Response In Pregnant Women Research Articles

Group B Streptococcus (GBS) vaccine

Intrapartum antibiotic prophylaxis (IPA) during labor for women identified as having recto-vaginal Groups B Streptococcus (GBS) colonization, has been successful in preventing early-onset invasive (<7 days of age) disease in new-borns in high income countries where implemented. Nevertheless, GBS remains a leading cause of neonatal sepsis in high-income settings, and is now also the leading cause of bacterial meningitis in USA. Also, the incidence of invasive GBS disease remains high in sub-Saharan African countries, where IAP is not feasible, whilst its contribution to neonatal sepsis is uncertain in South Asia. Furthermore, recent data indicate that the burden of GBS associated stillbirths might be similar to that for EOD in some African countries. Recent advances in the prevention of invasive GBS disease during early infancy, including the potential to prevent late onset disease (7-89 days age) which is not preventable by IAP, is the development of polyvalent polysaccharide protein conjugate vaccines. Recent studies have reported on the safety and immunogenicity of a trivalent (serotypes Ia, Ib and III) GBS polysaccharide protein conjugate vaccine (GBS-3CV). This vaccine elicits immune responses in pregnant women vaccinated during the last trimester, albeit less so among women in whom the pre-vaccination antibody titers were less than the lower detection limit of the assay. The ratio of antibody transfer to the newborns’ of these women was approximately 0.5-0.7, indicating less efficient transplacental transfer of polysaccharide targeted IgG than is observed for IgG targeted at protein antigens. Furthermore, vaccination of HIV-infected women, elicited lower quantitative antibody responses than in HIV-uninfected women, suggesting the need for different vaccine schedules in these women. Also, the GBS conjugate vaccine appears to be more immunogenic in African than European/North American women. The licensure of a GBS vaccine for pregnant women aimed at protection against invasive GBS disease of their newborns will, however, require sample size in excess of 70,000 participants for an invasive disease endpoint. An alternate licensure pathway, as is the case for meningococcal vaccine, could be premised on establishing a sero-correlate of protection against invasive disease and using this to license the vaccine based on immunogenicity and safety.

Knowledge Attitude and Practice Regarding Antenatal Care among Pregnant Women in Rural Area of Lahore

Background: Prenatal care is medical valuation of mother and fetus, for the duration of gestation used for getting best possible result for the mother and child. Early observation and ongoing care during pregnancy provided more favorable births compared to no prenatal observation. Methodology: The quantitative cross-sectional study design was used with convenient sampling (n=133) from community of Hussain Abad Lahore. Pregnant women between the ages of 20 to 45 years of age. Data was analyzed on SPSS 21 version and application of chi-square test (p=&lt;0.05). Result: The respondents 69.1% (n=94) were identified that pregnant women require to go for their checkup. This study reveals that (n=31) 21.4% participants were agree, (n=98)71.1% participants were disagreed, (n=06)4.4% were neutral that they have Seek antenatal care regularly during pregnancy. 83.1% women believe that antenatal checkup is worthy to monitor mother &amp; fetus’ well-being. Conclusion: 64.7% pregnant women response in yes regarding knowledge about antenatal care. The attitude was shown positive somewhere as 69.6% women were agree and as well as negative, also as 30.1% respondents were disagreed and therefore 61% participants have positive practices towards antenatal care. There was significant association between qualification and knowledge of expectant women about prenatal care, significant association in qualification and attitude and there was insignificant association in qualification and practices. Int. J. Soc. Sc. Manage. Vol. 5, Issue-3: 155-162

