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1.
Pesqui. vet. bras ; 42: e06819, 2022. ilus
Article in English | LILACS, VETINDEX | ID: biblio-1356555

ABSTRACT

Pasteurella pneumotropica is a bacterium that has so far not been described as a cause of placentitis in animals. Two cases of aborted equine fetuses were sent to the Department of Veterinary Pathology of the "Universidade Federal do Rio Grande do Sul" (SPV-UFRGS) for anatomopathological examination. Both cases presented suppurative placentitis associated with multiple basophilic bacterial cells. After bacterial isolation and biochemical analysis, P. pneumotropica was identified.(AU)


Pasteurella pneumotropica é uma bactéria que até o momento não foi descrita como causa de placentite em animais. Dois casos de fetos equinos abortados foram enviados ao Setor de Patologia Veterinária da Universidade Federal do Rio Grande do Sul (SPV-UFRGS) para exame anatomopatológico. Em ambos os casos se observou placentite supurativa associada a múltiplas colônias bacterianas basofílicas. Após o isolamento bacteriano e análise bioquímica, indentificou-se P. pneumotropica.(AU)


Subject(s)
Animals , Female , Pregnancy , Pasteurella Infections/veterinary , Placenta/pathology , Abortion, Veterinary/etiology , Abortion, Veterinary/microbiology , Abortion, Veterinary/pathology , Pasteurella pneumotropica , Horses , Placenta Diseases/veterinary
2.
Rev. bras. ginecol. obstet ; 43(11): 862-869, Nov. 2021. tab
Article in English | LILACS | ID: biblio-1357072

ABSTRACT

Abstract The puerperium is a complex period that begins with placental delivery and lasts for 6 weeks, during which readaptation of the female organism and redistribution of blood volume occur. This period is conducive to the occurrence of thromboembolic events. In the context of the SARS-CoV-2 pandemic, the virus responsible for COVID-19, the attention of the scientific community and health professionals has been focused on obtaining insights on different aspects of this disease, including etiology, transmission, diagnosis, and treatment. Regarding the pregnancy-postpartum cycle, it is opportune to review the clinical conditions that can occur during this period and to investigate dyspnea as a postpartum symptom in order to avoid its immediate association with COVID-19 without further investigation, which can lead to overlooking the diagnosis of other important and occasionally fatal conditions.


Resumo O puerpério é um período complexo que se inicia com a dequitação placentária e dura por 6 semanas, no qual a readaptação do organismo materno e a redistribuição do volume sanguíneo ocorrem, além de ser também um cenário propício para eventos pró-trombóticos. No contexto da pandemia de SARS-CoV-2, vírus responsável pela COVID-19, a atenção da comunidade científica e dos profissionais da saúde está voltada a elucidar os aspectos da doença, como a etiologia, a transmissão, o diagnóstico e o tratamento. Considerando o ciclo gravídico-puerperal, é oportuna a revisão de condições clínicas que ocorrem durante este período e que apresentam a dispneia como sintoma, a fimde evitar que ela seja automaticamente associada à COVID-19 sem investigações aprofundadas, o que pode levar à negligência do diagnóstico de outras condições importantes e que podem ser, por vezes, fatais.


Subject(s)
Humans , Female , Pregnancy , COVID-19 , Placenta , Postpartum Period , Dyspnea/diagnosis , Dyspnea/etiology , Dyspnea/epidemiology , SARS-CoV-2
3.
Rev. méd. Urug ; 37(3): e37314, set. 2021. graf
Article in Spanish | LILACS, BNUY | ID: biblio-1341562

ABSTRACT

Resumen: La secuencia de perfusión arterial reversa (TRAP) es una complicación muy poco frecuente y grave de los embarazos gemelares monocoriónicos. Generalmente ocurre cuando el corazón de un gemelo de apariencia normal sirve como bomba para uno o más gemelos dismórficos cuya cabeza, órganos torácicos y extremidades superiores no se desarrollan completamente o no se desarrollan en absoluto y, por lo tanto, carecen de actividad cardíaca. La arquitectura placentaria vascular anómala provoca un cambio en el flujo arterial hacia el gemelo acardíaco. Los mecanismos fisiopatológicos exactos que conducen a este fenómeno devastador no se conocen bien. Compartiremos el caso clínico de una paciente de 19 años, cursando un embarazo gemelar monocorial monoamniótico, en que realizamos diagnóstico de TRAPS, y realizamos la coagulación laser de la arteria nutricia del feto acárdico.


Abstract: Twin reversed arterial perfusion sequence (TRAPS) is rather an unusual and severe complication of monochorionic twin pregnancies. It usually occurs when the normal-appearance heart of a twin acts as a pump for one or more dysmorphic twins whose head, thoracic organs and upper limbs fail to totally develop or do not develop at all and thus, have no cardiac activity. The abnormal vascular architecture at the placenta changes the arterial flow towards the acardiac twin. The exact pathophysiological mechanisms that result in this devastating phenomenon are still unknown. The study presents the clinical case of a 19-year- old patient pregnant with monoamniotic, monochorionic twins and a diagnosis of TRAPS, treated by laser coagulation of the acardiac twin's umbilical cord.


