Premature Separation Research Articles

164 Placental abruption by maternal country of birth: A nationwide population-based study

Introduction: Placental abruption, defined as the premature separation of placenta, is a serious complication in pregnancy. While its incidence varies across countries, the information of how abruption varies in immigrant populations is limited. Aim: The aims of this study were to estimate the incidence of placental abruption in immigrant women compared to non-immigrants by maternal country and region of birth, reason for immigration and length of residence. Methods: We conducted a nationwide population-based study using data from the Medical Birth Registry of Norway and Statistics Norway (1990-2016).

Cohesin-Mediated Chromatin Interactions and Autoimmunity.

Proper physiological functioning of any cell type requires ordered chromatin organization. In this context, cohesin complex performs important functions preventing premature separation of sister chromatids after DNA replication. In partnership with CCCTC-binding factor, it ensures insulator activity to organize enhancers and promoters within regulatory chromatin. Homozygous mutations and dysfunction of individual cohesin proteins are embryonically lethal in humans and mice, which limits in vivo research work to embryonic stem cells and progenitors. Conditional alleles of cohesin complex proteins have been generated to investigate their functional roles in greater detail at later developmental stages. Thus, genome regulation enabled by action of cohesin proteins is potentially crucial in lineage cell development, including immune homeostasis. In this review, we provide current knowledge on the role of cohesin complex in leukocyte maturation and adaptive immunity. Conditional knockout and shRNA-mediated inhibition of individual cohesin proteins in mice demonstrated their importance in haematopoiesis, adipogenesis and inflammation. Notably, these effects occur rather through changes in transcriptional gene regulation than through expected cell cycle defects. This positions cohesin at the crossroad of immune pathways including NF-kB, IL-6, and IFNγ signaling. Cohesin proteins emerged as vital regulators at early developmental stages of thymocytes and B cells and after antigen challenge. Human genome-wide association studies are remarkably concordant with these findings and present associations between cohesin and rheumatoid arthritis, multiple sclerosis and HLA-B27 related chronic inflammatory conditions. Furthermore, bioinformatic prediction based on protein-protein interactions reveal a tight connection between the cohesin complex and immune relevant processes supporting the notion that cohesin will unearth new clues in regulation of autoimmunity.

Measuring errors over time: towards a quantitative theory of chromosome segregation error correction

The mammalian mitotic spindle segregates an equal number of chromosomes to daughter cells. Over the course of spindle assembly, many initially erroneous attachments between kinetochores and microtubules are fixed through a process called error correction. Despite the importance of chromosome segregation errors in many human health conditions, we lack quantitative methods to characterize the dynamic error correction process and how it is impaired in disease states. We have developed a novel experimental method and analysis framework to quantify chromosome segregation error correction in human tissue culture cells with live cell confocal imaging of spindle assembly, timed premature chromosome separation, and automated counting of kinetochores after cell division.

Frequency of Abruptio Placenta in Women With Pregnancy-Induced Hypertension.

Background: Bleeding that takes place after premature separation of the normally situated placenta, usually after 20 weeks of pregnancy, is known as abruptio placenta. Factors increasing chances of abruptio placenta are advanced age pregnancy, parity, smoking, pregnancy-induced hypertension, pre-eclampsia, and previous incidence of abruptio. The objective of the study was to find the frequency of abruptio placenta in women with pregnancy-induced hypertension.Methods: This descriptive prospective study was conducted in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Karachi, from January to July, 2021. Women of gestational age above 20 weeks were included. Patients with blood pressure ≥140/90mmHg were considered as having pregnancy-induced hypertension. Early separation of the normally placed placental from the uterine wall was defined as placental abruption with clinical signs of painful vaginal bleeding (concealed or revealed), uterine contractions, and non-reassuring fetal heart rate. Descriptive statistics were calculated. Stratification was done and the post-stratification chi-square test was applied. P-value ≤ 0.05 was taken as significant.Results: A total of 205 patients were included in the study. The mean age was 24.26±2.92 years. The mean gestational age was 30.82±3.22 weeks. The mean parity was 2.59±0.80 children. Mean systolic blood pressure was 148.48±5.99 mmHg and mean diastolic blood pressure was 94.85±3.05 mmHg. Bleeding was reported in 110 (53.7%) cases. Lower abdominal tenderness in 125 (60.5%) cases. Fetal heart rate was normal in 16.6% of the cases. Abruptio placenta was observed in 29 (14.1%) patients.Conclusion:Abruptio placenta is a life-threatening condition that occurs during pregnancy that can result in both maternal and fetal morbidity and mortality. Adequate and urgent intervention can result in a favourable outcome.

