scholarly journals 352: Are mullerian anomalies associated with increased risk for adverse pregnancy outcome?

2015 ◽  
Vol 212 (1) ◽  
pp. S185-S186
Author(s):  
Liran Hiersch ◽  
Eran Ashwal ◽  
Amir Aviram ◽  
Hadas Miremberg ◽  
Arnon Wiznitzer ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Adverse Pregnancy Outcome ◽  
Mullerian Anomalies ◽  
Müllerian Anomalies ◽  
Increased Risk ◽  
Adverse Pregnancy

scholarly journals POS0737 LOW PRECONCEPTIONAL COMPLEMENT LEVEL IS RELATED WITH ADVERSE OBSTETRIC OUTCOME IN A MULTICENTRIC COHORT OF PREGNANCY IN PATIENTS WITH APS AND APL POSITIVITY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 619.2-620
Author(s):  
D. Lini ◽  
C. Nalli ◽  
L. Andreoli ◽  
F. Crisafulli ◽  
M. Fredi ◽  
...  
Keyword(s):  
Pregnancy Outcome ◽  
Complement Activation ◽  
Pregnancy Complications ◽  
Antiphospholipid Antibodies ◽  
Pregnancy Loss ◽  
Adverse Pregnancy Outcome ◽  
Obstetric Outcome ◽  
Complement Level ◽  
Increased Risk ◽  
Adverse Pregnancy

Background:The role of complement in the antiphospholipid (aPL) related pathology has been widely studied in animal models. Antiphospholipid antibodies can induce fetal loss in experimental animals but mice deficient in specific complement components (C4, C3, C5) appear somehow protected. In addition, in pregnant mice injected with aPL, antibody deposition has been found at decidual level causing focal necrosis, apoptosis and neutrophil infiltrates and supporting aPL pathogenetic potential. On the other hand, human studies did find hypocomplementemia associated to pregnancy complications in patients with obstetric antiphospholipid syndrome (APS). These results, however, are not unanimously confirmed and, in addition, some studies only show increased levels of complement activation products (i.e. Bb) and not decreased levels of C3 and/or C4. A recently study focusing on complement level in early pregnancy and before pregnancy showed a significant correlation with pregnancy complications and loss in a large cohort of primary APS.Objectives:To investigate if the simple detection of low C3 and/or C4 could be considered a risk factor for adverse pregnancy outcome in APS and aPL carriers pregnancies.Methods:We performed a multicentric study including patients from 10 Italian and 1 Russian Centers. Data on pregnancies in women with primary APS (n=434) and asymptomatic carriers with persistently positive aPL but not fulfilling clinical criteria for APS (n=218) were retrospectively collected. Serum C3 and C4 levels were evaluated by nephelometry; hypocomplementemia was defined by local laboratory reference values. Statistical analysis was performed using GraphPad.Results:Preconceptional complement levels and gestational outcome were available for 107 (25%) pregnancies in APS out of 434 and for 196 (90%) pregnancies in aPL carriers women out of 218. In pregnancies with low preconceptional C3 and/or C4, a significantly higher prevalence of pregnancy losses was observed (p=0.019). A subgroup analysis focusing on triple aPL positive patients was also performed. Preconceptional low C3 and/or C4 levels were found to be associated with an increased rate of pregnancy loss (p = 0.027) in this subgroup also. Otherwise, adverse pregnancy outcomes in single or double aPL positive women were not related to preconception complement levels (p = 0.44) (Table 1). Of note, all the pregnancy losses in the triple positive group occurred in patients treated with low dose aspirin and low molecular weight heparin from the time of positive pregnancy test.Conclusion:Our findings confirm that decreased complement levels before pregnancy are associated with increased risk of adverse outcome. This has been seen only in in women with triple aPL positivity, indeed single or double positivity does not show this trend. Complement levels are cheap and easy to be measured therefore they could represent a useful aid to identify patients at increased risk of pregnancy loss. test positivity.References:[1]De Carolis S, et al. Complementemia and obstetric outcome in pregnancy with antiphospholipid syndrome. Lupus (2012) 21:776–8.[2]Kim MY, et al. Complement activation predicts adverse pregnancy outcome in patients with systemic lupus erythematosus and/or antiphospholipid antibodies. Ann Rheum Dis (2018) 77:549–55.[3]Fredi M, et al. Risk Factors for Adverse Maternal and Fetal Outcomes in Women With Confirmed aPL Positivity: Results From a Multicenter Study of 283 Pregnancies. Front Immunol. 2018 May 7;9:864.Triple aPL positivitySingle or double aPL positivityGestational outcomeLow C3/C4 (n=49)Normal C3/C4(n=17)pLow C3/C4 (n=57)Normal C3/C4(n=165)pTerm live birth (>37w)15 (31%)6 (35%)ns34 (60%)110 (67%)nsPreterm live birth (≤37w)22 (45%)11 (65%)ns15 (26%)38 (23%)nsPregnancy losses (abortion and miscarriages)12 (24%)0 (0%)0.0278 (14%) 17 (10%)nsDisclosure of Interests:None declared

scholarly journals Heat Shock Proteins and Heat Shock Protein-Antibody Complexes in Placental Tissues

