Fetal haemoglobin and alpha 1 microglobulin as biochemical markers in predicting preeclampsia in late first trimester and early second trimester of pregnancy

Background: Preeclampsia is a multi system disorder with placenta as the organ of origin and maternal endothelium being the organ of target. According to recent studies, the cell free haemoglobin induces oxidative stress mediated damage to the blood placenta barrier with consequently elevated levels of HbF in maternal blood. Alpha 1 microglobulin is an endogenous protein with antioxidant property, present in elevated levels in maternal blood in response to oxidative stress. This fact forms the basis for our study. The objective of the present study was to establish association between high levels of fetal hemoglobin and alpha 1 microglobulin in plasma of pregnant women between 10 to 16 weeks of gestational age and subsequent development of preeclampsia.Methods: This was a prospective cohort study undertaken in the Department of Obstetrics and Gynaecology, ISO -KGH, between December 2016 to November 2017. A total of 100 pregnant women were included in the study after getting informed written consent. Both primigravida and multigravida, belonging to age group of 20 to 35 years (singleton/ multiple) between 10 to 16 weeks GA and with BMI between 16 to 35 kg/m2 were included in the study. A woman with Diabetes mellitus, Hypertension, Renal disease, Epilepsy and Vascular disorders were excluded from the study.Results: The cut off value for alpha 1 microglobulin was 1.86ng/ml and the cut off value of fetal haemoglobin was 1.92ng/ml above which the pregnant women develop preeclampsia.Conclusions: Higher values of fetal hemoglobin and alpha 1 microglobulin in pregnant women between 10 to 16 weeks gestational age positively correlates with development of preeclampsia in those women.

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Fetal-Maternal Hemorrhage in First-Trimester Intrauterine Hematoma

Fetal Diagnosis and Therapy ◽

10.1159/000513747 ◽

2021 ◽

Vol 48 (3) ◽

pp. 227-234

Author(s):

Thaisa A.R.M. Narciso ◽

Mara S Hoshida ◽

Priscilla R Costa ◽

Andrea Niquirilo ◽

Sckarlet E Biancolin ◽

...

Keyword(s):

Flow Cytometry ◽

Pregnant Women ◽

Fetal Hemoglobin ◽

First Trimester ◽

Maternal Blood ◽

Control Group ◽

Asymptomatic Patients ◽

Ultrasound Findings ◽

Moderate Negative Correlation ◽

And Control

Objective: The objective of this study was to compare the frequency and percentage of fetal hemoglobin (HbF%) by flow cytometry of (1) first-trimester asymptomatic patients with intrauterine hematoma (IUH), (2) first-trimester pregnant patients with vaginal bleeding (VB), and (3) first-trimester asymptomatic pregnant women without hematoma. Methods: Prospective study involving pregnant women in the first trimester of pregnancy. Patients with ultrasound findings of asymptomatic hematoma and with VB were paired with asymptomatic pregnant women of same gestational age without hematoma (control group [CG]). Maternal blood HbF% was evaluated by flow cytometry. The groups were compared in terms of circulating fetal hemoglobin and HbF%. Results: Sixty-six patients were selected, 22 with hematoma, 17 with bleeding, and 27 in the CG. Fetal hemoglobin was detected in 15 patients with hematoma (68.2%) and 13 with bleeding (76.5%) and in 20 of the control (74.1%) (p = 0.830). The mean HbF% of each group was 0.054, 0.012, and 0.042 for hematoma, bleeding, and control, respectively, and differences were not significant (p = 0.141). There was a moderate negative correlation between the volume of hematoma and HbF% (rSpearman = −0.527; p = 0.012). Conclusions: The fetal-maternal hemorrhage expressed by Hbf% in first-trimester pregnancies did not seem to differ between patients with and without ultrasound findings of IUH.