Діагностичні резерви деталізації гострого апендициту у вагітних

Мета роботи: встановити додаткові діагностичні критерії діагностики гострого апендициту у вагітних для оптимізації лікування даної патології.Матеріали і методи. В період із 2004 до 2012 р. у хірургічне відділення міської клінічної лікарні № 1, № 3 м. Києва було госпіталізовано 864 вагітні жінки, які були розділені на досліджувану (n=473) та контрольну (n=391) групи. Найчастіше зустрічався ГА – 258 (29,8 %) від усіх випадків госпіталізації. В процесі обстеження поряд із загальноприйнятими дослідженнями вивчалися гематологічні, цитологічні та імунологічні показники у вагітних із діагнозом гострий апендицит. Для оцінки патогенетичних механізмів формування запальної реакції у вагітних досліджуваної групи, а також для можливості проведення диференційної діагностики та проведення раннього прогнозування ускладнень проводили дослідження активності функціонування неспецифічної резистентності та імунологічної реактивності: НСТ-тест, визначення рівнів Ig M, Ig G, Ig E, Ig A, ПРК (прокальцитоніну), Il β-1, ФНП (фактор некрозу пухлини).Результати досліджень та їх обговорення. При проведенні біохімічних досліджень для встановлення типових додаткових маркерів ГА у вагітних ми встановили, що у пацієнтів спостерігаються ознаки розвитку ендотоксикозу, пов’язані з накопиченням токсинів мікробного походження (ТЗН), декомпенсацією функціональної активності фагоцитуючих клітин – нейтрофільних гранулоцитів (індекс стимуляції) та токсинозв’язуючої та біосентизуючої здатності печінки, коефіцієнт де Рітіса, наявність кріоглобулінів. При цьому встановлено, що у пацієнтів другої клінічною групи дані тенденції були більш виразні. Визначено, що у пацієнтів обох клінічних груп проявляють такі ознаки запальної відповіді, як підвищення концентрації основних запальних медіаторів – Іл-1 та ФНП відносно значень здорових осіб. Встановлено, що в другій основній клінічній групі данні зміни були більш виразні, що свідчить про значну активність запальних реакцій. При цьому компенсуюча дія протизапальних медіаторів була знижена, що може бути причиною декомпенсованої реакції та причиною розвитку ризику системної запальної відповіді.

Effects of sevoflurane or propofol combined with remifentanil anesthesia on clinical efficacy and stress response in pregnant women with pregnancy-induced hypertension.

To compare the effects of sevoflurane or propofol combined with remifentanil anesthesia on the clinical efficacy and stress response of pregnancy-induced hypertension (PIHS) in cesarean section. 150 patients with PIHS and treated with cesarean section in our hospital from May 2015 to September 2016 were selected. All patients were randomly divided into sevoflurane-remifentanil group (n=75) and propofol-remifentanil (n=75). The elbow blood of patients in both groups were collected, the levels of Norepinephrine (NE) adrenaline (AD), cortisol and blood glucose in plasma were compared at before anesthesia induction (T0), operation 30 min (T1), end of operation (T2), 2 h after operation (T3), 24 h after operation (T4). The blood pressure control, muscle control, anesthesia onset time, maternal pain and complications were compared between the two groups. The patients in the sevoflurane group were superior to the propofol group (p<0.05) in terms of muscle control effect, anesthesia onset time and maternal pain. There was no significant difference between the two groups in terms of blood pressure control and anesthesia complications (p>0.05). There was no significant difference in plasma AD, NE, cortisol and blood glucose between the two groups before induction of anesthesia (p>0.05). However, the plasma markers of the two groups began to increase after anesthesia induction and reached peak at T2 or T3, returned back to preoperative level or higher than before surgery at T4. The levels of AD, NE, cortisol and blood glucose in plasma of sevoflurane group were significantly lower than those in propofol group at T1-T4 time point, the difference was statistically significant (p<0.05). The clinical efficacy of sevoflurane combined with remifentanil anesthesia is better than that of propofol combined with remifentanil, and it can effectively reduce the stress of pregnant women with pregnancy-induced hypertension treated with cesarean section.

