BACKGROUND: Placenta previa is the abnormal implantation of the placenta into the lower segment of the uterus, is associated with adverse maternal and fetal outcomes such as placenta accreta spectrum disorders, antepartum and postpartum hemorrhage, fetal growth restriction, prematurity, stillbirth and neonatal death, thrombophlebitis, and septicemia. The aim of the study was to assess retrospectively how the later onset of placenta previa affects the microRNA expression profile in the whole peripheral blood during the first trimester of gestation. METHODS: Regarding the occurrence of the association between aberrant microRNA expression profiles at early stages of gestation and later onset of various pregnancy-related complications, we selected for the study pregnancies developing placenta previa as the only pregnancy-related disorder. In total, 24 singleton pregnancies diagnosed with placenta previa that underwent first-trimester prenatal screening and delivered on-site within the period November 2012-May 2018 were included in the study. Overall, 80 normal pregnancies that delivered appropriate-for-gestational age newborns after completing 37 weeks of gestation were selected as the control group based on the equality of the length of biological sample storage. RESULTS: Downregulation of multiple microRNAs (miR-20b-5p, miR-24-3p, miR-26a-5p, miR-92a-3p, miR-103a-3p, miR-130b-3p, miR-133a-3p, miR-145-5p, miR-146a-5p, miR-155-5p, miR-181a-5p, miR-195-5p, miR-210-3p, miR-342-3p, and miR-574-3p) was observed in pregnancies destined to develop placenta previa. The combination of seven microRNAs (miR-130b-3p, miR-145-5p, miR-155-5p, miR-181a-5p, miR-210-3p, miR-342-3p, and miR-574-3p) showed the highest accuracy (AUC 0.937, p < 0.001, 100.0% sensitivity, 83.75% specificity) to differentiate, at early stages of gestation, between pregnancies with a normal course of gestation and those with placenta previa diagnosed in the second half of pregnancy. Overall, 75% of pregnancies destined to develop placenta previa were correctly identified at 10.0% FPR. CONCLUSION: Consecutive large-scale analyses must be performed to verify the reliability of the proposed novel early predictive model for placenta previa occurring as the only pregnancy-related disorder.

• Klíčová slova
• first trimester screening, gene expression, microRNAs, placenta previa, prediction, whole peripheral venous blood,
• Publikační typ
• časopisecké články MeSH

AIM: The aim of this study was to determine the prevalence of maternal hypothyroidism in the first trimester from 11 to 14 weeks of gestation according to the American Thyroid Association (ATA) guidelines from 2017 and to compare the rates for singleton and twin pregnancies. METHODS: A total of 4965 consecutive Caucasian singleton pregnancies and 109 Caucasian twin pregnancies were included in the investigation. Patients with a history of thyroid gland disorder were excluded. Subclinical maternal hypothyroidism was defined as a thyroid stimulating hormone (TSH) concentration above the 97.5th percentile and free thyroxine (fT4) within the range of a reference population of women at 11-14 weeks of gestation. Overt maternal hypothyroidism was defined as a TSH concentration above the 97.5th percentile and an fT4 below the 2.5th percentile of the reference population.TSH, fT4, and anti thyroid peroxidase antibody (TPOAb) were measured by immunochemiluminescent assays on an 16200 Abbott Architect analyzer. RESULTS: The prevalence of hypothyroidism for twin pregnancies was no higher than that for singleton pregnancies; 6.42% (7/109) vs. 5.32% (264/4965), respectively; P=0.61. All twin pregnancies were subclinical. Singleton hypothyroid pregnancies included 4.91% (244 cases) of subclinical and 0.41% (20 cases) of overt hypothyroidism. The prevalence of TPOAb positive hypothyroid women for twin pregnancies and singleton pregnancies was 71% (5/7) vs. 52% (137/264 cases), respectively but the differences were not statistically significant; P=0.31. CONCLUSION: Each first trimester screening center should establish its TSH and fT4 reference ranges. Our center had higher upper reference limits of TSH than that of the universally fixed limit of 2.5 mU/L, which led to a lower measured prevalence of maternal hypothyroidism. A large number of hypothyroid women were TPOAb positive.

