalence, diagnosis, treatment of uterine cysts and their difference from the embryo during ultrasound examination. Endometrial cysts are often the cause of infertility and indicate pathological changes in the uterus, occurring in older mares. There are two types of uterine cysts: endometrial glandular cysts and lymphatic lacunar cysts. Endometrial cysts are usually smaller than lymphatic cysts located in the endometrium and are composed of endometrial glands. Lymphatic cysts cause obstruction of the lymphatic channels and appear as single or multilobular structures. Cysts can result from chronic degenerative changes in the endometrium and their clinical significance varies. For example, in terms of fertility, their influence is related to size, conditioning, content and location in the uterus. The presence of small cysts often indicates matte structures. In addition, larger or more active cysts have an impact on the course of pregnancy. Single large or small cysts can lead to embryonic pregnancy failure, which is the most difficult recognition of maternal pregnancy. Careful testing methods can effectively monitor the mare's condition and ensure the prospects for a successful pregnancy. This pathology is diagnosed using rectal and ultrasound examinations. There are many treatment options: they can be removed by surgery, hysteroscopic biopsy forceps, snare, laser (diode, CO2 or Nd/YAG laser), electrocoagulation or injection of 70 % ethanol (sclerotherapy method). But unfortunately, many cysts are prone to relapse. Sometimes the presence of cysts can interfere with the diagnosis of pregnancy or lead to an erroneous diagnosis of “multiple pregnancy”, since cysts under ultrasound exposure appear as filling fluid structures in the endometrial lumen. For this reason, it is important to be able to diagnose, predict consequences and treatment options in the mare.

Pregnancy monitoring and parturition in dogs

Management of term pregnant dogs is a major and frequent clinical situation in small animal reproductive veterinary practices, and can be challenging. Whether a pregnancy is planned or unplanned, these cases require careful monitoring to prevent maternal distress and neonatal loss. Reproductive system evaluation of female dogs is useful for determination of ovulation during breeding management, pregnancy diagnosis, and for timing of cesarean surgery, among other clinical scenarios. Basic understanding of female dog’s reproductive physiology is mandatory to interpret relevant hormonal assays and other complementary diagnostics such as vaginal cytological evaluation and imaging (ultrasonography and radiography) for clinical decisions. This review covers physiology, diagnostics, and clinical outcomes relevant for pregnancy monitoring and parturition.

Examining childhood and adulthood stressors as risk factors for gestational diabetes mellitus in working pregnant individuals: A prospective cohort study

AimsThis study aimed to examine the individual and joint associations of adverse childhood experiences (ACEs) and maternal work and non-work related stressors with the risk of gestational diabetes mellitus (GDM). MethodsWorking pregnant individuals (n = 1163) from a United States (U.S.) prospective cohort conducted in South Carolina between 2016 and 2021 were included in the study. ACEs were assessed at study enrollment before 20 gestational weeks (GW), while maternal stressors were assessed in late pregnancy and GDM diagnosis occurred between 24 and 30 GW. Multivariable logistic regressions were performed to assess associations of ACEs and maternal stressors with GDM. ResultsChildhood abuse, an ACE subdomain, was associated with an elevated but statistically insignificant risk of GDM (adjusted OR = 1.47; 95 % CI: 0.85–2.53). Only maternal work stressors were associated with an increased risk of GDM (adjusted OR = 2.11; 95 % CI: 1.17–3.79) and the association became much stronger among those with childhood abuse experiences (adjusted OR = 3.80; 95 % CI:1.68–8.60). ConclusionAmong U.S. working pregnant individuals, having work stressors during pregnancy was associated with an elevated risk of developing GDM, particularly among those who had childhood experience of abuse.