Resumo: A seqüência reversa de perfusão arterial (TRAPS) é uma complicação muito rara e grave de gestações gemelares monocoriônicas. Geralmente ocorre quando o coração de um gêmeo de aparência normal serve como uma bomba para um ou mais gêmeos dismórficos cuja cabeça, órgãos torácicos e membros superiores não se desenvolvem totalmente ou não se desenvolvem e, portanto, não têm atividade cardíaca. A arquitetura vascular placentária anormal causa uma mudança no fluxo arterial para o gêmeo acardíaco. Os mecanismos fisiopatológicos exatos que levam a esse fenômeno devastador não são bem compreendidos. Descrevemos o caso clínico de uma paciente de 19 anos, portadora de gestação gemelar monocoriônica monoamniótica, na qual fizemos o diagnóstico de TRAPS e realizamos coagulação a laser da artéria nutritiva do feto acardíaco.


Subject(s)
Humans , Female , Pregnancy , Adult , Laser Coagulation , Fetal Heart/abnormalities , Fetofetal Transfusion , Placenta/pathology , Umbilical Arteries/surgery , Pregnancy, Twin
5.
Rev. bras. ginecol. obstet ; 43(7): 560-569, July 2021. tab, graf
Article in English | LILACS | ID: biblio-1347251

ABSTRACT

Abstract Introduction Preeclampsia (PE) is a pregnancy complication associated with increased maternal and perinatal morbidity and mortality. The disease presents with recent onset hypertension (after 20 weeks of gestation) and proteinuria, and can progress to multiple organ dysfunction, with worse outcomes among early onset preeclampsia (EOP) cases (<34 weeks). The placenta is considered the root cause of PE; it represents the interface between the mother and the fetus, and acts as a macromembrane between the two circulations, due to its villous and vascular structures. Therefore, in pathological conditions, macroscopic and microscopic evaluation can provide clinically useful information that can confirm diagnosis and enlighten about outcomes and future therapeutic benefit. Objective To perform an integrative review of the literature on pathological placental findings associated to preeclampsia (comparing EOP and late onset preeclampsia [LOP]) and its impacts on clinical manifestations. Results: Cases of EOP presented worse maternal and perinatal outcomes, and pathophysiological and anatomopathological findings were different between EOP and LOP placentas, with less placental perfusion, greater placental pathological changes with less villous volume (villous hypoplasia), greater amount of trophoblastic debris, syncytial nodules, microcalcification, villous infarcts, decidual arteriolopathy in EOP placentas when compared with LOP placentas. Clinically, the use of low doses of aspirin has been shown to be effective in preventing PE, as well asmagnesium sulfate in preventing seizures in cases of severe features. Conclusion The anatomopathological characteristics between EOP and LOP are significantly different, with large morphological changes in cases of EOP, such as


Resumo Introdução A pré-eclâmpsia (PE) é uma complicação da gravidez associada ao aumento da morbidade e mortalidade materna e perinatal. A doença se apresenta com hipertensão de início recente (após 20 semanas de gestação) e proteinúria, que pode progredir para disfunção de múltiplos órgãos, com resultados piores entre os casos de início precoce (<34 semanas). A placenta é considerada a principal causa da PE, representando a interface entre a mãe e o feto, e atuando como uma macromembrana entre as duas circulações, devido às suas estruturas vilosas e vasculares, demodo que, em condições patológicas, avaliações macroscópicas e microscópicas podem fornecer informações clinicamente úteis, que podem fornecer diagnóstico, prognóstico e benefício terapêutico. Objetivo Realizar uma revisão integrativa da literatura para compreender e descrever os achados placentários patológicos associados à pré-eclâmpsia e seus impactos nas manifestações clínicas. Resultados Os casos de início precoce apresentaram piores desfechos maternos e perinatais, e os achados fisiopatológicos e anatomopatológicos foram diferentes entre as placentas de início precoce e início tardio, commenor perfusão placentária, maiores alterações patológicas placentárias commenor volume viloso (hipoplasia vilosa), maior quantidade de debris trofoblásticos, nódulos sinciciais, microcalcificação, infartos vilosos, arteriolopatia decidual em placentas de início precoce quando comparadas com placentas de início tardio. Clinicamente, o uso de baixas doses de aspirina tem se mostrado significativo na prevenção da PE, assim como o sulfato de magnésio na prevenção de convulsões na doença com manifestações de gravidade. Conclusão As características anatomopatológicas entre a pré-eclâmpsia precoce e tardia são significativamente diferentes, com grandes alterações morfológicas nos casos de início precoce, como hipóxia, infartos vilosos e hipoplasia, entre outros, na tentativa de estabilizar o fluxo sanguíneo para o feto. Portanto, um entendimento comum do exame macroscópico básico e dos padrões histológicos da lesão é importante para maximizar o benefício diagnóstico, prognóstico e terapêutico do exame da placenta e, consequentemente, reduzir os riscos para a mãe e o feto.


