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Martens MD, Fernando AS, Gordon JW. A new trick for an old dog? Myocardial-specific roles for prostaglandins as mediators of ischemic injury and repair. Am J Physiol Heart Circ Physiol 2021; 320:H2169-H2184. [PMID: 33861147 DOI: 10.1152/ajpheart.00872.2020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
The small lipid-derived paracrine signaling molecules known as prostaglandins have been recognized for their ability to modulate many facets of cardiovascular physiology since their initial discovery more than 85 years ago. Although the role of prostaglandins in the vasculature has gained significant attention across time, a handful of historical studies have also directly implicated the cardiomyocyte in both prostaglandin synthesis and release. Recently, our understanding of how prostaglandin receptor modulation impacts and contributes to myocardial structure and function has gained attention while leaving most other components of myocardial prostaglandin metabolism and signaling unexplored. This mini-review highlights both the key historical studies that underpin modern prostaglandin research in the heart, while concurrently presenting the latest findings related to how prostaglandin metabolism and signaling impact myocardial injury and repair.
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Affiliation(s)
- Matthew D Martens
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Science, University of Manitoba, Winnipeg, Manitoba, Canada.,The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Amy S Fernando
- The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
| | - Joseph W Gordon
- Department of Human Anatomy and Cell Science, Rady Faculty of Health Science, University of Manitoba, Winnipeg, Manitoba, Canada.,College of Nursing, Rady Faculty of Health Science, University of Manitoba, Winnipeg, Manitoba, Canada.,The Diabetes Research Envisioned and Accomplished in Manitoba (DREAM) Theme, Children's Hospital Research Institute of Manitoba, Winnipeg, Manitoba, Canada
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Pierce S, Bakker R, Myers DA, Edwards RK. Clinical Insights for Cervical Ripening and Labor Induction Using Prostaglandins. AJP Rep 2018; 8:e307-e314. [PMID: 30377555 PMCID: PMC6205862 DOI: 10.1055/s-0038-1675351] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/11/2018] [Indexed: 10/29/2022] Open
Abstract
Cervical ripening is often the first component of labor induction and is used to facilitate the softening and thinning of the cervix in preparation for labor. Common methods used for cervical ripening include both mechanical (e.g., Foley or Cook catheters) and pharmacologic (e.g., prostaglandins) methods. The choice of method(s) for ripening should take into account the patient's medical and obstetric history, clinical characteristics, and risk of adverse effects if uterine tachysystole were to occur. In this narrative review, we highlight the differences between the prostaglandins dinoprostone and misoprostol with respect to pharmacology and pharmacokinetics, efficacy, and potential safety concerns. Practical guidance on choosing an appropriate prostaglandin agent for cervical ripening and labor induction is provided via the use of clinical vignettes. Considering the advantages and disadvantages of each preparation allows clinicians to individualize treatment, depending on the indications for induction and unique characteristics of each patient.