СОСТОЯНИЕ ИММУННОЙ СИСТЕМЫ У ЖЕНЩИН ВО ВТОРОМ ТРИМЕСТРЕ БЕРЕМЕННОСТИ ПРИ ОБОСТРЕНИИ ХРОНИЧЕСКОГО ПРОСТОГО БРОНХИТА, ОБУСЛОВЛЕННОМ ГРИППОМ А(Н3N2)

The contents of anti-influenza antibodies, secretory immunoglobulin A (sIgA) and circulating immune complexes (CIC) were studied in 145 women in the second trimester of pregnancy. All women were divided into 5 groups. The first group included 30 women with the physiologic course of pregnancy. The second one consisted of 30 patients with chronic simple bronchitis (CB) in remission. The third group had 30 patients with the exacerbation of CB caused by influenza A(H3N2) (antibody titers were 1:16-1:64); the fourth group included 30 patients with CB, whose exacerbation was caused by influenza (antibody titers were 1:32-1:128). It was found out that in the second group there were higher concentrations of sIgA (7.34±0.37 mg/L) and CIC (0.191±0.006 units of optical density), than in the first group (5.86±0.43 mg/L, p&lt;0.05 and 0.095±0.003 units of optical density, respectively, p&lt;0.001). It can probably be explained by the stimulating influence of persistent virus infection on the local immunity and its important role in the development of autoimmune responses in pregnant women. In the fifth group unlike the third group there were registered minimal contents of sIgA: 3.86±0.25 mg/L (p&lt;0.001) and maximal level of CIC: 0.232±0.006 units of optical density (p&lt;0.001). The revealed changes suggested the decrease of local immune protection of airways and autoimmune alteration of a woman’s body caused by high intensity of humoral immunity to influenza virus A(H3N2) under exacerbation of chronic simple bronchitis in patients in the second trimester of gestation.

СОСТОЯНИЕ ИММУННОЙ СИСТЕМЫ У ЖЕНЩИН ВО ВТОРОМ ТРИМЕСТРЕ БЕРЕМЕННОСТИ ПРИ ОБОСТРЕНИИ ХРОНИЧЕСКОГО ПРОСТОГО БРОНХИТА, ОБУСЛОВЛЕННОМ ГРИППОМ А(Н3N2)

The contents of anti-influenza antibodies, secretory immunoglobulin A (sIgA) and circulating immune complexes (CIC) were studied in 145 women in the second trimester of pregnancy. All women were divided into 5 groups. The first group included 30 women with the physiologic course of pregnancy. The second one consisted of 30 patients with chronic simple bronchitis (CB) in remission. The third group had 30 patients with the exacerbation of CB caused by influenza A(H3N2) (antibody titers were 1:16-1:64); the fourth group included 30 patients with CB, whose exacerbation was caused by influenza (antibody titers were 1:32-1:128). It was found out that in the second group there were higher concentrations of sIgA (7.34±0.37 mg/L) and CIC (0.191±0.006 units of optical density), than in the first group (5.86±0.43 mg/L, p&lt;0.05 and 0.095±0.003 units of optical density, respectively, p&lt;0.001). It can probably be explained by the stimulating influence of persistent virus infection on the local immunity and its important role in the development of autoimmune responses in pregnant women. In the fifth group unlike the third group there were registered minimal contents of sIgA: 3.86±0.25 mg/L (p&lt;0.001) and maximal level of CIC: 0.232±0.006 units of optical density (p&lt;0.001). The revealed changes suggested the decrease of local immune protection of airways and autoimmune alteration of a woman’s body caused by high intensity of humoral immunity to influenza virus A(H3N2) under exacerbation of chronic simple bronchitis in patients in the second trimester of gestation.

