Morphological features of the placenta in obese women

Hypothesis/Aims of study. Obesity and severe chronic somatic pathology in a woman leads to a rapid depletion of compensatory and adaptive reserves of the placenta and to the progression of circulatory and dystrophic changes, which causes intrauterine growth retardation and reduces the likelihood of a favorable course of pregnancy and childbirth. The aim of this study was to assess the morphological features of the vascular component of placental villi in obese women. Study design, materials and methods. Histological and immunohistochemical studies were conducted on 41 placentas from obese patients with and without gestational diabetes mellitus and from healthy patients, endothelial marker CD34+ expression being assessed in chorionic villi. Results. In obese patients, chronic placental insufficiency is presented in most cases as a dissociated form with persistence of not only mature but also immature villi, which indicates early structural pathology of the placenta. Conclusion. Obesity in women contributes to more frequent chronic placental insufficiency with severe circulatory disorders and varying degrees of severity of compensatory and adaptive changes.

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Early prediction of placental insufficiency in obese women

V F Snegirev Archives of Obstetrics and Gynecology ◽

10.17816/2313-8726-2021-8-40-47 ◽

2021 ◽

Vol 8 (1) ◽

pp. 40-47

Author(s):

Natalya S. Datsenko ◽

Igor O. Marinkin ◽

Tat’yana M. Sokolova ◽

Tat’yana V. Kiseleva ◽

Anna V. Yakimova

Keyword(s):

Pregnant Women ◽

Placental Insufficiency ◽

Reproductive Age ◽

Control Group ◽

Obese Women ◽

Growth State ◽

Pregnancy And Childbirth ◽

Paired Samples ◽

Fetoplacental Complex ◽

Prevalence Of Obesity

Obesity is one of the most important problems in modern health care. The high prevalence of this pathology also affects women of reproductive age, which leads to an increase in the prevalence of obesity in pregnant women. Purpose of the work ‒ analysis of the effect of adipokine indicators on predicting the development of placental insufficiency in obese women. Materials and methods. 225 women were examined who were subdivided by such a parameter as obesity into 4 groups: 3 main and 1 control. The control group consisted of 55 pregnant women with an initially normal BMI value (18.5‒24.9 kg/m2). Group 1st included 109 pregnant women with grade I obesity (BMI 31.88 1.4 kg/m2), group 2nd ‒ 34 pregnant women with grade II obesity (BMI 36.6 1.1 kg/m2), group 3rd ‒ 31 pregnant women with grade III obesity (BMI 42.2 1.9 kg/m2). We studied the data of the anamnesis of pregnant women (somatic and obstetric-gynecological), indicators of adiponectin and omentin, peculiarities of the course of pregnancy and childbirth (data of cardiotocography (CTG), ultrasound markers of disturbances in the formation and functioning of the fetoplacental complex), indicators of labor activity, parameters of newborns (mass-growth, state on the Apgar scale, ponderal index, fetal-placental ratio) and the course of the postpartum period. When conducting statistical analysis in the case of comparing two dependent (paired) samples of parameters, the paired Students t-test was used. The results were considered statistically significant if the р was less than 0.05. With this indicator, the value of the probability of difference between the compared categories was more than 95%. Results. The possibility of predicting the development of placental insufficiency depending on the concentrations of omentin and adiponectin was confirmed. The development of placental insufficiency is most likely with omentin values in the range of 177.6‒191.2 g/ml and adiponectin in the range of 16.0‒22.5 g/ml. Conclusion. Determination of adipokine levels at 8‒9 weeks gestation may be practically significant in predicting the development of placental insufficiency in obese women.

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The Effect of HSV-1 Seropositivity on the Course of Pregnancy, Childbirth and the Condition of Newborns

Microorganisms ◽

10.3390/microorganisms10010176 ◽

2022 ◽

Vol 10 (1) ◽

pp. 176

Author(s):

Irina Anatolyevna Andrievskaya ◽

Irina Valentinovna Zhukovets ◽

Inna Victorovna Dovzhikova ◽

Nataliya Alexandrovna Ishutina ◽

Ksenia Konstantinovna Petrova

Keyword(s):

