Epithelial cells lining the vagina are major components of genital tract immunity. The influence of the vaginal microbiome on properties of host epithelial cells is largely unexplored. We evaluated whether differences in the most abundant lactobacilli species or bacterial genera in the vagina of first trimester pregnant women were associated with variations in the extent of stress and autophagy in vaginal epithelial cells. Read More
Cellular Reprogramming and Embryo Biotechnology Laboratory, Dental Research Institute, BK21, Seoul National University School of Dentistry, Seoul, Republic of Korea.
Although assisted reproductive technology (ART) currently exists, the only embryo preservation technology that is available is cryopreservation. In the present study, small molecules were used to hold embryos at room temperature. The basic medium for embryo holding for a short period of time at 4 °C, 10 °C and 20 °C consisted of 1% BSA non-cryopreservation medium (BNC) instead of fetal bovine serum. Read More
Chlamydia trachomatis is an obligate intracellular bacterium whose only natural host is man. Although asymptomatic in most women, genital tract chlamydial infections are a leading cause of pelvic inflammatory disease, tubal factor infertility and ectopic pregnancy. C. Read More
Front Med (Lausanne) 2017 25;4:117. Epub 2017 Jul 25.
Department of Microbiology, Panjab University, Chandigarh, India.
Malaria in pregnancy poses a great health risk to mother and her fetus and results into complications, such as abortion, still birth, intra uterine growth retardation, and low birth weight. The heavy infiltration of Plasmodium falciparum-infected RBCs in the intervillous spaces of placenta seems to be responsible for all the complications observed. Infected RBCs in the placenta cause an inflammatory environment with increase in inflammatory cells and cytokines which is deleterious to the placenta. Read More
Introduction: Subcapital femoral neck fractures are associated with high morbidity and mortality. These fractures mostly occur as a result of a high-force impact from traffic accidents and a fall from a great height, though non-traumatic forms are described in transient osteoporosis during the second half of pregnancy, in convulsions during electric shock, eclampsia, hypocalcemia, osteomalacia, renal osteodystrophy and myeloma.
Case Report: In this report we present a bilateral subcapital femoral neck fracture in a woman sustained two days after delivery. Read More
Splenic ectopic pregnancy refers to the implantation of the oosperm in the spleen. If not diagnosed early, the results of this phenomenon would almost certainly be splenic rupture, which is equivalent to the spontaneous rupture of the spleen. If the patient has no history of trauma, it is difficult to diagnose this condition early and an explicit diagnosis is often obtained by exploratory laparotomy. Read More
Group A streptococcal (GAS) toxic shock syndrome (TSS) is a rare life-threatening illness. Most reported cases have occurred in the post-partum period. Here, we report a rare case of a primigravid who developed GAS TSS in the third trimester. Read More
More than 70 years ago, the phenomenon of "postural shock" in the supine position was described in healthy women in late pregnancy. Since then, avoidance of the supine position has become a key component of clinical practice. Indeed, performing pelvic tilt in mothers at term to avoid aortocaval compression is a universally adopted measure, particularly during cesarean delivery. Read More
Takotsubo syndrome (TTS) is an acute and reversible heart failure syndrome, usually occurring in females but rarely in the peripartum period. In women with a history of peripartum TTS, it is unclear how to manage subsequent pregnancies. A 39-year-old female with a history of peripartum TTS complicated by cardiogenic shock became pregnant again. Read More
Peripartum cardiomyopathy (PPCM) is an idiopathic cardiomyopathy presenting with heart failure due to left ventricular systolic dysfunction towards the end of pregnancy or in the months following delivery, where no other cause of heart failure is found. We report a case of a woman with PPCM who developed a critical cardiogenic shock with repeated cardiopulmonary resuscitation. We show for the first time that mechanical circulatory support combined with high-dose bromocriptine therapy to suppress systemic prolactin levels may serve as an effective therapeutic option in patients with fulminant PPCM and cardiogenic shock. Read More
Aim: To evaluate outcome of acute management and risk of rebleeding in patients with massive hemorrhage due to hepatocellular adenoma (HCA).