T-Cell Mediated Immune Responses in Obstetric Population Acutely Infected With Toxoplasmosis in Kano, Nigeria

Toxoplasmosis is a disease caused by an obligate intracellular protozoan parasite Toxoplasma gondii which is endemic worldwide.. There is paucity of reports on the immunological responses of pregnant women to toxoplasmosis in Kano. This study was carried to determine T-cell mediated immune responses in pregnant women with acute toxoplasmosis in Kano and factors associated with seropositivity. A total of 320 blood samples were collected and assayed for anti- Toxoplasma gondii Immunoglobulin M (IgM) antibody using ELISA test kit. Samples were assayed for CD4, CD8, using BDFACSCount and the cytokines interferon-gamma (IFN-ϒ), tumour necrosis factor-alpha (TNF-α) using ELISA test kits while differential leucocytes count was carried out microscopically by Leishman staining technique. The IgM seroprevalence was 24(7.5%) and 296(92.5%) were negative. Associated risk factors were cat ownership and consumption of unwashed vegetables (p values = 0.0014 and 0.001 respectively). Mean CD4, CD8, CD4:CD8 and differential count were within normal range for the study subjects with no statistically significant relationship across trimesters. IFN-ϒ and TNF-α were elevated. Moderate eosinophilia appeared with statistically significant relationship between lymphocyte and neutrophil counts across trimesters ( p value = 0.0278). The immunomodulatory effect of pregnancy does not classically suppress T-cell mediated immune responses as our findings revealed normal but slightly reduced distribution of CD4 and CD8 cell counts with elevated IFN- ϒ and TNF-α. The findings revealed the immune status of the study subjects, as slightly modulated, nonetheless, it is urgent to offer adequate health education programs on toxoplasmosis to pregnant women yet to be infected on how to prevent the infection so as to avoid occurrence of congenital infection.&#x0D;

Respon Imun Pada Penderita Asma Selama Kehamilan

The immune system of a woman while pregnant it would be more sensitive than usual. Therefore, pregnant women are particularly vulnerable to some diseases, particularly influenza. A new study suggests that women who often experience flu during pregnancy, would be at risk of having children with asthma. In addition, asthma and allergies can also be inheritable. If both parents have allergies, the child has an allergy risk 75 percent. If only one parent with allergies, or if a near of kin has an allergy, the child will have a 30 to 40 percent risk of experiencing various types of allergies. However, if the parents do not have allergies at all, the risk of allergies in children only 10 to 15 percent. This scientific work aimed to determine the immune response in pregnant women with a asthma. This scientific work methods using literature study. Effect of pregnancy on the incidence of asthma attacks in each patient are not the same, even attacks are not common in a first pregnancy and subsequent pregnancies. Usually the attack will arise from the age of 24 weeks to 36 weeks, and will be reduced by the end of pregnancy. Effect of asthma in mother and the fetus is very dependent on the frequency and severity of asthma attacks, because of the mother and the fetus will experience hypoxia. Hypoxia if not addressed would have a detrimental effect on the fetus, such as miscarriage, premature delivery, and fetal weight were not in accordance with gestational age. It is expected the public to give more attention and be aware in patients with asthma, especially in during pregnancy.;Keywords : immune system , pregnant women , asthma

Infección por zika en el Perú: de amenaza a problema de salud

El virus zika es un flavivirus transmitido por mosquitos que ha emergido como una amenaza significativa en la región de las Américas, especialmente para la gestante. Recientes brotes en América Central y del Sur se han asociado con un incremento en la incidencia de microcefalia y otras anomalías del sistema nervioso central en recién nacidos. Existe un vínculo causal entre la infección por zika durante el embarazo, con microcefalia y otros trastornos neurológicos. La región se enfrenta a una probable epidemia de magnitud con potenciales consecuencias en gestantes y recién nacidos. Se revisa la epidemiología del virus zika, su amenaza al embarazo, consecuencias clínicas y su impacto en la salud pública. Existe una serie de características de los mecanismos de infección, difusión que da sustento a intervenciones preventivas, diagnóstico y manejo de la enfermedad. Es importante intensificar su vigilancia epidemiológica, trabajar en la prevención y una adecuada respuesta de manejo a gestantes con diagnóstico presuntivo o con infección por virus zika. Está demostrada su presencia en varias regiones del Perú; a diciembre 2016 se ha confirmado 61 gestantes, en particular en Jaén, Cajamarca con 36 casos. Se ha comunicado el nacimiento de 38 neonatos; de ellos, 32 recién nacidos corresponden a Jaén. Estos neonatos al nacer no han presentado microcefalia ni otras complicaciones. Frente a la comprensible preocupación entre la población en general acerca del zika y su riesgo sobre la gestante y el feto, se deben asegurar estrategias de vigilancia epidemiológica y control para zika. Estas acciones deben incluir una adecuada preparación preconcepcional, trabajo en control vectorial, control de la gestante y coordinación entre el sistema de salud y la población, a fin de reducir los riesgos, asegurando adecuada protección a la mujer, a la gestante y al feto.

