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Journal Article 2010; 31(6): 842-847 PubMed PMID: 21196907 Citation  Keywords:  Adult, Comorbidity, Diagnosis, Differential, Female, Fetal Development, Fetal Growth Retardation:diagnostic imaging, Fetus, Humans, Hypertension, Pregnancy-Induced:diagnostic imaging, Pregnancy, Smoking:adverse effects, Ultrasonography, Prenatal, Umbilica.   

OBJECTIVE: The aim of this study was to determine the characteristic features of the umbilical cord morphology in selected cases of intrauterine growth restriction (IUGR): tobacco smoking, pregnancy-induced hypertension and idiopathic IUGR.

MATERIALS AND METHODS: 136 pregnant women were included in the study - 86 patients with IUGR (IUGR group) and 50 women with uncomplicated course of pregnancy (control group). In the IUGR group 31 women were smokers, 27 suffered from pregnancy-induced hypertension, and 28 had an unknown reason for IUGR. Each of them underwent ultrasound examination to measure fetal growth and to assess morphological parameters of the umbilical cord.

RESULTS: Significant differences between the control group and the whole IUGR group in terms of the diameter of the umbilical cord and diameter of the umbilical vein - smaller diameters in the IUGR group than in the control group. Significant differences among IUGR subgroups in terms of area of Wharton's jelly and diameters of the umbilical cord, vein and artery. Significant difference in the length of the uncoiled section among the IUGR subgroups.

CONCLUSIONS: 1. The umbilical cord in IUGR and concomitant tobacco smoking is hyper-coiled with coiling index independent of fetal weight and high content of Wharton's jelly. 2. The umbilical cord in IUGR and concomitant pregnancy-induced hypertension is thinnest with thinnest vessels and the smallest content of Wharton's jelly. 3. The assessment of umbilical cord morphology should become an integral part of ultrasound exam in pregnancies complicated by IUGR....

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Journal Article 2010; 31(5): 708-716 PubMed PMID: 21173740 Citation  Keywords:  Androstatrienes:administration & dosage, Animals, Brain:drug effects, Enzyme Inhibitors:administration & dosage, Female, Gestational Age, Injections, Intraperitoneal, Male, Pharmaceutical Vehicles:administration & dosage, Pregnancy, Prenatal Exposure Dela.   

OBJECTIVE: In order to clarify the effect of the prenatal (PN) treatment of the drug 1,4,6-androstatriene-3,17-dione (ATD) which blocks the conversion of testosterone into estradiol on male sexual behavior of the rats offsprings, from the effect of the mild stress induced by the PN administration of the Propylene glycol (PG), the vehicle used to dissolve ATD.

METHODS: Pregnant Wistar rats were divided into three groups. The CON group did not receive any kind of treatment. The other two groups (PG and ATD) were injected i.p. during gestation (days 11-22) with 0 and 5 mg of ATD, dissolved in 0.1 ml of PG, respectively, doses reported by other authors. Sexual performance of the male pups was analyzed three months later in four successive tests.

RESULTS: In the first sexual test of these naive rats, the percentage of males mounting, intromitting, ejaculating and the ejaculation frequency of the ATD group decreased significantly in comparison with the CON group. Also in the first and 4th tests, mounting, intromission and ejaculation latencies, as in the post-ejaculatory refractory period, ATD group, was significantly longer in comparison with the CON group. PG males showed a male sexual behavior (MSB) similar to that observed in the ATD group, but the differences did not reach statistical significance when they were compared with the CON group.

CONCLUSION: We considered that the PN stress induced by the daily administration of PG and ATD, results in a slower execution of the MSB in both groups and avoid distinguish the effect of the ATD. Then chronic PN injections, as a route of administration, could act as mild stressor and may have additive effects on drugs affecting brain sexual differentiation....

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Journal Article 2010; 31(4): 573-576 PubMed PMID: 20802445 Citation  Keywords:  Adiponectin:blood, Enzyme-Linked Immunosorbent Assay, Female, Humans, Insulin:blood, Insulin Resistance, Leptin:blood, Organ Size, Placenta:anatomy & histology, Pregnancy, Pregnancy Trimester, First, Ultrasonography, Prenatal,.   

OBJECTIVE: The dysregulation of adiponectin and leptin is found in insulin resistance. There is evidence that both cytokines and insulin might contribute to the placental development and the fetal growth. The objective of this study was to evaluate the relationship of maternal plasma cytokine and insulin concentrations with the placental dimension in the first trimester of pregnancy.

METHODS: 34 women with singleton pregnancy, between 11th and 14th weeks, were included to the study. Plasma levels of adiponectin, leptin, insulin and glucose were quantified with ultrasound measurements of the placenta. HOMA-IR were calculated to assess the insulin sensitivity.

RESULTS: Mean concentrations of adiponectin, leptin and insulin were 18,39±13.99 µg/ml; 6.99±5.67 ng/ml and 43.98±23.89 pmol/l respectively. The placenta thickness was positively associated with the maternal adiponectin plasma concentration (r=0.36; p=0.037). There were no associations between placental measurements and leptin, fasting insulin, fasting glucose and HOMA-IR. There was not significant correlation between placental measurements and the fetal Crown Rump Length (CRL).

