Clinical characteristics of vasa previa with low-lying placenta / 中华围产医学杂志

Objective:To investigate the clinical characteristics of vasa previa (VP) with low-lying placenta (LP).Methods:A retrospective case-control study was conducted on pregnant women with VP who delivered at Guangzhou Women and Children's Medical Center from January 2015 to August 2021. According to the status of LP, these cases were classified into VP with LP (VP+LP) and VP without LP (VP-LP) group. The cases diagnosed with placenta previa (PP, n=128) during the same period were collected as control. Maternal-fetal clinical characteristics and outcomes were compared among the three groups using t-test, Mann-Whitney U test, and Chi-square test (or Fisher's exact test). Results:During the study period, 116 VP cases were diagnosed, accounting for 0.085% (116/136 450) of all deliveries. Apart from one case of intrauterine death caused by non-VP reasons in the third trimester, there were 64 in the VP+LP group and 51 in the VP-LP group. VP+LP cases accounted for about 2.9% (64/2 219) of all the cases with PP or LP. The proportions of multiparae and women with a history of cesarean section were significantly higher in the VP+LP group than in the VP-LP group [62.5% (40/64) vs 39.2% (20/51), χ 2= 6.17, P=0.013; 31.3% (20/64) vs 13.7% (7/51), χ 2= 4.85, P=0.028]. Besides, a rare type of VP (type Ⅲ) was only found in the VP+LP group (9.4%, 6/64). The median gestational age at first diagnosis by prenatal ultrasound was significantly larger in the VP+LP group than in the VP-LP group [28.3 (23.6-31.7) vs 23.9 (23.3-25.9) weeks, Z=2.61, P=0.007]. There was no significant difference in the incidence of antepartum hemorrhage between the two groups. In contrast, the amount of postpartum hemorrhage was significantly increased in the VP+LP group [550 (436-732) vs 420 (300-540) ml, Z=3.37, P=0.001]. Compared with the VP-LP group, the VP+LP group showed a lower incidence of lower neonatal Apgar score (<7 at 5 min) and hypoxic-ischemic encephalopathy [0.0%(0/64) vs 6.9%(4/58), 0.0%(0/64) vs 8.6% (5/58), Fisher's exact test, both P<0.05]. No neonatal death was reported in the VP+LP and VP-LP groups. No significant difference in the incidence of antepartum hemorrhage was found between the VP+LP group and the PP group. Still, the median time at delivery was earlier [36.0 (34.3-36.9) vs 37.0 (35.7-37.3) weeks, Z=3.79, P<0.001], and the incidence of abnormal fetal heart rate was higher [10.9% (7/64) vs 3.1% (4/128), Fisher's exact test , P=0.044] in the VP+LP group. Furthermore, the neonatal NICU admission rate and the incidence of respiratory distress syndrome were significantly higher in the VP+LP group than in the PP group [36.4% (24/66) vs 12.1% (16/132), χ 2= 16.04, P<0.001; 25.8% (17/66) vs 12.1% (16/132), χ 2= 5.89, P=0.015]. Conclusions:For VP+LP cases, there might be an additional type (type Ⅲ VP). Patients with VP+LP would have more blood loss within 24 h after delivery and a higher risk of adverse neonatal outcomes. Intensive attention should be paid to those diagnosed with LP during the third trimester to identify any VP.

Subcutaneous terbutaline and oral nifedipine for intrapartum fetal resuscitation: a prospective randomized controlled study / 中华围产医学杂志

