Background Previous evidence suggests that methionine(Met)consumption can promote placental angiogenesis and improve fetal survival.To investigate the mechanisms by which increased levels of Met as hydroxyl-Met(OHMet)...Background Previous evidence suggests that methionine(Met)consumption can promote placental angiogenesis and improve fetal survival.To investigate the mechanisms by which increased levels of Met as hydroxyl-Met(OHMet)improve placental function,forty sows were divided into four groups and fed either a control diet,or diets supplemented with 0.15%OHMet,0.3%OHMet or 0.3%Met(n=10).Placentas were collected immediately after expulsion,and extracted proteins were analyzed by tandem mass tag based quantitative proteomic analysis.Results We found that 0.15%OHMet consumption significantly increased placental vascular density compared with the control.Proteomic analysis identified 5,136 proteins,87 of these were differentially expressed(P<0.05,|fold change|>1.2).Enriched pathways in the Kyoto Encyclopedia of Genes and Genomes for 0.15%OHMet vs.control and 0.15%OHMet vs.0.3%OHMet were glutathione metabolism;for 0.15%OHMet vs.0.3%Met,they were NOD-like receptor signaling and apoptosis.Further analysis revealed that 0.15%OHMet supplementation upregulated the protein expression of glutathione-S-transferase(GSTT1)in placentas and trophoblast cells compared with the control and 0.3%OHMet groups,upregulated thioredoxin(TXN)in placentas and trophoblast cells compared with the 0.3%OHMet and 0.3%Met groups,and decreased reactive oxygen species(ROS)levels in trophoblast cells compared with other groups.In contrast,sows fed 0.3%OHMet or 0.3%Met diets increased placental interleukin 1βlevels compared with the control,and upregulated the protein expression of complex I-B9(NDUFA3)compared with the 0.15%OHMet group.Furthermore,homocysteine,an intermediate in the trans-sulphuration pathway of Met,damaged placental function by inhibiting the protein expression of TXN,leading to apoptosis and ROS production.Conclusion Although dietary 0.15%OHMet supplementation improved placental angiogenesis and increased antioxidative capacity,0.3%OHMet or 0.3%Met supplementation impaired placental function by aggravating inflammation and oxidative stress,which is associated with cumulative homocysteine levels.展开更多
Placenta abnormalities,which are collectively termed as placenta accreta spec-trum(PAS),are increasing globally in the female population due to the large nu-mber of cesarean sections performed worldwide.PAS represents...Placenta abnormalities,which are collectively termed as placenta accreta spec-trum(PAS),are increasing globally in the female population due to the large nu-mber of cesarean sections performed worldwide.PAS represents a rare but life-threatening occurrence that can lead to an increased risk of postpartum hemorr-hage due to the abnormal infiltration of the chorionic villi in the uterine wall up to the adjacent structures.Performing a prophylactic occlusion of the iliac arteries for a brief amount of time using balloon-occlusion endovascular catheters in patients with PAS can help control unwanted blood losses during cesarean delivery or postpartum demolition surgery.The aim of this narrative minireview was to pro-vide an overview of the aspects about prophylactic occlusion with endovascular balloons in patients with PAS and to analyze current evidence on this topic.In particular,this minireview included an overview of indications,patient selection,type of materials and devices used,technical advice and suggestions,clinical outcomes,and complications to give every interventional radiologist as well as every gynecologist and midwife all the information that is needed to address this particular condition in a safe and prompt manner.展开更多
Background Progressive oxidative stress easily occurs as a result of a gradual increase in the intensity of maternal metabolism due to rapid foetal development and increased intensity of lactation.However,studies on t...Background Progressive oxidative stress easily occurs as a result of a gradual increase in the intensity of maternal metabolism due to rapid foetal development and increased intensity of lactation.However,studies on the effects of processive oxidative stress on nutrient transport in the placenta have received little attention.The present study was conducted on sows at 85 days of gestation to study the effects of pterostilbene(PTE)on maternal oxidative stress status and placental nutrient transport.Results PTE increased the antioxidant capacity and immunoglobulin content in mothers’blood and milk,reduced the level of inflammatory factors,and improved the nutrient content of milk.PTE also reduced sow backfat loss and the number of weak sons,and increased piglet weaning weight and total weaning litter weight.We subsequently found that PTE enhanced placental glucose and fatty acid transport and further affected glycolipid metabolism by increasing the expression of LAL,PYGM,and Gbe-1,which activated the PI3K phosphorylation pathway.Moreover,PTE addition altered the relative abundance of the Firmicutes,Proteobacteria,Parabacillus,and Bacteroidetes-like RF16 groups in sow faeces.PTE increased the levels of acetate,propionate,butyrate and isovalerate in the faeces.Conclusions These findings reveal that the addition of PTE during pregnancy and lactation mitigates the effects of processive oxidative stress on offspring development by altering maternal microbial and placental nutrient trans-port capacity.展开更多
Imprinted genes play a key role in regulating mammalian placental and embryonic development.Here,we generated glutaminyl-peptide cyclotransferase-knockout(Qpct^(-/-))mice utilizing the clustered regularly interspaced ...Imprinted genes play a key role in regulating mammalian placental and embryonic development.Here,we generated glutaminyl-peptide cyclotransferase-knockout(Qpct^(-/-))mice utilizing the clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated protein 9(Cas9)platform and identified Qpct as a novel anti-angiogenic factor in regulating mouse placentation.Compared with Qpct^(+/+)mice,placentae and embryos(Qpct^(-/+)and Qpct^(-/-))showed significant overgrowth at embryonic Day 12.5(E12.5),E15.5,and E18.5.Using single-cell transcriptome analysis of 32309 cells from Qpct^(+/+)and Qpct^(-/-)mouse placentae,we identified 13 cell clusters via single-nucleus RNA sequencing(snRNA-seq)(8880 Qpct^(+/+)and 13577 Qpct^(-/-)cells)and 20 cell clusters via single-cell RNA sequencing(scRNA-seq)(6567 Qpct^(+/+)and 3285 Qpct^(-/-)cells).Furthermore,we observed a global up-regulation of pro-angiogenic genes in the Qpct^(-/-)background.Immunohistochemistry assays revealed a notable increase in the number of blood vessels in the decidual and labyrinthine layers of E15.5 Qpct^(-/+)and Qpct^(-/-)mice.Moreover,the elevation of multiple pairs of ligand-receptor interactions was observed in decidual cells,endothelial cells,and macrophages,promoting angiogenesis and inflammatory response.Our findings indicate that loss of maternal Qpct leads to altered phenotypic characteristics of placentae and embryos and promotes angiogenesis in murine placentae.展开更多
Background The placenta plays a crucial role in supporting and influencing fetal development.We compared the effects of prepartum supplementation with omega-3(n-3)fatty acid(FA)sources,flaxseed oil(FLX)and fish oil(FO...Background The placenta plays a crucial role in supporting and influencing fetal development.We compared the effects of prepartum supplementation with omega-3(n-3)fatty acid(FA)sources,flaxseed oil(FLX)and fish oil(FO),on the expression of genes and proteins related to lipid metabolism,inflammation,oxidative stress,and the endocannabinoid system(ECS)in the expelled placenta,as well as on FA profile and inflammatory response of neonates.Late-pregnant Holstein dairy cows were supplemented with saturated fat(CTL),FLX,or FO.Placental cotyledons(n=5)were collected immediately after expulsion,and extracted RNA and proteins were analyzed by RTPCR and proteomic analysis.Neonatal blood was assessed for FA composition and concentrations of inflammatory markers.Results FO increased the gene expression of fatty acid binding protein 4(FABP4),interleukin 10(IL-10),catalase(CAT),cannabinoid receptor 1(CNR1),and cannabinoid receptor 2(CNR2)compared with CTL placenta.Gene expression of ECS-enzyme FA-amide hydrolase(FAAH)was lower in FLX and FO than in CTL.Proteomic analysis identified 3,974 proteins;of these,51–59 were differentially abundant between treatments(P≤0.05,|fold change|≥1.5).Top canonical pathways enriched in FLX vs.CTL and in FO vs.CTL were triglyceride metabolism and inflammatory processes.Both n-3 FA increased the placental abundance of FA binding proteins(FABPs)3 and 7.The abundance of CNR1 cannabinoid-receptor-interacting-protein-1(CNRIP1)was reduced in FO vs.FLX.In silico modeling affirmed that bovine FABPs bind to endocannabinoids.The FLX increased the abundance of inflammatory CD44-antigen and secreted-phosphoprotein-1,whereas prostaglandin-endoperoxide synthase 2 was decreased in FO vs.CTL placenta.Maternal FO enriched neonatal plasma with n-3 FAs,and both FLX and FO reduced interleukin-6 concentrations compared with CTL.Conclusion Maternal n-3 FA from FLX and FO differentially affected the bovine placenta;both enhanced lipid metabolism and modulated oxidative stress,however,FO increased some transcriptional ECS components,possibly related to the increased FABPs.Maternal FO induced a unique balance of pro-and anti-inflammatory components in the placenta.Taken together,different sources of n-3 FA during late pregnancy enhanced placental immune and metabolic processes,which may affect the neonatal immune system.展开更多