A rare case of premature and parallel posterior descending artery and posterior left ventricular branch with conus crossing the right ventricular outflow tract causing provocative coronary ischemia

We report a rarely encountered case of premature and parallel posterior descending artery (PDA) and posterior left ventricular branch (PLVB) in a case of 22-year-old male with effort angina Class II for the last 6 months in whom treadmill test (TMT) was strongly positive for provocative coronary ischemia with structurally normal heart and good biventricular function. Interestingly, all the coronaries were normal without any obstructive coronary lesion. Paradoxically, those two prematurely separating branches were small making the distal right coronary artery (RCA) territory relatively ischemic attributing toward a strongly positive TMT. Small anomalous coronary is a well-known cause of demand ischemia, but our case is unique to describe small prematurely originating PDA and PLVB were the culprit behind coronary ischemia in a young male without conventional risk factors. Furthermore, much premature separation of PDA and PLVB is rarely encountered in routine clinical practice, and recognition of this anomaly is important as it should not be mistaken for duplicate RCA, dual RCA, or split RCA. Our case is also unique to illustrate the association of the premature and parallel PDA and PLVB with a conus crossing the right ventricular outflow tract without the presence of structural heart disease.

Najvažnije o abrupciji placente - klinička slika i lečenje

Placental abruption is defined as the premature separation of the placenta from the uterus. Rapid diagnosis and adequate medical intervention provide a good outcome, which is not possible in all countries. Any bleeding that occurs in the second half of pregnancy raises the suspicion of placental abruption, which is associated with fetal and maternal morbidity and mortality. The clinical picture and consequences for the fetus depend on the degree of bleeding and the amount of blood. Complete abruption leads to the disruption of fetal circulation and oxygenation, asphyxia, and stillbirth. In case of partial abruption, the consequences for the fetus depend on the degree of bleeding. In complete abruption, fetal death is inevitable unless an emergency cesarean delivery is undertaken.

Rice Cell Division Cycle 20s are required for faithful chromosome segregation and cytokinesis during meiosis.

Chromosome segregation must be under strict regulation to maintain chromosome euploidy and stability. Cell Division Cycle 20 (CDC20) is an essential cell cycle regulator that promotes the metaphase-to-anaphase transition and functions in the spindle assembly checkpoint, a surveillance pathway that ensures the fidelity of chromosome segregation. Plant CDC20 genes are present in multiple copies, and whether CDC20s have the same functions in plants as in yeast and animals is unclear, given the potential for divergence or redundancy among the multiple copies. Here, we studied all three CDC20 genes in rice (Oryza sativa) and constructed two triple mutants by clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein 9-mediated genome editing to explore their roles in development. Knocking out all three CDC20 genes led to total sterility but did not affect vegetative development. Loss of the three CDC20 proteins did not alter mitotic division but severely disrupted meiosis as a result of asynchronous and unequal chromosome segregation, chromosome lagging, and premature separation of chromatids. Immunofluorescence of tubulin revealed malformed meiotic spindles in microsporocytes of the triple mutants. Furthermore, cytokinesis of meiosis I was absent or abnormal, and cytokinesis II was completely prevented in all mutant microsporocytes; thus, no tetrads or pollen formed in either cdc20 triple mutant. Finally, the subcellular structures and functions of the tapetum were disturbed by the lack of CDC20 proteins. These findings demonstrate that the three rice CDC20s play redundant roles but are indispensable for faithful meiotic chromosome segregation and cytokinesis, which are required for the production of fertile microspores.

