Early Pregnancy
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PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257418
Carolina dos Santos Amaral ◽  
Gabrielle Rebeca Everling Correa ◽  
Lady Katerine Serrano Mujica ◽  
Mariani Farias Fiorenza ◽  
Suzan Gonçalves Rosa ◽  

One of the major causes of early pregnancy loss is heat stress. In ruminants, interferon tau (IFNT) is the embryo signal to the mother. Once the interferon signaling pathway is activated, it drives gene expression for interferon-stimulated genes (ISGs) and alters neutrophils responses. The aim of the present study was to evaluate interferon (IFN) pathway, ISGs and gene expression in polymorphonuclear leukocytes (PMN) and oxidative stress in dairy cows under heat stress. Pregnant cows had their estrous cycle synchronized and randomly assigned to a comfort or heat stress group. Blood samples were collected at artificial insemination (AI) and on Days 10, 14 and 18 following AI. Pregnant cows were pregnancy checked by ultrasound on Day 30 and confirmed on Day 60 post-AI. Results are presented as mean ± SEM. The corpus luteum (CL) diameter was not different between groups of pregnant cows; concentration of progesterone of pregnant cows on Day 18 following AI was greater in comfort group compared to heat stressed group. Comfort pregnant cows had higher expression of all analyzed genes from interferon pathway, except for IFNAR1, on both Days 14 and 18. Conversely, heat stressed cows did not show altered expression of IFNT pathway genes and ISGs between Days 10, 14, and 18 after AI. The oxidative stress, determined as malondialdehyde (MDA) levels, was greater in heat stress group on Days 10, 14 and 18, independent of pregnancy status. Heat stress negatively influences expression of ISGs, IFN pathway gene expression in neutrophils, and oxidative stress. Our data suggest that lower conception rates in cows under heat stress are multifactorial, with the association of interferon pathway activation and the unbalanced oxidative stress being main contributing factors.

2021 ◽  
Vol 21 (1) ◽  
Tatsuya Arakaki ◽  
Junichi Hasegawa ◽  
Akihiko Sekizawa ◽  
Tomoaki Ikeda ◽  
Isamu Ishiwata ◽  

Abstract Background Few reports have presented an overall view of pregnant women with coronavirus disease 2019 (COVID-19) across an entire country and throughout the entire gestation period. Furthermore, no such reports are available for Japan. We examined the clinical characteristics and outcomes of pregnant women with COVID‑19 on a national scale in Japan. Methods A nationwide questionnaire-based survey for all 2,185 maternity services in Japan was conducted between July and August 2020. Information regarding maternal characteristics and epidemiological, clinical, treatment, and perinatal outcomes of pregnant women diagnosed with COVID-19 between 16 January and 30 June 2020 were collected. Main outcome measures were incidence of pregnant women with COVID-19 and infant infection, positive rate of the universal screening test for asymptomatic pregnant women, identification of infection route and rates of maternal death, and severe cases. Results Responses from 1,418 institutions were assessed (65% of all delivery institutions in Japan). Seventy-two pregnant women were reported to have been diagnosed with COVID-19. The positive rate of the universal screening test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among asymptomatic pregnant women was 0.03% (2/7428). The most common route of infection was familial (57%). Fifty-eight pregnant women with COVID-19 were symptomatic, of whom five (8.6%) had a severe infection and one died (a tourist). Severe respiratory symptoms, oxygen administration, and pneumonia were frequently reported in the third trimester and postpartum period compared with in early pregnancy (22.2% vs 2.5% [P = 0.03], 38.9% vs 7.5% [P = 0.01], and 50.0% vs 7.5% [P < 0.001], respectively). All pregnant women with COVID-19 underwent caesarean sections, regardless of symptoms. There were no SARS-CoV-2 transmissions to newborns. Conclusions In Japan, the number of cases of COVID-19 infection in pregnant women is very low. Compared with early pregnancy, late pregnancy may be a risk factor for exacerbation of symptoms and familial transmission is the most common route of infection. The importance of infection prevention should be emphasised, especially in women in late pregnancy, their families, and any cohabitants.

2021 ◽  
Chen Zhou ◽  
Gengyuan Cai ◽  
Fanming Meng ◽  
Qun Hu ◽  
Guohao Liang ◽  

Abstract Background Accurate early detection of pregnancy status is a prerequisite for effective monitoring of fertility in pig. In the early phase of pregnancy, because the embryo is small and in a free state, it is difficult to determine whether it is pregnant based on B-ultrasound examination. This calls for development of novel tools to accurately diagnose early pregnancy. Metabolomics reveal the metabolic status of cells, tissues and organisms. Results In this study, we investigated urinary metabolites in sows during early pregnancy. A total of 32 samples from 8 sows were collected at estrus and each phase of early pregnancy (days 9, 12, and 15 of gestation). Metabolites in urine samples from different sows obtained from gestation and estrus phases were analyzed via ultra-high performance liquid chromatography/mass spectrometry. A total of 530 metabolites were identified with high confidence in all samples. Compared with samples collected during the estrus phase, 269 differential metabolites were found in samples obtained during early pregnancy. Conclusions These metabolites included lipids and lipid-like molecules, organic acids and their derivatives, organic oxygen compounds, organoheterocyclic compounds, benzenoids, among others. These metabolites, such as choline and pregnanediol-3-glucuronide, play a very important role in pregnancy. They also regulate pregnancy in other animals. Our results provide novel insights into the metabolic changes in the urine of sows in the early pregnancy phase. The level of different metabolites in urine can be used to diagnosis pregnancy in sows. Understanding these metabolic changes is helpful for better management of pregnant sows.

