232 PARTHENOGENETIC DEVELOPMENT AND PLOIDY OF BOVINE OOCYTES FOLLOWING VARIOUS CHEMICAL ACTIVATION REGIMENS

2008 ◽  
Vol 20 (1) ◽  
pp. 195
Author(s):  
S.-A. Ock ◽  
G.-J. Rho
Keyword(s):  
Polar Body ◽  
Chemical Activation ◽  
Blastocyst Stage ◽  
Blastocyst Development ◽  
Parthenogenetic Development ◽  
Group 5 ◽  
Group 2 ◽  
Ion Treatment ◽  
Bovine Oocytes ◽  
Group 1

Bovine oocytes treated using various combinations of ionomycin (Ion), cycloheximide (CHX), and cytochalasin B (CCB) were evaluated for developmental rates and ploidy status. Metaphase II oocytes were allocated 5 treatment groups, and the groups were treated as follows: Group 1: 5 µm Ion for 5 min; Group 2: Ion + 10 µg mL–1 CHX for 5 h; Group 3: Ion + 10 µg mL–1 CHX + 5 µg mL–1 CCB for 1 h + 10 µg mL–1 CHX for 4 h; Group 4: Ion + 10 µg mL–1 CHX + 5 µg mL–1 CCB for 3 h + 10 µg mL–1 CHX for 2 h; and Group 5: Ion + 10 µg mL–1 CHX + 5 µg mL–1 CCB for 5. Difference among groups was analyzed using one-way ANOVA by SPSS 10.0 (SPSS, Inc., Chicago, IL, USA). In Experiment 1, 430 oocytes in 4 replicates were compared for the extrusion rate of the second polar body (PB) at 8 h after Ion treatment among groups. Group 5 exhibited significantly (P < 0.05) lower rates of second PB extrusion than did Groups 1–4 (22% v. 53–67%). Experiment 2 compared the rates of cleavage at 48 h and development to the blastocyst stage at 216 h after Ion treatment among groups. A total of 536 oocytes were used in 5 replicates. Parthenotes in Group 1 showed lower rates of cleavage and blastocyst development than those in other groups (20% and 1% v. 53–67% and 6–31%). Among the groups, parthenotes in Group 5 showed significantly (P < 0.05) higher blastocyst development. In Experiment 3, at 8 h after Ion treatment, oocytes from Groups 2, 3, and 5 were divided into two subgroups based on the presence or absence of the second PB, and assessed for cleavage rates and ploidy in 239 2-cell-stage parthenotes in 4 replicates, as described earlier by King et al. (1979 Vet. Sci. Commun. 3, 51–56). The cleavage rates did not differ among activation treatments, or by the presence or absence of the second PB in any activation group. The haploid rate was significantly (P < 0.05) higher in Group 2 than in Groups 3 and 5 (38% v. 19% and 0%, respectively). The diploid rate was significantly (P < 0.05) higher in Group 5 than in Groups 2 and 3 (88% v. 69% and 45%, respectively). In Experiment 4, the diploid rate of Group 2 blastocyst-stage parthenotes was 100% (4/4), whereas the diploid rates of Groups 3 and 5 blastocyst-stage parthenotes were 50% (6/12) and 71% (17/24), respectively, but the rates did not differ among groups. These results indicate that oocyte activation by CHX/CCB for 5 h after Ion treatment could enhance parthenogenetic development in bovines with higher rates of diploidy by preventing the extrusion of the second PB.

