Gestational duration Dotaz Zobrazit nápovědu
In alloxan-induced diabetic rats (Wistar, females, age 3-4 months of postnatal life) the large spectrum of fatty acids in blood serum, brain cortex, medulla oblongata and liver was studied. The fatty acids, using gas chromatography, were detected as methyl esters and the methods were published previously (Šmídová and al. 1994). Alloxan (Merck) administered i.p., 140 mg/kg body weight, caused immediately elevation (three times) of blood sugar levels. On the 13th day the rats were killed. The results are as follows: a) In blood serum alloxan diabetes of cca two weeks duration caused a significantly increased participation of saturated FA and decreased participation of both polyunsaturated FA (n-3 and n-6). b) In brain cortex no differences between controls and diabetic rats in the indicated groups of FA were found. c) In the medulla oblongata an increased participation of polyunsaturated fatty acids n-6 was established. d) In hepatic tissue the increased participation of saturated FA as well as a decreased participation of FA n-6 was described. Analysing the main groups of FA we found especially in n-3 and n-6 FA several significant changes in single FA (a smaller pool of arachidonic acid in blood serum as well as in liver, decreased participation of docosahexaenoic acid in the brain cortex, etc.). The purpose and possible consequences of such changes are discussed.
BACKGROUND: Amniotic fluid is clinically accessible via amniocentesis and its protein composition may correspond to birth timing. Early changes in the amniotic fluid proteome could therefore be associated with the subsequent development of spontaneous preterm delivery. OBJECTIVE: The main objective of this study was to perform unbiased proteomics analysis of the association between mid-trimester amniotic fluid proteome and spontaneous preterm delivery and gestational duration, respectively. A secondary objective was to validate and replicate the findings by enzyme-linked immunosorbent assay using a second independent cohort. METHODS: Women undergoing a mid-trimester genetic amniocentesis at Sahlgrenska University Hospital/Östra between September 2008 and September 2011 were enrolled in this study, designed in three analytical stages; 1) an unbiased proteomic discovery phase using LC-MS analysis of 22 women with subsequent spontaneous preterm delivery (cases) and 37 women who delivered at term (controls), 2) a validation phase of proteins of interest identified in stage 1, and 3) a replication phase of the proteins that passed validation using a second independent cohort consisting of 20 cases and 40 matched controls. RESULTS: Nine proteins were nominally significantly associated with both spontaneous preterm delivery and gestational duration, after adjustment for gestational age at sampling, but none of the proteins were significant after correction for multiple testing. Several of these proteins have previously been described as being associated with spontaneous PTD etiology and six of them were thus validated using enzyme linked immunosorbent assay. Two of the proteins passed validation; Neutrophil gelatinase-associated lipocalin and plasminogen activator inhibitor 1, but the results could not be replicated in a second cohort. CONCLUSIONS: Neutrophil gelatinase-associated lipocalin and Plasminogen activator inhibitor 1 are potential biomarkers of spontaneous preterm delivery and gestational duration but the findings could not be replicated. The negative findings are supported by the fact that none of the nine proteins from the exploratory phase were significant after correction for multiple testing.
