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Am J Reprod Immunol 2021 May 2:e13437. Epub 2021 May 2.

Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany.

Background: Maternal immunological rejection of the semi-allogenic fetus is discussed as one of the significant factors involved in early pregnancy loss. An array of cytokines secreted by both maternal and fetal cells is involved in generating a delicate maternal immune tolerance. Interleukin 7 (IL-7) is discussed to play a key role in pro-inflammatory processes, but there is still limited insight into the pathophysiological input on placentation and embryonic development in early pregnancy loss. Read More

Lancet 2021 May 27;397(10285):1675-1682. Epub 2021 Apr 27.

Division of Biomedical Sciences, Warwick Medical School, University of Warwick, Warwick, UK; Tommy's National Centre for Miscarriage Research, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.

Women who have had repeated miscarriages often have uncertainties about the cause, the likelihood of recurrence, the investigations they need, and the treatments that might help. Health-care policy makers and providers have uncertainties about the optimal ways to organise and provide care. For this Series paper, we have developed recommendations for practice from literature reviews, appraisal of guidelines, and a UK-wide consensus conference that was held in December, 2019. Read More

Reprod Biomed Online 2021 Feb 28. Epub 2021 Feb 28.

Pregnancy Loss Research Group, Department of Obstetrics and Gynaecology, University College Cork, Cork T12 DC4A, Ireland; The Irish Centre for Maternal and Child Health, University College Cork, Cork University Maternity Hospital, Cork T12 DC4A, Ireland; College of Medicine and Health, University College Cork Cork T12 EKDO, Ireland.

Recurrent miscarriage affects 1-2% of women of reproductive age, depending on the definition used. A systematic review was conducted to identify, appraise and describe clinical practice guidelines (CPG) published since 2000 for the investigation, management, and/or follow-up of recurrent miscarriage within high-income countries. Six major databases, eight guideline repositories and the websites of 11 professional organizations were searched to identify potentially eligible studies. Read More

Int J Obstet Anesth 2021 Mar 29:102985. Epub 2021 Mar 29.

Department of Anaesthesia and Pain Medicine, King Edward Memorial Hospital, Perth, WA, Australia.

Antepartum anemia impacts over a third of pregnant women globally and is associated with major maternal and perinatal morbidity, including peripartum transfusion, maternal death, maternal infection, preterm birth, and neurodevelopmental disorders among offspring. Postpartum anemia impacts up to 80% of women in low-income and rural populations and up to 50% of women in Europe and the United States, and is associated with postpartum depression, fatigue, impaired cognition, and altered maternal-infant bonding. Iron deficiency is the most common cause of maternal anemia because of insufficient maternal iron stores at the start of pregnancy, increased pregnancy-related iron requirements, and iron losses due to blood loss during parturition. Read More

Ultrasound Obstet Gynecol 2021 Apr 10. Epub 2021 Apr 10.

Harris Birthright Research Centre of Fetal Medicine, King's College Hospital, London, UK.

Objective: To expand the limited knowledge on cell-free (cf)DNA analysis of maternal blood for trisomies 21, 18 and 13 in twin pregnancies by updating the data from the Fetal Medicine Foundation (FMF) on prospective first trimester screening and those arising from systematic review of the literature.

Methods: The FMF data were derived from prospective screening for trisomies 21, 18 and 13 in twin pregnancies at 10 -14 weeks' gestation using the Harmony® prenatal test of Roche/Ariosa Diagnostics, Inc. Search of Medline, Embase, CENTRAL (The Cochrane Library), ClinicalTrials. Read More

J Matern Fetal Neonatal Med 2021 Apr 5:1-7. Epub 2021 Apr 5.

Laboratory of Pharmacology, Faculty of Medicine, Democritus University of Thrace, Alexandroupolis, Greece.

Objective: The aim of this study was to examine the role of growth factors associated with angiogenesis and oxidative stress in the pathogenesis of spontaneous miscarriage.

Methods: We performed a comparative mRNA expression analysis of VEGF, PlGF, Flt-1, Angiogenin and Endoglin using Real-Time PCR, in the placenta and decidua collected from 12 patients presenting with spontaneous abortion and from 14 women undergoing induced abortion, during the first and second trimester of pregnancy.

Results: The mRNA expression of Flt-1 was significantly upregulated in the placenta of spontaneous abortions (5. Read More

Brain Sci 2021 Mar 4;11(3). Epub 2021 Mar 4.