53 THE EFFECT OF ELECTRICAL PULSE ON DEVELOPMENT OF NT BOVINE EMBRYOS FROM CARTILAGE CELLS

2009 ◽  
Vol 21 (1) ◽  
pp. 126 ◽  
Author(s):  
A. Tas ◽  
S. Arat ◽  
G. Cetinkaya ◽  
T. Akkoc ◽  
H. Bagis
Keyword(s):  
Electrical Stimulation ◽  
Single Cells ◽  
Chemical Activation ◽  
Human Reproduction ◽  
Cartilage Tissue ◽  
Blastocyst Development ◽  
Development Rates ◽  
Significant Difference ◽  
Group 2 ◽  
Group 1

In some previous NT studies, it was reported that oocyte activation starts with electrical stimulation applied before chemical activation (Rzucidlo SJ et al. 2004 Reprod. Fertil. Dev. 16(1,2), 157; Arat S et al. 2006 Reprod. Fertil. Dev. 18(1,2), 119). Therefore; one of the several parameters affecting reprogramming of somatic cells is the fusion parameter and time. Electrical stimulation has also an effect on embryo quality (Milazzotto MP et al. 2008 Reprod. Dom. Anim. 43, 319–322). The objective of this study was to examine the effect of fusion parameter and time on blastocysts development rates on somatic cell nucleus transfer(SCNT). Bovine oocytes isolated from slaughterhouse ovaries were matured in TCM199 supplemented with 10% fetal bovine serum (FBS), sodiumpyruvate, penicillin/streptomycin, epidermal growth factor (EGF), bFSH, and bLH in a humidified atmosphere of 5% CO2 in air for 18 h. Single cells derived from cartilage tissue of Anatolian Black Cow were inserted into the perivitelline space of the enucleated oocytes. In the first experiment, NT couples were fused by 2.66 kV cm–1, 30 μs, 1 pulse (Group 1) in sorbitol fusion buffer (0.25 m sorbitol, 0.1 mm Calcium acetate, 0.5 mm Mg Acetate). After one hour of the first fusion nonfused NT couples were refused by 1.40 kV cm–1, 40 μs, 1 pulse (Group 2). After fusion, all fused NT couples in group 1 (1.5 h after the first fusion) and 2 (1.5 h after the second fusion) were activated using a combination of cytochalasin D (2.5 μg mL–1) and cycloheximide (CHX, 10 μg mL–1) for 1 h and CHX alone for 4 h. Following activation, reconstructed oocytes were cultured in Sage cleavage medium supplemented with 8 mg mL–1 BSA for 72 h and then developing embryos were cultured in Sage blastocyst media (Tang R et al. 2006 Human Reproduction 21(5), 1179–1183) supplemented with 4 mg mL–1 BSA + 5% FCS for an additional 4 days. Differences among groups were analyzed by one-way ANOVA after arcsin square transformation(P = 0.05). There was no significant difference on fusion rates observed between Group 1(49.4%) and Group 2(47.5%). However, the result showed that the blastocyst development was seriously decreased after second fusion(Group 1: 30.8% and group 2: 2.5%). This was considered as a negative effect of the electrical stimulation which was applied twice on NT couples. In the second experiment; development rates of embryos were compared from NT couples fused 24 or 28 hours after maturation. In this experiment, fusion was applied one time. NT couples fused approximately 24 and 28 h postmaturation were considered as early and late, respectively. The results showed that there was no significant differences between the two groups on the blastocysts development rates (31.6% early and 28.4% late). According to the these results, 4 h difference at oocyte ages was not an effective parameter on the blastocyst development rates of NT embryos. This study was supported by a grant from TUBITAK TOVAG 104O360 and KAMAG, Turkey (106G005).

133 Effect of cytokines on the quality bovine oocytes matured invitro

2021 ◽  
Vol 33 (2) ◽  
pp. 174
Author(s):  
G. N. Singina ◽  
E. N. Shedova ◽  
T. E. Taradajnic
Keyword(s):  
Growth Factor ◽  
Leukaemia Inhibitory Factor ◽  
Control Group ◽  
Group 4 ◽  
First Polar Body ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Bovine Oocytes ◽  
Group 1

