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Doppler e marcadores séricos maternos na predição de complicações da gestação; Doppler and maternal serum screening in the prediction of pregnancy complications

COSTA, Fabrício da Silva; ROCHA, Rebeca Silveira; CUNHA, Sérgio Pereira da; REIS, Francisco Cândido dos; BEREZOWSKI, Aderson Tadeu; ANTUNES-RODRIGUES, José
Fonte: Colégio Brasileiro de Radiologia e Diagnóstico por Imagem Publicador: Colégio Brasileiro de Radiologia e Diagnóstico por Imagem
Tipo: Artigo de Revista Científica
POR
Relevância na Pesquisa
56.28%
OBJETIVO: Comparar a eficácia do Doppler das artérias uterinas e de marcadores séricos maternos na predição de complicações da gestação. MATERIAIS E MÉTODOS: Trata-se de um estudo prospectivo com 49 primigestas, incluídas no estudo na 18ª semana, sendo coletada a amostra sanguínea para a realização das dosagens séricas, realizadas pelo método de quimioluminescência (alfa-fetoproteína, gonadotrofina coriônica humana e óxido nítrico) e radioimunoensaio (peptídio atrial natriurético). O Doppler das artérias uterinas foi realizado entre 24-26 semanas, determinando a presença ou ausência de incisura na onda de velocidade de fluxo. Na análise estatística utilizou-se o teste de Mann-Whitney, para amostras não-paramétricas, e o teste exato de Fisher, para parâmetros qualitativos. RESULTADOS: Os valores de sensibilidade, especificidade, valor preditivo positivo e valor preditivo negativo foram, respectivamente, de 8,3%, 97,0%, 50,0% e 74,4% para a alfa-fetoproteína; 8,3%, 87,9%, 20,0% e 72,5% para a gonadotrofina coriônica humana; 16,7%, 97,0%, 33,3% e 76,2% para o peptídio atrial natriurético; e 16,7%, 93,9%, 50,0% e 75,6% para o óxido nítrico. A sensibilidade do Doppler foi de 75,0%, especificidade de 63...

Effect of dietary factors in pregnancy on risk of pregnancy complications: results from the Norwegian Mother and Child Cohort Study1234

Meltzer, Helle Margrete; Brantsæter, Anne Lise; Nilsen, Roy M; Magnus, Per; Alexander, Jan; Haugen, Margareta
Fonte: American Society for Nutrition Publicador: American Society for Nutrition
Tipo: Artigo de Revista Científica
EN
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56.23%
There has been a thrilling development , as well as profound changes, in our understanding of the effect of fetal nutrition on the development and health of the child. The Norwegian Mother and Child Cohort Study (MoBa) is an ongoing nationwide population-based pregnancy cohort study that between 1999 and 2008 recruited 90,723 women with 106,981 pregnancies and 108,487 children. The objective of MoBa is to test specific etiologic hypotheses by estimating the association between exposures and diseases with a special focus on disorders that may originate in early life. An important aspect in this regard is maternal diet and nutritional status during pregnancy. Nutritional factors have long been considered to be important determinants of maternal and fetal health, and dietary information is currently being collected in a number of pregnancy cohorts in Europe and the United States. Thus far, pregnancy complications studied in MoBa are preterm birth, preeclampsia, and fetal growth; and the aim of this article is to report results of recently published studies of dietary factors in relation to these outcomes. Numerous studies are planned using MoBa data, and the aim is to add to the knowledge of the interplay between dietary factors, nonnutrients...

IFPA Award in Placentology Lecture: Complicated interactions between genes and the environment in placentation, pregnancy outcome and long term health

Roberts, C.
Fonte: W B Saunders Co Ltd Publicador: W B Saunders Co Ltd
Tipo: Artigo de Revista Científica
Publicado em //2010 EN
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56.32%
Most research on the developmental origins of health and disease has implicated poor nutrition in the fetus, most often conferred by deficiencies in maternal nutrition, as an important causal factor that programmes offspring physiology for adult disease. Emerging evidence implicates interactions between genes and the environment that may help to explain why poor growth before birth is associated with a variety of adult onset diseases that appear in different individuals of the same birthweight. However, it is underappreciated that the placenta, particularly trophoblast invasion, is key to health of both the mother and child in both the short and long term and that the role of the father is more important than perhaps ever expected. Intrauterine growth restriction (IUGR) is but one of a continuum of several pregnancy complications that may be related and that may reflect the long term health of both parents and offspring. These include preeclampsia, pre-term birth and gestational diabetes, as well as IUGR. Polymorphisms in genes that regulate how the placenta invades maternal tissues, differentiates and functions and how the mother adapts to pregnancy have been identified as candidates that confer risk to pregnancy success. Potentially...

