scholarly journals Kisspeptin and Hematologic Parameters as Predictive Biomarkers for First-Trimester Abortions

Author(s):  
Ümit Görkem ◽  
Özgür Kan ◽  
Mehmet Ömer Bostancı ◽  
Deniz Taşkıran ◽  
Hasan Ali İnal

Objective: Spontaneous abortion is the most common complication of early pregnancy, affecting up to 20% of recognized pregnancies. Kisspeptin is predominantly released by placental syncytiotrophoblasts, and regulates their placental invasion into the uterine matrices. We aimed to establish an association of serum kisspeptin levels with pregnancy outcomes during the early gestational stage of the first trimester. Method: In this prospective study, 90 pregnant women in their 7 to 8 6/7 gestational weeks were classified into three groups: (i) The control group, consisting of healthy pregnant women (n=30), (ii) the threatened abortion group (n=30), and (iii) the spontaneous abortion group (n=30). The maternal serum samples were analyzed for complete blood count parameters and kisspeptin levels. Results: There was no statistical difference regarding body mass index (BMI) and gestational age (p=0.370). Regarding detailed obstetric notations, including gravida, parity, abortion, and living children, socioeconomic levels, and employment rates, all study groups were comparable (p>0.05, for all). No significant association was found regarding the biochemical parameters of complete blood count, including neutrophil, lymphocyte, and platelet concentrations, as well as neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) (p>0.05, for all). The median serum kisspeptin levels of the study groups did not differ between the groups (p=0.153). Correlation analysis revealed no significant relationship between serum kisspeptin levels and other study parameters in any study groups (p>0.05, for all) Conclusions: We found no statistically significant relationship between serum kisspeptin concentrations and pregnancy outcomes in the early gestational stage of the first trimester, and serum kisspeptin concentrations did not seem to be a reliable marker to distinguish abortion status from viable pregnancy

Author(s):  
Saad Bakrim ◽  
Youssef Motiaa ◽  
Ali Ouarour ◽  
Azlarab Masrar

Introduction: numerous biological parameters are physiologically modified during normal pregnancy, in particular hematology. The knowledge of these modifications of the maternal body by biologists and clinicians allows the screening of possible anomalies. In Morocco, the reference values of the complete blood count test for pregnant woman are missing, as are those specific to different trimesters of pregnancy. The aim of this study is to look for the reference values for healthy pregnant women of the Northwest region of Morocco, to compare them to those of non-pregnant women (control) and to those of the literature. Methods: blood samples were taken voluntarily from 3898 healthy pregnant women from 18 to 46 years old who presented themselves at the center of health Kalaa and at the service of gynecology obstetrics of the Provincial Hospital Center of M'diq (Morocco), for prenatal care. To establish the reference intervals of the CBC for non-pregnant women, a control group was constituted by 7035 healthy women from 18 to 50 years old selected according to the Moroccan law of blood donation. The CBC was measured on a Sysmex KX21N® analyzer. For each sample a systematic blood smear was done to determine the leukocyte differential. Results: a statistically significant difference between the pregnant women and control group was noted (p < 0.05) for all the hematological parameters: red blood cells, hematocrit, hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, leukocytes, neutrophils, basophils, eosinophils, lymphocytes, monocytes, platelets and mean platelet volume. So, the comparison of the averages established between the first, second and third trimester of pregnancy showed the existence of a significant variation with regard to all the parameters of the CBC test looked for (p < 0.001). Conclusion: the present study provides additional baseline data for basic hematological parameters in healthy pregnant Moroccan women and concluded that pregnancy in women has the tendency to alter some hematological indices. For these reasons, there is an interest to take these modifications into account for optimal maternal and fetal medical care.


