Fetal vascular malperfusion score is linked with developing preeclampsia in women with gestational diabetes mellitus: a retrospective cohort study

SUMMARY OBJECTIVE: Fetal vascular malperfusion is associated with poor perinatal outcomes in women with preeclampsia and gestational diabetes mellitus. The aim of this study was to determine the association between fetal vascular malperfusion score and syncytiotrophoblast basement membrane thickness and clinicopathological variables, such as developing preeclampsia in women with gestational diabetes mellitus. METHODS: This retrospective cohort study included 65 pregnant participants (34 with gestational diabetes mellitus and 31 controls) between January 2019 and January 2022. Gestational diabetes mellitus was diagnosed as ≥2 of 4 elevated values on a 3-h, 100-g oral glucose tolerance test. The fetal vascular malperfusion score was evaluated by endothelial CD34 positivity in the villous stroma of the placenta. The association between fetal vascular malperfusion score and syncytiotrophoblast basement membrane thickness with clinicopathological variables in women with gestational diabetes mellitus was evaluated. RESULTS: It was revealed that the gestational diabetes mellitus group had greater fetal vascular malperfusion scores than the control group (gestational diabetes mellitus group fetal vascular malperfusion score: 34.2±9.1 and control group fetal vascular malperfusion score: 26.5±8.7, respectively, p=0.0009). Syncytiotrophoblast basement membrane thickness was correlated with the development of preeclampsia, trophoblast proliferation, and fetal vascular malperfusions (0.3952, p=0.0129; 0.3487, p=0.0211; and 0.4331, p=0.0082, respectively). On the contrary, fetal vascular malperfusions were correlated with the development of preeclampsia, villous edema, and trophoblast proliferation (0.3154, p=0.0343; 0.2922, p=0.4123; and 0.3142, p=0.0355, respectively). CONCLUSION: The gestational diabetes mellitus group displayed significantly higher fetal vascular malperfusion scores and thickening of the syncytiotrophoblast basement membrane than the control group. There is a correlation between developing preeclampsia and the fetal vascular malperfusion scores and the syncytiotrophoblast basement membrane thickness.

Higroma quístico retronucal como marcador de anomalías cromosómicas en el primer trimestre de la gestación - Actualización

Objetivo. Evaluar la asociación del higroma quístico retronucal (HQR) y anomalías cromosómicas fetales. Métodos. Estudio observacional retrospectivo de 323 fetos del primer trimestre con riesgo para anomalías cromosómicas diagnosticados por ecografía entre las 11 y 13,6 semanas. Resultados. De 323 fetos con riesgo para anomalías cromosómicas, se encontró 132 casos de anomalías cromosómicas (40,9%). Se identificaron 145 casos de HQR; en 64 (56,6%) se realizó biopsia de vellosidades coriales y en 81 (43,5%) amniocentesis, hallándose cariotipo anómalo en 82 (56,6%). De 88 fetos con HQR aislado, 33 casos (37,5%) tuvieron alguna anomalía cromosómica; en 58 fetos con HQR asociado a otros hallazgos anormales, se encontró que en 43 fetos (74,1%) hubo anomalías cromosómicas, y de ellos 24 (41,4%) tenían onda de flujo (OVF) anormal del ductus venoso, 17 (29,3%) tenían edema generalizado, 8 casos (13,8%) con cardiopatía, 7 (12,1%) ausencia del hueso nasal. Los valores predictivos del HQR fueron: sensibilidad (S) 62,1%, especificidad (E) 67%, valor predictivo positivo (VPP) 56,6%, valor predictivo negativo (VPN) 71,9%, p<0,001, OR: 3,3. El HQR asociado a otros hallazgos anormales, tuvo los siguientes valores predictivos: S 52,4%, E 76,2%, VPP 76,2%, OR: 3,5, LR+: 2,2, p<0,000. El edema generalizado y el ductus venoso anormal tuvieron los valores predictivos más altos: VPP 88,2% y 83,3%, respectivamente. Las anomalías cromosómicas encontradas con mayor frecuencia fueron: T21 (53,7%), monosomía X (18,3%), T18 (15,9%), T13 (6,1%). Conclusiones. El higroma quístico retronucal es un marcador de riesgo con alto valor predictivo para anomalías cromosómicas, siendo mayor cuando está asociado a otros hallazgos ecográficos anormales. La identificación ecográfica del HQR en el tamizaje prenatal del primer trimestre debería ser indicación para recomendar una prueba diagnóstica para anomalías cromosómicas.

Objective: To evaluate the association of retronucal cystic hygroma (RCH) and fetal chromosomal abnormalities. Methods: Retrospective observational study of 323 first trimester fetuses at risk for chromosomal abnormalities diagnosed by ultrasound between 11 and 13.6 weeks. Results: Of 323 fetuses at risk for chromosomal abnormalities, 132 cases of chromosomal abnormalities were found (40.9%). A total of 145 cases of RCH were identified; chorionic villus biopsy was performed in 64 (56.6%) and amniocentesis in 81 (43.5%); an abnormal karyotype was found in 82 (56.6%). Of 88 fetuses with isolated RCH, 33 (37.5%) had some chromosomal abnormality. In 58 fetuses with RCH associated with other abnormal findings, chromosomal abnormalities were found in 43 fetuses (74.1%) and of these 24 (41.4%) had abnormal ductus venosus flow wave (DVF), 17 (29.3%) had generalized edema, 8 cases (13.8%) with cardiopathy, 7 (12,1%) with absent nasal bone. The predictive values of RCH were sensitivity (S) 62.1%, specificity (Sp) 67%, positive predictive value (PPV) 56.6%, negative predictive value (NPV) 71.9%, p<0.001, OR: 3.3. RCH associated with other abnormal findings were S 52.4%, Sp 76.2%, PPV 76.2%, OR: 3.5, LR+: 2.2, p<0.000. Generalized edema and abnormal ductus venosus had the highest predictive values: PPV 88.2% and 83.3%, respectively. The most frequently found chromosomal abnormalities were T21 (53.7%), monosomy X (18.3%), T18 (15.9%), T13 (6.1%). Conclusions: Retronucal cystic hygroma is a risk marker with high predictive value for chromosomal abnormalities, being higher when associated with other abnormal ultrasound findings. Ultrasonographic identification of RCH in first trimester prenatal screening should be an indication to recommend diagnostic testing for chromosomal abnormalities.

