Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was co...Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.展开更多
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
[ 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
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
目的:探讨宫腔球囊压迫联合缩宫素在高危型前置胎盘剖宫产术中预防产后出血的临床效果。方法:采用随机对照试验,选取2022年1月至2025年1月南阳市中心医院产科收治的82例高危型前置胎盘患者,随机分为对照组(n=41,单纯缩宫素治疗)和观察组...目的:探讨宫腔球囊压迫联合缩宫素在高危型前置胎盘剖宫产术中预防产后出血的临床效果。方法:采用随机对照试验,选取2022年1月至2025年1月南阳市中心医院产科收治的82例高危型前置胎盘患者,随机分为对照组(n=41,单纯缩宫素治疗)和观察组(n=41,缩宫素联合宫腔球囊压迫术)。比较两组术中及术后出血量、血红蛋白变化、产后出血发生率及不良反应。结果:观察组术中出血量(856.34±198.72 m L vs 1285.67±243.89 m L,P<0.001)、术后24 h出血量(156.23±48.91 m L vs 298.56±72.84 m L,P<0.001)显著低于对照组;产后出血发生率(19.51% vs 56.10%,P<0.001)明显降低;术后24 h时血红蛋白水平(106.74±14.26 g/L vs 92.35±12.89 g/L,P<0.001)更高。两组不良反应发生率无显著差异(4.88%vs 4.88%,P=1.000)。结论:宫腔球囊压迫联合缩宫素可有效减少高危型前置胎盘剖宫产术中及术后出血,降低产后出血发生率,且安全性良好。展开更多
Background: Resveratrol, a plant phenol, affords protection against inflammation and oxidative stress. The objective of this study was to investigate the effects of dietary resveratrol supplementation during pregnancy...Background: Resveratrol, a plant phenol, affords protection against inflammation and oxidative stress. The objective of this study was to investigate the effects of dietary resveratrol supplementation during pregnancy and lactation on the antioxidant status of sows and piglets and on antioxidant gene expression and pathway in placenta.Methods: Forty sows were allotted to 2 dietary treatments 20 d after breeding. Sows were fed a control diet and a control diet with 300 mg/kg resveratrol. Oxidative stress biomarkers and antioxidant enzymes were measured in the placenta, milk, and plasma of sows and piglets. Antioxidant gene expression and protein expression of Kelch-like ECH-associated protein 1-Nuclear factor E2-related factor 2(Keap1-Nrf2), nuclear factor kappa B-p65(NFκB-p65) and sirtuin1(Sirt1) were quantified in the placenta.Results: Dietary resveratrol increased the litter and piglets weaning weights. Antioxidant status in the milk, placenta and plasma of sows and piglets was partially improved by dietary resveratrol. In placenta, Nrf2 protein expression was increased and Keap1 protein expression was decreased by dietary resveratrol. The m RNA expression of antioxidant genes including catalase(CAT), glutathione peroxidase 1(GPX1), GPX4, superoxide dismutase 1(SOD1)and heme oxygenase 1(HO1), and phase 2 detoxification genes, including glutamate-cysteine ligase modifier(GCLM), microsomal glutathione S-transferase 1(MGST1) and UDP glucuronosyltransferase family 1 member A1(UGT1 A1), was increased by dietary resveratrol. Dietary resveratrol also increased Sirt1 and phosphorylated NFκB-p65 protein expression in the placenta. We failed to observe any influences of dietary resveratrol on pro-inflammatory cytokine levels, including those of interleukin 1β(IL-1β), IL-6, IL-8 and tumor necrosis factor α(TNF-α). However, we observed that the m RNA expression of IL-8 in placenta was reduced by maternal resveratrol. In addition, dietary resveratrol showed interactive effects with day of lactation on activities of SOD and CAT and levels of malonaldehyde(MDA) and hydrogen peroxide(H2 O2) in milk.Conclusions: Dietary resveratrol supplementation during pregnancy and lactation improves the antioxidant status of sows and piglets, which is beneficial to the reproductive performance of sows. Dietary resveratrol regulates placental antioxidant gene expression by the Keap1-Nrf2 pathway and Sirt1 in placenta.展开更多