2016 ◽  
pp. 72-74
Author(s):  
E.V. Kravchenko ◽  

In women with miscarriage in early pregnancy by ultrasound was studied the volume of the ovum, the volume of the cavity of the amnion and their relationship. Using special three-dimensional VOCAL program performed the calculation of the volume of the chorion, the evaluation of his vascular system based on the definition of the vascularization index (VI) and flow index (FI). The aim of the study: to study the stages of growth and vascularization of the chorion with the threat of miscarriage in the first trimester of gestation. Materials and methods. There were examined 50 pregnant women with threat of miscarriage at early terms of gestation: 30 - burdened obstetric history (BOH), receiving the drug micronized progesterone 50 mg 3-4 times per day (the main group) and 20 pregnant women, the history of which was not encumbered, who were on symptomatic therapy (control group). Results. Analysis of the frequency of occurrence of extragenital pathology in the study groups showed that in women with recurrent pregnancy loss and BOH somatic diseases were almost 2 times more often than in the control group (respectively 60% and 30%). The frequency of infectious complications in the first trimester of pregnancy in women with threatened abortion and BOH compared to the control group of patients, significantly more frequently noted violations of vaginal microbiocenosis, in the form of gardnerellosis (20% and 10%), Candida vaginitis (30% and 5.5%) and urogenital infections – chlamydia, ureaplasmosis, mycoplasmosis (15% and 0%). All pregnant women was carried out sanitation of the source of infection in the first trimester of gestation – local therapy, systemic treatment after completion of the processes of placentation. Conclusion. The study found that use of micronized progesterone in miscarriage in the first trimester of gestation contributes to the growth of the volume of the chorion, the intensity of the flow in the parenchyma and a complete restructuring of the spiral arteries resulting in inadequate formation of the placental-uterine blood flow, which certainly improves the prediction of the further course of pregnancy. Key words: miscarriage, the I trimester of gestation, the vessels of the chorion.


Author(s):  
Hiwa Abdulrahman Ahmad ◽  
Mehri Mirhaj Muhammd salih ◽  
Kamal Ahmed Khidir

Disorder of maternal immune responses during pregnancy triggers immunological rejection of fetus antigens by maternal immune components, contribute to spontaneous abortion or miscarriage. The study was designed to concentrated on immunoglobulins (IgM, IgG and IgA) and complement elements (C3 and C4)   serum levels changes in normal pregnant and abortion women. Study groups were classified into normal pregnant women (20), spontaneous abortion (30) and non-pregnant women (16) as a control group, attending to Shahid Dr. Khalid Hospital/Department of Gynecology and Obstetrics/Koya city. Serum levels of immunoglobulins (IgG, IgM, and IgA), complement proteins (C3 and C4) were determined and analyzed for normal pregnant, abortion and control groups by using Single Radial Immunodiffusion (SRID) technique. The results demonstrated that concentration of IgG levels in abortion differed significantly in compare to normal pregnancy (p ≤0.05), while there were no significant differences in IgM and IgA serum levels among groups (p >0.05). Also, statistical analysis revealed that serum levels of C3 and C4 significantly decreased in abortion group compared to normal pregnant and non-pregnant groups (p ≤0.05). Concluded that complement proteins (C3 andC4) are a good defense line during normal pregnancy, sometime activation (hyper-consuming) of complement elements may provoke spontaneous abortion, while immunoglobulins are a little role in inducing of miscarriage in pregnant women. 


2020 ◽  
Vol 7 (10) ◽  
pp. 71-77
Author(s):  
MOHAMED S. A. EMARAH ◽  
MOHAMED A. EL-NAGGAR ◽  
ABEER EL SHABACY ◽  
SAHAR H. QUSHWA

Recurrent miscarriage, defined as loss of two or more consecutive pregnancies, occurs in 1–2% of couples attempting to bear children. The major causes of recurrent pregnancy loss (RPL) based on the literature include parental structural chromosome rearrangement, immunologic factors (i.e. antiphospholipid syndrome), thrombophilic factors (both inherited and acquired), anatomic factors of uterine anomalies, and endocrinologic disorders. Luteal phase defect, polycystic ovarian syndrome (PCOS), diabetes mellitus, thyroid disease and hyperprolactinemia are among the endocrinologic disorders implicated in approximately 17% to 20% of RPL. The prevalence of hypothyroidism in the general population of reproductive age is about 2-3%. The aim of this study is to observe the benefit of screening for hypothyroidism amongst women with recurrent spontaneous abortion early in the first trimester. The study included one hundred and sixty (160) women, in the reproductive age of life, where there ages ranged from 20 – 33 years, and divided into two groups. Study group which included eighty (80), non pregnant women with a history of two or more consecutive spontaneous abortions early in the first trimester, with no living children and control group which included eighty (80), non pregnant women having one or more living children without any history of abortion. Hypothyroidism was noted in ten (10) cases (12.5%) in the study group and noted in two (2) cases (2.5%) in the control group with a statistically significant difference (P < 0.01). The mean levels of TSH in the study group was 22.71  13.13 Iu/ml. Conclusion: Screening for hypothyroidism has clinical significance and would help to reduce miscarriage rate in women with recurrent spontaneous abortion.