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The possibility of modifications methods of determine volume of amniotic fluid

Journal of obstetrics and women s diseases ◽

10.17816/jowd65312-17 ◽

2016 ◽

Vol 65 (3) ◽

pp. 12-17

Author(s):

Viktor A Mudrov

Keyword(s):

Body Mass Index ◽

Amniotic Fluid ◽

Pregnant Women ◽

Body Mass ◽

Gestational Age ◽

First Trimester ◽

Fetal Weight ◽

Abdominal Circumference ◽

Pregnancy And Childbirth ◽

Maternity Hospitals

Selection of the optimal tactics of pregnancy and childbirth significantly depends on the expected volume of amniotic fluid. The amount of amniotic fluid reflects a condition of a fetus and changes at pathological conditions of both a fetus, and an uteroplacental complex. The aim of the study was a modification of methods for determining the expected volume of amniotic fluid. On the basis of maternity hospitals Trans-Baikal Region in the years 2013-2015 was held retrospective and prospective analysis of 300 labor histories, which were divided into 3 equal groups: 1 group - pregnant women with a body mass index (BMI) for Quetelet less than 24, Group 2 - with a BMI from 24 to 30, group 3 - with a BMI more than 30. In order to determine the expected volume of amniotic fluid were used the subjective method, the Chamberlain’s and Phelan’s methods. The error in determining volume of amniotic fluid by the existing methods exceeds 10 %, that defined need of creation of a quantitative method. On the basis of mathematical and 3d-modeling of the volume of amniotic fluid and fetal weight determined pattern change, which is expressed by the formula: VAF = IAF × М × π / GA2, where IAF - index of amniotic fluid (mm), M - fetal weight (g), GA - gestational age (weeks). Through a comprehensive analysis of anthropometric research of the pregnant women defined formula’s volume of amniotic fluid: V = 0,017 × HUF × (AC - 25 × BMI / GA)2 - М, where GA - gestational age (weeks), AC - abdominal circumference of the pregnant women (cm), BMI - body mass index for Quetelet in the first trimester of pregnancy (kg/m2), HUF - height of an uterine fundus (cm), M - the estimated fetal weight (g). In calculating volume of amniotic fluid according to the proposed ultrasonic formula error does not exceed 5,3 %, anthropometric formula error does not exceed 10,2 %. Thus, the method has a smaller error compared to the standard, and can be used to reliably determine volume of amniotic fluid in II and III trimester of pregnancy.

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Matrix metalloproteinases MMP-2 and MMP-9 as markers for the prediction of preeclampsia in the first trimester

Česká gynekologie ◽

10.48095/cccg2021228 ◽

2021 ◽

Vol 86 (4) ◽

pp. 228-235

Author(s):

Elena Timokhina ◽

◽

Vadim Zinin ◽

Irina Ignatko ◽

Sapyat Ibragimova ◽

...

Keyword(s):

Matrix Metalloproteinases ◽

Matrix Metalloproteinase ◽

Pregnant Women ◽

Prognostic Significance ◽

Subsequent Development ◽

First Trimester ◽

Control Group ◽

Early Markers ◽

Threatening Condition ◽

Metalloproteinase 9

Summary: Introduction: Preeclampsia is a life-threatening condition for the mother and foetus. Globally, it is diagnosed in 10 mil. women every year, which accounts for 3% to 8% of all pregnancies. Currently there is no proven effective treatment for preeclampsia. The aforesaid text actualises the issue of predicting this complication. To determine the prognostic significance of matrix metalloproteinases-2 and -9 levels as early markers of preeclampsia, the present prospective study was conducted. Materials and methods: The levels of matrix metalloproteinases-2  and -9  were assessed in 72  patients. Thirty-four  of them subsequently developed preeclampsia during pregnancy (20 patients with moderate preeclampsia, 14 patients with severe preeclampsia), and constituted the basic group; 38 patients made up the control group. Results: In pregnant women with the subsequent development of preeclampsia, the level of matrix metalloproteinase-2 at 11–13 weeks of gestation was 155 ± 73.4 ng/mL and significantly exceeded its level in pregnant women without hypertensive disorders – 75.0 ± 32.8 ng/mL. The study conducted demonstrates a significantly lower concentration of matrix metalloproteinase-9 in pregnant women with preeclampsia compared to the control – 749 ± 296 ng/mL and 1,667 ± 552 ng/mL (P < 0.001). The performed research figures that in the first trimester, the cut-off value of matrix metalloproteinase-2 for predicting the development of preeclampsia is ≥ 102 ng/mL (sensitivity 88.24% and specificity 82.76%). For matrix metalloproteinase-9, a level of ≤ 980 ng/mL in the first trimester predicts the development of preeclampsia with a sensitivity of 85.29% and a specificity of 84.48%. Conclusion: The study established the cut-off values of matrix metalloproteinases-2 and -9 for predicting the development of preeclampsia in the first trimester.

