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Kosinski P, Borowski D, Brawura-Biskupski-Samaha R, Cnota W, Debska M, Drews K, Grzesiak M, Jaczynska R, Janiak K, Kaczmarek P, Lipa M, Litwinska M, Luterek K, Olejek A, Polczynska-Kaniak E, Preis K, Szaflik K, Szymkiewicz-Dangel J, Swiatkowska-Freund M, Wegrzyn P, Wielgos M, Wloch A, Zamlynski J, Zamlynski M, Sieroszewski P. Fetal therapy guidelines of the Polish Society of Gynecologists and Obstetricians - Fetal Therapy Section. Ginekol Pol 2024; 95:285-315. [PMID: 38632880 DOI: 10.5603/gpl.100108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2024] [Accepted: 04/03/2024] [Indexed: 04/19/2024] Open
Affiliation(s)
- Przemyslaw Kosinski
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland.
| | - Dariusz Borowski
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital, Kielce, Poland
| | | | - Wojciech Cnota
- Chair and Department of Gynecology and Obstetrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Marzena Debska
- National Medical Institute of the Ministry of the Interior and Administration in Warsaw, Poland
| | - Krzysztof Drews
- Department of Perinatology and Women's Diseases, Poznan University of Medical Sciences, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
- 2nd Chair and Department of Gynecology and Obstetrics, Medical University of Lodz, Poland
| | - Renata Jaczynska
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland
| | - Katarzyna Janiak
- Department of Gynecology, Reproductive, Fetal Therapy and Infertility Diagnosis and Treatment, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Piotr Kaczmarek
- Department of Gynecology, Reproductive, Fetal Therapy and Infertility Diagnosis and Treatment, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Michal Lipa
- National Medical Institute of the Ministry of the Interior and Administration in Warsaw, Poland
| | - Magdalena Litwinska
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Katarzyna Luterek
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland
| | - Anita Olejek
- Department of Gynecology, Obstetrics and Oncological Gynecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | | | - Krzysztof Preis
- Department of Gynecology and Obstetrics, Medical University of Gdansk, Poland
- Department of Obstetrics, Gynecology and Gynecological Oncology, Provincial Multi-specialist Hospital in Torun, Poland
| | - Krzysztof Szaflik
- Department of Gynecology, Reproductive, Fetal Therapy and Infertility Diagnosis and Treatment, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Joanna Szymkiewicz-Dangel
- Department of Perinatal Cardiology and Congenital Defects, Centre of Postgraduate Medical Education, Warsaw, Poland
| | | | - Piotr Wegrzyn
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Poland
| | - Miroslaw Wielgos
- National Medical Institute of the Ministry of the Interior and Administration in Warsaw, Poland
- Medical Faculty, Lazarski University, Warsaw, Poland
| | - Agata Wloch
- Chair and Department of Gynecology and Obstetrics, Faculty of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Jacek Zamlynski
- Department of Gynecology, Obstetrics and Oncological Gynecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Mateusz Zamlynski
- Department of Gynecology, Obstetrics and Oncological Gynecology, Faculty of Medical Sciences in Zabrze, Medical University of Silesia, Katowice, Poland
| | - Piotr Sieroszewski
- 1st Department of the Gynecology and Obstetrics, Medical University of Lodz, Poland
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Sieroszewski P, Bomba-Opon D, Czajkowski K, Drews K, Grzesiak M, Leszczynska-Gorzelak B, Scholz A, Kalinka J, Kosinka-Kaczynska K, Kwiatkowski S, Mierzynski R, Preis K, Ropacka-Lesiak M, Swiatkowska-Freund M, Wielgos M, Zimmer M, Huras H. Guidelines of the Polish Society of Gynecologists and Obstetricians on the diagnosis and management of pregnancies complicated by prelabor rupture of the membranes. Ginekol Pol 2024:VM/OJS/J/98339. [PMID: 38506477 DOI: 10.5603/gpl.98339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 11/28/2023] [Indexed: 03/21/2024] Open
Affiliation(s)
- Piotr Sieroszewski
- 1st Department of Gynaecology and Obstetrics, Medical University of Lodz, Poland
| | - Dorota Bomba-Opon
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Krzysztof Czajkowski
- 2nd Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Krzysztof Drews