2021 ◽  
Vol 6 (1) ◽  
pp. 48-52
Author(s):  
İbrahim Kale ◽  
Çağlar Helvacıoğlu ◽  
Tuğba Erel Muğurtay

Objective. Investigation of the relationship between the first trimester complete blood count parameters and miscarriage. Materials and Methods. The study group consisted of 39 patients who admitted to the hospital with the diagnosis of abortus imminens between January 2016 and December 2019, and whose pregnancy ended as miscarriage before the 20th week. The control group consisted of 200 randomly selected healthy pregnant women, with follow-up and delivery in our hospital. Patient information was obtained retrospectively from the hospital records. Results. Age and BMI of both groups were similar. There was no significant difference between the two groups in terms of basophil, neutrophil, eosinophil, lymphocyte, monocyte, platelets, RBC, hemoglobin, hematocrit, MCV, MCH, MCHC, RDW, MPV, Pct and PDW, while leukocyte and neutrophil counts was statistically significantly higher in the miscarriage group (p=0,002, p=0,001, respectively). NLR was statistically higher in the miscarriage group (p=0,005), PLR was also higher in the miscarriage group, but this did not reach statistical significance (p=0,056). Both groups were similar in terms of MLR. Conclusions. High NLR levels obtained from the hemogram results in the first trimester seems to be associated with miscarriage. NLR can be an easy, cheap and useful tool for predicting pregnancy prognosis in patients with abortus imminens.


2016 ◽  
pp. 160-164
Author(s):  
D.N. Maslo ◽  

The objective: frequency decrease perinatal pathologies at women after ART on the basis of studying clinical-ehografical, endocrinological, biochemical, dopplerometrical, cardiotokografical and morphological researches, and also improvement of algorithm of diagnostic and treatment-and-prophylactic actions. Patients and methods. The work basis is made spent by us from 2012 on 2015 by complex inspection of 300 pregnant women from which 250 were after ART and 50 – firstlabours which pragnency without ART, and also their newborns. For the decision of an object in view of research spent to two stages. At 1 stage spent prosperctive research which included 150 pregnant women: з them 100 women pregnancy at which has come out ART (1 group) and 50 healthy women (control group). At 2 stage spent prospective randomization in which result of patients after ART have divided on two equal groups by therapy principle: 2 basic group - 75 pregnant women after ART at which used the algorithm improved by us; 3 group of comparison - 75 pregnant women after ART which have been spent on the standard treatment-and-prophylactic actions. Results. The results suggest that women after using ART is a high frequency of reproductive losses in the first trimester (10.0%), 3.0% of spontaneous abortion from 16 to 22 weeks, and 3.0% "early" premature delivery (22 to 28 weeks of pregnancy). The frequency of violations of the functional state of placenta in women after using IVF is 63.0%, which is the main cause of high levels of perinatal losses (40.0 ‰), and delivery by cesarean section (96.0%). Placental dysfunction in women after using ART characterized by retrohorialnyh hematoma (21.0%); size mismatch fruit (30.0%) and hypertonicity of the uterus (73.0%) against changes in fruit-placental blood flow - increased resistance index in umbilical artery and increased vascular resistance in the uterine arteries. Endocrinological and biochemical changes in placental dysfunction in women after using IVF starting from 28 weeks of pregnancy and are in significant reduction in progesterone, placental b1-microglobulin, B2-microglobulin of fertility and trophic в-glycoprotein. Conclusion. The received results: use of the algorithm of diagnostic and treatment-and-prophylactic actions improved by us allows to lower frequency of spontaneous interruption of pregnancy till 22 weeks – from 13.0% to 5.7%; «early» premature birth – from 3.0% to 1.0%; placentary dysfunction from 63.0% to 40.6%; cesarean sections – from 96.0% to 56.5%, and also perinatal losses – from 40.0‰ to 16.2‰. Key words: pregnancy, childbirth, auxiliary reproductive technologies.