Gestational weight gain and adverse pregnancy outcomes in a nulliparous cohort

Chung, J.; Taylor, R.; Thompson, J.; Anderson, N.; Dekker, G.; Kenny, L.; McCowan, L.
Fonte: Elsevier Sci Ireland Ltd Publicador: Elsevier Sci Ireland Ltd
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
56.26%
OBJECTIVE: Excessive gestational weight gain (GWG) is an important contributing factor to the obesity epidemic in women and is associated with pregnancy complications. We investigated the relationship between GWG and caesarean delivery in labour, large for gestational age (LGA), small for gestational age (SGA) infants and pregnancy-induced hypertension by maternal pre-pregnancy body mass index (BMI) in a contemporary nulliparous cohort. STUDY DESIGN: Using 2009 Institute of Medicine guidelines, participants in the SCOPE study (from Cork, Ireland, Auckland, New Zealand and Adelaide, Australia) were classified into GWG categories (low, normal and high) according to pre-pregnancy BMI. Maternal characteristics and pregnancy outcomes were compared between weight gain categories. SGA and LGA were defined as <10th and >90th customised birthweight centile. Multivariable analysis adjusted for confounding factors that impact on GWG including BMI. RESULTS: Of 1950 participants, 17.2% (n=335) achieved the recommended GWG, 8.6% (n=167) had low and 74.3% (n=1448) had high GWG. Women with high GWG had increased rates of LGA infants [adjusted OR 4.45 (95% CI 2.49-7.99)] and caesarean delivery in labour [aOR 1.46 (1.03-2.07)]. SGA was increased in women with low GWG [aOR 1.79 (1.06-3.00)]. CONCLUSION: Three quarters of participants had high GWG...

Exploration and confirmation of factors associated with uncomplicated pregnancy in nulliparous women: prospective cohort study

Chappell, L.; Seed, P.; Myers, J.; Taylor, R.; Kenny, L.; Dekker, G.; Walker, J.; McCowan, L.; North, R.; Poston, L.
Fonte: BMJ Publishing Group Publicador: BMJ Publishing Group
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
56.42%
Objective: To identify factors at 15 and 20 weeks’ gestation associated with a subsequent uncomplicated pregnancy. Design: Prospective international multicentre observational cohort study. Setting: Auckland, New Zealand and Adelaide, Australia (exploration and local replication dataset) and Manchester, Leeds, and London, United Kingdom, and Cork, Republic of Ireland (external confirmation dataset). Participants: 5628 healthy nulliparous women with a singleton pregnancy. Main outcome measure: Uncomplicated pregnancy, defined as a normotensive pregnancy delivered at >37 weeks’ gestation, resulting in a liveborn baby not small for gestational age, and the absence of any other significant pregnancy complications. In a stepwise logistic regression the comparison group was women with a complicated pregnancy. Results: Of the 5628 women, 3452 (61.3%) had an uncomplicated pregnancy. Factors that reduced the likelihood of an uncomplicated pregnancy included increased body mass index (relative risk 0.74, 95% confidence intervals 0.65 to 0.84), misuse of drugs in the first trimester (0.90, 0.84 to 0.97), mean diastolic blood pressure (for each 5 mm Hg increase 0.92, 0.91 to 0.94), and mean systolic blood pressure (for each 5 mm Hg increase 0.95...