Mitotic phosphorylation of tumor suppressor DAB2IP maintains spindle assembly checkpoint and chromosomal stability through activating PLK1-Mps1 signal pathway and stabilizing mitotic checkpoint complex

Chromosomal instability (CIN) is a driving force for cancer development. The most common causes of CIN include the dysregulation of the spindle assembly checkpoint (SAC), which is a surveillance mechanism that prevents premature chromosome separation during mitosis by targeting anaphase-promoting complex/cyclosome (APC/C). DAB2IP is frequently silenced in advanced prostate cancer (PCa) and is associated with aggressive phenotypes of PCa. Our previous study showed that DAB2IP activates PLK1 and functions in mitotic regulation. Here, we report the novel mitotic phosphorylation of DAB2IP by Cdks, which mediates DAB2IP’s interaction with PLK1 and the activation of the PLK1-Mps1 pathway. DAB2IP interacts with Cdc20 in a phosphorylation-independent manner. However, the phosphorylation of DAB2IP inhibits the ubiquitylation of Cdc20 in response to SAC, and blocks the premature release of the APC/C-MCC. The PLK1-Mps1 pathway plays an important role in mitotic checkpoint complex (MCC) assembly. It is likely that DAB2IP acts as a scaffold to aid PLK1-Mps1 in targeting Cdc20. Depletion or loss of the Cdks-mediated phosphorylation of DAB2IP destabilizes the MCC, impairs the SAC, and increases chromosome missegregation and subsequent CIN, thus contributing to tumorigenesis. Collectively, these results demonstrate the mechanism of DAB2IP in SAC regulation and provide a rationale for targeting the SAC to cause lethal CIN against DAB2IP-deficient aggressive PCa, which exhibits a weak SAC.

A CASE REPORT WITH SEVERE CONGENITAL FACTOR XIII DEFICIENCY AND AN UNCOMPLICATED PREGNANCY AND BIRTH PROCESS

Factor XIII deficiency is an extremely rare type among bleeding diathesis. In factor XIII deficiency, normal results of coagulation screening tests are expected. It usually does not cause spontaneous bleeding. Apart from bleeding diathesis, it may cause delayed wound healing and recurrent spontaneous abortions in women. Here, we present a 32-year-old case with severe congenital factor XIII deficiency who had an uncomplicated pregnancy and birth with regular replacement therapies. A 32-year-old patient with severe congenital factor XIII deficiency, who had a history of spontaneous abortion at the 11th week of her first pregnancy, applied to our center with a request for childbirth. It was learned that the factor XIII levels of the patient could not be measured, that she was using plasma-derived FXIII concentrate at a dose of 25 units/kg every time once a month, and in cases where this could not be obtained, 5 units/kg cryoprecipitate was given instead. After the completion of the pre-pregnancy assessments, starting 3 months before the planned pregnancy and continuing for the whole pregnancy and for 3 months after birth, 25 units/kg plasma-derived concentrate at a dose of 25 units/kg was applied each time and every two weeks, and in cases where this could not be provided, the follow-up was continued by applying cryoprecipitate at a dose of 5 units / kg instead. During this whole process, FXIII levels ranged between 70% and 100%. The patient, who developed an abortion risk due to decidual bleeding in the first trimester, was hospitalized and an additional 25 units / kg plasma-derived FXIII concentrate was administered and a parenteral dose of 30 mg / kg tranexamic acid was applied until the signs of decidual bleeding disappeared. An additional 50 units/kg dose of plasma-derived FXIII concentrate was administered to the patient 30 minutes before birth who had a planned delivery by cesarean section at 38 weeks of gestation, and 30 mg/kg parenteral tranexamic acid was administered for 7 days following the delivery. FXIII level was detected 50% in the child of a healthy, 3500-g born boy. The patient and her baby, who are in the first year after birth, are followed up without any complications, and prophylactic plasma-derived FXIII concentrate or cryoprecipitate is administered to the patient once a month. Inherited bleeding diathesis lead to an increased risk of bleeding and abortion in obstetric patients. Factor XIII deficiency is an extremely rare type among them. FXIII has a role in angiogenesis as well as hemostasis. Therefore, wound healing and tissue repair are impaired in Factor XIII deficiency. The risk of premature separation of the placenta, miscarriage especially in the first trimester, and postpartum uterine bleeding are increased in FXIII deficiency. Tranexamic acid can be used safely in obstetric patients with bleeding diathesis. It may be possible to ensure that patients with factor XIII deficiency have an uncomplicated pregnancy and delivery with regular follow-ups, regular prophylactic factor preparations, plasma replacements if they are not found, and in cases of bleeding, with additional doses of factor preparations or plasma replacement applications with tranexamic acid.

From obstetric casuistry

The interest of the case is in the spontaneous premature separation of the placenta at 472 months. pregnancy with excessive overstretching of the uterus, blood flowing, which made it difficult to correctly recognize the disease process.

