scholarly journals Does maternal serum progesterone level in early pregnancy predict placental dysfunction in third trimester?

2021 ◽  
Vol 29 (1) ◽  
pp. 39-45
Author(s):  
Gülşen Doğan Durdağ ◽  
Şafak Yılmaz Baran ◽  
Songül Alemdaroğlu ◽  
Hakan Kalaycı ◽  
Seda Yüksel Şimşek ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Threshold Value ◽  
First Trimester ◽  
Maternal Serum ◽  
Third Trimester ◽  
Serum Progesterone ◽  
The Third ◽  
Placental Dysfunction ◽  
Significant Difference ◽  
Relationship Of

Objective Progesterone, which is necessary for maintenance of pregnancy, is secreted by corpus luteum until 10 weeks of gestation, and is produced from the placenta afterwards. Aim of this study is to investigate the relationship of serum progesterone concentrations measured in 6–8 weeks and 12 weeks of gestation with the parameters that may demonstrate placental dysfunction in the third trimester. Methods Relationship of the progesterone values measured at 6–8 weeks and 12 weeks of gestation with indicators of placental dysfunction, including hypertensive disorders of pregnancy, intrauterine growth restriction, preterm delivery and low birth weight, were evaluated. Furthermore, based on a previous study, two groups with progesterone levels below and above 11 ng/mL in early pregnancy were formed, and the difference between these groups regarding gestational outcomes were investigated. Results Progesterone concentrations at 6–8 and 12 weeks of gestation were not significantly different between the subgroups with and without gestational complications indicating placental dysfunction (p>0.05 for all parameters). As for the two groups, significant difference was not found in terms of third trimester complications due to progesterone cut-off of 11 ng/mL at 6-8 weeks of gestation. Conclusion In this study, we did not find progesterone values measured at early and late first trimester periods to be associated with placental dysfunction in the third trimester. Also, we did not validate a previously suggested threshold value to predict gestational outcome. Therefore, routine first trimester progesterone screening in guiding pregnancy follow-up may not be appropriate.

scholarly journals Comparison of Salivary Alpha-Amylase, Sialic Acid, and pH in Pregnant and Nonpregnant Subjects

2021 ◽  
Author(s):  
Masoomeh Shirzaiy ◽  
Zohreh Dalirsani
Keyword(s):  
Sialic Acid ◽  
Pregnant Women ◽  
First Trimester ◽  
Control Group ◽  
Case Group ◽  
Third Trimester ◽  
The Third ◽  
Significant Difference ◽  
Salivary Ph ◽  
The Mean

Abstract Objectives During pregnancy, systemic physiological alterations lead to some changes in the oral cavity, which could prepare the mouth environment for oral and dental problems. This study was aimed to investigate salivary α-amylase, sialic acid levels, and pH levels in pregnant and nonpregnant females. Materials and Methods In this analytical, case–control study, unstimulated saliva samples were collected with spiting method from 35 pregnant women (case group) and 35 nonpregnant women (control group) and transferred to the laboratory to assess salivary α-amylase, sialic acid, and pH levels. Data were analyzed by SPSS (version: 19) software through statistical methods of independent t-test and analysis of variance. Results The mean sialic acid levels were 2.285 ± 1.230 mg/dL in pregnant and 2.744 ± 1.326 in nonpregnant women without any significant difference (p = 0.138). The mean salivary α-amylase concentrations were 2.461 ± 1.869 U/L and 2.439 ± 2.058 U/L, respectively, in pregnant and nonpregnant women, with no significant difference (p = 0.963).The mean salivary pH in nonpregnant women was significantly more than that in pregnant women (7.845 ± 0.430 and 6.868 ± 0.413, respectively) (p < 0.001). Also, the mean salivary pH levels in pregnant women were 7.474 ± 0.420 in the first trimester, 6.868 ± 0.413 in the second trimester, and 6.568 ± 0.387 in the third trimester, which were significantly different (p < 0.001). Conclusion Salivary sialic acid and α-amylase levels among pregnant women were no different from those of other subjects. During pregnancy, the salivary pH significantly reduced, and the mean salivary pH during pregnancy had a decreasing trend from the first trimester to the third trimester.

scholarly journals Laboratory options for risk assessment of pregnancy pathologies