The placenta plays a crucial role in successful mammalian reproduction.Ruminant animals possess a semi-invasive placenta characterized by a highly vascularized structure formed by maternal endometrial caruncles and fe...The placenta plays a crucial role in successful mammalian reproduction.Ruminant animals possess a semi-invasive placenta characterized by a highly vascularized structure formed by maternal endometrial caruncles and fetal placental cotyledons,essential for full-term fetal development.The cow placenta harbors at least two trophoblast cell populations:uninucleate(UNC)and binucleate(BNC)cells.However,the limited capacity to elucidate the transcriptomic dynamics of the placental natural environment has resulted in a poor understanding of both the molecular and cellular interactions between trophoblast cells and niches,and the molecular mechanisms governing trophoblast differentiation and functionalization.To fill this knowledge gap,we employed Stereo-seq to map spatial gene expression patterns at near single-cell resolution in the cow placenta at 90 and 130 days of gestation,attaining high-resolution,spatially resolved gene expression profiles.Based on clustering and cell marker gene expression analyses,key transcription factors,including YBX1 and NPAS2,were shown to regulate the heterogeneity of trophoblast cell subpopulations.Cell communication and trajectory analysis provided a framework for understanding cell-cell interactions and the differentiation of trophoblasts into BNCs in the placental microenvironment.Differential analysis of cell trajectories identified a set of genes involved in regulation of trophoblast differentiation.Additionally,spatial modules and co-variant genes that help shape specific tissue structures were identified.Together,these findings provide foundational insights into important biological pathways critical to the placental development and function in cows.展开更多
Objective:To describe and determine the association between Covid-19 vaccination in pregnancy and placental pathology.Methods:Conducted in a tertiary hospital in Medan,Indonesia,from April 30th 2022 to June 30th 2022,...Objective:To describe and determine the association between Covid-19 vaccination in pregnancy and placental pathology.Methods:Conducted in a tertiary hospital in Medan,Indonesia,from April 30th 2022 to June 30th 2022,this single-center cross-sectional study involved Covid-19 vaccinated and unvaccinated women with singleton full-term pregnancies delivering live fetuses via cesarean section.Maternal characteristics,placental pathologies,and the placental index were documented at enrollment.The association between Covid-19 vaccination status and placental pathology was assessed.Results:The study enrolled 200 pregnant women,including 110 vaccinated women and 90 unvaccinated women.No significant differences were observed in birthweight(P=0.48),placental index(P=0.48),and placental pathology findings[intervillous bleeding(P=0.20),increased syncytial knots(P=0.83),chorangiosis(P=0.13),villous stromal edema(P=0.13),vascular dilation and congestion(P=0.13),and vascular wall thrombus(P=0.71)]between the vaccinated and unvaccinated groups.Conclusions:This study revealed no statistically significant association between Covid-19 vaccination and placental pathology.The findings support the safety of Covid-19 vaccination during pregnancy,in regards to changes of the placental pathology.展开更多
Background Tissue non-specific alkaline phosphatase(TNSALP;encoded by the ALPL gene)has a critical role in the postnatal regulation of p hospliate homeostasis,yet how TNSALP activity and expression are regulated durin...Background Tissue non-specific alkaline phosphatase(TNSALP;encoded by the ALPL gene)has a critical role in the postnatal regulation of p hospliate homeostasis,yet how TNSALP activity and expression are regulated during pregnancy remain largely unknown.This study tested the hypothesis that progesterone(P4)and/or interferon tau(IFNT)regulate TNSALP activity during pregnancy in sheep.Methods In Exp.1,ewes were bred and received daily intramuscular injections of either corn oil vehicle(CO)or 25 mg progesterone in CO(P4)for the first 8 days of pregnancy and were hysterectomized on either Day 9,12,or 125 of gestation.In Exp.2,ewes were fitted with intrauterine catheters on Day 7 of the estrous cycle and received daily intramuscular injections of 50 mg P4 in CO and/or 75 mg progesterone receptor antagonist(RU486)in CO from Days 8 to 15,and twice daily intrauterine injections of either control proteins(CX)or IFNT(25μg/uterine horn/d)from Days 11 to 15(treatment groups:P4+CX;P4+IFNT;RU486+P4+CX;and RU486+P4+IFNT)and were hysterectomized on Day 16.Results In Exp.1,endometria from ewes administered P4 had greater expression of ALPL mRNA than ewes administered CO on Day 12.TNSALP activity appeared greater in the epithelia,stratum compactum stroma,and endothelium of the blood vessels in the endometrium and myometrium from ewes administered P4 than ewes administered CO on Day 12.On Day 125,TNSALP activity localized to uterine epithelial and endothelial cells,independent of P4 treatment.TNSALP activity in placentomes appeared greater in P4 treated ewes and was detected in endothelial cells and caruncular tissue in P4 treated but not CO treated ewes.In Exp.2,endometrial homogenates from ewes administered RU486+P4+CX had lower TNSALP activity those for P4+CX and P4+IFNT ewes.Immunoreactive TNSALP protein appeared greater in the mid-and deep-glandular epithelia in RU486+P4+CX treated ewes as compared to the other treatment groups.Enzymatic activity appeared greater on the apical surface of the deep glandular epithelia in endometria from ewes treated with RU486+P4+CX compared to the other treatment groups.Conclusions These results suggest that P4,but not IFNT,regulates the expression and activity of TNSALP in uteroplacental tissues and has the potential to contribute to the regulation of phosphate availability that is critical for conceptus development during pregnancy.展开更多