Does Enoxaparin treatment have any effects on the placenta in women with unexplained histories of habitual abortion? A case control study

ABSTRACT BACKGROUND: It is very common to offer low molecular weight heparin (LMWH) medications to women with unexplained habitual abortion, to increase the livebirth rate. Although no benefit from LMWH has been clearly demonstrated, examination of the effects of enoxaparin on placental structure is lacking. OBJECTIVE: To assess placental structural changes in pregnancies treated with enoxaparin, compared with controls. DESIGN AND SETTING: Case-control study in an obstetrics and gynecology unit of a tertiary-level university hospital in Turkey. METHODS: Forty patients who had had term pregnancies and live births but also histories of habitual abortion were recruited for this study. Placentas were sampled using a systematic random sampling method. Tissue samples were obtained, embedded and sectioned for routine histological analyses. Hematoxylin and eosin staining was used. Surface area and length estimates from placental components were evaluated by using Image J. Cell proliferation and apoptosis were also assessed via immunohistochemistry. RESULTS: There were no significant differences between the groups regarding maternal age, abortion rate, birth weight or gestational age. Comparison of the enoxaparin and control groups showed that there were no significant differences in terms of surface area and ratios of placental components. We found that Bcl-2 was generally expressed at high levels in the enoxaparin group, while there was no difference in terms of Ki-67 between the groups. CONCLUSIONS: This study demonstrates that enoxaparin did not show any significant effect on the placental structure of cases that had histories of habitual abortion.

A study of tubal ectopic pregnancy based on the histopathology of fallopian tubes in the age group of 20-35 years

Purpose: Ectopic pregnancy is a life-threatening condition for the mother. Disruptions of the fallopian tube are considered to be important in its pathogenesis. The present study was conducted to observe the histopathology of this dreaded disease which could lead to the development of suitable remedies. Methods: Cases diagnosed with ectopic gestation in the fallopian tube who subsequently underwent salpingectomy were considered for the study. Histopathology of sections from the affected fallopian tubes was studied under the light microscope after staining with H and E. Results: Most cases presented with amenorrhoea, whereas others had dysmenorrhoea, menorrhagia, and menometrorrhagia. Histopathologic findings included the presence of salpingitis (acute and chronic), calcification, sclerosed vessel and. Conclusion: Past history of inflammatory diseases, especially PID plays an important role in the subsequent development of ectopic pregnancy. Its prevention and treatment can lead to a decrease in the incidence of ectopic pregnancy.

First-trimester chorionic villus sampling: genetic analysis of 985 cases / 中华围产医学杂志

Objective To investigate the value and safety of first-trimester chorionic villus sampling (CVS) in prenatal diagnosis.Methods This study retrospectively analyzed the clinical data of 985 cases undergoing CVS and prenatal diagnosis with karyotyping and fluorescence in situ hybridization (FISH) in the Department of Obstetrics and Gynecology of Peking University First Hospital from January 2012 to December 2017.The success rate of cell culture,indications for prenatal diagnosis,karyotyping results,and complications of CVS were described.Results Among the 985 cases,970 (98.48％) underwent FISH and 893 (90.66％) received karyotyping,and 878 (89.14％) accepted both.After CVS,the success rate of cell culture was 96.64％ (863/893).Abnormal ultrasonographic findings (42.64％,420/985) were the most common indications for prenatal diagnosis.In this study,181 cases of chromosomal abnormalities were detected,including numerical and structural abnormalities,accounting for 18.38％ of all 985 cases.Those cases with abnormal ultrasonographic images had the highest detection rate of chromosomal abnormalities (31.90％,134/420),followed by those with adverse pregnant history (11.83％,20/169) and advanced maternal age (8.21％,11/134).In addition,there was a discrepancy between karyotyping and FISH results,which might due to 16 cases of placental mosaicism and 13 cases of maternal cell contamination (MCC).Embryonic demises were reported in six cases (0.61％,6/985),including four with chromosomal numerical abnormalities within four weeks after CVS.No other short-or long-term postoperative complications were found in the rest 979 cases (99.39％).Conclusions CVS in the first trimester is a safe and reliable invasive method for prenatal diagnosis,which can help to obtain an earlier diagnosis in a certain population such as those with abnormal ultrasonographic findings,thus improve the pertinence and efficiency of prenatal diagnosis.However,the potential influences of placental mosaicism and MCC on the diagnostic results should not be ignored.