2019 ◽  
pp. S415-S425
Author(s):  
A. Kestlerová ◽  
L Krofta ◽  
A. Žufić ◽  
K. Hamplová Běhávková ◽  
J. Račko ◽  
...  
Keyword(s):  
Fetal Heart ◽  
Chromosomal Abnormalities ◽  
First Trimester ◽  
Nuchal Translucency ◽  
Placental Growth Factor ◽  
Third Trimester ◽  
The Third ◽  
Placental Dysfunction ◽  
Immunological Markers ◽  
Pathological Conditions

The most effective method of screening for chromosomal abnormalities and evaluating the risk of pregnancy pathologies in the first trimester is combined screening. The algorithm of screening is based on the combination of maternal age, measuring of the nuchal translucency and the fetal heart rate and analysis of the placental products of free ß-hCG and PAPP-A. For the screening of preeclampsia, placental growth factor (PlGF) is added. To distinguish between preeclampsia and other pathologies caused by placental dysfunction it is recommended to also extend the screening with selected immunological markers. We concluded that elevated biochemical and immunological markers can help to predict the threat of preeclampsia in the third trimester. Some markers can probably predict the development of particularly severe pathological conditions.

Activin A and follistatin are dynamically regulated during human pregnancy

1997 ◽  
Vol 152 (2) ◽  
pp. 167-174 ◽  
Author(s):  
T K Woodruff ◽  
P Sluss ◽  
E Wang ◽  
I Janssen ◽  
M S Mersol-Barg
Keyword(s):  
Pregnant Women ◽  
Binding Protein ◽  
First Trimester ◽  
Activin A ◽  
Maternal Serum ◽  
Third Trimester ◽  
Serum Samples ◽  
Biologically Relevant ◽  
Human Pregnancy ◽  
The Third

Abstract Activin A (βA–βA) and activin B (βB–βB) are related dimeric proteins that regulate numerous cellular activities. Activin activity is bioneutralized by follistatin, a specific and high-affinity binding protein. Recently, our group developed specific and sensitive enzyme-linked immunosorbent activin assays that do not detect either activin isoform when bound to follistatin, therefore, the assays are specific for biologically relevant ligands. Activin A is measurable in the serum of pregnant women (cross-sectional sample collection), while activin B is not detected in maternal serum. However, activin B is measurable in amniotic fluid and cord blood sera. The purpose of this study was to measure serum activin A, activin B, and follistatin prospectively in longitudinally collected samples during pregnancy. This study design offered observations of relative changes in serum hormone concentration with each person serving as an internal reference. Serum samples were collected bimonthly from seven pregnant women beginning within the second month of gestation, and up to, but not including, the onset of labor. Six of the seven women had normal labor and delivery. One patient required pitocin (an oxytocin agonist) for induction of labor which led to delivery. Activin A, activin B, total follistatin, free follistatin, human chorionic gonadotropin, estradiol, progesterone, FSH, and LH were measured in maternal serum samples using specific assays. Serum activin A levels increased in the final month of pregnancy in the six patients who delivered following normal labor (<0·78 ng/ml (first trimester) to 1–6 ng/ml (term)). Activin B was not detected in any serum sample (<0·78 pg/ml). Total serum follistatin (free follistatin, follistatin–activin, and follistatin–inhibin) increased 10- to 45-fold in the final month of pregnancy in four of the women undergoing normal labor (10 ng/ml (first trimester) to 100–450 ng/ml (final month)). Total follistatin was high and variable in two women throughout pregnancy. Total follistatin returned to basal serum concentration in three of the patients during the last 2 weeks of pregnancy. Free follistatin was detected throughout pregnancy (range <2–35 ng/ml). Free follistatin represented a small percentage of the total follistatin throughout the time of pregnancy and did not rise coincident with the rise in total follistatin. Serum activin A and activin B were not detected during the entire course of pregnancy in the one patient who did not have normal labor and total follistatin did not rise in the last trimester of pregnancy. Gonadotropin and steroid hormones were measured in all patients and were within normative ranges for human pregnancy (inclusive of the non-laboring patient). The results suggest that immunodetectable activin A is present in the third trimester of pregnant women who have normal onset labor. The total follistatin assay results suggest that follistatin–activin (or –inhibin) complexes are upregulated during the third trimester of pregnancy. Importantly, activin A production exceeds the binding capacity of circulating follistatin. Because binding protein free activin A is biologically active we conclude that the activin A detected in late pregnancy is biologically relevant. The findings are consistent with our hypothesis that activin A is an endocrine factor during the last trimester of human pregnancy and may be involved in normal labor. Journal of Endocrinology (1997) 152, 167–174

scholarly journals Predictors of Birthweight in Healthy Women Attending A Rural Antenatal Clinic

