scholarly journals The physiologic and therapeutic role of Heparin in implantation and placentation

2014 ◽  
Author(s):  
Michela Quaranta ◽  
Offer Erez ◽  
Salvatore Andrea Mastrolia ◽  
Arie Koifman ◽  
Elad Leron ◽  
...  
Keyword(s):  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Preterm Labor ◽  
Normal Pregnancy ◽  
Fetal Demise ◽  
Therapeutic Role ◽  
Intrauterine Growth ◽  
Treatment And Prevention ◽  
Normal Gestation

Implantation, trophoblast development and placentation are crucial processes in the establishment and development of normal pregnancy. Abnormalities of these processes can lead to pregnancy complications named the great obstetrical syndromes (preeclampsia, intrauterine growth restriction, fetal demise, premature prelabor rupture or membranes, preterm labor, and recurrent pregnancy loss). There is mounting evidence regarding the physiological and therapeutic role of heparins in the establishment of normal gestation and as a modality for treatment and prevention of pregnancy complications. In this review we will summarize the properties and the physiological contribute of heparins to the success of implantation and placentation and normal pregnancy.

scholarly journals The physiologic and therapeutic role of Heparin in implantation and placentation

2014 ◽  
Author(s):  
Michela Quaranta ◽  
Offer Erez ◽  
Salvatore Andrea Mastrolia ◽  
Arie Koifman ◽  
Elad Leron ◽  
...  
Keyword(s):  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Preterm Labor ◽  
Normal Pregnancy ◽  
Fetal Demise ◽  
Therapeutic Role ◽  
Intrauterine Growth ◽  
Treatment And Prevention ◽  
Normal Gestation

Implantation, trophoblast development and placentation are crucial processes in the establishment and development of normal pregnancy. Abnormalities of these processes can lead to pregnancy complications named the great obstetrical syndromes (preeclampsia, intrauterine growth restriction, fetal demise, premature prelabor rupture or membranes, preterm labor, and recurrent pregnancy loss). There is mounting evidence regarding the physiological and therapeutic role of heparins in the establishment of normal gestation and as a modality for treatment and prevention of pregnancy complications. In this review we will summarize the properties and the physiological contribute of heparins to the success of implantation and placentation and normal pregnancy.

scholarly journals The risk of cesarean delivery after labor induction among women with prior pregnancy complications: A subgroup analysis of the AFFIRM study

2019 ◽  
Author(s):  
Leslie Skeith ◽  
Grégoire Le Gal ◽  
Johanna IP de Vries ◽  
Saskia Middeldorp ◽  
Mariëtte Goddijn ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Primary Outcome ◽  
Late Pregnancy ◽  
Labor Induction ◽  
Intrauterine Growth ◽  
Randomized Controlled ◽  
Level Data

Abstract Objective: To determine the risk of cesarean delivery after labor induction among patients with prior placenta-mediated pregnancy complications (pre-eclampsia, late pregnancy loss, placental abruption or intrauterine growth restriction). Study Design: The AFFIRM database includes patient level data from 9 randomized controlled trials that evaluated the role of LMWH versus no LMWH during pregnancy to prevent recurrent placenta-mediated pregnancy complications. The primary outcome of this sub-study was the proportion of women who had an unplanned cesarean delivery after induction of labor compared to after spontaneous labor. Results: There were 512 patients from 7 randomized trials included in our sub-study. There was no difference in the risk of cesarean delivery between women with labor induction (21/148, 14.2%) and spontaneous labor (79/364, 21.7%) (odds ratio (OR) 0.60, 95% CI, 0.35-1.01; p=0.052). Among 274 women who used LMWH prophylaxis during pregnancy, the risk of cesarean delivery was lower among those that underwent labor induction (9.8%) compared to spontaneous labor (22.4%) (OR 0.38, 95% CI, 0.17-0.84; p=0.01). Conclusions: The risk of cesarean delivery is not increased after labor induction among a higher risk patient population with prior pregnancy complications. Our results suggest that women who receive LMWH during pregnancy might benefit from labor induction.

