Background Undernutrition disrupts pregnant ewe's metabolic homeostasis and severely inhibits fetal growth and development.In this study,undernourished and nutrition-recovery pregnant sheep models and rumen epithe...Background Undernutrition disrupts pregnant ewe's metabolic homeostasis and severely inhibits fetal growth and development.In this study,undernourished and nutrition-recovery pregnant sheep models and rumen epithelial cells were utilized to investigate the mechanisms behind undernutrition-induced disruptions in male fetal rumen metabolism and development.Results Maternal undernutrition significantly reduced male fetal rumen weight and papilla length,width and surface area.Maternal undernutrition extremely suppressed nutrient metabolism and energy production in male fetal rumen via JAK3/STAT3 signaling to inhibit cell cycle progression and male fetal rumen development,while maternal nutritional recovery partially restored metabolic inhibition but failed to alleviate male fetal rumen development.Meanwhile,64 differentially expressed miRNAs(DEMs)were identified in male fetal rumen between undernourished ewes and controls.Novel miR-736 was overexpressed both in male fetal rumen of undernourished and nutrition-recovery models.E2F transcription factor 2(E2F2)and MYB proto-oncogene like 2(MYBL2)were the intersection of male fetal rumen differentially expressed genes(DEGs)and DEMs target genes integrated analysis and were predicted as novel miR-736 target genes.Further,we confirmed that novel miR-736 targeted and downregulated E2F2 and MYBL2 expression levels.Silencing E2F2 and MYBL2 promoted apoptosis and inhibited S-phase entry in rumen epithelial cells.Conclusions In summary,maternal undernutrition disrupted male fetal rumen metabolism and elevated novel miR-736,which targeted and downregulated E2F2 and MYBL2 to inhibit cell cycle progression and promote apoptosis,finally inhibited male fetal rumen development.This study provides new insights into the epigenetic mechanisms underlying maternal undernutrition-induced male fetal rumen developmental deficits.展开更多
Decidual natural killer(dNK)cells are believed to be critical for maintaining maternal/fetal tolerance and regulating placental vascular remodeling based upon their abundance and unique phenotype during early pregnanc...Decidual natural killer(dNK)cells are believed to be critical for maintaining maternal/fetal tolerance and regulating placental vascular remodeling based upon their abundance and unique phenotype during early pregnancy.However,the mechanism for how the dNK cells play such important roles in successful pregnancy remains undefined.Here,we identified a subtype of dNK cells characterized as having a CD3-CD56^brightCD25^+phenotype.We found that CD56^brightCD25^+NK cells preferentially localize to the maternal/fetal interface during early human pregnancy.CD25^+dNK cells account for approximately 75%of CD25-expressing decidual immune cells(DICs).However,less than 5%of CD25-positive peripheral blood mononuclear cells are CD25^+NK cells.Furthermore,CD25^+and CD25^-dNK cells exhibit distinct phenotypes:CD25^+dNK cells display a more activated phenotype and greater cytokine-secreting capacity.Interestingly,coculture of peripheral NK(pNK)cells with primary trophoblasts upregulates the percentage of CD25-expressing pNK cells,resulting in increased expression of activation markers and cytokine production by pNK cells.In addition,we demonstrated that the CXCL12/CXCR4 axis is crucial for the recruitment of CD25^+dNK cells and contributes to the accumulation of CD3^-CD56^brightCD25^+dNK cells at the maternal/fetal interface.Thus,our data reveal that the crosstalk between trophoblasts and pNK cells leads to the accumulation of CD3^-CD56^brightCD25^+dNK cells,which exert a regulating effect at the maternal/fetal interface.展开更多
The regulatory mechanism of Th2 bias at the maternal/fetal interface remains unclear. In this study, we characterized cytokine production in decidual stromal cells （DSCs）, decidual immune cells （DICs） and embryo-d...The regulatory mechanism of Th2 bias at the maternal/fetal interface remains unclear. In this study, we characterized cytokine production in decidual stromal cells （DSCs）, decidual immune cells （DICs） and embryo-derived trophoblast cells, and investigated the regulation of CXCL12/CXCR4 interaction on Th2 bias at the maternal/fetal interface in early human pregnancy. We found differential production of Th 1-type and Th2-type cytoki nes by trophoblasts, DSCs and DICs. The secretion of these cytokines varied in different cell cocultures, conduced to Th2 bias. Flow cytometry showed that coculture of trophoblasts with DSCs and DICs significantly increased IL-4 and IL-IO production in trophoblasts, and IL-IO production in DSCs. However, the coculture of trophoblasts with DSCs and DICs significantly increased interferon （IFN）-7 expression in DSCs, and tumor-necrosis factor （TNF）-a expression in DICs. No change was seen in Thl-type cytokine production in trophoblasts, and in Th2-type cytokine production in DICs in all cocultures. Furthermore, pre-treatment with anti-CXCR4 neutralizing antibody upregulated the production of the Thl-type cytokines IFN-y and TNF-a, and downregulated the production of the Th2-type cytokines IL-4 and IL-IO, in trophoblasts, DSCs, DICs or their cocultures. Interestingly, rhCXCL12 inhibited production of the Thl-type cytokine TNF-a and enhanced the expression of the Th2-type cytokines such as IL-4 and IL-IO in DICs; this effect was abrogated by anti-CXCR4 antibody. Our present study has elucidated the individual contributions of component cells to the shaping of Th2 bias, and uncovered a complicated cross-talk viathe CXCL12/CXCR4 signal at the maternal/fetal interface in early human pregnancy.展开更多
The oviduct epithelium is the initial maternal contact site for embryos after fertilization,offering the microenviron-ment before implantation.This early gestation period is particularly sensitive to stress,which can ...The oviduct epithelium is the initial maternal contact site for embryos after fertilization,offering the microenviron-ment before implantation.This early gestation period is particularly sensitive to stress,which can cause reduced fertil-ity and reproductive disorders in mammals.Nevertheless,the local impact of elevated stress hormones on the ovi-duct epithelium has received limited attention to date,except for a few reports on polyovulatory species like mice and pigs.In this study,we focused on the effects of chronic maternal stress on cattle,given its association with infertil-ity issues in this monoovulatory species.Bovine oviduct epithelial cells(BOEC)differentiated at the air–liquid interface(ALI)were stimulated with 250 nmol/L cortisol for 1 or 3 weeks.Subsequently,they were assessed for morphology,bioelectrical properties,and gene expression related to oviduct function,glucocorticoid pathway,cortisol metabo-lism,inflammation,and apoptosis.Results revealed adverse effects of cortisol on epithelium structure,featured by deciliation,vacuole formation,and multilayering.Additionally,cortisol exposure led to an increase in transepithelial potential difference,downregulated mRNA expression of the major glucocorticoid receptor(NR3C1),upregulated the expression of cortisol-responsive genes(FKBP5,TSC22D3),and significant downregulation of oviductal glycopro-tein 1(OVGP1)and steroid receptors PGR and ESR1.The systematic comparison to a similar experiment previously performed by us in porcine oviduct epithelial cells,indicated that bovine cultures were more susceptible to elevated cortisol levels than porcine.The distinct responses between both species are likely linked to their divergence in the cortisol-induced expression changes of HSD11B2,an enzyme controlling the cellular capacity to metabolise cortisol.These findings provide insights into the species-specific reactions and reproductive consequences triggered by maternal stress.展开更多
In this study, the expression of IL-24 at maternal-fetal interface and the roles in extravillous trophoblast （the TEV-1 cell line） invasion were examined. Immunohistochemistry was used to detect the expression of IL...In this study, the expression of IL-24 at maternal-fetal interface and the roles in extravillous trophoblast （the TEV-1 cell line） invasion were examined. Immunohistochemistry was used to detect the expression of IL-24 in villi and decidual tissue. The proliferation of TEV-1 cells under the effect of IL-24 was measured by MTT assay. The invasiveness of TEV-1 cells under the effect of recombinant IL-24 （rhIL-24） was examined by transwell system. Immunohistochemical detection showed that IL-24 was expressed in the villi and decidual tissue, and distributed in villous column, trophoblasts, stroma and blood vessels. The proliferation of TEV-1 cells was not inhibited by rhIL-24 of various concentrations. The examination of invasion in vitro showed that rhIL-24 could inhibit the invasion of TEV-1 cells in a concentration-dependent manner. The results suggested IL-24 could inhibit the invasion of TEV-1 cells. Therefore, IL-24 produced by maternal-fetal interface in human first trimester pregnancy may influence the invasion of trophoblasts and is involved in normal pregnancy.展开更多