Neonatal Period ◽

Recurrent Infection ◽

First Trimester ◽

Placental Insufficiency ◽

Igg Antibodies ◽

Pregnancy And Childbirth ◽

Serological Status ◽

Anemia In Pregnancy ◽

In Pregnancy ◽

Hsv 1

The goal of this research was to evaluate seropositivity to HSV-1 among pregnant women and its effect on the course of pregnancy, childbirth and the condition of newborns. Methods: The serological status, socio-demographic characteristics, parity of pregnancy and childbirth and condition of newborns in women seronegative and seropositive to HSV-1 with recurrent infection and its latent course during pregnancy were analyzed. Newborns from these mothers made up the corresponding groups. Results: Low titers of IgG antibodies to HSV-1 in women in the first trimester of pregnancy are associated with threatened miscarriage, anemia in pregnancy and chronic placental insufficiency. High titers of IgG antibodies to HSV-1 in women in the second trimester of pregnancy are associated with late miscarriages and premature births, anemia in pregnancy, chronic placental insufficiency, labor anomalies, early neonatal complications (cerebral ischemia, respiratory distress syndrome) and localized skin rashes. Low titers of IgG antibodies to HSV-1 in women in the third trimester of pregnancy are associated with premature birth, anemia in pregnancy, chronic placental insufficiency, endometritis, complications of the early neonatal period and localized skin rashes. Conclusions: Our research showed that low or high titers of IgG antibodies to HSV-1, determined by the timing of recurrence of infection during pregnancy, are associated with a high incidence of somatic pathology and complications in pregnancy, childbirth and the neonatal period.

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Features of the morphological structure of the placenta in pregnant women with preeclampsia

Biomedical update ◽

10.52739/bio-up.2.2021.10-15 ◽

2021 ◽

pp. 10-15

Author(s):

Volodymyr I. Chermak ◽

Ihor I. Chermak ◽

Chukwuanyinonso O. Ikeotuonye ◽

Anatolii Ya. Senchuk

Keyword(s):

Risk Factors ◽

Pregnant Women ◽

High Frequency ◽

Morphological Changes ◽

Morphological Structure ◽

Morphological Features ◽

Placental Insufficiency ◽

Control Group ◽

Basic Group ◽

Adaptive Reactions

To study morphological features of the placenta in women in labor, pregnancy which complicated by preeclampsia we studied 26 placentae, of which 17 were from pregnant women with mild to moderate preeclampsia (basic group) and 9 from healthy women (control group). Histologically the study was conducted with methodically recommendations of T.D. Zadorozhnaya et al. for light microscopy. During the study of morphological features of the placenta in women in labor with preeclampsia were installed morphological changes in the placenta, which reflect a tendency to develop compensatory-adaptive reactions following their stress and exhaustion, which is a sign of placental insufficiency. Received data allow claiming a high frequency of development placental insufficiency in pregnant women with risk factors such as chronic salpingo-oophoritis, anemia, late preeclampsia, and inflammation diseases kidney.

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The value of blood serotonin for effective weight loss in obese women

Obesity and metabolism ◽

10.14341/omet2015331-35 ◽

2015 ◽

Vol 12 (3) ◽

pp. 31-35

Author(s):

Natal'ya Vadimovna Anikina ◽

Elena Nikolaevna Smirnova

Keyword(s):

Weight Loss ◽

Body Weight ◽

Clinical Laboratory ◽

Normal Weight ◽

Obese Patients ◽

Obese Women ◽

Endothelin 1 ◽

Excessive Accumulation ◽

Made In

Introduction. Obesity is a disorder of energy balance, which leads to excessive accumulation of fat. In recent years, many important discoveries were made in this field, including the discovery of hormones produced by adipose tissue and the identification of many of the central and peripheral pathways of energy balance.Objective. To study the levels of hormones that affect appetite and metabolism in women with obesity baseline and after weight loss while taking sibutramine.Materials and methods. The study included 56 women aged 42,9±9,5 years, with a BMI of 34,6±6,1 kg/m2. All patients underwent clinical, laboratory and instrumental examination. Hormonal study included determination of serotonin, leptin, ghrelin, endothelin-1, adiponectin.Results: In women with obesity we identified hyperleptinemia and increased serotonin levels. The decrease in body weight in patients receiving sibutramine was accompanied by lower levels of serotonin, leptin, ghrelin, endothelin-1, and increase of adiponectin.Conclusions: Obese patients have significantly elevated levels of leptin, serotonin, ghrelin compared to women of normal weight. Sibutramine treatment leads to a decrease in serotonin, leptin, ghrelin and is more effective in women with a BMI less than 36,5 kg/m2.