First-trimester chorionic villus sampling: genetic analysis of 985 cases / 中华围产医学杂志

Objective@#To investigate the value and safety of first-trimester chorionic villus sampling (CVS) in prenatal diagnosis.@*Methods@#This study retrospectively analyzed the clinical data of 985 cases undergoing CVS and prenatal diagnosis with karyotyping and fluorescence in situ hybridization (FISH) in the Department of Obstetrics and Gynecology of Peking University First Hospital from January 2012 to December 2017. The success rate of cell culture, indications for prenatal diagnosis, karyotyping results, and complications of CVS were described.@*Results@#Among the 985 cases, 970 (98.48%) underwent FISH and 893 (90.66%) received karyotyping, and 878 (89.14%) accepted both. After CVS, the success rate of cell culture was 96.64% (863/893). Abnormal ultrasonographic findings (42.64%, 420/985) were the most common indications for prenatal diagnosis. In this study, 181 cases of chromosomal abnormalities were detected, including numerical and structural abnormalities, accounting for 18.38% of all 985 cases. Those cases with abnormal ultrasonographic images had the highest detection rate of chromosomal abnormalities (31.90%, 134/420), followed by those with adverse pregnant history (11.83%, 20/169) and advanced maternal age (8.21%, 11/134). In addition, there was a discrepancy between karyotyping and FISH results, which might due to 16 cases of placental mosaicism and 13 cases of maternal cell contamination (MCC). Embryonic demises were reported in six cases (0.61%, 6/985), including four with chromosomal numerical abnormalities within four weeks after CVS. No other short- or long-term postoperative complications were found in the rest 979 cases (99.39%).@*Conclusions@#CVS in the first trimester is a safe and reliable invasive method for prenatal diagnosis, which can help to obtain an earlier diagnosis in a certain population such as those with abnormal ultrasonographic findings, thus improve the pertinence and efficiency of prenatal diagnosis. However, the potential influences of placental mosaicism and MCC on the diagnostic results should not be ignored.

Inclusion of kaolin in the feed of Japanese quails during the production phase / Inclusión de caolín en el alimento de codornices japonesas durante la fase de producción / Inclusão de caulim na alimentação de codornas japonesas durante a fase de produção

Abstract Background: Kaolin may improve quail performance by maintaining intestinal integrity and improving nutrient absorption. Objective: To evaluate the overall performance, egg quality, moisture, nitrogen and calcium content in the excreta, intestinal morphology and financial analysis of kaolin in Japanese quail feed during the production phase. Methods: A total of 192 Japanese quails, distributed in a completely randomized design with four treatments and six repetitions with eight birds each, were used. Kaolin levels added to the diet were 0, 1.5, 3.0, and 4.5%. Results: Kaolin reduced feed consumption. Additionally, egg production, feed conversion and viability increased. Moisture, nitrogen and calcium in the excreta decreased. Height and width of the intestinal villi increased with increasing levels of kaolin in the diet. Kaolin had no effect on egg quality. Inclusion level of 1.5% kaolin allowed for greater economic gains. Conclusion: Kaolin improved performance, intestinal morphology, and reduced the moisture, nitrogen and calcium contents in the excreta. Egg quality remained unchanged with the addition of kaolin, and the best economic response resulted with the addition 1.5% kaolin.

Resumen Antecedentes: El caolín puede mejorar el rendimiento de la codorniz al mantener la integridad intestinal y una mayor absorción de nutrientes. Objetivo: Evaluar el rendimiento general, calidad del huevo, humedad, contenido de nitrógeno y calcio en la excreta, morfología intestinal, y realizar un análisis financiero de la inclusion de caolín en el alimento de codorniz japonesa durante la fase de producción. Métodos: Se utilizaron un total de 192 codornices japonesas, distribuidas en un diseño completamente al azar con cuatro tratamientos y seis repeticiones con ocho aves cada una. Los niveles de caolín agregado a la dieta fueron 0; 1,5; 3,0; y 4,5%. Resultados: El caolin redujo el consumo de alimento, hubo una mejora en el porcentaje de huevos producidos, la conversión del alimento y la viabilidad, Los niveles de humedad, nitrógeno y calcio en la excreta disminuyeron, la altura y el ancho de las vellosidades intestinales aumentaron con la inclusión de niveles crecientes de caolín. No hubo efecto sobre la calidad del huevo. Los niveles de inclusión de 1,5% de caolín permitieron mayores ganancias económicas. Conclusión: El caolín mejoró el rendimiento, la morfología intestinal y redujo los contenidos de humedad, nitrógeno y calcio en las excretas. La calidad de los huevos producidos se mantuvo sin cambios con la adición de diferentes niveles de caolín, y el mejor nivel de inclusion de caolín -según el análisis económico- fue de 1,5%.

Resumo Antecedentes: O caulim pode melhorar o desempenho de codornas mantendo a integridade intestinal e maior absorção de nutrientes. Objetivo: Avaliar o desempenho global, a qualidade do ovo, a umidade, o teor de nitrogênio e cálcio na excreta, a morfologia intestinal e a análise financeira do caulim em codornas japonesas durante a fase de produção. Métodos: Foram utilizadas 192 codornas japonesas, distribuídas em delineamento inteiramente casualizado, com quatro tratamentos e seis repetições, com oito aves cada. Os níveis de caulim adicionados à dieta foram 0; 1,5; 3,0; 4,5%. Resultados: O consumo de ração foi reduzido, houve melhora na porcentagem de ovos produzidos, conversão alimentar e viabilidade, os níveis de umidade, nitrogênio e cálcio nas excretas diminuíram, a altura e a largura das vilosidades intestinais aumentaram com a inclusão de níveis crescentes de caulim. Não houve efeito na qualidade do ovo. Os níveis de inclusão de 1,5% de caulim permitiram maiores ganhos econômicos. Conclusão: O caulim melhorou o desempenho, a morfologia intestinal e reduziu os teores de umidade, nitrogênio e cálcio na excreta. A qualidade dos ovos produzidos permaneceu inalterada com a adição de diferentes níveis de caulim, e o melhor nível de caulim, de acordo com a análise econômica, foi de 1,5% como aditivo para as codornas japonesas.