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Pre-Eclampsia , Pregnancy Complications , Hypertension , Placenta , Fetus
6.
Rev. bras. ginecol. obstet ; 43(7): 545-559, July 2021. tab, graf
Article in English | LILACS | ID: biblio-1347249

ABSTRACT

Abstract Fetal growth restriction (FGR) occurswhen the fetus does not reach its intrauterine potential for growth and development as a result of compromise in placental function. It is a condition that affects 5 to 10% of pregnancies and is the second most common cause of perinatal morbidity and mortality. Children born with FGR are at risk of impaired neurological and cognitive development and cardiovascular or endocrine diseases in adulthood. The purpose of the present revision is to perform a literature search for evidence on the detection and assessment by ultrasound of brain injury linked to FGR during fetal life. Using a systematic approach and quantitative evaluation as study methodology, we reviewed ultrasound studies of the fetal brain structure of growth-restricted fetuses with objective quality measures. A total of eight studies were identified. High quality studies were identified for measurement of brain volumes; corpus callosum; brain fissure depth measurements, and cavum septi pellucidi width measurement. A low-quality study was available for transverse cerebellar diameter measurement in FGR. Further prospective randomized studies are needed to understand the changes that occur in the brain of fetuseswith restricted growth, as well as their correlation with the changes in cognitive development observed.


Resumo A restrição do crescimento fetal (RCF) ocorre quando umfeto não consegue atingir seu potencial de crescimento intrauterino, na maioria das vezes por compromisso da função placentária. É uma condição que afeta de 5 a 10% das gravidezes e é a segunda causa mais comum de morbidade e mortalidade perinatal. Crianças nascidas com RCF incorrem em maior risco de atraso no desenvolvimento neurológico e cognitivo, bem como de doenças cardiovasculares e/ou endócrinas, na idade adulta. O objetivo desta revisão foi o de pesquisar na literatura evidência sobre o diagnóstico pré-natal por ecografia de lesões cerebrais relacionadas com a RCF. Utilizando uma abordagem sistemática, avaliamos de forma quantitativa a metodologia dos oito estudos que preencheram os critérios de inclusão e foram, assim, incluídos nesta revisão. Foram identificados estudos de alta qualidade para a medição dos volumes cerebrais;medição do corpo caloso; medição da profundidade das incisuras cerebrais emedição do cavum do septo pelúcido. Os autores identificaram um estudo de qualidade inferior sobre a medição transversal do diâmetro transcerebelar em fetos com RCF. Mais estudos prospectivos randomizados são necessários para perceber quais as alterações que ocorrem no cerébro dos fetos com restrição do seu crescimento, bem como, a sua correlação com as alterações do desenvolvimento cognitivo observadas.


Subject(s)
Humans , Female , Pregnancy , Child , Adult , Placenta , Ultrasonography, Prenatal , Brain/diagnostic imaging , Biometry , Gestational Age , Fetal Growth Retardation/diagnostic imaging , Fetus
7.
Rev. bras. ginecol. obstet ; 43(6): 474-479, June 2021. tab
Article in English | LILACS | ID: biblio-1341139

ABSTRACT

Abstract Placental pathophysiology in SARS-CoV-2 infection can help researchers understand more about the infection and its impact on thematernal/neonatal outcomes. This brief review provides an overview about some aspects of the placental pathology in SARSCoV- 2 infection. In total, 11 papers were included. The current literature suggests that there are no specific histopathological characteristics in the placenta related to SARSCoV- 2 infection, but placentas frominfected women aremore likely to show findings of maternal and/or fetal malperfusion. The most common findings in placentas from infected women were fibrin deposition and intense recruitment of inflammatory infiltrates. The transplacental transmission of this virus is unlikely to occur, probably due to low expression of the receptor for SARS-CoV-2 in placental cell types. Further studies are needed to improve our knowledge about the interaction between the virus and the mother-fetus dyad and the impact on maternal and neonatal/fetal outcomes.


Resumo A fisiopatologia da placenta na infecção por SARS-CoV-2 pode ajudar os pesquisadores a entender mais sobre a infecção e seu impacto nos resultados maternos/neonatais. Esta revisão breve fornece uma visão geral sobre alguns aspectos da patologia placentária na infecção por SARS-CoV-2. Ao todo, 11 artigos foram incluídos. A literatura atual sugere que não há características histopatológicas específicas nas placentas relacionadas à infecção por SARS-CoV-2, mas as placentas de mulheres infectadas têm maior probabilidade de apresentar achados de má perfusão materna e/ou fetal. Os achados mais comuns em placentas de mulheres infectadas foram deposição de fibrina e intenso recrutamento de infiltrado inflamatório. A transmissão transplacentária deste vírus é improvável, devido à baixa expressão do receptor para SARS-CoV-2 em tipos de células da placenta. Mais estudos são necessários para melhorar nosso conhecimento sobre a interação entre o vírus e a díade mãe-feto e o impacto nos resultados maternos e neonatais/fetais.