As has been shown previously, fibroblast growth factor 2 (FGF2), leukaemia inhibitory factor (LIF), and insulin-like growth factor 1 (IGF1) in combination play a positive role in maintaining the quality of mammalian oocytes maturing invitro. In the present work, we studied the effects of these cytokines in optimal concentrations when added in combination to IVM medium on the nuclear status and development competence of bovine oocytes. Slaughterhouse-derived cumulus–oocyte complexes (COC) (n=1107 COC) were cultured for 22h in either IVM medium [TCM-199 supplemented with 10% fetal calf serum (FCS), 0.2mM sodium pyruvate, 10μgmL−1 porcine FSH, and 10μgmL−1 ovine LH] (Control) or the same IVM medium supplemented with FGF2, LIF, and IGF1. The eight combinations of cytokines tested during maturation were (1) 20ngmL−1 LIF/10ngmL−1 IGF1/10ngmL−1 FGF2 (Group 1); (2) 20ngmL−1 LIF/10ngmL−1 IGF1/40ngmL−1 FGF2 (Group 2); (3) 20ngmL−1 LIF/20ngmL−1 IGF1/10ngmL−1 FGF2 (Group 3); (4) 20ngmL−1 LIF/20ngmL−1 IGF1/40ngmL−1 FGF2 (Group 4); (5) 5ngmL−1 LIF/10ngmL−1 IGF1/10ngmL−1 FGF2 (Group 5); (6) 5ngmL−1 LIF/10ngmL−1 IGF1/40ngmL−1 FGF2 (Group 6); (7) 5ngmL−1 LIF/20ngmL−1 IGF1/10ngmL−1 FGF2 (Group 7); and (8) 5ngmL−1 LIF/20ngmL− 1 IGF1/40ngmL−1 FGF2 (Group 8). After IVM, matured and denuded oocytes were activated by culturing in 5μM ionomycin solution for 5min followed by 4h in 2mM 4-dimethylaminopyridine (DMAP) and 10mgmL−1 cyclohexamide. Activated oocytes were cultured in CR1aa medium until Day 5 and then transferred to the same medium supplemented with 5% FCS and cultured until Day 7. All cultures were performed at 38.5°C and 5% CO2 in humidified air. At Days 2 and 7 after activation, the cleavage and blastocyst rates were determined. The data from 6 to 7 replicates (122–181 oocytes per treatment) were analysed by ANOVA. The rate of MII oocytes, assessed by the presence of the first polar body, did not differ between the groups and reached 67.1 to 84.5%. Cleavage rate was higher (84.5±2.9%, P&lt;0.05) in Group 1 compared with Control (68.9±2.7%), Group 4 (67.1±4.9%) and Group 7 (66.6±2.0%), but not compared with Group 2 (76.5±4.8%), Group 3 (76.6±4.8%), Group 5 (78.2±3.1%), or Group 8 (79.9±3.1%). The percentage of blastocyst formation relative to the total number of MII oocytes in the control group was 19.6±2.4%. The culture of COC in Group 1 (20 ngmL−1 LIF/10ngmL−1 IGF1/10ngmL−1 FGF2) and Group 2 (20ngmL−1 LIF/10ngmL−1 IGF1/40ngmL−1 FGF2) caused the blastocyst yield to increase to 33.0±3.8 and 31.2±4.3%, respectively (P&lt;0.05), whereas the culture COC in other cytokine-treated groups had no effect. In Groups 3 to 8, the blastocyst rates were 22.9±4.6, 19.2±3.0, 24.2±3.2, 27.8±1.7, 21.6±1.8, and 25.5±9.0%, respectively, and did not differ (except Group 4) compared with those of Group 1 and Group 2. In conclusion, LIF, FGF2, and IGF1 in optimal combinations can maintain competence for parthenogenetic development of bovine COC during their maturation invitro. This research was supported by RFBR (projects No. 18-29-07089) and the Ministry of Science and Higher Education of Russia.

scholarly journals Disparate consequences of heat stress exposure during meiotic maturation: embryo development after chemical activation vs fertilization of bovine oocytes