Preconceptional low-dose aspirin for the prevention of hypertensive pregnancy complications and preterm delivery after IVF: a meta-analysis with individual patient data

Groeneveld, E.; Lambers, M.; Lambalk, C.; Broeze, K.; Haapsamo, M.; de Sutter, P.; Schoot, B.; Schats, R.; Mol, B.; Hompes, P.
Fonte: Oxford University Press Publicador: Oxford University Press
Tipo: Artigo de Revista Científica
Publicado em //2013 EN
Relevância na Pesquisa
66.47%
STUDY QUESTION Does preconceptionally started low-dose aspirin prevent hypertensive pregnancy complications and preterm delivery in IVF patients? SUMMARY ANSWER The current data do not support the use of preconceptionally started low-dose aspirin treatment for the prevention of hypertensive pregnancy complications and preterm delivery in IVF women. WHAT IS KNOWN ALREADY Studies starting low-dose aspirin treatment as prevention in the second trimester of pregnancy found no or only moderate reductions in the relative risk of developing pre-eclampsia. Low-dose aspirin was possibly started too late, that is after the first episode of trophoblast invasion. STUDY DESIGN, SIZE, DURATION We performed a meta-analysis with individual patient data (IPD), in which four authors could provide IPD on a total of 268 pregnancies (n = 131 treated with aspirin, n = 137 placebo). Data on hypertensive pregnancy complications and preterm delivery were collected. PARTICIPANTS/MATERIALS, SETTING, METHODS All separate databases were merged into a summary database. Treatment effect of aspirin on the incidence of hypertensive pregnancy complications (n = 187) and preterm delivery (n = 180) were estimated with odds ratios (OR) and 95% confidence intervals (95% CI) using multivariable logistic regression. MAIN RESULTS AND THE ROLE OF CHANCE There were significantly fewer twin pregnancies in the aspirin group (OR 0.55 95% CI 0.30–0.98)...

Clinical, psychosocial, and economic effects of antenatal day care for three medical complications of pregnancy: a randomised controlled trial of 395 women

Turnbull, D.; Wilkinson, C.; Gerard, K.; Shanahan, M.; Ryan, P.; Griffith, E.; Kruzins, G.; Stamp, G.
Fonte: Lancet Ltd Publicador: Lancet Ltd
Tipo: Artigo de Revista Científica
Publicado em //2004 EN
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56.31%
BACKGROUND: Day care is increasingly being used for complications of pregnancy, but there is little published evidence on its efficacy. We assessed the clinical, psychosocial, and economic effects of day care for three pregnancy complications in a randomised trial of day care versus standard care on an antenatal ward. METHODS: 395 women were randomly assigned day (263) or ward (132) care in a ratio of two to one, stratified for major diagnostic categories (non-proteinuric hypertension, proteinuric hypertension, and preterm premature rupture of membranes). The research hypothesis was that for these disorders, as an alternative to admission, antenatal day care will reduce specified interventions and investigations, result in no differences in clinical outcome, lead to greater satisfaction and psychological wellbeing, and be more cost-effective. Data were collected through case-note review, self-report questionnaires (response rates 81.0% or higher) and via the hospital's financial system. Analysis was by intention to treat. FINDINGS: All participants were included in the analyses. There were no differences between the groups in antenatal tests or investigations or intrapartum interventions. The total duration of antenatal care episodes was shorter in the day-care group than in the ward group (median 17 [IQR 5-9] vs 57 [35-123] h; p=0.001). Overall stay was also significantly shorter in the day-care group (mean 7.22 [SE 0.31] vs 8.53 [0.44]; p=0.014). The median number of care episodes was three (range one to 14) in the day-care group and two (one to nine) in the ward group (p=0.01). There were no statistically or clinically significant differences in maternal or perinatal outcomes. The day-care group reported greater satisfaction...

Vitamin C supplementation in pregnancy

Rumbold, A.; Crowther, C.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2005 EN
Relevância na Pesquisa
56.27%
BACKGROUND: Vitamin E supplementation may help reduce the risk of pregnancy complications involving oxidative stress, such as pre-eclampsia. There is a need to evaluate the efficacy and safety of vitamin E supplementation in pregnancy. OBJECTIVES: To assess the effects of vitamin E supplementation, alone or in combination with other separate supplements, on pregnancy outcomes, adverse events, side-effects and use of health services. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (23 June 2004), the Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2004), MEDLINE (1966 to May 2004), Current Contents (1998 to May 2004) and EMBASE (1980 to May 2004). SELECTION CRITERIA: All randomised or quasi-randomised controlled trials evaluating vitamin E supplementation in pregnant women. We excluded interventions using a multivitamin supplement that contained vitamin E. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trials for inclusion, extracted data and assessed trial quality. MAIN RESULTS: Four trials, involving 566 women either at high risk of pre-eclampsia or with established pre-eclampsia, were eligible for this review. All trials assessed vitamin E in combination with other supplements and two trials were published in abstract form only. No difference was found between women supplemented with vitamin E in combination with other supplements during pregnancy compared with placebo for the risk of stillbirth (relative risk (RR) was 0.77...