Subject(s)
Humans , Female , Pregnancy , Placenta/pathology , Pregnancy Complications, Infectious/pathology , COVID-19/pathology , Placenta/physiopathology , Placenta/blood supply , Placenta/virology , Pregnancy Complications, Infectious/physiopathology , Pregnancy Complications, Infectious/virology , Infectious Disease Transmission, Vertical , COVID-19/physiopathology , COVID-19/virology
8.
Rev. bras. ginecol. obstet ; 43(5): 377-383, May 2021. graf
Article in English | LILACS | ID: biblio-1288557

ABSTRACT

Abstract Objective The coronavirus disease 2019 (COVID-19) is a pandemic viral disease, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The impact of the disease among the obstetric population remains unclear, and the study of the placenta can provide valuable information. Adequate sampling of the placental tissue can help characterize the pathways of viral infections. Methods A protocol of placental sampling is proposed, aiming at guaranteeing representativity of the placenta and describing the adequate conservation of samples and their integrity for future analysis. The protocol is presented in its complete and simplified versions, allowing its implementation in different complexity settings. Results Sampling with the minimum possible interval from childbirth is the key for adequate sampling and storage. This protocol has already been implemented during the Zika virus outbreak. Conclusion A protocol for adequate sampling and storage of placental tissue is fundamental for adequate evaluation of viral infections on the placenta. During the COVID-19 pandemic, implementation of this protocol may help to elucidate critical aspects of the SARS-CoV-2 infection.


Resumo Objetivo A doença do novo coronavírus (COVID-19) é uma doença viral pandêmica causada pelo coronavírus da síndrome respiratória aguda 2 (SARS-CoV-2). O impacto da doença entre a população obstétrica ainda é incerto, e o estudo da placenta pode fornecer informações valiosas. Assim, a coleta adequada do tecido placentário pode ajudar a caracterizar algumas propriedades das infecções virais. Métodos Um protocolo de coleta placentária é proposto, objetivando a garantia de representatividade da placenta, descrevendo a maneira de conservação adequada das amostras, e visando garantir sua integridade para análises futuras. O protocolo é apresentado em suas versões completa e simplificada, permitindo sua implementação em diferentes configurações de infraestrutura. Resultados A amostragem com o intervalo mínimo possível do parto é essencial para coleta e armazenamento adequados. Esse protocolo já foi implementado durante a epidemia de vírus Zika. Conclusão Um protocolo para coleta e armazenamento adequados de tecido placentário é fundamental para a avaliação adequada de infecções virais na placenta. Durante a pandemia de COVID-19, a implementação deste protocolo pode ajudar a elucidar aspectos críticos da infecção por SARS-CoV-2.


Subject(s)
Humans , Female , Pregnancy , Placenta/virology , Specimen Handling/methods , Specimen Handling/standards , COVID-19/virology , Virology/methods , Virology/standards , Virus Diseases/virology
9.
Rev. gaúch. enferm ; 42: e20200241, 2021. tab, graf
Article in English | LILACS, BDENF | ID: biblio-1251774

ABSTRACT

ABSTRACT Objective Measure umbilical cord pulsatility time and evaluate correlation/association with maternal and neonatal characteristics. Method Cross-sectional study, with 76 binomials, carried out in 2017, in a maternity hospital in Alagoas. Analysis with Pearson or Spearman correlation test and Mann-Whitney or Kruskal-Wallis test. Results Sixty-two parturients and their newborns participated of the research. The women had a gestational age ≥ 37 weeks, natural cephalic birth, without distortions. The newborns had average weight of 3326.29g, mostly male. The umbilical cord pulsatility time was 285.48s. There is a correlation between umbilical cord pulsatility time and placental delivery time (p<0.001). Other correlations/associations were not significant. Conclusion It suggested using a correlation between pulsatility time and placental delivery time in clinical decision making for good practices in childbirth assistance.


RESUMEN Objetivo Medir tiempo de pulsatilidad del cordón umbilical y evaluar la correlación/asociación con las características maternas y neonatales. Método Estudio transversal, con 76 pares, realizado en 2017, en maternidad en Alagoas. Análisis con la prueba de correlación de Pearson o Spearman y la prueba de Mann-Whitney o Kruskal-Wallis. Resultados Sesenta y dos mujeres en trabajo de parto y sus recién nacidos participaron. Las mujeres tenían edad gestacional ≥ 37 semanas, parto cefálico normal, sin distorsiones. Los recién nacidos tenían peso promedio de 3326.29g, la mayoría de ellos varones. Tiempo de pulsatilidad del cordón umbilical fue de 285.48s. Había correlación entre el tiempo de pulsatilidad del cordón umbilical y el momento del parto placentario (p<0,001). Otras correlaciones/asociaciones no fueron significativas. Conclusión Sugiere una correlación entre el tiempo de pulsatilidad y el tiempo de parto placentario para las buenas prácticas en la atención del parto.


RESUMO Objetivo Mensurar tempo de pulsatilidade do cordão umbilical e avaliar correlação/associação com característica maternas e neonatais. Método Estudo transversal, com 76 binômios, realizado no ano de 2017, em maternidade de Alagoas. Análise com teste de correlação de Pearson ou Spearman e teste de Mann-Whitney ou Kruskal-Wallis. Resultados Sessenta e duas parturientes e seus recém-nascidos participaram da pesquisa. As mulheres tinham idade gestacional ≥ 37 semanas, parto normal cefálico, sem distorcias. Os recém-nascidos tinham peso médio de 3326,29g, maioria do sexo masculino. O tempo de pulsatilidade do cordão umbilical foi 285,48s. Há correlação entre tempo de pulsatilidade do cordão umbilical e tempo de dequitação da placenta (p<0,001). Demais correlações/associações não foram significativas. Conclusão Sugere-se o uso correlação entre tempo de pulsatilidade e tempo de dequitação da placenta na tomada de decisão clínica para boas práticas na assistência ao parto.