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Correlation between first trimester uric acid level and subsequent development of gestational diabetes mellitus

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20170391 ◽

2017 ◽

Vol 6 (2) ◽

pp. 606

Author(s):

Amudha P. ◽

Nithya D. ◽

Pradeeba S. ◽

Manochithra B.

Keyword(s):

Diabetes Mellitus ◽

Uric Acid ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Serum Uric Acid ◽

Uric Acid Level ◽

Acid Level ◽

Subsequent Development ◽

First Trimester

Background: The aim of the study was to correlate between first trimester uric acid level and its association with subsequent development of gestational diabetes mellitus.Methods: This is a prospective study conducted at Govt. Raja Mirasudar Hospital attached to Thanjavur Medical College, Thanjavur over a period of one year from September 2015. A total of one hundred and eighty seven ante natal women less than 14 weeks of gestational age who attended the outpatient antenatal department were included in this study. Serum uric acid estimation was done in women with <14 weeks of gestation and they were subsequently screened for GDM between 24 to 28 weeks by oral glucose tolerance test (OGTT) with 75 gms glucose according to IADPSG criteria.Results: In our study, among 178 antenatal pregnant women 13 with uric acid >3.6 mg/dl and 2 with serum uric acid <3.6 mg/dl developed GDM. This shows development of GDM increases with increase in uric acid concentration.Conclusions: Though our study results suggest that serum uric acid level estimation in first trimester can be used as a marker to predict GDM in pregnant women, large scale studies are required before it can be recommended as a routine first trimester screening test for prediction of gestational diabetes mellitus.

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Gestational age-specific reference intervals for 15 biochemical measurands during normal pregnancy in China

Annals of Clinical Biochemistry International Journal of Laboratory Medicine ◽

10.1177/0004563217738801 ◽

2017 ◽

Vol 55 (4) ◽

pp. 446-452 ◽

Cited By ~ 5

Author(s):

Yanpeng Dai ◽

Junjie Liu ◽

Enwu Yuan ◽

Yushan Li ◽

Quanxian Wang ◽

...

Keyword(s):

Pregnant Women ◽

Gestational Age ◽

Parametric Method ◽

First Trimester ◽

Normal Pregnancy ◽

Reference Intervals ◽

Specific Reference ◽

Gamma Glutamyl Transpeptidase ◽

Cross Sectional ◽

Laboratory Results

Aims Physiological changes that occur during pregnancy can influence biochemical parameters. Therefore, using reference intervals based on specimens from non-pregnant women to interpret laboratory results during pregnancy may be inappropriate. This study aimed to establish the essential reference intervals for a range of analytes during pregnancy. Methods A cross-sectional study was performed in 13,656 healthy pregnant and 2634 non-pregnant women. Fifteen biochemical measurands relating to renal and hepatic function were analysed using an Olympus AU5400 analyzer (Olympus, Tokyo, Japan). All the laboratory results were checked for outliers using Dixon’s test. Reference intervals were established using a non-parametric method. Results Alanine aminotransferase, aspartate aminotransferase, albumin, cholinesterase, creatinine, direct bilirubin, gamma-glutamyl transpeptidase, total bilirubin, total bile acid and total protein showed a decrease during the whole gestational period, while alkaline phosphatase and uric acid increased. Urea nitrogen, β2-microglobulin and cystatin-C fell significantly during the first trimester and then remained relatively stable until third trimester. Reference intervals of all the measurands during normal pregnancy have been established. Conclusions The reference intervals established here can be adopted in other clinical laboratories after appropriate validation. We verified the importance, for some measurands, of partitioning by gestational age when establishing reference intervals during pregnancy.