Over 1 billion people globally are estimated to be infected with Toxoplasma gondii with severe or unknown consequences and no safe and effective therapies are available against congenital or persistent chronic infecti...Over 1 billion people globally are estimated to be infected with Toxoplasma gondii with severe or unknown consequences and no safe and effective therapies are available against congenital or persistent chronic infection. We propose that atovaquone and diclazuril synergistically protect against fetal-maternal toxoplasmosis. Methods: Programmed pregnant mice were treated with atovaquone and diclazuril monotherapy, or combined (atovaquone + diclazuril) therapy and infected with tachyzoites (0, 300, 600) and the course of infection was studied. Results: Infected dams with low dose (300) developed moderate toxoplasmosis complications and treatments were similarly effective with minor differences between monotherapies. In contrast, major differences were observed amongst varied treatments during high-dose (600) infection and severe related-toxoplasmosis complications as follows. Dams developed hydrothorax, ascities and excess weight gain. Combined therapy (P < 0.01) and to a lesser extent diclazuril monotherapy (P 0.05) protected dams from excess weight, hydrothorax, and ascities. Infected dams exhibited splenomegaly, hepatomegaly and severe hepatitis. Combined therapy synergistically normalized pathology (P < 0.001) and to a lesser degree monotherapy (diclazuril P 0.01, and atovaquone P 0.05) protected dams from hepatitis and splemomegaly. Additionally, behavioral response to pain stimuli and fetal weight and fetal numbers were significantly preserved in treated dams. Conclusions: This is the first report describing combined atovaquone and diclazuril therapy a) to be safe in pregnancy, b) to exert novel synergistic effects, and c) to protect dams and their nested fetuses against adverse effects of severe toxoplasmosis.展开更多
BACKGROUND: Premature rupture of membrane(PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is ver...BACKGROUND: Premature rupture of membrane(PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is very important to decrease maternal and child mortality and for better management and prevention of complications. Thus, this study aimed to detect the maternal and fetal outcomes and associated factors in term PROM at Mizan-Aman General Hospital, south-west Ethiopia.METHODS: A retrospective cross sectional study was conducted using data available at MizanAman General Hospital during a period of 3 years(January 2011 to December 2013). We examined records of 4 525 women who gave birth in the hospital; out of these women, 185 were diagnosed with term PROM and all of them were included in the study. The data of these women were collected using a checklist based on registration books. The data were analyzed using SPSS version 20.0 statistical package. The association between independent and dependent variables was assessed by bivariate and multiple logistic regression analyses. 95%CI and P value less than 0.05 were considered statistically signifi cant.RESULTS: Of the 4 525 women who gave birth in the hospital, 202 were complicated by term PROM. About 22.2% of the women showed unfavorable maternal outcomes. The most common cause of maternal morbidity and mortality was puerperal sepsis. About 33.5% of neonates experienced unfavorable outcomes. The duration of PROM >12 hours(AOR=5.6, 95%CI 1.3–24.1) latency >24 hours(AOR=2.8, 95%CI 1.7–11.8), residing in rural areas(AOR=4.2, 95%CI 3.96–29.4) and birth weight less than 2 500 g were associated with unfavorable outcomes.CONCLUSION: Women residing in rural areas, long latency, and neonates with birth weight less 2 500 g may have unfavorable outcomes. Therefore, optimum obstetric and medical care is essential for the reduction of the devastating complications related to disorders.展开更多
Objective To explore the effects of prenatal exposure to polybrominated diphenyl ethers(PBDEs)on placental size and birth outcomes.Methods Based on the perspective Wenzhou Birth Cohort,this nested case-control study i...Objective To explore the effects of prenatal exposure to polybrominated diphenyl ethers(PBDEs)on placental size and birth outcomes.Methods Based on the perspective Wenzhou Birth Cohort,this nested case-control study included 101 fetal growth restriction(FGR)and 101 healthy newborns.Maternal serum samples were collected during the third trimester and measured for PBDEs by gas chromatography tandem mass spectrometry.The basic information of mother-newborn pairs was collected from questionnaires,whereas the placental size and birth outcomes of newborns were obtained from hospital records.Results A total of 19 brominated diphenyle ether(BDE)congeners were detected in maternal serum samples.Higher concentrations of BDE-207,-208,-209,and∑19PBDEs were detected in FGR cases than in controls.Increased BDE-207,-208,-209,and∑19PBDEs levels in maternal serum were related to decreased placental length,breadth,surface area,birth weight,birth length,gestational age,and Quetelet index of newborns.After adjusting for confounders,BDE-207 and∑19PBDE concentrations in maternal serum were significantly associated with an increased risk of FGR.Conclusion A negative association was found between PBDE levels in maternal serum and placental size and birth outcomes.Prenatal PBDE exposure may be associated with elevated risk of the incidence of FGR birth.展开更多
BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventio...BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.展开更多
Introduction:Diabetes mellitus(DM),a metabolic disorder,leads to organ damage due to chronic hyperglycemia with multiple pathogenic processes.Gestational diabetes mellitus(GDM)poses risks to mothers and offspring,incr...Introduction:Diabetes mellitus(DM),a metabolic disorder,leads to organ damage due to chronic hyperglycemia with multiple pathogenic processes.Gestational diabetes mellitus(GDM)poses risks to mothers and offspring,increasing the incidence of structural congenital heart disease(CHD)and myocardial hypertrophy in newborns.Objective:This review aimed to examine the association between maternal diabetes mellitus and CHD.Methods:This systematic review used the STROBE and TRIPOD checklists registered in PROSPERO(CRD42024513858).It focused on diagnostic test accuracy using the Munn et al.protocol for systematic assessment,emphasizing the“PIRD”:Population,Index Test,Reference Test,Diagnosis of Interest.This review aimed the following PIRD model question:‘Does diabetic pregnant woman inffuence in fetal cardiac malformation?’using PRISMA 2020 statement.A systematic review was conducted on 19 October 2023 in the following databases:PubMed/MEDLINE,Embase(Elsevier),CINAHL(EBSCO),Scopus(Elsevier),Web of Science(Clarivate Analytics),LILACS,and SciELO.Only articles in English,Spanish,and Portuguese languages were selected.Results:Seven studies between 2018 and 2023 were selected.The studies differed in terms of the cardiac ultrasound parameters used to assess CHD and diagnose diabetes mellitus in pregnancy.They highlight the importance of fetal echocardiography in detecting CHD prenatally and assessing the impact of diabetes mellitus on fetal cardiac health,recommending proactive care planning and early intervention for better outcomes.Conclusions:The studies highlight the impact of maternal diabetes mellitus,particularly GDM,on fetal cardiac development and support early detection by fetal echocardiography.Standardization and collaboration are essential to reffne management and outcomes in high-risk pregnancies.展开更多
<strong>Objectives:</strong> The goal was to assess the risk factors for emergency cesarean section versus prophylactic caesarean section. <strong>Materials and Methods:</strong> This was a des...<strong>Objectives:</strong> The goal was to assess the risk factors for emergency cesarean section versus prophylactic caesarean section. <strong>Materials and Methods:</strong> This was a descriptive analytical cross-sectional study of the Type Cas/Witnesses at the Reference Health Centre of Commune V of the District of Bamako in Mali. The sample consisted of 100 cases for 200 controls (1 case for 2 controls) with retrospective collection of data for the period from January 1 to July 11, 2011 (6 months and 11 days). <strong>Results:</strong> During the study period, out of a total of 3559 deliveries, we recorded 2,794 vaginal deliveries, 78.50% and 765 caesarean sections or 21.50%. Of the 765ceras, we performed 353 emergency caesarean sections or 46.15% and 412 prophylactic caesarean sections 53.85%. We have selected 100 prophylactic caesarean section files and 200 emergency caesarean section files. The average age of the patients was 27.41 years-5.84 with extreme ages of 14 to 40 years. 100% of our patients (Cas) had performed at least one antenatal consultation compared to 83.5% of the parturients evacuated (Witnesses). The most frequently cited reasons for evacuation were: acute fetal suffering, non-cephalic presentation and excessive uterine height with 30%, 17.5% and 12% respectively. The bulk of the caesarean section indications were dominated by dystocies with 90% in cases compared to 65% in Witnesses, followed by acute fetal suffering with 30% in Witnesses. We recorded 30% perinatal deaths among Witnesses compared to 1% in Cases. We recorded 16 uterine ruptures in the Witnesses among which 2 hysterectomies and 14 hystererraphia. <strong>Conclusion:</strong> Prophylactic caesarean section improves maternal and perinatal prognosis more than emergency caesarean section.展开更多
Non-invasive prenatal gene diagnosis has been developed rapidly in the recent years,and numerous medical researchers are focusing on it.Such techniques could not only achieve prenatal diagnosis accurately,but also pre...Non-invasive prenatal gene diagnosis has been developed rapidly in the recent years,and numerous medical researchers are focusing on it.Such techniques could not only achieve prenatal diagnosis accurately,but also prevent tangential illness in fetuses and thus,reduce the incidence of diseases.Moreover,it is non-invasive prenatal gene diagnosis that prevents potential threaten and danger to both mothers and fetuses.Therefore,it is welcomed by clinical gynecologist and obstetrian,researchers of medical genetics,and especially,pregnancies.This review article touches briefly on the advanced development of using cell-free DNA,RNA in maternal plasma and urine for non-invasive prenatal gene diagnosis.展开更多