The Lasting Legacy of Seasonal Influenza: In-Utero Exposure and Labor Market Outcomes

Pregnancy conditions have been shown to matter for later economic success, but many threats to fetal development that have been identified are difficult to prevent. In this paper I study seasonal influenza, a preventable illness that comes around every year and causes strong inflammatory responses in pregnant women. Using administrative data from Denmark, I identify the effects of maternal influenza on the exposed offspring via sibling comparison, exploiting both society-wide influenza spread and information on individual mothers who suffer strong infections during pregnancy. In the short term, maternal influenza leads to a doubling of prematurity and low birth weight, by triggering premature labor among women infected in the third trimester. Following exposed offspring into young adulthood, I observe a 9% earnings reduction and a 35% increase in welfare dependence. These long-term effects are strongest for influenza infections during the second trimester and they are partly explained by a decline in educational attainment, pointing to cognitive impairment. This effect pattern suggests that maternal influenza damages the fetus through multiple mechanisms, and much of the damage may not be visible at birth. Taken together, these results provide evidence that strong infections during pregnancy are an often overlooked prenatal threat with long-term consequences.

Effect of maternal exercises on biophysical fetal and maternal parameters: a transversal study.

ABSTRACTObjective To evaluate the acute effects of maternal and fetal hemodynamic responses in pregnant women submitted to fetal Doppler and an aerobic physical exercise test according to the degree of effort during the activity and the impact on the well-being.Methods Transversal study with low risk pregnant women, obtained by convenience sample with gestational age between 26 to 34 weeks. The participants carry out a progressive exercise test.Results After the exercise session, reduced resistance (p=0.02) and pulsatility indices (p=0.01) were identified in the umbilical artery; however, other Doppler parameters analyzed, in addition to cardiotocography and fetal biophysical profile did not achieve significant change. Maternal parameters obtained linear growth with activity, but it was not possible to establish a standard with the Borg scale, and oxygen saturation remained stable.Conclusion A short submaximal exercise had little effect on placental blood flow after exercise in pregnancies without complications, corroborating that healthy fetus maintains homeostasis even in situations that alter maternal hemodynamics.

Amniocentesis increases level of anxiety in women with invasive prenatal diagnosis of Down syndrome

Backgound &lt;br /&gt;Invasive prenatal diagnosis (PND) through amniocentesis and chorionic villus sampling (CVS) can detect Down syndrome. Pregnant women usually experience a variety of psychological responses associated with invasive PND. This study is intended to assess depression, anxiety and stress levels and the factors related to their psychological responses in pregnant women with invasive prenatal diagnosis of Down syndrome.&lt;br /&gt;&lt;br /&gt;Methods &lt;br /&gt;A cross sectional study was conducted at Kandang Kerbau Women’s and Children’s Hospital, Singapore. The psychological responses of 70 women undergoing PND were assessed by Depression Anxiety Stress Scale 21 (DASS 21) questionnaire. A multiple linear regression analysis was used to analyze association between knowledge and perceived risk with psychological responses (CI 95% and significance value p&amp;lt;0.05).&lt;br /&gt;&lt;br /&gt;Results &lt;br /&gt;More than half of the participants had normal anxiety (55.7%), stress (72.8%), depression levels (65.8%). The results revealed significantly higher level of anxiety in women with gestational age &amp;gt;13 weeks who had pursued amniocentesis. Women with no previous children had higher levels of depression and stress. Women who pursued amniocentesis had significantly higher anxiety scores compared to women undergoing CVS (p=0.015).&lt;br /&gt;&lt;br /&gt;Conclusions &lt;br /&gt;Women’s psychological responses are associated with gestational age, type of procedure and parity. The level of anxiety increased in women who underwent amniocentesis for diagnosis of Down syndrome. Knowledge and perceived risk of having a baby with Down syndrome do not seem to have psychological effects to women.