Vitamin E supplementation in pregnancy

Rumbold, A.; Crowther, C.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2005 EN
Relevância na Pesquisa
56.26%
BACKGROUND: Vitamin C supplementation may help reduce the risk of pregnancy complications like pre-eclampsia, intrauterine growth restriction and maternal anaemia. There is a need to evaluate the efficacy and safety of vitamin C supplementation in pregnancy. OBJECTIVES: To evaluate the effects of vitamin C supplementation, alone or in combination with other separate supplements, on pregnancy outcomes, adverse events, side-effects and use of health resources. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group Trials Register (23 June 2004), Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 2, 2004), MEDLINE, Current Contents and EMBASE. SELECTION CRITERIA: All randomised or quasi-randomised controlled trials evaluating vitamin C supplementation in pregnant women. Interventions using a multivitamin supplement containing vitamin C or where the primary supplement was iron were excluded. DATA COLLECTION AND ANALYSIS: Two authors independently assessed trials for inclusion, extracted data and assessed trial quality. MAIN RESULTS: Five trials, involving 766 women, are included in this review. No difference was seen between women supplemented with vitamin C alone or combined with other supplements compared with placebo for the risk of stillbirth (relative risk (RR) 0.87...

Antenatal day care units versus hospital admission for women with complicated pregnancy

Dowswell, T.; Middleton, P.; Weeks, A.
Fonte: Update Software Ltd Publicador: Update Software Ltd
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
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56.31%
BACKGROUND: Antenatal day care units have been widely used as an alternative to inpatient care for women with pregnancy complications including mild and moderate hypertension, and preterm prelabour rupture of the membranes. OBJECTIVES: The objective of this review is to compare day care units with routine care or hospital admission for women with pregnancy complications in terms of maternal and perinatal outcomes, length of hospital stay, acceptability, and costs to women and health services providers. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (February 2009). SELECTION CRITERIA: Randomised controlled trials comparing day care with inpatient or routine care for women with complicated pregnancy. DATA COLLECTION AND ANALYSIS: Two review authors independently carried out data extraction and assessed studies for risk of bias. MAIN RESULTS: Three trials with a total of 504 women were included. For most outcomes it was not possible to pool results from trials in meta-analyses as outcomes were measured in different ways.Compared with women in the ward/routine care group, women attending day care units were less likely to be admitted to hospital overnight (risk ratio 0.46, 95% confidence interval 0.34 to 0.62). The average length of antenatal admission was shorter for women attending for day care...

Pregnancy outcome following women's participation in a randomised controlled trial of acupuncture to treat nausea and vomiting in early pregnancy

Smith, C.; Crowther, C.; Beilby, J.
Fonte: Churchill Livingstone Publicador: Churchill Livingstone
Tipo: Artigo de Revista Científica
Publicado em //2002 EN
Relevância na Pesquisa
56.35%
Objectives: Recent studies have concluded that acupuncture is safe in the hands of a qualified practitioner. This study assessed the risk of adverse effects of acupuncture administered during pregnancy. Methods: 593 women with nausea and vomiting in early pregnancy volunteered to participate in a randomised controlled trial, conducted at the Women's and Children's Hospital, in South Australia. Patients were given either traditional acupuncture, formula acupuncture, sham acupuncture or no acupuncture. Outcome Measures: Data were collected on perinatal outcome, congenital abnormalities, pregnancy complications and the newborn. Results: No differences were found between study groups in the incidence of perinatal outcome, congenital abnormalities, pregnancy complications and other infant outcomes. Conclusion: Our findings suggest that no serious adverse effects arise from acupuncture administered in early pregnancy.; http://www.elsevier.com/wps/find/journaldescription.cws_home/623020/description#description; C. Smith; C. Crowther; and J. Beilby; Copyright © 2002 Elsevier Science Ltd. All rights reserved.