eLife ◽  
2021 ◽  
Vol 10 ◽  
Sharon R Ladyman ◽  
Kirsten M Carter ◽  
Matt L Gillett ◽  
Zin Khant Aung ◽  
David R Grattan

As part of the maternal adaptations to pregnancy, mice show a rapid, profound reduction in voluntary running wheel activity (RWA) as soon as pregnancy is achieved. Here, we evaluate the hypothesis that prolactin, one of the first hormones to change secretion pattern following mating, is involved in driving this suppression of physical activity levels during pregnancy. We show that prolactin can acutely suppress RWA in non-pregnant female mice, and that conditional deletion of prolactin receptors (Prlr) from either most forebrain neurons or from GABA neurons prevented the early pregnancy-induced suppression of RWA. Deletion of Prlr specifically from the medial preoptic area, a brain region associated with multiple homeostatic and behavioural roles including parental behaviour, completely abolished the early pregnancy-induced suppression of RWA. As pregnancy progresses, prolactin action continues to contribute to the further suppression of RWA, although it is not the only factor involved. Our data demonstrate a key role for prolactin in suppressing voluntary physical activity during early pregnancy, highlighting a novel biological basis for reduced physical activity in pregnancy.

2021 ◽  
Mustafa YILDIZ ◽  
Esra Nur CICEK ◽  
Gokhan DEMIRAYAK ◽  
Orhan SAHIN ◽  
Yagmur OLMEZ ◽  

Abstract BACKGROUND: To evaluate the doubling rate of maternal serum serial β-hCG and a single initial serum progesterone level to predict fetal viability before ultrasonography in women diagnosed with intrauterine pregnancy of undetectable viability. METHODS: 336 pregnant women who applied to the outpatient clinic at Istanbul Okmeydanı City Hospital between March and December 2018 were evaluated on a “Prospective observational” basis. 236 women were excluded from the study for various reasons. The study was completed with 100 pregnant women diagnosed with intrauterine pregnancy (IUP) involving suspected fetal viability by transvaginal ultrasonography only, who met the inclusion criteria with CRL: < 7mm and mean gestational sac diameter: < 25mm. Serum β-hCG and progesterone were taken at the first admission. After 48 hours, control serum β-hCG was taken and the increase rates were calculated. Early pregnancy loss was diagnosed by (transvaginal) TV-USG performed after the days 7, 11 and 14. Patients were divided into two groups as fetal heart rate (FHR) positive (viable) and FHR negative (early pregnancy loss). Pregnancy results were compared with β-hCG increase rates and progesterone value. SPSS 22.0 software was used for statistical analysis and P<0.05 was accepted as statistically significant.RESULTS: No statistically significant result was obtained between the viable and early pregnancy loss (FHR +/-) groups in terms of maternal age, previous pregnancy anamnesis, nationality, presenting symptoms, or ultrasound findings. According to the last menstrual period, the mean gestational age was 45.1±14 days in the viable (FHR+) group and 51.3±14 days in the Early pregnancy loss (FHR-) group, and this difference was found to be statistically significant. Estimation modality was developed in terms of viability with the serum progesterone values and increase rates of β-hCG. The study, which was conducted with a confidence interval of 95%, found the viability rate to be 70% with a β-hCG increase rate of 31%, 80% in the case of an increase by 49%, 90% in the case of an increase by 73%, 95% in the case of an increase by 97%, and 100% in the case of an increase by 181%. For progesterone, when the value was 5.9 ng/ml, the viability rate was 49%, and it was 69% at 10.5 ng/ml, 80% at 13.4 ng/ml, 90% at 18.0 ng/ml, 95% at 21.7 ng/ml, 99% at 29.3 ng/ml, and 100% at 37.5 ng/ml and above. In conclusion, the significant efficacy values of β-hCG increase and first progesterone level in predicting viability were found to be ROC AUC: [0.748 (0.621-0.874)] and ROC AUC: [0.796 (0.685-0.907)], respectively.CONCLUSION: Either Serial β-hCG ratio or serum progesterone level can be used alone to predict pregnancy outcome in early pregnancy. With dissemination of similar studies, estimation modalities can be improved and TV-USG examinations can help shortening the waiting time for results to reduce anxiety of families, hospital admissions and health expenses.