scholarly journals The risk of cesarean delivery after labor induction among women with prior pregnancy complications: a subgroup analysis of the AFFIRM study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Leslie Skeith ◽  
◽  
Grégoire Le Gal ◽  
Johanna I. P. de Vries ◽  
Saskia Middeldorp ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Primary Outcome ◽  
Late Pregnancy ◽  
Labor Induction ◽  
Intrauterine Growth ◽  
Randomized Controlled ◽  
Level Data

Abstract Background To determine the risk of cesarean delivery after labor induction among patients with prior placenta-mediated pregnancy complications (pre-eclampsia, late pregnancy loss, placental abruption or intrauterine growth restriction). Methods The AFFIRM database includes patient level data from 9 randomized controlled trials that evaluated the role of LMWH versus no LMWH during pregnancy to prevent recurrent placenta-mediated pregnancy complications. The primary outcome of this sub-study was the proportion of women who had an unplanned cesarean delivery after induction of labor compared to after spontaneous labor. Results There were 512 patients from 7 randomized trials included in our sub-study. There was no difference in the risk of cesarean delivery between women with labor induction (21/148, 14.2%) and spontaneous labor (79/364, 21.7%) (odds ratio (OR) 0.60, 95% CI, 0.35–1.01; p = 0.052). Among 274 women who used LMWH prophylaxis during pregnancy, the risk of cesarean delivery was lower among those that underwent labor induction (9.8%) compared to spontaneous labor (22.4%) (OR 0.38, 95% CI, 0.17–0.84; p = 0.01). Conclusions The risk of cesarean delivery is not increased after labor induction among a higher risk patient population with prior pregnancy complications. Our results suggest that women who receive LMWH during pregnancy might benefit from labor induction.

scholarly journals The Role of the Leucocytosis Parameter in the Occurrence of Pregnancy Complications in Women with Periodontal Disease

2019 ◽  
Vol 70 (11) ◽  
pp. 3967-3970
Author(s):  
Camelia Fiera Maglaviceanu ◽  
Edwin Sever Bechir ◽  
Mihaela Jana Tuculina ◽  
Constantin Daguci ◽  
Ionela Teodora Dascalu ◽  
...  
Keyword(s):  
Periodontal Disease ◽  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
The Body ◽  
Intrauterine Growth ◽  
Obstetrics And Gynaecology ◽  
Severe Periodontitis ◽  
Significant Difference ◽  
Control Segment

For the present study, a total number of 109 pregnant patients in the second trimester of pregnancy were selected from the case studies of the Clinic of Obstetrics and Gynaecology of the Municipal Clinical Hospital Filantropia in Craiova. Among these, 56 patients had gingivitis, 26 had mild, moderate, or severe periodontitis, and 27 patients were used as a control segment. Each patient had her leukocytes values tested and they had their oral cavity examined. Leukocyte neutrophils are the primary cells of the body�s defence system as well as primary protective cells against periodontal disease. Based on the study, we can say that there is a significant difference between the average number of leukocytes found in the four groups, because the result of the ANOVA test was below the threshold p [0.001. By analyzing the involvement of the leucocytosis parameter in the occurrence or presence of pregnancy complications, we found it present in periodontal disease pregnant women who had complications, namely: premature birth, preeclampsia, or intrauterine growth restriction.

scholarly journals The role of Sirtuin1–PPARγ axis in placental development and function

2018 ◽  
Vol 60 (4) ◽  
pp. R201-R212 ◽  
Author(s):  
Jonathan Pham ◽  
Kanaga Arul Nambi Rajan ◽  
Ping Li ◽  
Mana M Parast
Keyword(s):  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Multiple Pregnancy ◽  
Well Being ◽  
Sirtuin 1 ◽  
Hypertensive Disorder ◽  
Placental Development ◽  
Intrauterine Growth ◽  
And Function

Placental development is important for proper in utero growth and development of the fetus, as well as maternal well-being during pregnancy. Abnormal differentiation of placental epithelial cells, called trophoblast, is at the root of multiple pregnancy complications, including miscarriage, the maternal hypertensive disorder preeclampsia and intrauterine growth restriction. The ligand-activated nuclear receptor, PPARγ, and nutrient sensor, Sirtuin-1, both play a role in numerous pathways important to cell survival and differentiation, metabolism and inflammation. However, each has also been identified as a key player in trophoblast differentiation and placental development. This review details these studies, and also describes how various stressors, including hypoxia and inflammation, alter the expression or activity of PPARγ and Sirtuin-1, thereby contributing to placenta-based pregnancy complications.

