Expression of the syncytin-1 and syncytin-2 genes in the trophoblastic tissue of the early pregnancy losses with normal and abnormal karyotypes.

BACKGROUND: Syncytin-1 and syncytin-2 which are endogenous retroviral genes products play a great role in syncytialization during trophoblast differentiation in normal placental tissues. In aneuploidic placentas due to the low level of pregnancy-induced hormones an alteration was occurred in the syncytialization process, while in the presence of cytogenetically abnormal karyotype the effect of syncytin gene expression levels on syncytialization process and in occured to spontaneous abortions is not clear. To reveal this, we investigated in syncytin-1 and syncytin-2 genes expression levels of chromosomally abnormal and normal trophophoblastic tissues and we also discussed the effect of the syncytin gene expression levels to the occurense of the spontaneous abortion. MATERIAL AND METHODS: To each one of the trophoblastic cells; cultivation, harvesting, banding, and analysis were performed and the chromosomes were classified according to the presence of abnormality and normal XY constitution. To exclude the maternal decidual cell contamination, female karyotyped abortion materials were omitted in control group. The patient group consisted of thirty six placental tissues including trisomy 16 (n = 10), triploidy (n = 9), monosomy X (n = 9), trisomy 21 (n = 5) and trisomy 7 (n = 3). The control group was consisting twenty placental tissues with XY karyotypes. The some part of the dissected frozen trophoblastic cells were used for RNA isolation and were proceeded to the determination of the expression levels of syncytin-1 and syncytin-2 genes by single-step Real Time PCR. The cDNAs were obtained by probes used in the same PCR stages. The sequence analysis of the syncytin-1 and syncytin-2 genes were performed, and read by the usage of the FinchTV 1.4.0 program. RESULTS: Between the expression levels of syncytin-1 and syncytin-2 genes were statistically difference in the patients and controls. There was a difference (p < 0.0001) between trisomy 7 and other patient groups and controls, regarding to the expression of syncytin-1 gene. Numerous mutations in the syncytin-1 and syncytin-2 genes (on the expression sites) were detected, and the mutation rate was higher in the syncytin-1 gene compared to the syncytin-2 gene in the patient and in the control groups (p < 0.001). CONCLUSION: The results of the study indicate that the expression of the syncytin-2 genes could be altered in the presence of chromosomally abnormal trophoblastic tissues, and these could lead to the loss of pregnancy due to the insufficient syncytialization. In sum, the current research has value for the further studies covering the mechanisms of trophoblast cell fusion, and syncytiotrophoblast regeneration, and thus the pathophysiology of human placental development in the presence of genomic anomaly.

Maternal cardiac risks in pre-eclamptic patients.

OBJECTIVE: To investigate the relationship between pre-eclampsia (PE) and maternal cardiac risk factors. MATERIAL-METHODS: A total of 41 pregnant women were included in this study. Patient groups consisted of 25 PE patients and 16 normal pregnant women as a control group. We measured the serum total cholesterol, high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), homocystein, apoprotein A1, apoprotein B100, lipoprotein (a), high sensitivity C-reactive protein (hsCRP), cystatin C levels as cardiac risk factors. Serum low-density lipoprotein (LDL) and very low density lipoprotein (VLDL) cholesterol levels were calculated using Friedwald equation. RESULTS: The levels of TG, LDL-C, homocysteine, apoprotein B100 and cystatine C were higher in the PE patients than those in the control group (p < 0.05). HDL-C and apolipoprotein's AI levels were lower than those of normotensive pregnants (p < 0.05). HsCRP levels were also higher in the patient group but the difference was not statistically significant. CONCLUSION: PE is an important and as yet, incompletely understood disorder of pregnancy. Our study showed that the blood levels for some cardiac risk factors were increased in women with PE, which may contribute to its multisystem pathology. Consideration should be given to monitoring women with PE for these cardiac risk factors in pre-eclamptic women both during pregnancy, as well as later in life.

Effects of maternal supplementary oxygen on the newborn for elective cesarean deliveries under spinal anesthesia.

PURPOSE: The aim of this investigation was to determine whether supplementary oxygen provided by either nasal cannula or face mask versus room air might affect fetal oxygenation during elective cesarean section under spinal anesthesia by assessing maternal and neonatal regional cerebral oxygenation (rSO(2)) with a cerebral oximeter. METHODS: Ninety parturients were randomly allocated into three groups: two groups received 5 L/min oxygen by either nasal cannula (Group NC, n = 30) or face mask (Group FM, n = 30), respectively, and the third group was allowed to breathe room air (Group RA, n = 30). After maternal mean arterial pressure, heart rate and peripheral oxygen saturation had been monitored, rSO(2) was determined by cerebral oximeter. Umbilical artery (UA) and venous (UV) blood samples were collected for blood gas analysis. Neonatal rSO(2) and Apgar scores were recorded. RESULTS: The mean maternal rSO(2) which was recorded 3 and 5 min after administration of the spinal block in Group FM was lower than that of Group NC (p = 0.033 and 0.042, respectively). Neonatal rSO(2), UA pH, UV pH and UA base excess (BE) were lower in Group FM than in the other groups (p < 0.05). The Apgar score (1 min) in Group FM was lower than that of Group RA (p = 0.046). CONCLUSION: The effect of maternal supplementary oxygen on the newborn has been demonstrated by a cerebral oximeter monitor and supported by umbilical cord blood gas analysis and Apgar scores.