Introduction: Pre-eclampsia is a complication of pregnancy that generally occurs in the third trimester. It is associated with a maternal and foetal mortality rate of around 27%. In view of the grim picture painted by...Introduction: Pre-eclampsia is a complication of pregnancy that generally occurs in the third trimester. It is associated with a maternal and foetal mortality rate of around 27%. In view of the grim picture painted by this condition for both mother and newborn, studies have been carried out into the early detection of patients at risk of developing pre-eclampsia. These make it possible to introduce pregnancy-specific monitoring and preventive strategies to reduce the incidence of the condition. Objective: To establish the link between placental ultrasound characteristics and the onset of pre-eclampsia. Methodology: A multicentre prospective cohort study was conducted in two hospitals in Yaoundé, namely the Yaoundé Gynaecological Obstetrics and Paediatrics Hospital and the Nkolndongo Health and Social Animation Centre, in the gynaecology and radiology departments over a period of 11 months, from October 2022 to August 2023. It included pregnant women who had undergone obstetric ultrasound between 12 and 18 weeks’ gestation. In addition to routine obstetric ultrasound, we performed obstetric Doppler measurements in these patients. The resistance index of the left and right uterine arteries, the umbilical artery and the placental volume were the characteristics sought. At the end of this examination, two groups were formed: cases (pathological Doppler group) and controls (normal Doppler group). Blood pressure and urine dipstick were taken at each antenatal visit until delivery, then during the immediate postpartum period and finally at 7 days, 21 days and 42 days after delivery. Results: Sixty-seven (67) patients were included. Of these, 35 (47.8%) had pathological Dopplers. Sixteen patients had arterial hypertension associated with proteinuria and were therefore labelled as pre-eclampsia (PE). This gives a prevalence of 23.9%. Fifteen (42.8%) of these patients belonged to the exposed group and one to the unexposed group. The mean IR of the pre-eclampsia patients was significantly higher than that of the patients without pre-eclampsia;respectively 0.74 ± 0.096 and 0.49 ± 0.097 for the right uterine arteries and 0.71 ± 0.13 and 0.52 ± 0.089 for the left uterine arteries. We found that an increase in the uterine artery resistance index was significantly associated with the onset of pre-eclampsia, with a relative risk of 13.7 and a p value Conclusion: Abnormal Doppler ultrasound between 12 and 18 weeks of amenorrhoea had good overall sensitivity for predicting pre-eclampsia. Among the Doppler indices, the uterine artery resistance index was the only one significantly associated with pre-eclampsia.展开更多
Vasa previa is a rare obstetric complication, characterized by fetal umbilical cord blood vessels being unprotected by Wharton’s jelly or placental tissue and located within 20 mm of the internal cervical os. This ca...Vasa previa is a rare obstetric complication, characterized by fetal umbilical cord blood vessels being unprotected by Wharton’s jelly or placental tissue and located within 20 mm of the internal cervical os. This case describes a late pregnancy antepartum hemorrhage that was promptly treated with a cesarean section. During the surgery, a ruptured vasa previa was found, and fortunately, the rupture was blocked by a clot, resulting in minimal blood loss. Both mother and baby had a good outcome. The case is used to elaborate on the high-risk factors, classification, diagnostic methods, and treatment plans for vasa previa, aiming to increase the detection rate of this condition and manage it systematically, ultimately improving perinatal outcomes.展开更多
Background: Detachment of the placenta occurs in about 96% of patients within 30 minutes of completion of the second stage of labour, thus any further delay there after is usually considered as retained placenta. It i...Background: Detachment of the placenta occurs in about 96% of patients within 30 minutes of completion of the second stage of labour, thus any further delay there after is usually considered as retained placenta. It is associated with the risk of post-partum haemorrhage and anaemia. Objectives: To determine the incidence, risk factors, clinical presentation and complications of retained placenta at the study centre during the period under review. Methods: This was a retrospective case-control study in which records of women with retained placenta between January 2011 and December 2015 were retrieved and analysed for their age, parity, risk factors, clinical presentation and associated complications and compared with equal number of patients without retained placenta. Results: There were 11 cases of retained placenta recorded among the total number of 2068 deliveries during the study period, giving an incidence of 0.53% retained placenta in this study. Majority of cases (45.4%) were between age 30 and 39 years which was similar to the controls (54.5%). Most of the cases were unbooked (81%). Similarly, most women in both cases (82%) and controls (73%) were multiparae. All the 5 cases (45.5%) that had post-partum haemorrhage received blood transfusion. The overall incidence of post-partum anaemia was 54%. The average weights of the placentae were significantly smaller in the cases with placental retention (p = 0.010). Conclusion: Retained placenta is associated with significant risks of post-partum haemorrhage and blood transfusion. Non-booking for antenatal care is the commonest risk factor identified for retained placenta in this study.展开更多
[ Objective ] The aim of the research was to reveal the mechanism of Yizhikang powder treatment on dairy cattle with retained placenta from the hemorheological perspective. [ Method] Dairy cattle with retained placent...[ Objective ] The aim of the research was to reveal the mechanism of Yizhikang powder treatment on dairy cattle with retained placenta from the hemorheological perspective. [ Method] Dairy cattle with retained placenta were treated with oral administration of Yizhikang powder. And their hemorheological indexes were measured and compared with the corresponding indicators of pre-administration group, healthy group, and control group （sick but untreated）.[ Result] There was large decrease amplitude in the indexes （whole blood viscosity, plasma viscosity, whole blood viscosity reduction viscosity, ESR, ESR equation K value, fibrinogen content, platelet aggregation rate, RBC deformability IF value） of treated dairy cattle with retained placenta. By t test, the indexes, except hematocrit, decreased significantly after treatment （P〈0.05） and reached the status of post partum healthy cows. The hemorheological indexes didn＇t change significantly in the control group before and after treatment. [ Conclusion] Yizhikang powder could significantly improve blood flow state and reduced the occurrence of qi stagnation and blood stasis in perinatal period.展开更多
This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta, and that in women with and without previous cesarean se...This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta, and that in women with and without previous cesarean section. In this study, placenta previa was defined as a placenta lying within 20 mm of the internal cervical os or overlapping it. We recruited 183 women diagnosed with previa between 20+0 weeks and 25+6 weeks. They were grouped according to their placenta location(anterior or posterior) and history of cesarean section. Comparative analysis was performed on demographic data, resolution rate of previa and pregnancy outcomes between anterior group and posterior group, and on those between cesarean section group and non-cesarean section group. Women with an anterior placenta tended to be advanced in parity(P=0.040) and have increased number of dilatation and curettage(P=0.044). The women in cesarean section group were significantly older(P=0.000) and had more parity(P=0.000), gravidity(P=0.000), and dilatation and curettage(P=0.048) than in non-cesarean section group. Resolution of previa at delivery occurred in 87.43% women in this study. Women with a posterior placenta had a higher rate of resolution(P=0.030), while history of cesarean section made no difference. Gestational age at resolution was earlier in posterior group(P=0.002) and non-cesarean section group(P=0.008) than in anterior group and cesarean section group correspondingly. Placenta location and prior cesarean section did not influence obstetric outcomes and neonatal outcomes. This study indicates that it is more likely to have subsequent resolution of the previa when the placenta is posteriorly located for women who are diagnosed with placenta previa in the second trimester.展开更多