Review: The feto-placental unit, pregnancy pathology and impact on long term maternal health

Clifton, V.; Stark, M.; Osei-Kumah, A.; Hodyl, N.
Fonte: W B Saunders Co Ltd Publicador: W B Saunders Co Ltd
Tipo: Artigo de Revista Científica
Publicado em //2012 EN
Relevância na Pesquisa
56.25%
Pregnancy induces a number of alterations to maternal physiology to accommodate the increased demands made by the developing fetus and placenta. These alterations appear at least in part to be driven by products derived from the feto-placental unit, including microchimeric cells, as well as placental exosomes and microparticles, inducing changes to maternal physiology both during pregnancy and beyond. Further, increasing evidence suggests that some of these alterations are dependent on the sex of the fetus. Pre-eclampsia and asthma represent two common pregnancy complications that have provided valuable insight into how the feto-placental unit influences maternal physiology in a sex-specific manner. Pregnancy-induced alterations in maternal physiology may expose pre-existing subclinical pathologies and provide insight into future maternal health and disease. While most pregnancy-induced alterations to the maternal system are reversed following delivery, some can persist after parturition leading to cardiovascular, metabolic and autoimmune disease and increased risk of early mortality.; V.L. Clifton, M.J. Stark, A. Osei-Kumah and N.A. Hodyl

Interventions for Trichomoniasis in Pregnancy; Cochrane Database Syst Rev

Gulmezoglu, A. M.; Azhar, M.
Fonte: Banco Mundial Publicador: Banco Mundial
Tipo: Journal Article; Journal Article
EN
Relevância na Pesquisa
56.27%
BACKGROUND: Vaginitis due to Trichomonas vaginalis is one of the most common of sexually transmitted diseases. Trichomoniasis affects women during pregnancy as well but it is not clearly established whether it causes preterm birth and other pregnancy complications. OBJECTIVES: The objective of this review was to assess the effects of various treatments for trichomoniasis during pregnancy. SEARCH STRATEGY: We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (14 January 2011). SELECTION CRITERIA: Randomized trials comparing anti-trichomonas agents during pregnancy. Trials including symptomatic or asymptomatic women with trichomoniasis were eligible. DATA COLLECTION AND ANALYSIS: Two review authors assessed eligibility and trial quality. MAIN RESULTS: We included two trials with 842 pregnant women. In both trials around 90% of women were cleared of trichomonas in the vagina after treatment. In the US trial, women with asymptomatic trichomoniasis between 16 and 23 weeks were treated with metronidazole on two occasions at least two weeks apart. The trial was stopped before reaching its target recruitment because metronidazole was not effective in reducing preterm birth and there was a likelihood of harm (risk ratio 1.78; 95% confidence interval 1.19 to 2.66). The South African trial recruited women later in pregnancy and did not have the design and power to address adverse clinical outcomes. We excluded two recent studies...

Maternal Mortality; Mortalidade materna Mortalite maternelle Mortalidad materna

World Bank
Fonte: Washington, DC Publicador: Washington, DC
Tipo: Publications & Research :: Brief; Publications & Research
ENGLISH
Relevância na Pesquisa
46.47%
Over 529,000 women die annually from complications during pregnancy, childbirth, or the postpartum period. Nearly all of these deaths occur in developing countries, where fertility rates are higher and a woman's life time risk of dying during pregnancy and childbirth is over 400 times higher than in developed countries. Additionally, an estimated 20 million women endure lifelong disabilities such as pelvic pain, incontinence, obstetric fistula, anemia and infertility. The main direct causes of maternal death are severe bleeding, unsafe abortion, infection, eclampsia, and obstructed labor; the indirect causes include anemia, malaria, heart disease, and HIV. Pregnancy complications are the main cause of death for women aged 15-19. High maternal mortality rates in many countries result from poor reproductive health care, including not having access to skilled care during pregnancy and childbirth and access to safe abortion even where it is legal, especially for the poorest women. Risks of poor outcomes during pregnancy and childbirth are exacerbated by poverty...