Objective:To compare the safety and efficacy of terbutaline and nifedipine for acute intrapartum fetal resuscitation (IUFR).Methods:This was a prospective randomized controlled study involving 110 pregnant women with non-reassuring fetal heart rate tracings (NRFHT) during delivery at Guangzhou Women and Children's Medical Center between January and April 2021. These women were randomly allocated to receive subcutaneous terbutaline sulphate (0.25 mg, terbutaline group) or oral nifedipine (10 mg, nifedipine group), with 55 subjects in each group. Hemodynamic parameters including blood pressure, heart rate, and oxygen saturation before and 5, 15 and 30 min after treatment as well as the success rate of intrapartum resuscitation, the onset time of medication, and the incidence of postpartum hemorrhage were analyzed using t test, Chi-square test or Fisher's exact test. Results:Two groups both showed no significant difference in the mean arterial pressure or oxygen saturation before or after treatment (all P>0.05). The heart rate was not affected in nifedipine group at any time points ( P>0.05). While the patients treated with terbutaline showed accelerated maternal heart rate 5, 15 and 30 min after administration as compared with the baseline[(97.0±20.2), (99.2±13.8), (91.8±12.6) vs (81.7±11.3) bpm, all P<0.001], but it began to decrease at 30 min, with a drop of 6.4 bpm compared with that at 15 min (95% CI: 1.5-11.2, P<0.05). None of the pregnant women had adverse reactions requiring medical intervention. The rates of successful acute resuscitation were similar in the two groups [terbutaline: 78.2% (43/55) vs nifedipine: 70.9% (39/55), χ 2= 0.77, P=0.381]. Terbutaline had a shorter onset time than nifedipine in slowing the frequency of contractions and returning fetal heart rate to class Ⅰ category [2(1-6) vs 6(1-10) min, U=2 348.50, P<0.001]. No significant difference was found between the two groups in terms of NRFHT-indicated cesarean section, assisted vaginal delivery, or second dose of tocolysis within 1 h (all P>0.05) nor in blood loss volume, postpartum hemorrhage rate, low Apgar score, low umbilical artery pH value (pH<7.2), neonatal asphyxia rate, or neonatal intensive care admission rate (all P>0.05). Conclusion:Terbutaline spends less time than nifedipine to take effect and may be an alternative for acute IUFR without significant adverse outcomes.

Effect of intrathecal analgesia on labor / 中华围产医学杂志

As an effective analgesic method,intrathecal analgesia has been widely accepted.Though labor analgesia could relieve the labor pain,it remains controversial about its adverse effects on labor progress and delivery outcomes.With the development of labor analgesia technique,a large number of clinical studies have suggested that the protocol,dosage and analgesic methods of local anesthesia may also affect the labor and delivery outcomes.There is a growing need to explore more optimized anesthetics and analgesic methods for clinical and scientific research.

Influences of initiation of epidural analgesia pain relief in early labor on uterine myoelectrical activity / 中华围产医学杂志