Intestinal lymphangiectasia: case report

Primary intestinal lymphangiectasia (PIL) was first described by Waldmann et al, in 1961. PIL is a rare disease with several hundred reported cases. It is rarely reported in adults because it is presumably a congenital disorder and when present in adults it typically produces a long duration of manifestation such as diarrhea, abdominal distention from ascites, and peripheral edema. This disorder is characterized by markedly dilated intestinal lymphatics, hypoproteinemia, generalized edema, lymphocytopenia hypogammaglobinemia, and immunologic anomalies. The loss of protein into the from dilated intestinal lymphatics leads to the development of hypoproteinemia in these patients and its demonstration is important in the diagnosis of intestinal lymphangiectasia. The disease can be secondary to congenital, secondary or idiopathic defects in the formation of the lymphatic ducts. In the present report, we describe a case of 15 years old female presented to our hospital with history of generalized edema, bilateral hand spasm, and diarrhea. Endoscopy of the patient revealed White spots (dilated lacteals), white nodules, and submucosal elevations were observed. Changes suggestive of the disease includes White villi and/or spots (dilated lacteals), white nodules, and submucosal elevations are observed. Xanthomata’s plaques are often visualized, there are no specific treatments for patients with PIL. treatment of patients with primary intestinal lymphangiectasia involves control of symptoms with the use of dietary, pharmaceutical, and behavioral modifications.

Microchip based on 3D printing technology for simulating intestinal villi and tumor surface topography / 上海交通大学学报（医学版）

Objective: To propose a method for making organ-on-a-chip based on 3D printing, and study the relationship between cell growth on the chips and various factors. Methods: Through 3D printing technology and surface microstructure transfer method, ulcer-like and ridge-like mi-crostructures of the tumor surface and the intestinal villi were fabricated on a polydimethylsiloxane (PDMS) chip. Combined with fluorescence imaging, the effects of surface modification, shapes and heights of microstructures, and culture time on the surface coverage and density of Caco-2 cells on the chip were measured. Results:The PDMS chip was more likely to induce cell adhesion and growth rather than the 3D printing resin chip. On the surface of three-dimensional structure, cell surface coverage and cell density increased after the surface was treated with rat tail collagen (P0.05). Conclusion: The intestinal villi and tumor topological organ chips can be fabricated by 3D printing technology and surface microstructure transfer method. The surface modification and microstructure height affect the cell growth on the surface.

Risk factor and hepatitis B virus makers during the first trimester in villi tissues of HBsAg-positive pregnant women / 中华实验和临床病毒学杂志

Objective@#To determine whether intrauterine infection with hepatitis B virus (HBV) occurs in early pregnancy and to characterize associated virulence factors.@*Methods@#Villi tissues and blood samples of 45 HBV surface antigen (HBsAg)-positive pregnant women were collected during the first trimester and HBV DNA loads were quantified by quantitative reverse transcription polymerase chain reaction (qRT-PCR). The expression of GCM1, HBsAg and hepatitis B core antigen (HBcAg) in villi tissues were detected by immunohistochemical method.@*Results@#Data from qRT-PCR showed that HBV DNA was detected in 14 of 45 villi tissues (positive rate of 31.11%), and 24 of 45 blood samples (positive rate of 53.33%), further statistical analysis showed that the positive rates of HBV DNA between blood samples and villi tissues were not significantly different (χ2=4.555, P=0.054). Among them, 12 samples were consistently positive between the villi and blood specimens, and HBsAg, HBeAg, HBeAb, HBV DNA from peripheral blood in these pregnant women were significantly higher than those of the other women (P value was 0.007, 0.004, 0.000, and 0.000 respectively). The multivariate logistic regression analysis showed that blood HBV DNA greater than 106 IU/ml was independently associated with HBV DNA positive in villi, and the HBsAg, HBeAg, villi tissues HBV DNA positive rates of these pregnant women were significantly higher than those of the other pregnant women (all P value were 0.000). Immunohistochemistry results showed that all 45 cases were positive for GCM1 expression in the cell nucleus. Nine cases also had HBsAg expression in the cytoplasm. Only one case was found to express HBV core antigen (HBcAg) in the nucleus.@*Conclusions@#HBV DNA and HBsAg can be detected from villi tissues harvested during the first trimester in HBsAg-positive pregnant women, and the results suggest an early occurrence of intrauterine infection of fetuses with high HBV levels.

