The influence of bacterial vaginosis on gestational week of the completion of delivery and biochemical markers of inflammation in the serum

Bacground/Aim. Preterm delivery is one of the most common complications in pregnancy, and it is the major cause (75- 80%) of all neonatal deaths. Bacterial vaginosis predisposes to an increased risk of preterm delivery, premature rupture of membrane and miscarriage. In this syndrome normal vaginal lactobacilli, which produce protective H2O2, are reduced and replaced with anaerobic, gram-negative bacteria and others. The aim of this study was to evaluate the influence of bacterial vaginosis on the week of delivery and biochemical markers of inflammation in the serum. Methods. A total of 186 pregnant women were included into this study, between the week 16 and 19 of pregnancy. In the study group there were 76 pregnant women with diagnosed bacterial vaginosis by the criteria based on vaginal Gram-stain Nugent score and Amsel criteria. In the control group there were 110 healthy women with normal vaginal flora. Ultrasound examination was performed in both groups. Vaginal fluid and blood samples were taken to determine biochemical markers with colorimetric methods. Results. The week of delivery was statistically significantly shorter in the study group and the levels of biochemical markers of inflammation (C-reactive protein and fibrinogen in the serum) were statistically significantly higher in women with bacterial vaginosis comparing to the control group. Also the levels of uric acid and white blood cells in the serum were higher in the study group compared to the control one. Conclusion. Our study indicates that the pregnancy complicated with bacterial vaginosis ends much earlier than the pregnancy without it. Also, higher levels of biochemical markers of inflammation in the serum in the study group, similarly to results of other studies, suggest that pathophysiological processes responsible for preterm delivery can begin very early in pregnancy.

Download Full-text

First epidemiological data for venotonics in pregnancy from the EFEMERIS database

Phlebology The Journal of Venous Disease ◽

10.1177/0268355515589679 ◽

2015 ◽

Vol 31 (5) ◽

pp. 344-348 ◽

Cited By ~ 6

Author(s):

Isabelle Lacroix ◽

Anna-Belle Beau ◽

Caroline Hurault-Delarue ◽

Claire Bouilhac ◽

Dominique Petiot ◽

...

Keyword(s):

Pregnant Women ◽

Adverse Pregnancy Outcome ◽

Pregnancy Termination ◽

Newborn Health ◽

Control Group ◽

Published Data ◽

Intrauterine Death ◽

Increased Risk ◽

Adverse Pregnancy ◽

In Pregnancy

Objective There are few published data about possible effects of veinotonics in pregnant women. The present study investigates potential adverse drug reactions of veinotonics in pregnancy. Method EFEMERIS is a database including prescribed and dispensed reimbursed drugs during pregnancy (data from Caisse Primaire d’Assurance Maladie) and outcomes (data from Maternal and Infant Protection Service and Antenatal diagnostic Centre). Women who delivered from 1 July 2004 to December 2007 in Haute-Garonne and were registered in the French Health Insurance Service have been included in the EFEMERIS database. We compared pregnancy outcomes and newborn health between women exposed to veinotonics during pregnancy and unexposed women. Results We found that 8998 women (24%) had received at least one prescription for venotonic agents during their pregnancy, corresponding to the period of organogenesis in 1200 cases. We compared data for these women with those for the 27,963 women for whom these drugs were not prescribed during pregnancy. The most widely used veinotonics were hesperidin, diosmin and troxerutin. Pregnancies led to 98.4% versus 93.6% of live births, 0.2% versus 0.2% of postnatal deaths and 1.6% versus 6.4% of pregnancy termination (miscarriage, ectopic pregnancy, medical termination, intrauterine death) in exposed and non-exposed groups, respectively. The risks of pregnancy termination (HR = 0.71 (0.60–0.84)) and prematurity (HR = 0.82 (0.73–0.93)) remained significantly lower in the women exposed to venotonics than in unexposed women. In the group of newborns whose mother had a prescription of veinotonics during organogenesis, 39 out of 1200 (3.4%) had a malformation versus 789 (3.0%) in the control group (ORa = 1.134 (0.873–1.472)). The risk of neonatal diseases was not increased by exposure to venotonic agents in the third trimester (4.9% versus 6.1% for the controls, ORa = 1.07 (0.95–1.20)). Conclusion We found no increased risk of adverse pregnancy outcome among women exposed to veinotonics compared with unexposed pregnant women.