Objective To assess the influences of early implementation of patient-controlled epidural analgesia (PCEA) in labor on uterine myoelectrical activity and delivery outcomes. Methods A prospective study was conducted on 240 singleton cephalic primiparae with spontaneous labor at Guangzhou Women and Children's Medical Center from January 2015 to October 2018. Those women, who were ready to accept PCEA, were randomly assigned to early- or late-PCEA group based on cervical dilation of 0-3 cm or 3-6 cm at the time of commencing PCEA, while those who refused PCEA in labor were classified as non-PCEA group. Uterine electromyographic activity and visual analogue score (VAS)were recorded before and 1 h and 2 h after PCEA. Patient satisfaction with labor, duration of the first stage of labor, volume of postpartum bleeding within 2 h after delivery and neonatal Apgar score were compared between different groups using multivariate analysis of variance, repeated measures analysis of variance, LSD-t test or Chi-square test. Results The VAS values 1 h after PCEA in the early- and late-PCEA group were both lower than that in the non-PCEA group (2.08±1.34 and 2.00±1.28 vs 7.65±1.04, LSD-t were － 27.713 and － 27.663, P<0.001) and those before PCEA (7.65±0.91 and 7.62±0.86, LSD-t were －32.879 and －33.349, P<0.001). The VAS values 2 h after PCEA in the early- and late-PCEA group were both lower than that in the non-PCEA group (1.63±1.53 and 1.41±1.56 vs 7.66±0.87, LSD-t were －27.018 and －27.823, P<0.001) and those before PCEA (LSD-t were －31.379 and －32.718, P<0.001).The patient satisfaction rate with labor was higher in the early-PCEA group comparing to the late-PCEA group [80.0% (72/90) vs 61.1% (55/90), P<0.001], and the two figures above were both higher than that of the non-PCEA group [20.0% (12/60), both P<0.001]. There was no significant difference in the duration of the first stage of labor, the volume of postpartum blood loss 2 h after delivery, oxytocin usage rate, the rate of convertion to cesarean section, neonatal birth weight or Apgar score at 1 or 5 min among the three groups (all P>0.05). There was also no significant difference in uterine electromyographic parameters among the three groups before or 2 h after PCEA (all P>0.05). The number and duration of burst, power density spectrum peak frequency, root mean square and total power 1 h after PCEA in the early- and later-PCEA group were all lower than those in the non-PCEA group [4.80±2.49 and 5.54±3.04 vs 9.67±2.44; (34.41±1.21) and (36.94±1.18) vs (41.68±1.53) s; (0.36±0.08) and (0.36±0.07) vs (0.48±0.05) Hz ; (0.05±0.04) and (0.05±0.05) vs (0.07±0.05) mV; (4.33±0.51) and (5.36 ±0.59) vs (9.90±1.43) pV2; all P<0.05]. Conclusions The effect of PCEA on uterine myoelectrical activity has no association with the commencing time. While early PCEA could alleviate the labor pain as soon as possible, which enable us to improve the efficacy of labor analgesia, patient satisfaction and maternal and neonatal safety without increasing cesarean section rate.

Expression of aquaporin-4 protein in the brain of preeclampsia model rats / 南方医科大学学报

<p><b>OBJECTIVE</b>To study the expression of aquaporin-4 (AQP4) protein in preeclampsia(PE) model rats.</p><p><b>METHODS</b>Adult SD rats were divided into PE model group (n=7) induced by endotoxin, normal pregnancy group (n=6) and non-pregnancy group (n=12) treated with an equal volume of saline. AQP4 protein expression in the brain of the rats was detected with immunohistochemical staining and Western blotting.</p><p><b>RESULTS</b>The blood pressure in PE model rats (135∓9 mmHg) was significantly higher than that in normal pregnancy rats (116∓8 mmHg) and non-pregnancy rats (112∓6 mmHg) (P<0.02). The rats in PE model group showed obvious proteinuria compared with the other two groups (3.8∓0.5 vs 2.6∓0.6 and 2.3∓0.4, P<0.05). Immunohistochemistry showed that AQP4 protein was localized primarily around the brain parenchymal blood vessels. Western analysis revealed a significantly elevated AQP4 protein expression in PE model group (39.6∓4.9) compared with that in normal pregnancy group (26.5∓4.3) and non-pregnancy group (9.7∓2.1) (P<0.01).</p><p><b>CONCLUSION</b>The up-regulation of AQP4 protein around the intraparenchymal blood vessels of the brain may play a role in the development of eclampsia.</p>

Prophylactic bilateral internal iliac arteries balloon occlusion in 13 patients of pernicious placenta previa with placenta accreta / 中华围产医学杂志