Morphological features of the human placenta and its free chorionic villi in normal pregnancies and those with diabetes and high blood pressure: literature review / Características morfológicas de la placenta humana y sus vellosidades coriales libres en gestas normales y con diabetes e hipertensión arterial: revisión de la literatura

The most prevalent pathologies during pregnancy, such as hypertension, gestational diabetes mellitus (GDM), and intrauterine growth restriction (IUGR), can determine modifications in macro- and microscopic morphological features of the placenta and its free chorionic villi. In the fetus it may be accompanied by pathological manifestations, with the embryo's future quality of life, and even its viability, at risk. The aim of this work is to perform a review of the morphological alterations that the placenta exhibits in pregnancies with GDM. A search on the topic in the scientific literature and specialized textbooks was carried out. The terms "placenta", "diabetes mellitus gestational" and "gestational diabetes mellitus" were used to define the search. Among the morphological modifications it was found that the placental weight/fetal weight ratio is higher in GDM and is associated mainly with histological changes. The distance between maternal and fetal circulation is increased because of an increase in the chorionic villi on the surface as well as greater thickness of the syncytiotrophoblast basal membrane due to an increased type IV collagen deposition. The stroma between the villi is edematous, which modifies the metabolic and endocrinal function of these placentas. Moreover, the capillary surface is enlarged due to the phenomena of vascular neoformation and a greater penetration of these vessels within the villi. Low oxygen partial pressure (pO2) was detected, which would produce a compensatory hyperplasia of terminal chorionic villi. In GDM the placenta undergoes alterations in its formation, structure, and function. According to the review, these alterations are related to an oxygenation deficiency in the fetus and changes in the transplacental transport of nutrients and other alterations, causing fetal overgrowth by increasing their availability in addition to other consequences to the developing fetus. In the case of high blood pressure during pregnancy, this produces accelerated maturation and rapid aging of the chorionic villi, with the risk of inducing a placental abruption. In addition, placental circulation is reduced by a third, decreasing oxygen saturation in the umbilical vessels and placing the health of the fetus at risk.

Las patologías de la gestación más prevalentes, como hipertensión, diabetes mellitus gestacional (DMG) y restricción del crecimiento uterino, pueden determinar modificaciones en las características morfológicas macro y microscópicas de la placenta y sus vellosidades coriales libres,y en el feto se puede acompañar de manifestaciones patológicas, con riesgo para su calidad de vida futura, e incluso su viabilidad. El objetivo de este trabajo consiste en realizar una revisión acerca de las alteraciones morfológicas que presenta la placenta en gestaciones con DMG. Se llevó a cabo una búsqueda sobre la temática en literatura científica y libros de texto especializados. Se utilizaron los términos "placenta", "diabetes mellitus gestacional" y "gestational diabetes mellitus" para orientar la búsqueda. Entre las modificaciones morfológicas se encontró que la relación peso placentario/peso fetal está aumentado en la DMG y se asocia principalmente a cambios histológicos. La distancia entre la circulación materna y la fetal está aumentada debido a un aumento de la superficie entre las vellosidades coriales, así como al mayor grosor de la membrana basal del sincitiotrofoblasto por un depósito elevado de colágeno tipo IV. El estroma entre las vellosidades se encuentra edematoso lo que va a modificar la función metabólica y endocrina de estas placentas. También hay aumento de la superficie capilar por fenómenos de neoformación vascular y una mayor penetración de estos vasos dentro de las vellosidades. Se detectó baja presión parcial de oxígeno (pO2), que produciría una hiperplasia compensatoria de vellosidades coriónicas terminales. En la DMG la placenta experimenta alteraciones en su formación, estructura y función. Según lo revisado, estas alteraciones están relacionadas con déficit en la oxigenación del feto, cambios en el transporte transplacentario de los nutrientes y otras alteraciones, ocasionando sobrecrecimiento fetal por aumento de su disponibilidad, entre otras consecuencias al feto en desarrollo. Y en el caso de la hipertensión arterial durante la gestación produce una maduración acelerada y envejecimiento rápido de las vellosidades coriales, con el riesgo de inducir un desprendimiento prematuro de placenta. Además se reduce la circulación placentaria en un tercio, disminuyendo la saturación de oxígeno en los vasos umbilicales del, poniendo en riesgo la salud del feto.

Morphometry of pectoral muscle fiber and intestinal villi of Calidris pusilla during the wintering period in Brazil / Morfometria da fibra muscular peitoral e das vilosidades intestinais de Calidris pusilla durante o período de invernada no Brasil

Migration is an event observed in several animals, such as shorebirds moving between the northern and southern hemispheres, during breeding and wintering intervals. Morphophysiological adaptations are necessary to allow the maintenance of migratory cycles and, therefore, studies with this focus can help clarify biological aspects related to migration. We analyzed the morphology variation in pectoral muscles and intestinal mucosa of Calidris pusilla, during different phases of the wintering period on the coast of Brazil. Fragments of pectoral muscles and duodenal were collected, fixed and processed for histology according to standard procedure, from specimens captured in a locality on the Brazilian coast. Modifications were found in the measured parameters among the three phases of wintering, arrival in Brazil (October, mid-period), January and departure to the Northern Hemisphere - May. The registered structural dynamism characterizes the growth of flight musculature and intestinal changes related to nutrition. Such changes occur temporarily due to the activities of preparation and migration between the northern and southern hemispheres.(AU)

A migração é um evento observado em vários animais, como as aves limícolas que se deslocam entre os hemisférios norte e sul, durante os intervalos de reprodução e invernada. Adaptações morfofisiológicas são necessárias para permitir a manutenção dos ciclos migratórios e, portanto, estudos com esse enfoque podem ajudar a esclarecer aspectos biológicos relacionados à migração. Analisamos a variação morfológica nos músculos peitorais e mucosa intestinal de Calidris pusilla, durante diferentes fases do período de invernada no litoral brasileiro. Fragmentos de músculos peitorais e duodenais foram coletados, fixados e processados ​​para histologia de acordo com o procedimento padrão, a partir de espécimes capturados na localidade da costa brasileira. O dinamismo estrutural registrado caracteriza o crescimento da musculatura de vôo e as alterações intestinais relacionadas à nutrição. As mudanças nos parâmetros medidos entre as três fases do inverno, chegada ao Brasil (outubro, meio período), janeiro e saída para o Hemisfério Norte. Tais mudanças ocorrem temporariamente devido às atividades de preparação e migração entre os hemisférios norte e sul.(AU)