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Modern approaches to the diagnosis of placental insufficiency according to cardiotocography

Research n Practical Medicine Journal ◽

10.17709/2409-2231-2018-5-3-9 ◽

2018 ◽

Vol 5 (3) ◽

pp. 96-101

Author(s):

I. M. Ordiyants ◽

U. T. Mekhdieva ◽

A. M. Savicheva

Keyword(s):

Blood Pressure ◽

Body Temperature ◽

Pregnant Women ◽

Pressure Pulse ◽

Automated Analysis ◽

Well Being ◽

Placental Insufficiency ◽

The Real ◽

Pregnancy And Childbirth ◽

Average Blood Pressure

Purpose.The goal is to determine the real possibili es of assessing the fetal condi on in the ante- and intranatal periods according to the data of cardiotocography.Paents and methods.73 pa ents with physiological pregnancy at 24-40 weeks were prospec vely examined. The prac cal signiﬁ cance of the g6b plus General MEDITECH automated fetal monitor, which allows to determine the condi on of the mother and fetus at the same me, was evaluated.Results.The average blood pressure in the examined women was 127.2 ± 3.6 by 73.7 ± 2.3 mm. gt; pillars, pulse – 76 ± 1,5 beats/min. As for the contrac le capacity of the uterus, 47 (64,4%) pregnant women in 24–30 weeks. associated with diagnosis, and 19 (26%) – are harbingers of the forthcoming birth. The average SpO2was 99.12 ± 0.11%. Regardless of the gesta onal age, in 7 (9.6%) pregnant women – 97%, 40 (54.8%) – 99% and 21 (28.8%) – 100%. In order to assess the fetal condi on by the nature of his heartbeat, we performed an automated CTG analysis according to W. Fisher, D. Redman, FIGO: according to W. Fisher, depending on the gesta onal age of 6–7 points, 12 (16.4%) pregnant women in 25–26 weeks and 9 (12.3%) – 40 weeks, which according to the ball scale corresponds to a suspicious type. The Doze–Redman criteria were met in 47 (64.4%) pregnant women and were not met – in 26 (35.6%). Interpreta on according to FIGO guidelines as normal was detected in 64 (87.7%) pregnant women and in 9 (12.3%) – doub ul. Depending on the period of pregnancy, this group consisted of the same 9 (12.3%) pregnant women in a period of 40 weeks.Conclusion.Automated analysis allows for the correla on between the main indicators of the well-being of the maternal organism (SpO2, blood pressure, pulse, body temperature, ECG) and fetal CTG parameters (Fisher scale, Dowz Redman criteria and FIGO guidelines) to develop obstetric tac cs for each speciﬁ c pa ent during pregnancy and childbirth.

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Problems of the Irradiation of the Pelvis Cancers in Obese Patients

Tumori Journal ◽

10.1177/030089166605200501 ◽

1966 ◽

Vol 52 (5) ◽

pp. 319-334 ◽

Cited By ~ 1

Author(s):

Lorenzo Magno

Keyword(s):

Gamma Rays ◽

Normal Subjects ◽

Correct Choice ◽

The Body ◽

Treatment Technique ◽

Obese Patients ◽

Obese Women ◽

Moving Beam ◽

Choice Of Treatment ◽

Obese Subjects

The irradiation of the pelvis in obese patients meets biological and technical difficulties sometimes considered insuperable. Chiefly when it is necessary to irradiate a very large volume of tissues (for instance, in the case of the irradiation of the pelvis in uterus and ovary cancers) radiotherapy is sometimes considered unsuitable because of considerations concerning the integral dose to be reached, the acute or late reactions expected, difficulties in the choice of the irradiation technique and the execution itself of the therapy. Actually the irradiation of the pelvis in obese patients is clinically possible: it has been performed without complications by the author up to integral doses of 6 × 107 grads in 50 days. The most important problem is the correct choice of treatment technique: when Co 60 gamma rays are employed, obese patients must be irradiated by means of moving beam techniques. The author brings into evidence that obese women, bearing uterus carcinomas, can be irradiated by means of biaxial pendular techniques, employing the same parameters (field at axis, arc width, position of the axis) as in normal subjects. In effect the pelvis in obese subjects is in the center of the corporal section, as in thin subjects. The shape of isodoses in pendular axial irradiations, for Co 60, does not dipend from the dimensions of the body irradiated. The properties of high voltage moving beam radiotherapy turn to the advantage of obese patients. Technical difficulties, which are not negligible, may always be overcome with proper devise.