Factores que influyen en la inseminación artificial con semen fresco en alpacas (<i>Vicugna pacos</i>)

The aim of the study was to evaluate factors that affect the fertility of artificial insemination (AI) with fresh diluted semen in alpacas. In Exp. 1, females with preovulatory follicles with diameters ≥7-≤ 9 or ≥10-≤12 mm were inseminated; in Exp. 2 the females were inseminated at 24, 26, 28 and 30 h after ovulation induction; In Exp. 3, alpacas were inseminated with semen at four concentrations: 15, 25, 35 and 45x106 sperm/ml; and in Exp. 4, using the best results from the previous experiments, 350 alpacas were inseminated in two peasant communities. Semen was collected by the post-copulatory method, using ejaculates with motility ≥60%, diluted in Tris-glucose-citric acid and egg yolk. Alpacas with preovulatory follicles ≥7 mm were selected for AI. Ovulation induction was done with a GnRH analogue and pregnancy diagnosis was made 30 days after service. Pregnancy rate was not affected by follicular size. AI 24 to 26 h after ovulation induction obtained a higher pregnancy rate (50 and 55%, respectively; p<0.05) compared to those inseminated at 28 and 30 h (35 and 30%). AI with 15x106 sperm/ml resulted in low pregnancy rates (30%) compared to 35 and 45x106 sperm/ml (50 and 55%, respectively). In the peasant communities, 55% pregnancy rate was obtained. The results suggest that the success of AI with fresh semen in alpacas is highly dependent on sperm dose and timing of insemination.

Study of Masanumasika Garbha Vikas Krama (Monthwise Devlopment during Pregnancy) in Context to Embryogenesis and Foetal Development

Sushruta Samhita is a significant Ayurvedic text on human anatomy and physiology. It provides detailed information on Garbha Vriddhi and Vikas Krama (Growth and Development) Various texts express different opinions regarding Garbha Utpatti (Fertilization) and Garbha Vriddhi. Acharyas have explained Garbhini Lakshana (Gravida symptoms) also. Which are helpful in early pregnancy diagnosis. Charaka has explained month wise symptoms in Garbhini during pregnancy. Now days, obstetrics is a fundamental field of study dealing with human reproduction, offering comprehensive information on fetal growth and development. Contemporary obstetrics has undergone extensive research and development. Neonatal mortality and fetal fatality are always the causes of concern. Samhitas provide pertinent resources on these topics. Acharyas have discussed about these in the reference of Garbhini. It takes a great deal of research and debate to comprehend the old Garbha Utpatti or Garbhavkranti notion. Examining both contemporary and Ayurvedic literature will aid in learning more about this. The goal of this study is to compare and clarify the concepts of embryogenesis from antiquity to the present

Relationship between Low Carbohydrate Diet and Postpartum Anxiety and Depression: Iranian Maternal and Child Health Cohort Study

Introduction: Postpartum depression, a form of depression, is a relatively common but serious medical condition that occurs following the birth of a baby. This study aimed to determine the relationship between the carbohydrate diet and the occurrence of anxiety and postpartum depression symptoms in women participating in the initial phase of the Maternal and Child Health Cohort Study, Yazd, Iran. Methods: This study was conducted on the data of 1028 pregnant women from the Yazd Maternal and Child Health Cohort Study. The study tools were food frequency questionnaire (FFQ) and postpartum depression questionnaire. Data related to dietary intake at the beginning of the study were collected in the first visit after pregnancy diagnosis and data related to depression in the second month after delivery. Carbohydrate intake score was calculated for each person according to summing up assigned scores to deciles of percentages of energy from macronutrients. Multivariable logistic regression models were used to estimate the odds ratio (ORs) and 95% confidence interval (CI) of postpartum depression and anxiety across quartiles of low carbohydrate diet scores. Results: Based on the multivariable-adjusted model, there was no significant association between low carbohydrate diet score and odds of postpartum depression (P=0.08). However, multivariable-adjusted model significantly indicated an association between low carbohydrate diet score in second tertile and the odds of postpartum anxiety (P=0.02) (OR: 0.36, 95% CI: 0.15-0.86). Conclusion: After adjusting the confounders, women in the second tertile of low carbohydrate diet score might have 64% lower chance of depression versus those in the first quartile. While low or high carbohydrate intake does not affect postpartum anxiety and depression, moderate carbohydrate intake might be anxiety protective.