Spatial analysis of pregnancy complications associated with maternal cardiovascular disease risk in Ontario

Stortz, Jessica
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
56.51%
Aim: The aim of this study was to: 1) investigate the geographic distribution of six pregnancy complications associated with future maternal cardiovascular disease risk in the province of Ontario and 2) to identify regions where women are likely to benefit from post-partum cardiovascular disease screening, based on the development of complications during pregnancy. Rationale: Cardiovascular disease is the leading cause of death in Canadian women. Pregnancy has been likened to a cardiovascular stress test and provides an early opportunity to assess a female’s lifetime risk of cardiovascular disease. Methods: This study was a retrospective analysis of data collected for the Niday Perinatal Database, provided by the Better Outcomes Registry & Network. Crude and age-standardized cumulative incidences of six pregnancy complications, and one or more pregnancy complications, were calculated for each Public Health Unit area in Ontario. The cumulative incidence of one or more pregnancy complications for women with no previous history of cardiovascular disease or traditional cardiovascular risk factors was calculated at the Public Health Unit and census subdivision area levels. Spatial statistics were applied to locate statistically significant clusters of high cumulative incidence. Results: Crude and age-standardized cumulative incidences of each pregnancy complication and one or more pregnancy complications varied across Public Health Unit areas in Ontario. The crude cumulative incidence of one or more complications ranged from 74 to 224 cases per 1000 pregnancies. The spatial analysis identified one statistically significant cluster of high cumulative incidence at the Public Health Unit area level...

Associations Between Pregnancy-Related Complications, Work and Non-Work Physical Activity and Elevated Blood Pressure in Female Hospital Employees

van de Ven-Dantes, Jane
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
56.44%
Abstract Objectives: To determine whether work and non-work physical activity (PA) modifies the relationship between pregnancy-related complications and future increased blood pressure (BP) in adult working women. Methods: Female full-time and part-time employees from a tertiary care hospital in South East Ontario (n = 330) provided demographic, PA and history of pregnancy complications information, and participated in anthropometric examination. Participants were classified according to BP status: 1) normal, defined as systolic blood pressure (SBP) < 120 mmHg and/or diastolic blood pressure (DBP) < 80 mmHg; and increased, defined as SBP ≥120 mmHg and/or DBP ≥ 80 mmHg or taking antihypertensive medication for BP control. Levels of PA and sedentary behaviour were calculated using the validated Global Physical Activity Questionnaire, which evaluates PA in the domains of work, transportation, and recreation. Results: Nineteen percent of the sample reported having a pregnancy-related complication. Thirty five percent of participants were classified as having increased BP. Logistic regression analysis determined that working women with a history of pregnancy complications had an increased risk of having elevated BP, after controlling for covariates such as age...

THE ROLE OF ABNORMAL MATERNAL INFLAMMATION IN THE PATHOGENESIS OF PREGNANCY COMPLICATIONS

COTECHINI, TIZIANA
Fonte: Quens University Publicador: Quens University
Tipo: Tese de Doutorado
EN; EN
Relevância na Pesquisa
56.38%
Pre-eclampsia (PE), fetal growth restriction (FGR) and fetal death are common complications associated with human pregnancy. A hallmark of these adverse pregnancy outcomes is reduced utero-placental perfusion, which is believed to arise as a consequence of deficient trophoblast-mediated spiral artery remodelling. Other common features of PE, FGR and fetal demise include reduced nitric oxide (NO) bioavailability, alterations in maternal hemostasis and an abnormal maternal inflammatory response. Despite all that is known, the causative factors leading to the development of these adverse pregnancy outcomes remain unidentified. The results of this thesis identify aberrant maternal inflammation as key to the pathogenesis of PE, FGR and fetal loss using a rat model in which pregnant rats are injected with low-dose lipopolysaccharide (LPS). In particular, our in vivo animal studies revealed a causal role for tumour necrosis factor-alpha (TNF) in the development of FGR, features of PE and the development of maternal coagulopathies associated with fetal death. Our work also revealed a pregnancy-specific effect whereby the deleterious effects of LPS administration to pregnant rats (i.e. cytokine release, glomerular pathology, elevated white blood cell counts) did not occur to the same magnitude when LPS was administered to non-pregnant animals. Gross examination of placentas from saline and LPS-treated animals revealed that inflammation altered placental morphometrics resulting in reduced placental weight and area. Importantly...