2005 ◽  
Vol 5 (8) ◽  
pp. 01-19
Author(s):  
Mathule MSL ◽  
Kennedy T ◽  
Gates G ◽  
Maria T Spicer
Keyword(s):  
First Trimester ◽  
Antenatal Clinic ◽  
Antenatal Visit ◽  
Third Trimester ◽  
The Third ◽  
Significant Difference ◽  
Maternal Parity ◽  
The Mean ◽  
Trimester Exposure ◽  
Pregnancy Weight

Birthweight is important to infant survival and the later health of a child. To promote optimum birthweight, in an environment that is vulnerable to seasonal food shortages, it is important to understand the relationship between birthweight and exposure to the hungry season. The objective of this study was to determine seasonal effects on birthweight and examined the ability of maternal and seasonal variables to predict birthweight in this cohort. The study was conducted at Scott Hospital-Morija which services rural communities in Lesotho. Women with normal healthy pregnancies without complications, with a clinic attendance of five or more times, who had full term singleton infants were included. Information including infant’s date of birth, infant’s birthweight and length, monthly maternal weights, and date of first and last antenatal visit were systematically and retrospectively extracted from 477 Antenatal Clinic (ANC) records covering a period of three years from May 1998 to April 2001. There were 252 male infants with mean birthweight of 3169g ± 420 and 225 female infants with mean birthweight of 3297g ± 436. A seasonal pattern was observed with a significant difference (p<0.05) between the mean birthweights in the December and January hungry season (3100g ± 70) and the mean birthweights in March, April, August and September (3310g ± 70). First trimester exposure to the hungry season had a tendency to correlate with birthweight (p<0.10). Third trimester exposure to the hungry season had a significant negative (r = - 0.106, p<0.05) relationship with birthweight. The best predictors of birthweight were maternal parity (p=0.0001), last pregnancy weight (p=0.0001) and exposure to the hungry season in the third trimester (p=0.022) with the first trimester (p=0.056) of pregnancy approaching significance. Thus, length of exposure to the hungry season is important in determining pregnancy outcomes. The regression model including last pregnancy weight, maternal parity and exposure to the hungry season in the third trimester explained 12.2% of the variance in birth weight (p=0.017). Increased surveillance of primigravid women, promoting pregnancy weight gain for optimal infant weight at term and supplementation during the hungry season are recommended.

Second-trimester maternal serum markers in the prediction of preeclampsia

2017 ◽  
Vol 45 (7) ◽  
Author(s):  
Qiong Luo ◽  
Xiujun Han
Keyword(s):  
Detection Rate ◽  
Late Onset ◽  
Serum Levels ◽  
Serum Markers ◽  
Maternal Serum ◽  
Second Trimester ◽  
Third Trimester ◽  
Roc Curve Analysis ◽  
The Third ◽  
Significant Difference

AbstractAim:To determine whether late second-trimester maternal serum biomarkers are useful for the prediction of preeclampsia during the third trimester, a case-control study including 33 preeclamptic and 71 healthy pregnancies was conducted. Maternal serum concentrations of placental protein 13 (PP13), pregnancy-associated plasma protein (PAPP-A), pentraxin3 (PTX3), soluble FMS-like tyrosine kinase-1 (sFlt-1), myostatin and follistatin-like-3 (FSLT-3) were measured at 24–28 weeks’ gestation. All the concentrations of these markers were compared between the preeclamptic and control groups. Receiver operating characteristic (ROC) curve analysis was applied to assess sensitivity and specificity of serum markers with significant difference.Results:The levels of PP13 and sFlt-1 were significantly increased and FSLT3 was significantly decreased in patients with preeclampsia. However, the concentration of PAPPA, PTX3 and myostatin did not differ significantly. In screening for preeclampsia during the third trimester by PP13, sFlt-1 and FSLT3, the detection rate was 61.3%, 48.1% and 39.1%, respectively, at 80% specificity, and the detection rate increased to 69.8% by combination of these three markers.Conclusion:Maternal serum levels of PP13, sFlt-1 and FSLT3 play an important role in predicting late-onset preeclampsia, and the combination of these three markers significantly increases the detection rate for prediction.

scholarly journals Calcium levels in maternal milk: relationships with calcium intake during the third trimester of pregnancy