• Klíčová slova
• gestation, hypothyroidism, immunoassay, pregnancy, thyroid disease,
• MeSH
• dospělí MeSH
• hypotyreóza krev   diagnóza   MeSH
• imunoanalýza metody   MeSH
• jodidperoxidasa imunologie   MeSH
• komplikace těhotenství krev   diagnóza   MeSH
• lidé MeSH
• protilátky metabolismus   MeSH
• první trimestr těhotenství MeSH
• retrospektivní studie MeSH
• těhotenství s dvojčaty fyziologie   MeSH
• těhotenství MeSH
• thyreotropin metabolismus   MeSH
• thyroxin metabolismus   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• pozorovací studie MeSH
• srovnávací studie MeSH
• Názvy látek
• jodidperoxidasa MeSH
• protilátky MeSH
• thyreotropin MeSH
• thyroxin MeSH

The aim of the study was to assess if cardiovascular disease-associated microRNAs would be able to predict during the early stages of gestation (within 10 to 13 weeks) subsequent onset of hypertensive pregnancy-related complications: gestational hypertension (GH) or preeclampsia (PE). Secondly, the goal of the study was to assess if cardiovascular disease-associated microRNAs would be able to detect the presence of chronic hypertension in early pregnancies. The retrospective study was performed on whole peripheral blood samples collected from singleton Caucasian pregnancies within the period November 2012 to March 2020. The case control study, nested in a cohort, involved all women with chronic hypertension (n = 29), all normotensive women that later developed GH (n = 83) or PE with or without fetal growth restriction (FGR) (n = 66), and 80 controls selected on the base of equal sample storage time. Whole peripheral blood profiling was performed with the selection of 29 cardiovascular disease-associated microRNAs using real-time RT-PCR. Upregulation of miR-1-3p (51.72% at 10.0% FPR) was observed in patients with chronic hypertension only. Upregulation of miR-20a-5p (44.83% and 33.33% at 10.0% FPR) and miR-146a-5p (65.52% and 42.42% at 10.0% FPR) was observed in patients with chronic hypertension and normotensive women with later occurrence of PE. Upregulation of miR-181a-5p was detected in normotensive women subsequently developing GH (22.89% at 10.0% FPR) or PE (40.91% at 10.0% FPR). In a part of women with subsequent onset of PE, upregulation of miR-143-3p (24.24% at 10.0% FPR), miR-145-5p (21.21% at 10.0% FPR), and miR-574-3p (27.27% at 10.0% FPR) was also present. The combination of microRNA biomarkers (miR-20a-5p, miR-143-3p, miR-145-5p, miR-146a-5p, miR-181a-5p, and miR-574-3p) can predict the later occurrence of PE in 48.48% of pregnancies at 10.0% FPR in early stages of gestation. The combination of upregulated microRNA biomarkers (miR-1-3p, miR-20a-5p, and miR-146a-5p) is able to identify 72.41% of pregnancies with chronic hypertension at 10.0% FPR in early stages of gestation. Cardiovascular disease-associated microRNAs represent promising biomarkers with very good diagnostical potential to be implemented into the current first trimester screening program to predict later occurrence of PE with or without FGR. The comparison of the predictive results of the routine first trimester screening for PE and/or FGR based on the criteria of the Fetal Medicine Foundation and the first trimester screening for PE wo/w FGR using a panel of six cardiovascular disease-associated microRNAs only revealed that the detection rate of PE increased 1.45-fold (48.48% vs. 33.33%).

• Klíčová slova
• cardiovascular microRNAs, chronic hypertension, early gestation, expression, gestational hypertension, prediction, preeclampsia, screening, whole peripheral venous blood,
• Publikační typ
• časopisecké články MeSH

Ultrasound examination of the conceptus and the uterine blood supply between 11 and 13 weeks' gestation provides important information about the state of the pregnancy at that point in time and about its future progress. Nuchal translucency measurement in conjunction with maternal serum markers (free-beta-human chorionic gonadotropin and pregnancy-associated plasma protein-A), has been shown to be a highly effective method for screening for aneuploidy. This is further improved by the addition of other more recently discovered first trimester ultrasound markers resulting in detection rates that exceed 90% with a false positive rate of 2.5%. Many fetal structural anomalies can be detected at this gestational age. Recently described first trimester evaluation of the posterior brain (intracranial translucency (IT)) provides an effective screening tool for the presence of open neural tube defects. Doppler measurement of the pulsatility index in the uterine arteries in conjunction with maternal history and examination as well as maternal serum biochemistries helps to accurately establish the risk of developing preeclampsia.