The physiologic anticoagulant and anti-inflammatory role of heparins and their utility in the prevention of pregnancy complications

2015 ◽  
Vol 113 (06) ◽  
pp. 1236-1246 ◽  
Author(s):  
Salvatore Andrea Mastrolia ◽  
Moshe Mazor ◽  
Gershon Holcberg ◽  
Elad Leron ◽  
Ofer Beharier ◽  
...  
Keyword(s):  
Intrauterine Growth Restriction ◽  
Preterm Labor ◽  
Vascular Lesions ◽  
Current Evidence ◽  
Fetal Demise ◽  
Recurrent Abortions ◽  
Anti Inflammatory ◽  
Prelabor Rupture Of Membranes ◽  
Physiologic Role

SummaryAccumulating evidence supports the concept of increased thrombin generation, placental vascular lesions, and inflammation as crucial points in the development of the great obstetrical syndromes [preeclampsia, intrauterine growth restriction (IUGR), preterm labor (PTL), preterm prelabor rupture of membranes (PROM), fetal demise and recurrent abortions]. In light of this, the role of heparins for primary or secondary prevention of these syndromes is becoming more and more apparent, mainly due to the antithrombotic and anti-inflammatory effects of heparins. There is agreement regarding the use of heparin in the prevention of gestational complications in patients with antiphospholipid syndrome, while its use for other obstetrical complications is under debate. In the present review we will describe the physiologic role of heparins on coagulation and inflammation and we will discuss current evidence regarding the use of heparins for the prevention/ treatment of obstetrical syndromes.

scholarly journals Involvement of miRNAs in Placental Alterations Mediated by Oxidative Stress

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Alexander Rudov ◽  
Walter Balduini ◽  
Silvia Carloni ◽  
Serafina Perrone ◽  
Giuseppe Buonocore ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Intrauterine Growth Restriction ◽  
Preterm Labor ◽  
Pregnancy Loss ◽  
Direct Link ◽  
Intrauterine Growth ◽  
Diagnosis And Prognosis ◽  
Pathological Conditions ◽  
Growing Body

Oxidative stress (OS) is known to be strongly involved in a large number of fetal, neonatal, and adult diseases, including placental disorders, leading to pregnancy loss and stillbirths. A growing body of research links OS to preeclampsia, gestational diabetes, obesity, spontaneous abortion, recurrent pregnancy, preterm labor, and intrauterine growth restriction. While a considerable number of miRNAs have been related to physiological functions and pathological conditions of the placenta, a direct link among these miRNAs, placental functions, and OS is still lacking. This review summarizes data describing the role of miRNAs in placental pathophysiological processes and their possible impact on OS damaging responses. As miRNAs can be found in circulation, improving our understanding on their role in the pathogenesis of pregnancy related disorders could have an important impact on the diagnosis and prognosis of these diseases.

scholarly journals Single Fetal Demise in Twin Pregnancy—A Great Concern but Still a Favorable Outcome

Diseases ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 33
Author(s):  
Bogdan Ioan Stefanescu ◽  
Ana-Maria Adam ◽  
Georgiana Bianca Constantin ◽  
Constantin Trus
Keyword(s):  
Intrauterine Growth Restriction ◽  
Preterm Labor ◽  
Twin Pregnancy ◽  
First Trimester ◽  
Neurological Complications ◽  
Third Trimester ◽  
Fetal Demise ◽  
Assisted Reproduction Techniques ◽  
Intrauterine Growth ◽  
Frequent Use