1999 ◽  
Vol 7 (4) ◽  
pp. 180-185 ◽  
Author(s):  
M. Ziegert ◽  
S. S. Witkin ◽  
I. Sziller ◽  
H. Alexander ◽  
E. Brylla ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Heat Shock ◽  
Heat Shock Proteins ◽  
Pregnancy Outcome ◽  
Preterm Labor ◽  
Adverse Pregnancy Outcome ◽  
Increased Risk ◽  
Circulating Antibodies ◽  
Adverse Pregnancy ◽  
Shock Proteins

Objective:The relationship between pregnancy outcome and expression of the heat shock proteins (hsps) or hsp-antibody complexes of 60kD (hsp60), 70kD (hsp70), and 90kD (hsp90) in placental tissue and circulating antibodies to hsps was evaluated.Method:Expression of hsp60, hsp70, and hsp90 in placentae from 12 women with preterm birth, eight with intrauterine growth restriction (IUGR), and 10 with term birth, as well as the presence of the corresponding antibodies, was investigated by a new carbocyanine double fluorescence technique. Results were compared with microbiological findings and circulating antibodies to hsps in sera.Results:In each placental specimen examined, hsp60, hsp70, and hsp90 were identified. However, hsp70-antibody complexes were detected in only four of the preterm labor cases. Similarly, hsp60-antibody complexes were detected in only five preterm labor patients and in one patient with IUGR. None of the placentae contained hsp90-antibody complexes. In the preterm birth group, all patients with hsp60-antibody complexes were also positive for circulating antibodies to hsp60. The presence of hsp70-antibody complexes also correlated with hsp70 antibody in sera.Conclusions:Formation of hsp60- and hsp70-antibody complexes in the placenta may contribute to the induction of preterm birth. Women sensitized to these antibodies may be at increased risk for adverse pregnancy outcome. Infect. Dis. Obstet. Gynecol. 7:180–185, 1999.

scholarly journals Value of PI of uterine artery at 23-24 weeks in the prediction of adverse pregnancy outcome

2017 ◽  
Vol 6 (12) ◽  
pp. 5435
Author(s):  
Anshu Dhar ◽  
Indu Kaul
Keyword(s):  
Pregnancy Outcome ◽  
Preterm Delivery ◽  
Uterine Artery ◽  
Adverse Pregnancy Outcome ◽  
Color Doppler ◽  
Subsequent Development ◽  
Adverse Outcomes ◽  
Intrauterine Death ◽  
Increased Risk ◽  
Adverse Pregnancy

Background: Increased resistance in uteroplacental circulation is associated with pregnancy complications. The aim of this study was to determine the role of uterine artery PI at 23-24 weeks gestation in predicting adverse pregnancy outcomes.Methods: 200 singleton pregnancies were prospectively examined with color Doppler to determine the PI of uterine artery at 23-24 weeks and study its correlation with subsequent development of adverse maternal and fetal outcomes defined as any or the combination of preeclampsia, intrauterine growth restriction (IUGR), intrauterine death (IUD), preterm delivery and placental abruption.Results: There were 13 cases (6.5%) with abnormal uterine artery Doppler results and 8 (61.5%) of them developed preeclampsia, out of these 8, 1 had IUGR as well and 3 had iatrogenic preterm delivery due to severe preeclampsia. 2 (15.4%) out of 13 had only IUGR. The pregnancies with adverse outcomes had significantly higher mean PI than those with normal outcomes (1.2±0.3 versus 0.857±0.179; p <0.001). The sensitivity, specificity, PPV and NPV of PI ≥95th percentile in the prediction of adverse pregnancy outcome was 35.71%, 98.26%, 76.92% and 90.37% respectively. The birth weight in higher mean PI group was significantly lower than in pregnancies with PI <95th percentile (2.33±0.49 kg versus 2.86±0.48 kg; p <001). No cases of spontaneous preterm labor, IUD or abruption were present in higher mean PI group.Conclusions: Increased uterine artery PI at 23-24 weeks of pregnancy is associated with an increased risk of adverse pregnancy outcomes. 

scholarly journals The Role of Placental Homeobox Genes in Human Fetal Growth Restriction

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Padma Murthi ◽  
Gayathri Rajaraman ◽  
Shaun Patrick Brennecke ◽  
Bill Kalionis
Keyword(s):  
Pregnancy Outcome ◽  
Fetal Growth ◽  
Fetal Growth Restriction ◽  
Transcriptional Control ◽  
Molecular Mechanisms ◽  
Adverse Pregnancy Outcome ◽  
Growth Restriction ◽  
Placental Development ◽  
Increased Risk ◽  
Adverse Pregnancy