Download Full-text

UTILITY OF PLACENTAL LEUCINE AMINOPEPTIDASE/OXYTOCINASE IN THE PREDICTION OF PRETERM DELIVERY IN PREGNANT WOMEN WITH THREATENED PRETERM LABOR

Asian Journal of Pharmaceutical and Clinical Research ◽

10.22159/ajpcr.2019.v12i4.32053 ◽

2019 ◽

pp. 301-307

Author(s):

MIAMI ABD–AL HASSAN ◽

ISRAA TALIB ABD AL KADIR ◽

NOOR HUMAM MOHAMMED

Keyword(s):

Serum Level ◽

Pregnant Women ◽

Preterm Delivery ◽

Gestational Age ◽

Preterm Labor ◽

Leucine Aminopeptidase ◽

Control Group ◽

Study Group ◽

Study Objective ◽

Threatened Preterm Labor

Objective: The study objective was to assess the utility of placental leucine aminopeptidase (P-LAP) marker for the prediction of delivery in patients presented with threatened preterm labor (TPL). Setting: This study was conducted at the Obstetrics and Gynaecology Department of Al-Yarmouk Teaching Hospital in the period from March 2017 to June 2018. Type of Study: This is a prospective case control study. Methods: This study included 90 pregnant women with gestational age from (28-36+6) weeks; 45 of them who presented with preterm uterine contractions were considered as the study group which was further subdivided into three subgroups according to gestational age 28–31+6 weeks, 32– 33+6 weeks, and 34–36+6 weeks. The other 45 pregnant women who presented to the hospital for regular antenatal care visit at comparable gestational age to the study group were considered as the control group. Hence, this study aimed to assess the serum level of P-LAP in both groups and compare it between those delivered preterm from term to assess its applicability as a predictor of preterm labor. Results: Serum level of P-LAP in pregnant women presented with TPL was found to be significantly lower in those delivered preterm (p<0.001), compared to those continued to term and control group especially in gestational ages ≥32 weeks, while the study found P-LAP level to be statistically insignificant in gestational age <32 weeks (p=0.052). The cutoff point for P-LAP serum level was = 21 (IU/ml) that below it, the pregnant women with TPL most probably deliver before 37 weeks of gestation with Sensitivity (85.7%) Specificity (90.3%), Positive predictive value (80.0%) Negative predictive (93.3%). Conclusion: The serum level of P-LAP was lower in women delivered preterm than those delivered at term, so it can be used as one of the markers for the prediction of preterm delivery, especially at gestational age >32 weeks.

Download Full-text

The lollipop with lemon aroma may be promising in nausea and vomiting in pregnancy

Gynecology Obstetrics and Reproductive Medicine ◽

10.21613/gorm.2019.973 ◽

2019 ◽

pp. 1

Author(s):

Ismail Biyik ◽

Fatih Keskin

Keyword(s):