Cholera in pregnancy: Clinical and immunological aspects

The objective of this study was to examine the clinical and immunological features of cholera in pregnancy. Women of reproductive age presenting to the icddr,b Dhaka hospital with cholera, and enrolled as part of a larger cohort study, were tested for pregnancy on admission. We compared initial clinical features and immune responses of pregnant patients with non-pregnant female patients at days 2, 7 and 21 after infection. Among reproductive age women enrolled between January 2001 and May 2006, 9.7% (14/144) were pregnant. The duration of diarrhoea prior to admission tended to be higher in pregnant compared to non-pregnant patients (p=0.08), but other clinical characteristics did not differ. Antibody responses to cholera toxin B subunit (CtxB), toxin-coregulated pilus A (TcpA), Vibrio cholerae lipopolysaccharide (LPS), and serum vibriocidal antibody responses, were comparable between pregnant and non-pregnant patients. There were no deaths among the pregnant cases or non-pregnant controls, and no adverse foetal outcomes, including stillbirths, during 21 days of follow up of pregnant cases. To our knowledge, this is the first report of immune responses in pregnant women with cholera. We found that pregnant woman early in pregnancy has comparable clinical illness and subsequent immune responses compared to non-pregnant women. These findings suggest that the evaluation of safety and immunogenicity of oral cholera vaccines in pregnancy should be an area of future investigations.

Low Molecular Weight Heparin Modulates Maternal Immune Response in Pregnant Women and Mice with Thrombophilia

Thrombophilia is associated with pregnancy complications. Treatment with low molecular weight heparin (LMWH) improves pregnancy outcome, but the underlying mechanisms are not clear. We analyzed Treg frequency in blood from thrombophilic pregnancies treated with LMWH (n = 32) or untreated (n = 33) and from healthy pregnancies (n = 39) at all trimesters. Additionally, we treated pregnant wild-type, heterozygous and homozygous factor-V-Leiden (FVL) mice with LMWH or PBS and determined Treg frequency, pro-/anti-inflammatory cytokine levels and Caspase-3-activity in placenta and decidua. Treg frequencies were increased in second and third trimester in LMWH-treated thrombophilic pregnancies compared to controls. Treg levels were comparable to those of normal pregnancies. Homozygous FVL mice had decreased decidual Tregs compared to wild-type mice. LMWH treatment normalized Tregs and was associated with increased decidual IL-10 mRNA. LMWH diminished Caspase-3-activity in mice of all genotypes. We demonstrated anti-apoptotic and anti-inflammatory effects of LMWH in pregnant FVL mice. LMWH increased Treg levels in mice and humans, which suggests benefits of LMWH treatment for thrombophilic women during pregnancy.

Enhanced response to music in pregnancy.