Temporal and age-related trends in risk factors for development of atrial fibrillation in peripartum patients

Abstract Background Incidence of atrial fibrillation (AF) in pregnancy has steadily increased over the past two decades and may be related to changes in rates of AF risk factors. Objective To characterize trends in the prevalence of AF risk factors among patients with peripartum AF. Methods TrinetX, a large national healthcare database, was used to identify patients with peripartum AF from 2017-2022. Inclusion criteria were female patients aged >18 years old who received a diagnosis of AF within one month prior to and one year after a diagnosis of pregnancy. Annual prevalence of pre-existing AF risk factors, including diabetes, chronic kidney disease (CKD), obesity, and hypertension, were obtained, normalized to the annual number of peripartum AF cases, and followed. In a second analysis, student’s t-test and standardized mean difference were used to compare the rates of AF risk factors between patients with peripartum AF and pregnant patients with no history of AF within the same time frame. Comparisons were performed across age ranges. Results From 2017-2022, there were 6,465 patients with peripartum AF and 2,852,348 pregnant patients with no AF. There was an increase in the proportion of peripartum AF patients with pre-existing obesity (16.7% to 18.5%) and hypertension (28.9% to 33.7%). In comparing pregnant patients with no AF history with peripartum AF patients, the standardized mean difference for rates of all risk factors increased with age group. The peripartum AF group had significantly higher rates of all risk factors across all age groups (p < 0.0001 for all groups). Conclusion Rates of pre-existing obesity and hypertension increased among patients with peripartum AF, which could be a factor in increasing rates of peripartum AF. Differences in rates of AF risk factors between peripartum AF patients and pregnant patients with no AF were more pronounced at older age groups.

Case Report: Acute Abdomen Due to Ruptured Ovarian Ectopic Pregnancy at 8 Weeks

Background Ovarian pregnancy is a rare type of ectopic pregnancy, accounting for 0.5% to 1% of all ectopic pregnancies, with an incidence ranging from 1 in 2,100 to 1 in 60,000 pregnancies. Due to its rarity and the lack of common risk factors, diagnosing ovarian pregnancy is often challenging and typically occurs during surgical exploration. Case Presentation We present the case of a 40-year-old woman who experienced severe pelvic pain, light vaginal bleeding, and 8 weeks of amenorrhea. Upon arrival at the hospital, she was hemodynamically unstable, with low blood pressure and a rapid heart rate. An ultrasound revealed an empty uterus, an irregular mass on her right ovary, and free fluid in the pelvis. Her beta-hCG level was elevated, and her hemoglobin level was low. Given the suspicion of an ectopic pregnancy, she underwent emergency surgery. During the operation, the surgical team discovered a large amount of clotted blood and a ruptured mass on her left ovary measuring 10 x 9.5 cm. Due to heavy bleeding, they performed a left oophorectomy and salpingectomy. Histopathological analysis later confirmed the diagnosis of ovarian pregnancy. Conclusion This case underscores the challenges in diagnosing ovarian pregnancy and highlights the necessity for prompt surgical intervention, particularly in unstable patients. Early detection and appropriate management are critical to prevent life-threatening complications.

Ultrasonic diagnosis of hepatic ectopic pregnancy: a case report

Hepatic ectopic pregnancy is an extremely rare ectopic pregnancy. Ectopic pregnancy is one of the reasons for acute abdominal pain. Ectopic pregnancy refers to the growth and development of zygotes outside the uterine cavity, and tubal pregnancy is the most common. Abdominal ectopic pregnancy is very rare, accounting for only 1.3% of all ectopic pregnancy including small intestine and large intestine, sigmoid colon, omentum, liver, diaphragm, pancreas, peritoneum and spleen [1], of which the incidence of hepatic ectopic pregnancy is about 1:15,000 per inner uterus pregnancy [2]. The present report describes the case of a 36-year-old woman who presented with continuous brown vaginal secretions after 57 days of amenorrhea. The patient was initially diagnosed with liver ectopic pregnancy by abdominal ultrasound and this was confirmed by laparoscopic exploration. The pathological examination revealed a pregnancy material in the liver tissue. The patient made good progress post-surgery, with serum levels returning to normal during a follow-up examination 1 month later. Overall, ultrasound and β-HCG levels are crucial in diagnosing ectopic pregnancy before patients show clinically consistent symptoms.