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Defective insulin signaling in placenta from pregnancies complicated by gestational diabetes mellitus

Acta Endocrinologica ◽

10.1530/eje-09-0031 ◽

2009 ◽

Vol 160 (4) ◽

pp. 567-578 ◽

Cited By ~ 107

Author(s):

Michelle Colomiere ◽

Michael Permezel ◽

Clyde Riley ◽

Gernot Desoye ◽

Martha Lappas

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Signaling Pathway ◽

Insulin Signaling ◽

Placental Tissue ◽

Insulin Signaling Pathway ◽

Obese Patients ◽

Obese Women ◽

Normal Controls

ObjectiveStudies in adipose tissue and skeletal muscle suggest that impaired insulin action is due to defects in the insulin signaling pathway and may play a role in the pathophysiology of insulin resistance associated with gestational diabetes mellitus (GDM) and obesity. The present study tested the hypothesis that endogenous expression levels in the human term placenta of insulin signaling components are altered in placental tissue from GDM women in comparison with normal controls and maternal obesity.Design and methodsPlacental tissue was collected from normal, diet-controlled GDM, and insulin-controlled GDM in both non-obese and obese women (n=6–7 per group). Western blotting and quantitative RT-PCR was performed to determine the level of expression in the insulin signaling pathway.ResultsThere was a significant increase in insulin receptor (IR) substrate (IRS)-1 protein expression with a concurrent decrease in IRS-2 protein expression in non-obese women with insulin-controlled GDM compared with diet-controlled GDM and normal controls. Furthermore, a decrease in both protein and mRNA expression of phosphatidyl-inositol-3-kinase (PI3-K) p85α and glucose transporter (GLUT)-4 was observed in non-obese and obese women with insulin controlled GDM compared with normal controls. When comparing non-obese to obese patients, significant decreases in mRNA expression of IR-β, PI3K p85α and GLUT-4 was found in obese patients.ConclusionOur results suggest that post receptor defects are present in the insulin signaling pathway in placenta of women with pregnancies complicated by diabetes and obesity. In addition, expression studies demonstrate post receptor alterations in insulin signaling possibly under selective maternal regulation and not fetal regulation.

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Osteoprotegerin Expression and Serum Values in Obese Women with Type 2 Diabetes Mellitus

10.21203/rs.3.rs-631858/v1 ◽

2021 ◽

Author(s):

Nearmeen M. Rashad ◽

Amal S. El-Shal ◽

Sally M Shalaby ◽

Walaa M Sarhan ◽

Hanim M. Abdel-Nour

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Type 2 Diabetes ◽

Type 2 Diabetes Mellitus ◽

Serum Levels ◽

Obese Patients ◽

Obese Women ◽

Expression Levels ◽

Obesity And Diabetes

Abstract Obesity and diabetes prevalence are increasing worldwide. We aimed by this work to detect the possible association of osteoprotegerin (OPG) gene expression with visceral adiposity indices and cardiometabolic risk factors among obese patients. This is research enrolled 150 controls and 150 obese cases subdivided into two subgroups non-diabetic (n = 70) and 80 patients with type 2 diabetes mellitus (T2DM). Circulating OPG expression levels were determined by RT-PCR. Serum OPG concentrations were assessed by ELISA.Our results explored that OPG serum levels were higher in the control group compared to obese women and obese diabetics had higher serum levels of OPG in comparison to obese non-diabetic patients. In obese group, regarding expression levels of OPG were higher than controls in diabetic obese patients, the blood expression levels of OPG were higher than non-diabetics patients. We found positive correlations between parameters of MetS and obesity indices, among them, the highest positive correlation found between VAI. After adjustment of the traditional risk factors, stepwise linear regression analysis test revealed that, OPG expression levels were independently correlated with HbA1c, HDL-cholesterol, and WHR. ROC analysis demonstrated that cutoff values of OPG expression levels and serum levels were 2.226 and 7.5; the AUC were 0.833 (95% CI = 0.821–0.946) and 0.981, respectively. Additionally, the sensitivities and the specificities of OPG expression were (90% and 86.2%), and OPG serum levels (98% and %94), respectively.OPG mRNA and serum levels are useful diagnostic biomarkers discriminate metabolic risk among obesity with or without T2DM.