The incidence of multiple pregnancies has increased in the last decades, mostly explained by the more frequent use of ovulation induction drugs and assisted reproduction techniques. Although single fetal death in the first trimester of twin pregnancy is not an uncommon event nor does it have serious consequences on the survival fetus, the death of one fetus in the second or third trimester of pregnancy is associated with a serious increase in morbidity and mortality for the surviving co-twin. Preterm labor, preeclampsia, intrauterine growth restriction (IUGR), neurological complications or even the death of the surviving twin have been associated with single fetal demise after mid gestation. We present a very rare case of twin pregnancy with single fetal demise at 26 weeks of gestation successfully managed to term.

scholarly journals The risk of cesarean delivery after labor induction among women with prior pregnancy complications: A subgroup analysis of the AFFIRM study

2019 ◽  
Author(s):  
Leslie Skeith ◽  
Grégoire Le Gal ◽  
Johanna IP de Vries ◽  
Saskia Middeldorp ◽  
Mariëtte Goddijn ◽  
...  
Keyword(s):  
Cesarean Delivery ◽  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Primary Outcome ◽  
Late Pregnancy ◽  
Labor Induction ◽  
Intrauterine Growth ◽  
Randomized Controlled ◽  
Level Data

Abstract Objective: To determine the risk of cesarean delivery after labor induction among patients with prior placenta-mediated pregnancy complications (pre-eclampsia, late pregnancy loss, placental abruption or intrauterine growth restriction). Study Design: The AFFIRM database includes patient level data from 9 randomized controlled trials that evaluated the role of LMWH versus no LMWH during pregnancy to prevent recurrent placenta-mediated pregnancy complications. The primary outcome of this sub-study was the proportion of women who had an unplanned cesarean delivery after induction of labor compared to after spontaneous labor. Results: There were 512 patients from 7 randomized trials included in our sub-study. There was no difference in the risk of cesarean delivery between women with labor induction (21/148, 14.2%) and spontaneous labor (79/364, 21.7%) (odds ratio (OR) 0.60, 95% CI, 0.35-1.01; p=0.052). Among 274 women who used LMWH prophylaxis during pregnancy, the risk of cesarean delivery was lower among those that underwent labor induction (9.8%) compared to spontaneous labor (22.4%) (OR 0.38, 95% CI, 0.17-0.84; p=0.01). Conclusions: The risk of cesarean delivery is not increased after labor induction among a higher risk patient population with prior pregnancy complications. Our results suggest that women who receive LMWH during pregnancy might benefit from labor induction.

scholarly journals The Role of the Leucocytosis Parameter in the Occurrence of Pregnancy Complications in Women with Periodontal Disease

2019 ◽  
Vol 70 (11) ◽  
pp. 3967-3970
Keyword(s):  
Periodontal Disease ◽  
Pregnancy Complications ◽  
Intrauterine Growth Restriction ◽  
Second Trimester ◽  
Intrauterine Growth ◽  
Obstetrics And Gynaecology ◽  
Severe Periodontitis ◽  
Significant Difference ◽  
Control Segment

For the present study, a total number of 109 pregnant patients in the second trimester of pregnancy were selected from the case studies of the Clinic of Obstetrics and Gynaecology of the Municipal Clinical Hospital Filantropia in Craiova. Among these, 56 patients had gingivitis, 26 had mild, moderate, or severe periodontitis, and 27 patients were used as a control segment. Each patient had her leukocytes values tested and they had their oral cavity examined. Leukocyte neutrophils are the primary cells of the body’s defence system as well as primary protective cells against periodontal disease. Based on the study, we can say that there is a significant difference between the average number of leukocytes found in the four groups, because the result of the ANOVA test was below the threshold p <0.001. By analyzing the involvement of the leucocytosis parameter in the occurrence or presence of pregnancy complications, we found it present in periodontal disease pregnant women who had complications, namely: premature birth, preeclampsia, or intrauterine growth restriction. Keywords: periodontitis, leukocytes, pregnant, preterm birth

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