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Histological changes of the liver and metabolic correlates in ewes with pregnancy toxemia
Cal, L.;Borteiro, C.;Benech, A.;Rodas, E.;Abreu, M.N.;Cruz, J. C.;González Monta?a, J. R.;
Arquivo Brasileiro de Medicina Veterinária e Zootecnia , 2009, DOI: 10.1590/S0102-09352009000200004
Abstract: the histological changes of the liver in ewes with pregnancy toxemia were characterized. ten ewes were fed on grass ad libitum, and another ten were starved from day 130 of pregnancy for up to four days. liver puncture biopsies were performed at days 70, 100, 130, and 140 of pregnancy, and at day 45 in postpartum. seric hydroxybutyrate (hb), non-esterified fatty acids (nefa), aspartate aminotransferase, and alkaline phosphatase were dosed. histological preparations revealed similar incidence and intensity of mild liver steatosis in both groups at day 130. starved ewes become toxemic (as indicated by hb), and at day 140 exhibited more severe injury in a higher proportion (9/9 vs. 4/10; p<0.01). almost all of them (7/9) had large amounts of small lipid droplets in almost every hepatocyte over the whole liver acinus, and higher nefa values. at day 45 in postpartum, both groups had mild steatotic changes as initially. a positive correlation between severity of liver damage seric and only aspartate aminotransferase was observed at day 140 in starved animals (p<0.05). this enzyme could be used to assess liver damage, but not alkaline phosphatase. all samples with degeneration corresponded to the microvesicular type. a short starvation period during late pregnancy in ewes produced reversible liver degeneration.
Term Pregnancy with Partial Molar Changes of Placenta
Amita Gupta,Yudhister Veer Gupta
JK Science : Journal of Medical Education & Research , 2003,
Abstract: A rare case report of successful term pregnancy with partial molar changes of placenta is beingreported. The patient was 2nd gravida with twin pregnancy with pregnancy induced hypertension(Pili). Patient under went LSCS and gave birth to two healthy looking babies. She was followed upand serum HCG (Human Chorinic Gouadotrophin) level returned to normal within 4 weeks afterdelivery.
Human Cytomegalovirus-Induces Cytokine Changes in the Placenta with Implications for Adverse Pregnancy Outcomes  [PDF]
Stuart T. Hamilton, Gillian Scott, Zin Naing, Jenna Iwasenko, Beverley Hall, Nicole Graf, Susan Arbuckle, Maria E. Craig, William D. Rawlinson
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0052899
Abstract: Human cytomegalovirus (CMV) infection of the developing fetus can result in adverse pregnancy outcomes including death in utero. Fetal injury results from direct viral cytopathic damage to the CMV-infected fetus, although evidence suggests CMV placental infection may indirectly cause injury to the fetus, possibly via immune dysregulation with placental dysfunction. This study investigated the effects of CMV infection on expression of the chemokine MCP-1 (CCL2) and cytokine TNF-α in placentae from naturally infected stillborn babies, and compared these changes with those found in placental villous explant histocultures acutely infected with CMV ex vivo. Tissue cytokine protein levels were assessed using quantitative immunohistochemistry. CMV-infected placentae from stillborn babies had significantly elevated MCP-1 and TNF-α levels compared with uninfected placentae (p = 0.001 and p = 0.007), which was not observed in placentae infected with other microorganisms (p = 0.62 and p = 0.71) (n = 7 per group). Modelling acute clinical infection using ex vivo placental explant histocultures showed infection with CMV laboratory strain AD169 (0.2 pfu/ml) caused significantly elevated expression of MCP-1 and TNF-α compared with uninfected explants (p = 0.0003 and p<0.0001) (n = 25 per group). Explant infection with wild-type Merlin at a tenfold lower multiplicity of infection (0.02 pfu/ml), caused a significant positive correlation between increased explant infection and upregulation of MCP-1 and TNF-α expression (p = 0.0001 and p = 0.017). Cytokine dysregulation has been associated with adverse outcomes of pregnancy, and can negatively affect placental development and function. These novel findings demonstrate CMV infection modulates the placental immune environment in vivo and in a multicellular ex vivo model, suggesting CMV-induced cytokine modulation as a potential initiator and/or exacerbator of placental and fetal injury.
Investigation on Some Biochemical and Clinical Parameters for Pregnancy Toxemia in Akkaraman Ewes
Engin Balikci,Atilla Yildiz,Fuat Gurdogan
Journal of Animal and Veterinary Advances , 2012,
Abstract: The aim of this study was to investigate some clinical and biochemical parameters for subclinical and clinical pregnancy toxemia and to determine the effect of early diagnosis on the success of curing. According to the results of clinical and biochemical parameters, 16 ewes were healthy (control group), 11 ewes had subclinical pregnancy toxemia (subclinic group) and 15 ewes had clinical pregnancy toxemia (clinic group). There was an increase at the levels of glucose, albumin, globulin in clinic group and Ca both in clinic and subclinic groups and a decrease at the levels of urea, AST, ALT in clinic group and BHBA both in clinic and subclinic groups after the treatment when compared with the period before treatment. Cure rates for subclinic and clinic groups were determined as 100% (11/11 ewes) and 73% (11/15 ewes), respectively. The parameters such as BHBA, glucose, ALT and AST should be taken in care especially in the period of last 6 weeks of pregnancy in ewes for early diagnosis of subclinical pregnancy toxemia.