Management of nontubal ectopic pregnancies - single center experience

Aims: Ectopic pregnancies can be defined as pregnancies in which the growing blastocyst implants outside the endometrial cavity. However, it is assumed that 0.5-1% of all pregnancies are ectopic pregnancies. The most common extrauterine implantation site is the fallopian tube. Non-tubal pregnancies (NTG Non-tubal pregnancies) account for less than 5% of all ectopic pregnancies but cause 8 times higher maternal mortality than tubal pregnancies. The study aimed to determine the frequency of nontubal ectopic pregnancies in a tertiary care unit in Turkey and the differences that may differentiate patients from tubal ectopic pregnancies. Methods: The purpose of this retrospective study was to analyze and describe the treatments of patients who were hospitalized for ectopic pregnancy in the Gynecology and Obstetrics Clinic of Mengücekgazi Training and Research Hospital from May 2014 to May 2024. Obstetric/gynecologic history, risk factors for previous ectopic non-tubal pregnancy, serum-hCG levels at the moment of diagnosis, ultrasound findings, surgical or medical treatment and treatment outcomes were presented. Results: In our institutional records, 240 patients received an ectopic pregnancy diagnosis. and n=23 nontubal ectopic pregnancies were identified. Cervical pregnancy (CP) (n=2), interstitial pregnancy (IP) (n=2), cesarean scar pregnancy (ScP) (n=10), ovarian pregnancy (OvP) (n=9) were detected. Conclusion: It emerges from our sample that NT-EP needs to be diagnosed quickly. This can assist in the conservative use of a medical or minimally invasive method. The significant advance in imaging technologies allows for a faster diagnosis, allowing the patient to be transferred to a referred center from where the best procedures can be selected, reducing the potential impact of surgery on the patient’s fertility.

Albert Sharman (1903-1970): Gynaecologist, inventor and teacher.

Albert Sharman was a Glasgow-born and based gynaecologist who pioneered research into infertility and the diagnosis of pregnancy using new techniques of investigation and treatment, many of his own design. His Fertility Clinic, opened in 1931, was the first in Britain, and became a model for those that followed. Working at Glasgow's Royal Samaritan Hospital for Women, he published widely in the medical press, especially the British Medical Journal and the Lancet, and he authored and co-edited several books, some aimed at a medical audience while others sought to explain complex issues surrounding puberty, fertility and the menopause to the general public.

Success of Artificial Insemination in Rural Area Cows

Biotechnologies of reproduction like artificial insemination were identified as a mean to intensify the local production. Therefore, some factors are still responsible to the failure of their applications in rural area. This survey was conducted from April to June 2023, to evaluate the effects of age, body weight, body condition score (BCS), calving rank, postpartum to artificial insemination interval and feed complementation on the success rate of artificial insemination in females Goudali. Thus, activities took place at two peri-urban livestock farms in the town of Ngaoundéré, in the Adamaoua region of Cameroon where 34 cows were concerned. The selected cows have an average of 8.21±2.41 years old, a body weight of 343±52.28 kg, a body condition score of 3.23±0.55, a calving rank of 2.21±1.22 and a postpartum to insemination interval of 4.39±1.40 months. The induction and synchronization of estrus were carried out based on the PRID-PGF2α-PMSG protocol which allowed to obtain a synchronization rate of 97.06% and the insemination were done 56-57 hours after the previous operation, with an imported semen of Brahman bull. During rectal palpation and early pregnancy diagnosis based on progesterone level measurement, the result shown that, 20 cows out of 33 inseminated were pregnant. The success rate of artificial insemination recorded was 60.6%. Amongst all the studied factors, analysis shown no significant (P> 0.05) effect on the success rate after artificial insemination. Thus, recommendations were made to popularize the use of artificial insemination and early pregnancy diagnosis test as a mean to improve reproductive performances of local farms. However, studies must be done to evaluate the cost of their applications in rural areas.