Mola hidatiforme parcial del segundo trimestre / Second trimester partial hydatidiform mole

La mola hidatiforme coexistente con un feto vivo es una entidad infrecuente que se caracteriza por la degeneración hidrópica de las vellosidades coriales, hiperplasia del trofoblasto y evidencia macroscópica de un feto. El objetivo del trabajo fue describir el caso clínico de una paciente con diagnóstico de mola parcial y edad gestacional de 23 semanas. Presentamos una paciente de 31 años remitida de consulta de perinatología con 22,5 semanas de gestación, tensión arterial elevada, signo de más y ecografía con 20 semanas que describe placenta con lagos venosos; con antecedentes de alfafetoproteína elevada. En el hospital empeoró su estado con una preeclampsia agravada, y con ecografía evolutiva que describe placenta de 71 mm, con múltiples lagos venosos. Se plantea posible enfermedad trofoblástica y se discute para interrupción del embarazo. Se realizó microcesárea, se obtiene feto muerto femenino de 600 gramos, con placenta de 400 gramos con múltiples vesículas que recuerdan la mola parcial, diagnóstico que se confirma posteriormente con estudio histopatológico. En la mola parcial, el embrión rara vez sobrevive hasta el segundo trimestre. Si no se realizan pruebas citogenéticas, posiblemente no se diagnostiquen porque los cambios histológicos suelen ser sutiles. La clínica, la fracción beta de la gonadotropina coriónica y el estudio de la placenta, el feto o ambos, son los que permitirán realizar el diagnóstico definitivo para determinar el seguimiento y disminuir las complicaciones(AU)

The hydatidiform mole coexisting with a living fetus is a rare entity that is characterized by hydropic degeneration of the chorionic villi, hyperplasia of the trophoblast and macroscopic evidence of a fetus. The objective of the study was to describe the clinical case of a patient with a diagnosis of partial mole and gestational age of 23 weeks. We present a 31-year-old patient referred for perinatology consultation with 22.5 weeks of gestation, high blood pressure, plus sign and ultrasound with 20 weeks describing placenta with venous lakes; and history of high alpha-fetoprotein. In the hospital, her condition worsened with aggravated preeclampsia, and with an evolving ultrasound, that describes a 71 mm placenta with multiple venous lakes. Possible trophoblastic disease arises and is discussed for termination of pregnancy. Micro-cesarean surgery was performed, a female fetus weighing 600 grams was obtained, a placenta of 400 grams with multiple vesicles that resemble partial mole. This diagnosis is later confirmed with histopathological study. In partial mole, the embryo rarely survives until the second trimester. If cytogenetic tests are not performed, they may not be diagnosed because the histological changes are usually subtle. The clinic, the beta fraction of the chorionic gonadotropin and the study of the placenta, the fetus or both, are the ones that will make the definitive diagnosis to determine the follow-up and decrease the complications(AU)

Aspectos morfocuantitativos de las vellosidades coriales libres en gestas normales, con diabetes, hipertensión arterial y restricción del crecimiento intrauterino / Morphoquantitative characteristics of free corial vellosities in normal births, with diabetes, hypertension and restriction of intrauterine growth

Las patologías de la gestación como la hipertensión, diabetes mellitus gestacional, o restricción del crecimiento intrauterino, pueden determinar modificaciones en las características morfológicas macro y microscópicas de la placenta y sus vellosidades coriales libres, y en el feto se puede acompañar de manifestaciones patológicas, con riesgo para su calidad de vida futura, e incluso su viabilidad. El objetivo de este trabajo consistió en describir aspectos morfométricos e histológicos de las vellosidades coriales libres en gestas normales, con diabetes e hipertensión arterial. Se utilizaron 30 placentas humanas y fueron separadas, según presencia o ausencia de patologías en el embarazo, en tres grupos: Normal (N), Síndrome Hipertensivo del Embarazo (SHE), Diabetes (D) y Restricción del Crecimiento Intrauterino (RCIU). Se usó ficha para registrar peso placentario y del recién nacido Todas las muestras fueron fijadas en formalina tamponada al 10 %. De cada una fueron extraídas 5 muestras, obteniendo 25 cortes por cada placenta. Posteriormente, fueron teñidas con H&E, Azul Alcián y Tricrómico de Masson. Además, se efectuó el análisis histológico y morfométrico (ImageJ®) de las vellosidades coriales. El análisis estadístico fue realizado utilizando ANOVA. Entre los cambios morfológicos, se encontró una relación peso placentario/peso del recién nacido aumentada en la Diabetes Mellitus Gestacional asociada a cambios histológicos. No hubo cambios morfométricos significativos entre placentas N, SHE y D. Hubo un aumento en el número de vasos coriales en placentas del grupo D (P < 0,05) y de la superficie entre las vellosidades coriales. En el grupo SHE hubo aumento moderado de nudos sinciciales y presencia de fibrina en el estroma. Las placentas con Diabetes Mellitus Gestacional experimentan alteraciones histológicas, como consecuencia de cambios estructurales y funcionales. Además, el aumento de vasos sanguíneos en placentas con diabetes se produce por neoformación vascular y mayor penetración de vasos sanguíneos dentro de las vellosidades. En el caso del SHE las alteraciones placentarias se relacionan con la gravedad de la enfermedad.