1996 ◽  
Vol 134 (1) ◽  
pp. 84-86 ◽  
Author(s):  
Judith Roberts ◽  
Carol Jenkins ◽  
Rhoda Wilson ◽  
Charles Pearson ◽  
Ian A Franklin ◽  
...  

Roberts J. Jenkins C, Wilson R, Pearson C, Franklin IA, MacLean MA, McKillop JH, Walker JJ. Recurrent miscarriage is associated with increased numbers of CD5/20 positive lymphocytes and an increased incidence of thyroid antibodies. Eur J Endocrinol 1996;134:84–6. ISSN 0804–4643 The aim of this study was to determine whether recurrent miscarriage (three or more miscarriages, no live children) was associated with an increased incidence of autoantibodies. Five groups were enrolled into the study; healthy non-pregnant women, healthy first-trimester pregnant women, women suffering spontaneous abortion, those undergoing termination of pregnancy and those with a previous history of miscarriage. The number of total B cells and the numbers of the antibody producing B cell subset CD5+/CD20+ were determined for each group. Samples were tested for anticardiolipin antibodies, antinuclear antibodies and thyroid microsomal and thyroglobulin antibodies. The results showed that compared to normal pregnancy or spontaneous abortion, recurrent miscarriage was associated with a significant increase in the number of CD5+/20+ positive cells (0.8 ± 0.3 vs 0.5 ± 0.1 vs 1.1 ± 0.3 × 108/l: p < 0.001). These women were also found to have a higher incidence of thyroid antibodies, with four out of the 11 patients being positive for thyroid microsomal antibodies. These results suggest that there may be an association between autoimmunity and recurrent miscarriage. R Wilson, Department of Medicine, Glasgow Royal Infirmary, 10 Alexandra Parade, Glasgow G31 2ER, UK


Author(s):  
Yang Yang ◽  
Jiashu Li ◽  
Yingying Zhou ◽  
Wen Dai ◽  
Weiping Teng ◽  
...  

Elevated thyroid stimulating hormone (TSH) is associated with an increased risk of spontaneous abortion (SA); however, the associated mechanism remains unclear. This study aimed to investigate the expression of microRNAs (miRNAs) and pathogenesis in the chorionic villi of TSH > 2.5 mIU/L-related SA patients. The chorionic villi were collected from pregnant women in the first trimester with TSH > 2.5 mIU/L with or without SA, as well as TSH < 2.5 mIU/L with or without SA to determine the level of miRNA expression. Differentially expressed miRNAs were confirmed by qRT-PCR in a total of 92 subjects. Cell counting kit-8 (CCK8), wound healing, transwell assays, and Western blotting were used to measure cellular biological functions and related protein in HTR-8/SVneo cells. The potential mechanisms were determined using a Luciferase reporter assay and rescue experiment. Compared with normal pregnant women, miR-17-5p was decreased and zinc finger protein 367 (ZNF367) was upregulated in the chorionic villi of TSH > 2.5 mIU/L-related SA patients. Using HTR-8/SVneo cells, we demonstrated that elevated TSH inhibited miR-17-5p expression, as well as trophoblast migration and invasion. The overexpression of miR-17-5p targeted and inhibited ZNF367 expression promoting the biological function of trophoblasts. Further studies confirmed that ZNF367 interference partially reversed the biological function of the miR-17-5p inhibitor on HTR-8/SVneo cells. Taken together, our results showed that miR-17-5p promoted biological function of trophoblasts by suppressing ZNF367.


2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Gayani Shashikala Amarasinghe ◽  
Thilini Chanchala Agampodi ◽  
Vasana Mendis ◽  
Krishanthi Malawanage ◽  
Chamila Kappagoda ◽  
...  