Reproduction ◽  
2011 ◽  
Vol 142 (6) ◽  
pp. 831-843 ◽  
Author(s):  
L A Rispoli ◽  
J L Lawrence ◽  
R R Payton ◽  
A M Saxton ◽  
G E Schrock ◽  
...  
Keyword(s):  
Heat Stress ◽  
Calcium Release ◽  
Chemical Activation ◽  
Blastocyst Stage ◽  
Developmental Differences ◽  
Meiotic Maturation ◽  
Stress Exposure ◽  
Blastocyst Development ◽  
Underlying Mechanisms ◽  
Bovine Oocytes

Consequences of heat stress exposure during the first 12 h of meiotic maturation differed depending on how and when bovine oocytes were activated. If heat-stressed oocytes underwent IVF at ∼24 h, blastocyst development was less than for respective controls and similar to that obtained for nonheat-stressed oocytes undergoing IVF at 30 h (i.e. slightly aged). In contrast, if heat-stressed oocytes underwent chemical activation with ionomycin/6-dimethylaminopurine at 24 h, blastocyst development was not only higher than respective controls, but also equivalent to development obtained after activation of nonheat-stressed oocytes at 30 h. Developmental differences in chemically activated vs IVF-derived embryos were not related to fertilization failure or gross alterations in cytoskeletal components. Rather, ionomycin-induced calcium release and MAP kinase activity were less in heat-stressed oocytes. While underlying mechanisms are multifactorial, ability to obtain equivalent or higher development after parthenogenetic activation demonstrates that oocytes experiencing heat stress during the first 12 h of meiotic maturation have the necessary components to develop to the blastocyst stage, but fail to do so after fertilization.

scholarly journals In Vitro Embryo Production and Transfer of Bubaline Embryos using Oocytes Derived from Transvaginal Ultrasound-Guided Follicular Aspiration (TUFA)

2014 ◽  
Vol 2 (2) ◽  
pp. 180-184
Author(s):  
FP Aquino ◽  
Eufrocina P. Atabay
Keyword(s):  
Transvaginal Ultrasound ◽  
Blastocyst Stage ◽  
Ultrasound Guided ◽  
Blastocyst Development ◽  
Embryo Production ◽  
Follicular Aspiration ◽  
Group 2 ◽  
Group 1 ◽  
Donor Cows

Transvaginal ultrasound-guided follicular aspiration (TUFA) has become a popular tool for embryo production in vitro due to its high degree of repeatability in terms of recovering oocytes from live animals. In Study 1, the quantity and quality of oocytes from Bulgarian Murrah buffalo cows (n=10) of varying ages (Group 1, 8-12; and Group 2, 13-17 years) were assessed. Group 1 buffalo donor cows yielded significantly higher (P<0.05) number of oocytes vs Group 2 buffalo donor cows (71 vs 29 oocytes, respectively), though in terms of oocyte quality, no difference was observed. In Study 2, oocytes collected (n=100) in Study 1 were matured, fertilized in vitro and the resulting zygotes were cultured which developed to blastocyst stage embryos. The maturation, fertilization and blastocyst development rates obtained were 53.0%, 40.0% and 32.5%, respectively. In Study 3, the viability of resulting blastocyst stage embryos was determined by transferring to recipient cows. Of 10 recipients 1 got pregnant and delivered a 35 kg male calf after 310 days gestation period. Overall, the results of the studies conducted demonstrated the potential of TUFA technology in the in vitro production of embryos which eventually could be used in the production of live offspring.DOI: http://dx.doi.org/10.3126/ijasbt.v2i2.10369Int J Appl Sci Biotechnol, Vol. 2(2): 180-184 

Does Perioperative Hemoglobin A1c Level Affect the Incidence, Pattern and Mortality of Lower Extremity Amputation?