1998 ◽  
Vol 79 (6) ◽  
pp. 501-507 ◽  
Author(s):  
Rosa M. Ortega ◽  
Rosa M. Martínez ◽  
M. Elena Quintas ◽  
Ana M. López-Sobaler ◽  
Pedro Andrés
Keyword(s):  
Maternal Serum ◽  
Third Trimester ◽  
Mature Milk ◽  
Maternal Milk ◽  
The Third ◽  
Lactating Mothers ◽  
The Mean ◽  
Transition Milk ◽  
Relationship Of ◽  
The Relationship

The aim of the present study was to investigate the relationship of Ca intake and serum Ca levels during the third trimester of pregnancy with levels of the same mineral in transition milk (days 13−14 of lactation) and mature milk (day 40 of lactation). The study subjects were a group of fifty-seven healthy, lactating mothers aged between 18 and 35 years (mean 27 (SD3·7) years) whose pregnancies and labour were attended by the Department of Obstetrics and Gynaecology of Cuenca INSALUD Hospital, Spain. Ca intake during the third trimester was determined by recording the consumption of foods over a 5 d period and by registering Ca provided by dietary supplements. The same method was used to investigate the intake of protein, vitamin D, fibre and Fe, nutrients that could affect the use of dietary Ca. Ca levels in maternal serum during this stage of pregnancy, during lactation and in transition and mature milk samples, were determined using 2-cresolphthalein complexone. During pregnancy 70·2% of subjects showed Ca intakes below 1100mg/d (75th percentile). The consumption of Ca supplements was very small and hardly modified the mean quantity supplied by the diet. Subjects with an intake < 1100mg/d showed no fall in Ca levels in serum, either during pregnancy or lactation, nor were decreased levels found in transition milk. However, these subjects showed lower Ca levels in mature milk (5·95 (SD1·56) mmol/1) than did subjects with greater Ca intakes (6·82 (SD1·31) mmol/1). This may suggest that breast-fed babies of mothers with lower Ca intakes during pregnancy also receive less Ca.

scholarly journals Perfluoroalkyl Substance Exposure Early In Pregnancy Was Negatively Associated With Late Pregnancy Cortisone Levels

2020 ◽  
Vol 105 (8) ◽  
pp. e2834-e2844 ◽  
Author(s):  
Anja Fenger Dreyer ◽  
Richard Christian Jensen ◽  
Dorte Glintborg ◽  
Anne Vibeke Schmedes ◽  
Ivan Brandslund ◽  
...  
Keyword(s):  
Early Pregnancy ◽  
Sulfonic Acid ◽  
Late Pregnancy ◽  
Fold Increase ◽  
First Trimester ◽  
Third Trimester ◽  
Substance Exposure ◽  
The Third ◽  
Perfluorodecanoic Acid ◽  
Gestational Week

Abstract Introduction During pregnancy, maternal cortisol levels are increased 3-fold by the third trimester. The enzyme 11β-hydroxysteroid dehydrogenase (11β-HSD, isoforms 1 and 2) regulates the balance between cortisol and cortisone levels. Perfluoroalkyl substances (PFAS) have been reported to inhibit 11β-HSD1 and more potently 11β-HSD2, which could lead to reduced levels of cortisol and more extensively cortisone. Aim The aim of this work is to investigate a possible effect of early pregnancy PFAS exposure on late pregnancy activity of 11β-HSD1 and 11β-HSD2 assessed by cortisol and cortisone levels in diurnal urine (dU) and blood samples. Methods This study is part of the prospective cohort study, Odense Child Cohort (OCC). A total of 1628 pregnant women had serum (S) concentrations of 5 PFAS (perfluorooctanoic acid [PFOA], perfluorooctane sulfonic acid [PFOS], perfluorohexane sulfonic acid [PFHxS], perfluorononanoic acid [PFNA], and perfluorodecanoic acid (PFDA)) measured in the first trimester (median gestational week, GW 11). dU cortisol and cortisone (n = 344) and S-cortisol (n = 1048) were measured in the third trimester (median GW 27). Results In multiple regression analyses, a 2-fold increase in S-PFOS was significantly associated with lower dU-cortisone (β = –9.1%, P &lt; .05) and higher dU-cortisol/dU-cortisone (dU-C/C) (β = 9.3%, P &lt; .05). In crude models, a doubling in PFOS, PFOA, PFHxS, and PFNA concentrations were associated with a significant increase in S-cortisol; however, these associations became insignificant after adjustment. Conclusion Early pregnancy maternal S-PFAS were inversely associated with late pregnancy dU-cortisone, indicating reduced activity of 11β-HSD2.