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Affiliation(s)
- Stephanie Pierce
- Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Ronan Bakker
- Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Dean A Myers
- Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Rodney K Edwards
- Section of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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The role of prostaglandins E1 and E2, dinoprostone, and misoprostol in cervical ripening and the induction of labor: a mechanistic approach. Arch Gynecol Obstet 2017; 296:167-179. [DOI: 10.1007/s00404-017-4418-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 05/30/2017] [Indexed: 12/23/2022]
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Wojciechowska A, Mlynarczuk J, Kotwica J. Disorders in barrier protein mRNA expression and placenta secretory activity under the influence of polychlorinated biphenyls in vitro. Theriogenology 2017; 89:9-19. [DOI: 10.1016/j.theriogenology.2016.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 10/06/2016] [Accepted: 10/07/2016] [Indexed: 12/19/2022]
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Changes in the mRNA expression of structural proteins, hormone synthesis and secretion from bovine placentome sections after DDT and DDE treatment. Toxicology 2017; 375:1-9. [DOI: 10.1016/j.tox.2016.11.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Revised: 06/14/2016] [Accepted: 11/25/2016] [Indexed: 01/27/2023]
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Madaan M, Agrawal S, Puri M, Nigam A, Kaur H, Trivedi SS. Is low dose vaginal misoprostol better than dinoprostone gel for induction of labor: a randomized controlled trial. J Clin Diagn Res 2014; 8:OC31-4. [PMID: 25386492 PMCID: PMC4225944 DOI: 10.7860/jcdr/2014/8101.4906] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 05/08/2014] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To compare the efficacy and safety profile of low dose vaginal misoprostol with dinoprostone gel for induction of labor in term pregnancies. METHODS The study was conducted at Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital on 100 pregnant women with term pregnancy after application of inclusion and exclusion criteria. The women were randomized in 2 groups of 50 women each. Group I received misoprostol 25μg at every six hour vaginally for a maximum of five doses for induction of labor; while group II received dinoprostone gel 0.5 mg every six hourly for a maximum of three doses. Maternal outcomes such as mode of delivery and induction delivery interval; and fetal outcomes such as APGAR score and incidence of NICU admission were assessed in both the groups. Statistical analysis was done using student t-test and chi-square test. RESULTS There was no significant difference in the mean induction to delivery interval in both the groups (14.32±0.13 hours in Group I and 14.92±0.18 hours in Group II, p=0.75), mode of delivery, indication of cesarean section and perinatal outcome. However, significant difference was observed in requirement of oxytocin augmentation in both the groups (32% in Group I and 68% in Group II, p=0.005). CONCLUSION Vaginal misoprostol in low doses is similar in efficacy and safety to dinoprostone gel for cervical ripening and labor induction in term pregnancy.
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Affiliation(s)
- Monika Madaan
- Ex Assistant Professor, Department of Obstetrics and Gynecology, LHMC & SSKH (Lady Hardinge Medical College and Smt Sucheta Kriplani Hospital), New Delhi, India
| | - Swati Agrawal
- Assistant Professor, Department of Obstetrics and Gynecology, LHMC & SSKH, New Delhi, India
| | - Manju Puri
- Professor, Department of Obstetrics and Gynecology, LHMC & SSKH, New Delhi, India
| | - Aruna Nigam
- Ex. Assistant Professor, Department of Obstetrics and Gynecology, LHMC & SSKH, New Delhi, India
| | - Harvinder Kaur
- GDMO, Department of Obstetrics and Gynecology, LHMC & SSKH, New Delhi, India
| | - Shubha Sagar Trivedi
- Director Professor, Department of Obstetrics and Gynecology, LHMC & SSKH, New Delhi, India
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Mahendru R, Yadav S. Shortening the induction delivery interval with prostaglandins: a randomized controlled trial of solo or in combination. J Turk Ger Gynecol Assoc 2011; 12:80-5. [PMID: 24591967 PMCID: PMC3939111 DOI: 10.5152/jtgga.2011.20] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2010] [Accepted: 03/27/2011] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE To compare the efficacy and safety of misoprostol alone with dinoprostone followed by misoprostol, all inserted intravaginally in induction of labor at term and the obstetrical outcome. MATERIAL AND METHODS A pilot study comprising 111 primigravidae, >37 gestational weeks with singleton pregnancy in cephalic presentation having an unfavorable Bishop score admitted for labor induction, were considered and randomly allocated into two groups. In group I (n=55) with intravaginal 25mcg misoprostol 4 hourly (six doses at the most) and and group II (n=56), with dinoprostone 0.5mg followed eight hours later by 25mcg misoprostol induction to vaginal delivery time was found to be significantly different, being 14.8 h in group-I and shorter in group-II with a mean of 11.6 h. Vaginal delivery rates within 12 h (groups-I and -II: 47.2%, as compared to 60.7%, respectively) were found to be higher with dinoprostone-misoprostol induction, as well as vaginal delivery rates in 24 h, 80.0% and 91.1%. The need for oxytocin augmentation was more frequent in the misoprostol than in the dinoprostone-misoprostol group, (61.8%, and 39.3%), and all these observations were statistically significant. Abnormal foetal heart rate pattern occurred more frequently (18.2%) in group-I in contrast to 5.3% in group-II, as was the incidence rate of (18.2%) who had passage of meconium in group-I, this rate being significantly different from group-II having meconium passage in 3 cases, a rate of 5.3%. CONCLUSION Using dinoprostone followed by vaginal misoprostol is safe and effective for induction of labor with less need for oxytocin augmentation and shorter induction delivery interval.