Gestational pathologies such as hypertension, gestational diabetes mellitus and restriction of intrauterine growth can determine changes in the macro and microscopic morphological characteristics of the placenta and its free chorionic villi. In the fetus it can be accompanied by pathological manifestations with risk to its viability and future quality of life. The aim of this work was to describe morphometric and histological aspects of free chorionic villi in normal pregnancies associated with diabetes, hypertension and restriction of intrauterine growth. Thirty human placentas were used and were separated into three groups: Normal (N), Hypertensive Pregnancy Syndrome (SHE), Diabetes (D), and Restriction of Intrauterine Growth (RIG) according to evident pathologies or absence thereof during pregnancy. Tab was used to record placental and newborn weight. All samples were fixed in 10 % buffered formalin. From each, 5 samples were extracted, obtaining 25 cuts for each placenta. Subsequently, they were stained with H & E, Alcian Blue and Masson's Trichrome. In addition, histological and morphometric analysis (ImageJ®) of the chorion villus was carried out. Statistical analysis was performed using ANOVA. Among the morphological changes, an increased placental weight / weight ratio of the newborn was found in Gestational Diabetes Mellitus associated with histological changes. There were no significant morphometric changes between placentas N, SHE and D. There was an increase in the number of corial vessels in placentas of group D (P <0.05) and of the surface between the chorion villi. In the SHE group there was a moderate increase in syncytial nodes and presence of fibrin in the stroma. Placentas with Gestational Diabetes Mellitus experience histological alterations, as a consequence of structural and functional changes. In addition, the increase of blood vessels in placentas D is produced by vascular neoformation and increased penetration of blood vessels into the villi. In the case of SHE, placental alterations are related to the severity of the disease.

Histomorphological study of placenta in gestational diabetes mellitus / Estudio histomorfológico de la placenta en diabetes mellitus gestacional

Evidence from the literature shows that well-controlled glucose levels during pregnancy are usually associated with normal placental morphology. The aim of this study was to identify the lacental changes attributed to maternal hyperglycemia. A total of 20 placentae were selected for study from a tertiary care medical center in Makkah city, Saudi Arabia. Out of 20, 10 placentae were from patients diagnosed with GDM based on IADSPG criteria, and 10 placentae were from patients with normal pregnancies without GDM. The morphometric measurements were recorded. The mean weight of GDM placentae were more than the normal placentae. Upon histopathology, significant changes such as syncytial knots, cytotrophoblastic cell proliferation, fibrinoid necrosis, stromal fibrosis, and hyalinized villi were observed in GDM placentae. GDM produces significant morphological alterations in the placentae, which might affect the developing fetus.

La evidencia de la literatura muestra que niveles de glucosa bien controlados durante el embarazo generalmente se asocian con una morfología placentaria normal. El objetivo de este estudio fue identificar los cambios placentarios atribuidos a la hiperglucemia materna. Un total de 20 placentas fueron seleccionadas para un estudio en un centro médico de atención terciaria en la ciudad de La Meca, Arabia Saudita. De 20 placentas, 10 de estas fueron de pacientes diagnosticadas con diabetes mellitus gestacional (DMG) según los criterios de IADSPG, y 10 placentas fueron de pacientes con embarazos normales sin DMG. Las mediciones morfométricas fueron registradas. El peso medio de las placentas GDM fue mayor que la placenta normal. Tras la histopatología, se observaron cambios significativos tales como nudos sincitiales, proliferación celular citotrofoblástica, necrosis fibrinoide, fibrosis estromal y vellosidades hialinizadas en placenta con DMG. La DMG produce alteraciones morfológicas significativas en las placentas, que pueden afectar al desarrollo del feto.

Placental osseous metaplasia associated with abortion in a mare: case report / Metaplasia óssea placentária associada a aborto em uma égua: relato de caso

The aim of this report is to describe a case of marked osseous metaplasia in the placenta associated with abortion in a mare. A 19-year-old Campolina mare with a history of multiple parturitions and absence of reproductive failure, aborted a fetus with approximately six months of gestation. There were no gross changes in the fetus and the placenta. Microscopically, there was multifocal replacement of fetal connective mesenchyme of the chorionic villi with well differentiated and partially mineralized osseous tissue (confirmed by von Kossa staining). To further characterize the collagenous component of the lesion, sections of the placenta were stained with Masson's trichrome and Picrosirius red. Osseous tissue deposition had abundance of type I collagen. To the best of our knowledge, this is the first report of osseous metaplasia in the placenta of a mare associated with abortion at mid gestation, presumably due to placentary insufficiency.(AU)

O objetivo deste relato é descrever um caso de metaplasia óssea em placenta equina, associada a aborto. Uma égua da raça Campolina, com aproximadamente 19 anos de idade, após múltiplas gestações e sem histórico de alterações reprodutivas, abortou feto com idade aproximada de seis meses. Não foram observadas alterações macroscópicas no feto e na placenta. Microscopicamente, havia substituição do mesênquima de vilosidades coriônicas por tecido ósseo bem diferenciado e parcialmente mineralizado (confirmada pela coloração de von Kossa). Para caracterização do componente colagenoso, foram realizadas colorações de tricrômico de Masson e picrosirius red. O tecido ósseo tinha predominância de colágeno do tipo I. Este é o primeiro relato de metaplasia óssea na placenta equina, associada a aborto no terço médio da gestação, presumivelmente devido à insuficiência placentária.(AU)

Roee of long non-coding RNAs maternally imprinted genes 3 in human villi development / 第二军医大学学报