Hospital Admission ◽

Pregnant Women ◽

Case Control Study ◽

First Trimester ◽

Nausea And Vomiting ◽

Control Group ◽

Study Group ◽

Time Of Presentation ◽

Control Study ◽

In Pregnancy

OBJECTIVE: To determine the effect of lemon-flavored lollipop on nausea and vomiting of pregnancy.STUDY DESIGN: This prospective case-control study included 67 first trimester pregnant women. The 12-hour Pregnancy-Unique Quantification of Emesis and Nausea score was calculated at the time of presentation to the hospital. The study group (32 cases) was given lemon-flavored lollipops while the control group (35 cases) did not receive lollipops. The Pregnancy-Unique Quantification of Emesis and Nausea scores of the patients were recalculated on the morning of the post-treatment day. RESULTS: The Pregnancy-Unique Quantification of Emesis and Nausea scores of the study group were higher (p=0.013) than in the control group on the day of admission. Pregnancy-Unique Quantification of Emesis and Nausea scores were similar between the groups on the day after hospital admission (p > 0.005). The Pregnancy-Unique Quantification of Emesis and Nausea difference values obtained by extracting the Pregnancy-Unique Quantification of Emesis and Nausea score on the day after hospital admission from the presentation Pregnancy-Unique Quantification of Emesis and Nausea score were higher in the study group (p=0.0046). Lemon-flavored lollipops were found to decrease nausea and vomiting of pregnancy. CONCLUSION: Lemon-flavored lollipops can be given especially to pregnant women who are concerned about the possible teratogenic effects of drug use in pregnancy. Lemon-flavored lollipops are cheap and easily accessible and therefore promising as a non-pharmacological complementary treatment for nausea and vomiting of pregnancy.

Download Full-text

Impact of Vaginal Microbiota on Gestation and Labour

Kuban Scientific Medical Bulletin ◽

10.25207/1608-6228-2020-27-6-30-43 ◽

2020 ◽

Vol 27 (6) ◽

pp. 30-43

Author(s):

L. Yu. Karakhalis ◽

N. S. Ivantsiv

Keyword(s):

Mass Spectrometry ◽

Bacterial Vaginosis ◽

Pregnant Women ◽

Vaginal Microbiota ◽

Vaginal Fluid ◽

Opportunistic Pathogens ◽

Premature Rupture ◽

Foetal Membranes ◽

Ph Metry ◽

In Pregnancy

Background. Imbalances of vagina microbiota in pregnant women entail the development of bacterial vaginosis and candidal vulvovaginitis. Lactobacterial strains modulate pro-inﬂammatory epithelium responses to enhance resistance, which renders lactobacteria promising agents in pregnant women with elevated pH.Objectives. Assessment of the lactobacterial impact on vaginal microbiota and the course of gestation and labour.Methods. A total of 261 pregnant women were examined and separated by cohorts according to pH of vaginal ﬂuid: ≥4.5 in cohort 1 (n = 147), <4.5 in cohort 2 (n = 114). Cohort 1 had age 29.9 (4.6) years, cohort 2 — 29.0 (4.6) years, p = 0.55. Screening: at weeks 11–14, 18–21, 30–34 and 36–41 of gestation we performed vaginal pH-metry, cervicometry, determined opportunistic pathogens and lactobacteria with mass spectrometry. Cohort 1 received lactobacteria. Statistical analyses were performed with Statistica 10.Results. In cohort 1 receiving lactobacteria, the number of women devoid of opportunistic ﬂora increased from 31.29 to 43.53%. In cohort 2 not receiving lactobacteria, this number decreased from 53.51 to 35.09%. In cohort 1, L. jensenii (correlates with bacterial vaginosis rate) was primarily isolated in 9.52% women, and in 14.91% — in cohort 2. The rate of L. jensenii increased to 14.96% in cohort 1 (receiving lactobacteria) and decreased to 3.51% in cohort 2 (not receiving lactobacteria). A higher L. jensenii rate correlated with absent growth of opportunistic pathogens. Increasing the rate of L. crispatus (suppresses opportunistic pathogens) to 14.96% in cohort 1 lead to a 1.9-fold diminishing of active opportunistic ﬂora. An increase of L. crispatus from 7.02 to 30.7% in cohort 2 supressed active opportunistic growth 3.9-fold at a normal baseline pH. Cervicometry values were invariant between the cohorts. Pregnancy complications were not observed under abundant lactobacterial growth. The risk of gestation loss occurred in 1.4% of women in cohort 1 and in 10.5% — in cohort 2. Abnormal labour and premature rupture of foetal membranes were more frequent in cohort 2.Conclusion. With a less favourable premorbid condition in cohort 1, vaginal changes with background lactobacterial therapy facilitate gestational health in pregnancy. Many “sterile” niches, especially the maternal generative passages, represent active low biomass environments inhabited by unique typical maternal microﬂora. Most remarkable is the correlation between health of vaginal microbiota and abnormal labour.