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Affiliation(s)
- Rajiv Mahendru
- Department of Obstetrics and Gynecology, Mmimsr, Mullana, Ambala, India
| | - Shweta Yadav
- Department of Obstetrics and Gynecology, Mmimsr, Mullana, Ambala, India
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Hinton AC, Grigsby PL, Pitzer BA, Brockman DE, Ittenbach RF, Hinton RB, Myatt L. Hormonal Regulation of Prostaglandin E2 Receptors: Localization and Expression in Rat Cervical Tissue. Reprod Sci 2009; 17:136-46. [DOI: 10.1177/1933719109348068] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Andrea C. Hinton
- Division of Maternal Fetal Medicine, Good Samaritan Hospital, Cincinnati, Ohio,
| | - Peta L. Grigsby
- Department of Obstetrics and Gynecology, University of Cincinnati School of Medicine, Cincinnati, Ohio
| | - Bradley A. Pitzer
- Department of Obstetrics and Gynecology, University of Cincinnati School of Medicine, Cincinnati, Ohio
| | - Diane E. Brockman
- Department of Obstetrics and Gynecology, University of Cincinnati School of Medicine, Cincinnati, Ohio
| | - Richard F. Ittenbach
- Division of Epidemiology and Statistics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Robert B. Hinton
- Division of Epidemiology and Statistics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Leslie Myatt
- Department of Obstetrics and Gynecology, University of Cincinnati School of Medicine, Cincinnati, Ohio
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Denguezli W, Trimech A, Haddad A, Hajjaji A, Saidani Z, Faleh R, Sakouhi M. Efficacy and safety of six hourly vaginal misoprostol versus intracervical dinoprostone: a randomized controlled trial. Arch Gynecol Obstet 2008; 276:119-24. [PMID: 17219155 DOI: 10.1007/s00404-006-0313-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2006] [Accepted: 12/12/2006] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To compare the efficacy and safety of intravaginal misoprostol versus dinoprostone cervical gel for cervical ripening and labour induction. METHODS We carried out an experimental clinical trial in which we enrolled 130 cervical consecutive patients with cervical ripening, randomly assigned to one of the following two treatment groups: (1) intravaginal misoprostol and (2) intracervical dinoprostone gel. A total of 50 microm of misoprostol was placed in the posterior vaginal fornix every 6 h for a maximum period of 24 h and 0.5 mg of dinoprostone was administrated in the uterine cervix every 6 h, for a maximum period of 24 h. The primary outcome measure was the number (rate) of women who went to vaginally deliver within 24 h of the protocol initiation. RESULTS Among 130 patients evaluated, 65 were allocated to the misoprostol group and 65 to the dinoprostone group. The proportion of vaginal delivery within 24 h was significantly higher in the misoprostol group (75%) than in the dinoprostone group (53.8%) (RR = 1.40, 95% CI [1.07-1.45], P = 0.02). There was no significant difference between the mean time interval of delivery in the misoprostol group and the dinoprostone group (14.9 vs.15.8 h) (P = 0.51). The Bishop score was significantly higher in the misoprostol group, 6 h after the onset of the study (1.38; relative risk, 95% CI [1.02-1.85], P = 0.03). The Caesarean delivery rate for fetal distress was higher in the dinoprostone group (21 vs. 10.8%, P = 0.15). The tachysystole (Misoprostol 6.1% vs. dinoprostone 4.6%, relative risk 1.15, 95% CI [0.6-2.24]) and hyperstimulation syndrome rates (Misoprostol 7.6% vs. dinoprostone 4.6%, relative risk 1.26, 95% CI [0.72-2.24]) were slightly increased in the misoprostol group than in the dinoprostone group without reaching the level of statistical signification. CONCLUSION Misoprostol as used in this protocol is more effective than cervical dinoprostone gel application in the cervical ripening and labour induction. There is a tendency for an increase in the rate of tachysystole and hyperstimulation syndrome.