Objective To explore the efficacy of prophylactic bilateral internal iliac arteries balloon occlusion in treatment of women with pernicious placenta previa complicated with placenta accreta.Methods A retrospective analysis was conducted on 41 cases of pernicious placenta previa with placenta accreta admitted to Guangzhou Women and Children's Medical Centre from January 2010 to December 2012.The study group (n=13) underwent prophylactic bilateral internal iliac arteries balloon placement before cesarean section and occlusion after delivery.The control group (n =28)received conventional haemostasis during cesarean section.The amount of blood loss and blood transfusion during the operation,the perioperative hemoglobin level,operation time and duration of hospitalization of the two groups were compared with t test or Chi square test.Results The volume of intraoperative hemorrhage of the study group was lower than of the control group [(1429±875) ml vs (4600± 2090) ml,t=6.840,P=0.000],the amount of intraoperative blood transfusion in the study group was also lower [(920±438) ml vs (3600± 1225) ml,t=10.251,P=0.000].Operation time and postoperative duration of hospitalization of the study group were shorter than those of the control group [(197±45) min vs (284±44) min,t 5.850,P=0.000; (6.7±1.3) d vs (8.2± 2.2) d,t=2.272,P=0.029].There was no statistical difference on hysterectomy rate between the two groups [11/13 vs 89％(25/28),x2=0.181,P 0.670)].In addition,two cases of reoperation,one case of pulmonary edema,two cases of coagulation disorder,one case of venous thrombosis in lower limbs,one case of renal dysfunction and pulmonary edema were reported in the control group,but none in the study group.Conclusions.Prophylactic bilateral internal iliac arteries balloon occlusion is effective in reducing intraoperative blood loss,transfusion,and relative complications in patients with pernicious placenta previa complicated with placenta accreta.

Clinical application of the modified Epworth Sleepiness Score in the gestation women combined with obstructive sleep apnea-hypopnea syndrome / 中国基层医药

Objective Screening OSAHS patients on pregnancy with Modified Epworth Sleepiness Scale( Epworth sleepiness scale,ESS)and to assess its effect. Methods 22 patients underwent the pregnancy,and pregnancy with OSAHS( mild in 23 cases,22 cases of moderate and severe in 19 cases)group were 64 people, By ESS and modified ESS score, EP and modified EP values was derived. The neck circumference ( NC), body mass index (BMI) was measured. Conduct of polysomnography ( PSG), apnea hypopnea index ( AHI ) and lowest oxygen saturation ( LSaO2 )ESS and modified ESS correlation with the AHI was analyzed and ROC curves was drawn. Results The EP value of pregnancy with mild OSAHS group has no significant difference between normal pregnancy group( P ＞ 0.05) ;the rest of pregnancy OSAHS group modified EP, EP values and the normal pregnancy group were significantly different ( all P＜0.05) ;modified EP, EP, NC, BMI values positively correlated with the AHI value, the correlation coefficient r were :0.876,0.748,0.671,0.670 ( all P ＜ 0.001 ) ;modified EP, EP, NC, BM I of the A UC values were 0.901,0.819,0.750, 0.779; when the modified EP = 8.5, had higher sensitivity ( 84.4% ) and specificity ( 90.9% ).Conclusion Modified ESS on pregnancy OSAHS patients had better clinical value of screening.

Re-exploration after peripartum hysterectomy in postpartum hemorrhage / 中华围产医学杂志

Objective To analyse the causes and clinical characteristics of re-exploration after peripartum hysterectomy due to postpartum hemorrhage. Methods Clinical data was analysed retrospectively including 88 critically ill obstetric patients who underwent peripartum hysterectomy due to postpartum hemorrhage in the Obstetric Critical Care Center of Guangzhou from January 1999 to July 2009, which were divided into re-explored group (n= 14) and non-re-explored group (n=74)depending on whether the patient underwent re-exploration after peripartum hysterectomy. The main demographic data and clinical details were compared between the two groups, including mode of delivery, indication and type of hysterectomy, interval from hysterectomy to re-exploration, surgical intervention, complications, blood loss, blood transfusion,Glasgow Coma Score(GCS), the need for mechanical ventilation, intensive care unit stay and hospital stay. Results Fourteen out of the 88 (15.91%) patients underwent re-exploration due to internal bleeding after peripartum hysterectomy.Removal of cervical stump was performed in five patients and stump hemostasis in eight cases.Significant difference was found between the re-exploration and non-re-explored group on thepercentage of patients complicated with disseminated intravascular coagulation(92.9% vs 43.2%,x2=11.598,P=0.001) and amniotic fluid embolism (28.6% vs 2.7%, x2 =8.663, P=0.003).0.000], blood transfusion [(8163.6± 3903.1 ) ml vs (2958.8± 2323.0) ml, P = 0.000], intensive care unit admission rate (100.0% vs 41.9%, x2 = 15.909, P= 0.000), the need for mechanical ventilation (100.0% vs 24.3%,P=0.000), the number of patients with GCS≤8 score (71.4% vs 25.7% ,x2 = 9.179, P = 0.002 ), the number of multiple organ dysfunction syndrome ( 71.4% vs 14.9%, x2 = 17.735, P = 0.000), intensive care unit stay [ ( 11.4 ± 10.0 ) d vs ( 1.3 ± 2.3 ) d, P =0.000] and hospital stay[(24.0±13.1) d vs (12.7±7.0) d, P=0.000]. Allof the 14 cases were clinical recovered before discharge. Conclusions The rate of re-exploration after peripartum hysterectomy is not low, and internal bleeding is the most common causes. The re-exploration after peripartum hysterectomy might be associated with coagulopathy and the mode of hysterectomy, and patients may experience more severe complications.