Download Full-text

The role of insulin-like growth factor in prediction and prevention of preterm delivery

Vojnosanitetski pregled ◽

10.2298/vsp1011883b ◽

2010 ◽

Vol 67 (11) ◽

pp. 883-886 ◽

Cited By ~ 3

Author(s):

Mirjana Bogavac ◽

Natasa Simin ◽

Milan Ranisavljevic ◽

Ljiljana Budisic

Keyword(s):

Growth Factor ◽

Pregnant Women ◽

Preterm Delivery ◽

Medical Practice ◽

Fetal Membranes ◽

Control Group ◽

Study Group ◽

Insulin Like Growth Factor ◽

Prediction And Prevention ◽

Cervicovaginal Secretion

Background/Aim. Prediction and prevention of preterm delivery remain great challenge. It is important to include in everyday medical practice determination of certain markers that could help identifying pregnant women with preterm delivery. Insulin like growth factor (IGF) is involved in the control mechanism of fetal and placental growth and development. The aim of this study was to examine the presence of insulin-like growth factor binding protein 1 (IGFBP-1) in cervicovaginal secretion of pregnant women with symptoms of preterm labor, but with apparently intact fetal membranes and to point out a possible application of the strip test for detection of phIGFBP-1 in diagnosis of preterm premature rupture of total membranes (PPROM) in everyday medical practice. Methods. The study was performed at the Department for Obstetrics and Gynecology, Clinical Center of Vojvodina between October 2008 and May 2009. The study included 54 pregnant women between 20-35 weeks of gestation (WG), divided into two groups: the study group (16 pregnant women with symptoms of preterm delivery that gave birth before 37 WG) and the control group (38 pregnant women with the normal course of pregnancy that gave birth on term). In cervicovaginal secretion of the examined pregnant women the level of IGFBP-1 was determined by the immunochromatographic assay with monoclonal antibodies 6303 as a detecting antibody (Actim PROM test, Medix Biochemica, Kauniainen, Finland). Results. Gestational age (GA) at delivery in the study group was 32.6 WG and in the control group it was 38.4 WG. Weight of newborns in the study group was 2,021 g and in the control group 3,430 g. IGFBP test was positive in 15 women (93.75%) of the study group, while in the control group it was positive only in 1 woman (2.63%). Conclusion. Test on phIGFBP-1 in cervicovaginal mucus was positive in 93.75% women with preterm delivery, suggesting that this test could be used in diagnosis of silent rupture of fetal membranes and in prediction of preterm delivery.

Download Full-text

Thyroid peroxidase antibody positivity among euthyroid pregnant women and its association with foeto-maternal outcome

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20181324 ◽

2018 ◽

Vol 7 (4) ◽

pp. 1400

Author(s):

Kanika Gulati ◽

Manjula Sharma ◽

Rekha Bharti ◽

Krishna Biswas ◽

Achla Batra ◽

...

Keyword(s):