Subject(s)
Humans , Female , Pregnancy , Placenta/physiology , Umbilical Cord/embryology , Natural Childbirth , Obstetric Nursing , Brazil , Epidemiology, Descriptive , Cross-Sectional Studies , Hospitals, Maternity
10.
Rev. latinoam. enferm. (Online) ; 29: e3494, 2021. graf
Article in English | LILACS, BDENF | ID: biblio-1347608

ABSTRACT

Objective: to analyze, in the scientific literature, the knowledge available on the use of the prone position in pregnant women diagnosed with COVID-19 or other health conditions. Method: an integrative literature review developed through the following guiding question: What is the scientific knowledge available on the use of the prone position in pregnant women with COVID-19 or other health conditions? The search for studies was carried out in eight databases. Results: using the prone position in pregnant women with Acute Respiratory Distress syndrome allowed for improvements in lung compliance and oxygenation. It also allowed reducing uterine compression on the maternal large vessels, and a reduction in blood pressure was observed in pregnant women with pre-eclampsia. The prone position was also safe in the surgical management of pregnant patients. In addition, the following conditions stood out as disadvantages related to the prone position in pregnant women: possibility of aortocaval compression, causing severe hypotension, and inability to easily monitor fetal status or to perform emergency Cesarean sections. Conclusion: the prone position was considered safe, reliable and comfortable for its use in the clinical management of pregnant women, where specific care measures must be taken to avoid compression of gravid abdomen, as well as fetal monitoring is important to detect placental circulation impairment.


Objetivo: analizar, en la literatura científica, el conocimiento disponible sobre el uso de la posición prona en gestantes diagnosticadas con COVID-19 u otras condiciones de salud. Método: revisión integradora de la literatura desarrollada a través de la siguiente pregunta orientadora: ¿Qué conocimiento científico está disponible sobre la aplicación de la posición prona en gestantes con COVID-19 u otras condiciones de salud? La búsqueda de estudios se realizó en ocho bases de datos. Resultados: colocar a las gestantes con Síndrome de Dificultad Respiratoria Aguda en posición prona permitió mejorar la distensibilidad pulmonar y la oxigenación. También permitió una reducción de la compresión uterina de los grandes vasos maternos y se observó una reducción de la presión arterial en gestantes con preeclampsia. La posición prona también demostró ser segura en el manejo quirúrgico de pacientes embarazadas. Además, se destacaron desventajas relacionadas con la posición prona en la gestante: posibilidad de que ocurra una compresión aortocava, que provoque hipotensión severa, y la imposibilidad de monitorear fácilmente el estado fetal o realizar una cesárea de emergencia. Conclusión: la aplicación de la posición prona para el manejo clínico de la gestante se consideró segura, confiable y cómoda, se deben implementar cuidados específicos para evitar la compresión del vientre materno y monitorear al feto para detectar si la circulación placentaria está comprometida.


Objetivo: analisar, na literatura científica, o conhecimento disponível sobre a utilização da posição prona em gestantes diagnosticadas com COVID-19 ou outras condições de saúde. Método: revisão integrativa da literatura desenvolvida mediante a seguinte questão norteadora: Qual o conhecimento científico disponível sobre a aplicação da posição prona em gestantes com COVID-19 ou outras condições de saúde? A busca de estudos foi realizada em oito bases de dados. Resultados: a aplicação da posição prona em gestantes com Síndrome do Desconforto Respiratório Agudo permitiu a melhora na complacência pulmonar e na oxigenação. Também possibilitou redução da compressão uterina sobre grandes vasos maternos e foi observada redução da pressão arterial em gestantes com pré-eclâmpsia. A posição prona também se mostrou segura no manejo cirúrgico de pacientes grávidas. Ademais, destacaram-se como desvantagens relacionadas à posição prona em gestantes: a possibilidade de ocorrência de compressão aortocaval, causando hipotensão grave, e a incapacidade de monitorar facilmente o estado fetal ou realizar cesariana de emergência. Conclusão: a posição prona foi considerada segura, confiável e confortável para aplicação no manejo clínico de gestantes, na qual cuidados específicos devem ser tomados para evitar compressão do abdome gravídico, assim como é relevante a monitorização fetal para detectar comprometimento de circulação placentária.