Manometric evaluation of anal sphincter function after vaginal and cesarean delivery.

OBJECTIVE: To compare anal sphincter function following spontaneous vaginal delivery and cesarean delivery, and assess the association of perineal length and sphincter injury with each delivery mode. METHOD: Perineal length was measured and anal manometric measurements were performed in 120 primigravidas before and after delivery. RESULTS: Mean values for maximum anal resting and squeeze pressures were significantly lower after delivery irrespective of the mode of delivery, but there was a positive correlation between postpartum maximum anal resting pressure and perineal length (r=0.24, P<0.01). CONCLUSION: Anal sphincter function was disturbed after both vaginal and cesarean delivery, a finding weakened by the fact that almost half of the cesareans were performed for cephalopelvic disproportion identified during labor.

Nicotine potentiates the electrical field stimulation-evoked contraction of non-pregnant rabbit myometrium.

The women who smoke have lower fertility rates which might be due to harmful effects of nicotine on tubal function and menstrual cycle. Although the uterine contractility of the non-pregnant uterus plays an important role in the human reproduction process, the influence of nicotine on the contractile responses in uterus is not known. Nicotine increases the release of neurotransmitters following nerve stimulation both in the central and peripheral nervous system through acting on nicotinic acetylcholine receptors (nAchRs). The aim of this study was to examine whether the electrical field stimulation (EFS)-evoked contraction is altered in rabbit myometrium strips in the presence of nicotine to evaluate the changes in contractility. EFS-evoked contractile responses were recorded from myometrium strips obtained from non-pregnant rabbits in the absence and presence of nicotine. Nicotine led to the increase in the amplitudes of the EFS-evoked contractile responses in a dose-dependent manner. Therefore, the effects of hexamethonium, cadmium, indomethacin, atropine, and N(omega)-Nitro-L-arginine methyl ester hydrochloride were tested on the EFS-evoked contractions in the absence or presence of nicotine to clarify the mechanisms of nicotine-induced potentiation in EFS-evoked contractile responses. Indomethacin, a non-selective cyclooxygenase inhibitor, and hexamethonium, a ganglionic blocker, inhibited nicotine-induced increase in EFS-evoked responses, whereas other chemicals produced no effect. These results suggest that nicotine-induced potentiation may be mediated by nAchRs and prostaglandins. In conclusion, failure of quiescence in the uterus due to increased contractility by nicotine might be one of the factors contributing to infertility in female smokers.

Is cytogenetic diagnosis of 46,XX karyotype spontaneous abortion specimens erroneous? Fluorescence in situ hybridization as a confirmatory technique.

AIM: Performing the standard cytogenetic technique on spontaneous abortion material is still a valuable tool, but finding a normal 46,XX karyotype can confuse investigators and lead to a problem in diagnosis. This is mainly because it is possible for the female or male conceptus to retain contaminating maternal cells. To address this possibility, we used fluorescence in situ hybridization technique (FISH). X (DXZ1: p11.1-q11.1 region) and Y (DYZ3: p11.1-q11.1 region) chromosome alpha-satellite probes were employed to confirm the karyotypes previously diagnosed as 46,XX by our cytogenetic laboratory, or to verify the occurrence of 'Y chromosome component'. METHODS: Besides conventional long-term tissue cultures and G-bands by trypsin using Giemsa (GTG) bandings, FISH analyses were also performed. RESULTS: A total of 134 spontaneous abortion specimens (singleton gestations) were referred for cytogenetic evaluation, of which 125 specimens were successfully karyotyped. Of these, 20.8% (26/125) had chromosome aberrations; 88.5% (23/26) of these aberrations were numerical and 11.5% (3/26) were structural. The most prevalent numerical anomalies were trisomies 15, 16 and 21, tetraploidies, triploidies and monosomy X. FISH results were obtained for 45 out of 92 cases with 46,XX, of which 2 (4.4%) showed XY signals. CONCLUSIONS: For accurate cytogenetic evaluation of spontaneous abortion materials, an additional technique such as FISH is required in order to confirm the cytogenetic results or to provide an estimate of the error rate in the analysis of miscarriages.