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Affiliation(s)
- Walid Denguezli
- University Hospital Fattouma Bourguiba, Unit of Obstetrics and Gynaecology, 5000 Monastir, Tunisia.
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Väisänen-Tommiska M, Mikkola TS, Ylikorkala O. Misoprostol induces cervical nitric oxide release in pregnant, but not in nonpregnant, women. Am J Obstet Gynecol 2005; 193:790-6. [PMID: 16150276 DOI: 10.1016/j.ajog.2005.02.084] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2004] [Revised: 02/08/2005] [Accepted: 02/08/2005] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The cells of the human uterine cervix synthesize nitric oxide, which may be a factor in cervical ripening. We studied the effect of misoprostol on cervical nitric oxide release in nonpregnant and pregnant women. STUDY DESIGN Seventy-two nonpregnant (n=15) and pregnant (n=57; 26 in early pregnancy, 31 in late pregnancy) women were treated with either vaginal misoprostol (n=54) or vaginal placebo (n=18). The dose of misoprostol was 400 mug in nonpregnant and early pregnancy group, and 25 mug in late pregnancy group. Serial cervical fluid samples, collected before and up to 3 hours after misoprostol/placebo, were assessed for the concentration of nitric oxide metabolites by means of the Griess reaction. RESULTS Placebo had no effect on cervical fluid nitric oxide metabolite level. In 1 to 3 hours, misoprostol induced 4.3- to 5.2-fold elevations in cervical fluid Nox concentrations in early pregnancy (P < .01), and 4.4- to 18.2-fold elevations in late pregnancy (P < .01), but these responses did not differ significantly from each other. Misoprostol had no effect on cervical fluid nitric oxide metabolites in nonpregnant women. There was a trend towards a relationship between cervical nitric oxide stimulation after misoprostol and cervical ripening. CONCLUSION Vaginal misoprostol stimulates cervical nitric oxide release in pregnancy. This suggests a joint action of nitric oxide and prostaglandins in cervical ripening.
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Affiliation(s)
- Mervi Väisänen-Tommiska
- Department of Obstetrics and Gynecology, Helsinki University Central Hospital, Helsinki, Finland
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Banu SK, Arosh JA, Chapdelaine P, Fortier MA. Expression of prostaglandin transporter in the bovine uterus and fetal membranes during pregnancy. Biol Reprod 2005; 73:230-6. [PMID: 15814899 DOI: 10.1095/biolreprod.105.039925] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
Abstract
Uteroplacental prostaglandins (PGs) play pivotal roles in the maintenance and termination of pregnancy in mammals. In the present study, we have characterized the expression of prostaglandin transporter (PGT) in placentome caruncles, intercaruncular tissues, fetal membranes, and utero-ovarian plexus during pregnancy in cattle. Pregnant bovine uteri were collected and classified into six groups covering the entire gestational length. In caruncles and intercaruncular tissues, PGT mRNA (also known as SLC02A1) and PGT protein were highly expressed at the late stage of pregnancy compared to the early and mid stages, whereas the level of expression is constant and low in fetal membranes throughout pregnancy. PGT mRNA and PGT protein were expressed at a constant level in the utero-ovarian plexus both ipsilateral and contralateral to corpus luteum throughout the course of pregnancy. Overall, the relative expression of PGT mRNA and PGT protein were higher in caruncles than in intercaruncular tissue and fetal membranes, whereas no differences were detected between intercaruncular tissues and fetal membranes at any stage of gestation. Immunohistochemistry indicated that PGT was preferentially expressed in caruncular epithelial cells of placentomes and endometrial luminal epithelial and myometrial smooth muscle cells of the intercaruncular regions. The level of PGT expression was comparatively higher in maternal components than in fetal components. In conclusion, differential spatiotemporal tissue-specific expression of PGT in uterine and intrauterine tissues suggests a role for this transporter in the exchange of PGs between the maternal and the fetal compartments, as well as for intrauterine metabolism of PGs during pregnancy.