Analysis of the cause and clinical characteristics of maternal cardiac arrest / 中华妇产科杂志

Objective To analyze the cause and clinical characteristics of maternal cardiac arrest.Methods The data of all cases of maternal cardiac arrest from January 2005 to December 2009 in Third Affiliated Hospital of Guangzhou Medical College was retrospectively studied.Results ( 1 ) A total of 41 maternal cardiac arrests (6 in prenatal period,2 in the first stage of labor,7 in the third stage of labor,26 in postpartum period ) were included.All patients regained spontaneous circulation after basic life support.Twelve (29％) mothers survived.Twelve cardiac arrests occurred in the hospital,and the totaldelivery number from January 2005 to December 2009 was 17101,with occurrence rate of 1:1425.(2) Thecauses of arrest were hemorrhagic shock (12,29％),amniotic fluid embolism (7,17％),severepreeclampsia/eclampsia (7,17％),septic shock (6,15％),cardiac disease (2,5％),unidentified cause (2,5％ ) and other occasional causes.(3) Thirty-seven (90％) in-hospital maternal cardiac arrest occurred in operation room (16,39％ ),ICU (7,17％ ),maternity wards (6,15％ ),delivery room (5,12％ ) and the emergency room (3,7％ ).Three (7％) arrest occurred out of hospital and one in the ambulance.Matemal survival rate was 2/3 in the emergency room,8/16 in the operation room,1/5 in the maternity wards,and 1/6 in the delivery room.No mother survived in ICU,ambulance or out of hospital.(4) Five of the 12 survived women showed ischemic encephalopathy after cardiac arrest and one of them developed cerebral infarction in the right corona radiate.(5) In 4 of the 8 cases of cardiac arrest in pregnancy,perimortem caesarean section (PMCS) was performed.In the four PMCS,2 mothers and 2 children survived.In the 4 cases that PMCS was not carried out,no infant survived.Conclusions Hemorrhagic shock,severe preeclampsia and eclampsia,amniotic fluid embolism are the major obstetric causes of maternal cardiac arrest.Septic shock and cardiac diseases are the major non-obstetric causes.Cardiac arrests occurred in emergency room and operation room has a higher maternal survival rate than those occurred in the delivery room and maternity wards.Timely PMCS may ensure the optimal outcome for mothers and fetuses.

Clinical outcomes and characteristics of concurrent eclampsia and hemolysis, elevated liver enzymes,and low platelets syndrome / 中华妇产科杂志