Numerical Investigation of Aeroelastic Deformation Effect on the NASA Common Research Model

The risk of the aeroelastic deformation of the wings to the flight safety has become increasingly prominent for commercial transport aircraft due to the requirements for lightweight structure. In this work, Reynolds averaged Navier-Stokes (RANS) method coupled with transfinite interpolation were employed to investigate the influence of static elastic deformation of wing on aerodynamic characteristics of NASA CRM. Both bend and twist distributions were scaled in numerical simulations based on dynamic pressure, which was shown to be reasonable by the compassions between the calculations and measurements. The numerical results show premature flow separation in the middle and outboard of the wing for original configuration. Furthermore, the flow separation was supressed by the upward bending of the wing and negative twist in the leading edge, and the aerodynamic characteristics of the aircraft were improved by the aeroelastic deformation.

Influence of diamond–matrix transition zone structure on mechanical properties and wear of sintered diamond-containing composites based on Fe–Cu–Ni–Sn matrix with varying CrB2 content

The influence of CrB2 additive (within the interval ranging from 0 to 8 wt%) on the formation of structure of the diamond–matrix transition zone and the matrix material, microhardness, elastic modulus, retention of diamond grains in Fe–Cu–Ni–Sn matrix material and wear resistance of sintered diamond-containing composites (DCCs) by the powder metallurgy method has been studied. Micro-mechanical and tribological tests were conducted using composite samples 10 mm in diameter and 5 mm thick. It has been established that the transition zone structure significantly depends on the CrB2 content in a composite and is of a different nature than that of the matrix material. The structure of DCCs transition zone based on 51Fe–32Cu–9Ni–8Sn matrix consists of Cu, α-Fe and Ni3Sn phases with graphite inclusions. The structure of DCCs transition zone based on 51Fe–32Cu–9Ni–8Sn matrix with CrB2 additives consists of the α-Fe phase and Fe3C, Cr7C3, Cr3C2 carbide layers without graphite inclusions.It has been shown that the hardness and the elastic modulus of sintered composite matrix material increase linearly as the concentration of CrB2 in their content increases while the wear rate decreases. The addition of 2 wt% of CrB2 to 51Fe–32Cu–9Ni–8Sn composite contributes to an increase in its hardness from 4.475 to 7.896 GPa and elastic modulus from 86.6 to 107.5 GPa thus reducing the wear rate from 21.61 × 10−6 to 10.04 × 10−6 mm3 N−1 m−1. The mechanism for enhancing the mechanical properties and wear resistance of DCCs samples containing CrB2 additives consists in refining of matrix phases of iron and copper from 25 μm to 10 μm and binding the carbon released during the graphitization of diamond grains to Fe3C, Cr7C3, Cr3C2 nanoscale carbides. This, in turn, increases the ability of matrix material to keep diamond grains from falling out during DCCs operation. Low values of mechanical properties and wear resistance of the initial (51Fe–32Cu–9Ni–8Sn) composite are attributed to the coarse-grained structure and formation of graphite inclusions in the diamond–matrix transition zone, causing its premature destruction and separation of diamond grains from the DCCs matrix.

Electrofusion Stimulation Is an Independent Factor of Chromosome Abnormality in Mice Oocytes Reconstructed via Spindle Transfer.

Oocytes reconstructed by spindle transfer (ST) are prone to chromosome abnormality, which is speculated to be caused by mechanical interference or premature activation, the mechanism is controversial. In this study, C57BL/6N oocytes were used as the model, and electrofusion ST was performed under normal conditions, Ca2+ free, and at room temperature, respectively. The effect of enucleation and electrofusion stimulation on MPF activity, spindle morphology, γ-tubulin localization and chromosome arrangement was compared. We found that electrofusion stimulation could induce premature chromosome separation and abnormal spindle morphology and assembly by decreasing the MPF activity, leading to premature activation, and thus resulting in chromosome abnormality in oocytes reconstructed via ST. Electrofusion stimulation was an independent factor of chromosome abnormality in oocytes reconstructed via ST, and was not related to enucleation, fusion status, temperature, or Ca2+. The electrofusion stimulation number should be minimized, with no more than 2 times being appropriate. As the electrofusion stimulation number increased, several typical abnormalities in chromosome arrangement and spindle assembly occurred. Although blastocyst culture could eliminate embryos with chromosomal abnormalities, it would significantly decrease the number of normal embryos and reduce the availability of embryos. The optimum operating condition for electrofusion ST was the 37°C group without Ca2+.