Abstract Background The Sustainable development goals, which focus strongly on equity, aim to end all forms of malnutrition by 2030. However, a significant cause of intergenerational transfer of malnutrition, anaemia in pregnancy, is still a challenge. It is especially so in the low- and middle-income settings where possible context-specific aetiologies leading to anaemia have been poorly explored. This study explores the prevalence of etiological factors significantly contributing to anaemia in pregnancy in Sri Lanka, a lower-middle-income country with a high prevalence of malnutrition albeit robust public health infrastructure. Methods All first-trimester pregnant women registered in the public maternal care programme in the Anuradhapura district from July to September 2019 were invited to participate in Rajarata Pregnancy Cohort (RaPCo). After a full blood count analysis, high-performance liquid chromatography, peripheral blood film examination, serum B12 and folate levels were performed in anaemic participants, guided by an algorithm based on the red cell indices in the full blood count. In addition, serum ferritin was tested in a random subsample of 213 participants. Anaemic women in this subsample underwent B12 and folate testing. Results Among 3127 participants, 14.4% (95%CI 13.2–15.7, n = 451) were anaemic. Haemoglobin ranged between 7.4 to 19.6 g/dl. 331(10.6%) had mild anaemia. Haemoglobin ≥13 g/dl was observed in 39(12.7%). Microcytic, normochromic-normocytic, hypochromic-normocytic and macrocytic anaemia was observed in 243(54%), 114(25.3%), 80(17.8%) and two (0.4%) of full blood counts in anaemic women, respectively. Microcytic anaemia with a red cell count ≥5 * 106 /μl demonstrated a 100% positive predictive value for minor haemoglobinopathies. Minor hemoglobinopathies were present in at least 23.3%(n = 105) of anaemic pregnant women. Prevalence of iron deficiency, B12 deficiency and Southeast Asian ovalocytosis among the anaemic was 41.9% (95%CI 26.4–59.2), 23.8% (95%CI 10.6–45.1) and 0.9% (95%CI 0.3–2.3%), respectively. Folate deficiency was not observed. Conclusion Even though iron deficiency remains the primary cause, minor hemoglobinopathies, B 12 deficiency and other aetiologies substantially contribute to anaemia in pregnancy in this study population. Public health interventions, including screening for minor hemoglobinopathies and multiple micronutrient supplementation in pregnancy, should be considered in the national programme for areas where these problems have been identified.


2021 ◽  
Vol 15 (4) ◽  
pp. e0009390
Author(s):  
Jamille Gregório Dombrowski ◽  
André Barateiro ◽  
Erika Paula Machado Peixoto ◽  
André Boler Cláudio da Silva Barros ◽  
Rodrigo Medeiros de Souza ◽  
...  

Background Malaria in Brazil represents one of the highest percentages of Latin America cases, where approximately 84% of infections are attributed to Plasmodium (P.) vivax. Despite the high incidence, many aspects of gestational malaria resulting from P. vivax infections remain poorly studied. As such, we aimed to evaluate the consequences of P. vivax infections during gestation on the health of mothers and their neonates in an endemic area of the Amazon. Methods and findings We have conducted an observational cohort study in Brazilian Amazon between January 2013 and April 2015. 600 pregnant women were enrolled and followed until delivery. After applying exclusion criteria, 329 mother-child pairs were included in the analysis. Clinical data regarding maternal infection, newborn’s anthropometric measures, placental histopathological characteristics, and angiogenic and inflammatory factors were evaluated. The presence of plasma IgG against the P. vivax (Pv) MSP119 protein was used as marker of exposure and possible associations with pregnancy outcomes were analyzed. Multivariate logistic regression analysis revealed that P. vivax infections during the first trimester of pregnancy are associated with adverse gestational outcomes such as premature birth (adjusted odds ratio [aOR] 8.12, 95% confidence interval [95%CI] 2.69–24.54, p < 0.0001) and reduced head circumference (aOR 3.58, 95%CI 1.29–9.97, p = 0.01). Histopathology analysis showed marked differences between placentas from P. vivax-infected and non-infected pregnant women, especially regarding placental monocytes infiltrate. Placental levels of vasomodulatory factors such as angiopoietin-2 (ANG-2) and complement proteins such as C5a were also altered at delivery. Plasma levels of anti-PvMSP119 IgG in infected pregnant women were shown to be a reliable exposure marker; yet, with no association with improved pregnancy outcomes. Conclusions This study indicates that P. vivax malaria during the first trimester of pregnancy represents a higher likelihood of subsequent poor pregnancy outcomes associated with marked placental histologic modification and angiogenic/inflammatory imbalance. Additionally, our findings support the idea that antibodies against PvMSP119 are not protective against poor pregnancy outcomes induced by P. vivax infections.


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