The impact of birth anesthesia on the parameters of oxygenation and acid-base balance in umbilical cord blood.

Background: There is a great number of studies dealing with the impact of birth anesthesia on the course of labor and condition of the newborn. The aim of this study was to investigate the impact of birth anesthesia on the parameters of oxygenation and acid-base balance in umbilical cord blood.Methods: Subjects were divided into four groups: vaginal delivery without anesthesia, vaginal delivery with epidural anesthesia, delivery by cesarean section under a subarachnoid block, and delivery by cesarean section under general anesthesia. The study included mothers aged 18-45 and their newborns born from a singleton normal pregnancy lasting 37-42 weeks, calculating the date of birth according to Naegele's Rule, which was confirmed by ultrasound assessment. The inclusion criteria were a birth weight between 2800 and 4100 gResults: Hematocrit, total hemoglobin, blood oxygen capacity and carboxyhemoglobin content (umbilical artery and vein mean values respectively in all study groups: 41.9 and 42.6%, 14.3 and 14.5 g/dl, 19.3 and 19.6 ml/dl) were similar in all groups and did not correlate with pH in either group. The mean pH value of umbilical cord arterial blood in the "vaginal delivery with epidural anesthesia" group was 7.27 and was significantly the lowest (p < .05) of all the examined groups, in the remaining groups, the mean values ranged between 7.29 and 7.30. Hemoglobin oxygen saturation, oxygenated hemoglobin content, and total oxygen content in umbilical cord blood were statistically significant (p < .001), almost twice as high in cesarean sections under general anesthesia than in cases of regional anesthesia regardless of the method of delivery. Vaginal deliveries had intermediate values of oxygenation parameters.Conclusion: Blood oxygenation of the fetus is a very good parameter to evaluate the clinical state of the baby. Due to most common hypotension of the mother by the regional anesthesia (subarachnoid or epidural), which is compensated by the application of the vasoconstrictors or only by the fluids, it comes to decrease in the oxygen supply of the fetus. We consider in this study that the general anesthesia can be, in some cases, more indicated than the regional anesthesia. The decision of which kind of anesthesia should be used needs to be made by the anesthetists and also by the obstetrician because it can affect the neonatal state after the delivery. It also needs to be mentioned that the time between the start of the anesthesia and the extraction of the fetus by the cesarean section should be as short as possible.

Physical Activity and Depressive Disorders in Pregnant Women-A Systematic Review.

Background and Objectives: Pregnancy is a unique period in the life of every woman. The lifestyle of a pregnant woman has a significant impact on her and her child's health. Regular physical activity is one of the elements that help maintain normal mental and physical well-being. In pregnant women who regularly have moderate physical activity, there is a lower risk of developing obesity and overweight. Physical exercises have an impact on maintaining proper muscular tonus, reduce pain and prepare for the exertion during labour. Based on the available literature, the aim of this study was to present the impact of physical activity on depressive disorders in pregnant women. Materials and Methods: A review of the literature was carried out in the Medline PubMed database. The basic search terms were: "pregnancy" AND "physical activity AND depression". The work included only English-language publications published in the years 2000-2018. Results: A total of 408 references were found. On the basis of an analysis of titles, abstracts and the language of publication (other than English), 354 articles were rejected, and 54 articles were fully read, of which five were rejected due to lack of access to the full version. Finally, 17 references were included in the review. Conclusions: Physical activity, at least once a week, significantly reduces the symptoms of depression in pregnant women and may be an important factor in the prevention of depression in this period.

Anti-Inflammatory Properties of Irisin, Mediator of Physical Activity, Are Connected with TLR4/MyD88 Signaling Pathway Activation.

Irisin, an adipomiokine known as a mediator of physical activity, induces the browning of adipose tissue and it has potentially protective properties in the development of obesity-related states, such as insulin resistance, arteriosclerosis, and type 2 diabetes. Despite numerous studies conducted on this factor, still little is known about its impact on the functioning of immunocompetent cells, but its potential anti-inflammatory properties were previously suggested. In the current study we investigated the role of irisin (0-100 nM) in the downstream pathway activation of Toll-like receptor 4 (TLR4) in RAW 264.7 macrophages stimulated with lipopolysaccharide (LPS; 100 ng/mL). The results have shown that irisin in high concentrations (50, 100 nM) significantly decreased the TLR4 and MyD88 protein levels, as well as the phosphorylation of nuclear factor-κB (NF-κB), consequently leading to the reduction in the release of crucial pro-inflammatory cytokines. The above was confirmed for interleukin 1ß (IL-1ß), tumor necrosis factor α (TNFα), interleukin 6 (IL-6), keratinocyte chemoattractant (KC), monocyte chemotactic protein 1 (MCP-1), as well as for high mobility group box 1 (HMGB1). Moreover, our results indicate that this effect is connected with irisin's impact on the phosphorylation of mitogen-activated protein kinases (MAPKs), where a significant reduction in p-JNK and p-ERK but not p-p38 was observed. In conclusion, these data suggest that irisin has potentially anti-inflammatory properties connected with the downregulation of downstream pathways of TLR4/MyD88.