Given a possible effect of estrogen on the pleasure-mediating dopaminergic system, musical appreciation in participants whose estrogen levels are naturally elevated during the oral contraceptive cycle and pregnancy has been investigated (n = 32, 15 pregnant, 17 nonpregnant; mean age 27.2). Results show more pronounced blood pressure responses to music in pregnant women. However, estrogen level differences during different phases of oral contraceptive intake did not have any effect, indicating that the observed changes were not related to estrogen. Effects of music on blood pressure were independent of valence, and dissonance elicited the greatest drop in blood pressure. Thus, the enhanced physiological response in pregnant women probably does not reflect a protective mechanism to avoid unpleasantness. Instead, this enhanced response is discussed in terms of a facilitation of prenatal conditioning to acoustical (musical) stimuli.

Words before actions- the significance of counselling in the Praena-Test era

Due to new offers in prenatal diagnostics pregnant women are forced to make choices. In Switzerland physicians are obliged to inform previous to prenatal tests and to obtain informed consent. Considering the complexity of this information and the consequences of a positive result, counselling is challenging, especially in an intercultural context. A questionnaire-based study compared information processing, test interpretation and emotional response of pregnant women from Switzerland and adjacent countries with Turkish women. Knowledge of the latter was significantly lower and they found counselling more unsettling, but their acceptance of prenatal tests was significantly higher. An empathetic approach and the right words are decisive, and counselling will even gain importance when considering the increase in options patients are confronted with.

Atraumatic restorative treatment for dental caries among pregnant women attending primary health centres: A small scale demonstration

Background: ART consists of a simplified, low-cost technique that uses only hand instruments in the removal of carious tissues to reduce contamination and viability of microorganisms. This technique requires immediate restoration of the cavity with adhesive restorative material, namely glass ionomer. Since ART approach causes lesser anxiety than the traditional restorative procedure, it may be a very useful tool for providing dental treatment to pregnant women. Objective: The present study was carried out to assess the pregnant women's response to undergo ART in Primary Health Centre set up and clinical evaluation of restoration at 6 month interval. Methods: Pregnant women visiting Primary health centres (PHCs) for prenatal check- up were examined. Those having cavities were restored using ART after taking informed consent. These were followed up telephonically 24 hours later and examined at the end of six months. Results: Of the 308 pregnant women examined, fifty teeth of forty five subjects (83%) were restored using ART. Out of that 45 (90%) were one surface restoration and five (10%) two surface restorations. None of the subjects felt pain during the procedure, 24 hours later or at the end of six months. All the subjects were satisfied with the treatment. All one surface fillings were intact and one out of five, two-surface filling was broken which was replaced with new restoration. Conclusion: This study demonstrates that the patients were satisfied with the ART which can be undertaken at lower cost. Together with preventive and promotional activities, oral health status of pregnant women who visit PHCs can be improved.Clinical Relevance to Interdisciplinary Dentistry Being based on the contemporary philosophy of minimum intervention and maximum preservation of the tooth structure, atraumatic restorative treatment (ART) has been considered a feasible treatment option for moderate to deep carious lesions and can be applied to the entire population.As ART approach causes lesser anxiety than the traditional restorative procedure using dental rotary instruments, it can be used among target groups like children and pregnant women to treat dental caries.This article is an attempt at demonstrating the effectiveness of ART in pregnant women attending primary health centres. This could be utilized for preventive care in low resource and low-cost settings

Alterations inTLRsas new molecular markers of congenital infections withHuman cytomegalovirus?

Toll-like receptors (TLRs) play a crucial role in non-specific immunity against various infections. The most common intrauterine infection, caused by Human cytomegalovirus (HCMV), results in perinatal morbidity and mortality of primary infected fetuses. The induction of immune response by TLRs was observed in HCMV infections in murine models and cell lines cultured in vitro. Studies reported an immunological response in pregnant women with primary HCMV infection and TLR2 activity in collecting of HCMV particles in placental syncytiotrophoblasts (STs) in vivo and cultured ST, and in stimulation of tumor necrosis factor (TNF)-α expression and damage of villous trophoblast. Expression levels of TLRs are associated with cell type, stage of pregnancy and response to microorganisms. We show the effect of HCMV infection on the development of pregnancy as well as the effect of TLR single-nucleotide polymorphisms on the occurrence and course of infectious diseases, immune response and diseases of pregnancy. We report the impact of TLRs on the function of miRNAs and the altered expression levels of these molecules, as observed in HCMV infections. We suggest that the methylation status of TLR gene promoter regions as epigenetic modifications may be significant in the immune response to HCMV infections. We conclude that it is important to study in detail the molecular mechanisms of TLR function in the immune response to HCMV infections in pregnancy.

