Expression of Estrogen Receptor and Telomerase Activity in Chorionic Villi and Decidua of Early Human Gestation / 대한산부인과학회잡지

OBJECTIVE: To investigate whether there is any differences between normal pregnancy (NP) and spontaneous abortion (SAB) regarding estrogen receptor (ER) expression and telomerase activity (TA) in the chorionic villi and decidual tissues. METHODS: Chorionic villi and decidual tissues were obtained between 6 and 9 weeks' gestation from 14 patients with SAB and 17 normal pregnant women who have undergone an elective abortion. All tissue samples were assayed for ER with enzyme immunoassay and also TA was analysed using telomeric repeat amplication protocol. RESULTS: A significant decrease in ER expression (2.81+/-2.77 fmol/mg of protein; p<.001) was demonstrated in SAB group compared to that of NP group (4.56+/-1.85 fmol/mg) in decidua. However, no significant difference in ER expression in chorionic villi was found between the two groups. SAB group showed significantly lower levels of TA than that of NP group in both chorionic villi (21.4% vs. 82.4%; p=.002) and deciduas (7.1% vs. 52.9%; p=.009). CONCLUSION: Our results suggest that decreased level of ER expression in deciduas might cause decidual senescence and eventually, spontaneous abortion.

Triple marker screening for fetal chromosomal abnormalities in Korean women of advanced maternal age

The purpose of this article is to assess the value of maternal serum triple marker screening of alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and unconjugated estriol (uE3) for the prenatal diagnosis of fetal chromosomal abnormalities in Korean women of advanced maternal age. Maternal sera were collected from 458 pregnant Korean women aged 35 between 15 and 20 weeks gestation before amniocentesis. A patient- specific second trimester risk for fetal Down's syndrome was calculated using the median values for AFP, hCG, uE3 and maternal age. Twelve fetal chromosomal abnormalities were identified. These included six cases of trisomy 21, one case of 46,XY/47,XY,+21, two cases of trisomy 18, one case of trisomy 13, and two cases of 45, X. A cutoff level of 1:200 detected 85.7% (6/7) of the cases of Down's syndrome and 20% (1/5) of the other aneuploidies, with a 27.3% false positive rate. However, a cutoff level of 1:270 did not result in any gains in detecting Down's syndrome or other aneuploidies at the expense of a false positive rate of 34.3%. Second trimester triple marker testing is an effective screening tool for detecting fetal Down's syndrome in Korean women > or = 35 years old. However, it is not an effective screening tool for non-Down's chromosomal abnormalities.

Effect of Hypoxia on Telomerase Activity in Placental Tissue in Pregnancies with Fetal Growth Restriction / 대한산부인과학회잡지

OBJECTIVE: To observe the difference in telomerase activity (TA) expression in the placenta between fetal growth restriction (FGR) with preeclampsia and those without and to evaluate the effect of oxygen concentration on the TA expression in the trophoblastic cells. METHODS: Telomerase activity was measured in 48 (normal pregnancies, 16; preeclampsia with FGR, 15; normotensive FGR, 17) placentas which were obtained between 32 and 41 weeks' gestations. Trophoblastic cells were extracted from 8 chorionic villi samples obtained from 8-10 weeks' placenta and were cultured in either 2%, 8%, and 20% oxygen atmosphere. Then TA was examined by using telomeric repeat amplification protocol (TRAP) assay. RESULTS: During 3rd trimester of pregnancy, exhibited TA expression in normal pregnancy, FGR complicated by preeclampsia, and normotensive FGR groups were 11 of 16 (68.8%), 4 of 15 (26.7%), and 4 of 17 (23.5%), respectively. Significantly lower level of TA was detected in the FGR group compared to the normal pregnancies (p=0.009), whereas within FGR pregnancies, presence of preeclampsia did not seem to have statistically significant effect on TA expression. TA expression levels were measured by optical density in trophoblasts cultured under various oxygen concentration which revealed that significantly higher TA was exhibited in the cells cultured in 2% oxygen compared to 8% and 20% (p<0.001). However no significant difference was noted in TA between cells cultured in 8% and 20% oxygen. CONCLUSION: Decreased TA in the placenta from pregnancies with FGR was noted regardless of presence of preeclampsia indicating a probable correlation between FGR and placental senescence. Since increased TA was noted in trophoblastic cells that were cultured in hypoxic condition, we could speculate that the intervillous oxygen tension during early-stage placental development plays a certain role in the placental degeneration in pregnancies complicated by FGR and preeclampsia.

Telomerase Activity In Human Placenta Tissues: Comparison Between Preeclampsia With and Without Fetal Growth Restriction / 대한산부인과학회잡지

OBJECTIVES: To analyze telomerase activity(TA) in human placenta tissues and to compare TA in preeclampsia with or without fetal growth restriction(FGR) METHODS: Fourty-six placenta specimens were obtained from pregnant women between 29 and 41 weeks' gestation. TA of each specimen was analyzed including 21 specimens without either preeclampsia or FGR(Group 1), 9 specimens with preeclampsia but without FGR(Group 2), and 16 specimens with both preeclampsia and FGR(Group 3). TA was analysed by radioisotope PCR based telomeric repeat amplification protocol(TRAP) assay. TA was calculated and translated into arbitrary units by computer-assisted densitometry with the control of TA in 293 cell lines. RESULTS: TA was expressed in 16 of 21(76.1%) in group 1, and in 3 of 9(33.3%) in group 2. In contrast, only 4 patients(25%) in group 3 expressed TA. Thus, TA was expressed significantly more often in group 1 than in group 2 and group 3(p=0.003). However, compared with group 2, expression of telomerase activity in group 3 was not reduced significantly(p>0.05). CONCLUSION: TA was minimal in placenta from preeclamptic women with and without FGR, suggesting placental senescence and apoptosis may be associated with FGR and severe preeclampsia.

Comparison of Telomerase Activity in Human Chorionic Villi between Eutopic and Ectopic Pregnancies / 대한산부인과학회잡지

No abstract available.

Recurrent Anencephaly in A Same Pregnant Women: Report of Two Cases / 대한산부인과학회잡지

The etiology of neural tube defects, a category encompassing spina bifida, anencephaly and encephalocele, remains highly controversial and unclear, However, there is overwhelming evidence supporting a multifactorial etiology for this group of defects. Recent studies have shown that folic acid supplements taken periconceptionally can reduce a woman's risk of having a child with a neural tube defect. Qenetic screening could identify women who will require folic acid supplements periconceptionally to reduce their risk of having a child with a neural tube defects. Recently, we encountered two cases of recurrent anencephaly that had occurted in a same pregnant woman in our hospital. We report these two cases with brief review of the literatures.