Department of Psychological & Brain Sciences, University of Delaware, Newark, DE 19716, USA.

Alcohol exposure (AE) during the third trimester of pregnancy-a period known as the brain growth spurt (BGS)-could result in a diagnosis of a fetal alcohol spectrum disorder (FASD), a hallmark of which is impaired executive functioning (EF). Coordinated activity between prefrontal cortex and hippocampus is necessary for EF and thalamic nucleus reuniens (Re), which is required for prefrontal-hippocampal coordination, is damaged following high-dose AE during the BGS. The current experiment utilized high-dose AE (5. Read More

Int J Mol Sci 2021 Mar 13;22(6). Epub 2021 Mar 13.

Department of Biophysics and Human Physiology, Faculty of Health Sciences, Warsaw Medical University, 02-091 Warsaw, Poland.

Tumor necrosis factor-alpha (TNF-α) is a multifunctional Th1 cytokine and one of the most important inflammatory cytokines. In pregnancy, TNF-α influences hormone synthesis, placental architecture, and embryonic development. It was also shown that increased levels of TNF-α are associated with pregnancy loss and preeclampsia. Read More

Acta Obstet Gynecol Scand 2021 Apr 2. Epub 2021 Apr 2.

Department of Obstetrics and Gynecology, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan.

Introduction: Women who have undergone radical trachelectomy as a fertility-sparing treatment for early-stage cervical cancer may be at higher risk for retained tissues after early-term miscarriage due to cervical cerclage or cervical necrosis. Dilatation and curettage or aspiration may present additional risks in these women. The aim of this study was to assess the efficacy of expectant management for early pregnancy miscarriage after radical trachelectomy. Read More

Am J Obstet Gynecol MFM 2021 Mar 22:100355. Epub 2021 Mar 22.

Child Population and Translational Health Research, Children's Hospital at Westmead Clinical School, The University of Sydney, Sydney NSW, Australia; Department of Maternal Fetal Medicine Royal Hospital for Women, Randwick NSW Australia; Department of Maternal Fetal Medicine, Royal North Shore Hospital, St Leonards NSW, Australia.

Congenital cytomegalovirus (cCMV) is caused by maternal primary or nonprimary infection during pregnancy and is a major preventable cause of neurodisability. Proposed strategies to reduce cCMV include primary prevention with maternal hygiene measures and secondary prevention by serological screening for the detection of maternal primary infection. A recent randomised trial found that high dose valaciclovir treatment resulted in a significant reduction in fetal infection after first trimester maternal primary infection, leading to calls to commence routine serological screening in pregnancy. Read More

Eur J Obstet Gynecol Reprod Biol 2021 May 17;260:114-117. Epub 2021 Mar 17.

Department of Obstetrics and Gynecology, Ministry of Health Ankara City Hospital, Ankara, Turkey.

Objective: To measure serum levels of podocalyxin (PODXL) in recurrent miscarriages as a marker of vascular endothelial dysfunction.

Study Design: In this case-control study, women who were hospitalized for singleton first-trimester pregnancy terminations due to missed abortion, anembryonic pregnancy, and inevitable abortion were included. There were 24 patients who were admitted for the first pregnancy termination, 39 patients who were admitted for recurrent pregnancy loss (RPL), and 25 fetal cardiac activity positive patients as the control group. Read More

JMIR Mhealth Uhealth 2021 03 16;9(3):e22147. Epub 2021 Mar 16.

Department of Obstetrics and Gynecology, National University Hospital, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Background: Women with a history of gestational diabetes mellitus (GDM) are at an increased risk of developing type 2 diabetes mellitus (T2DM). Lifestyle interventions aimed at postpartum weight loss to reduce T2DM risk have been reported, but poor compliance remains a barrier. Smartphone-based interventions may improve compliance, but data on its use in women with recent GDM are limited. Read More

Womens Health (Lond) 2021 Jan-Dec;17:1745506521999495

Department of Neurology, Faculty of Medicine, P.J. Šafarik University and University Hospital L. Pasteur, Košice, Slovakia.

Introduction: There is an ongoing debate about the use of recombinant tissue plasminogen activator in acute stroke during pregnancy. The aim of our case report is to present that even in a small stroke centre intravenous thrombolysis can be used on a pregnant woman if the benefit outweighs the risk and to summarize the diagnostic workup in a pregnant woman with stroke.