Introduction: Female Genital Mutilation (FGM) is a public health problem. There are 100 to 140 million girls and women who suffer every year in the world [1]. The aim of this study is to improve the medical care and r...Introduction: Female Genital Mutilation (FGM) is a public health problem. There are 100 to 140 million girls and women who suffer every year in the world [1]. The aim of this study is to improve the medical care and reduce complications of FGM at the Regionalhospital of N’zérékoré, to determine their frequency, and to evaluate the maternal-fetalprognosis. Methods: The study was conducted at the Regional Hospital of N’zérékoré. This was a cross-sectional, descriptive and analytic study of 6 months, from 1 September 2016 to 28 February 2017, including all pregnant women admitted for childbirth who had a complication of female genital mutilation. Results: A total of 1295 women gave birth in the service, of which 1204 women were women with female genital mutilation. Given a frequency of 92.97%, of these 1204 mutilated women, 223 presented obstetrical complications during their delivery, a proportion of 17.22%. They were mostly young patients, mostly housewives who were not in school. Type II FGM was the most common (53.06%). Obstetric complications were dominated by complicated perinatal tears (54.08%), and hemorrhages (40.81%). The catch was dominated by perineorrhaphy. Conclusion: The frequency of FGM was 92.97% and that of their obstetric complications 17.22%. Most were house-wives, not in school. There was FGM type II. The abandonment of FGM would reduce maternal and perinatal morbidity and mortality.展开更多
Background: Women awaiting fetal echocardiography (fECHO) report high anxiety. It is unclear if anxiety decreases after performance of fECHO. Methods: At fECHO, subjects’ current (state) vs baseline (trait) anxiety w...Background: Women awaiting fetal echocardiography (fECHO) report high anxiety. It is unclear if anxiety decreases after performance of fECHO. Methods: At fECHO, subjects’ current (state) vs baseline (trait) anxiety was assessed using the Spielberger State-Trait Anxiety Inventory. Anxiety scores of the pre- and post-fECHO groups were compared. Results: From January 2007 to January 2009, we recruited 84 subjects: 40 pre-fECHO and 44 post-fECHO. Of the post-fECHO group, 30 had normal fetal cardiac structure and function confirmed, 12 were told of an abnormality, and 2 were told to follow up equivocal results. Anxiety scores were compared between the 40 pre-fECHO subjects and the 30 post-fECHO subjects with normal results. The mean state anxiety score of the pre-fECHO group was higher than that of the post-fECHO group (42.1 ± 15.1 vs 30.8 ± 8.5, p < 0.001);there was no difference in trait scores. Neither state nor trait anxiety was associated with maternal age, parity, history of miscarriage or known fetal anomaly. Compared to those with a normal fECHO (N = 30), subjects with an abnormal fECHO result (N = 12) had higher state anxiety (46.8 ± 15.5 vs 30.8 ± 8.5, p = 0.005). There was no difference in anxiety scores between subjects awaiting fECHO and post-fECHO subjects who had an abnormal result. Conclusion: Immediately following normal fECHO, women report low anxiety compared with women awaiting fECHO. Women awaiting fECHO report anxiety levels that are as high as women who are told there is fetal cardiac anomaly.展开更多
<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Urinary tract infection (UTI) is common in pregnancy...<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and </span><span style="font-family:Verdana;">health expenditure. The burden of this condition has been understudied in Came</span><span style="font-family:Verdana;">roon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Re</span><span><span style="font-family:Verdana;">ferral Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted an analytic matched case-control study </span></span><span style="font-family:Verdana;">of 206 pregnant wom</span><span style="font-family:Verdana;">en with evid</span><span style="font-family:Verdana;">ence of uri</span><span style="font-family:Verdana;">nary tract infectio</span><span style="font-family:Verdana;">n (103 cases)</span><span style="font-family:Verdana;"> an</span><span style="font-family:Verdana;">d </span><span style="font-family:Verdana;">those without (103 controls) who underwent antenatal care and gave birth at </span><span style="font-family:Verdana;">the DRH from January 2019 to April 2019. Socio-demographic, laboratory and</span> <span style="font-family:Verdana;">maternal-fetal outcome data were collected using a pre-tested structured questionnai</span><span style="font-family:Verdana;">re and analyzed with SPSS version 23. Statistical significance was set at </span><span><span style="font-family:Verdana;">p < 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> (51.5%), </span><i><span style="font-family:Verdana;">Proteus mirabilis</span></i><span style="font-family:Verdana;"> (15.5%), </span><i><span style="font-family:Verdana;">S</span></i></span><i><span style="font-family:Verdana;">taphylococcus aureus</span></i><span style="font-family:Verdana;"> (11.7%) and </span><i><span style="font-family:Verdana;">Klebsiella sp</span></i><span style="font-family:Verdana;">. (6.8%) were the predominant uropathogens of UTI. Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1;95% CI: 1.11 - 3.55, p = 0.0023), preterm labor (AOR 4.4;95% CI: 1.0 - 2.7, p = 0.008) and preterm birth (AOR 4.6;95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth weight (AOR 2.1;95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13;95% CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5;95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> was the main uropathogenic </span><span style="font-family:Verdana;">agent of UTI during pregnancy. Maternal outcomes of UTI were puerperal pyel</span><span style="font-family:Verdana;">onephritis, preterm labor and delivery while fetal outcomes include: low-birth </span><span style="font-family:Verdana;">weight, neonatal infection and neonatal intensive care admission. Prompt diagnosis of this condition is the cornerstone to avoid adverse outcomes.</span></span></span></span>展开更多
Background: Studies on physical activity during pregnancy and its impact on mother and fetus are still limited. International protocols consider only aerobic exercise and fail to provide information about other modali...Background: Studies on physical activity during pregnancy and its impact on mother and fetus are still limited. International protocols consider only aerobic exercise and fail to provide information about other modalities such as isometric exercise. Isometric exercise promotes cardiorespiratory resistance and muscle strengthening, but it is rarely tested on pregnant women because it increases maternal blood pressure and can subsequently affect placental circulation. Objective: To evaluate maternal and fetal response of low-risk pregnant women undergoing isometric testing through a Doppler velocimetry study. Methodology: A cross-sectional, experimental study was performed on 46 healthy pregnant women (gestational age between 26 and 36 weeks) who underwent isometric testing. This testing was performed using a handgrip dynamometer to measure maternal and fetal hemodynamic parameters before, during, and after isometric testing. Results: There was a significant increase in systolic blood pressure (BP;pre-isometrics 113.13 ± 9.92 mmHg, during isometrics 117.13 ± 10.24 mmHg, and post-isometrics 112.43 ± 9.87 mmHg, p 0.001) and heart rate (HR;pre-isometrics 87.52 ± 14.10 bpm, during isometrics 97.61 ± 14.83 bpm, and post-isometrics 85.13 ± 13.24 bpm, p 0.001). There were significant decreases in the pulsatility index (PI;pre-isometrics 0.63 ± 0.15, during isometrics 0.56 ± 0.15, and post-isometrics 0.65 ± 0.17, p = 0.001), resistance index (RI;pre-isometrics 0.44 ± 0.08, during isometrics 0.40 ± 0.07, and post-isometrics 0.45 ± 0.08, p = 0.001), and systolic/diastolic (S/D) ratio (pre-isometrics 1.81 ± 0.26, during isometrics 1.69 ± 0.24, and post-isometrics 1.85 ± 0.29, p 0.001) of the left uterine artery (UA). These results showed significant changes only during the isometric exercise, and not between the pre- and post-isometric exercises. There were no significant differences in fetal parameters when the results before, during, and after the isometric test were compared. Conclusion: Isometric testing had no repercussions for fetal hemodynamics in healthy low-risk pregnant women.展开更多
<strong>Aim:</strong><span style="font-family:Verdana;"> To describe the epidemiological, therapeutic and prognostic aspects of eclampsia at the second reference hospital in the urban commu...<strong>Aim:</strong><span style="font-family:Verdana;"> To describe the epidemiological, therapeutic and prognostic aspects of eclampsia at the second reference hospital in the urban commune of Ségou in Mali.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Patient and Methods:</span></b><span style="font-family:Verdana;"> This was a descriptive, cross-sectional, analytical, retrospective and prospective study based on a comprehensive de-engineering.</span><span style="font-family:Verdana;"> It covered a 3-year period from January 1, 2010 to December 31, 2012 and involved 176 cases.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The incidence of eclampsia during the study period was 2.9%. Classically, it occurred in 74.4% in young primigeste, in 73.9% in the</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">3</span><sup><span style="font-family:Verdana;">rd</span></sup><span style="font-family:Verdana;"> trimester of pregnancy and 26.1% of cases during postpartum. We recorded maternal complications such as retro-placental hematoma, acute kidney failure and delivery hemorrhage. The case fatality rate was 2.3% or 4 cases of maternal death. At the fetal level, there was 29.5% prematurity, 31.8% neonatal suffering, 11.4% hypotrophy, 11.9% </span><i><span style="font-family:Verdana;">in</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">utero</span></i><span style="font-family:Verdana;"> fetal death and 7.4% early neonatal death.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The maternal-fetal prognosis remains reserved despite the progress made in the management of eclampsia in our services.</span>展开更多
Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the art...Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the artificial induction of labor with misoprostol. It was a descriptive prospective study conducted from September 1, 2018 to February 28, 2019 at the maternity unit of the Referral Health Center (RHC) in commune I of Bamako. It was about any pregnant woman at term who had received misoprostol as part of the artificial induction of labor. 102 cases of artificial induction with misoprostol 200 μg were collected out of 3641 deliveries, or a frequency of 2.8%. The age group 28 - 32 years accounted for 56.86% with an average age of 28.8 years. Multiparous represented 54.90% of the number. The history of diabetes and hypertension involved 37.25% of the pregnant women. The main indication was premature rupture of membranes (PRM) (40.2%). Induction was performed between the 37</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> and 41</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> week of amenorrhea (69.6%). The trigger index according to BISHOP was greater than 7 (50.98%). Induction was done only with 3/4 of misoprostol tablet 200 μg (43.14%). The average labor time was 7 hours (89.22%). The vaginal birth concerned 92.16% of pregnant women. An APGAR10 was noted in 97.85% of newborns after 05 minutes. AIL with misoprostol was practiced at the Center. The main indication was the premature rupture of the membranes. It improves the maternal and fetal prognosis.展开更多
<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</str...<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong> All pregnant women are at risk of obstetric complications </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">leading to high fetal-maternal mortality and morbidity. The aim of this work was to evaluate the maternal and fetal prognosis of evacuated parturients.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Patient and Method</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: we conducted a prospective analytical survey for four months, from April 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to July 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2018 in the Maternity of N’Djamena Mother and Child Hospital about the maternal and fetal prognosis of evacuated parturients. Any parturient evacuated or referred for obstetric complications was included. Study parameters were epidemiological, clinical, para-clinical, therapeutic and prognosis order. These parameters were analyzed in the SPSS 18 French version software.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: Evacuated parturients represented 20% of maternity admissions. The average age was 23.9 years, with extremes ranging from 15 and 43 years. They were uneducated in 72.9%, primiparous in 46.8% of cases. The three delays were dominated by the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> delay, which represented 34.1% of cases. In this series, 26.3% parturients had presented obstetric com</span><span style="font-family:Verdana;">plications. Preruptive syndrome was the most common complication with</span><span style="font-family:Verdana;"> 29.3% cases. Predisposing factors to maternal-fetal complications were low attendance antenatal care, late evacuation and distance travelled. The mater</span><span style="font-family:Verdana;">nal mortality rate was 3%. Fetal complications were observed in 28.3% of cas</span><span style="font-family:Verdana;">es and the neonatal mortality rate was 24.6%.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: The maternal </span><span style="font-family:Verdana;">and fetal complications of evacuated parturients are a real public health</span><span style="font-family:Verdana;"> problem in our regions. The suppression of delays, capacity reinforcement of peripheral maternity and the periodic recycling peripheral centers to recognize </span><span style="font-family:Verdana;">obstetric emergencies will contribute to improve the maternal and fetal</span><span style="font-family:Verdana;"> prognosis of evacuated parturients.</span></span></span></span>展开更多
<strong>Introduction:</strong><span style="font-family:Verdana;"> Uterine rupture is a complete or incomplete non-surgical continuity solution of the wall of the gravid uterus. Indeed, it i...<strong>Introduction:</strong><span style="font-family:Verdana;"> Uterine rupture is a complete or incomplete non-surgical continuity solution of the wall of the gravid uterus. Indeed, it is a Affection obstetrical condition whose maternal-fetal prognosis is poor in terms of morbidity and mortality. </span><span style="font-family:Verdana;"><strong>Objectives:</strong></span><span style="font-family:Verdana;"> To assess the risk factors for uterine rupture in the Koutiala Health District. </span><span style="font-family:Verdana;"><strong>Methods:</strong></span><span style="font-family:Verdana;"> This was a descriptive and analytical cross-sectional prospective collection study from January 1, 2019 to December 31, 2019, a 12-month period. In our study, all patients admitted to the maternity ward were included during the study period for which the diagnosis of uterine rupture was made. </span><span style="font-family:Verdana;"><strong>Results:</strong></span><span style="font-family:Verdana;"> Out of a total of deliveries, we recorded 27 cases of uterine rupture, a frequency of 1.04%. The average age of our patients was 32 years with extremes of 19 and 45 years. We notice 92.6% of uterine ruptures during the transfer. Almost 3/4 of our parturients were out of school 70.4% versus 11.1% in primary school and 18.5% in secondary school. The majority of patients affected by uterine rupture came from rural areas 85.2%. Only 14.8% were from Koutiala city. The admission time to the Koutiala Reference Health Centre was 2 hours 30 minutes in 50.85% of our patients with extremes of 15 minutes and 4 hours 30</span><span style="font-family:" color:windowtext;font-weight:normal;"=""> </span><span style="font-family:Verdana;">min. The average parity was 6.30 - 3036;large </span><span style="font-family:Verdana;">multiparous</span><span style="font-family:Verdana;"> accounted for 63% in our sample followed by </span><span style="font-family:Verdana;">multiparous</span><span style="font-family:Verdana;"> 18.5%. As for pregnancy follow-up, 100% of the patients had not performed any prenatal consultations. In 85.2% hysterrhaphy was performed intervention and hysterectomy in 14.8%. Maternal prognosis was satisfactory in 96.30% of cases. From the point of view of morbidity: 1 case of bladder-vaginal fistula was recorded and corrected by the bladder survey at home for 15 days. Late complications were the occurrence of anemia in 16 patients who were transfused and 1 case of phlebitis. We recorded 1 maternal death and 25 stillbirths. </span><span style="font-family:Verdana;"><strong>Conclusion:</strong></span><span style="font-family:Verdana;"> Uterine rupture is one of the leading causes of maternal and fetal mortality in Mali.</span>展开更多
基金supported by the National Natural Science Foundation of China(32402767)National Key Research and Development Program of China(2022YFD1301102)+3 种基金Anhui Province Natural Science Foundation Youth Project(2308085QC104)AAU Introduction of High-level Talent Funds(RC392107)Key Laboratory of Utilization of Livestock and Forage Resources in Circum-Tarim Region(Co-construction by Ministry and Province),Ministry of Agriculture and Rural Affairs(BSGJSYS202502)the China Agriculture Research System(CARS-38)。
文摘Background Undernutrition disrupts pregnant ewe's metabolic homeostasis and severely inhibits fetal growth and development.In this study,undernourished and nutrition-recovery pregnant sheep models and rumen epithelial cells were utilized to investigate the mechanisms behind undernutrition-induced disruptions in male fetal rumen metabolism and development.Results Maternal undernutrition significantly reduced male fetal rumen weight and papilla length,width and surface area.Maternal undernutrition extremely suppressed nutrient metabolism and energy production in male fetal rumen via JAK3/STAT3 signaling to inhibit cell cycle progression and male fetal rumen development,while maternal nutritional recovery partially restored metabolic inhibition but failed to alleviate male fetal rumen development.Meanwhile,64 differentially expressed miRNAs(DEMs)were identified in male fetal rumen between undernourished ewes and controls.Novel miR-736 was overexpressed both in male fetal rumen of undernourished and nutrition-recovery models.E2F transcription factor 2(E2F2)and MYB proto-oncogene like 2(MYBL2)were the intersection of male fetal rumen differentially expressed genes(DEGs)and DEMs target genes integrated analysis and were predicted as novel miR-736 target genes.Further,we confirmed that novel miR-736 targeted and downregulated E2F2 and MYBL2 expression levels.Silencing E2F2 and MYBL2 promoted apoptosis and inhibited S-phase entry in rumen epithelial cells.Conclusions In summary,maternal undernutrition disrupted male fetal rumen metabolism and elevated novel miR-736,which targeted and downregulated E2F2 and MYBL2 to inhibit cell cycle progression and promote apoptosis,finally inhibited male fetal rumen development.This study provides new insights into the epigenetic mechanisms underlying maternal undernutrition-induced male fetal rumen developmental deficits.