Cureus ◽  
2021 ◽  
Meenakshi Sundaram Andra Suryanarayana ◽  
Kishore Vellingiri ◽  
Saransh Kumar Agarwal N ◽  
Bhushan Mohan

2021 ◽  
Baris Ata ◽  
Luca Gianaroli ◽  
Kersti Lundin ◽  
Saria Mcheik ◽  

Abstract Study question What is the impact of SARS-CoV-2 infection on the outcome of a pregnancy after medically assisted reproduction? Summary answer Our results suggest that medically assisted reproduction (MAR) pregnancies are not differentially affected by SARS-CoV-2 infection compared to spontaneous pregnancies. What is known already Information on the effects of COVID-19 on pregnancy after MAR is scarce when women get infected during MAR or early pregnancy, even though such information is vital for informing women seeking pregnancy. Study design, size, duration Data from SARS-CoV-2 affected MAR pregnancies were collected between May 2020 and June 2021 through a voluntary data collection, organised by the European Society of Human Reproduction and Embryology (ESHRE). Participants/materials, setting, methods All ESHRE members were invited to participate to an online data collection for SARS-CoV-2-infected MAR pregnancies. Main results and the role of chance The dataset includes 80 cases from 32 countries, including 67 live births, 10 miscarriages, 2 stillbirths and 1 maternal death. An additional 25pregnancies were ongoing at the time of writing. Limitations, reasons for caution An international data registry based on voluntary contribution can be subject to selective reporting with possible risks of over- or under-estimation. Wider implications of the findings The current data can be used to guide clinical decisions in the care of women pregnant after MAR, in the context of the COVID-19 pandemic. Study funding/competing interest(s) The authors acknowledge the support of ESHRE for the data registry and meetings. JT reports grants or contracts from Sigrid Juselius Foundation, EU and Helsinki University Hospital Funds, outside the scope of the current work. The other authors declare that they have no conflict of interest.

2021 ◽  
Vol 37 (7) ◽  
Yan Lu ◽  
Zhongying Ding ◽  
Wenwen Li ◽  
Lina Mei ◽  
Linglong Shen ◽  

Objectives: To investigate whether a combination of clinical risk factors, early pregnancy serum markers, and uterine artery pulsatility index (UTPI) can be used to predict twin preeclampsia (PE). Methods: This case control study included women with twin pregnancies who had undergone obstetrics treatments and gave birth at the Huzhou Maternity and Child Health Care Hospital from October 2018 to November 2020. Patients with PE comprised study group, and patients without PE comprised control group based on selection criteria and a 1:1 ratio. Statistical analysis was performed using clinical risk factors, early pregnancy serum markers, and UTPIs, and the area under the receiver operating curve (AUC. Sensitivity, and the specificity of different combinations of these variables were calculated to predict PE in women with twin pregnancy. Results: Logistic regression analysis revealed four independent predictors for the onset of PE during twin pregnancies: first delivery (OR, 7.51; P=0.045), conception method (OR, 7.11; P=0.036), β-HCG level (per SD OR, 2.73; P=0.026), and UTPI (OR, 0.17; P=0.043). First-delivery and IVF pregnancy methods both lead to a 7-fold increase in the PE risk during twin pregnancies. Every one sigma (standard deviation) increase in the β-HCG level led to a 2.73-fold increase in the PE risk. Every UTPI increment by 1.0 reduces the risk of PE by 83%. The prediction efficiencies were based on an AUC of 0.837, a sensitivity of 69%, and a specificity of 92% for the clinical risk factors; an AUC of 0.800, a sensitivity of 81%, and specificity of 78% for the β-HCG level, and an AUC of 0.814, a sensitivity of 88%, and a specificity of 65% for the UTPI. AUC was 0.928, sensitivity 85%, and a specificity 88% after applying the three types of indicators together for prediction. Conclusions: By combining early pregnancy serum markers (β-HCG), and UTPI, the predictive value for PE during twin pregnancy is improved together with its sensitivity and specificity. doi: https://doi.org/10.12669/pjms.37.7.5041 How to cite this:Lu Y, Ding Z, Li W, Mei L, Shen L, Shan H. Prediction of twin pregnancy preeclampsia based on clinical risk factors, early pregnancy serum markers, and uterine artery pulsatility index. Pak J Med Sci. 2021;37(7):---------.  doi: https://doi.org/10.12669/pjms.37.7.5041 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Mathilde Bergamelli ◽  
Hélène Martin ◽  
Mélinda Bénard ◽  
Jérôme Ausseil ◽  
Jean-Michel Mansuy ◽  

Extracellular vesicles (EVs) have increasingly been recognized as key players in a wide variety of physiological and pathological contexts, including during pregnancy. Notably, EVs appear both as possible biomarkers and as mediators involved in the communication of the placenta with the maternal and fetal sides. A better understanding of the physiological and pathological roles of EVs strongly depends on the development of adequate and reliable study models, specifically at the beginning of pregnancy where many adverse pregnancy outcomes have their origin. In this study, we describe the isolation of small EVs from a histoculture model of first trimester placental explants in normal conditions as well as upon infection by human cytomegalovirus. Using bead-based multiplex cytometry and electron microscopy combined with biochemical approaches, we characterized these small EVs and defined their associated markers and ultrastructure. We observed that infection led to changes in the expression level of several surface markers, without affecting the secretion and integrity of small EVs. Our findings lay the foundation for studying the functional role of EVs during early pregnancy, along with the identification of new predictive biomarkers for the severity and outcome of this congenital infection, which are still sorely lacking.

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