Methods: This retrospective cohort study included all consecutive patients who presented to our hospital with massive hemorrhage (grade II or III) due to ruptured HCA and were admitted for observation and/or intervention between 1999-2016. The diagnosis of HCA was based on radiological findings from contrast-enhanced magnetic resonance imaging (MRI) or pathological findings from biopsy or resection of the HCA. Read More
We report a fatal case of post-partum streptococcal toxic shock syndrome in a patient who was previously healthy and had presented to the emergency department with an extensive blistering ecchymotic lesions over her right buttock and thigh associated with severe pain. The pregnancy had been uncomplicated, and the mode of delivery had been spontaneous vaginal delivery with an episiotomy. She was found to have septicemic shock requiring high inotropic support. Read More
Background: Ectopic pregnancy is the leading cause of pregnancy related deaths in the first trimester. The aim of this study was to evaluate the frequency of risk factors, clinical presentation, diagnostic methods and site of ectopic pregnancy.
Methods: This descriptive cross sectional study was conducted in Gynaecology and Obstetrical Unit-A of Ayub Teaching Hospital Abbottabad from 1st October 2013 to 31st October 2015. Read More
A case of a 37-year-old female primagravida who attended the emergency department (ED) via ambulance in hypotensive shock. She was 10 weeks pregnant, but had an inevitable miscarriage confirmed in the local Early Pregnancy Unit 3 weeks previously. She was hypotension (90/60â€‰mm Hg), bradycardic (45 bpm) and was peripherally shut down. Read More
Uterine fibroids in pregnancy present with numerous complications. However, spontaneous rupture is a rare and potentially life-threatening event. We report a case of a 43-year-old multiparous woman who presented with hypovolemic shock secondary to a ruptured uterine fibroid 2 days after a spontaneous vaginal delivery. Read More
Salmonella Typhi can be a significant cause of morbidity and mortality in pregnant females with adverse outcomes. Risk of infections increases manifold during pregnancy due to hormonal changes and immunological phenomena. S. Read More
SOMANZ (Society of Obstetric Medicine Australia and New Zealand) has written a guideline to provide evidence-based guidance for the investigation and care of women with sepsis in pregnancy or the postpartum period. The guideline is evidence-based and incorporates recent changes in the definition of sepsis. The etiology, investigation and treatment of bacterial, viral and non-infective causes of sepsis are discussed. Read More
Introduction: Even decades after the development of effective low-cost antibiotics, sepsis persists as the foremost cause of preventable maternal death worldwide. In developing countries like India, where the paramount impediment to intervention is poverty, maternal mortality due to sepsis is a continuing representation of maternal health inequality.
Aim: To determine the incidence, risk factors and mortality in women presenting with puerperal sepsis in a tertiary care health facility in India. Read More
Vascular dysfunction has been reported in women with recurrent pregnancy loss (RPL). We investigated the severity of vascular dysfunction in non-pregnant women with RPL and its correlation with anti-heat shock protein (HSP) antibodies that are known to induce arteriosclerosis. We measured the serum anti-HSP60 antibodies, anti-HSP70 antibodies, and anti-phospholipid antibodies (APA) in 68 women with RPL and 29 healthy controls. Read More
MCN Am J Matern Child Nurs 2017 Jul/Aug;42(4):194-198
Sheryl E. Parfitt is a Clinical Educator, HonorHealth Scottsdale Shea Medical Center, Scottsdale, AZ. The author can be reached via e-mail at Mary L. Bogat is a Staff Nurse, HonorHealth Scottsdale Shea Medical Center, Scottsdale, and Clinical Instructor, Scottsdale Community College, Scottsdale, Arizona State University, Tempe, AZ. Sandra L. Hering is a Informatics Support Specialist, HonorHealth Scottsdale Shea Medical Center, Scottsdale, AZ. Cheryl Roth is a Nurse Practitioner, HonorHealth Scottsdale Shea Medical Center, Scottsdale, AZ.