Fetal growth restriction (FGR) is an adverse pregnancy outcome associated with significant perinatal and paediatric morbidity and mortality, and an increased risk of chronic disease later in adult life. One of the key causes of adverse pregnancy outcome is fetal growth restriction (FGR). While a number of maternal, fetal, and environmental factors are known causes of FGR, the majority of FGR cases remain idiopathic. These idiopathic FGR pregnancies are frequently associated with placental insufficiency, possibly as a result of placental maldevelopment. Understanding the molecular mechanisms of abnormal placental development in idiopathic FGR is, therefore, of increasing importance. Here, we review our understanding of transcriptional control of normal placental development and abnormal placental development associated with human idiopathic FGR. We also assess the potential for understanding transcriptional control as a means for revealing new molecular targets for the detection, diagnosis, and clinical management of idiopathic FGR.

scholarly journals Subchorionic hematoma. Causes, pathogenesis, diagnostic and treatment management

2013 ◽  
Vol 62 (4) ◽  
pp. 37-47 ◽  
Author(s):  
Julia Viktorovna Kovalyova
Keyword(s):  
Pregnancy Outcome ◽  
Early Pregnancy ◽  
Adverse Pregnancy Outcome ◽  
First Trimester ◽  
Pregnancy Complication ◽  
Treatment Management ◽  
Live Embryo ◽  
Increased Risk ◽  
Threatened Abortion ◽  
Adverse Pregnancy

Threatened abortion is one of the most common complications of early pregnancy. In the presence of a live embryo, the most frequently encountered sonographic finding is a subchorionic hematoma. Resent studies suggest that the presence of intrauterine hematoma during the first trimester may identify a population of patients at increased risk for adverse pregnancy outcome. In the review the etiology, pathogenesis of subchorionic hematoma and diagnostic and treatment management of patients with such pregnancy complication are described.

scholarly journals Uterine Artery Doppler in the Prediction of Preeclampsia and Adverse Pregnancy Outcome

2010 ◽  
Vol 4 (2) ◽  
pp. 117-122
Author(s):  
George Daskalakis ◽  
Aris Antsaklis
Keyword(s):  
Pregnancy Outcome ◽  
Uterine Artery ◽  
Adverse Pregnancy Outcome ◽  
False Positive Rate ◽  
First Trimester ◽  
Maternal Serum ◽  
Uterine Artery Doppler ◽  
Mortality And Morbidity ◽  
Increased Risk ◽  
Adverse Pregnancy

Abstract Preeclampsia and fetal growth restriction are major causes of perinatal mortality and morbidity. Several studies have shown that a generalized endothelial dysfunction is associated with these complications. Clinical trials have shown that pregnant women who demonstrate high resistance in uteroplacental blood flow are at higher risk for preeclampsia. Uterine artery Doppler studies both in the second and the first trimester can predict pregnancies at increased risk of the complications of impaired placentation. The sensitivity for predicting severe preeclampsia ranges between 80 and 90% for a false positive rate of 5 to 7%. Uterine artery Doppler screening at 20 to 24 weeks’ gestation is superior to first trimester screening, and appears to fulfill the requirements for a worthwhile screening test. Further research is needed to better assess the value of various combinations of uterine artery Doppler and maternal serum markers, for the prediction of adverse pregnancy outcome.

Renal disease in pregnancy

2020 ◽  
pp. 170-185
Author(s):  
David Williams
Keyword(s):  
Kidney Disease ◽  
Renal Disease ◽  
Pregnancy Outcome ◽  
Chronic Renal Disease ◽  
Adverse Pregnancy Outcome ◽  
Physiological Change ◽  
Healthy Pregnancy ◽  
Increased Risk ◽  
Adverse Pregnancy ◽  
In Pregnancy

The kidneys undergo marked physiological changes during healthy pregnancy. Awareness of these gestational changes is critical to the management of kidney disease in pregnancy as they both mask and mimic renal disease. Gestational changes to maternal vasculature, clotting, and metabolism predispose previously healthy women to a unique set of acute kidney injuries during pregnancy, whereas women with chronic kidney disease make suboptimal gestational adaptations to pregnancy, with an increased risk of adverse pregnancy outcome and possible further damage to their kidneys. Women with kidney transplants can be confident about the safety of established immunosuppressive regimens during pregnancy and can expect a good pregnancy outcome dictated by the function of their renal graft. Pregnancy outcomes for women on renal replacement therapy have improved through intensive haemodialysis regimens that mimic gestational physiological change. This chapter describes renal physiological change and the management of acute and chronic renal disease in pregnancy.

Sign in / Sign up

Export Citation Format

Share Document