2019 ◽  
Vol 17 (4) ◽  
pp. 354-364
Author(s):  
Hassan Al-Thani ◽  
Moamena El-Matbouly ◽  
Maryam Al-Sulaiti ◽  
Noora Al-Thani ◽  
Mohammad Asim ◽  
...  
Keyword(s):  
Glycemic Control ◽  
Lower Extremity ◽  
Hazard Ratio ◽  
Lower Extremity Amputation ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Extremity Amputation ◽  
Group 1

Background: We hypothesized that perioperative HbA1c influenced the pattern and outcomes of Lower Extremity Amputation (LEA). Methods: A retrospective analysis was conducted for all patients who underwent LEA between 2000 and 2013. Patients were categorized into 5 groups according to their perioperative HbA1c values [Group 1 (<6.5%), Group 2 (6.5-7.4%), Group 3 (7.5-8.4%), Group 4 (8.5-9.4%) and Group 5 (≥9.5%)]. We identified 848 patients with LEA; perioperative HbA1c levels were available in 547 cases (Group 1: 18.8%, Group 2: 17.7%, Group 3: 15.0%, Group 4: 13.5% and Group 5: 34.9%). Major amputation was performed in 35%, 32%, 22%, 10.8% and 13.6%, respectively. Results: The overall mortality was 36.5%; of that one quarter occurred during the index hospitalization. Mortality was higher in Group 1 (57.4%) compared with Groups 2-5 (46.9%, 38.3%, 36.1% and 31.2%, respectively, p=0.001). Cox regression analysis showed that poor glycemic control (Group 4 and 5) had lower risk of mortality post-LEA [hazard ratio 0.57 (95% CI 0.35-0.93) and hazard ratio 0.46 (95% CI 0.31-0.69)]; this mortality risk persisted even after adjustment for age and sex but was statistically insignificant. The rate of LEA was greater among poor glycemic control patients; however, the mortality was higher among patients with tight control. Conclusion: The effects of HbA1c on the immediate and long-term LEA outcomes and its therapeutic implications need further investigation.

scholarly journals Association between serum oestradiol level on the hCG administration day and neonatal birthweight after IVF-ET among 3659 singleton live births

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yu Liu ◽  
Jing Li ◽  
Wanyu Zhang ◽  
Yihong Guo
Keyword(s):  
Birth Weight ◽  
Ovarian Stimulation ◽  
Group 4 ◽  
Group 6 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
The Impact ◽  
Ivf Et ◽  
Group 1

AbstractOestradiol, an important hormone in follicular development and endometrial receptivity, is closely related to clinical outcomes of fresh in vitro fertilization-embryo transfer (IVF-ET) cycles. A supraphysiologic E2 level is inevitable during controlled ovarian hyper-stimulation (COH), and its effect on the outcome of IVF-ET is controversial. The aim of this retrospective study is to evaluate the association between elevated serum oestradiol (E2) levels on the day of human chorionic gonadotrophin (hCG) administration and neonatal birthweight after IVF-ET cycles. The data of 3659 infertile patients with fresh IVF-ET cycles were analysed retrospectively between August 2009 and February 2017 in First Hospital of Zhengzhou University. Patients were categorized by serum E2 levels on the day of hCG administration into six groups: group 1 (serum E2 levels ≤ 1000 pg/mL, n = 230), group 2 (serum E2 levels between 1001 and 2000 pg/mL, n = 524), group 3 (serum E2 levels between 2001 and 3000 pg/mL, n = 783), group 4 (serum E2 levels between 3001 and 4000 pg/mL, n = 721), group 5 (serum E2 levels between 4001 and 5000 pg/mL, n = 548 ), and group 6 (serum E2 levels > 5000 pg/mL, n = 852). Univariate linear regression was used to evaluate the independent correlation between each factor and outcome index. Multiple logistic regression was used to adjust for confounding factors. The LBW rates were as follows: 3.0% (group 1), 2.9% (group 2), 1.9% (group 3), 2.9% (group 4), 2.9% (group 5), and 2.0% (group 6) (P = 0.629), respectively. There were no statistically significant differences in the incidences of neonatal LBW among the six groups. We did not detect an association between peak serum E2 level during ovarian stimulation and neonatal birthweight after IVF-ET. The results of this retrospective cohort study showed that serum E2 peak levels during ovarian stimulation were not associated with birth weight during IVF cycles. In addition, no association was found between higher E2 levels and increased LBW risk. Our observations suggest that the hyper-oestrogenic milieu during COS does not seem to have adverse effects on the birthweight of offspring after IVF. Although this study provides some reference, the obstetric-related factors were not included due to historical reasons. The impact of the high estrogen environment during COS on the birth weight of IVF offspring still needs future research.