Subject(s)
Humans , Female , Pregnancy , Placenta , Prone Position , SARS Virus , COVID-19
11.
Braz. j. med. biol. res ; 54(9): e9570, 2021. graf
Article in English | LILACS | ID: biblio-1278586

ABSTRACT

High proportions of placental lymphocytes expressing DX5+/CD25+/FOXP3+/CD45+/CD4+ are beneficial to maintain immune tolerance and improve pregnancy outcomes. This study aimed to compare and evaluate the therapeutic effects of aspirin, vitamin D3 (VitD3), and progesterone on the autoimmune recurrent spontaneous abortion (RSA) model. The autoimmune RSA mouse model was constructed, and the embryo loss rate was calculated for each group. Then, primary mouse placental lymphocytes were isolated, and the expression of DX5+/CD25+/FOXP3+/CD45+/CD4+ was detected through flow cytometry. The serum levels of anti-cardiolipin antibody (ACA), β2-GP1, CXCL6, IFN-γ, and IL-6 were measured by ELISA to evaluate the proportion of Th1 and Th2 cells. Autoimmune RSA significantly increased the embryo loss rate, which was improved by aspirin, VitD3, and progesterone treatment, and progesterone treatment had the best effect among the three treatments. The positive expression of DX5+/CD25+/FOXP3+/CD45+/CD4+ in the VitD3 and progesterone groups was significantly higher than that in the autoimmune RSA group, and the expression was highest in the progesterone treatment group. In the plasma of autoimmune RSA mice, the ACA, β2-GP1, CXCL6, and IFN-γ levels were significantly higher and the IL-6 level was lower than the levels in control mice. All these changes could be reversed by aspirin and progesterone treatment. In conclusion, aspirin, VitD3 and progesterone treatment improved pregnancy outcomes in autoimmune RSA mice by regulating the Th1/Th2 balance and cytokines, and progesterone had the best effect of the three treatments.


Subject(s)
Humans , Animals , Female , Pregnancy , Mice , Progesterone , Abortion, Habitual/prevention & control , Abortion, Habitual/drug therapy , Placenta , Pregnancy Outcome , Aspirin , Cholecalciferol/therapeutic use
12.
Braz. j. med. biol. res ; 54(8): e11073, 2021. tab, graf
Article in English | LILACS | ID: biblio-1249327

ABSTRACT

The study evaluated the effect of the supernatant of placental explants from preeclamptic (PE) and normotensive (NT) pregnant women after tissue treatment with or without vitamin D (VD) on oxidative stress and nitric oxide (NO) bioavailability in human umbilical vein endothelial cells (HUVEC). Placental explants were prepared from eight NT and eight PE women, and supernatants were obtained after incubation with or without hydrogen peroxide (H2O2) and/or VD. HUVEC were cultured for 24 h with supernatants, and the following parameters were analyzed in HUVEC cultures: NO, nitrate (NO3-), and nitrite (NO2-) levels, lipid peroxidation, and intracellular reactive oxygen species (ROS). Results showed that the production of NO3-, NO2-, malondialdehyde (MDA), and ROS were significantly higher in HUVEC treated with explant supernatant from PE compared to NT pregnant women, while the supernatant of PE explants treated with VD led to a decrease in these parameters. A significantly high production of NO was detected in HUVEC cultured with control supernatant of NT group, and in cultures treated with supernatant of PE explants treated with VD. Taken together, these results demonstrated that cultures of placental explants from PE women with VD treatment generated a supernatant that decreased oxidative stress and increased the bioavailability of NO in endothelial cells.


Subject(s)
Humans , Female , Pregnancy , Pre-Eclampsia/metabolism , Nitric Oxide/metabolism , Placenta/metabolism , Vitamin D/metabolism , Biological Availability , Cells, Cultured , Oxidative Stress , Human Umbilical Vein Endothelial Cells , Hydrogen Peroxide
13.
Article in Chinese | WPRIM | ID: wpr-888392

ABSTRACT

OBJECTIVE@#To review the clinical data of a fetus with false positive result of non-invasive prenatal testing (NIPT) due to confined placental mosaicism (CPM).@*METHODS@#Amniotic fluid sample was taken from a pregnant women with high risk for chromosome 16 aneuploidy for karyotyping analysis, single nucleotide polymorphism array (SNP array) and interphase fluorescence in situ hybridization (FISH). Genetic testing was also conducted on the fetal and maternal surface of the placenta, root of umbilical cord and fetal skin tissue after induced abortion.@*RESULTS@#Cytogenetic analysis of the amniotic fluid sample yielded a normal karyotype. SNP array revealed mosaicism (20%) of trisomy 16 in the fetus. FISH confirmed the presence of mosaicism (25%) for trisomy 16. After induced labor, all sampled sites of placenta were confirmed to contain trisomy 16 by SNP array, while the analysis of fetal skin tissue yielded a negative result.@*CONCLUSION@#CPM is an important factor for false positive NIPT result. Prenatal identification of CPM and strengthened pregnancy management are important to reduce adverse pregnancy outcomes.


Subject(s)
Amniocentesis , Chromosomes, Human, Pair 16/genetics , Cytogenetic Analysis , Female , Fetus , Humans , In Situ Hybridization, Fluorescence , Molecular Biology , Mosaicism , Placenta , Pregnancy , Prenatal Diagnosis , Trisomy/genetics
14.
Acta Physiologica Sinica ; (6): 103-114, 2021.
Article in Chinese | WPRIM | ID: wpr-878240

ABSTRACT

Natural killer (NK) cells are the main immune cells at the maternal-fetal interface and accumulate in the uterine decidua in early pregnancy. Many studies have shown that NK cells at the maternal-fetal interface have unique phenotypes and play critical roles in various processes, including immune tolerance during pregnancy, decidualization, invasion of trophoblasts, remodeling of the uterine spiral artery, formation of the placenta and growth of embryo. However, specific functions of NK cells and their mechanism remain to be fully elucidated. This review summarizes the research progress of NK cells at the maternal-fetal interface and their roles in the pregnancy-related disorders in recent years. The aims of this review are to gain deep insight of the function of NK cells at the maternal-fetal interface and provide new ideas for intervention of pregnancy-related diseases.


