scholarly journals Examining the Relationship Between Gastroschisis and Placental Fetal Vascular Malperfusion

2021 ◽  
pp. 109352662110296
Author(s):  
Brittany Ruschkowski ◽  
Ahmed Nasr ◽  
Irina Oltean ◽  
Sarah Lawrence ◽  
Dina El Demellawy

Introduction Gastroschisis is a congenital malformation characterized by intestinal herniation through an abdominal wall defect. Despite its unknown pathogenesis, known risk factors include maternal smoking, alcohol use, and young maternal age. Previous work has shown that gastroschisis is associated with placental delayed villous maturation, and the goal of this study was to assess for additional associated placental pathologies that may help clarify the pathogenesis of gastroschisis. Methods We conducted a retrospective slide review of 29 placentas of neonates with gastroschisis. Additionally, we reviewed pathology reports from one control group of 30 placentas with other congenital malformations. Gross and histological data were collected based on a standardized rubric. Results Gastroschisis was associated with increased placental fetal vascular malperfusion (FVM) in 62% of cases (versus 0% of controls, p < 0.0001). It was also associated with increased placental villous maldevelopment in 76% of cases (versus 3% of controls, p < 0.0001). Conclusion Our study demonstrates an association between gastroschisis and FVM. While FVM could be the consequence of vascular disruption due to the ventral location of gastroschisis, it could also reflect estrogen-induced thrombosis in early pregnancy. Further research is needed to separate these possibilities and determine the cause of the placental FVM observed in gastroschisis.

2019 ◽  
Vol 23 (3) ◽  
pp. 197-203
Author(s):  
Brittany Ruschkowski ◽  
Anthea Lafreniere ◽  
Dina El Demellawy ◽  
David Grynspan

Gastroschisis is a congenital abnormality characterized by visceral herniation through an abdominal wall defect. While the cause of gastroschisis is unknown, it has been linked to risk factors including young maternal age, smoking, and alcohol use during pregnancy. To date, the only established placental correlate is amniocyte vacuolization. Based on our clinical experience, we hypothesized that delayed villous maturation (DVM) is also associated with gastroschisis. We conducted a retrospective slide review of 23 placentas of neonates with gastroschisis. Additionally, we selected 2 control groups of placentas: 1 with a previous diagnosis of DVM and 1 with normal villous morphology. All placentas were randomized and reviewed by 2 perinatal pathologists, who were blinded to the group; DVM and amniocyte vacuolization were assessed. Gastroschisis was associated with increased placental DVM in 65.2% of cases (vs 13.6% of controls; P = .0007) and increased amniocyte vacuolization in 52.2% of cases (vs 9.1% of controls; P = .003) compared to the control group. Based on the normal and DVM groups, kappa agreement between current slide review and initial pathology diagnosis was 0.419, indicating moderate agreement. Our study shows that gastroschisis is associated with placental DVM. This association may be due to (1) a common upstream factor contributing to both gastroschisis and DVM or (2) DVM may be a consequence of the altered placental and amniotic environment in the context of gastroschisis.


Author(s):  
Rafael Calvão BARBUTO ◽  
Ivana DUVAL-ARAUJO ◽  
Sumara Marques BARRAL ◽  
Raphael Grossi ROCHA ◽  
Cristiane de Souza BECHARA ◽  
...  