scholarly journals Morphological Characterization of Isolates of Phomopsis vexans of Bangladesh

2013 ◽  
Vol 8 (1-2) ◽  
pp. 123-130
Author(s):  
MM Islam ◽  
M Asaduzzaman ◽  
ME Hoque ◽  
MB Meah
Keyword(s):  
Morphological Characterization ◽  
Cultural Properties ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Phomopsis Vexans ◽  
Group 1

Forty four isolates of Phomopsis vexans from different eggplant cultivars collected from core eggplant growing regions of Bangladesh which were characterized using mycological characteristics. Variation exists among the isolates of Phomopsis vexans of Bangladesh covering two types of farm having two ecosystems and the isolates were grouped into five distinct groups based on their cultural properties. The highest sized ? conidia were observed in group -1 and the lowest size in-group -2. The highest sized ? conidia were recorded in group -5 and the lowest in-group –2. The highest pycnidial size noted in-group -3 and the smallest sized pycnidia were recorded in group –1. DOI: http://dx.doi.org/10.3329/jsf.v8i1-2.14635 J. Sci. Foundation, 8(1&2): 123-130, June-December 2010

Timing of melatonin treatment: differential effects on oestrus and coat growth in goats

1997 ◽  
Vol 65 (2) ◽  
pp. 267-273 ◽  
Author(s):  
I. A. Forsyth ◽  
F. E. Gebbie ◽  
J. Arendt
Keyword(s):  
Goat Milk ◽  
Normal Weight ◽  
Ovarian Activity ◽  
Plasma Prolactin ◽  
Dairy Goats ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

AbstractTo avoid winter scarcity of fresh goat milk, simple methods of advancing the season of kidding would be commercially valuable. A combination of long-day light treatment followed by melatonin is successful but other aspects of seasonality including coat growth are also reset. To investigate whether effects on breeding season and coat growth can be dissociated, British Saanen dairy goats (no. = 30) were randomly allocated to one of six groups. Control goats were untreated. Goats in the other five groups received 2 months of treatment with 20 h light: 4 h darkness (20L: 4D) and were then given 3 mg melatonin orally at 16.00 hfor 2 months. The treatments started on 11 January (group 1), 29 March (group 2), 14 June (group 3), 30 August (group 4) and 8 November (group 5). Weekly blood samples were taken for the measurement of progesterone to monitor ovarian activity and prolactin. Side patches (10 cm ×10 cm) were clipped monthly from alternate sides and weighed to measure coat growth. The onset of ovarian activity was advanced from a median date of 15 November in controls to 24 May in group 1 (P < 0·01), 16 August in group 2 (P < 0·05) and 18 October in group 3 (? < 0·05). Groups 4 and 5 showed no significant change in the onset of oestrus (median onset dates 8 November and 1 November, respectively). Group 1 goats came into season again with controls in November. In all except group 5, treatment interacted with time to affect significantly the growth of the coat. The pattern of coat growth was most altered (P < 0·001) in groups 1 and 2. This was associated with effects on plasma prolactin concentrations of light stimulation and melatonin suppression. Group 1 goats resynchronized with control goats to show a coat of normal weight in the winter following treatment. Division of milking goat herds into spring and autumn kidding groups is, therefore, a practical possibility, but effects on overall milk yield require study.