Case Report: Our case describes a 31-year-old woman presenting in her third trimester with a sudden onset of slurred speech, severe right hemiparesis, facial nerve central palsy, eyes deviation to the left, right side hemianopia, hemisensory loss, psychomotor agitation and pain in the right lower limb. Read More

J Matern Fetal Neonatal Med 2021 Mar 8:1-8. Epub 2021 Mar 8.

Department of Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China.

Objective: To observe the lacunar-like changes in cesarean scar pregnancy (CSP) ultrasonography in first trimester and to explore its relationship with clinical outcome in early pregnancy termination.

Methods: This is a retrospective case-control study. Patients who were diagnosed as CSP and chose to terminate pregnancy from January 2017 to April 2020 were enrolled. Read More

PLoS One 2021 8;16(3):e0247573. Epub 2021 Mar 8.

Department of Anatomy, College of Medicine, University of Ibadan, Ibadan, Nigeria.

Kola nut (from Cola nitida) is popular in Nigeria and West Africa and is commonly consumed by pregnant women during the first trimester to alleviate morning sickness and dizziness. There is, however, a dearth of information on its effects on the developing brain. This study, therefore, investigated the potential effects of kola nut on the structure of the developing neonatal and juvenile cerebellum in the rat. Read More

Parasit Vectors 2021 Mar 2;14(1):132. Epub 2021 Mar 2.

Department of Parasitology, Institute of Functional Biology and Ecology, Faculty of Biology, University of Warsaw, 1 Miecznikowa Str, 02-096, Warsaw, Poland.

Background: Protozoa in the genus Babesia are transmitted to humans through tick bites and cause babesiosis, a malaria-like illness. Vertical transmission of Babesia spp. has been reported in mammals; however, the exact timing and mechanisms involved are not currently known. Read More

J Womens Health (Larchmt) 2021 Mar 1. Epub 2021 Mar 1.

Department of Women's Health, Dell Medical School, The University of Texas at Austin, Texas, USA.

Pregnancy loss is the most common complication of pregnancy and understanding the needs of individuals experiencing pregnancy loss will help the medical team provide patient-centered care. Few studies address differences in needs of individuals regarding timing of pregnancy losses and number of losses. An anonymous nine-question survey assessing the experience and immediate needs of individuals who have had pregnancy loss. Read More

J Hum Reprod Sci 2020 Oct-Dec;13(4):340-348. Epub 2020 Dec 28.

Human Genetics Department, Medical Research Institute, Alexandria University, Alexandria, Egypt.

Background: Recurrent pregnancy loss (RPL) is a major reproductive health issue, affecting 2%-5% of couples. Genetic factors, mainly chromosomal abnormalities, are the most common cause of early miscarriage accounting for 50%-60% of first trimester abortion.

Aim: To estimate the prevalence and nature of chromosomal anomalies in couples with recurrent miscarriage. Read More

J Racial Ethn Health Disparities 2021 Feb 23. Epub 2021 Feb 23.

Institute for Women's Health, Virginia Commonwealth University, Richmond, VA, USA.

Background: In the USA, infant mortality remains a major public health concern, particularly for Black women and their infants who continue to experience disproportionately high mortality rates. Prenatal care is a key determinant of infant health, with inadequate prenatal care increasing risk for prematurity, stillbirth, neonatal loss, and infant death. The aim of the present study was to determine if concurrent delivery of patient navigation and behavioral incentives to at-risk Black pregnant women could improve prenatal care attendance and associated maternal and infant outcomes. Read More

Front Cell Dev Biol 2021 4;9:607332. Epub 2021 Feb 4.

Department of Reproductive Endocrinology, School of Medicine, Women's Hospital, Zhejiang University, Hangzhou, China.

Embryo implantation and trophoblast invasion are principal limiting factors of pregnancy establishment. Aberrant embryo development or improper trophoblast differentiation and invasion may lead to various unfavorable pregnancy-related outcomes, including early pregnancy loss (EPL). Our clinical data show that the serum BMP2 levels were significantly increased during the first trimester of pregnancy and that the serum and BMP2 expression levels were lower in women with EPL than in women with normal early pregnancies. Read More

Trop Biomed 2020 Dec;37(4):1038-1049

Section of Parasitology, Department of Zoology, Aligarh Muslim University, Aligarh, India.

Toxoplasma gondii is a protozoan parasite that can infect all mammals, serving as intermediate hosts. The cause of congenital toxoplasmosis is transplacental transmission of the parasite to the foetus, resulting in wide range of manifestations from mild chorioretinitis to miscarriage. Its frequency can be reduced by early screening of pregnant women which is based mainly on tests for anti-Toxoplasma antibodies. Read More

Placenta 2021 03 14;106:25-29. Epub 2021 Feb 14.