• MeSH
• aneuploidie * MeSH
• biologické markery krev   MeSH
• chromozomální poruchy diagnóza   MeSH
• defekty neurální trubice diagnóza   MeSH
• lidé MeSH
• měření nuchální translucence MeSH
• preeklampsie diagnóza   MeSH
• prenatální diagnóza * MeSH
• první trimestr těhotenství * MeSH
• těhotenství MeSH
• ultrasonografie prenatální MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH
• Názvy látek
• biologické markery MeSH

OBJECTIVE: The oronasal cavity in humans develops during embryonic day 30-60. There are three critical periods when this process can be affected, resulting in a specific type of orofacial cleft: cleft lip (CL), cleft palate (CP), or most serious, total cleft lip+palate (CLP). We assessed whether gestational bleeding during early pregnancy might act to produce a non-specific worsening of embryo status resulting in extension of the basic cleft type (CL or CP) into more serious CLP. STUDY DESIGN: In a group of the child patients with orofacial clefts, the cleft spectrum was correlated with first trimester gestational bleeding reported by the mother. Data were also related to the gender of patients, hereditary factors and additional malformations. RESULTS: Among 2524 mothers who gave birth to babies with an orofacial cleft in the Czech Republic during 1983-2009, 253 (10.0%) had gestational bleeding. Among the children with an orofacial cleft, 497 (19.7%) had an orofacial cleft among relatives and 297 (11.8%) exhibited an additional congenital malformation. In comparison with mothers without bleeding, there was significant increase of children with CLP (p < 0.01) at the expense of children with CP, whose number significantly decreased (p < 0.01) in the bleeding mothers. In the group of children with clefts among relatives we did not find any significant change associated with bleeding. The maternal bleeding was more frequent in children with additional malformations, but this difference was not significant (p = 0.112). CONCLUSION: We hypothesize that size/extent and therefore seriousness of orofacial cleft might increase as a consequence of hypoxia resulting from gestational bleeding.

• MeSH
• kardiovaskulární komplikace v těhotenství epidemiologie   MeSH
• lidé MeSH
• první trimestr těhotenství MeSH
• rizikové faktory MeSH
• rozštěp patra epidemiologie   patologie   MeSH
• rozštěp rtu epidemiologie   patologie   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH

OBJECTIVE: To provide an overview of the etiology and early dia-gnosis of triple pregnancy, with emphasis on the possibilities of ultrasound and magnetic resonance (MR) imaging. METHODOLOGY: Processing of data from the available literature on the issue of triple pregnancy. CONCLUSION: Spontaneous triple pregnancy conception is rare. In most cases, it is a concept associated with assisted reproduction methods. Multiple pregnancy is associated with a higher incidence of complications during pregnancy and childbirth, but it also has its own specific complications. Chorionicity and amnionicity of multiple pregnancies are two important parameters in determining the strategy of dispensary care in pregnancy and management of childbirth. The use of ultrasound and MR imaging is crucial for their accurate determination in early pregnancy.

• Klíčová slova
• high-risk pregnancy, multiple pregnancy, triple pregnancy,
• MeSH
• amnion diagnostické zobrazování   MeSH
• časná diagnóza MeSH
• chorion * diagnostické zobrazování   MeSH
• lidé MeSH
• těhotenství mnohočetné MeSH
• těhotenství MeSH
• ultrasonografie prenatální * metody   MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