- MeSH
- amniocentéza MeSH
- dospělí MeSH
- druhý trimestr těhotenství metabolismus MeSH
- gestační stáří * MeSH
- kohortové studie MeSH
- lidé MeSH
- plodová voda chemie metabolismus MeSH
- předčasný porod metabolismus MeSH
- proteom analýza MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Research Support, N.I.H., Extramural MeSH
INTRODUCTION: Spontaneous preterm delivery (<37 gestational weeks) has a multifactorial etiology with still incompletely identified pathways. Amniotic fluid is a biofluid with great potential for insights into the feto-maternal milieu. It is rich in metabolites, and metabolic consequences of inflammation is yet researched only to a limited extent. Metabolomic profiling provides opportunities to identify potential biomarkers of inflammatory conditioned pregnancy complications such as spontaneous preterm delivery. OBJECTIVE: The aim of this study was to perform metabolomic profiling of amniotic fluid from uncomplicated singleton pregnancies in the mid-trimester to identify potential biomarkers associated with spontaneous preterm delivery and gestational duration at delivery. A secondary aim was to replicate previously reported mid-trimester amniotic fluid metabolic biomarkers of spontaneous preterm delivery in asymptomatic women. METHOD: A nested case-control study was performed within a larger cohort study of asymptomatic pregnant women undergoing mid-trimester genetic amniocentesis at 14-19 gestational weeks in Gothenburg, Sweden. Medical records were used to obtain clinical data and delivery outcome variables. Amniotic fluid samples from women with a subsequent spontaneous preterm delivery (n = 37) were matched with amniotic fluid samples from women with a subsequent spontaneous delivery at term (n = 37). Amniotic fluid samples underwent untargeted metabolomic analyses using liquid chromatography-mass spectrometry. Multivariate random forest analyses were used for data processing. A secondary targeted analysis was performed, aiming to replicate previously reported mid-trimester amniotic fluid metabolic biomarkers in women with a subsequent spontaneous preterm delivery. RESULTS: Multivariate analysis did not distinguish the samples from women with a subsequent spontaneous preterm delivery from those with a subsequent term delivery. Neither was the metabolic profile associated with gestational duration at delivery. Potential metabolic biomarker candidates were identified from four publications by two different research groups relating mid-trimester amniotic fluid metabolomes to spontaneous PTD, of which fifteen markers were included in the secondary analysis. None of these were replicated. CONCLUSIONS: Metabolomic profiles of early mid-trimester amniotic fluid were not associated with spontaneous preterm delivery or gestational duration at delivery in this cohort.
- MeSH
- amniocentéza MeSH
- biologické markery metabolismus MeSH
- druhý trimestr těhotenství MeSH
- gestační stáří MeSH
- kohortové studie MeSH
- lidé MeSH
- novorozenec MeSH
- plodová voda * metabolismus MeSH
- předčasný porod * diagnóza metabolismus MeSH
- studie případů a kontrol MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Cíl studie: Srovnání efektu léčby intrahepatické těhotenské cholestázy monoterapií ursodeoxycholovou kyselinou s monoterapií S-adenosyl-L-metioninem a kombinovaným podáváním obou léčiv. Metodika: V rozmezí leden 1999 až červen 2005 byly zařazeny do studie všechny ženy s jednočetným těhotenstvím se středně těžkými nebo těžkými projevy intrahepatální cholestázy, u kterých k manifestaci příznaků došlo před ukončeným 36. gestačním týdnem. Po randomizaci obálkovou metodou část z nich byla léčena ursodeoxycholovou kyselinou (UDCA)v dávce 3x250 mg p.o, část S-adenosyl-L-metioninem (SAMe) v dávce 500 mg v pomalé nitrožilní infuzi 2krát denně po l4 dnů a dále v případě potřeby 2x500 mg p.o. Třetí skupinu tvořily ženy, které byly léčeny kombinací obou léčiv ve stejném dávkovacím schématu. Hematologické a biochemické parametry byly sledovány v týdenních intervalech. Stav plodu byl pečlivě monitorován pomocí kardiotokografu a ultrazvuku. Výsledky: Ze 78 zařazených žen 25 bylo léčeno monoterapií SAMe, 26 monoterapií UDCA a 27 žen bylo léčeno kombinací obou léčiv. Skupiny se nelišily gestačním stářím, věkem, paritou a ani délkou léčby. Rovněž hodnoty sledovaných biochemických parametrů se statisticky významně v době randomizace nelišily. Všechny modely léčby vedly ke zlepšení kožního pruritu. Kombinovaná léčba a monoterapie UDCA vedly k výraznému zlepšení sledovaných biochemických parametrů (žlučových kyselin, ALT a AST) ve srovnání s monoterapií SAMe. Rozdíly jsou statisticky významné (p<0,01). Efekt kombinované terapie ve srovnání s monoterapií UDCA nastupuje dříve, i když statisticky jsou rozdíly jen na hranici významnosti. Perinatální výsledky byly ve všech skupinách srovnatelné. V celém souboru jsme nezaznamenali nežádoucí účinky léčby ani u jednoho z léčebných modelů. Závěry: Kyselina ursodeoxycholová je účinným lékem při zlepšení biochemických parametrů ICP. Spolu s S-adenosyl-L-metioninem působí synergicky. Ovlivňuje-li úspěšná léčba příznivě i itrauterinní stav plodu, není zatím jasné. Dobré perinatální výsledky lze zatím spíše přičíst úzkostlivému sledování stavu plodu in utero a dobrému časování ukončení těhotenství.