Objective To evaluate the efficacy and safety of uterine artery embolization(UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical re...Objective To evaluate the efficacy and safety of uterine artery embolization(UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women(mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization. The complications, control of hemorrhage and recurrent bleeding of the placenta left inside the uterus were retrospectively collected for assessment. Results All patients underwent transcatheter embolization of bilateral uterine arteries. The technical success rate of embolization was 100%. Bleeding was controlled in 17 of 18 patients(94%) during follow-up period(median 18 months, 3-31months) without further bleeding recurred. One patient with placenta percreta undertook an emergent hysterectomy along with surgical bladder repair after UAE because of persistent uterine bleeding. Eight patients had postembolization syndrome and no other complications occurred. Conclusion Uterine artery embolization is an effective and safe treatment for the management of primary postpartum massive hemorrhage associated with placenta accreta.展开更多
Human placenta-derived mononuclear cells (MNC) were isolated by a Percoll density gradient and cultured in mesenchymal stem cell (MSC) maintenance medium. The homogenous layer of adherent cells exhibited a typical...Human placenta-derived mononuclear cells (MNC) were isolated by a Percoll density gradient and cultured in mesenchymal stem cell (MSC) maintenance medium. The homogenous layer of adherent cells exhibited a typical fibroblastlike morphology, a large expansive potential, and cell cycle characteristics including a subset of quiescent cells. In vitro differentiation assays showed the tripotential differentiation capacity of these cells toward adipogenic, osteogenic and chondrogenic lineages. Flow cytometry analyses and immunocytochemistry stain showed that placental MSC was a homogeneous cell population devoid of hematopoietic cells, which uniformly expressed CD29, CD44, CD73, CD105, CD166, laminin, fibronectin and vimentin while being negative for expression of CD31, CD34, CD45 and m-smooth muscle actin. Most importantly, immuno-phenotypic analyses demonstrated that these cells expressed class Ⅰ major histocompatibility complex (MHC-I), but they did not express MHC-Ⅱ molecules. Additionally these cells could suppress umbilical cord blood (UCB) lymphocytes proliferation induced by cellular or nonspecific mitogenic stimuli. This strongly implies that they may have potential application in allograft transplantation. Since placenta and UCB are homogeneous, the MSC derived from human placenta can be transplanted combined with hematopoietic stem cells (HSC) from UCB to reduce the potential graft-versus-host disease (GVHD) in recipients.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
In order to assess the number and function of macrophages in the placenta of pregnancy complicated with gestational diabetes mellitus (GDM) as well as those of normal pregnancies, placenta samples were collected fro...In order to assess the number and function of macrophages in the placenta of pregnancy complicated with gestational diabetes mellitus (GDM) as well as those of normal pregnancies, placenta samples were collected from 15 GDM patients (GDM group) and 10 normal pregnant women (control group). The expression levels of macrophage markers (CD68/CD14) and inflammatory cytokines (IL-6/TNF-α) in placenta were detected using immunohistochemistry and PCR. The results showed that the number of CD68+ or CD14+ cells in the GMD group was remarkably higher than that in the control group (P〈0.05), indicating that the number of macrophages in the GDM group was significantly greater than that in the control group. The mRNA expression levels of CD68+, IL-6 and TNF-α were higher in the GMD group than in the control group. In conclusion, more macrophages accumulate in placenta of pregnancy complicated with GDM, and the expression levels of pro-inflammation factors are also in- creased in GDM pregnancies, suggesting that macrophages and inflammatory mediators (IL-6 and TNF-α) mav olav an imoortant role in GDM.展开更多