Early maternal separation is not associated with changes in telomere length in domestic kittens (Felis catus).

ObjectiveStudies of multiple species have found that adverse early life experiences, including childhood trauma and maternal separation, can result in accelerated telomere shortening. The objective of this study was to determine if premature separation from the mother affected telomere length in domestic kittens (Felis catus). Subjects were 42 orphaned kittens and 10 mother-reared kittens from local animal rescue groups and shelters. DNA was extracted from whole blood collected from kittens at approximately 1 week and 2 months of age. Telomere length was assessed by qPCR (quantitative polymerase chain reaction) from a total of 86 samples and expressed as a ratio of telomere PCR relative to a single copy gene PCR (T/S).ResultsA generalized linear mixed model found there were no detectable differences in telomere length based on survival (F1, 76.2 = 3.35, p = 0.07), orphan status (F1, 56.5 = 0.44, p = 0.51), time point (F1, 43.5 = 0.19, p = 0.67), or the interaction between orphan status and time (F1, 43.5 = 0.86, p = 0.36). Although in other species telomere shortening is commonly associated with aging, even early in life, we did not find evidence for telomere shortening by two months of age. Our results suggest that the experience of early maternal separation in domestic cats who are subsequently hand-reared by humans does not accelerate telomere shortening compared to mother-reared kittens, at least in the first few months of life.

Cell Division and Rearrangement Dynamics Coordinated by Planar Cell Polarity Pathway in Growth Plate Cartilage

Chondrodysplasias, resulting in dwarfism and altered skeletal growth, are heritable disorders affecting 1 in 4000 to 5000 births. Long bone growth is tightly controlled by sequential chondrocyte maturation through spatially distinct zones in growth plate cartilage. Discoid proliferative chondrocytes form a division plane parallel to the longitudinal axis of the bone and rotate 90 degrees to stack the cells in a unique columnar architecture, which potentiates further limb growth. Noncanonical, β-catenin-independent, Wnt signaling is needed to align division planes and promote organized column formation, which makes the planar cell polarity (PCP) pathway a strong candidate in determining column architecture. Viral manipulation of PCP pathway proteins in chicken embryo growth plates interfered with cell division orientation, but conclusions were limited by fixed tissue sections. To expand our depth of mechanistic inquiry, we sought to develop a method to analyze genetic deletions of PCP pathway proteins and dynamically monitor chondrocyte rearrangement in living growth plate tissue. We hypothesize that Wnt-dependent PCP signaling is required for proliferative chondrocyte rearrangement. Using mice with membrane bound GFP expression and confocal microscopy, we generated time-lapse videos of chondrocytes from live cranial base growth plate explants. Genetic knockout of upstream Wnt5a ligand and inducible, cartilage-specific deletion of Vangl2 transmembrane receptor and Ror2 kinase co-receptor result in significant differences in the final division plane angle distributions compared to normal (p-value<0.0001). Vangl2 is a core PCP protein phosphorylated by Ror2 in response to Wnt5a signaling. While disrupted rearrangement could be a cause of the disorganized proliferative zone, the daughter cells also have premature separation at their interface. Normal chondrocytes separate on average 14.0±6.6 hours after division, while Ror2, Wnt5a, and Vangl2 mutants have significantly shorter separation times (5.2±4.0, 7.8±4.4, and 9.1±3.9 hours, respectively). Our results show that proper rearrangement of proliferative chondrocytes is dependent on PCP pathway activity; however, it is unclear if the premature separation is occurring through disengagement of the cadherin-dependent daughter cell interface or deposition of extracellular matrix between the cells. The focus of future studies is to determine what is acting downstream of the PCP pathway to regulate adhesion dynamics and determine the extrinsic requirements guiding polarized chondrocyte behaviors. These results will advance approaches to cartilage engineering to treat chondrodysplasias by understanding the mechanistic cues required for proper cartilage tissue architecture and growth.

Impact of maternal infection with hepatitis B virus on pregnancy complications and neonatal outcomes for women undergoing assisted reproductive technology treatment: A population-based study.