Thrombotic complications in pregnancy: a case-based review of the evidence

Pregnancy is a prothrombotic state due to an estrogen-driven shift in the coagulation system, increased venous stasis, and external restriction of blood flow caused by the gravid uterus. Venous thromboembolism (VTE) is a leading cause of morbidity and mortality in pregnancy. Preventing, recognizing, and treating thrombosis in pregnancy, as well as the postpartum period, often challenges decision making in the clinical setting. In early pregnancy, guidance with respects to thrombophilia testing and anticoagulation in increasing the likelihood of live birth among patients with recurrent miscarriages is evolving. This review explores emerging data that support clinical decision making in thrombosis care in women with common thrombotic complications in pregnancy. The first case outlines VTE diagnosis in pregnancy, initial anticoagulation management, management around delivery and postpartum, and subsequent long-term anticoagulation treatment. The second case examines testing for inherited and acquired thrombophilia in the setting of recurrent miscarriage and the management of obstetric antiphospholipid syndrome. Lastly, the third case reviews VTE risk assessment and prevention in pregnancy and the postpartum period, as well as duration and dose of postpartum thromboprophylaxis. Review of these common clinical scenarios surrounding thrombotic complications in pregnancy demonstrates recent advances in high-quality data, current gaps in knowledge, and variation in expert opinion. Ultimately, multidisciplinary discussion and teamwork remain key to optimal, safe care. Clinicians must prioritize collaborative, high-quality trials and prospective clinical management studies to better understand and define best practice in this population.

Potential Risk Factors for Developing Cesarean Scar Pregnancy in Women With a History of Cesarean Section.

Cesarean scar pregnancy (CSP) occurs in 0.2%-0.5% of women with a previous cesarean section globally. Multiple factors influence the development of CSP; however, to date, the critical factors contributing to the development of CSP have not been fully explored due to its relatively low incidence. Moreover, CSP can be clinically categorized into type 1 and type 2 CSP. In this retrospective study with a large sample size, we investigated potential risk factors that could contribute to CSP development. Two hundred-one women diagnosed with CSP, either type 1 or type 2 CSP, and 1700 pregnant women with a history of cesarean section but without CSP diagnosis in subsequent pregnancy were included. Gravidity, previous live birth(s), consecutive cesarean section(s), surgical abortion(s), the interval between the pregnancies, and maternal age were compared between the 2 groups. Gravidity, the number of previous live births, the number of previous consecutive cesarean sections, and the number of surgical abortions were significantly associated with CSP development in women with a past cesarean section. This association was regardless of the subtypes of CSP. Notably, the interval between 2 pregnancies was also significantly associated with CSP development, but this association was only seen in type 2 CSP. However, maternal age was not an independent risk factor for CSP development. Additionally, a higher incidence of CSP was observed in China compared to that reported in the literature. In addition to a previous cesarean section, our study highlights at the number of surgical abortions also contributes to the development of CSP.

7527 Subacute Thyroiditis in First Trimester of Pregnancy: Rare Cause of Thyrotoxicosis

Abstract Disclosure: K. Wilcher: None. A. Gupta: None. Background: Subacute thyroiditis (SAT) is extremely rare in pregnancy with only 8 prior cases reported in the literature. SAT can result in maternal and fetal complications. In this case report, we describe a case of subacute thyroiditis presenting in the first trimester of pregnancy. Case Presentation: A 38-year-old female with past medical history of stillbirth presented with thyrotoxicosis in gestational week 10 of her pregnancy. The patient has a history of stillbirth in gestational week 38 of her first pregnancy requiring cesarean section one year prior to presentation. She was in the process of getting in vitro fertilization (IVF) and had an egg retrieval. During the process, she started on thyroxine 50 mcg daily for blood thyroid-stimulating hormone (TSH) 3.77 mcIU/mL. She became pregnant without the help of IVF and stopped thyroxine. One month later, labs showed low TSH 0.022 mcIU/mL (reference range: 0.4-4.5 mcIU/mL) and high blood free thyroxine (FT4) 1.87 ng/dL (reference range: 0.7-1.8 ng/dL). Repeat labs two weeks later showed low blood TSH 0.012 mcIU/mL, high FT4 2.08 ng/dL, and high blood free triiodothyronine (FT3) 5.2 pg/mL (reference range: 2.3-4.2 pg/mL). She was referred to endocrinology for evaluation. She reported mild intermittent right sided neck pain since diagnosis of pregnancy. She denied any history of viral infection, cough, or fever. She reported symptoms of severe nausea, mild constipation, and mild anxiety. She denied diarrhea, tremors, changes in voice, palpitations, or weight loss. Her family history is significant for hypothyroidism in her father. Physical exam demonstrated a non-tender, symmetric thyroid without enlargement or nodules. Ultrasound showed heterogenous thyroid with an ill-defined heterogenous area in the right lobe appearing pseudo-nodule, and increased vascularity. At this time, the patient was diagnosed with mild gestational hyperthyroidism with a plan to monitor thyroid hormone levels. Repeat labs two weeks later showed low blood TSH 0.005 mcIU/mL, high FT4 2.35 ng/dL, and high FT3 6.4 pg/mL. TSH-receptor antibodies, thyroid stimulating immunoglobulin, and thyroid peroxidase antibodies were normal on testing. In gestational week 16, labs showed normal TSH 2.76 mcIU/mL, low FT4 0.56 ng/dL, and low FT3 2.1 pg/mL. At that time, she started on levothyroxine 75 mcg daily and was diagnosed with subacute thyroiditis. Follow up labs in gestational weeks 18, 20, and 24 showed improvement in TSH and FT4 on thyroid hormone supplementation. Conclusion: This case report discusses the findings of SAT in first trimester pregnancy. Currently, she is in gestational week 28 and still requiring thyroid hormone supplementation. SAT in pregnancy is very rare. This case report significantly contributes to the literature and current knowledge of the prevalence, presentation, and disease process of subacute thyroiditis in first trimester pregnancy. Presentation: 6/2/2024