Background : The use of alloplastic meshes has been historically contra-indicated in patients with infection. Aim : To evaluate the use of polypropylene meshes in the treatment of abdominal wall defects in rats with peritonitis. Methods : Twenty Wistar female rats were divided into two groups: induction of peritonitis (test group) and without peritonitis (control group). An abdominal wall defect was created in all animals, and polypropylene mesh was applied. The evaluation of the tensile strength of the mesh was carried out using tensiometer and microscopic analysis of the healing area was done. Results : More adhesion of the mesh to the rat abdominal wall was observed in test group. The histopathological analyses showed prevalence of moderate to accentuated granulation tissue in both groups, without significant differences. Conclusion : The use of the mesh coverage on abdominal wall defects of rats with induced peritonitis did not show worse results than its use in healthy animals, nor was its integration to the resident tissue any worse.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Natasha T. Logsdon ◽  
Carla M. Gallo ◽  
Luciano Alves Favorito ◽  
Francisco J. Sampaio

AbstractAnalyze the biometric parameters and the size (area) of abdominal wall defect (AWD) in fetuses with gastroschisis and omphaloceles and correlate them with the herniated internal organs. We studied 22 fetuses (11 with AWDs and 11 without anomalies). In all fetuses we evaluated the xiphopubic distance (XPD) and iliac crest distance (ICD). In fetuses with AWDs we dissected the abdominal wall and measured the width and length of the defect for calculating its area and studying the correlation between the size of the defect with the organs that were herniated. For statistical analysis, the Anova and Tukey post-test were used (p < 0.05). The XPD in the control group had mean of 4.2 mm (2.3–5.9; SD ± 1.11), while in the AWDs it was 4.2 mm (2.9–5.5; SD ± 0.98) (p = 0.4366). The ICD had mean values of 2.5 mm (1.6–3.4; SD ± 0.58) in the control group, and 2.3 mm (1.2–3.0; SD ± 0.56) in AWDs fetuses (p = 0.6963). The number of herniate organs do not have significant correlation with the area of the defect (r2 = 0.2504, p = 0.5068). There is no correlation between the size (area) of abdominal wall defects and the number of the internal organs that herniated. Therefore, the hole size is not a predictor of the severity of the gastroschisis or omphalocele.


2016 ◽  
Vol 26 (2) ◽  
pp. 165 ◽  
Author(s):  
Shayna D. Hibbs ◽  
Amanda Bennett ◽  
Yessenia Castro ◽  
Kristin M. Rankin ◽  
James W. Collins, Jr.

<p><strong>Background</strong>: US-born Mexican American women have greater rates of preterm birth and consequent overall infant mortality than their Mexico-born peers. However, the relation of Mexican American women’s<br />nativity to rates of congenital anomalies is poorly understood. Hispanic ethnicity and young maternal age are well-known risk factors for gastroschisis.</p><p><br /><strong>Objective</strong>: To determine the extent to which nativity of Mexican American women is associated with abdominal wall defects.</p><p><strong>Methods</strong>: Stratified and multivariable logistic regression analyses were performed on the 2003-2004 National Center for Health Statistics linked live birth-infant death cohort. Only Mexican American infants were studied. Maternal variables examined included nativity, age, education, marital status, parity, and prenatal care usage.</p><p><strong>Results:</strong> Infants with US-born Mexican American mothers (n=451,272) had an abdominal wall defect rate of 3.9/10,000 compared with 2.0/10,000 for those with Mexico-born mothers (n=786,878), RR=1.9 (1.5-2.4). Though a greater percentage of US-born (compared wtih Mexico-born) Mexican American mothers were teens, the nativity disparity was actually widest among women in their 20s. The adjusted (controlling for maternal age, education, marital status, parity, and prenatal care) odds ratio of abdominal wall defects among infants of US-born (compared with Mexico-born) Mexican American mothers was 1.6 (1.2-2.0).</p><p><strong>Conclusions</strong>: US-born Mexican American women have nearly a two-fold greater rate of delivering an infant with an abdominal wall defect than their Mexico-born counterparts. This phenomenon is only partially explained by traditional risk factors and highlights a detrimental impact of lifelong residence in the United States, or something closely related to it, on the<br />pregnancy outcome of Mexican American women. Ethn Dis; 2016;26(2):165-170; doi:10.18865/ed.26.2.165</p>


2003 ◽  
Vol 62 (4) ◽  
pp. 241-249 ◽  
Author(s):  
M. Bolognini ◽  
B. Plancherel ◽  
J. Laget ◽  
P. Stéphan ◽  
O. Halfon