Objective The purpose was to describe the outcomes and characteristics of the obstetric patients with concurrent eclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome (HELLP) syndrome. Methods We retrospectively collected the materials between December 1999 and December 2008 in Obstetric Critical Care Center of Guangzhou. There were 76 patients in rolled then they were divided into two groups according to with or without HELLP syndrome. All the patients were injected Magnesium Sulfate to control seizure and to prevent the recurring of seizure. We analyzed the characteristics (such as age, gestational weeks, blood pressure after seizure), complications, biochemistry markers, the rate for intensive care unit (ICU) admittion, the need for mechanical ventilation, the Glasgow coma score (GCS) when admitted into ICU, computed tomography scan (CT) or magnetic resonance imaging (MRI),death rate of maternal and others, then compared between the two groups. Results ( 1 ) General data:There were 17 patients admitted with both eclampsia and HELLP syndrome, and 59 patients admitted eclampsia without HELLP syndrome. The incidence of eclampsia with HELLP syndrome was 22% (17/76).In eclampsia with HELLP syndrome group, the systolic blood pressure was higher and the rate of preterm also was higher [ (182 ± 20) mm Hg (1 mm Hg=0. 133 kPa)vs. (159± 21 ) mm Hg, P ＜ 0. 05 ]. But in regard to the age, gestational weeks, the rate of regular prenatal care and diastolic blood pressure, there were no differences between the two groups. (2) Biochemistry markers: the aspartate transaminase (AST), lanine transaminase (ALT), blood urea nitrogen and creatinine were significantly increased in eclampsia with HELLP syndrome group than eclampsia without HELLP syndrome group [ (879 ± 337) U/L vs. (90 ± 27)U/L, (344 ±83) U/Lvs. (43 ±11)U/L, (2245 ±294) U/L vs. (485 ±61)U/L, (14 ±9) mmol/L vs.(7 ± 3) mmol/L, ( 140 ± 92) μmol/L vs. (83 ± 28 ) μmol/L, P ＜ 0. 01, P ＜ 0. 05 ], and the platelet was lower in eclampsia with HELLP syndrome group [ (38 ± 13) × 109/L vs ( 172 ±46) × 109/L, P ＜0. 01 ].(3) Clinical outcomes: The maternal death rate was 35% (6/17) in eclampsia with HELLP syndrome patients, and significantly higher than the rate in eclampsia without HELLP syndrome group (3%, 2/59)(P ＜ 0. 05 ). There were more patients admitted to ICU and more patients who need mechanical ventilation in eclampsia with HELLP syndrome (13/17 vs. 34%, 9/17 vs. 24/, P ＜0. 05), also more patients with GCS ≤8 in eclampsia with HELLP syndrome when admitted to ICU ( 8/17 vs. 7/59, P ＜ 0. 05 ), compared to the eclampsia without HELLP syndrome group. There were more patients complicated with cerebral venous thrombosis and cerebral hemorrhage in eclampsia with HELLP syndrome group than other group (8/17 vs.7%, P ＜ 0. 05 ). Five of six patients died of cerebral hemorrhage in eclampsia with HELLP syndrome group,while other two missing cases in eclampsia without HELLP syndrome group all died of cerebral hemorrhage.The all missing cases were performed CT or MRI and seven (7/8) of them showed cerebral hemorrhage.Conclusion The incidence of concurrent eclampsia and HELLP syndrome was not rare, it happened seriously and with more mortalities, such as cerebral hemorrhage, and also the maternal mortality rate was significantly higher. It should be warning that the obstetrician should take great attention for these women,and consider life support treatment for them.

Relationship between changes of endogenous nitric oxide synthase inhibitor and hydrolase and initiation of pre-eclampsia / 中华妇产科杂志