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First-trimester increase in oxidative stress and risk of small-for-gestational-age fetus

BJOG An International Journal of Obstetrics & Gynaecology ◽

10.1111/j.1471-0528.2008.02096.x ◽

2009 ◽

Vol 116 (5) ◽

pp. 637-642 ◽

Cited By ~ 47

Author(s):

N Potdar ◽

R Singh ◽

V Mistry ◽

MD Evans ◽

PB Farmer ◽

...

Keyword(s):

Oxidative Stress ◽

Gestational Age ◽

Small For Gestational Age ◽

First Trimester

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Determination of Prooxidant–Antioxidant Balance during Uncomplicated Pregnancy Using a Rapid Assay

Journal of Medical Biochemistry ◽

10.2478/jomb-2013-0018 ◽

2013 ◽

Vol 32 (3) ◽

pp. 227-232 ◽

Cited By ~ 4

Author(s):

Hassan Boskabadi ◽

Mahdieh Moeini ◽

Fatemeh Tara ◽

Shima Tavallaie ◽

Hamidreza Saber ◽

...

Keyword(s):

Oxidative Stress ◽

Pregnant Women ◽

Demographic Data ◽

First Trimester ◽

Normal Pregnancy ◽

Redox Status ◽

Uncomplicated Pregnancy ◽

Biochemical Indices ◽

Post Hoc

Summary Background: Oxidative stress is thought to be a major contributor to complications during pregnancy, for example preeclampsia. However, reports regarding prooxidant-antioxidant balance in uncomplicated pregnancy are inconsistent. In this study, we aimed to compare the levels of oxidative stress in non-pregnant women with apparently normal pregnant women during the first trimester and at delivery. Methods: An assay for the determination of prooxidant-antioxidant balance (PAB) was used in this study, in which the prooxidant burden and the antioxidant capacity were measured simultaneously in a single assay. The levels of oxidative stress were determined in 85 non-pregnant and 64 primigravid pregnant women. Results: Demographic data and biochemical indices did not differ significantly between the groups. Differences between PAB values were significant based on one-way ANOVA analysis (P<0.001). Using a post hoc test, we observed a statistically significant increase in PAB values during the first trimester and last trimester (P<0.001). Conclusions: Normal pregnancy is associated with a change in the measure of redox status, as assessed by the PAB assay.

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Frequency of subclinical hypothyroidism and mean serum TSH level in first trimester of pregnancy.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.12.6316 ◽

2021 ◽

Vol 28 (12) ◽

pp. 1763-1767

Author(s):

Fouzia Perveen ◽

Lubna Ali ◽

Afshan Hasan

Keyword(s):

Pregnant Women ◽

Gestational Age ◽

Subclinical Hypothyroidism ◽

Maternal Age ◽

Age Groups ◽

First Trimester ◽

Level Data ◽

First Trimester Of Pregnancy ◽

The Mean ◽

Serum Tsh

Objective: To find out the frequency of subclinical hypothyroidism (SCH) in our pregnant population during 1st Trimester and the mean TSH level in first trimester of pregnancy. Study Design: Cross Sectional Descriptive study. Setting: Dow University Hospital and Dr Ruth KM Pfau CHK. Period: June 2015 to May 2016. Material & Methods: All Pregnant women with <14 weeks gestation were screened for Serum TSH level. Data were recorded after informed consent and institutional ethical approval. Variables recorded were age, parity, gestational age and serum TSH level. Data were analyzed on SPSS version 16. Mean and SD were calculated for quantitative variables ie. Age, parity, gestational age, serum TSH level and serum free T4 level. Mean TSH level according to age group, parity and gestational age groups were determined by applying ANOVA test. Correlation of Serum TSH level with the maternal age, parity and gestational age groups were also assessed by Pearson Correlation test. Significant P-value was taken as <0.05. Results: The frequency of SCH found was 19.35% by taking cut off limit of <2.5 IU/L and 3.55% by taking cut off limit of <4.5 IU/L among total of 310 pregnant women. Mean TSH level was 1.84±1.36 IU/L. The mean maternal age was 27.22 ± 4.43 yrs. while median parity was 1. Mean gestational age of these patients were 9.41 ± 2.748 weeks and out of these 160 (51.61%) were between 4-9 weeks and 150(48.38%) between 10-14 weeks. Majority (74%) of these women belonged to lower middle socioeconomic class. Mean TSH level coorelation between different age groups, parity groups and gestational age groups were found to be insignificant. Conclusion: The prevalence of SCH is not so high and mean TSH level in our population was 1.84 IU/L. But to establish reference range for Pakistani population, further studies in population of different backgrounds and geographical distribution needs to be evaluated.