Objective:To evaluate the efficacy and safety of balloon occlusion of the abdominal aorta for the treatment of pernicious placenta previa with placenta accreta.Methods:The clinical data of 623 patients with pernicious...Objective:To evaluate the efficacy and safety of balloon occlusion of the abdominal aorta for the treatment of pernicious placenta previa with placenta accreta.Methods:The clinical data of 623 patients with pernicious placenta previa combined with placenta accrete,who were admitted to our hospital from January 2013 to January 2019 were retrospectively analyzed.All patients underwent abdominal aortic balloon occlusion combined with cesarean section,and 78 patients underwent sequential bilateral uterine artery embolization.We analyzed the operation time,intraoperative blood loss,blood transfusion volume,intraoperative and postoperative complications,fetal radiation exposure time and dose,and the Apgar score of the newborns.We also performed other evaluations to ascertain the efficacy and safety of abdominal aortic balloon occlusion treatment for dangerous placenta previa with placenta accrete.Results:Of the 623 patients,545 underwent only abdominal aortic balloon occlusion,and 78 underwent uterine artery embolization due to intraoperative or postoperative bleeding.The uterus was successfully preserved in all patients.Except for five cases of right lower extremity arterial thrombosis,the remaining patients did not have postoperative lower extremity arteriovenous thrombosis,renal insufficiency,late postpartum hemorrhage,ectopic embolism,spinal cord or peripheral nerve damage,pelvic infection,or other serious complications.The mean operative time was 65.3(±14.5)min.The mean intraoperative blood loss was620(±570)ml.Ninety-six patients(15.4%,96/623)were treated with blood transfusion,and the average amount of blood transfused was 750(±400)ml.The average number of hospitalization days was 6.8(±3.4)days,the average time of fetal ray exposure was 5.2(±1.6)s,and the average radiation dose was 4.1(±2.7)m Gy.The neonatal Apgar score,was 8.4(±0.6)points at 1 min,and 9.6(±0.4)points at 5 min.In the follow-up to May 31,2019,29 patients were lost to follow-up,96 were lactating,and 498 were menstruating.Except for the cases lost to follow-up,the remaining 596 surviving newborns(including 2 twins)showed no abnormalities at the 42-day postnatal outpatient follow-up examination.Conclusion:Balloon occlusion of the abdominal aorta is a safe and effective method for the treatment of pernicious placenta previa with placenta accreta.展开更多
Objective:To investigate the clinical utility of ultrasound-guided balloon occlusion in cesarean section in patients with sinister placenta previa.Methods:The Interventional and Ultrasound Departments of the authors’...Objective:To investigate the clinical utility of ultrasound-guided balloon occlusion in cesarean section in patients with sinister placenta previa.Methods:The Interventional and Ultrasound Departments of the authors’center assisted obstetrics to complete cesarean section in cases of sinister placenta previa.A total of 130 patients with implanted sinister placenta previa were diagnosed using obstetrical ultrasound and magnetic resonance imaging(MRI).Before cesarean section,the balloon was positioned in the bilateral radial or abdominal aorta.Immediately after delivery of the fetus,the balloon was temporarily filled to transiently seal the target vessel.According to the obstetrician’s assessment of hemostasis,the balloon was withdrawn at the appropriate time.Among the 130 patients,there was one case of abdominal aortic occlusion,with 129 cases blocked by the bilateral common iliac artery.Results:All 130 cases were successfully blocked,with an average blocking time of<15 min,while intraoperative blood loss was 800–1500 ml.Conclusion:Ultrasound-guided balloon blocking treatment before cesarean section can mitigate the dangers of placenta previa and significantly reduce blood loss with no exposure to X-ray radiation.Thus,the technique merits serious consideration.展开更多
BACKGROUND Mifepristone-induced abortion(MIA)has been used worldwide to terminate pregnancies.However,the association between placenta accrete(PA)and MIA has seldom been reported.CASE SUMMARY A 26-year-old pregnant wo...BACKGROUND Mifepristone-induced abortion(MIA)has been used worldwide to terminate pregnancies.However,the association between placenta accrete(PA)and MIA has seldom been reported.CASE SUMMARY A 26-year-old pregnant woman presented with painless vaginal bleeding at 35 wk of gestation.She had a medical abortion(mifepristone followed by misoprostol)1 year ago at the sixth week of gestation.Her personal history for previous surgery was negative.Abdominal ultrasonography showed a normal foetus with complete placenta previa.The foetal membrane ruptured with massive vaginal bleeding and severe abdominal pain.An emergency Caesarean section was performed,and the newborn was delivered.The placenta failed to expel and manual extraction was carried out.A large defect was noted in the uterine fundus and repair of the uterine rupture was conducted immediately.The postoperative pathology report showed placenta accreta.CONCLUSION The evidence suggests a possible etiologic role of MIA in PA,as the incidence of PA after MIA is much higher than general population.Millions of pregnancies are complicated by PA each year,some of which result in fatality.To prevent subsequent placental complications after MIA,hormonal supplementation might be a promising therapeutic options.However,further studies are needed to identify the high-risk factors and to confirm the effectiveness of estrogen supplement therapy.展开更多
Objective:?The study’s objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Backgrou...Objective:?The study’s objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Background:?Traditionally, 2D ultrasound was used for the diagnosis of a suspected morbidly adherent placenta (MAP) previa. More objective techniques like 3D power Doppler haven’t been well studied. Study Design:?A prospective cohort study?is?designed for women with gestational age between 28 and?32 weeks with suspected placenta previa. Patients were examined by 2D ultrasound which was used in management decisions.?3D Power Doppler’s VI, FI and VFI were measured during the same examination after manual tracing of placenta;data were blinded to obstetricians. Histopathology was performed to confirm MAP. Results: Our results showed that the 3D power Doppler VI ≥ 16 predicted the diagnosis of MAP with 100% sensitivity, 100% specificity which is better than those of 2D ultrasound. While VI > 33.1 measured by 3D Doppler predicted severe MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound. Conclusion:?In patients with placenta previa, the 3D Doppler’s vascular index accurately predicts MAP. Furthermore, vascular and vascular flow indices of 3D Doppler were more predictive of severe cases of MAP compared to 2D ultrasound.展开更多
Yaks live in Qinghai-Tibet Plateau （4 km above sea level）, and the nutrient components of their placenta were determined, including 17 kinds of amino acids and 11 kinds of trace elements. The results showed that the...Yaks live in Qinghai-Tibet Plateau （4 km above sea level）, and the nutrient components of their placenta were determined, including 17 kinds of amino acids and 11 kinds of trace elements. The results showed that there are abundant amino acids and trace elements in the placenta of yak, equal to that of human and deer, indicating some medical and nutritional value of yak placenta.展开更多
Studies of calcium transfer across the placenta have been reviewed because of the physiological and nutritional importance of this mineral during pregnancy, especially in order to better understand its contribution to...Studies of calcium transfer across the placenta have been reviewed because of the physiological and nutritional importance of this mineral during pregnancy, especially in order to better understand its contribution to development of the fetal skeleton. The placental transfer of maternal calcium to the fetus represents a vital mechanism for fetal development and breast-milk production, yet little meaningful information is currently available regarding the biochemical mechanisms involved in this process. Once again, the use of different animal models as rodents, rabbit, sheep and bovine have demonstrate different mechanisms of calcium transport across the placenta and contribute to better understand its effects in both fetus and mother during the gestation. In relation to the transfer of calcium from the mother to fetus data suggest it occur via an active mechanism;thus calcium concentration is higher in fetus than in maternal blood. Despite conflicting reports, several investigators agreed that calcium concentration in the fetal blood is mainly regulated by fetal parathyroid hormone and plasma concentration of vitamin D3, a metabolite that plays a key role in calcium transport through the syncytial cells.展开更多