The aim of this study was to investigate the impact of maternal hepatitis B virus (HBV) status on pregnancy complications and neonatal outcomes for women undergoing assisted reproductive technology (ART). A total of 7,011 pregnancies achieved by ART were included from a population-based database involving 523,111 pregnancies. Exposures of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) among pregnant women were routinely tested at the first antenatal visit for all pregnancies. We collected pregnancy complications (e.g., gestational diabetes mellitus [GDM], intrahepatic cholestasis of pregnancy [ICP]), neonatal outcomes and confounding variables from the same database. Univariate and multivariate analyses by adjusting confounders were conducted to evaluate the impact of maternal HBV infection. Prevalence of HBsAg seropositivity (HBsAg+) was 11.34% (95% CI 10.6-12.1) and that of HBsAg and HBeAg co-seropositivity (HBsAg+HBeAg+) was 2.55% (2.1-3.0) among included population. Compared with HBsAg-group, ICP risk in the HBsAg+group was higher (4.03% vs. 1.79%; adjusted odds ratio [aOR] 2.49, 1.65-3.77). Similarly, ICP prevalence in the HBsAg+HBeAg+ group was higher than that in the HBsAg-HBeAg- group (6.47% vs. 1.61%; aOR 4.78, 2.28-9.98). No associations were found between maternal HBV infection (i.e., HBsAg+, HBsAg+HBeAg+, or HBsAg+HBeAg-) and other adverse outcomes for women undergoing ART (i.e., GDM, pre-eclampsia, placental previa, premature separation of placenta, premature rupture of membranes, preterm birth and low birthweight) in this study. In conclusion, maternal HBV infection (HBsAg+or HBsAg+HBeAg+) probably increase ICP risk, but may not associate with other pregnancy complications or neonatal outcomes for pregnant women who underwent ART.

Optimization of kenaf fibre reinforced polymer laminate for shear strengthening of RC beams using embedded connector

Kenaf fibre reinforced polymer (KFRP) laminate has gained its potentiality in shear strengthening of reinforced concrete beams recently, thus, method to obtain the minimal required dimension of KFRP shear strip is the utmost demand. The main aim of this research was to optimize the dimension of KFRP laminate for shear strengthening of RC beam. In experimental programme, high strength KFRP laminate and seven full scale RC beams were fabricated. The beams were shear strengthened using 7.5 mm thick and 20 mm, 30 mm and 35 mm widths of KFRP laminate, the dimensions of those shear strips were based on design strains of 0.007, 0.0045 and 0.004 respectively. Beams were also shear strengthened using CFRP laminates with similar widths of KFRP laminates for comparison. All beams were numerically analysed. Parametric study on design strain based on theoretical model was also conducted. Results showed that shear strengthened beam with 0.007 strain of KFRP laminate failed due to fracture of laminate. However, beams with laminate strains of 0.0045 and 0.004 did not show fracture or debonding of KFRP laminates, both beams had shown ductile flexural mode of failures with higher failure loads. In contrast, all CFRP laminate strengthened beams failed because of cover separation of laminates followed by shear. The failure loads of KFRP laminates strengthened beams were found to be higher as compared to those of CFRP laminates. The KFRP laminates were effectively enhanced shear capacity of strengthened beams without showing any premature failure even with the design strain of 0.0045, while, CFRP laminate showed premature cover separation failure with design strain of 0.002. Theoretical model showed that higher strength of concrete and length of laminate increased debonding or design strain of laminate. The numerical model predicted flexural and shear behaviour of shear strengthened beams. The flexural behaviour of strengthened beams based on numerical analysis were closely comparable with those of experimental findings. However, the model had limitation to predict local debonding failure of shear strip due to cracks and the effects of debonding on shear behaviour of strengthened beams.

Single nucleotide polymorphism array and cytogenetic analyses of ovarian teratomas in children.