基金This work was supported by the Key Project of Shanghai Basic Research from Shanghai Municipal Science and Technology Commission(STCSM)(12JC1401600 to DJL)the Key Project of Shanghai Municipal Education Commission(MECSM)(14ZZ013 to MRD)+1 种基金the Nature Science Foundation from National Nature Science Foundation of China(NSFC)(NSFC31270969 to DJLNSFC81070537,NSFC31171437 and NSFC81370770 to MRD,NSFC31300751 to HLP,NSFC81370730 to QF).
文摘Decidual natural killer(dNK)cells are believed to be critical for maintaining maternal/fetal tolerance and regulating placental vascular remodeling based upon their abundance and unique phenotype during early pregnancy.However,the mechanism for how the dNK cells play such important roles in successful pregnancy remains undefined.Here,we identified a subtype of dNK cells characterized as having a CD3-CD56^brightCD25^+phenotype.We found that CD56^brightCD25^+NK cells preferentially localize to the maternal/fetal interface during early human pregnancy.CD25^+dNK cells account for approximately 75%of CD25-expressing decidual immune cells(DICs).However,less than 5%of CD25-positive peripheral blood mononuclear cells are CD25^+NK cells.Furthermore,CD25^+and CD25^-dNK cells exhibit distinct phenotypes:CD25^+dNK cells display a more activated phenotype and greater cytokine-secreting capacity.Interestingly,coculture of peripheral NK(pNK)cells with primary trophoblasts upregulates the percentage of CD25-expressing pNK cells,resulting in increased expression of activation markers and cytokine production by pNK cells.In addition,we demonstrated that the CXCL12/CXCR4 axis is crucial for the recruitment of CD25^+dNK cells and contributes to the accumulation of CD3^-CD56^brightCD25^+dNK cells at the maternal/fetal interface.Thus,our data reveal that the crosstalk between trophoblasts and pNK cells leads to the accumulation of CD3^-CD56^brightCD25^+dNK cells,which exert a regulating effect at the maternal/fetal interface.
文摘The regulatory mechanism of Th2 bias at the maternal/fetal interface remains unclear. In this study, we characterized cytokine production in decidual stromal cells （DSCs）, decidual immune cells （DICs） and embryo-derived trophoblast cells, and investigated the regulation of CXCL12/CXCR4 interaction on Th2 bias at the maternal/fetal interface in early human pregnancy. We found differential production of Th 1-type and Th2-type cytoki nes by trophoblasts, DSCs and DICs. The secretion of these cytokines varied in different cell cocultures, conduced to Th2 bias. Flow cytometry showed that coculture of trophoblasts with DSCs and DICs significantly increased IL-4 and IL-IO production in trophoblasts, and IL-IO production in DSCs. However, the coculture of trophoblasts with DSCs and DICs significantly increased interferon （IFN）-7 expression in DSCs, and tumor-necrosis factor （TNF）-a expression in DICs. No change was seen in Thl-type cytokine production in trophoblasts, and in Th2-type cytokine production in DICs in all cocultures. Furthermore, pre-treatment with anti-CXCR4 neutralizing antibody upregulated the production of the Thl-type cytokines IFN-y and TNF-a, and downregulated the production of the Th2-type cytokines IL-4 and IL-IO, in trophoblasts, DSCs, DICs or their cocultures. Interestingly, rhCXCL12 inhibited production of the Thl-type cytokine TNF-a and enhanced the expression of the Th2-type cytokines such as IL-4 and IL-IO in DICs; this effect was abrogated by anti-CXCR4 antibody. Our present study has elucidated the individual contributions of component cells to the shaping of Th2 bias, and uncovered a complicated cross-talk viathe CXCL12/CXCR4 signal at the maternal/fetal interface in early human pregnancy.
基金German research Foundation(DFG,grant numbers:CH2321/1–1 and SCHO1231/7–1)JH has received a scholarship from the Chinese Scholarship Council(CSC No.:201908350115).
文摘The oviduct epithelium is the initial maternal contact site for embryos after fertilization,offering the microenviron-ment before implantation.This early gestation period is particularly sensitive to stress,which can cause reduced fertil-ity and reproductive disorders in mammals.Nevertheless,the local impact of elevated stress hormones on the ovi-duct epithelium has received limited attention to date,except for a few reports on polyovulatory species like mice and pigs.In this study,we focused on the effects of chronic maternal stress on cattle,given its association with infertil-ity issues in this monoovulatory species.Bovine oviduct epithelial cells(BOEC)differentiated at the air–liquid interface(ALI)were stimulated with 250 nmol/L cortisol for 1 or 3 weeks.Subsequently,they were assessed for morphology,bioelectrical properties,and gene expression related to oviduct function,glucocorticoid pathway,cortisol metabo-lism,inflammation,and apoptosis.Results revealed adverse effects of cortisol on epithelium structure,featured by deciliation,vacuole formation,and multilayering.Additionally,cortisol exposure led to an increase in transepithelial potential difference,downregulated mRNA expression of the major glucocorticoid receptor(NR3C1),upregulated the expression of cortisol-responsive genes(FKBP5,TSC22D3),and significant downregulation of oviductal glycopro-tein 1(OVGP1)and steroid receptors PGR and ESR1.The systematic comparison to a similar experiment previously performed by us in porcine oviduct epithelial cells,indicated that bovine cultures were more susceptible to elevated cortisol levels than porcine.The distinct responses between both species are likely linked to their divergence in the cortisol-induced expression changes of HSD11B2,an enzyme controlling the cellular capacity to metabolise cortisol.These findings provide insights into the species-specific reactions and reproductive consequences triggered by maternal stress.
基金the Natural Science Foundation of Hubei province (No. 2005ABA149)
文摘In this study, the expression of IL-24 at maternal-fetal interface and the roles in extravillous trophoblast （the TEV-1 cell line） invasion were examined. Immunohistochemistry was used to detect the expression of IL-24 in villi and decidual tissue. The proliferation of TEV-1 cells under the effect of IL-24 was measured by MTT assay. The invasiveness of TEV-1 cells under the effect of recombinant IL-24 （rhIL-24） was examined by transwell system. Immunohistochemical detection showed that IL-24 was expressed in the villi and decidual tissue, and distributed in villous column, trophoblasts, stroma and blood vessels. The proliferation of TEV-1 cells was not inhibited by rhIL-24 of various concentrations. The examination of invasion in vitro showed that rhIL-24 could inhibit the invasion of TEV-1 cells in a concentration-dependent manner. The results suggested IL-24 could inhibit the invasion of TEV-1 cells. Therefore, IL-24 produced by maternal-fetal interface in human first trimester pregnancy may influence the invasion of trophoblasts and is involved in normal pregnancy.
