Inflammatory-Metal Profile as a Hallmark for COVID-19 Severity During Pregnancy.

Pregnancy makes women more susceptible to infectious agents; however, available data on the effect of SARS-CoV-2 on pregnant women are limited. To date, inflammatory responses and changes in serum metal concentration have been reported in COVID-19 patients, but few associations between metal ions and cytokines have been described. The aim of this study was to evaluate correlations between inflammatory markers and serum metal ions in third-trimester pregnant women with varying COVID-19 disease severity. Patients with severe symptoms had increased concentrations of serum magnesium, copper, and calcium ions and decreased concentrations of iron, zinc, and sodium ions. Potassium ions were unaffected. Pro-inflammatory cytokines IL-6, TNF-α, IL-8, IL-1α, anti-inflammatory cytokine IL-4, and the IP-10 chemokine were induced in the severe presentation of COVID-19 during pregnancy. Robust negative correlations between iron/magnesium and zinc/IL-6, and a positive correlation between copper/IP-10 were observed in pregnant women with the severe form of the disease. Thus, coordinated alterations of serum metal ions and inflammatory markers - suggestive of underlying pathophysiological interactions-occur during SARS-CoV-2 infection in pregnancy.

Gestational Weight Gain Influences the Adipokine-Oxidative Stress Association during Pregnancy.

INTRODUCTION AND OBJECTIVE: The weight gained during pregnancy could determine the immediate and future health of the mother-child dyad. Excessive gestational weight gain (EGWG) due to abnormal adipose tissue (AT) accumulation is strongly associated with adverse perinatal outcomes as gestational diabetes, macrosomia, obesity, and hypertension further in life. Dysregulation of adipokine, AT dysfunction, and an imbalance in the prooxidant-antioxidant systems are critical features in altered AT accumulation. This study was aimed to investigate the association between adipokines and oxidative stress markers in pregnant women and the influence of the GWG on this association. METHODS: Maternal blood samples were obtained in the third trimester of pregnancy (n = 74) and serum adipokines (adiponectin, leptin, and resistin), oxidative damage markers: 8-oxo-2'-deoxyguanosine (8-oxodG), lipohydroperoxides (LOOH), malondialdehyde (MDA), and carbonylated proteins (CP), and glucose a metabolic marker were measured. RESULTS: Women with EGWG had low adiponectin levels than women with adequate weight gain (AWG) or insufficient weight gain (IWG). Multiple linear regression models revealed a positive association between adiponectin and 8-oxodG in women with AWG (B = 1.09, 95% CI: 164-222, p = 0.027) and IWG (B = 0.860, 95% CI: 0.199-1.52, p = 0.013) but not in women with EGWG. In women with EGWG, leptin was positively associated with LOOH (p = 0.018), MDA (p = 0.005), and CP (p = 0.010) oxidative markers. CONCLUSION: Our findings suggest that concurrent mechanisms regulate adipokine production and oxidative stress in pregnant women and that this regulation is influenced by GWG, probably due to an excessive AT accumulation.

Isolation of Viable Adipocytes and Stromal Vascular Fraction from Human Visceral Adipose Tissue Suitable for RNA Analysis and Macrophage Phenotyping.

Visceral adipose tissue (VAT) is an active metabolic organ composed mainly of mature adipocytes and stromal vascular fraction (SVF) cells, which release different bioactive molecules that control metabolic, hormonal, and immune processes; currently, it is unclear how these processes are regulated within the adipose tissue. Therefore, the development of methods evaluating the contribution of each cell population to the pathophysiology of adipose tissue is crucial. This protocol describes the isolation steps and provides the necessary troubleshooting guidelines for efficient isolation of viable mature adipocytes and SVF from human VAT biopsies in a single process, using a collagenase enzymatic digestion technique. Moreover, the protocol is also optimized to identify macrophage subsets and perform mature adipocyte RNA isolation for gene expression studies, which allows performing studies dissecting the interaction between these cell populations. Briefly, VAT biopsies are washed, minced mechanically, and digested to generate a single-cell suspension. After centrifugation, mature adipocytes are isolated by flotation from the SVF pellet. The RNA extraction protocol ensures a high yield of total RNA (including miRNAs) from adipocytes for downstream expression assays. Simultaneously, SVF cells are used to characterize macrophage subsets (pro- and anti-inflammatory phenotype) through flow cytometry analysis.