Department of Obstetrics and Gynecology, Turkish Ministry of Health, Ankara City Hospital, Ankara, Turkey; University of Health Sciences, Istanbul, Turkey. Electronic address:

Introduction: The possibility of vertical transmission of SARS-CoV-2 from the mother to the fetus is one of the most crucial issues regarding the COVID-19 effects on pregnancy. In this study, we aimed to explore the risk of maternal-fetal transmission before 24 weeks of gestation, through analysis of abortion materials collected from PCR-positive women with pregnancy loss. To the best of our knowledge, apart from case reports, this study is the first prospective work on the vertical transmission of SARS-CoV-2 in early pregnancy. Read More

BMC Pregnancy Childbirth 2021 Feb 20;21(1):154. Epub 2021 Feb 20.

Nuffield Department of Primary Care Health Sciences, University of Oxford, Radcliffe Primary Care Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford, OX2 6GG, UK.

Background: Excess gestational weight gain is common and an important risk factor for adverse pregnancy outcomes. Regular weighing can be used to assess and manage weight gain, but NICE guidelines do not recommend routine weighing during antenatal care. Trials that have tested the effectiveness of self-weighing to manage GWG have been unsuccesful in engaging women in regular self-weighing, although the reasons for lack of engagement are not fully understood. Read More

J Family Reprod Health 2020 Jun;14(2):81-87

Cellular and Molecular Research Centre, Qazvin University of Medical Sciences, Qazvin, Iran.

The purpose of this study was comparison of association of three main first trimester screening factors with pregnancy outcomes among Iranian pregnant women. This prospective study was done during 2017-2019 years in Qazvin, Iran. To do so, a total of 1500pregnant women in first trimester were enrolled. Read More

Sci Rep 2021 Feb 11;11(1):3568. Epub 2021 Feb 11.

Department of Health Sciences, Karlstad University, Karlstad, Sweden.

Many first trimester sporadic miscarriages are unexplained and the role of environmental exposures is unknown. The present aim was to study if levels of Perfluoroalkyl substances (PFASs) in early pregnancy are associated with unexplained, sporadic first trimester miscarriage. The study was performed within the Swedish SELMA pregnancy cohort. Read More

FASEB J 2021 Mar;35(3):e21351

Shanghai Key Laboratory of Female Reproductive Endocrine Related Diseases, Obstetrics and Gynecology Hospital, Fudan University, Shanghai, People's Republic of China.

Autophagy plays an important role in the normal development and function of trophoblast cells and is precisely regulated during pregnancy. Dysregulated autophagy contributes to the abnormal proliferation of trophoblasts, which is closely related to the occurrence of pregnancy-related diseases. Placenta specific 8 (PLAC8, Onzin) is a multifaceted protein proven to promote autophagy and potentiate various tumor progression. Read More

J Reprod Immunol 2021 04 30;144:103283. Epub 2021 Jan 30.

Department of Obstetrics and Gynecology, University Hospital Munich, LMU Munich, Germany.

Background: Pregnancy is an extraordinarily complex immunological process. For successful pregnancy maintenance the maternal immune system must adapt to and tolerate the semi-allogenic fetus at the fetomaternal interface of the placenta. This balance is regulated by cytokines with a predominant T helper 2 (Th-2) system and a suppressed inflammatory T helper 1 (Th-1) response. Read More

JAAPA 2021 03;34(3):22-27

Toni Jackson is an assistant professor in the PA program at Wake Forest University School of Medicine in Winston-Salem, N.C. At the time this article was written, she was an assistant professor in the PA program at High Point (N.C.) University. Elyse Watkins is an associate professor in the PA program at the University of Lynchburg in Lynchburg, Va., and an assistant clinical professor in the PA program at Florida State University in Tallahassee, Fla. The authors have disclosed no potential conflicts of interest, financial or otherwise.

Abstract: Previously called spontaneous abortion, early pregnancy loss (EPL) is the preferred term encompassing threatened abortion, incomplete abortion, complete abortion, and anembryonic pregnancy. EPL has many causes, including chromosomal abnormalities, immunologic and infectious causes, and underlying maternal risk factors. Because many patients present with first-trimester bleeding, clinicians must know the appropriate evaluation and management techniques. Read More