Pregnant Women ◽

Antenatal Clinic ◽

Maternal Outcome ◽

Control Group ◽

Thyroid Peroxidase ◽

Study Group ◽

Thyroid Peroxidase Antibody ◽

Increased Risk ◽

Term Delivery ◽

Adverse Pregnancy

Background: Thyroid peroxidase antibody (TPO-Ab) positivity is associated with increased risk of adverse pregnancy outcomes. The present study was planned to find out the prevalence of TPO-Ab and its association with adverse foeto-maternal outcome in euthyroid pregnant women.Methods: A total of 510 euthyroid pregnant women with <20 weeks gestation were recruited from antenatal clinic. Serum TPO-Ab testing was done and women were divided into 2 groups. The study group comprised of TPO-Ab positive women and control group comprised of age and parity matched TPO-Ab negative women, double in number to that of the study group. Repeat Serum TSH was done at term/delivery and women were followed till delivery for foeto-maternal outcome.Results: The prevalence of TPO-Ab positivity in euthyroid pregnant women was 11.3%. A significant number of women in the study group developed hypothyroidism at term/delivery, 18.61% vs 7.61%, respectively, p=0.02. None of the women in the study or control group developed gestational diabetes or placental abruption, or had babies with NND or RDS. There was one IUD in the study group, rest of the maternal and foetal outcomes studied were not statistically significant between two the groups. The caesarean section rates in both groups was not statistically different, however, there were more caesarean sections done for foetal distress in the study group, p=0.04.Conclusions: Thyroid peroxidase positivity is present in 11.3% of euthyroid women and is associated with an increased risk of developing hypothyroidism during pregnancy. It is not associated with adverse foeto-maternal outcome.

Download Full-text

Insulin Increases Adipose Adiponectin in Pregnancy by Inhibiting Ubiquitination and Degradation: Impact of Obesity

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgab680 ◽

2021 ◽

Author(s):

Irving L M H Aye ◽

Fredrick J Rosario ◽

Anita Kramer ◽

Oddrun Kristiansen ◽

Trond M Michelsen ◽

...

Keyword(s):

Insulin Resistance ◽

Adipose Tissue ◽

Gestational Diabetes ◽

Er Stress ◽

Pregnant Women ◽

Adipose Tissues ◽

Markers Of Inflammation ◽

Increased Risk ◽

Obesity In Pregnancy ◽

In Pregnancy

Abstract Context Circulating adiponectin levels are decreased in pregnant women with obesity or gestational diabetes, and this is believed to contribute to the insulin resistance and increased risk of fetal overgrowth associated with these conditions. However, the molecular mechanisms regulating adiponectin secretion from maternal adipose tissues in pregnancy are poorly understood. Objective We tested the hypothesis that obesity in pregnancy is associated with adipose tissue insulin resistance and increased adiponectin ubiquitination and degradation, caused by inflammation and endoplasmic reticulum (ER) stress. Methods Visceral adipose tissues were collected from lean and obese pregnant humans and mice. Total and ubiquitinated adiponectin, and markers of inflammation, ER stress, and insulin resistance were examined in adipose tissues. The role of insulin, inflammation, and ER stress in mediating adiponectin ubiquitination and degradation was examined using 3T3L-1 adipocytes. Results Obesity in pregnancy is associated with adipose tissue inflammation, ER stress, insulin resistance, increased adiponectin ubiquitination, and decreased total abundance of adiponectin. Adiponectin ubiquitination was increased in visceral fat of obese pregnant women as compared to lean pregnant women. We further observed that insulin prevents, whereas ER stress and inflammation promote, adiponectin ubiquitination and degradation in differentiated 3T3-L1 adipocytes. Conclusion We have identified adiponectin ubiquitination as a key mechanism by which obesity diminishes adiponectin secretion in pregnancy. This information will help us better understand the mechanisms controlling maternal insulin resistance and fetal growth in pregnancy and may provide a foundation for the development of strategies aimed at improving adiponectin production in pregnant women with obesity or gestational diabetes.

Download Full-text

Impact of vaginal and cervical colonisation/infection on preterm delivery

Vojnosanitetski pregled ◽

10.2298/vsp0804273m ◽

2008 ◽

Vol 65 (4) ◽

pp. 273-280 ◽

Cited By ~ 1

Author(s):

Gordana Mijovic ◽

Goran Lukic ◽

Nebojsa Jokmanovic ◽

Snezana Crnogorac ◽

Nada Kuljic-Kapulica ◽

...