Incidence and Clinical Study Ovine Pregnancy Toxemia in Al-Hassa Region, Saudi Arabia
Abdul-Aziz M. Al-Mujalli
Journal of Animal and Veterinary Advances , 2012,
Abstract: Retrospective data concerning the occurrence of pregnancy toxemia in ewes presented to Veterinary Teaching Hospital, King Faisal University from 1992-2003 was obtained. Twenty seven ewes presented to same clinic in 2004 with the suspicious of pregnancy toxemia were subjected to clinical and laboratory examinations. Blood samples for glucose level determination were taken from the 6 ewes proved to have pregnancy toxemia. At the same time blood samples were collected from 6 healthy non pregnant and 6 healthy pregnant ewes as control. The incidence of pregnancy toxemia in the 12 years recorded ranges between 6.5-37%. The highest incidence was reported in 1998 (37%), while the lowest incidence was reported in 2003 (6.5%). The clinical manifestations showed by the 6 animals proved to have disease were mainly nervous manifestations. The level of blood glucose in ewes with pregnancy toxemia was 1.02 0.14 mmol L 1, while in healthy non pregnant and pregnant was 2.95 0.65 mmol L 1 and 2.7 0.14 mmol L 1, respectively. It could be concluded that the incidence of the disease in reported years is low to moderate and the disease has significant effect of blood glucose level.
The Placenta in a Diabetic Pregnancy  [PDF]
Hiden U,Desoye G
Journal für Reproduktionsmedizin und Endokrinologie , 2010,
Abstract: Diabetes in pregnancy is associated with a derangement of hormones, cytokines, metabolites and growth factors in the maternal and foetal compartment. These may influence placental growth and development that are tightly regulated in time and space. The distinct effects of the diabetic environment depend on the time in gestation when diabetic insult occurs. Because of its establishment in the second half of gestation, gestational diabetes mellitus will influence placental processes in late gestation, whereas pre-gestational diabetes such as Type-I and Type-II diabetes may also affect processes in the first trimester. Altered placental function in pre-gestational diabetes may include changes in invasion ultimately leading to an enhanced risk of early pregnancy loss, growth restriction and pre-eclampsia, as well as a long-term stimulatory effect on placental growth leading to placentomegaly, which is frequently associated with diabetic pregnancies. Diabetes later in gestation affects vascularisation, storage of maternal nutrients in particular glycogen and lipids and may also enhance oxygen transfer. It is still unresolved if the placental alterations in diabetes ultimately contribute to or prevent the foetal phenotype often seen in diabetes i.e., excessive fetal fat accretion.
Pathological, clinical and biochemical investigation of naturally occurring pregnancy toxemia of sheep
Kabakci N.,Yarim G.,Yarim M.,Duru O.
Acta Veterinaria , 2003, DOI: 10.2298/avb0303161k
Abstract: A sick ewe in late pregnancy presented with clinical incoordination lipping, amaurosis, head tilt gait and nervous symptoms such as circling movements. A smell of ketones on the breath was detected. The sick animal died during clinical examination and, together with three more dead animals belonging to the same flock, was submitted to the laboratory for necropsy. The uteri of all pregnant animals contained late-term twin fetuses. The most prominent lesion was extensive fatty infiltration of the liver. Massive lipidosis and lipid vacuoles were seen in sections of the livers. In three brains, there was prominent vacuolation in the white matter. Urine analysis revealed ketonuria in most of the suspected sheep from the same flock. Serum glucose, cholesterol, high density lipoprotein cholesterol, and blood urea nitrogen concentrations were lower (p£0.05) and serum triglycerides aspartate aminotransferase and alanine aminotransferase activities were higher (p£0.05) in these sheep than in the controls. After a change of diet and treatment, with glucose and dexamethasone serum glucose levels significantly increased (p£0.001) and urine ketone bodies decreased but the other biocemical differences remained.