Aim of the Study: To compare the efficacy of the monotherapy with ursodeoxycholic acid and S- adenosyl- L-methione with combined effect of both drugs in the treatment in pregnant women with intrahepatic cholestasis of pregnancy. Methodology: All women with singleton pregnancy at <36 weeks of gestation with moderate or severe form of ICP during January 1999 to June 2005 were enrolled. All were randomly assigned oral ursodeoxycholic acid (UDCA) 3 x 250mg daily or 500mg S–adenosyl–L-methione (SAMe) twice daily in slow running infusion for twelve days ongoing oral 500 mg twice daily until delivery. Haematological and biochemical parameters were evaluated every week. Intensive monitoring of the fetus with cardiotocography and utrasound were accompanied. Results: Of the 78 women enrolled, 25 received SAMe and 26 UDCA monotherapy. 27 women received combined therapy with both drugs. At enrolment, gestational age, duration of therapy, parity and biochemical characteristics were similar in the groups. All types of therapy improve the pruritus. The combined therapy and the monotherapy with UDCA led to improving of the serum concentrations of bile acids, asparate aminotranspherase, alanine aminotranspherase compared with monotherapy with SAMe. The differencies were statisticaly significant (p>0.01). The combined therapy led to quicker decrease of serum concentrations of bile acids and transaminases compared with UDCA monotherapy, however the results are only of borderline statistical significance. Gestational age at the time of labor and rate of prematurity were similar in all groups. No adverse effects were noted on the fetuses or neonates with either therapy. Conclusions: Ursodeoxycholic acid is effective in improving the biochemical parametres during the treatment of ICP. There is probably the synergistic effect with S adenosyl-L-methione. Whether the successful treatment influence the conditions of the fetus is not clear. The good perinatal outocome is probably more due to the precise monitoring of the intrauterine well-being of the fetus. The project is supported by IGA MZ CR (No. NH/7376-3).
- MeSH
- finanční podpora výzkumu jako téma MeSH
- intrahepatální cholestáza farmakoterapie MeSH
- kombinovaná farmakoterapie MeSH
- komplikace těhotenství MeSH
- kyselina ursodeoxycholová terapeutické užití MeSH
- lidé MeSH
- prospektivní studie MeSH
- S-adenosylmethionin terapeutické užití MeSH
- těhotenství MeSH
- Check Tag
- lidé MeSH
- těhotenství MeSH
Women with gestational diabetes mellitus (GDM) are at increased risk for cardiovascular diseases (CVD) events compared with women without GDM. The aim of the present study was to evaluate 200 parameters of the heart electric field in 35 women with GDM under optimal glycemic compensation compared to 32 healthy pregnant women. All examinations were performed in the 36th week of gestation. The parameters in ECG body surface mapping (BSM) were registered by the diagnostic system Cardiag 112.2. The absolute values of maximum and minimum in depolarization and repolarization isopotential, isointegral and isoarea maps were not significantly different between the groups. These findings correspond to the result of heart rate variability examination. However BSM revealed the significant prolongation of QRS complex (p=0.05), shortening of ventricular myocardial activation time (ICHVAT) (p=0.01), prolongation of mean QT duration (p=0.01) and increase of QT interval dispersion (p=0.01) in women with GDM. Duration of QRS and ICHVAT significantly correlated with interventricular septum and posterior wall thickness in GDM group, QTd interval correlated significantly with HbA1C level. We conclude that despite of optimal metabolic control several significant abnormalities detected by ECG BSM are still present in patients with GDM.