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Chemotherapy for breast cancer during pregnancy induces vascular alterations and impaired development of placental villi: a preliminary histopathological study.

10.21203/rs.2.17106/v1 ◽

2019 ◽

Author(s):

Alessandro Del Gobbo ◽

Giovanna Scarfone ◽

Fedro Alessandro Peccatori ◽

Antonella Villa ◽

Wally Ossola ◽

...

Keyword(s):

Breast Cancer ◽

Birth Weight ◽

Pregnant Women ◽

Gestational Age ◽

First Trimester ◽

Histopathological Study ◽

Third Trimester ◽

Significant Difference ◽

Placental Villi ◽

Fetal Malformations

Abstract Breast cancer is diagnosed in approximately 1/3000 pregnant women. Chemotherapy may be administered after the first trimester, with improved maternal outcome and relatively few pregnancy and offspring complications. Nonetheless, no information about the effects of different chemotherapy regimens on placenta architecture and vasculature are available. Methods To evaluate histological alterations in placentas of women affected by breast cancer and treated with chemotherapy during pregnancy, we retrospectively analyzed 23 placentas of patients affected by breast cancer and treated with chemotherapy during pregnancy and 23 control placentas of women without breast cancer and with physiological pregnancies of the same gestational age. Results All the patients had breast ductal infiltrating carcinoma, 19 of 23 cases had a G3 cancer. All patients were treated with 2-6 cycles of chemotherapy starting after 16 weeks of gestation, with different protocols. No hypertensive complications and no pre-eclampsia episodes were observed; birth weight was consistent with gestational age in all babies in both group with no uneventful outcomes and no perinatal mortality or fetal malformations. Twenty out of 23 cases (86%) showed hypoxia-induced villous alterations, including increased syncytial knotting (Tenney-Parker changes), perivillar fibrin deposits, distal villous hypoplasia or accelerated maturation and focal villous chorangiosis. These alterations were found in 19 out of 23 controls (83%), with no statistically significant difference between the two groups. Conclusions These results shows that chemotherapy in the second and third trimester of pregnancy may lead to non-specific alterations in placental vasculature and morphology.

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Immunologic Studies of Hemoglobins

Blood ◽

10.1182/blood.v10.11.1092.1092 ◽

1955 ◽

Vol 10 (11) ◽

pp. 1092-1099 ◽

Cited By ~ 36

Author(s):

DONALD L. RUCKNAGEL ◽

AMOZ I. CHERNOFF

Keyword(s):

Pregnant Women ◽

Post Partum ◽

Fetal Hemoglobin ◽

Maternal Blood ◽

Hormonal Changes ◽

Placental Barrier ◽

Second Trimester ◽

Fetal Blood ◽

In Pregnancy

Abstract Changes in the concentration of fetal hemoglobin in maternal blood during pregnancy and after delivery were studied in 91 pregnant women. Significant elevations of fetal hemoglobin were detected in the blood of ten women during the second trimester of pregnancy; these values fell toward normal during the ensuing pregnancy and post partum periods. In no instance could a rise in fetal hemoglobin be detected after delivery. The significance of these observations is discussed; it is suggested that acute hormonal changes early in pregnancy may be responsible for the reactivation of a fetal erythropoietic anlage with the resultant production by the mother of erythrocytes containing fetal hemoglobin. The method used was not sensitive enough, however, to detect minute amounts of fetal blood which may have crossed the placental barrier.

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