Hemoperitoneum Caused by Placenta Percreta in the Third Trimester of Pregnancy
Roya Faraji Darkhaneh,Maryam Asgharnia,Sohrab Aghazadeh
Iranian Journal of Medical Sciences , 2009,
Abstract: The placental adhesive disorders such as placenta accreta andplacenta percreta are the rare causes of serious obstetric hemorrhages.They are associated with high maternal morbidity andmortality. Placenta percreta is usually diagnosed in the thirdtrimester of pregnancy as a massive postpartum hemorrhagewhen an attempt to remove the placenta reveals lack of acleavage plane. Here we report an unusual presentation of placentapercreta as hemoperitoneum and hemorrhagic shock inthe third trimester of pregnancy. A 33-year-old woman wasadmitted to hospital at the 35th weeks of gestation with abdominalpain and hemorrhagic shock. Laparotomy was immediatelyperformed because of intra-abdominal bleeding. Uponinspection, a posterior laceration of the uterus was noted.Pathologic investigation of the uterus showed placenta percreta.The patient recovered uneventfully. Spontaneous ruptureof the uterus can be occured in the absence of uterinetrauma. In the differential diagnosis of a pregnant woman presentingwith hypotension, abdominal pain, and fetal death, ruptureof the uterus caused by placenta percreta should be considered.Rapid diagnosis, blood transfusion, and emergency laparotomyare the key steps in successful management.
Mid-Gestational Gene Expression Profile in Placenta and Link to Pregnancy Complications  [PDF]
Liis Uusküla,Jaana M?nnik,Kristiina Rull,Ave Minajeva,Sulev K?ks,Pille Vaas,Pille Teesalu,Jüri Reimand,Maris Laan
PLOS ONE , 2012, DOI: 10.1371/journal.pone.0049248
Abstract: Despite the importance of placenta in mediating rapid physiological changes in pregnancy, data on temporal dynamics of placental gene expression are limited. We completed the first transcriptome profiling of human placental gene expression dynamics (GeneChips, Affymetrix?; ~47,000 transcripts) from early to mid-gestation (n = 10; gestational weeks 5–18) and report 154 genes with significant transcriptional changes (ANOVA, FDR P<0.1). TaqMan RT-qPCR analysis (n = 43; gestational weeks 5–41) confirmed a significant (ANOVA and t-test, FDR P<0.05) mid-gestational peak of placental gene expression for BMP5, CCNG2, CDH11, FST, GATM, GPR183, ITGBL1, PLAGL1, SLC16A10 and STC1, followed by sharp decrease in mRNA levels at term (t-test, FDR P<0.05). We hypothesized that normal course of late pregnancy may be affected when genes characteristic to mid-gestation placenta remain highly expressed until term, and analyzed their expression in term placentas from normal and complicated pregnancies [preeclampsia (PE), n = 12; gestational diabetes mellitus (GDM), n = 12; small- and large-for-gestational-age newborns (SGA, LGA), n = 12+12]. STC1 (stanniocalcin 1) exhibited increased mRNA levels in all studied complications, with the most significant effect in PE- and SGA-groups (t-test, FDR P<0.05). In post-partum maternal plasma, the highest STC1 hormone levels (ELISA, n = 129) were found in women who had developed PE and delivered a SGA newborn (median 731 vs 418 pg/ml in controls; ANCOVA, P = 0.00048). Significantly higher expression (t-test, FDR P<0.05) of CCNG2 and LYPD6 accompanied with enhanced immunostaining of the protein was detected in placental sections of PE and GDM cases (n = 15). Our study demonstrates the importance of temporal dynamics of placental transcriptional regulation across three trimesters of gestation. Interestingly, many genes with high expression in mid-gestation placenta have also been implicated in adult complex disease, promoting the discussion on the role of placenta in developmental programming. The discovery of elevated maternal plasma STC1 in pregnancy complications warrants further investigations of its potential as a biomarker.
Obstetric factors and pregnancy outcome in placenta previa  [PDF]
N Ojha
Journal of Institute of Medicine , 2012, DOI: 10.3126/joim.v34i2.9053
Abstract: Introduction: Placenta previa is one of the major causes for maternal morbidity and mortality. The aim of this study was to analyze the obstetrical factors associated with placenta previa and to find out the maternal and perinatal outcome of these cases. Methods: This was a retrospective study conducted in the Department of Obstetrics and Gynecology of TUTH. Hospital chart records of four years (1st January 2008 to 31st December 2011) were collected. Chart records of all women who had undergone cesarean section for placenta previa were reviewed. Relevant clinical findings were noted. Results: During the study period, there were 82 cases of cesarean sections done for placenta previa, which is 0.55% of the total deliveries. Of the eighty two cases, charts could be obtained of the 70 patients for the analysis. 21.4% had total placenta previa. Maximum women were in age group 26-30 years. Sixty one percent of the patients were multipara. Sixteen patients had history of cesarean section and 20 cases had abortions in previous pregnancy. Malpresentation was present in more than one fifth (21.4%) of the patient. 45.7% of the babies were preterm and 27% were low birth weight babies. Seven babies had neonatal death. Almost one third (31.4%) of the patient had blood loss ≥500ml. There were four cases with blood loss ≥1000ml. Among them two had loss of more than two liters. Ten patients required blood transfusion. One patient had cesarean hysterectomy. Conclusion: Placenta previa poses danger to both the mother and the baby. There is high maternal morbidity and adverse perinatal outcome. DOI: http://dx.doi.org/10.3126/joim.v34i2.9053 ? Journal of Institute of Medicine August, 2012; 34:2 38-41
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