THE EFFECTS OF SLAUGHTER WEIGHT AND SEX ON THE COOKING LOSSES FROM AND PALATABILITY ATTRIBUTES OF PORK LOIN CHOPS

1984 ◽  
Vol 64 (1) ◽  
pp. 39-43 ◽  
Author(s):  
L. E. JEREMIAH ◽  
G. M. WEISS
Keyword(s):  
Key Words ◽  
Slaughter Weight ◽  
Cooking Properties ◽  
Group 4 ◽  
Practical Standpoint ◽  
Group 3 ◽  
Pork Loin ◽  
Group 5 ◽  
Group 2 ◽  
Group 1

A total of 130 barrows and 113 gilts were slaughtered over a range of liveweights from 65.6 to 143.9 kg. These animals were randomly assigned to six different liveweight groups (group 1, less than 79.5 kg; group 2, 79.5 through 93.1 kg; group 3, 93.2 through 106.7 kg; group 4, 106.8 through 120.4 kg; group 5, 120.5 through 134.0 kg; and group 6, 134.1 kg and over) and utilized to evaluate the effects of slaughter weight and sex on palatability and cooking properties. The composite results indicated that the slaughter weight of both barrows and gilts can, from a practical standpoint, be increased to take advantage of potential economic advantages without meaningfully altering cooking losses or palatability attributes. Key words: Pork, slaughter weight, sex, palatability, cooking losses

Abstract 15193: Pulmonary Hypertension in Pregnancy: WHO Group 1 Outcomes Improved, Time to Focus on WHO Group 2

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
William H Marshall ◽  
Stephen Gee ◽  
Woobeen Lim ◽  
Elisa A Bradley ◽  
Lauren Lastinger ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Post Partum ◽  
Systolic Pressure ◽  
Adverse Outcomes ◽  
Cardiac Events ◽  
Ventricular Systolic Pressure ◽  
Group 5 ◽  
Group 2 ◽  
In Pregnancy ◽  
Group 1

Introduction: Pregnancy is contraindicated in women with pulmonary hypertension (PH), yet many still decide to pursue pregnancy. Hypothesis: We hypothesized improved maternal mortality with PH at our center’s cardio-obstetrics program and sought to identify factors to estimate the risk of major adverse cardiac events (MACE). Methods: Pregnant women with right ventricular systolic pressure (RVSP) ≥35 mmHg or tricuspid regurgitant velocity > 2.8 m/s on transthoracic echocardiogram (TTE) were identified. Women with intermediate to high probability PH by ESC criteria (TTE or catheterization, n = 70) were classified using the 6 th World Society of PH definitions. Results: In 70 women with PH (30 ± 6 years-old, RVSP 52 ± 16 mmHg) there were 12 (17%) with WHO Group 1 PH, 45 (64%) with Group 2 PH, 4 (6%) with Group 3 PH and 9 (13%) with Group 5 PH (Figure A). Baseline characteristics were similar except: Group 1 PH had 83% on prostacyclin (PC) therapy, higher RVSP (78 ± 20 mmHg vs. Groups 2 (46 ± 9), 3 (44 ± 2 mmHg) and 5 PH (48 ± 10mmHg), p<0.01), and compared to Group 2 PH, more Group 1 PH women were diagnosed pre-pregnancy (9 (75%) vs. 12 (27%), p = 0.01) and had cardio-obstetrics care (10 (83%) vs. 16 (36%), p < 0.01) (Figure B - E). There were no peripartum deaths, however 3 (4.3%) women with Group 2 PH had late mortality (7 ± 4 months post-partum). MACE occurred in 24 (34%) women and was more likely in those with: NYHA FC ≥ 2 (95% CI 4.7-57, p < 0.01), pre-eclampsia (95% CI 1.2-13, p = 0.03), RVSP >50 mmHg (95% CI 1.3-10, p = 0.02) and LVEF <50% (95% CI 1.1-8.8, p = 0.04) (Figure F). Preterm birth occurred in 32 (49%) pregnancies, with no neonatal mortality. Conclusion: To conclude, in a large single center cohort we report 100% 1-year survival in Groups 1, 3, and 5 PH, with most Group 1 PH patients on PC therapy and under cardio-obstetrics care. We identify Group 2 PH as an under-recognized group for adverse outcomes in pregnancy, with NYHA FC, pre-eclampsia, RVSP >50 mmHg and LVEF <50% associated with increased MACE.

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