Biological research in pregnancy and perinatology最新文献

A method of diagnosis of early periods of pregnancy has been developed. Immunospecific serum to human decidual tissue protein D1 was used. The technique is relatively simple, easily reproducible and can be used for a differential gynecologic diagnosis as well as for a diagnosis of pregnancy.

Using a modified method of lectin affinity crossed-line immunoelectrophoresis, we studied the alpha-fetoprotein (AFP) subfractions in sera from 12 pregnant Japanese women, at 22 and 42 weeks of gestation. The method involves the first dimension electrophoresis in agarose gel containing concanavalin A (Con A) or lentil lectin (LCH), the second dimension immunoelectrophoresis in agarose gel containing polyclonal antibody against AFP, reaction with peroxidase-conjugated Protein A and staining with 4-methoxy-1-naphthol. We found that type a of Con A or type C of LCH was the only subfraction present in maternal circulation at the second or third trimester. These AFP subfractions were assumed to be of fetal liver-origin. The minimum concentration which yielded an immunoprecipitation peak was approximately 100 ng/ml, being twenty times more sensitive than the conventional lectin affinity crossed-line immunoelectrophoresis.

Benzodiazepines are presently the most widely prescribed drugs. They are considered as safe drugs although there is appreciable evidence from animal experiments as well as from epidemiological evaluations that they act as teratogens. The pertinent literature is subjected to a synopsis with results from pharmacological, biochemical and behavioral research. Recent views of the mechanisms of teratogenic action serve to propose several points of attack where benzodiazepines can disturb the development of the central nervous system. This attack can take place during organogenesis, during early differentiation of neural anlagen after neural tube closure or during biochemical differentiation of the brain. It is suggested that intake of benzodiazepines at any time during pregnancy may result in visible malformations, in functional deficits or in behavioral anomalies of the exposed children.

Decidual cells are a morphologically distinct cell population arising in the endometrium during pregnancy. Decidualisation can also be elicited by artificial stimuli in suitably hormone primed animals. A variety of histophysiological reactions accompany decidualisation and culminate in the differentiation of endometrial stromal cells to decidual ones. Typical ultrastructural features characterise antimesometrial and mesometrial decidual cells. The functional role of these cells is consistent with their structural complexities and definite life span. The metrial gland forms a separate class of cells associated with decidualisation. Recent observations on the origin of both decidual and metrial gland cells from the bone marrow suggest an immunological role.

The urinary output of prostaglandin E2 (PGE2) during and following Cesarean section (CS) was investigated in 21 patients. Urinary PGE2, probably reflecting renal production of PGE2, increased about two-fold during anesthesia and surgery and persisted for at least one additional hour. PGE2 output also correlated with the dose of oxytocin administered. The possibility that renal perfusion may be compromised during CS and that increased synthesis of prostaglandins (PGs) may serve to protect the kidney against ischemia is suggested.

In order to quantify the frequency of placental tissue changes in pregnancies complicated by hypertension and the correlation with the severity of the disease we studied 15 term-placentas of healthy women and 33 placentas of patients with pregnancy hypertension using phase contrast microscopy. Applying microscopy (phase contrast) a total of 50 fields were inspected from 5 different, representative areas of each placenta. We counted the (absolute) number of fields with trophoblastic hyperplasia; trophoblast sprouts; with interstitial edema; with hemorrhagia and with fibrinoid degeneration and necrosis. Trophoblastic hyperplasia as well as interstitial edema were rare in term-placentas of healthy women. Typically in hypertensive pregnancies these findings together with trophoblast sprouts increased proportionally to severity. We conclude that these results indicate a retardation of maturation of placenta tissues in hypertensive pregnancy. Although hemorrhagia and fibrinoid degeneration were observed in all placentas they were more frequent in pregnancies complicated by hypertension. This might be a consequence of changed placental perfusion of the intervillous space. In immature placentas hemorrhagia and fibrinoid degeneration induce additional restriction of placental capacity which seems to be responsible for decreased fetal birth weight and arterial cord pH. When morphological alterations of placenta tissue, e.g. trophoblast sprouts, trophoblast hyperplasia, stroma edema, hemorrhagia and fibrinoid degenerations were quantified and correlated to blood pressure of the mother, we found a positive correlation. Increased numbers of trophoblastic sprouts and trophoblastic hyperplasia indicate a placental immaturity whereas edema, hemorrhagia and degenerations can be taken as the result of elevated blood pressure.

Cultured endothelial cells (EC) from the umbilical veins of infants of non-diabetic mothers induced retraction of fibrin clots formed by addition of thrombin to cell-free plasma. Fibrin clot retraction activity increased with time, reaching a maximum within 24 hours and was inhibited at 4 degrees C or in the presence of EDTA. This retraction had many characteristics in common with that induced by platelets. EC obtained from the umbilical veins of infants of poorly controlled insulin dependent diabetic mothers (IDDM) showed similar patterns of retraction. However, compared to normals, these cells induced greater retraction. Since the retraction of fibrin clots is thought to promote the exposure of sub-endothelial layers and since such an exposure plays a major role in thrombogenesis, we suggest that retraction of fibrin clot by EC should be taken into account in evaluating pre-thrombotic states.

Details of some common scoring systems in use for perinatal medicine are outlined. Their advantages and limitations are briefly discussed.

Renal clearance of most amino acids was increased in the third trimester of pregnancy. The greatest change was with glycine, where clearance increased thirteen-fold and the plasma level decreased. No difference in renal clearance of amino acids was demonstrated in four patients with proteinuric hypertension when compared with that in normal pregnancy. Progesterone, given to non-pregnant women, caused a fall in mean plasma glycine. This was associated with increased renal clearance in 2 out of 3 women, and indicates that progesterone may contribute to the increased renal excretion of some amino acids in pregnancy, probably acting selectively on tubular reabsorption.

Somatomedin evolution has been studied by employing three different bioassays in 181 pregnant women from the 7th week of gestation to delivery and in 18 women during the course of labor. In 105 additional mothers of full-term or pre-term neonates a significant increase of a serum growth-promoting activity (thymidine activity) was observed at delivery, as compared to nonpregnant controls, with a progressive return to normal levels in the post-partum period. Different results were found according to the assay method used, suggesting the multiplicity of growth factors and specific adaptations related to the stages of pregnancy.