Vascular Alterations in Uterine and Ovarian Hemodynamics and Hormonal Analysis throughout Pregnancy Loss in Cows under Heat Stress.

This current study examined the ovarian (OA) and middle uterine arteries (MUA) blood flow under heat stress conditions regarding hormonal status (progesterone (P4), estradiol (E2), and nitric oxide metabolites (NOMs) assays). Eighteen pluriparous cows were examined, with twelve only being subjected to the natural mating as the other six animals were not bred. Pregnancy diagnosis was confirmed at day 30 by embryonic heartbeat and CL graviditatis (n = 6; pregnant), but some animals (n = 6) showed early embryonic death (EED), with the presence of control cows (n = 6). In the pregnant group, luteal diameter (cm) increased after mating, while in the pregnancy loss group it increased (p < 0.05) until reaching day 38 (1.41 ± 0.03), then decreased again. Luteal vascularity was declined in cows with EED after day 36 (p < 0.05) and reached its lowest level at day 50. P4 levels elevated in cows with EED until day 36 (13.64 ± 0.11) then declined. Both ipsilateral OA and MUA Doppler indices were declined in both groups except in cows who suffered from EED; both were elevated from day 38 until day 50 after mating. Ipsilateral peak systolic point (PSV cm/sec) of OA and MUA was elevated in both groups (p < 0.05), but in cows with EED this parameter was declined. E2 and NOMs levels were declined in cows with EED from day 40 and day 38 after mating (p < 0.05), respectively. This study provided novel data on the relations among the luteal diameter, E2, P4, and NOM levels, and luteal hemodynamics that predicts the amount of blood supply, which acts as a sensitive parameter to detect the alterations in luteal function during the first 50 days after mating.

The Use of Japanese Traditional (Kampo) Medicines Before and During Pregnancy in Japan: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

Japanese traditional (Kampo) medicines are often used for pregnant women in Japan. However, no comprehensive studies have been conducted regarding the self-reported use of these medicines during pregnancy. This study investigated the use of Kampo medicines during pregnancy in Japan using the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study). Questionnaires were distributed to pregnant women participating in the TMM BirThree Cohort Study (July 2013 to March 2017) at approximately 12 weeks (early pregnancy) and 26 weeks (middle pregnancy). We analysed Kampo medicines use over three periods: (1) 12 months before pregnancy diagnosis, (2) the period between pregnancy diagnosis and around Week 12 of pregnancy and (3) from around Week 12 of pregnancy. In total, 19 220 women were included in the analysis. The proportions using prescribed Kampo medicines were 4.1% before pregnancy diagnosis, 4.5% from diagnosis to Week 12% and 4.5% after Week 12 of pregnancy. The most frequently prescribed Kampo medicines were tokishakuyakusan (1.0%) before pregnancy diagnosis, shoseiryuto (1.3%) from diagnosis to Week 12 and shoseiryuto (1.5%) Post-week 12. Sixty of the pregnant women used Kampo medicines containing crude drugs, which should be administered cautiously during pregnancy. The proportion of Kampo medicines use before and during pregnancy was 4%-5%. Some pregnant women used Kampo medicines containing crude drugs that should be administered cautiously during pregnancy. Further research is required to determine the safety of Kampo medicines during pregnancy.