The aim of this study, which was carried out in the French-speacking part of Switzerland, was to examine the relationship between suicide attempts and self-mutilation by adolescents and young adults. The population, aged 14-25 years (N = 308), included a clinical sample of dependent subjects (drug abuse and eating disorders) compared to a control sample. On the basis of the Mini Neuropsychiatric Interview ( Sheehan et al., 1998 ), DSM-IV criteria were used for the inclusion of the clinical population. The results concerning the occurrence of suicide attempts as well as on self-mutilation confirm most of the hypotheses postulated: suicidal attempts and self-mutilation were more common in the clinical group compared to the control group, and there was a correlation between suicide attempts and self-mutilation. However, there was only a partial overlap, attesting that suicide and self-harm might correspond to two different types of behaviour.


2018 ◽  
Vol 22 (5) ◽  
pp. 45-50
Author(s):  
A. M. Mambetova ◽  
A. M. Inarokova ◽  
N. N. Shabalova ◽  
D. V. Bizheva ◽  
A. T. Mahiyeva

THE AIM. To determine the concentration of natriuretic peptide in the blood serum in children with congenital malformations of the urinary system (CM US) and to compare with the activity of renin-angiotensin-aldosterone system (RAAS).MATERIALS AND METHODS.119 patients with CM US aged 3 to 18 years were examined. A control group of 10 clinically healthy children. 3 groups were assigned: group I – 55 children with  congenital vesicoureteral reflux, and group II – 34 children with  congenital hydronephrosis and ureterohydronephrosis, III group – 30 children with other forms of dysembryogenesis of the US. Following indicators were identified by ELISA in the blood: renin, aldosterone,  N – terminal propeptide natriuretic hormone (NT-рroВNР). RESULTS.NT-рroВNР, renin and aldosterone hyperproduction were diagnosed in 59,6%, 69,7%, 54.6 % of sick children relatively. Concentrations were higher in all variants of  malformations in comparison with the control group. Significant  differences were revealed in obstructive species, where arterial  hypertension (AH) was diagnosed more often. Patients with AH  recorded significantly higher concentrations of NT-proВNР and renin.CONCLUSION.The key point in pathological processes developmentand progression in the cardiovascular system and kidneys is the  activation of RAAS. The system of natriuretic factors is important in maintaining the compensated state of patients due to the blockade of RAAS.


2019 ◽  
Vol 8 ◽  
pp. 1549
Author(s):  
Babak Pezeshki ◽  
Ehsan Bahramali ◽  
Amir Ansari ◽  
Aliasghar Karimi ◽  
Mojtaba Frajam ◽  
...  

Background: Diabetes mellitus (DM) is a common metabolic disease worldwide and has many complications. The vascular events are the major complication of DM that have an important effect on mortality and disability. The physical activity (PA) enhances the vascular function by several pathways. The aim of this study was to evaluation of the relationship between PA and vascular diseases in patients with DM.Materials and Methods: This research was performed as the case-control study that was extracted from a prospective epidemiological research study in Iran (PERSIAN). The patients with type 2 DM more than six months defined as case group and the non-DM subjects in control group with ratio 1:2, and both groups were matched in the term of age and sex. The MET score was used to evaluate the level of PA and blood glucose, lipid profile, body mass index, overweight, dyslipidemia, glomerular filtration rate, myocardial infarction (MI), unstable angina, and stroke.Results: Overall, 1242 patients with DM were extracted, and 2484 non-diabetic subjects were investigated. In the case group, 355(28.6 %) and 887(71.4%) were men and women, respectively, the and 710 (28.6%) men and 1774(71.4%) women in control group. The mean MET score was 30 and 40.97 in the DM and non-DM groups, respectively (P˂0.001). The frequency of MI, stroke, and cardiac ischemia were 44 (3.5%), 37 (3%), and 267 (21.5%), respectively in DM group, and 54 (2.2%), 43 (1.7%), and 389 (15.7%), respectively in non-DM group.Conclusion: The incidence of vascular events associated with PA level in patients with DM and adherence to regular PA reduce the vascular events and DM complications. [GMJ.2019;inpress:e1549]