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Affiliation(s)
- S K Banu
- Unité d'Ontogénie et Reproduction, Centre Hospitalier Universitaire de Québec, Université Laval, Québec, Canada G1K 7P4
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Papanikolaou EG, Plachouras N, Drougia A, Andronikou S, Vlachou C, Stefos T, Paraskevaidis E, Zikopoulos K. Comparison of misoprostol and dinoprostone for elective induction of labour in nulliparous women at full term: a randomized prospective study. Reprod Biol Endocrinol 2004; 2:70. [PMID: 15450119 PMCID: PMC524504 DOI: 10.1186/1477-7827-2-70] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2004] [Accepted: 09/27/2004] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The objective of this randomized prospective study was to compare the efficacy of 50 mcg vaginal misoprostol and 3 mg dinoprostone, administered every nine hours for a maximum of three doses, for elective induction of labor in a specific cohort of nulliparous women with an unfavorable cervix and more than 40 weeks of gestation. MATERIAL AND METHODS One hundred and sixty-three pregnant women with more than 285 days of gestation were recruited and analyzed. The main outcome measures were time from induction to delivery and incidence of vaginal delivery within 12 and 24 hours. Admission rate to the neonatal intensive care unit within 24 hours post delivery was a secondary outcome. RESULTS The induction-delivery interval was significantly lower in the misoprostol group than in the dinoprostone group (11.9 h vs. 15.5 h, p < 0.001). With misoprostol, more women delivered within 12 hours (57.5% vs. 32.5%, p < 0.01) and 24 hours (98.7% vs. 91.4%, p < 0.05), spontaneous rupture of the membranes occurred more frequently (38.8% vs. 20.5%, p < 0.05), there was less need for oxytocin augmentation (65.8% vs. 81.5%, p < 0.05) and fewer additional doses were required (7.5% vs. 22%, p < 0.05). Although not statistically significant, a lower Caesarean section (CS) rate was observed with misoprostol (7.5% vs. 13.3%, p > 0.05) but with the disadvantage of higher abnormal fetal heart rate (FHR) tracings (22.5% vs. 12%, p > 0.05). From the misoprostol group more neonates were admitted to the intensive neonatal unit, than from the dinoprostone group (13.5% vs. 4.8%, p > 0.05). One woman had an unexplained stillbirth following the administration of one dose of dinoprostone. CONCLUSIONS Vaginal misoprostol, compared with dinoprostone in the regimens used, is more effective in elective inductions of labor beyond 40 weeks of gestation. Nevertheless, this is at the expense of more abnormal FHR tracings and more admissions to the neonatal unit, indicating that the faster approach is not necessarily the better approach to childbirth.
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Affiliation(s)
- Evangelos G Papanikolaou
- Department of Obstetrics and Gynecology, University Hospital of Ioannina, Medical School of Ioannina, Ioannina, Greece
| | - Nikos Plachouras
- Department of Obstetrics and Gynecology, University Hospital of Ioannina, Medical School of Ioannina, Ioannina, Greece
| | - Aikaterini Drougia
- Department of Neonatology, University Hospital of Ioannina, Medical School of Ioannina, Ioannina, Greece
| | - Styliani Andronikou
- Department of Neonatology, University Hospital of Ioannina, Medical School of Ioannina, Ioannina, Greece
| | - Christina Vlachou
- Department of Obstetrics and Gynecology, University Hospital of Ioannina, Medical School of Ioannina, Ioannina, Greece
| | - Theodoros Stefos
- Department of Obstetrics and Gynecology, University Hospital of Ioannina, Medical School of Ioannina, Ioannina, Greece
| | - Evangelos Paraskevaidis
- Department of Obstetrics and Gynecology, University Hospital of Ioannina, Medical School of Ioannina, Ioannina, Greece
| | - Konstantinos Zikopoulos
- Department of Obstetrics and Gynecology, University Hospital of Ioannina, Medical School of Ioannina, Ioannina, Greece
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