The Safety and Immunogenicity of Trivalent Inactivated Influenza Vaccination: A Study of Maternal-Cord Blood Pairs in Taiwan

BackgroundThere are little data about adverse effects and immunogenicity of flu vaccine in Asian pregnant women.MethodsThis prospective trial (NCT01514708) enrolled 46 pregnant women who received a single intramuscular dose of trivalent flu vaccine (AdimFlu-S®) containing 15 mcg of hemagglutinin for each strain/0.5 mL from influenza A (H1N1), influenza A (H3N2), and influenza B after the first trimester. Blood samples were collected at day 0 and 28 after vaccination, and at delivery. Cord blood was also collected. Hemagglutination inhibition (HAI) assays were performed to determine seroprotection and seroconversion rates and fold increase in the HAI geometric mean titer (GMT).ResultsTwenty-eight days after vaccination the seroprotection rate against H1N1, H3N2, and influenza B was 91.3%, 84.8% and 56.5%, respectively. The GMT fold increase was 12.8, 8.4, and 4.6 for H1N1, H3N2, and influenza B, respectively. At delivery, both the seroprotection rate (86.4%, 68.2%, and 47.7%) and GMT fold increase (9.4, 5.7 and 3.8) were slightly lower than day 28. The seroprotection rate and GMT fold increase in maternal and cord blood samples were comparable. No significant adverse effects were detected.ConclusionsTrivalent flu vaccine induces a strong immune response in pregnant women and their infants without adverse effects.Trial RegistrationClinical Trials. gov NCT01514708

Reduced postprandial GLP‐1 responses in women with gestational diabetes mellitus

We investigated postprandial glucagon-like peptide-1 (GLP-1) responses in pregnant women with and without gestational diabetes mellitus (GDM) and again following delivery when normal glucose tolerance (NGT) was re-established. Eleven women with GDM [plasma glucose (PG) concentration at 120 min after a 75-g oral glucose tolerance test (OGTT): 10.0 ± 0.9 mM (mean ± SD); age: 31 ± 6 years; body mass index (BMI): 31.6 ± 6.4 kg/m(2) ; haemoglobin A1c (HbA1c): 5.6 ± 0.5%] and eight pregnant women with NGT (PG(120 min), OGTT : 5.7 ± 0.7 mM; age: 28 ± 3 years; BMI: 29.7 ± 5.4 kg/m(2) ; HbA1c: 5.4 ± 0.3%) were investigated with a 4-h liquid meal test during third trimester (TT) and 3-4 months postpartum (PP). All patients with GDM re-established NGT following delivery. Pregnancy was associated with low postprandial GLP-1 responses. Patients with GDM exhibited reduced postprandial GLP-1 responses compared to their PP levels [area under curve (AUC): 5.5 ± 1.3 vs. 8.4 ± 3.2 nM × min, p=0.005], but the difference among NGT women (7.3 ± 2.8 vs. 8.8 ± 2.0 nM × min, p=0.066) was not statistically significant. Pregnancy did not influence postprandial responses of the other incretin hormone glucose-dependent insulinotropic polypeptide (GIP) in any of the groups, but GDM patients were characterized by greater postprandial GIP responses during both TT and PP compared to NGT subjects. Pregnancy is associated with reduced postprandial GLP-1 responses (most pronounced in patients with GDM) that normalize after delivery. In contrast, postprandial GIP responses seem unaffected by pregnancy but is increased in GDM patients.