Objective To investigate the role of dimethylarginine dimethylaminohydrolase-2 (DDAH-2)/asymmetric dimethylarginine(ADMA)in pathophiology of preeclampsia by detecting expression of DDAH-2 in placenta and serum plasma ADMA.Methods From Jan.2004 to Jan.2005,30 preeclampsia patients(PE group)were chosen in the Third Affiliated Hospital.Guangzhou Medical College matched with 10 normal third trimester women as control(control group).The placental DDAH-2 mRNA expression was detected by fluorescence quantitative polymerase chain reaction(FQ-PCR)and the plasma concentration of ADMA WSB determined by high performance liquid chromatography(HPLC).Results(1)The level of ADMA in PE group was significantly higher that than of control group[(18.0±7.2)mg/L vs.(10.3±1.7)mg/L,P<0.01].The expression level of ADMA in preeclampsia occurring before 34 gestatinal weeks WaS significantly higher than that of preeclampsia occurring after 34 gestational weeks[(22.0±7.0)ms/L vs.(12.7±2.8)mg/L,P<0.01].(2)The Placental DDAH-2 mRNA expression in preeclampsia patients was remarkably lower than that of control group[1×10(5.23±0.45)copy/μlvs.1×10(5.65±0.08)copy/μl,P<0.01].The Placental DDAH-2 mRNA in preeclampsia occurring before 34 gestatinal weeks was significantly lower than that of preeclampsia occurring after 34 gestational weeks [1×10(5.02±0.46)copy/μl vs.1×10(5.61±0.19)copy/μl,P<0.01].Conclusion Our results suggested that low expression of DDAH-2 in placenta and increased serum ADMA level might confer the susceptibility to preeclampsia.

Expression of aquaporin-1,3,8,9 mRNA in human amniotic membranes in polyhydranmios / 中华围产医学杂志

Objective To determine the expression of aquaporin-1,3,8,9 mRNA (AQP-1,3,8, 9) in amniotic membranes in pregnant women with polyhydramnios. Methods Amniotic membranes were collected from women who presented with either polyhydramnios (n= 5)or normal amniotic fluid volume (control, n= 5) underwent elective cesarean sections at term. The AQP-1,3,8,9 mRNA expression were detected by reverse transcriptase-polymerase chain reaction (RT-PCR). Results The expression of AQP-9 mRNA on fetal membranes were significantly higher in polyhydramnios groups (1. 1403±0. 0831) than that of control (0. 5903±0. 1909) (P = 0. 002), although the expression of AQP-1, 3 and 8 showed no significant difference between the two groups (P= 0. 972, 0. 242,0. 608, respectively). Conclusions AQP-9 may play an important role in maintaining the volume and the balance of different components of amniotic fluid in polyhydramnios cases.

Aquaporin 8 expression in human placenta and fetal membrane / 中国组织工程研究

BACKGROUND: Placenta and fetal membrane play an important role In maternal-fetal homeostasis. However, the molecular and cellular mechanisms underlying water transfer across placenta and amniotic membrane remain unknown. It is hypothesized that maternal-fetal fluid exchanges via aquaporin (AQP) water channels in the placenta and fetal membrane.OBJECTIVE: To investigate AQP8 protein expression in normal human placenta and fetal membrane.DESIGN, TIME AND SETTING: A control observation was performed at the Central Laboratory of Guangzhou Medical College from July to December 2005.MATERIALS: Human placenta and fetal membrane tissues from 5 elective cesarean section deliveries of normal term pregnancies (range 37-42 weeks) were studied. Maternal age averaged (27?) years old. Experimental protocol was approved by the Hospital's Ethics Committee.METHODS: Thirty minutes after delivery, fetal membrane and placenta were dissected and washed with sterile physiological saline. Some were frozen at -80?, and the remaining tissues were fixed for 24-48 hours with 10% neutral formalin and paraffin embedded for immunohistochemical staining.MAIN OUTCOME MEASURES: AQP8 expression and distribution in human placenta and fetal membrane were detected by the reverse transcription-polymerase chain reaction (RT-PCR), immunohistochemistry, and Western blotting analysis.RESULTS: RT-PCR results showed that AQP8 mRNA was expressed in both placenta and fetal membrane tissues. Western blotting analysis also yielded positive results in placenta and fetal membrane with a specific band site at approximately 45 000.Immunohistochemistry results revealed that AQP8 protein was expressed in placental syncytiotrophoblasts, amniotic epithelial cells, and chorion cytotrophoblasts.CONCLUSION: At protein level, AQP8 is expressed in placental syncytiotrophoblasts, amniotic epithelial cells, and chorion cytotrophoblasts.