Teratomas are the most common tumors in the ovary during childhood. Previous studies suggested that they may be derived from germ cells at any developmental stage from premeiotic oogonia through meiotic oocytes to post-meiotic ova. The majority of mature teratomas reveal normal karyotypes and immature teratomas show higher frequency of chromosomal abnormalities. We analyzed fresh tissue samples from 25 primary ovarian teratomas and three extraovarian deposits using whole genome single nucleotide polymorphism (SNP) array and karyotype. SNP array detected five patterns of copy neutral loss of heterozygosity (CN-LOH): failure of meiosis I (type I) in 12 tumors, failure of meiosis II (type II) in six tumors, endoreduplication of a haploid ovum (type III) in two tumors, premeiotic error (type IV) in four tumors, and both meiotic I and meiotic II errors in one tumor (type V). Three tumors with type I error had a single chromosome showing meiotic II error, and two tumors with type II error had a single chromosome showing premature sister-chromatid separation in meiosis I. Lack of recombination in multiple chromosomes in meiosis I were common, chromosomes 17, 7, 8, 21, and 22 were most commonly involved. Abnormal karyotypes were observed in four teratomas including +3, del(3q), +7, +8, +12, and i(18q). The extraovarian deposits revealed the same CN-LOH pattern as the primary teratoma. In summary, SNP array reveals the origin of ovarian teratoma and we propose a new mechanism that consecutive meiotic I and II errors occur frequently in ovarian teratomas.

Assessment of abruptio placentae cases in M.G.M. healthcare institute, Kalamboli: A cross-sectional study

Introduction: Abruptio placenta is a serious obstetric complication which is characterised by the premature separation of the placenta. It is also associated with premature deliveries, maternal and fetal morbidities. Multiple factors are known to be associated with increased risk of placental abruption as alcohol and cocaine use and cigarette smoking, and nutritional deficiencies etc. Materials and Methods: It was a retrospective study conducted among 47 cases of abruptio placentae admitted under the department of obstetrics and gynecology, in MGM Hospital, Kalamboli, Navi Mumbai, for a period of 2 years (December 2015 to December 2017). Results: The mean age of presentation was reported to be 26.59 years. The incidence of abruptio placentae was found to be least after the age of 35 years (Table 1). Majority of cases were multigravida, while 32% cases presented with AP were primigravida. Among the multigravida cases, the majority of cases were of gravida 2 and 3 and the mean gravida order was 2.4. Conclusions: From the current study, we can conclude that multiparty, cesarean section, previous abortion, and placental abruption can be considered at high risk of placental abruption. Keywords: Abruptio placenta, Obstetric complications, Premature delivery, Maternal mortality, Maternal morbidity.

A narrative review of delaying cord clamping 2020—who, what, when, where, why and how?

: Delayed cord clamping (DCC) facilitates transfusion benefit for infants with spontaneous ventilation. Visibly apneic infants with normal heart rate and cardiac output, while still connected to intact placental circulation are capable of oxygenation and ventilation through the placental fetal-maternal respiratory membrane as they achieve normal perinatal cardiorespiratory and hemodynamic transition, and optimal mother-infant bonding. We aim to describe recent human physiology studies during DCC and implications for clinical practice. The risks of maternal hemorrhage and/or interruption of fetoplacental gas exchange due to premature and occult placental separation prior to establishment of this transition, occur in ~10% of deliveries. These risks must be carefully adjudicated as we seek to provide benefit to the majority (~90%) of infants at birth. Recognizing risk to the mother or infant peri-partum is critical to distinguishing these two groups, resulting in inability to provide DCC, or truncating its intended duration. This narrative review focuses on optimal placental transfusion duration, increased infant iron stores, improved early brain myelination and long-term neurodevelopmental advantage. Term infants with five minutes of DCC show ~100g birthweight increase, presumably the weight of additional transfused blood. Extremely preterm infants (<28–29 weeks gestation) or extremely low birth weight (ELBW) (<1,000 g) neonates, optimally prepared (with antenatal steroids and infant neuro-protective magnesium sulfate) have survival advantage, improved euthermia, less likelihood of intubation in the delivery room (DR) and/or during hospitalization, improved hematocrit, less transfusion risk and enhanced iron transfer. Improved iron transfer results in optimal infant brain myelination, a putative mechanism for neurodevelopmental functional enhancement. Optimal DCC duration is unknown but 2–5 minutes is likely safe and effective for most infants (being not feasible in all) and probably of greatest benefit to the least mature, without adversely affecting cord blood gases at birth, nor increasing maternal risk of postpartum hemorrhage. Absolute contraindications for DCC include perinatal sentinel events such as premature placental separation, cord prolapse, uterine rupture and certain maternal life-threatening events. Relative contraindications include prolonged infant apnea. Truncation of intended DCC duration is appropriate if infant cardiac output and/or utero-placental integrity are not reassuring.