文摘Over 1 billion people globally are estimated to be infected with Toxoplasma gondii with severe or unknown consequences and no safe and effective therapies are available against congenital or persistent chronic infection. We propose that atovaquone and diclazuril synergistically protect against fetal-maternal toxoplasmosis. Methods: Programmed pregnant mice were treated with atovaquone and diclazuril monotherapy, or combined (atovaquone + diclazuril) therapy and infected with tachyzoites (0, 300, 600) and the course of infection was studied. Results: Infected dams with low dose (300) developed moderate toxoplasmosis complications and treatments were similarly effective with minor differences between monotherapies. In contrast, major differences were observed amongst varied treatments during high-dose (600) infection and severe related-toxoplasmosis complications as follows. Dams developed hydrothorax, ascities and excess weight gain. Combined therapy (P < 0.01) and to a lesser extent diclazuril monotherapy (P 0.05) protected dams from excess weight, hydrothorax, and ascities. Infected dams exhibited splenomegaly, hepatomegaly and severe hepatitis. Combined therapy synergistically normalized pathology (P < 0.001) and to a lesser degree monotherapy (diclazuril P 0.01, and atovaquone P 0.05) protected dams from hepatitis and splemomegaly. Additionally, behavioral response to pain stimuli and fetal weight and fetal numbers were significantly preserved in treated dams. Conclusions: This is the first report describing combined atovaquone and diclazuril therapy a) to be safe in pregnancy, b) to exert novel synergistic effects, and c) to protect dams and their nested fetuses against adverse effects of severe toxoplasmosis.
文摘BACKGROUND: Premature rupture of membrane(PROM) is linked to significant maternal prenatal mortalities and morbidity. In Ethiopia, where maternal mortality is still high, the maternal and fetal outcomes in PROM is very important to decrease maternal and child mortality and for better management and prevention of complications. Thus, this study aimed to detect the maternal and fetal outcomes and associated factors in term PROM at Mizan-Aman General Hospital, south-west Ethiopia.METHODS: A retrospective cross sectional study was conducted using data available at MizanAman General Hospital during a period of 3 years(January 2011 to December 2013). We examined records of 4 525 women who gave birth in the hospital; out of these women, 185 were diagnosed with term PROM and all of them were included in the study. The data of these women were collected using a checklist based on registration books. The data were analyzed using SPSS version 20.0 statistical package. The association between independent and dependent variables was assessed by bivariate and multiple logistic regression analyses. 95%CI and P value less than 0.05 were considered statistically signifi cant.RESULTS: Of the 4 525 women who gave birth in the hospital, 202 were complicated by term PROM. About 22.2% of the women showed unfavorable maternal outcomes. The most common cause of maternal morbidity and mortality was puerperal sepsis. About 33.5% of neonates experienced unfavorable outcomes. The duration of PROM >12 hours(AOR=5.6, 95%CI 1.3–24.1) latency >24 hours(AOR=2.8, 95%CI 1.7–11.8), residing in rural areas(AOR=4.2, 95%CI 3.96–29.4) and birth weight less than 2 500 g were associated with unfavorable outcomes.CONCLUSION: Women residing in rural areas, long latency, and neonates with birth weight less 2 500 g may have unfavorable outcomes. Therefore, optimum obstetric and medical care is essential for the reduction of the devastating complications related to disorders.
基金the National Natural Science Foundation of China[No.21577026]。
文摘Objective To explore the effects of prenatal exposure to polybrominated diphenyl ethers(PBDEs)on placental size and birth outcomes.Methods Based on the perspective Wenzhou Birth Cohort,this nested case-control study included 101 fetal growth restriction(FGR)and 101 healthy newborns.Maternal serum samples were collected during the third trimester and measured for PBDEs by gas chromatography tandem mass spectrometry.The basic information of mother-newborn pairs was collected from questionnaires,whereas the placental size and birth outcomes of newborns were obtained from hospital records.Results A total of 19 brominated diphenyle ether(BDE)congeners were detected in maternal serum samples.Higher concentrations of BDE-207,-208,-209,and∑19PBDEs were detected in FGR cases than in controls.Increased BDE-207,-208,-209,and∑19PBDEs levels in maternal serum were related to decreased placental length,breadth,surface area,birth weight,birth length,gestational age,and Quetelet index of newborns.After adjusting for confounders,BDE-207 and∑19PBDE concentrations in maternal serum were significantly associated with an increased risk of FGR.Conclusion A negative association was found between PBDE levels in maternal serum and placental size and birth outcomes.Prenatal PBDE exposure may be associated with elevated risk of the incidence of FGR birth.
文摘BACKGROUND Primiparas are usually at high risk of experiencing perinatal depression,which may cause prolonged labor,increased blood loss,and intensified pain,affecting maternal and fetal outcomes.Therefore,interventions are necessary to improve maternal and fetal outcomes and alleviate primiparas’negative emotions(NEs).AIM To discusses the impact of nursing responsibility in midwifery and postural and psychological interventions on maternal and fetal outcomes as well as primiparas’NEs.METHODS As participants,115 primiparas admitted to Quanzhou Maternity and Child Healthcare Hospital between May 2020 and May 2022 were selected.Among them,56 primiparas(control group,Con)were subjected to conventional midwifery and routine nursing.The remaining 59(research group,Res)were subjected to the nursing model of midwifery and postural and psychological interventions.Both groups were comparatively analyzed from the perspectives of delivery mode(cesarean,natural,or forceps-assisted),maternal and fetal outcomes(uterine inertia,postpartum hemorrhage,placental abruption,neonatal pulmonary injury,and neonatal asphyxia),NEs(Hamilton Anxiety/Depressionrating Scale,HAMA/HAMD),labor duration,and nursing satisfaction.RESULTS The Res exhibited a markedly higher natural delivery rate and nursing satisfaction than the Con.Additionally,the Res indicated a lower incidence of adverse events(e.g.,uterine inertia,postpartum hemorrhage,placental abruption,neonatal lung injury,and neonatal asphyxia)and shortened duration of various stages of labor.It also showed statistically lower post-interventional HAMA and HAMD scores than the Con and pre-interventional values.CONCLUSION The nursing model of midwifery and postural and psychological interventions increase the natural delivery rate and reduce the duration of each labor stage.These are also conducive to improving maternal and fetal outcomes and mitigating primiparas’NEs and thus deserve popularity in clinical practice.
文摘Introduction:Diabetes mellitus(DM),a metabolic disorder,leads to organ damage due to chronic hyperglycemia with multiple pathogenic processes.Gestational diabetes mellitus(GDM)poses risks to mothers and offspring,increasing the incidence of structural congenital heart disease(CHD)and myocardial hypertrophy in newborns.Objective:This review aimed to examine the association between maternal diabetes mellitus and CHD.Methods:This systematic review used the STROBE and TRIPOD checklists registered in PROSPERO(CRD42024513858).It focused on diagnostic test accuracy using the Munn et al.protocol for systematic assessment,emphasizing the“PIRD”:Population,Index Test,Reference Test,Diagnosis of Interest.This review aimed the following PIRD model question:‘Does diabetic pregnant woman inffuence in fetal cardiac malformation?’using PRISMA 2020 statement.A systematic review was conducted on 19 October 2023 in the following databases:PubMed/MEDLINE,Embase(Elsevier),CINAHL(EBSCO),Scopus(Elsevier),Web of Science(Clarivate Analytics),LILACS,and SciELO.Only articles in English,Spanish,and Portuguese languages were selected.Results:Seven studies between 2018 and 2023 were selected.The studies differed in terms of the cardiac ultrasound parameters used to assess CHD and diagnose diabetes mellitus in pregnancy.They highlight the importance of fetal echocardiography in detecting CHD prenatally and assessing the impact of diabetes mellitus on fetal cardiac health,recommending proactive care planning and early intervention for better outcomes.Conclusions:The studies highlight the impact of maternal diabetes mellitus,particularly GDM,on fetal cardiac development and support early detection by fetal echocardiography.Standardization and collaboration are essential to reffne management and outcomes in high-risk pregnancies.
文摘<strong>Objectives:</strong> The goal was to assess the risk factors for emergency cesarean section versus prophylactic caesarean section. <strong>Materials and Methods:</strong> This was a descriptive analytical cross-sectional study of the Type Cas/Witnesses at the Reference Health Centre of Commune V of the District of Bamako in Mali. The sample consisted of 100 cases for 200 controls (1 case for 2 controls) with retrospective collection of data for the period from January 1 to July 11, 2011 (6 months and 11 days). <strong>Results:</strong> During the study period, out of a total of 3559 deliveries, we recorded 2,794 vaginal deliveries, 78.50% and 765 caesarean sections or 21.50%. Of the 765ceras, we performed 353 emergency caesarean sections or 46.15% and 412 prophylactic caesarean sections 53.85%. We have selected 100 prophylactic caesarean section files and 200 emergency caesarean section files. The average age of the patients was 27.41 years-5.84 with extreme ages of 14 to 40 years. 100% of our patients (Cas) had performed at least one antenatal consultation compared to 83.5% of the parturients evacuated (Witnesses). The most frequently cited reasons for evacuation were: acute fetal suffering, non-cephalic presentation and excessive uterine height with 30%, 17.5% and 12% respectively. The bulk of the caesarean section indications were dominated by dystocies with 90% in cases compared to 65% in Witnesses, followed by acute fetal suffering with 30% in Witnesses. We recorded 30% perinatal deaths among Witnesses compared to 1% in Cases. We recorded 16 uterine ruptures in the Witnesses among which 2 hysterectomies and 14 hystererraphia. <strong>Conclusion:</strong> Prophylactic caesarean section improves maternal and perinatal prognosis more than emergency caesarean section.