Evaluation of the knowledge of pregnant women about the relationship between oral diseases and pregnancy complications

Catão,Carmem Dolores de Sá; Gomes,Thaissa de Amorim; Rodrigues,Rachel Queiroz Ferreira; Soares,Renata de Souza Coelho
Fonte: Universidade Estadual Paulista Júlio de Mesquita Filho Publicador: Universidade Estadual Paulista Júlio de Mesquita Filho
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/02/2015 EN
Relevância na Pesquisa
56.24%
INTRODUCTION: Chronic persistent low-level infection in pregnant women, such as periodontal disease (PD) may impair maternal-fetal unit, since the infectious process induces the release of chemical mediators involved in the process of prematurity. OBJECTIVE: To assess the knowledge of mothers as regards the relationship between oral diseases and pregnancy complications. METHOD: A cross-sectional epidemiological study was conducted with 104 pregnant women indexed in the Primary Care Information System (SIAB), in the Family Health Strategies (FHS), using a structured questionnaire. Data were recorded in SPSS and analyzed using descriptive and inferential statistics, considering a significance level of 5%. RESULT: Most patients (64.4%) were domestic workers, (48.1%) aged 24 to 34 years, (55.8%) showed complete the 2nd grade and incomplete high school education, and (49%) were primiparous. Among the participants, 76% were unaware of the relationship between oral disease, prematurity and giving birth to low birth weight babies. Statistically significant association was found between: educational level and knowledge about prenatal dental care (p = 0.012); since it was shown that 90.4% ignored the existence of this activity and 65.4% had never received information about the care of baby's oral hygiene (p = 0.003). CONCLUSION: Most women were unaware of the relationship of PD with prematurity...

Placental endoplasmic reticulum stress negatively regulates transcription of placental growth factor via ATF4 and ATF6 ?: implications for the pathophysiology of human pregnancy complications

Mizuuchi, Masahito; Cindrova-Davies, Tereza; Olovsson, Matts; Charnock-Jone, D. Stephen; Burton, Graham J.; Yung, Hong Wa
Fonte: Wiley Publicador: Wiley
Tipo: Article; accepted version
EN
Relevância na Pesquisa
56.31%
This is the author accepted manuscript. The final version is available from Wiley via http://dx.doi.org/10.1002/path.4678; Low maternal circulating concentrations of placental growth factor (PlGF) are one of the hallmarks of human pregnancy complications, including fetal growth restriction (FGR) and early-onset pre-eclampsia (PE). Currently, PlGF is used clinically with other biomarkers to screen for high-risk cases, although the mechanisms underlying its regulation are largely unknown. Placental endoplasmic reticulum (ER) stress has recently been found to be elevated in cases of FGR, and to an even greater extent in early-onset PE complicated with FGR. ER stress activates the unfolded protein response (UPR); attenuation of protein translation and a reduction in cell growth and proliferation play crucial roles in the pathophysiology of these complications of pregnancy. In this study, we further identified that ER stress regulates release of PlGF. We first observed that down-regulation of PlGF protein was associated with nuclear localization of ATF4, ATF6? and ATF6? in the syncytiotrophoblast of placentas from PE patients. Transcript analysis showed a decrease of PlGF mRNA, and an increase from genes encoding those UPR transcription factors...

The effects of anemia on pregnancy outcome in patients with pyelonephritis.

Dotters-Katz, SK; Grotegut, CA; Heine, RP
Fonte: Universidade Duke Publicador: Universidade Duke
Tipo: Artigo de Revista Científica Formato: 780960 - ?
Publicado em //2013 ENG
Relevância na Pesquisa
56.33%
OBJECTIVE: Pyelonephritis is a common infectious morbidity of pregnancy. Though anemia is commonly associated with pyelonephritis, there are little data describing the effect of pyelonephritis with anemia on pregnancy outcomes. The purpose of this study was to further assess the association of anemia with infectious morbidity and pregnancy complications among women with pyelonephritis. STUDY DESIGN: We conducted a retrospective cohort study of pregnant women admitted to Duke University Hospital between July 2006 and May 2012 with pyelonephritis. Demographic, laboratory, and clinical data from the subject's pregnancy and hospitalizations were analyzed. Patients with pyelonephritis and anemia (a hematocrit < 32) were compared to those without anemia. Descriptive statistics were used to compare the two groups. RESULTS: 114 pregnant women were admitted with pyelonephritis and 45 (39.5%) had anemia on admission. There was no significant difference in age, race, preexisting medical conditions, or urine bacterial species between patients with anemia and those without. Women with anemia were more likely to deliver preterm (OR 3.3 (95% CI 1.07, 11.4), P = 0.04). When controlling for race and history of preterm delivery, women with anemia continued to have increased odds of preterm birth (OR 6.0...