Objective To study the effect of long non-coding RNAs (lncRNAs) maternally imprinted genes 3 (MEG3) on human abortion vilii development and to explore the related molecular mechanisms. Methods We collected the vilii samples from 15 spontaneous abortion (SA) and 15 induced abortion (IA) patients. Immunohistochemistry was applied to detect the expressions of apoptosis factor Bax and apoptosis inhibitory factor Bcl-2 in vilii samples. Real-time quantitative polymerase chain reaction (qPCR) was used to analyze the levels of MEG3 of vilii samples. Overexpression of MEG3 in human trophoblast cell line HTR-8/SVneo was identified by qPCR; the invasion ability of HTR-8/SVneo cells was examined by matrigel invasion assay in MEG3 overexpression and control groups. Results Immunohistochemistry showed that the expression of Bax in IA group was lower than that in SA group, while the expression of Bcl-2 was higher (P<0.01). The level of MEG3 in IA group was significantly higher than that in SA group (P<0.01). The expression of MEG3 was obviously increased and invasion ability was inhibited in MEG3 overexpressed HTR-8/SVneo cells (P<0.01). Conclusion LncRNAs MEG3 may regulate the apoptosis and invasive ability of bizarre trophoblastic cells and influence on the development of human villi.

Chromosome abnormality analysis of 7 036 chorionic villi inspontaneous miscarriage cases by multiplex ligation-dependent probe amplification / 中华检验医学杂志

Objective To investigate chromosomal aneuploidy of chorionic villior tissue from embryo arrestor spontaneous miscarriage by the method of multiplex ligation-dependent probe amplification(MLPA), and to provide genetic etiology data for recurrent spontaneous abortion(RSA) and embryo arrest.Methods The clinical retrospective analysis was used during November 2013 to October 2016 in Shenzhen Maternity and Child Healthcare Hospital.The genomic DNA of 7 036 chorionic villi or tissue samples from embryo arrestor pregnancy loss were extracted by resin and Proteinase K, following detected by multiplex ligation-dependent probe amplification, and then analyzed by descriptive and frequency statistic using SPSS17.0 software.Results Totally 2 984 samples (42.41%) with chromosomal aneuploidy were detected, of which, the top five were trisomy 16(826)11.74%, monosomy X (Turner,401)5.70%, trisomy 22(247)3.51%, trisomy 13(149)2.12% and trisomy 21(144)2.05%.Aneuploidy 19 or 17 were rare,just 1 and 3 cases respectively.The aneuploidy of chromosome 1 was not discovered yet.There were 161 samples (2.28%) for segmental deletion and/or duplication cases.Besides of the monosomy X(Turner,401), monsomy 21 was also high frequency(17,0.24%).In addition, 56 samples(0.80%)were double trisomic,while 2 samples(0.03%)were tris-trisomy.Thirteen samples(0.18%)were heterosome trisomy,and five samples(0.07%)were Turner combined trisomy.Fifteen samples(0.21%) were unbalanced translocation of the arm,while 20 samples(0.28%) were nonhomologous chromosome translocation.Conclusions Trisome and monosome were the majority of chromosome abnormality (above 90%), as well as the main cause of spontaneous miscarriage.Meanwhile the chromosome aneuploidy (including segment deletion or duplication) could be screened by MLPA quickly, thoroughly and efficiently, further more discover the carrier of balanced translocation in couples and provide valuable genetic information for next pregnancy.

Chorionic villus cell culture and karyotype analysis in 1983 cases of spontaneous miscarriage / 中华妇产科杂志

Objective To investigate the relationship between spontaneous miscarriage and embryonic chromosome abnormalities,and to evaluate the clinical application of karyotype analysis by chorionic villus cell culture. Methods The chorionic villus karyotype of 1983 cases of miscarriage from January 2010 to July 2016 in Guangzhou Women and Children′ s Mecical Center were analyzed retrospectively. The miscarried chorionic villi were obtained by curettage under sterilized condition. The chromosome specimens were prepared after chorionic villus cell culture. Karyotype analysis was performed by G-banding technique. Results In the 1983 samples, successful karyotype analysis was performed in 1770 cases, with the successful rate of 89.98%. Chromosomal abnormalities were found in 1038 cases (58.64%,1038/1770). Chromosomal structural abnormalities were found in 37 cases. The numeral abnormalities were more common than structural abnormalities, and most of the numeral abnormalities were aneupoidies. In turn, they were trisomy 16, 45,X, trisomy 22, trisomy 2, trisomy 21, trisomy 15. The most common structural abnormality was balanced translocation, including Robersonian translocation. Female embryoes accounted for 61.02%(1080/1770) miscarriages and for 57.4%(596/1770) of chromosomal abnormalities, while male embroyes acoounted for 61.02%(1080/1770),57.4%(596/1770)respectively. The proportion of female embryoes was higher than male embryoes. The median age of the patients was 30 years old(16-46 years old). As the maternal age increased, the proportion chromosomal abnormalities increased. The incidence of chromosomal abnormalities in the advanced age group (≥35 years) was 68.38%(240/351), which was significantly higher than that in the younger group (56.24% ,798/1419; χ2=17.10, P<0.01). Conclusions Embryonic chromosomal abnormalities are the most common cause of early spontaneous miscarriage. The abnormalities centralize in some karyotypes. There is certain relationship between maternal age and the incidence of miscarriage, as well as the embryonic gender. Chorionic villus cell culture and karyotype analysis are helpful in finding the cause of miscarriage and counsel the patients.