In spite of many medical breakthroughs, sepsis continues to be challenging to identify, treat, and successfully resolve, including among the obstetric population. Sepsis is the result of an overactive, complex inflammatory response that is not completely understood. Currently there are no nationally agreed-upon criteria for systemic inflammatory response syndrome or sepsis in pregnant or peripartum women, as the physiologic changes of pregnancy have not been taken into consideration. Read More
p23 is a small acidic protein with intrinsic molecular chaperone activity. It is best known as a co-chaperone of the major cytosolic molecular chaperone Hsp90. p23 binds the N-terminus of Hsp90 and stabilizes the ATP-bound and N-terminally closed Hsp90 dimer. Read More
Objective: To evaluate the effect of endoplasmic reticulum stress in trophocytes, in patients with intrahepatic cholestasis of pregnancy (ICP). Methods: Sixty-one pregnant women who were hospitalized in Women's Hospital, School of Medicine, Zhejiang University from January to December 2015 were recruited. Thirty-one women who were diagnosed as ICP were defined as the ICP group and 30 healthy pregnant women were defined as the control group. Read More
Females show a varying degree of ischemic sensitivity throughout their lifespan, which is not fully explained by hormonal or genetic factors. Epidemiological data suggest that sex-specific life experiences such as pregnancy increase stroke risk. This work evaluated the role of parity on stroke outcome. Read More
Objective: To assess outcomes among pregnant women diagnosed with dengue infection.
Methods: In a retrospective study, the medical records of all pregnant women with dengue infection admitted to Safdarjung Hospital, New Delhi, India, from July to December 2015 were reviewed. Maternal and fetal outcomes were compared by pregnancy length and stage of disease at diagnosis. Read More
Successful implantation is dependent on the appropriate decidualization of endometrial stromal cells for the establishment of pregnancy in women. Mycobacterial heat shock protein 65 (HSP65) is involved in pathogenesis of the genital tuberculosis (GTB), one of the common causes of infertility in emerging countries. Though implantation failure appears to be the major cause, understanding the status of decidualizaiton process in women diagnosed with GTB has not been thoroughly addressed. Read More
Candidate in sociology at Goldsmiths, University of London, UK.
Chile allows abortion under no circumstances. Whether it's fetal anomaly incompatible with life or congenital malformation resulting in little or no life expectancy, all Chilean women are expected to carry their pregnancies to term. In this context, in January 2015 the Chilean Congress began debating a bill to legalize abortion on three grounds, including fatal congenital malformation. Read More
Hypertension 2017 Aug 12;70(2):390-400. Epub 2017 Jun 12.
From the Biochemistry, Structural and Stem Cell Biology, Graduate Biomedical Sciences (J.A.L.), Division of Molecular and Translational Biomedicine, Department of Anesthesiology and Perioperative Medicine (J.A.L., M.A.C., A.L., S.A., S.D., S.M.), Division of Neonatology, Department of Pediatrics (C.R., N.A., T.J.), Division of Cardiovascular Disease, Department of Medicine (W.E.B., L.D.), and Cellular and Molecular Pathology, Department of Pathology (R.P.P.), University of Alabama at Birmingham; and Department of Biochemistry and Molecular Biology and Center for Cardiovascular Research, Saint Louis University, MO (D.A.F.).
Inhalation of oxidant gases has been implicated in adverse outcomes in pregnancy, but animal models to address mechanisms and studies to identify potential pregnancy-specific therapies are lacking. Herein, we show that inhalation of bromine at 600 parts per million for 30 minutes by pregnant mice on the 15th day of embryonic development results in significantly lower survival after 96 hours than an identical level of exposure in nonpregnant mice. On the 19th embryonic day, bromine-exposed pregnant mice have increased systemic blood pressure, abnormal placental development, severe fetal growth restriction, systemic inflammation, increased levels of circulating antiangiogenic short fms-like tyrosine kinase-1, and evidence of pulmonary and cardiac injury. Read More
Group A streptococci infection has re-emerged since the 1980s and onward, despite the awareness of the etiology and the use of penicillin. It now accounts for more than 75,000 deaths worldwide every year. Postpartum women have a 20-fold increased incidence of group A streptococci disease compared to non-pregnant women. Read More
School of Population and Public Health (Muraca, Lisonkova, Joseph); Department of Obstetrics & Gynaecology (Muraca, Sabr, Lisonkova, Skoll, Cundiff, Joseph); Department of Statistics (Brant), The University of British Columbia, Vancouver, BC; Department of Obstetrics and Gynaecology (Sabr), King Saud University, Riyadh, Saudi Arabia.