文摘Non-invasive prenatal gene diagnosis has been developed rapidly in the recent years,and numerous medical researchers are focusing on it.Such techniques could not only achieve prenatal diagnosis accurately,but also prevent tangential illness in fetuses and thus,reduce the incidence of diseases.Moreover,it is non-invasive prenatal gene diagnosis that prevents potential threaten and danger to both mothers and fetuses.Therefore,it is welcomed by clinical gynecologist and obstetrian,researchers of medical genetics,and especially,pregnancies.This review article touches briefly on the advanced development of using cell-free DNA,RNA in maternal plasma and urine for non-invasive prenatal gene diagnosis.
文摘Introduction: Female Genital Mutilation (FGM) is a public health problem. There are 100 to 140 million girls and women who suffer every year in the world [1]. The aim of this study is to improve the medical care and reduce complications of FGM at the Regionalhospital of N’zérékoré, to determine their frequency, and to evaluate the maternal-fetalprognosis. Methods: The study was conducted at the Regional Hospital of N’zérékoré. This was a cross-sectional, descriptive and analytic study of 6 months, from 1 September 2016 to 28 February 2017, including all pregnant women admitted for childbirth who had a complication of female genital mutilation. Results: A total of 1295 women gave birth in the service, of which 1204 women were women with female genital mutilation. Given a frequency of 92.97%, of these 1204 mutilated women, 223 presented obstetrical complications during their delivery, a proportion of 17.22%. They were mostly young patients, mostly housewives who were not in school. Type II FGM was the most common (53.06%). Obstetric complications were dominated by complicated perinatal tears (54.08%), and hemorrhages (40.81%). The catch was dominated by perineorrhaphy. Conclusion: The frequency of FGM was 92.97% and that of their obstetric complications 17.22%. Most were house-wives, not in school. There was FGM type II. The abandonment of FGM would reduce maternal and perinatal morbidity and mortality.
文摘Background: Women awaiting fetal echocardiography (fECHO) report high anxiety. It is unclear if anxiety decreases after performance of fECHO. Methods: At fECHO, subjects’ current (state) vs baseline (trait) anxiety was assessed using the Spielberger State-Trait Anxiety Inventory. Anxiety scores of the pre- and post-fECHO groups were compared. Results: From January 2007 to January 2009, we recruited 84 subjects: 40 pre-fECHO and 44 post-fECHO. Of the post-fECHO group, 30 had normal fetal cardiac structure and function confirmed, 12 were told of an abnormality, and 2 were told to follow up equivocal results. Anxiety scores were compared between the 40 pre-fECHO subjects and the 30 post-fECHO subjects with normal results. The mean state anxiety score of the pre-fECHO group was higher than that of the post-fECHO group (42.1 ± 15.1 vs 30.8 ± 8.5, p < 0.001);there was no difference in trait scores. Neither state nor trait anxiety was associated with maternal age, parity, history of miscarriage or known fetal anomaly. Compared to those with a normal fECHO (N = 30), subjects with an abnormal fECHO result (N = 12) had higher state anxiety (46.8 ± 15.5 vs 30.8 ± 8.5, p = 0.005). There was no difference in anxiety scores between subjects awaiting fECHO and post-fECHO subjects who had an abnormal result. Conclusion: Immediately following normal fECHO, women report low anxiety compared with women awaiting fECHO. Women awaiting fECHO report anxiety levels that are as high as women who are told there is fetal cardiac anomaly.
文摘<strong>Background:</strong><span><span><span style="font-family:""><span style="font-family:Verdana;"> Urinary tract infection (UTI) is common in pregnancy and accounts for a high burden of maternal and perinatal morbidity/mortality and </span><span style="font-family:Verdana;">health expenditure. The burden of this condition has been understudied in Came</span><span style="font-family:Verdana;">roon. We aimed to determine the uropathogens of urinary tract infection in pregnancy, and the maternal-fetal outcomes of UTI at the Douala Re</span><span><span style="font-family:Verdana;">ferral Hospital. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> We conducted an analytic matched case-control study </span></span><span style="font-family:Verdana;">of 206 pregnant wom</span><span style="font-family:Verdana;">en with evid</span><span style="font-family:Verdana;">ence of uri</span><span style="font-family:Verdana;">nary tract infectio</span><span style="font-family:Verdana;">n (103 cases)</span><span style="font-family:Verdana;"> an</span><span style="font-family:Verdana;">d </span><span style="font-family:Verdana;">those without (103 controls) who underwent antenatal care and gave birth at </span><span style="font-family:Verdana;">the DRH from January 2019 to April 2019. Socio-demographic, laboratory and</span> <span style="font-family:Verdana;">maternal-fetal outcome data were collected using a pre-tested structured questionnai</span><span style="font-family:Verdana;">re and analyzed with SPSS version 23. Statistical significance was set at </span><span><span style="font-family:Verdana;">p < 0.05. </span><b><span style="font-family:Verdana;">Results:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> (51.5%), </span><i><span style="font-family:Verdana;">Proteus mirabilis</span></i><span style="font-family:Verdana;"> (15.5%), </span><i><span style="font-family:Verdana;">S</span></i></span><i><span style="font-family:Verdana;">taphylococcus aureus</span></i><span style="font-family:Verdana;"> (11.7%) and </span><i><span style="font-family:Verdana;">Klebsiella sp</span></i><span style="font-family:Verdana;">. (6.8%) were the predominant uropathogens of UTI. Maternal outcomes of UTI were puerperal pyelonephritis (AOR 3.1;95% CI: 1.11 - 3.55, p = 0.0023), preterm labor (AOR 4.4;95% CI: 1.0 - 2.7, p = 0.008) and preterm birth (AOR 4.6;95% CI 1.9 - 22.9, p = 0.05). Furthermore, low birth weight (AOR 2.1;95% CI: 0.8 - 5.6, p = 0.05), neonatal infection (AOR 13;95% CI: 0.9 - 191.6, p = 0.04) and neonatal intensive care unit admission (AOR 2.5;95% CI: 1.7 - 3.6, p = 0.003) were fetal outcomes of UTI. </span><b><span style="font-family:Verdana;">Conclusion:</span></b> <i><span style="font-family:Verdana;">Escherichia coli</span></i><span style="font-family:Verdana;"> was the main uropathogenic </span><span style="font-family:Verdana;">agent of UTI during pregnancy. Maternal outcomes of UTI were puerperal pyel</span><span style="font-family:Verdana;">onephritis, preterm labor and delivery while fetal outcomes include: low-birth </span><span style="font-family:Verdana;">weight, neonatal infection and neonatal intensive care admission. Prompt diagnosis of this condition is the cornerstone to avoid adverse outcomes.</span></span></span></span>
文摘Background: Studies on physical activity during pregnancy and its impact on mother and fetus are still limited. International protocols consider only aerobic exercise and fail to provide information about other modalities such as isometric exercise. Isometric exercise promotes cardiorespiratory resistance and muscle strengthening, but it is rarely tested on pregnant women because it increases maternal blood pressure and can subsequently affect placental circulation. Objective: To evaluate maternal and fetal response of low-risk pregnant women undergoing isometric testing through a Doppler velocimetry study. Methodology: A cross-sectional, experimental study was performed on 46 healthy pregnant women (gestational age between 26 and 36 weeks) who underwent isometric testing. This testing was performed using a handgrip dynamometer to measure maternal and fetal hemodynamic parameters before, during, and after isometric testing. Results: There was a significant increase in systolic blood pressure (BP;pre-isometrics 113.13 ± 9.92 mmHg, during isometrics 117.13 ± 10.24 mmHg, and post-isometrics 112.43 ± 9.87 mmHg, p 0.001) and heart rate (HR;pre-isometrics 87.52 ± 14.10 bpm, during isometrics 97.61 ± 14.83 bpm, and post-isometrics 85.13 ± 13.24 bpm, p 0.001). There were significant decreases in the pulsatility index (PI;pre-isometrics 0.63 ± 0.15, during isometrics 0.56 ± 0.15, and post-isometrics 0.65 ± 0.17, p = 0.001), resistance index (RI;pre-isometrics 0.44 ± 0.08, during isometrics 0.40 ± 0.07, and post-isometrics 0.45 ± 0.08, p = 0.001), and systolic/diastolic (S/D) ratio (pre-isometrics 1.81 ± 0.26, during isometrics 1.69 ± 0.24, and post-isometrics 1.85 ± 0.29, p 0.001) of the left uterine artery (UA). These results showed significant changes only during the isometric exercise, and not between the pre- and post-isometric exercises. There were no significant differences in fetal parameters when the results before, during, and after the isometric test were compared. Conclusion: Isometric testing had no repercussions for fetal hemodynamics in healthy low-risk pregnant women.