The association between etio-pathogenesis of morbidly adherent placenta (MAP) or placenta cretas and adenomyosis has never been described in medical literature. Contrary to the believe that MAP is due to direct invasi...The association between etio-pathogenesis of morbidly adherent placenta (MAP) or placenta cretas and adenomyosis has never been described in medical literature. Contrary to the believe that MAP is due to direct invasion of trophoblastic tissues into the adjacent normal myometrium due to prior uterine surgeries, this article describes how pre-existence of adenomyosis acts as a precursor for the development of placenta cretas. It elucidates how prior uterine traumas such as surgeries, repeated childbirths and endometritis cause endometrial tissues to invade the myometrium as a result of disruption of decidua basalis. The invaded endometrial tissues cause hyper-plasia and hypertrophy of surrounding myometrium to form the clinical entity called adenomyosis. The over-expression of bcl-2 oncogene in the endometrium causes inhibition of apoptosis of endometrial cells removing the barrier of trophoblastic tissues to invade the myometrium to form MAP. This hypothesis is based on the similarity of their clinical perspectives, similar pathological description of the two disease entities and their common molecular components. Both diseases increase with age;more in women older than 35 years and also in those with history of previous endometrial traumas such as surgeries, childbirth and endometritis. Both diseases also share common pathological factors and molecular components due to absence of deciduas basalis and over-expression of bcl-2 oncoprotein gene, inhibition of cell apoptosis and failure to find genetic abnormalities such as mutations of K-ras, P53 or LOH. An ongoing study looking at uterine specimens from cesarean hysterectomies and pelvic MRI evaluation of patients with retained placentas to prove that pre-existing adenomyosis may be a precursor to the development of morbidly adherent placenta is near to conclusion.展开更多
基金financially supported by the Adisseo Innovation Research Center for Nutrition and Health(060–2222319005)Natural Science Foundation of Sichuan(2023NSFSC1135)National Natural Science Foundation of China(31972603)。
文摘Background Previous evidence suggests that methionine(Met)consumption can promote placental angiogenesis and improve fetal survival.To investigate the mechanisms by which increased levels of Met as hydroxyl-Met(OHMet)improve placental function,forty sows were divided into four groups and fed either a control diet,or diets supplemented with 0.15%OHMet,0.3%OHMet or 0.3%Met(n=10).Placentas were collected immediately after expulsion,and extracted proteins were analyzed by tandem mass tag based quantitative proteomic analysis.Results We found that 0.15%OHMet consumption significantly increased placental vascular density compared with the control.Proteomic analysis identified 5,136 proteins,87 of these were differentially expressed(P<0.05,|fold change|>1.2).Enriched pathways in the Kyoto Encyclopedia of Genes and Genomes for 0.15%OHMet vs.control and 0.15%OHMet vs.0.3%OHMet were glutathione metabolism;for 0.15%OHMet vs.0.3%Met,they were NOD-like receptor signaling and apoptosis.Further analysis revealed that 0.15%OHMet supplementation upregulated the protein expression of glutathione-S-transferase(GSTT1)in placentas and trophoblast cells compared with the control and 0.3%OHMet groups,upregulated thioredoxin(TXN)in placentas and trophoblast cells compared with the 0.3%OHMet and 0.3%Met groups,and decreased reactive oxygen species(ROS)levels in trophoblast cells compared with other groups.In contrast,sows fed 0.3%OHMet or 0.3%Met diets increased placental interleukin 1βlevels compared with the control,and upregulated the protein expression of complex I-B9(NDUFA3)compared with the 0.15%OHMet group.Furthermore,homocysteine,an intermediate in the trans-sulphuration pathway of Met,damaged placental function by inhibiting the protein expression of TXN,leading to apoptosis and ROS production.Conclusion Although dietary 0.15%OHMet supplementation improved placental angiogenesis and increased antioxidative capacity,0.3%OHMet or 0.3%Met supplementation impaired placental function by aggravating inflammation and oxidative stress,which is associated with cumulative homocysteine levels.
文摘Placenta abnormalities,which are collectively termed as placenta accreta spec-trum(PAS),are increasing globally in the female population due to the large nu-mber of cesarean sections performed worldwide.PAS represents a rare but life-threatening occurrence that can lead to an increased risk of postpartum hemorr-hage due to the abnormal infiltration of the chorionic villi in the uterine wall up to the adjacent structures.Performing a prophylactic occlusion of the iliac arteries for a brief amount of time using balloon-occlusion endovascular catheters in patients with PAS can help control unwanted blood losses during cesarean delivery or postpartum demolition surgery.The aim of this narrative minireview was to pro-vide an overview of the aspects about prophylactic occlusion with endovascular balloons in patients with PAS and to analyze current evidence on this topic.In particular,this minireview included an overview of indications,patient selection,type of materials and devices used,technical advice and suggestions,clinical outcomes,and complications to give every interventional radiologist as well as every gynecologist and midwife all the information that is needed to address this particular condition in a safe and prompt manner.
基金Natural Science Foundation of Heilongjiang Province(YQ2022C014)National Natural Science Foundation of China(32302768).
文摘Background Progressive oxidative stress easily occurs as a result of a gradual increase in the intensity of maternal metabolism due to rapid foetal development and increased intensity of lactation.However,studies on the effects of processive oxidative stress on nutrient transport in the placenta have received little attention.The present study was conducted on sows at 85 days of gestation to study the effects of pterostilbene(PTE)on maternal oxidative stress status and placental nutrient transport.Results PTE increased the antioxidant capacity and immunoglobulin content in mothers’blood and milk,reduced the level of inflammatory factors,and improved the nutrient content of milk.PTE also reduced sow backfat loss and the number of weak sons,and increased piglet weaning weight and total weaning litter weight.We subsequently found that PTE enhanced placental glucose and fatty acid transport and further affected glycolipid metabolism by increasing the expression of LAL,PYGM,and Gbe-1,which activated the PI3K phosphorylation pathway.Moreover,PTE addition altered the relative abundance of the Firmicutes,Proteobacteria,Parabacillus,and Bacteroidetes-like RF16 groups in sow faeces.PTE increased the levels of acetate,propionate,butyrate and isovalerate in the faeces.Conclusions These findings reveal that the addition of PTE during pregnancy and lactation mitigates the effects of processive oxidative stress on offspring development by altering maternal microbial and placental nutrient trans-port capacity.
基金supported by the National Natural Science Foundation of China(No.32271165)the Interdisciplinary Project in Ocean Research of Tongji University(No.2022-2-ZD-02),China.
文摘Imprinted genes play a key role in regulating mammalian placental and embryonic development.Here,we generated glutaminyl-peptide cyclotransferase-knockout(Qpct^(-/-))mice utilizing the clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated protein 9(Cas9)platform and identified Qpct as a novel anti-angiogenic factor in regulating mouse placentation.Compared with Qpct^(+/+)mice,placentae and embryos(Qpct^(-/+)and Qpct^(-/-))showed significant overgrowth at embryonic Day 12.5(E12.5),E15.5,and E18.5.Using single-cell transcriptome analysis of 32309 cells from Qpct^(+/+)and Qpct^(-/-)mouse placentae,we identified 13 cell clusters via single-nucleus RNA sequencing(snRNA-seq)(8880 Qpct^(+/+)and 13577 Qpct^(-/-)cells)and 20 cell clusters via single-cell RNA sequencing(scRNA-seq)(6567 Qpct^(+/+)and 3285 Qpct^(-/-)cells).Furthermore,we observed a global up-regulation of pro-angiogenic genes in the Qpct^(-/-)background.Immunohistochemistry assays revealed a notable increase in the number of blood vessels in the decidual and labyrinthine layers of E15.5 Qpct^(-/+)and Qpct^(-/-)mice.Moreover,the elevation of multiple pairs of ligand-receptor interactions was observed in decidual cells,endothelial cells,and macrophages,promoting angiogenesis and inflammatory response.Our findings indicate that loss of maternal Qpct leads to altered phenotypic characteristics of placentae and embryos and promotes angiogenesis in murine placentae.