To investigate the expression of osteopontin (OPN) and its receptor integrin αvβ3 in the placental tissue from pregnant women complicated with preeclampsia, the expression of OPN and αvβ3 in the placenta of the ...To investigate the expression of osteopontin (OPN) and its receptor integrin αvβ3 in the placental tissue from pregnant women complicated with preeclampsia, the expression of OPN and αvβ3 in the placenta of the pregnant women with preeclampsia and healthy pregnant women was detected by immunohistochemistry, Western blotting and RT-PCR. Our results showed that OPN and αvβ3 protein were expressed in the placenta from normal pregnant woman and those with preeclampsia. OPN was located in the placental syncytiotrophoblasts and the cytoplasm of capillary endothelial cells and integrin αvβ3 was mainly expressed on the surface of trophoblast cells. Expression of OPN and integrin αvβ3 in the placental tissue from preeclampsia subjects was significantly lower than that from the control group (P〈0.05). Compared with the control group, expression of OPN in the placental tissue from preeclampsia group was significantly lower (P〈0.05) but there was no significant difference in the expression of αv and β3 between the preeclampsia group and the controls. It is concluded that OPN and its receptor integrin αvβ3 may be involved in the pathogenesis of preeclampsia.展开更多
文摘Objective:To characterize placental morphologic features in Moroccan women with adverse outcomes,across different clinical contexts,based on the Amsterdam consensus classification.Methods:A prospective analysis was conducted on placentas with umbilical cords collected fresh between March 1,2024 and July 15,2024 from women with adverse pregnancy outcomes.Clinical data(age,parity,gravidity,complications)were retrieved.Macroscopic parameters(weight,dimensions,cord insertion,membranes,lesions)were assessed,followed by systematic sampling.Tissue was processed by standard histology(formalin fixation,paraffin embedding,hematoxylin and eosin staining),and lesions were classified per Amsterdam criteria.Results:16 placentas from patients with adverse pregnancy outcomes were included.The median maternal age was 30 years.Adverse conditions included placental abruption(50%),intrauterine growth restriction(IUGR,38%),intrauterine fetal death(IUFD,31%),pre-eclampsia/eclampsia(19%),premature rupture of membranes(13%),and oligohydramnios(13%).Several placentas were associated with more than one adverse condition.Histopathology revealed maternal vascular malperfusion lesions in 94%,particularly in pre-eclampsia,IUGR,and IUFD.Fetal vascular malperfusion was found in 88%,mainly in IUGR and IUFD.Inflammatory lesions,dominated by acute maternal and fetal responses stage 3(necrotizing chorioamnionitis and funisitis),were primarily linked to IUFD.Conclusions:Placental examination enhances understanding of the pathophysiology underlying adverse pregnancy outcomes,supports diagnostic confirmation,and guides preventive strategies for recurrence.This study highlights the prevalence of maternal vascular malperfusion in Moroccan women and emphasizes the importance of systematic placental histopathology in obstetric care.
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.
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.
文摘为探讨不同浓度尿苷酸(UMP)对母羊胎盘滋养层细胞营养转运相关基因表达的影响,试验选取原代母羊胎盘滋养层细胞,分别加入0、50、100、200 mM和400 mM的尿苷酸处理细胞,检测细胞活力、营养物质转运及PI3K-Akt-mTOR信号通路相关基因的表达。结果显示:(1)与对照组相比,当UMP浓度在50~100 mM时对细胞活力无显著影响(P>0.05),而当UMP浓度达200 mM时会显著抑制细胞活力(P<0.05)。(2)与对照组相比,随着UMP浓度的升高,当UMP浓度达100 mM时,葡萄糖转运载体GLUT4,脂肪酸转运载体FATP1、FATP4以及氨基酸转运载体SLC38A4的mRNA表达水平显著提高(P<0.05)。而当UMP浓度达200 mM时,葡萄糖转运载体GLUT1的mRNA表达水平显著低于100 mM UMP处理组(P<0.05)。随着UMP浓度达400 mM时,葡萄糖氨基酸转运载体GLUT1、GLUT3、脂肪酸转运载体FATP1以及SLC38A2、SLC38A4的mRNA表达水平显著低于100 mM UMP处理组(P<0.05)。(3)与对照组相比,随着UMP浓度的升高,当UMP浓度达100 mM时,血管内皮生长因子VEGF、NOS3的mRNA表达水平显著提高(P<0.05)。而当UMP浓度达200 mM时,与100 mM UMP组相比,VEGE、NOS3的mRNA表达水平显著降低(P<0.05)。(4)对照组相比,不同浓度的UMP对细胞PI3K、Akt以及mTOR的mRNA表达水平无显著影响(P>0.05)。而当UMP浓度达100 mM时,P70S6K以及4EBP1的mRNA表达水平显著升高(P<0.05),而后又随着UMP浓度增加显著降低(P<0.05)。综上所述,不同浓度UMP会影响细胞生长活力、细胞营养物质转运载体基因、细胞功能因子的表达以及PI3K-Akt-mTOR通路相关因子的基因表达水平,并且100 mM UMP作用浓度最佳。
文摘目的:探讨宫腔球囊压迫联合缩宫素在高危型前置胎盘剖宫产术中预防产后出血的临床效果。方法:采用随机对照试验,选取2022年1月至2025年1月南阳市中心医院产科收治的82例高危型前置胎盘患者,随机分为对照组(n=41,单纯缩宫素治疗)和观察组(n=41,缩宫素联合宫腔球囊压迫术)。比较两组术中及术后出血量、血红蛋白变化、产后出血发生率及不良反应。结果:观察组术中出血量(856.34±198.72 m L vs 1285.67±243.89 m L,P<0.001)、术后24 h出血量(156.23±48.91 m L vs 298.56±72.84 m L,P<0.001)显著低于对照组;产后出血发生率(19.51% vs 56.10%,P<0.001)明显降低;术后24 h时血红蛋白水平(106.74±14.26 g/L vs 92.35±12.89 g/L,P<0.001)更高。两组不良反应发生率无显著差异(4.88%vs 4.88%,P=1.000)。结论:宫腔球囊压迫联合缩宫素可有效减少高危型前置胎盘剖宫产术中及术后出血,降低产后出血发生率,且安全性良好。