Keyword(s):

Pregnant Women ◽

Preterm Delivery ◽

Genital Tract ◽

Bacterial Infections ◽

Control Group ◽

Study Group ◽

Bacterial Antigen ◽

Death Cases ◽

Microbiological Analyses ◽

Period Of Gestation

Background/Aim. Preterm delivery together with insufficient body weight and death cases in newborns is the main issue in obstetrics. About 40% of preterm delivery is caused by infections. The aim of this study was to investigate whether and which bacterial infections of genital tract can be associated with preterm delivery, and depending on when diagnosis was made. Method. The study involved 216 pregnant women. According to pregnancy outcome, two groups were formed. The study group involved 29 pregnant women who had preterm delivery out of which nine were examined in I trimester, eight in II trimester and 12 in III trimester. The control group involved 187 pregnant women out of which 47 were examined in I trimester, 73 in II trimester and 67 in III trimester. Bacteriological examination of vaginal and cervical swabs was done in all pregnant women. Infection was diagnosed by finding bacterial antigen in cervical swabs or positive cultures of vaginal and/or cervical swabs followed by the presence of the increased number of polymorphonuclears in direct microscopic preparation. Results. The results showed that in III trimester of pregnancy vaginal bacterial infection was statistically more common (p = 0.021) in women who had preterm delivery (66.7%) in relation to women who delivered in term (29.9%). In this period of gestation the increased number of polymorphonuclears in DMP of vaginal swabs is more common in the women of the study group (75%) than in the women of the control group (43.3%). Preterm delivery was registered in 16.1% women whose microbiological analyses were done in I trimester, 9.9% women in whom microbiological analyses were done in II trimester and in 15.2% pregnant women microbiologically tested in III trimester. Conclusion. Based on the obtained results it could be concluded that bacterial infections of genital tract and period of gestation when infection is diagnosed have influence on reducing perinatal morbidity and mortality caused by preterm delivery.

Download Full-text

Pathological features of the sequence in pregnant women with delayed fetal growth

HEALTH OF WOMAN ◽

10.15574/hw.2019.140.50 ◽

2019 ◽

pp. 50-54

Author(s):

V.O. Golyanovskiy ◽

◽

Ye.O. Didyk ◽

Keyword(s):

Pregnant Women ◽

Intrauterine Growth Restriction ◽

Normal Development ◽

Intrauterine Infection ◽

Normal Pregnancy ◽

Growth Restriction ◽

Control Group ◽

Intrauterine Growth ◽

Increased Risk ◽

Infection And Inflammation

Pregnant women with intrauterine growth restriction (IUGR) have an increased risk of adverse perinatal and long-term complications compared with the birth of children with normal body weight. Thus, IUGR is one of the main challenges for the global health system, especially in poor and developing countries. Morpho-functional studies of the placentas help in determining the causes of IUGR, and therefore, timely prevent complications in pregnant women with IUGR. The objective: The purpose of this study is to investigate various morphometric and pathomorphological changes in the placenta, including inflammatory, in cases of IUGR, and to establish a correlation of these results with the etiology and complications for the fetus. Materials and methods. In the current study, 54 placentas of the fetuses with IUGR (the main group) were compared with 50 placentas of the fetuses with normal development (control group). The criteria for the inclusion of IUGR were gestational age more than 30 weeks and all fetuses with a weight less than 10th percentile for this period of pregnancy. The placenta material was studied pathomorphologically with laboratory screening for infection and inflammation. Similarly, the results were determined for placentas of the fetuses with normal development compared to placentas with IUGR. Results. The placenta study showed the presence of calcification in the case of IUGR, as well as in the case of prolonged pregnancy. However, calcification of the placenta in the case of IUGR was more progressive compared with placenta in the normal pregnancy. In addition, the presence of intrauterine infection and inflammation was observed, which could also lead to an adverse outcome for the further progression of pregnancy with IUGR. Conclusion. A comparative macro- and microscopic pathomorphological study of the placentas in the two groups has shown a significant increase in the pathological changes in all the anatomical structures of the fetuses with IUGR. Key words: Intrauterine growth restriction (IUGR), fetal weight, pathomorphological changes of the placenta.

Download Full-text