Correlations Between the Values of Maternal Glycemia from the Last Trimester of Pregnancy and Fetal Birth Weight

2013 ◽  
Vol 20 (3) ◽  
pp. 259-265
Author(s):  
Monica Vereş ◽  
Aurel Babeş ◽  
Szidonia Lacziko
Keyword(s):  
First Trimester ◽  
Mean Value ◽  
Fetal Macrosomia ◽  
Entire Group ◽  
Third Trimester ◽  
The Third ◽  
Group I ◽  
Fetal Birth Weight ◽  
First Trimester Of Pregnancy ◽  
The Mean

Abstract Background and aims: Gestational diabetes represents a form of diabetes diagnosed during pregnancy that is not clearly overt diabetes. In the last trimester of gestation the growth of fetoplacental unit takes place, thus maternal hyperglycemia will determine an increased transplacental passage, hyperinsulinemia and fetal macrosomia. The aim of our study was that o analyzing the effect of maternal glycemia from the last trimester of pregnancy over fetal weight. Material and method: We run an observational study on a group of 46 pregnant women taken into evidence from the first trimester of pregnancy, separated in two groups according to blood glucose determined in the third trimester (before birth): group I normoglycemic and group II with hyperglycemia (>92mg/dl). Results: The mean value of third trimester glycemia for the entire group was of 87.13±22.03. The mean value of the glycemia determined in the third trimester of pregnancy was higher in the second group (109.17 mg/dl) in comparison to the first group (74.,21 mg/dl). The ROC curve for third trimester glycemia as fetal macrosomia appreciation test has an AUC of 0.517. Conclusions: Glycemia determined in the last trimester of pregnancy cannot be used alone as the predictive factor for fetal macrosomia.

scholarly journals Infliximab clearance decreases in the second and third trimesters of pregnancy in inflammatory bowel disease

2020 ◽  
pp. 205064062096461
Author(s):  
Ana-Marija Grišić ◽  
Maria Dorn-Rasmussen ◽  
Bella Ungar ◽  
Jørn Brynskov ◽  
Johan F K F Ilvemark ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
First Trimester ◽  
Interquartile Range ◽  
Therapeutic Drug ◽  
Population Pharmacokinetic ◽  
Second Trimester ◽  
Third Trimester ◽  
The Third ◽  
Inflammatory Bowel

Background Infliximab therapy during pregnancy in inflammatory bowel disease is challenged by a dilemma between maintaining adequate maternal disease control while minimizing fetal infliximab exposure. We investigated the effects of pregnancy on infliximab pharmacokinetics. Methods The study population comprised 23 retrospectively identified pregnancies. Patients with inflammatory bowel disease were generally in clinical remission at pregnancy conception (74%) and received steady infliximab maintenance therapy (5 mg/kg q8w n = 17; q6w n = 4; q10w n = 1; 10 mg/kg q8w n = 1). Trough blood samples had been obtained in the same patients prior to pregnancy ( n = 119), the first trimester ( n = 16), second trimester ( n = 18), third trimester ( n = 7), and post-pregnancy ( n = 12). Data were analyzed using nonlinear mixed-effects population pharmacokinetic modelling. Results Dose-normalized infliximab concentrations were significantly higher during the second trimester (median 15 µg/mL/kg, interquartile range 10–21) compared to pre-pregnancy (7, 2–12; p = 0.003), the first trimester (9, 1–12; p = 0.04), or post-pregnancy (6, interquartile range 3–11; p > 0.05) in patients with inflammatory bowel disease. Similar trends were observed in the third trimester (13, 7–36; p > 0.05). A one-compartment model with linear elimination described the pharmacokinetics of infliximab (volume of distribution = 18.2 L; clearance 0.61 L/day). Maternal infliximab exposure was influenced by the second and third trimester of pregnancy and anti-infliximab antibodies, and not by pregnancy-imposed physiological changes in, for example, body weight or albumin. Infliximab clearance decreased significantly during the second and third trimesters by up to 15% as compared to pre- and post-pregnancy and the first trimester. The increased maternal infliximab exposure was weakly associated with lowered clinical disease activity. Pharmacokinetic model simulations of virtual patients indicated the increased maternal infliximab trough concentrations imposed by pregnancy will not completely counteract the decrease in infliximab concentration if therapy is paused in the third trimester. Conclusion Infliximab clearance decreases significantly in the second and third trimesters, leading to increasing maternal infliximab concentrations in any given regimen. Maternal infliximab levels may thus be maintained as constant in a de-intensified regimen by therapeutic drug monitoring guidance in inflammatory bowel disease.

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