基金financially supported by the Chief Scientist of the Ministry of Agriculture,grant number 20-04-0015,Rishon Lezion,Israel。
文摘Background The placenta plays a crucial role in supporting and influencing fetal development.We compared the effects of prepartum supplementation with omega-3(n-3)fatty acid(FA)sources,flaxseed oil(FLX)and fish oil(FO),on the expression of genes and proteins related to lipid metabolism,inflammation,oxidative stress,and the endocannabinoid system(ECS)in the expelled placenta,as well as on FA profile and inflammatory response of neonates.Late-pregnant Holstein dairy cows were supplemented with saturated fat(CTL),FLX,or FO.Placental cotyledons(n=5)were collected immediately after expulsion,and extracted RNA and proteins were analyzed by RTPCR and proteomic analysis.Neonatal blood was assessed for FA composition and concentrations of inflammatory markers.Results FO increased the gene expression of fatty acid binding protein 4(FABP4),interleukin 10(IL-10),catalase(CAT),cannabinoid receptor 1(CNR1),and cannabinoid receptor 2(CNR2)compared with CTL placenta.Gene expression of ECS-enzyme FA-amide hydrolase(FAAH)was lower in FLX and FO than in CTL.Proteomic analysis identified 3,974 proteins;of these,51–59 were differentially abundant between treatments(P≤0.05,|fold change|≥1.5).Top canonical pathways enriched in FLX vs.CTL and in FO vs.CTL were triglyceride metabolism and inflammatory processes.Both n-3 FA increased the placental abundance of FA binding proteins(FABPs)3 and 7.The abundance of CNR1 cannabinoid-receptor-interacting-protein-1(CNRIP1)was reduced in FO vs.FLX.In silico modeling affirmed that bovine FABPs bind to endocannabinoids.The FLX increased the abundance of inflammatory CD44-antigen and secreted-phosphoprotein-1,whereas prostaglandin-endoperoxide synthase 2 was decreased in FO vs.CTL placenta.Maternal FO enriched neonatal plasma with n-3 FAs,and both FLX and FO reduced interleukin-6 concentrations compared with CTL.Conclusion Maternal n-3 FA from FLX and FO differentially affected the bovine placenta;both enhanced lipid metabolism and modulated oxidative stress,however,FO increased some transcriptional ECS components,possibly related to the increased FABPs.Maternal FO induced a unique balance of pro-and anti-inflammatory components in the placenta.Taken together,different sources of n-3 FA during late pregnancy enhanced placental immune and metabolic processes,which may affect the neonatal immune system.
基金supported by the National Key R&D Program of China(2022YFF1000100)Technology Application and Development Program for Rapid Propagation of Cow Breeding(20211117000005)+2 种基金Basic Science(Agricultural Biology)Research Center of Shaanxi(K3030922016)Ningxia Hui Autonomous Region Key R&D Projects(2021BEF01001)Natural Science Basic Research Program of Shaanxi(2022JQ-171)。
文摘The placenta plays a crucial role in successful mammalian reproduction.Ruminant animals possess a semi-invasive placenta characterized by a highly vascularized structure formed by maternal endometrial caruncles and fetal placental cotyledons,essential for full-term fetal development.The cow placenta harbors at least two trophoblast cell populations:uninucleate(UNC)and binucleate(BNC)cells.However,the limited capacity to elucidate the transcriptomic dynamics of the placental natural environment has resulted in a poor understanding of both the molecular and cellular interactions between trophoblast cells and niches,and the molecular mechanisms governing trophoblast differentiation and functionalization.To fill this knowledge gap,we employed Stereo-seq to map spatial gene expression patterns at near single-cell resolution in the cow placenta at 90 and 130 days of gestation,attaining high-resolution,spatially resolved gene expression profiles.Based on clustering and cell marker gene expression analyses,key transcription factors,including YBX1 and NPAS2,were shown to regulate the heterogeneity of trophoblast cell subpopulations.Cell communication and trajectory analysis provided a framework for understanding cell-cell interactions and the differentiation of trophoblasts into BNCs in the placental microenvironment.Differential analysis of cell trajectories identified a set of genes involved in regulation of trophoblast differentiation.Additionally,spatial modules and co-variant genes that help shape specific tissue structures were identified.Together,these findings provide foundational insights into important biological pathways critical to the placental development and function in cows.
文摘Objective:To describe and determine the association between Covid-19 vaccination in pregnancy and placental pathology.Methods:Conducted in a tertiary hospital in Medan,Indonesia,from April 30th 2022 to June 30th 2022,this single-center cross-sectional study involved Covid-19 vaccinated and unvaccinated women with singleton full-term pregnancies delivering live fetuses via cesarean section.Maternal characteristics,placental pathologies,and the placental index were documented at enrollment.The association between Covid-19 vaccination status and placental pathology was assessed.Results:The study enrolled 200 pregnant women,including 110 vaccinated women and 90 unvaccinated women.No significant differences were observed in birthweight(P=0.48),placental index(P=0.48),and placental pathology findings[intervillous bleeding(P=0.20),increased syncytial knots(P=0.83),chorangiosis(P=0.13),villous stromal edema(P=0.13),vascular dilation and congestion(P=0.13),and vascular wall thrombus(P=0.71)]between the vaccinated and unvaccinated groups.Conclusions:This study revealed no statistically significant association between Covid-19 vaccination and placental pathology.The findings support the safety of Covid-19 vaccination during pregnancy,in regards to changes of the placental pathology.
基金supported by Agriculture and Food Research Initiative Competitive Grant 2016–67015-24958 from the USDA National Institute of Food and Agriculture。
文摘Background Tissue non-specific alkaline phosphatase(TNSALP;encoded by the ALPL gene)has a critical role in the postnatal regulation of p hospliate homeostasis,yet how TNSALP activity and expression are regulated during pregnancy remain largely unknown.This study tested the hypothesis that progesterone(P4)and/or interferon tau(IFNT)regulate TNSALP activity during pregnancy in sheep.Methods In Exp.1,ewes were bred and received daily intramuscular injections of either corn oil vehicle(CO)or 25 mg progesterone in CO(P4)for the first 8 days of pregnancy and were hysterectomized on either Day 9,12,or 125 of gestation.In Exp.2,ewes were fitted with intrauterine catheters on Day 7 of the estrous cycle and received daily intramuscular injections of 50 mg P4 in CO and/or 75 mg progesterone receptor antagonist(RU486)in CO from Days 8 to 15,and twice daily intrauterine injections of either control proteins(CX)or IFNT(25μg/uterine horn/d)from Days 11 to 15(treatment groups:P4+CX;P4+IFNT;RU486+P4+CX;and RU486+P4+IFNT)and were hysterectomized on Day 16.Results In Exp.1,endometria from ewes administered P4 had greater expression of ALPL mRNA than ewes administered CO on Day 12.TNSALP activity appeared greater in the epithelia,stratum compactum stroma,and endothelium of the blood vessels in the endometrium and myometrium from ewes administered P4 than ewes administered CO on Day 12.On Day 125,TNSALP activity localized to uterine epithelial and endothelial cells,independent of P4 treatment.TNSALP activity in placentomes appeared greater in P4 treated ewes and was detected in endothelial cells and caruncular tissue in P4 treated but not CO treated ewes.In Exp.2,endometrial homogenates from ewes administered RU486+P4+CX had lower TNSALP activity those for P4+CX and P4+IFNT ewes.Immunoreactive TNSALP protein appeared greater in the mid-and deep-glandular epithelia in RU486+P4+CX treated ewes as compared to the other treatment groups.Enzymatic activity appeared greater on the apical surface of the deep glandular epithelia in endometria from ewes treated with RU486+P4+CX compared to the other treatment groups.Conclusions These results suggest that P4,but not IFNT,regulates the expression and activity of TNSALP in uteroplacental tissues and has the potential to contribute to the regulation of phosphate availability that is critical for conceptus development during pregnancy.