BACKGROUND: Soluble fms-like tyrosine kinase-1 (sFlt-1) and placental growth factor (PlGF) are used in diagnosing preeclampsia (PE), but their potential in early prediction in pregnant women at 16 to 20 weeks gestation (WG) has remained unexplored. METHODS: We retrospectively measured serum levels of sFlt-1 and PlGF in 120 pregnant women at 16 to 20 WG. Among these women, 16 had early-onset PE and 23 had late-onset PE. RESULTS: Compared with normal pregnancy values, in the serum of women in whom PE later developed, sFlt-1 values increased (P <.001), values of PlGF decreased (P = .001), and the sFlt-1/PlGF ratio increased (P <.001) as early as 16 to 20 WG. Receiver operating characteristic (ROC) curve analysis for the sFlt-1/PlGF ratio at 16 to 20 WG showed an area under the curve (AUC) value of 0.863 (95% confidence interval [CI], 0.788-0.918), P <.001, sensitivity of 74.4%, and specificity of 86.6% for PE in general; and AUC of 0.970 (95% CI, 0.913-0.994), P <.001, sensitivity of 100%, and specificity of 81.5% for early-onset PE only. Also, we determined the 5th and 95th percentiles for sFlt-1, PlGF, and sFlt-1/PlGF ratio values of healthy pregnant women. CONCLUSION: sFlt-1 and PlGF and, in particular, the sFlt-1/PlGF ratio can detect PE as early as 16 to 20 WG-as long as 10 to 15 weeks before PE onset.

• MeSH
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• placentární růstový faktor krev   MeSH
• preeklampsie krev   diagnóza   MeSH
• receptor 1 pro vaskulární endoteliální růstový faktor krev   MeSH
• retrospektivní studie MeSH
• senzitivita a specificita MeSH
• těhotenství MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mladý dospělý MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• FLT1 protein, human MeSH Prohlížeč
• PGF protein, human MeSH Prohlížeč
• placentární růstový faktor MeSH
• receptor 1 pro vaskulární endoteliální růstový faktor MeSH

The results of measurement of 17-hydroxyprogesterone (17-OH-P) in 125 samples of amniotic fluid (AF) from early amniocenteses are presented. The fetuses from all pregnancies studied were unaffected by congenital adrenal hyperphasia caused by 21-hydroxylase deficiency. The AF 17-OH-P level increases slightly but significantly between the 11th and 15th week of gestation, with a maximum in the 14th week. There is no difference between the values measured in male and female fetuses. The AF 17-OH-P levels from the early gestation were compared with those from the 16th-22nd week of pregnancy (published previously). The overall differences of AF 17-OH-P concentrations when considered in all gestational age groups in the whole period 12-22 weeks were statistically insignificant. Thus, the biochemical prenatal diagnosis of congenital adrenal hyperplasia due to 21-hydroxylase deficiency and control of its early fetal treatment could be carried out starting from the end of the first trimester in the same way as at the later period of gestation.

• MeSH
• 17-alfa-hydroxyprogesteron MeSH
• druhý trimestr těhotenství metabolismus   MeSH
• gestační stáří MeSH
• hydroxyprogesterony metabolismus   MeSH
• interval spolehlivosti MeSH
• kongenitální adrenální hyperplazie diagnóza   MeSH
• lidé MeSH
• plodová voda metabolismus   MeSH
• prenatální diagnóza MeSH
• první trimestr těhotenství metabolismus   MeSH
• referenční hodnoty MeSH
• sexuální faktory MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• 17-alfa-hydroxyprogesteron MeSH
• hydroxyprogesterony MeSH

• Klíčová slova
• POSTOPERATIVE CARE *, PUERPERIUM *,
• MeSH
• časné pohybování * MeSH
• lidé MeSH
• pooperační péče * MeSH
• poporodní období * MeSH
• porodní děj * MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

OBJECTIVE: Draw attention to the possibility to use ultrasonographic examination to predict abortion in the 1st trimester of gestation. DESIGN: Review. SETTING: Institute for the Care of Mother and Child, Prague. SUBJECT AND METHOD: Review article on possibilities of ultrasonographic examination to predict abortion during the first trimester of gestation. The article is divided according to the images of different extraembryonic and embryonic structures which may be important for prediction of abortion during the first trimester of gestation. Illustrations are from the author's own observations. CONCLUSION: The presented review draws attention to the possible use of transvaginal ultrasonography in prediction of gestational complications in early stages of the first trimester of gestation. Abnormalities in the size and shape of some embryonic and extraembryonic structures make it possible to detect early complications, still in the stages of embryogenesis, which may lead to early gestational loss.

• MeSH
• extraembryonální obaly diagnostické zobrazování   MeSH
• lidé MeSH
• plod MeSH
• první trimestr těhotenství MeSH
• samovolný potrat diagnostické zobrazování   MeSH
• srdeční frekvence plodu MeSH
• těhotenství MeSH
• ultrasonografie prenatální * MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• přehledy MeSH