- MeSH
- dospělí MeSH
- echokardiografie MeSH
- gestační diabetes krev patofyziologie ultrasonografie MeSH
- krevní glukóza MeSH
- lidé MeSH
- mapování potenciálů tělesného povrchu * MeSH
- srdeční frekvence MeSH
- studie případů a kontrol MeSH
- těhotenství MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
BACKGROUNDS: The large, international, randomized controlled NeoPInS trial showed that procalcitonin (PCT)-guided decision making was superior to standard care in reducing the duration of antibiotic therapy and hospitalization in neonates suspected of early-onset sepsis (EOS), without increased adverse events. This study aimed to perform a cost-minimization study of the NeoPInS trial, comparing health care costs of standard care and PCT-guided decision making based on the NeoPInS algorithm, and to analyze subgroups based on country, risk category and gestational age. METHODS: Data from the NeoPInS trial in neonates born after 34 weeks of gestational age with suspected EOS in the first 72 h of life requiring antibiotic therapy were used. We performed a cost-minimization study of health care costs, comparing standard care to PCT-guided decision making. RESULTS: In total, 1489 neonates were included in the study, of which 754 were treated according to PCT-guided decision making and 735 received standard care. Mean health care costs of PCT-guided decision making were not significantly different from costs of standard care (€3649 vs. €3616). Considering subgroups, we found a significant reduction in health care costs of PCT-guided decision making for risk category 'infection unlikely' and for gestational age ≥ 37 weeks in the Netherlands, Switzerland and the Czech Republic, and for gestational age < 37 weeks in the Czech Republic. CONCLUSIONS: Health care costs of PCT-guided decision making of term and late-preterm neonates with suspected EOS are not significantly different from costs of standard care. Significant cost reduction was found for risk category 'infection unlikely,' and is affected by both the price of PCT-testing and (prolonged) hospitalization due to SAEs.
- MeSH
- antibakteriální látky * terapeutické užití MeSH
- časná diagnóza MeSH
- klinické rozhodování * metody MeSH
- lidé MeSH
- náklady na zdravotní péči * statistika a číselné údaje MeSH
- novorozenec MeSH
- prokalcitonin krev MeSH
- sepse * diagnóza farmakoterapie MeSH
- trvání terapie * MeSH
- Check Tag
- lidé MeSH
- novorozenec MeSH
- Publikační typ
- časopisecké články MeSH
A trend of the shortening duration of pregnancies carried to term has been observed in several countries and represents a growing public health concern. This paper describes the trend in the Czech Republic and shows its relation to the changing demographic structure of mothers and the organisation of maternity care. Data from the birth register are used and supplemented with information about the capacity of maternity care (number of beds at maternity clinics, number of obstetricians and midwives). Logistic regression is used to estimate the odds of 37 to 39 vs 40+ completed weeks of gestation. The results show that the average gestational age at term decreased by 2.1 days between 2000 and 2013. The odds of 37 to 39 weeks of gestational duration increased, mainly due to the reduction in the number of beds at maternity clinics (adjusted odds ratio of 1.51). The effects of the number of health care staff members were weaker. The number of midwives positively influenced gestational duration, while the number of obstetricians had a negative effect. Maternal demographic structure cannot explain the trend. A likely explanation is the increased use of planned early term caesarean sections.
- MeSH
- babictví MeSH
- dospělí MeSH
- gestační stáří * MeSH
- hodnocení výsledků zdravotní péče MeSH
- indukovaný porod * MeSH
- lidé MeSH
- logistické modely MeSH
- lůžková kapacita nemocnice MeSH
- mladý dospělý MeSH
- porod v termínu * MeSH
- registrace MeSH
- služby zdravotní péče o matku MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika MeSH
Cíl studie: Srovnání fetálních ultrazvukových biometrických parametrů hlavičky (obvod – HC, biparietální průměr – BPD) a stehenní kosti (délka femuru – FL) s ohledem na délku těhotenství a pohlaví plodu. Typ studie: Prospektivní studie. Název a sídlo pracoviště: Gynekologicko-porodnická klinika, Ústav lékařské genetiky a fetální medicíny, Ústav preventivního lékařství LF Univerzity Palackého a FN, Olomouc. Metodika: Ultrazvuková biometrie byla prováděna v souladu s metodikou uvedenou v referenčních tabulkách. U všech plodů bylo změřeno HC, BPD a FL. Ze studie byla vyloučena riziková těhotenství, plody v poloze koncem pánevním a vícečetná těhotenství. Výsledky: Celkem bylo provedeno 427 ultrazvukových biometrií mezi 16.–38. týdnem těhotenství. Plody mužského pohlaví měly signifikantně větší obvod hlavičky (HC) i biparietální průměr (BPD) ve srovnání s plody ženského pohlaví a s délkou těhotenství rozdíl narůstal. V období do 20. týdne byl rozdíl (HC + 3,9 dne; 3,0 %, a BPD + 4,1; 3,2 %), mezi 20.–30. týdnem (HC + 6,8 dne; 4,3 %, a BPD + 6,9 ; 4,4 %) a po 30. týdnu (HC + 12,3 dne; 5,6 %, a BPD + 12,9; 5,9 %). V období do 20. týdne byl rozdíl mezi HC a FL u plodů mužského pohlaví + 2,1 dne (95%Cl 1,7–2,6; p <0,001), mezi 20.–30. týdnem + 3,4 dny (95%Cl 2,5–4,2; p <0,001) a po 30. týdnu + 9,7 dne (95%Cl 7,3–12,1; p <0,001). Závěr: Podle výsledků této studie mají plody mužského pohlaví signifikantně větší biparietální průměr i obvod hlavičky. Rozdíl je patrný již od 16. týdne těhotenství a narůstá s délkou gestace. Při nálezu diskrepance v ultrazvukové biometrii hlavičky plodu a délkou stehenní kosti by mělo být zohledněno i pohlaví plodu.