Background: Increased use of operative vaginal delivery (i.e., forceps or vacuum application), of which 20% occurs at midpelvic station, has been advocated to reduce the rate of cesarean delivery. Read More
Pregnant women represent a small subset of all intensive care unit (ICU) admissions and may require intensive care for "obstetric" or "nonobstetric" reasons. Women may be admitted to the ICU at any stage of pregnancy or in the postpartum period. Pregnancy may be discovered at the time of admission to the ICU. Read More
Reprod Health 2017 May 30;14(1):67. Epub 2017 May 30.
UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), Department of Reproductive Health and Research, World Health Organization, Geneva, Switzerland.
Background: There is a need for a clear and actionable definition of maternal sepsis, in order to better assess the burden of this condition, trigger timely and effective treatment and allow comparisons across facilities and countries. The objective of this study was to review maternal sepsis definitions and identification criteria and to report on the results of an expert consultation to develop a new international definition of maternal sepsis.
Methods: All original and review articles and WHO documents, as well as clinical guidelines providing definitions and/or identification criteria of maternal sepsis were included. Read More
Objective: Spontaneous heterotopic triplets, a tubal ectopic pregnancy and a twin pregnancy, are rare disorders. The study aimed to examine all available evidence regarding signs and symptoms, imaging findings, management and newborn outcome of spontaneous heterotopic triplets.
Design: A literature search in Medline and EMBASE databases from 2000 to 2016 was conducted. Read More
Primary splenic pregnancy, a type of abdominal pregnancy, is very rare and potentially life-threatening, particularly without an accurate preoperative diagnosis. Herein we describe the case of a 27-year-old woman who had primary splenic pregnancy with hemorrhagic shock due to spleen rupture, who was successfully treated by laparotomy. Read More
The differential diagnosis of acute abdominal pain in pregnancy is broad and can be complicated by atypical manifestations that are due to the anatomic distortions and physiologic changes of pregnancy. Due to the lack of clinical understanding, angular pregnancy does not appear to be recognized as a clinical entity and many cases are likely to go undiagnosed. This is a case report of a 34-year-old woman who was referred to the obstetrics emergency department with sudden abdominal pain and in a state of hypovolemic shock. Read More
Background: Puerperal uterine inversion is a rare, potentially life-threatening obstetrical emergency. The current literature consists of small case series and a single nationwide study from Europe with only 15 cases.
Objective: We aimed to define the incidence, temporal trends, and outcomes in women with uterine inversion using a nationally representative US cohort. Read More
Ras homolog gene family, member A (RhoA) is widely expressed throughout the female reproductive system. To assess its role in progesterone receptor-expressing cells, we generated RhoA conditional knockout mice RhoAd/d (RhoAf/f-Pgr-Cre+/-). RhoAd/d female mice had comparable mating activity, serum luteinizing hormone, prolactin, and estradiol levels and ovulation with control but were infertile with progesterone insufficiency, indicating impaired steroidogenesis in RhoAd/d corpus luteum (CL). Read More
The post-traumatic nightmare is the reliving of traumatic scenes during sleep and is linked to post-traumatic stress disorder. Unlike other forms of dreams, it can happen at any stage of sleep, invasively, and makes the person relive their traumatic scenario, which can plunge them into a state of terror and shock. Post-traumatic nightmares thereby maintain and reactivate the traumatic memory. Read More
Thermal stress in India is one of the major constraints affecting dairy cattle productivity. Every attempt should be made to ameliorate the heat and calving related stress in high producing dairy cows for higher economic returns. In the current study, inorganic zinc was tried to alleviate the adverse effects of thermal stress in periparturient cows. Read More
Progesterone synthesis in human placenta is essential to maintain pregnancy. The limiting step in placental progesterone synthesis is cholesterol transport from the cytoplasm to the inner mitochondrial membrane. Multiple proteins located in mitochondrial contact sites seem to play a key role in this process. Read More
Background: Maternal mortality and morbidity are the priority agenda for sub-Saharan Africa including Ethiopia. Uterine rupture is the leading cause of maternal and fetal death in developing countries. Limited evidence is available on the magnitude of uterine rupture; maternal and fetal outcomes of uterine rupture and factors associated with maternal death secondary to uterine rupture in Ethiopia. Read More
MCN Am J Matern Child Nurs 2017 Jul/Aug;42(4):206-209
Sheryl E. Parfitt is a Clinical Educator, HonorHealth Scottsdale Shea Medical Center, Scottsdale, AZ. The author can be reached via e-mail at Mary L. Bogat is a Staff Nurse, HonorHealth Scottsdale Shea Medical Center, Scottsdale; Clinical Instructor, Scottsdale Community College, Scottsdale and Arizona State University, Tempe, AZ. Cheryl Roth is a Nurse Practitioner, HonorHealth Scottsdale Shea Medical Center, Scottsdale, AZ.