Lupus ◽  
2020 ◽  
Vol 29 (2) ◽  
pp. 182-190
Author(s):  
W Batista Cicarini ◽  
R C Figueiredo Duarte ◽  
K Silvestre Ferreira ◽  
C de Mello Gomes Loures ◽  
R Vargas Consoli ◽  
...  

We have explored the relationship between possible hemostatic changes and clinical manifestation of the systemic lupus erythematosus (SLE) as a function of greater or lesser disease activity according to Systemic Lupus Erythematosus Disease Activity Index-2000 (SLEDAI-2K) criteria. Endothelial injury and hypercoagulability were investigated in patients with SLE by measuring thrombomodulin (TM), D-dimer (DDi) and thrombin generation (TG) potential. A total of 90 participants were distributed into three groups: 1) women with SLE presenting with low disease activity (laSLE) (SLEDAI-2K ≤ 4), 2) women with SLE presenting with moderate to high disease activity (mhaSLE) (SLEDAI-2K > 4), and 3) a control group comprising healthy women. Levels of TM and DDi were higher both in the laSLE and mhaSLE groups compared to controls and in mhaSLE compared to the laSLE group. With respect to TG assay, lagtime and endogen thrombin potential, low concentrations of tissue factor provided the best results for discrimination among groups. Analysis of these data allow us to conclude that TM, DDi and TG are potentially useful markers for discriminating patients with very active from those with lower active disease. Higher SLE activity may cause endothelial injury, resulting in higher TG and consequently a hypercoagulability state underlying the picture of thrombosis common in this inflammatory disease.


Author(s):  
Zora Lazúrová ◽  
Jana Figurová ◽  
Beáta Hubková ◽  
Jana Mašlanková ◽  
Ivica Lazúrová

Abstract Objectives There is a growing evidence indicating an impact of endocrine distrupting chemicals such as bisphenol A (BPA) on human reproduction. Its higher levels in serum or urine have been documented in women with polycystic ovary syndrome (PCOS), however the relationship to ovarian steroidogenesis remains unclear. Aim of the study was to compare urinary BPA (U-BPA) concentrations among PCOS women and control group. Second aim was to assess the relationship of U-BPA to ovarian steroidogenesis in the group with PCOS. Methods Eighty six Caucasian women (age 28.5 ± 5.1 years) diagnosed with PCOS and 32 controls of age 24.9 ± 4.4 years were included in the study. Fasting blood samples were analyzed for biochemical parameters and steroid hormones. U-BPA was measured in the morning urine sample using high pressure liquid chromatography. Results PCOS women had significantly higher U-BPA as compared with control group (p=0.0001). Those with high levels of U-BPA (U-BPA ≥2.14 ug/g creatinine) demonstrated higher serum insulin (p=0.029) and HOMA IR (p=0.037), lower serum estrone (p=0.05), estradiol (p=0.0126), FSH (p=0.0056), and FAI (p=0.0088), as compared with low-BPA group (U- BPA <2.14 ug/g creatinine). In PCOS women, U-BPA positively correlated with age (p=0.0026; R2=0.17), negatively with estradiol (p=0.0001, R2=0.5), testosterone (p=0.0078, R2=0.15), free-testosterone (p=0.0094, R2=0.12) and FAI (p=0.0003, R2=0.32), respectively. Conclusions PCOS women have significantly higher U-BPA concentrations than healthy controls. U-BPA positively correlates with age and negatively with ovarian steroid hormones suggesting a possible suppressive effect of bisphenol A on ovarian steroidogenesis.


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