Subject(s)
Decidua , Female , Humans , Killer Cells, Natural , Maternal-Fetal Exchange , Placenta , Pregnancy , Trophoblasts , Uterus
15.
Article in Chinese | WPRIM | ID: wpr-921991

ABSTRACT

Fetal cell free DNA (cfDNA) in maternal blood circulation mainly originates from placental trophoblasts which have dual characteristics of apoptotic cells and the embryo, and can be affected by maternal factors. Pregnancy-related diseases including preeclampsia, gestational diabetes mellitus, preeclampsia, macrosomia and fetal growth restriction can seriously affect maternal health and pregnancy outcome. Early prediction and timely intervention are important means to reduce the risk. Fetal cfDNA and prediction of pregnancy-related diseases have become a hot topicfor current research. This paper reviews the latest progress made in the field.


Subject(s)
Cell-Free Nucleic Acids/genetics , Female , Fetus , Humans , Placenta , Pregnancy , Pregnancy Complications , Pregnancy Outcome
16.
Article in Chinese | WPRIM | ID: wpr-921967

ABSTRACT

ABCC1 gene is expressed in various tissues and organs of the human body, and can transport substrates including drugs, heavy metals, toxic substances and organic anions. Previous research on ABCC1 gene has mostly focused on tumor multidrug resistance. Recently, ABCC1 has been proposed as a candidate gene for hereditary hearing impairment, which has attracted much attention. ABCC1-associated deafness may be related to its role in biological barriers. This article has summarized recent progress in the study of the role of ABCC1 in the blood-testis barrier, placental barrier, blood-brain barrier, blood-labyrinth barrier, which may provide insight into its biological functions.


Subject(s)
Biological Transport , Deafness/genetics , Female , Humans , Male , Multidrug Resistance-Associated Proteins/genetics , Placenta , Pregnancy
17.
Acta Physiologica Sinica ; (6): 991-998, 2021.
Article in Chinese | WPRIM | ID: wpr-921304

ABSTRACT

Placenta is the only link between the pregnant woman and fetus, and the basis for maintaining the normal pregnancy process and fetal development. Maternal stress is the maternal physiological and psychological changes caused by various factors, characterized by the increased level of glucocorticoid, which affects the hypothalamic-pituitary-target gland axis and regulates the expression of target genes. Maternal stress also changes the weight, metabolism and nutrient transportation of the placenta, which will substantially influence the development of fetus. This paper will firstly summarize the characteristics of maternal stress and its influence on offspring. Then, the changes in the body under maternal stress will be described. Finally, we will clarify the proven mechanisms underlying maternal stress and raise some important problems that have not been clarified in this area. The study of maternal stress on fetus and its underlying mechanisms will serve as theoretical basis for the diagnosis and treatment of the stress-related pregnant diseases and disorders.


Subject(s)
Female , Fetal Development , Fetus , Humans , Placenta , Pregnancy
18.
Article in Chinese | WPRIM | ID: wpr-879535

ABSTRACT

OBJECTIVE@#To compare the mRNA level of cell proliferation-related genes Twist1, SIRT1, FGF2 and TGF-β3 in placenta mesenchymal stem cells (PA-MSCs), umbilical cord mensenchymals (UC-MSCs) and dental pulp mesenchymal stem cells (DP-MSCs).@*METHODS@#The morphology of various passages of PA-MSCs, UC-MSCs and DP-MSCs were observed by microscopy. Proliferation and promoting ability of the three cell lines were detected with the MTT method. Real-time PCR (RT-PCR) was used to determine the mRNA levels of Twist1, SIRT1, FGF2, TGF-β3.@*RESULTS@#The morphology of UC-MSCs and DP-MSCs was different from that of PA-MSCs. Proliferation ability and promoting ability of the PA-MSCs was superior to that of UC-MSCs and DP-MSCs. In PA-MSCs, expression level of Twist1 and TGF-β3 was the highest and FGF2 was the lowest. SIRT1 was highly expressed in UC-MSCs. With the cell subcultured, different expression levels of Twist1, SIRT1, FGF2, TGF-β3 was observed in PA-MSCs, UC-MSCs and DP-MSCs.@*CONCLUSION@#Up-regulated expression of the Twist1, SIRT1 and TGF-β3 genes can promote proliferation of PA-MSCs, UC-MSCs and DP-MSCs, whilst TGF-β3 may inhibit these. The regulatory effect of Twist1, SIRT1, FGF2 and TGF-β3 genes on PA-MSCs, UC-MSCs and DP-MSCs are different.