Sepsis during pregnancy is one of the five leading causes of maternal mortality worldwide. Early recognition and prompt treatment of maternal sepsis is necessary to improve patient outcomes. Patient education on practices that reduce infections may be helpful in decreasing rates of sepsis. Read More
Background: Gastroschisis, a birth defect of the abdominal wall, is increasing in prevalence. The largest increase in prevalence has been observed among young mothers (<20 years). The prevalence of Chlamydia trachomatis (CT) infection is highest among young women and has also been increasing over time. Read More
Induction of the 70 kDa heat shock protein (hsp70) and autophagy are two major mechanisms that promote cell homeostasis during the rapid cell growth and differentiation characteristic of reproduction. Hsp70 insures proper assembly, conformation, and intracellular transport of nascent proteins. Autophagy removes from the cytoplasm proteins, other macromolecules, and organelles that are no longer functional or needed and recycles their components for synthesis of new products under nutritionally limiting conditions. Read More
The small heat shock protein B (HSPB) family is comprised of eleven members with many being induced by physiological stressors. In addition to being molecular chaperones, it is clear these proteins also play important roles in cell death regulation, cytoskeletal rearrangements, and immune system activation. These processes are important for the uterine smooth muscle or myometrium during pregnancy as it changes from a quiescent tissue, during the majority of pregnancy, to a powerful and contractile tissue at labor. Read More
Background: Invasive group A streptococci infections in pregnancy have historically led to severe maternal and neonatal morbidity and mortality. We are reporting a rare and novel case of successful treatment of third-trimester group A streptococci infection with early, aggressive intervention and maintenance of the pregnancy to term.
Case: A 35 year old woman initially presented with fever, flu-like symptoms, and preterm contractions at 34 weeks of gestation. Read More
Heat shock protein 70 (Hsp70) is not only a molecular chaperone in cytosol, but also presents in synaptic plasma membranes. To detect plasmalemmal Hsp70 (pl-Hsp70), neurons were immunostained with anti-Hsp70 antibody without permeabilization and fixation. Dotted immunofluorescent signals at neuronal cell bodies and neurites indicated the localization of Hsp70 on the neuronal cell surface. Read More
Introduction: Kidney damage during pregnancy constitutes a diagnostic and therapeutic challenge. However, it is not entirely known whether a kidney condition recognised before the pregnancy releases an organism's response to pregnancy, or whether pregnancy itself worsens kidney function.
Objective: The aim of the study was immunohistochemical evaluation of cells of kidneys of pregnant rats under the influence of nitric oxide (NO), with measurement of the immunoexpression of cellular stress markers (p-53, HSP 70). Read More
Pregnancy-related acute kidney injury (PRAKI) contributes to 3-7% of overall acute kidney injury (AKI) cases in Indian subcontinent. The aim of this study was to determine the outcomes of PRAKI and risk factors associated with renal injury and maternal mortality. One hundred and sixty-five patients with PRAKI, seen at M. Read More