Objective: To compare female and male fetuses in terms of intrauterine ultrasound growth measurements (HC - head circumference, BPD - biparietal diameter, FL - femur lenght) depending on gestational age. Design: A prospective study. Setting: Department of Obstetrics and Gynecology, Department of Medical Genetics and Fetal Medicine, Department of Preventive Medicine, University Hospital, Olomouc. Methods: All ultrasound biometric measurements were performed according to the methodology published with the reference charts. Risk pregnancies, multiple pregnancies and breech presentations were excluded. Results: Fetal HC, BPD and FL were measured in 427 ultrasound examinations at 16 - 38 weeks. Male fetuses had significantly larger HC and BPD measurements compared to female fetuses and these differences increased with advancing gestation. In the 16 - 21 week scans estimated difference was (HC + 3.9 days, 3.0% and BPD + 4.1, 3.2%), during the 21 - 30 week scans (HC + 6.8 days, 4.3% and BPD + 6.9, 4.4%) and in the 31 - 38 week scans (HC + 12.3 days, 5.6% and BPD + 12.9, 5.9%) for males. Male fetuses had significantly larger HC compared to FL measurements. In the 16 - 21 week scans, estimated difference was + 2.1 days (95%Cl 1.7 - 2.6, P < 0.001), during the 21 - 30 week scans + 3.4 days (95%Cl 2.5 - 4.2, P < 0.001) and in the 31 - 38 week scans + 9.7 days (95%Cl 7.3 - 12.1, P < 0.001). Conclusion: This study suggests that male fetuses have significantly larger head circumference (HC) and biparietal diameter (BPD) measurements compared to female fetuses. These prenatal sex-related differences are established by as early as 16 weeks of gestation and tend to increase with advancing gestational age. In the case of discrepancy finding between head (HC, BPD) and femur lenght (FL) measurements the fetal gender should be taken into account.
INTRODUCTION: In this study we detail the effect of different fixation agents and the duration of storage has on the immunohistochemical staining positivity of samples of archival embryonic and fetal tissues. MATERIALS AND METHODS: The samples were stained by indirect two-step immunohistochemistry (IHC) method for Ki-67, cyclin A and β-actin. RESULTS: Irrespective of the length of tissue archiving, tissue fixation with 10% neutral buffered formalin had better IHC intensity results in all cases when compared to methacarn-fixed tissues. In the case of β-actin, this difference was statistically significant, while differences in Ki-67 and cyclin A were not. The second aspect studied was which effect tissue block archiving duration has on the IHC reactivity. We demonstrated a statistically significant decrease in IHC positivity for all studied antigens between the samples that were archived for 10-19 or 20-45 years, regardless the fixative solution. CONCLUSION: To the best of our knowledge, the influence that the duration of tissue block archiving has on IHC positivity in human embryo and fetal tissue material has not yet been studied. Although the causes of the IHC positivity decline in archived tissue blocks are not well understood, a possible decrease in IHC over time should be considered, particularly in retrospective studies.
- MeSH
- aktiny analýza MeSH
- antigen Ki-67 analýza MeSH
- barvení a značení normy MeSH
- časové faktory MeSH
- chloroform MeSH
- cyklin A analýza MeSH
- fixace tkání metody MeSH
- fixativa MeSH
- formaldehyd MeSH
- gestační stáří MeSH
- imunohistochemie normy MeSH
- játra embryologie MeSH
- králíci MeSH
- kyselina octová MeSH
- lidé MeSH
- methanol MeSH
- myši MeSH
- placenta embryologie MeSH
- střeva embryologie MeSH
- těhotenství MeSH
- zvířata MeSH
- Check Tag
- králíci MeSH
- lidé MeSH
- myši MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