文摘Introduction: Pre-eclampsia is a complication of pregnancy that generally occurs in the third trimester. It is associated with a maternal and foetal mortality rate of around 27%. In view of the grim picture painted by this condition for both mother and newborn, studies have been carried out into the early detection of patients at risk of developing pre-eclampsia. These make it possible to introduce pregnancy-specific monitoring and preventive strategies to reduce the incidence of the condition. Objective: To establish the link between placental ultrasound characteristics and the onset of pre-eclampsia. Methodology: A multicentre prospective cohort study was conducted in two hospitals in Yaoundé, namely the Yaoundé Gynaecological Obstetrics and Paediatrics Hospital and the Nkolndongo Health and Social Animation Centre, in the gynaecology and radiology departments over a period of 11 months, from October 2022 to August 2023. It included pregnant women who had undergone obstetric ultrasound between 12 and 18 weeks’ gestation. In addition to routine obstetric ultrasound, we performed obstetric Doppler measurements in these patients. The resistance index of the left and right uterine arteries, the umbilical artery and the placental volume were the characteristics sought. At the end of this examination, two groups were formed: cases (pathological Doppler group) and controls (normal Doppler group). Blood pressure and urine dipstick were taken at each antenatal visit until delivery, then during the immediate postpartum period and finally at 7 days, 21 days and 42 days after delivery. Results: Sixty-seven (67) patients were included. Of these, 35 (47.8%) had pathological Dopplers. Sixteen patients had arterial hypertension associated with proteinuria and were therefore labelled as pre-eclampsia (PE). This gives a prevalence of 23.9%. Fifteen (42.8%) of these patients belonged to the exposed group and one to the unexposed group. The mean IR of the pre-eclampsia patients was significantly higher than that of the patients without pre-eclampsia;respectively 0.74 ± 0.096 and 0.49 ± 0.097 for the right uterine arteries and 0.71 ± 0.13 and 0.52 ± 0.089 for the left uterine arteries. We found that an increase in the uterine artery resistance index was significantly associated with the onset of pre-eclampsia, with a relative risk of 13.7 and a p value Conclusion: Abnormal Doppler ultrasound between 12 and 18 weeks of amenorrhoea had good overall sensitivity for predicting pre-eclampsia. Among the Doppler indices, the uterine artery resistance index was the only one significantly associated with pre-eclampsia.
文摘Vasa previa is a rare obstetric complication, characterized by fetal umbilical cord blood vessels being unprotected by Wharton’s jelly or placental tissue and located within 20 mm of the internal cervical os. This case describes a late pregnancy antepartum hemorrhage that was promptly treated with a cesarean section. During the surgery, a ruptured vasa previa was found, and fortunately, the rupture was blocked by a clot, resulting in minimal blood loss. Both mother and baby had a good outcome. The case is used to elaborate on the high-risk factors, classification, diagnostic methods, and treatment plans for vasa previa, aiming to increase the detection rate of this condition and manage it systematically, ultimately improving perinatal outcomes.
文摘Background: Detachment of the placenta occurs in about 96% of patients within 30 minutes of completion of the second stage of labour, thus any further delay there after is usually considered as retained placenta. It is associated with the risk of post-partum haemorrhage and anaemia. Objectives: To determine the incidence, risk factors, clinical presentation and complications of retained placenta at the study centre during the period under review. Methods: This was a retrospective case-control study in which records of women with retained placenta between January 2011 and December 2015 were retrieved and analysed for their age, parity, risk factors, clinical presentation and associated complications and compared with equal number of patients without retained placenta. Results: There were 11 cases of retained placenta recorded among the total number of 2068 deliveries during the study period, giving an incidence of 0.53% retained placenta in this study. Majority of cases (45.4%) were between age 30 and 39 years which was similar to the controls (54.5%). Most of the cases were unbooked (81%). Similarly, most women in both cases (82%) and controls (73%) were multiparae. All the 5 cases (45.5%) that had post-partum haemorrhage received blood transfusion. The overall incidence of post-partum anaemia was 54%. The average weights of the placentae were significantly smaller in the cases with placental retention (p = 0.010). Conclusion: Retained placenta is associated with significant risks of post-partum haemorrhage and blood transfusion. Non-booking for antenatal care is the commonest risk factor identified for retained placenta in this study.
基金Supported by Science and Technology Key Projects of Xinjiang Pro-duction and Construction Corps (2006GG22)~~
文摘[ Objective ] The aim of the research was to reveal the mechanism of Yizhikang powder treatment on dairy cattle with retained placenta from the hemorheological perspective. [ Method] Dairy cattle with retained placenta were treated with oral administration of Yizhikang powder. And their hemorheological indexes were measured and compared with the corresponding indicators of pre-administration group, healthy group, and control group （sick but untreated）.[ Result] There was large decrease amplitude in the indexes （whole blood viscosity, plasma viscosity, whole blood viscosity reduction viscosity, ESR, ESR equation K value, fibrinogen content, platelet aggregation rate, RBC deformability IF value） of treated dairy cattle with retained placenta. By t test, the indexes, except hematocrit, decreased significantly after treatment （P〈0.05） and reached the status of post partum healthy cows. The hemorheological indexes didn＇t change significantly in the control group before and after treatment. [ Conclusion] Yizhikang powder could significantly improve blood flow state and reduced the occurrence of qi stagnation and blood stasis in perinatal period.
基金supported by grants from National Natural Science Foundation of China(Nos.30672243 and 81200354)Hubei Provincial Population and Family Planning Commission of China(No.JS-20130017)Huazhong University of Science and Technology(No.2013YGYL016)
文摘This prospective study was conducted to assess the rate of resolution of second trimester placenta previa in women with anterior placenta and posterior placenta, and that in women with and without previous cesarean section. In this study, placenta previa was defined as a placenta lying within 20 mm of the internal cervical os or overlapping it. We recruited 183 women diagnosed with previa between 20+0 weeks and 25+6 weeks. They were grouped according to their placenta location(anterior or posterior) and history of cesarean section. Comparative analysis was performed on demographic data, resolution rate of previa and pregnancy outcomes between anterior group and posterior group, and on those between cesarean section group and non-cesarean section group. Women with an anterior placenta tended to be advanced in parity(P=0.040) and have increased number of dilatation and curettage(P=0.044). The women in cesarean section group were significantly older(P=0.000) and had more parity(P=0.000), gravidity(P=0.000), and dilatation and curettage(P=0.048) than in non-cesarean section group. Resolution of previa at delivery occurred in 87.43% women in this study. Women with a posterior placenta had a higher rate of resolution(P=0.030), while history of cesarean section made no difference. Gestational age at resolution was earlier in posterior group(P=0.002) and non-cesarean section group(P=0.008) than in anterior group and cesarean section group correspondingly. Placenta location and prior cesarean section did not influence obstetric outcomes and neonatal outcomes. This study indicates that it is more likely to have subsequent resolution of the previa when the placenta is posteriorly located for women who are diagnosed with placenta previa in the second trimester.