基金supported by the National Key Research and Development Plan of China(2016YFD0501207)the China Agriculture Research System(CARS-36)the National Basic Research Program(2012CB124703)
文摘Background: Resveratrol, a plant phenol, affords protection against inflammation and oxidative stress. The objective of this study was to investigate the effects of dietary resveratrol supplementation during pregnancy and lactation on the antioxidant status of sows and piglets and on antioxidant gene expression and pathway in placenta.Methods: Forty sows were allotted to 2 dietary treatments 20 d after breeding. Sows were fed a control diet and a control diet with 300 mg/kg resveratrol. Oxidative stress biomarkers and antioxidant enzymes were measured in the placenta, milk, and plasma of sows and piglets. Antioxidant gene expression and protein expression of Kelch-like ECH-associated protein 1-Nuclear factor E2-related factor 2(Keap1-Nrf2), nuclear factor kappa B-p65(NFκB-p65) and sirtuin1(Sirt1) were quantified in the placenta.Results: Dietary resveratrol increased the litter and piglets weaning weights. Antioxidant status in the milk, placenta and plasma of sows and piglets was partially improved by dietary resveratrol. In placenta, Nrf2 protein expression was increased and Keap1 protein expression was decreased by dietary resveratrol. The m RNA expression of antioxidant genes including catalase(CAT), glutathione peroxidase 1(GPX1), GPX4, superoxide dismutase 1(SOD1)and heme oxygenase 1(HO1), and phase 2 detoxification genes, including glutamate-cysteine ligase modifier(GCLM), microsomal glutathione S-transferase 1(MGST1) and UDP glucuronosyltransferase family 1 member A1(UGT1 A1), was increased by dietary resveratrol. Dietary resveratrol also increased Sirt1 and phosphorylated NFκB-p65 protein expression in the placenta. We failed to observe any influences of dietary resveratrol on pro-inflammatory cytokine levels, including those of interleukin 1β(IL-1β), IL-6, IL-8 and tumor necrosis factor α(TNF-α). However, we observed that the m RNA expression of IL-8 in placenta was reduced by maternal resveratrol. In addition, dietary resveratrol showed interactive effects with day of lactation on activities of SOD and CAT and levels of malonaldehyde(MDA) and hydrogen peroxide(H2 O2) in milk.Conclusions: Dietary resveratrol supplementation during pregnancy and lactation improves the antioxidant status of sows and piglets, which is beneficial to the reproductive performance of sows. Dietary resveratrol regulates placental antioxidant gene expression by the Keap1-Nrf2 pathway and Sirt1 in placenta.
文摘Objective To evaluate the efficacy and safety of uterine artery embolization(UAE) in the management of primary postpartum hemorrhage associated with placenta accreta. Methods We retrospectively reviewed the medical records of patients with placenta accreta between January 2010 and August 2014. Totally 18 women(mean age 30.8±4.2 years) of primary massive postpartum hemorrhage with diagnosis of placenta accrete received treatment of UAE after delivery. Images of DSA and medical records were reviewed. Technical success was defined as control of bleeding after embolization. The complications, control of hemorrhage and recurrent bleeding of the placenta left inside the uterus were retrospectively collected for assessment. Results All patients underwent transcatheter embolization of bilateral uterine arteries. The technical success rate of embolization was 100%. Bleeding was controlled in 17 of 18 patients(94%) during follow-up period(median 18 months, 3-31months) without further bleeding recurred. One patient with placenta percreta undertook an emergent hysterectomy along with surgical bladder repair after UAE because of persistent uterine bleeding. Eight patients had postembolization syndrome and no other complications occurred. Conclusion Uterine artery embolization is an effective and safe treatment for the management of primary postpartum massive hemorrhage associated with placenta accreta.