CONCLUSIONS: The results of this study imply that maternal adiponectin plasma concentration may have a role in placental growth....

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Journal Article 2009; 30(6): 729-732 PubMed PMID: 20038928 Citation  Keywords:  Adiponectin:blood, Adult, Blood Glucose:metabolism, Female, Fetal Development:physiology, Humans, Insulin:blood, Insulin Resistance, Leptin:blood, Pregnancy, Pregnancy Trimester, First:metabolism, Ultrasonography, Prenatal,.   

OBJECTIVE: Fetal growth is determined by genetic factors and placental supply. There is evidence that insulin might contribute to the up-regulation of placental transporter activity. The dysregulation of adiponectin and leptin is found in insulin resistance. The objective of this study was to evaluate the relation of maternal plasma cytokine and insulin concentrations in the first trimester of pregnancy to fetal growth.

METHODS: 55 women with singleton pregnancy, between 12th and 14th weeks of gestation, were included to the study. Plasma concentrations of adiponectin, leptin, insulin and glucose were analyzed together with fetal ultrasound measurements and neonatal birth weight. The HOMA-IR were calculated (fasting insulin (microU/ml) x fasting glucose (mmol/l/22.5) to assess the insulin sensitivity.

RESULTS: Mean concentrations of adiponectin, leptin and insulin were 15.29 +/- 13.83 microg/ml, 6.93+/-5.39 ng/ml and 43.59+/-26.28, respectively. The average insulin resistance defined by HOMA-IR was 1.35+/-0.8. The ratios of adiponectin to leptin, adiponectin to insulin and HOMA-IR were calculated. The percentiles of fetal crown-rump length (CRL) were negatively correlated with adiponectin plasma concentration (r=-0.32; p<0.05), with no relation to leptin and insulin plasma concentration. Correlations between fetus CRL percentile and the ratio of adiponectin to leptin concentration (r=-0.37; p<0.02) and adiponectin to HOMA-IR (r=0.35; p<0.05) were also observed. No association between adiponectin, leptin, fasting insulin, HOMA-IR and neonatal birth weight or birth weight percentile was found. The percentile of fetal CRL in the 1st trimester was positively correlated with neonatal birth weight percentile (r=0.3; p<0.05).

CONCLUSIONS: The results of this study imply that maternal adiponectin concentration may play a role in early determination of fetal growth....

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Journal Article 2009; 30(5): 652-656 PubMed PMID: 20035261 Citation  Keywords:  Adult, Biometry:methods, Blood Glucose:metabolism, Diabetes, Gestational:blood, Female, Fetal Development, Fetus:anatomy & histology, Gestational Age, Glucose Tolerance Test, Humans, Lipids:blood, Pregnancy, Ultrasonography, Prenatal:methods,.   

OBJECTIVE: The aim of this study was to determine whether there is an association between ultrasound fetal biometry and lipids and glucose profiles at the beginning of gestational diabetes (GDM) treatment.

METHODS: In 98 women with GDM plasma glucose and lipid profile were measured between 27-32 weeks' of gestation. The association between the biochemical parameters and the measurements and percentiles of the biparietal diameter (BPD), femur length (FL) and abdominal circumference (AC), estimated fetal weight (EFW) and the actual birthweight (BW) were analyzed.

RESULTS: There was no significant association between fetal and neonatal biometry measurements and maternal glucose concentrations. Highly significant positive correlation was found between triglicerydes and fetal biometry at the beginning of GDM treatment: AC, BPD, FL and EFW (p=0.007, p=0.018, p=0.018, p=0.013, respectively), as well as between total cholesterol and bi-parietal diameter (p=0.04). Associations between maternal plasma lipids and birthweight or birthweight percentile were not evident.

CONCLUSIONS: These data suggest that maternal lipids and carbohydrates metabolic disturbance are an important determinant for fetal growth in pregnancy before gestational diabetes is diagnosed....

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Comparative Study 2008; 29(2): 272-280 PubMed PMID: 18404135 Citation  Keywords:  Adolescent, Attention Deficit Disorder with Hyperactivity:blood, Case-Control Studies, Child, Child Development Disorders, Pervasive:blood, Child, Preschool, Developmental Disabilities:blood, Female, Humans, Male, Mothers, Pregnancy, Prenatal Exposure Del.   

BACKGROUND: Many formulations of Thimerosal (49.55% mercury by weight)-containing Rho(D) immune globulins (TCRs) were routinely administered to Rh-negative mothers in the US prior to 2002.

OBJECTIVES: It was hypothesized: (1) if prenatal Rho(D)-immune globulin preparation exposure was a risk factor for neurodevelopmental disorders (NDs) then more children with NDs would have Rh-negative mothers compared to controls; and (2) if Thimerosal in the Rho(D)-immune globulin preparations was the ingredient associated with NDs, following the removal of Thimerosal from all manufactured Rho(D)-immune globulin preparations from 2002 in the US the frequency of maternal Rh-negativity among children with NDs should be similar to control populations.