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A Comparative Study of Maternal and Fetal Outcome in Obese Non- Obese Pregnant Women

10.53350/pjmhs2115103397 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3397-3399

Author(s):

Anisa Saleem ◽

Bushra Mehmood ◽

Amna Aslam ◽

Rubina Kausar

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Apgar Score ◽

Post Partum ◽

Obese Patients ◽

Obese Women ◽

Group I ◽

Post Partum Haemorrhage ◽

Group Ii ◽

Nicu Admission

Objective: The aim of this study is to determine the adverse pregnancy outcomes in obese and non- obese women. Study Design: Randomized controlled trial Place and Duration: Department of Gyne & Obs, Shahida Islam Teaching Hospital Lodhran, during from 01-07-2020 to 31-07-2021. Methods: Total one hundred and eighty patients were enrolled in this study. Patients were aged between 18- 50 years. Patients detailed demographics were recorded after taking written consent. Patients were equally divided into two groups I and II. 90 obese patients were included in group I and equally non-obese patients were included in group II. Frequency of pre-eclampsia, gestational diabetes mellitus and post-partum haemorrhage were calculated. Adverse outcomes (cesarean section, instrumental delivery, induction of labor and prolong labor, hypertensive disorder) were also calculated among both groups. Fetal outcomes were perinatal mortality, Low birth weight, Low Apgar score and NICU admission were observed. Complete data was analyzed by SPSS 24.0 version. Results: Mean age of the patients in group I was 34.12±4.59 years with mean BMI 31.12±8.67 Kg/m2 and in group II mean age was 26.13 ±5.78 years with mean BMI 23.03±9.48 Kg/m2. Frequency of pre-eclampsia in obese group I were high among 40 (44.4%) patients as compared to group II 9 (10%) patients , frequency of gestational diabetes mellitus in group I was among 21 (23.3%) patients and 6 (6.7%) patients were in group II, post partum haemorrhage was seen in 57 (63.3%) cases in group I and 29 (32.2%) cases in group II. Fetal outcomes, perinatal mortality in group I 5 (5.5%) and in group II was 4 (4.4%), low birth weight in group I was among 21 (23.3%) and in group II was 45(50%), low apgar score in group I was 14 (15.5%) and in group II was 9 (10%), 43 (47.8%) in group I went to NICU admission and 28 (31.1%) patient in group II admitted to NICU. Conclusion: Pregnancy-related complications such as gestational diabetes, pre-term labour, and pre-eclampsia are more likely in obese women, according to our data. Having a baby with a woman who is obese might lead to serious difficulties for both mother and baby. Maternal obesity is connected with an increased risk of feto-maternal morbidity and mortality. Keywords: Pre-eclampsia, Gestational diabetes, Partum haemorrhage, Apgar score, NICU

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Efectos adversos perinatales asociados a adiposidad materna durante la gestación

Revista de Obstetricia y Ginecología de Venezuela ◽

10.51288/00810406 ◽

2021 ◽

Vol 81 (04) ◽

pp. 329-341

Author(s):

Héctor Hernández ◽

◽

Joseph Hernández ◽

Freddy Bello

Keyword(s):

Adverse Effects ◽

Overweight And Obesity ◽

University Hospital ◽

Homogeneous Distribution ◽

Type I ◽

Hypertensive Disorder ◽

Obese Patients ◽

Obese Women ◽

Tract Infections ◽

Clinical Records

Objective: To determine perinatal adverse effects associated with maternal adiposity during pregnancy between November 2017 and October 2018, in the Obstetrics and Gynecology Service at the University Hospital: Dr. Jesús María Casal Ramos, Acarigua – Araure, Edo. Portuguesa. Methods: Descriptive, retrospective cross-sectional with a sample consisting of 115 clinical records of overweight and obese pregnant women. Results: No early adolescent primigestas were found. Among the 67 overweight and type I obese patients, women aged 26-30 years (22/32.8 % and 10/34.5 %) predominated, followed by the 21-25 group (18/26.9 % and 8/27.6 %). Patients with type II and III obesity had a more homogeneous distribution. Weight gain during pregnancy was less than 10 kg in 85 patients (73.9 %). Full-term pregnancies predominated in all groups (91 %, 82.2 %, 80% and 88.9 %). Delivery was predominantly vaginal in overweight and obese patients type I (70.1% and 51.7%), cesarean section was more frequent in typi II and III obesity (60 % and 55.6 %). The most frequent maternal complications in overweight patients were: vaginal infections (25.4 %), urinary tract infections (14.9%) and anemia (14.9 %). Among obese women there was a higher frequency of hypertensive disorder of pregnancy (24.1 %, 50 % and 55.6 % in obesity I, II and III, respectively). Among the neonatal complications, low weight and prematurity predominated. Conclusions: Overweight and obesity are factors related to maternal and perinatal adverse effects. Key words: Adiposity, Perinatal effects, Overweight.

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