基金This study was supported by a grant from National Natural Science Foundation of China(No.30271245)Hi-Tech Research and Development Program of China(863 Program)(No.2003AA205170)+1 种基金National Basic Research Program of China(973 Program)(No.G 1999054302)a grant from Bejing Gynecology and Obstetrics Hospital Affiliate of Capital University of Medical Sciences.
文摘Human placenta-derived mononuclear cells (MNC) were isolated by a Percoll density gradient and cultured in mesenchymal stem cell (MSC) maintenance medium. The homogenous layer of adherent cells exhibited a typical fibroblastlike morphology, a large expansive potential, and cell cycle characteristics including a subset of quiescent cells. In vitro differentiation assays showed the tripotential differentiation capacity of these cells toward adipogenic, osteogenic and chondrogenic lineages. Flow cytometry analyses and immunocytochemistry stain showed that placental MSC was a homogeneous cell population devoid of hematopoietic cells, which uniformly expressed CD29, CD44, CD73, CD105, CD166, laminin, fibronectin and vimentin while being negative for expression of CD31, CD34, CD45 and m-smooth muscle actin. Most importantly, immuno-phenotypic analyses demonstrated that these cells expressed class Ⅰ major histocompatibility complex (MHC-I), but they did not express MHC-Ⅱ molecules. Additionally these cells could suppress umbilical cord blood (UCB) lymphocytes proliferation induced by cellular or nonspecific mitogenic stimuli. This strongly implies that they may have potential application in allograft transplantation. Since placenta and UCB are homogeneous, the MSC derived from human placenta can be transplanted combined with hematopoietic stem cells (HSC) from UCB to reduce the potential graft-versus-host disease (GVHD) in recipients.
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In order to assess the number and function of macrophages in the placenta of pregnancy complicated with gestational diabetes mellitus (GDM) as well as those of normal pregnancies, placenta samples were collected from 15 GDM patients (GDM group) and 10 normal pregnant women (control group). The expression levels of macrophage markers (CD68/CD14) and inflammatory cytokines (IL-6/TNF-α) in placenta were detected using immunohistochemistry and PCR. The results showed that the number of CD68+ or CD14+ cells in the GMD group was remarkably higher than that in the control group (P〈0.05), indicating that the number of macrophages in the GDM group was significantly greater than that in the control group. The mRNA expression levels of CD68+, IL-6 and TNF-α were higher in the GMD group than in the control group. In conclusion, more macrophages accumulate in placenta of pregnancy complicated with GDM, and the expression levels of pro-inflammation factors are also in- creased in GDM pregnancies, suggesting that macrophages and inflammatory mediators (IL-6 and TNF-α) mav olav an imoortant role in GDM.
基金supported by a grant from Shenzhen Municipal Science and Technology Program (No 200802107)a grant for medical research programs from the Health Department of Guangdong Province (No A2009593)
文摘To investigate the expression of osteopontin (OPN) and its receptor integrin αvβ3 in the placental tissue from pregnant women complicated with preeclampsia, the expression of OPN and αvβ3 in the placenta of the pregnant women with preeclampsia and healthy pregnant women was detected by immunohistochemistry, Western blotting and RT-PCR. Our results showed that OPN and αvβ3 protein were expressed in the placenta from normal pregnant woman and those with preeclampsia. OPN was located in the placental syncytiotrophoblasts and the cytoplasm of capillary endothelial cells and integrin αvβ3 was mainly expressed on the surface of trophoblast cells. Expression of OPN and integrin αvβ3 in the placental tissue from preeclampsia subjects was significantly lower than that from the control group (P〈0.05). Compared with the control group, expression of OPN in the placental tissue from preeclampsia group was significantly lower (P〈0.05) but there was no significant difference in the expression of αv and β3 between the preeclampsia group and the controls. It is concluded that OPN and its receptor integrin αvβ3 may be involved in the pathogenesis of preeclampsia.