METHODS: Maternal Rh-negativity was assessed at two sites (Clinic A-Lynchburg, VA; Clinic B-Rockville and Baltimore, MD) among 298 Caucasian children with NDs and known Rh-status. As controls, maternal Rh-negativity frequency was determined from 124 Caucasian children (born 1987-2001) without NDs at Clinic A, and the Rh-negativity frequency was determined from 1,021 Caucasian pregnant mothers that presented for prenatal genetic care at Clinic B (1980-1989). Additionally, 22 Caucasian patients with NDs born from 2002 onwards (Clinics A and B) were assessed for maternal Rh-negativity.

RESULTS: There were significant and comparable increases in maternal Rh-negativity among children with NDs (Clinic: A=24.2%), autism spectrum disorders (Clinic: A=28.3%, B=25.3%), and attention-deficit-disorder/attention-deficit-hyperactivity-disorder (Clinic: A=26.3%) observed at both clinics in comparison to both control groups (Clinic: A=12.1%, B=13.9%) employed. Children with NDs born post-2001 had a maternal Rh-negativity frequency (13.6%) similar to controls.

CONCLUSION: This study associates TCR exposure with some NDs in children....

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Journal Article 2007; 28(5): 713-716 PubMed PMID: 17984953 Citation  Keywords:  Blood Flow Velocity, Female, Fetal Heart:physiology, Fetus:blood supply, Gestational Age, Humans, Pregnancy, Reference Values, Regional Blood Flow, Ultrasonography, Doppler, Pulsed, Ultrasonography, Prenatal:methods, Umbilical Veins:diagnostic imaging, Ve.   

UNLABELLED: The ductus venosus is the very important part of fetal venous circulation. It plays a central role in return of venous blood from the placenta. This unique shunt carries well-oxygenated blood from the umbilical vein through the inferior atrial inlet on its way across the foramen ovale. Using Doppler ultrasound, it is possible to assess the blood flow in fetal vessels including ductus venosus. It is observed, in animal and human studies, that the typical waveform for blood flow in ductus venosus in early pregnancy can be different depending on numerous conditions e.g. fetal karyotype. This study is performed to assess the physiologic parameters of blood flow in ductus venosus in uncomplicated early pregnancy.

MATERIAL AND METHODS: 404 women were examined between 11+0 and 13+6 weeks (+ days) of gestation by ultrasound. Fetal crown-rump length (CRL) was measured to assess the gestational age. The assessment of risk of fetal abnormalities was based on nuchal translucency (NT) measurement. The ductus venosus blood flow with color and spectral Doppler was obtained in all patients. The following features were assessed: pulsatility index (PI), and direction of flow (positive/negative) during atrial contraction (wave A). All cases were followed up to 22 weeks of gestation when the control scan was performed.

RESULTS AND CONCLUSIONS: 30 cases were excluded from the uncomplicated group due to: high risk of fetal abnormalities, fetal loss, confirmed fetal abnormalities and utero-placental pathology. 374 women were considered as uncomplicated pregnancy. In both uncomplicated and complicated groups the mean values for pulsatility index (PI) were established. The mean PI value in uncomplicated pregnancies was: 0.91 (SD +/- 0.32). No significant differences between groups were noticed. In 370 cases of uncomplicated pregnancy the A wave direction was positive but in 1.1% of cases the reverse flow in atrial contraction was observed....

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Journal Article 2007; 28(5): 671-674 PubMed PMID: 17984938 Citation  Keywords:  Animals, Aromatase:metabolism, Cholestenone 5 alpha-Reductase:metabolism, Female, Hypothalamus, Middle:embryology, Immobilization, Pregnancy, Prenatal Exposure Delayed Effects, Preoptic Area:embryology, Rats, Rats, Wistar, Sex Characteristics, Stress, Psy.   

OBJECTIVES: Prenatal stress results in demasculinization and feminization of sexual behavior in adult male rats. Earlier the preventive effect of testosterone replacement of an androgen deficiency in male fetuses during exposure to stress has been demonstrated. Nevertheless the neuroendocrine mechanisms underlying hormonal protection of the brain sexual differentiation are not clear.

MATERIAL AND METHODS: Time-mated rats were undergone to 1 h strict immobilization during days 15 to 21 of gestation. Another group of stressed dams was injected with testosterone propionate on the 17th, 19th and 21st gestational days subcutaneously (5 mg/kg b.w.) 30 min prior to restraining. Aromatase and 5alpha-reductase activities were determined in the preoptic area and medial basal hypothalamus of 10-day old offspring.

RESULTS: Aromatase activity in the preoptic area declined in affected with prenatal stress males and reached the normal female level. It completely restored in prenatally stressed males under influence of prenatal testosterone replacement. 5alpha-reductase activity decreased in the preoptic area of prenatally stressed females. In those pretreated with testosterone propionate, 5alpha-reductase activity was significantly elevated above normal level.

CONCLUSIONS: The data obtained demonstrate a preservation of aromatase activity in the preoptic area of males resulted from testosterone replacement. Presumably testosterone exerts its protective effect on the male sexual behavior by prevention of neurochemical feminization of the brain preoptic area and, perhaps, due to some other mechanisms....

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