文摘<strong>Aim:</strong><span style="font-family:Verdana;"> To describe the epidemiological, therapeutic and prognostic aspects of eclampsia at the second reference hospital in the urban commune of Ségou in Mali.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Patient and Methods:</span></b><span style="font-family:Verdana;"> This was a descriptive, cross-sectional, analytical, retrospective and prospective study based on a comprehensive de-engineering.</span><span style="font-family:Verdana;"> It covered a 3-year period from January 1, 2010 to December 31, 2012 and involved 176 cases.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> The incidence of eclampsia during the study period was 2.9%. Classically, it occurred in 74.4% in young primigeste, in 73.9% in the</span><span style="font-family:;" "=""> </span><span style="font-family:;" "=""><span style="font-family:Verdana;">3</span><sup><span style="font-family:Verdana;">rd</span></sup><span style="font-family:Verdana;"> trimester of pregnancy and 26.1% of cases during postpartum. We recorded maternal complications such as retro-placental hematoma, acute kidney failure and delivery hemorrhage. The case fatality rate was 2.3% or 4 cases of maternal death. At the fetal level, there was 29.5% prematurity, 31.8% neonatal suffering, 11.4% hypotrophy, 11.9% </span><i><span style="font-family:Verdana;">in</span></i></span><i><span style="font-family:;" "=""> </span></i><i><span style="font-family:Verdana;">utero</span></i><span style="font-family:Verdana;"> fetal death and 7.4% early neonatal death.</span><span style="font-family:;" "=""> </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> The maternal-fetal prognosis remains reserved despite the progress made in the management of eclampsia in our services.</span>
文摘Artificial induction of labor (AIL) is the set of techniques intended to induce childbirth in order to reduce maternal-fetal mortality. The aim of this paper was to study the maternal and fetal prognosis after the artificial induction of labor with misoprostol. It was a descriptive prospective study conducted from September 1, 2018 to February 28, 2019 at the maternity unit of the Referral Health Center (RHC) in commune I of Bamako. It was about any pregnant woman at term who had received misoprostol as part of the artificial induction of labor. 102 cases of artificial induction with misoprostol 200 μg were collected out of 3641 deliveries, or a frequency of 2.8%. The age group 28 - 32 years accounted for 56.86% with an average age of 28.8 years. Multiparous represented 54.90% of the number. The history of diabetes and hypertension involved 37.25% of the pregnant women. The main indication was premature rupture of membranes (PRM) (40.2%). Induction was performed between the 37</span><sup><span style="font-family:Verdana;">th</span></sup><span style="font-family:Verdana;"> and 41</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> week of amenorrhea (69.6%). The trigger index according to BISHOP was greater than 7 (50.98%). Induction was done only with 3/4 of misoprostol tablet 200 μg (43.14%). The average labor time was 7 hours (89.22%). The vaginal birth concerned 92.16% of pregnant women. An APGAR10 was noted in 97.85% of newborns after 05 minutes. AIL with misoprostol was practiced at the Center. The main indication was the premature rupture of the membranes. It improves the maternal and fetal prognosis.
文摘<strong>Introduction</strong><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;"><strong>:</strong> All pregnant women are at risk of obstetric complications </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">leading to high fetal-maternal mortality and morbidity. The aim of this work was to evaluate the maternal and fetal prognosis of evacuated parturients.</span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Patient and Method</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: we conducted a prospective analytical survey for four months, from April 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> to July 31</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;">, 2018 in the Maternity of N’Djamena Mother and Child Hospital about the maternal and fetal prognosis of evacuated parturients. Any parturient evacuated or referred for obstetric complications was included. Study parameters were epidemiological, clinical, para-clinical, therapeutic and prognosis order. These parameters were analyzed in the SPSS 18 French version software.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Results</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: Evacuated parturients represented 20% of maternity admissions. The average age was 23.9 years, with extremes ranging from 15 and 43 years. They were uneducated in 72.9%, primiparous in 46.8% of cases. The three delays were dominated by the 1</span><sup><span style="font-family:Verdana;">st</span></sup><span style="font-family:Verdana;"> delay, which represented 34.1% of cases. In this series, 26.3% parturients had presented obstetric com</span><span style="font-family:Verdana;">plications. Preruptive syndrome was the most common complication with</span><span style="font-family:Verdana;"> 29.3% cases. Predisposing factors to maternal-fetal complications were low attendance antenatal care, late evacuation and distance travelled. The mater</span><span style="font-family:Verdana;">nal mortality rate was 3%. Fetal complications were observed in 28.3% of cas</span><span style="font-family:Verdana;">es and the neonatal mortality rate was 24.6%.</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">Conclusion</span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">: The maternal </span><span style="font-family:Verdana;">and fetal complications of evacuated parturients are a real public health</span><span style="font-family:Verdana;"> problem in our regions. The suppression of delays, capacity reinforcement of peripheral maternity and the periodic recycling peripheral centers to recognize </span><span style="font-family:Verdana;">obstetric emergencies will contribute to improve the maternal and fetal</span><span style="font-family:Verdana;"> prognosis of evacuated parturients.</span></span></span></span>
文摘<strong>Introduction:</strong><span style="font-family:Verdana;"> Uterine rupture is a complete or incomplete non-surgical continuity solution of the wall of the gravid uterus. Indeed, it is a Affection obstetrical condition whose maternal-fetal prognosis is poor in terms of morbidity and mortality. </span><span style="font-family:Verdana;"><strong>Objectives:</strong></span><span style="font-family:Verdana;"> To assess the risk factors for uterine rupture in the Koutiala Health District. </span><span style="font-family:Verdana;"><strong>Methods:</strong></span><span style="font-family:Verdana;"> This was a descriptive and analytical cross-sectional prospective collection study from January 1, 2019 to December 31, 2019, a 12-month period. In our study, all patients admitted to the maternity ward were included during the study period for which the diagnosis of uterine rupture was made. </span><span style="font-family:Verdana;"><strong>Results:</strong></span><span style="font-family:Verdana;"> Out of a total of deliveries, we recorded 27 cases of uterine rupture, a frequency of 1.04%. The average age of our patients was 32 years with extremes of 19 and 45 years. We notice 92.6% of uterine ruptures during the transfer. Almost 3/4 of our parturients were out of school 70.4% versus 11.1% in primary school and 18.5% in secondary school. The majority of patients affected by uterine rupture came from rural areas 85.2%. Only 14.8% were from Koutiala city. The admission time to the Koutiala Reference Health Centre was 2 hours 30 minutes in 50.85% of our patients with extremes of 15 minutes and 4 hours 30</span><span style="font-family:" color:windowtext;font-weight:normal;"=""> </span><span style="font-family:Verdana;">min. The average parity was 6.30 - 3036;large </span><span style="font-family:Verdana;">multiparous</span><span style="font-family:Verdana;"> accounted for 63% in our sample followed by </span><span style="font-family:Verdana;">multiparous</span><span style="font-family:Verdana;"> 18.5%. As for pregnancy follow-up, 100% of the patients had not performed any prenatal consultations. In 85.2% hysterrhaphy was performed intervention and hysterectomy in 14.8%. Maternal prognosis was satisfactory in 96.30% of cases. From the point of view of morbidity: 1 case of bladder-vaginal fistula was recorded and corrected by the bladder survey at home for 15 days. Late complications were the occurrence of anemia in 16 patients who were transfused and 1 case of phlebitis. We recorded 1 maternal death and 25 stillbirths. </span><span style="font-family:Verdana;"><strong>Conclusion:</strong></span><span style="font-family:Verdana;"> Uterine rupture is one of the leading causes of maternal and fetal mortality in Mali.</span>