Maternal and Fetal Lipid and Adipokine Profiles and Their Association with Obesity.

Background. Maternal metabolic changes impact fetal metabolism resulting in a higher risk for developing chronic diseases later in life. The aim of this study was to assess the association between maternal and fetal adipokine and lipid profiles, as well as the influence of maternal weight on this association. Methods. Healthy pregnant women at term who delivered by C-section were enrolled. Maternal and fetal glucose, lipid profile, adiponectin, leptin, and resistin levels were analyzed by obesity and maternal weight gain. Statistics included descriptives, correlations, and mean differences (SPSS v20.0). Results. Adiponectin and resistin concentrations were higher in fetal blood, while leptin was lower (p < 0.05). A significant inverse association between maternal resistin and fetal LDL-cholesterol (LDL-C) (r = -0.327; p = 0.022) was observed. A positive correlation was found between maternal and fetal resistin (r = 0.358; p = 0.013). Women with excessive weight gain had higher leptin levels and their fetuses showed higher LDL-C levels (p < 0.05). Conclusions. Maternal resistin showed an inverse association with fetal LDL-C, suggesting that maternal adiposity status may play an active role in the regulation of fetal lipid profile and consequently, in fetal programming. Excessive maternal weight gain during pregnancy may exert an effect over metabolic mediators in both mother and newborn.

[Obstetric hemorrhage control Bakri balloon]. / Control de la hemorragia obstétrica con balón de Bakri.

BACKGROUND: Obstetric hemorrhage is the second leading cause of maternal death in Mexico. Intrauterine tamponades are a valuable resource for the limitation of bleeding. OBJECTIVE: Analyze the success rate of the Bakri balloon in the control of obstetric hemorrhage and calculate the fill volume with clinical parameters. MATERIAL AND METHODS: Descriptive, retrospective and observational study Subjects were included who presented refractory hemorrhage on administration of uterotonics (postpartum, caesarean section, post-caesarean section, and post-miscarriage); a Bakri balloon was inserted with epidural anesthesia. The procedure was considered successful where there was immediate cessation of hemorrhage without recurrence. The fill volume in milliliters (FV) was analyzed with a linear regression that included gestational age in weeks (GA) and neonatal weight in grams (NW). RESULTS: The study included 35 subjects: 20 postpartum (57.1%), 10 caesarean and post-caesarean section (28.5%), and 5 post-miscarriage (14.2%). Use of the Bakri balloon was successful in 33 cases (94.2%). Unsuccessful cases involved subinvolution of the placental site and placenta accreta. Fill volume correlated with gestational age (r=0.50, p=0.001) and with neonatal weight (r=0.47, p=0.002). The linear regression equation for calculation of the fill volume is FV = 150 + (4.3 x GA) + (0.03 x NW), (p = 0.003). CONCLUSION: Use of the Bakri balloon is safe, simple, and effective; we encountered no adverse reactions in this study. The procedure can be carried out after delivery or miscarriage or during or after a caesarean section.

[Urethral erosion secondary to the placing of tension-free vaginal tape. A case report]. / Erosión uretral secundaria a la colocación de una cinta vaginal libre de tensión. Reporte de un caso.

UNLABELLED: Tension free vaginal tape is a minimally invasive surgical procedure for urinary incontinence treatment. Urethral erosion is an uncommon complication which presents in around 0.9% of the cases after the procedure. CASE: Female of 68-year-old with an urodynamic diagnosis of type II stress urinary incontinence treated surgically with a tension free vaginal tape in February 2003 without any intraoperative complications. In the post-op she had acute urinary retention for one week, needing a transurethral catheter. Three months after surgery she reported dysuria, hematuria, frequency and urgency; the physical examination was normal with a positive urine culture to Escherichia coli sensitive to Nitrofurantoine. A cystoscopy was performed with the following findings: the tape was found in 25% of the right lower quadrant mid third of the urethra, the tape was cut vaginally without any further complications.