文摘Objective:To evaluate the efficacy and safety of balloon occlusion of the abdominal aorta for the treatment of pernicious placenta previa with placenta accreta.Methods:The clinical data of 623 patients with pernicious placenta previa combined with placenta accrete,who were admitted to our hospital from January 2013 to January 2019 were retrospectively analyzed.All patients underwent abdominal aortic balloon occlusion combined with cesarean section,and 78 patients underwent sequential bilateral uterine artery embolization.We analyzed the operation time,intraoperative blood loss,blood transfusion volume,intraoperative and postoperative complications,fetal radiation exposure time and dose,and the Apgar score of the newborns.We also performed other evaluations to ascertain the efficacy and safety of abdominal aortic balloon occlusion treatment for dangerous placenta previa with placenta accrete.Results:Of the 623 patients,545 underwent only abdominal aortic balloon occlusion,and 78 underwent uterine artery embolization due to intraoperative or postoperative bleeding.The uterus was successfully preserved in all patients.Except for five cases of right lower extremity arterial thrombosis,the remaining patients did not have postoperative lower extremity arteriovenous thrombosis,renal insufficiency,late postpartum hemorrhage,ectopic embolism,spinal cord or peripheral nerve damage,pelvic infection,or other serious complications.The mean operative time was 65.3(±14.5)min.The mean intraoperative blood loss was620(±570)ml.Ninety-six patients(15.4%,96/623)were treated with blood transfusion,and the average amount of blood transfused was 750(±400)ml.The average number of hospitalization days was 6.8(±3.4)days,the average time of fetal ray exposure was 5.2(±1.6)s,and the average radiation dose was 4.1(±2.7)m Gy.The neonatal Apgar score,was 8.4(±0.6)points at 1 min,and 9.6(±0.4)points at 5 min.In the follow-up to May 31,2019,29 patients were lost to follow-up,96 were lactating,and 498 were menstruating.Except for the cases lost to follow-up,the remaining 596 surviving newborns(including 2 twins)showed no abnormalities at the 42-day postnatal outpatient follow-up examination.Conclusion:Balloon occlusion of the abdominal aorta is a safe and effective method for the treatment of pernicious placenta previa with placenta accreta.
文摘Objective:To investigate the clinical utility of ultrasound-guided balloon occlusion in cesarean section in patients with sinister placenta previa.Methods:The Interventional and Ultrasound Departments of the authors’center assisted obstetrics to complete cesarean section in cases of sinister placenta previa.A total of 130 patients with implanted sinister placenta previa were diagnosed using obstetrical ultrasound and magnetic resonance imaging(MRI).Before cesarean section,the balloon was positioned in the bilateral radial or abdominal aorta.Immediately after delivery of the fetus,the balloon was temporarily filled to transiently seal the target vessel.According to the obstetrician’s assessment of hemostasis,the balloon was withdrawn at the appropriate time.Among the 130 patients,there was one case of abdominal aortic occlusion,with 129 cases blocked by the bilateral common iliac artery.Results:All 130 cases were successfully blocked,with an average blocking time of<15 min,while intraoperative blood loss was 800–1500 ml.Conclusion:Ultrasound-guided balloon blocking treatment before cesarean section can mitigate the dangers of placenta previa and significantly reduce blood loss with no exposure to X-ray radiation.Thus,the technique merits serious consideration.
文摘BACKGROUND Mifepristone-induced abortion(MIA)has been used worldwide to terminate pregnancies.However,the association between placenta accrete(PA)and MIA has seldom been reported.CASE SUMMARY A 26-year-old pregnant woman presented with painless vaginal bleeding at 35 wk of gestation.She had a medical abortion(mifepristone followed by misoprostol)1 year ago at the sixth week of gestation.Her personal history for previous surgery was negative.Abdominal ultrasonography showed a normal foetus with complete placenta previa.The foetal membrane ruptured with massive vaginal bleeding and severe abdominal pain.An emergency Caesarean section was performed,and the newborn was delivered.The placenta failed to expel and manual extraction was carried out.A large defect was noted in the uterine fundus and repair of the uterine rupture was conducted immediately.The postoperative pathology report showed placenta accreta.CONCLUSION The evidence suggests a possible etiologic role of MIA in PA,as the incidence of PA after MIA is much higher than general population.Millions of pregnancies are complicated by PA each year,some of which result in fatality.To prevent subsequent placental complications after MIA,hormonal supplementation might be a promising therapeutic options.However,further studies are needed to identify the high-risk factors and to confirm the effectiveness of estrogen supplement therapy.
文摘Objective:?The study’s objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Background:?Traditionally, 2D ultrasound was used for the diagnosis of a suspected morbidly adherent placenta (MAP) previa. More objective techniques like 3D power Doppler haven’t been well studied. Study Design:?A prospective cohort study?is?designed for women with gestational age between 28 and?32 weeks with suspected placenta previa. Patients were examined by 2D ultrasound which was used in management decisions.?3D Power Doppler’s VI, FI and VFI were measured during the same examination after manual tracing of placenta;data were blinded to obstetricians. Histopathology was performed to confirm MAP. Results: Our results showed that the 3D power Doppler VI ≥ 16 predicted the diagnosis of MAP with 100% sensitivity, 100% specificity which is better than those of 2D ultrasound. While VI > 33.1 measured by 3D Doppler predicted severe MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound. Conclusion:?In patients with placenta previa, the 3D Doppler’s vascular index accurately predicts MAP. Furthermore, vascular and vascular flow indices of 3D Doppler were more predictive of severe cases of MAP compared to 2D ultrasound.
文摘Yaks live in Qinghai-Tibet Plateau （4 km above sea level）, and the nutrient components of their placenta were determined, including 17 kinds of amino acids and 11 kinds of trace elements. The results showed that there are abundant amino acids and trace elements in the placenta of yak, equal to that of human and deer, indicating some medical and nutritional value of yak placenta.
文摘Studies of calcium transfer across the placenta have been reviewed because of the physiological and nutritional importance of this mineral during pregnancy, especially in order to better understand its contribution to development of the fetal skeleton. The placental transfer of maternal calcium to the fetus represents a vital mechanism for fetal development and breast-milk production, yet little meaningful information is currently available regarding the biochemical mechanisms involved in this process. Once again, the use of different animal models as rodents, rabbit, sheep and bovine have demonstrate different mechanisms of calcium transport across the placenta and contribute to better understand its effects in both fetus and mother during the gestation. In relation to the transfer of calcium from the mother to fetus data suggest it occur via an active mechanism;thus calcium concentration is higher in fetus than in maternal blood. Despite conflicting reports, several investigators agreed that calcium concentration in the fetal blood is mainly regulated by fetal parathyroid hormone and plasma concentration of vitamin D3, a metabolite that plays a key role in calcium transport through the syncytial cells.
文摘The association between etio-pathogenesis of morbidly adherent placenta (MAP) or placenta cretas and adenomyosis has never been described in medical literature. Contrary to the believe that MAP is due to direct invasion of trophoblastic tissues into the adjacent normal myometrium due to prior uterine surgeries, this article describes how pre-existence of adenomyosis acts as a precursor for the development of placenta cretas. It elucidates how prior uterine traumas such as surgeries, repeated childbirths and endometritis cause endometrial tissues to invade the myometrium as a result of disruption of decidua basalis. The invaded endometrial tissues cause hyper-plasia and hypertrophy of surrounding myometrium to form the clinical entity called adenomyosis. The over-expression of bcl-2 oncogene in the endometrium causes inhibition of apoptosis of endometrial cells removing the barrier of trophoblastic tissues to invade the myometrium to form MAP. This hypothesis is based on the similarity of their clinical perspectives, similar pathological description of the two disease entities and their common molecular components. Both diseases increase with age;more in women older than 35 years and also in those with history of previous endometrial traumas such as surgeries, childbirth and endometritis. Both diseases also share common pathological factors and molecular components due to absence of deciduas basalis and over-expression of bcl-2 oncoprotein gene, inhibition of cell apoptosis and failure to find genetic abnormalities such as mutations of K-ras, P53 or LOH. An ongoing study looking at uterine specimens from cesarean hysterectomies and pelvic MRI evaluation of patients with retained placentas to prove that pre-existing adenomyosis may be a precursor to the development of morbidly adherent placenta is near to conclusion.