Subject(s)
Cell Differentiation , Cell Proliferation/genetics , Cells, Cultured , Dental Pulp/cytology , Female , Fibroblast Growth Factor 2/genetics , Humans , Mesenchymal Stem Cells/cytology , Nuclear Proteins/genetics , Placenta/cytology , Pregnancy , Sirtuin 1/genetics , Transforming Growth Factor beta3/genetics , Twist-Related Protein 1/genetics , Umbilical Cord/cytology
19.
Article in English | WPRIM | ID: wpr-888606

ABSTRACT

BACKGROUND@#Particulate matter (PM), a major component of ambient air pollution, accounts for a substantial burden of diseases and fatality worldwide. Maternal exposure to PM during pregnancy is particularly harmful to children's health since this is a phase of rapid human growth and development.@*METHOD@#In this review, we synthesize the scientific evidence on adverse health outcomes in children following prenatal exposure to the smallest toxic components, fine (PM@*RESULTS@#Maternal exposure to fine and ultrafine PM directly and indirectly yields numerous adverse birth outcomes and impacts on children's respiratory systems, immune status, brain development, and cardiometabolic health. The biological mechanisms underlying adverse effects include direct placental translocation of ultrafine particles, placental and systemic maternal oxidative stress and inflammation elicited by both fine and ultrafine PM, epigenetic changes, and potential endocrine effects that influence long-term health.@*CONCLUSION@#Policies to reduce maternal exposure and health consequences in children should be a high priority. PM


Subject(s)
Adult , Air Pollutants/adverse effects , Air Pollution/prevention & control , Animals , Cardiovascular Diseases/chemically induced , Child Health , Child, Preschool , Disease Models, Animal , Endocrine System Diseases/chemically induced , Epigenomics , Female , Humans , Immune System Diseases/chemically induced , Infant , Infant, Newborn , Male , Maternal Exposure/adverse effects , Nervous System Diseases/chemically induced , Oxidative Stress , Particle Size , Particulate Matter/adverse effects , Placenta , Pregnancy , Pregnancy Outcome/epidemiology , Prenatal Exposure Delayed Effects/epidemiology , Respiratory Tract Diseases/chemically induced , Young Adult
20.
Rev. argent. neurocir ; 34(4): 300-314, dic. 2020. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1150441

ABSTRACT

Introducción: La neurocirugía vascular, tanto la microquirúrgica como endovascular, ha progresado significativamente en el tratamiento de la patología cerebrovascular. Sin embargo, en una considerable proporción de casos este tipo de patología no puede ser resuelta definitivamente mediante un único abordaje. Por lo cual consideramos que el neurocirujano en formación debe capacitarse con ambas técnicas.Se describe un modelo de entrenamiento en microcirugía y en nociones básicas del material y técnica neuroendovascular, utilizando placenta humana y recursos de baja complejidad. Material y método: Se utilizaron 20 placentas humanas, instrumental y sutura de uso habitual en microcirugía, microscopio quirúrgico Newton®XX1, material para procedimientos endovasculares; equipo de radioscopia (arco en C Phillips BV Pulsera®), un cráneo óseo y un cabezal de fijación tipo Sugita® adaptado a su uso en laboratorio. Los ejercicios consistieron en: 1. Disección y exposición de los vasos arteriales y venosos del corion; 2. Anastomosis término-terminal, termino-lateral y latero-lateral; 3. Generación de aneurismas laterales, de bifurcación o trifurcación; 4. Creación de bypass extra-intracraneano; 5. Clipado de los aneurismas en superficie y dentro del cráneo; 6. Control angiográfico pre y post clipado. 7. Embolización con coils de los aneurismas experimentales y de vasos placentarios con partículas de Spongostan®. Resultados: Aunque los vasos tienen una estructura y consistencia diferentes a los habituales para el neurocirujano, la placenta ofrece una variabilidad de calibres y formatos donde practicar los diferentes ejercicios. Conclusión: El entrenamiento en técnicas microquirúrgicas y neurointervencionistas puede ser realizado en modelos placentarios de simulación, que permiten el desarrollo háptico progresivo previo a la realización de un procedimiento in vivo.


Objective: Describe a training model in microsurgery and neuroendovascular surgery, using human placenta and low complexity resources. Material and methods: 20 human placentas, instruments and sutures were used in microsurgery, Newton XX1 surgical microscope, material for endovascular procedures; radioscopy equipment (C-arch Phillips BV Pulsera), a bony skull and a Sugita head adapted for laboratory use. The exercises consisted of: 1. Dissection and exposure of the arterial and venous vessels of the chorion; 2. End-to-end, end-to-side, side-to-side anastomosis; 3. Generation of lateral, bifurcation or trifurcation aneurysms; 4. Creation of extra-intracranial bypass; 5. Clipping of aneurysms on the surface and inside the skull; 6. Pre and post clipping angiographic control. 7. Coil embolization of experimental aneurysms and placental vessels embolization with spongostan particles. Results: Although the vessels have a different structure and consistency than usual for the neurosurgeon, the placenta offers a variability of sizes and formats to practice the different exercises. Conclusion: Training in microsurgical and neurointerventionist techniques can be carried out in placental models, which allow progressive haptic development prior to performing an in vivo procedure.


Subject(s)
Humans , Microsurgery , Placenta , Therapeutics , Simulation Technique , Methods , Endovascular Procedures , Neurosurgery
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