- Department of Perinatology and Women's Diseases, Poznan University of Medical Sciences, Poznan, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynaecology, Polish Mother's Memorial Hospital Research Institute in Lodz, Poland
| | | | - Anna Scholz
- 1st Department of Obstetrics and Gynecology, CMKP in Warsaw, Poland
| | | | - Katarzyna Kosinka-Kaczynska
- Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education in Warsaw, Poland
| | - Sebastian Kwiatkowski
- Department of Obstetrics and Gynecology, Independent Public Clinical Hospital No 2, Medical University in Szczecin, Poland
| | - Radzislaw Mierzynski
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland
| | - Krzysztof Preis
- The Academy of Applied Medical and Social Sciences Elblag, Poland
| | - Mariola Ropacka-Lesiak
- Department of Perinatology and Gynaecology, Poznan University of Medical Sciences, Poznan, Poland
| | | | | | - Mariusz Zimmer
- 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Poland
| | - Hubert Huras
- Department of Obstetrics and Perinatology Collegium Medicum Jagiellonia University Cracow, Poland
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3
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Szyrzisko W, Grzesiak M. Periovarian Adipose Tissue - an Impact on Ovarian Functions. Physiol Res 2024; 73:1-8. [PMID: 38466000 PMCID: PMC11019623 DOI: 10.33549/physiolres.935206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 11/22/2023] [Indexed: 04/26/2024] Open
Abstract
Periovarian adipose tissue (POAT) is a type of gonadal white adipose tissue that surrounds the ovary. POAT is a source of various bioactive molecules, such as adipokines, cytokines, chemokines, growth factors and hormones. Thereby it could influence crucial ovarian functions. Recent findings showed that removal of POAT affects folliculogenesis and steroidogenesis in the ovary. Furthermore, changes in the morphology and function of POAT were observed in women during menopause or polycystic ovary syndrome. Although the relationship between the body's energy status and fertility in females is generally well known, the contribution of POAT remains still elusive. Therefore, the objective of this review is summarizing the actual state of knowledge about POAT function in physiological and pathological processes within the ovary.
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Affiliation(s)
- W Szyrzisko
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University in Krakow, Krakow, Republic of Poland.
| | - M Grzesiak
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Faculty of Biology, Jagiellonian University in Krakow, Krakow, Republic of Poland.
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4
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Rybak-Krzyszkowska M, Górecka J, Huras H, Massalska-Wolska M, Staśkiewicz M, Gach A, Kondracka A, Staniczek J, Górczewski W, Borowski D, Jaczyńska R, Grzesiak M, Krzeszowski W. Cytomegalovirus Infection in Pregnancy Prevention and Treatment Options: A Systematic Review and Meta-Analysis. Viruses 2023; 15:2142. [PMID: 38005820 PMCID: PMC10675417 DOI: 10.3390/v15112142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 10/06/2023] [Accepted: 10/19/2023] [Indexed: 11/26/2023] Open
Abstract
OBJECTIVES Cytomegalovirus (CMV) infection is a significant health concern affecting numerous expectant mothers across the globe. CMV is the leading cause of health problems and developmental delays among infected infants. Notably, this study examines CMV infection in pregnancy, its management, prevention mechanisms, and treatment options. METHODS Specifically, information from the Cochrane Library, PUBMED, Wiley Online, Science Direct, and Taylor Francis databases were reviewed along with additional records identified through the register, the Google Scholar search engine. Based on the search, 21 articles were identified for systematic review. RESULTS A total of six randomized controlled trials (RCTs) were utilized for a meta-analytic review. As heterogeneity was substantial, the random effects model was used for meta-analysis. Utilizing the random-effects model, the restricted maximum likelihood (REML) approach, the estimate of effect size (d = -0.479, 95% CI = -0.977 to 0.019, p = 0.060) suggests the results are not statistically significant, so it cannot be inferred that the prevention methods used were effective, despite an inverse relationship between treatment and number of infected cases. The findings indicated that several techniques are used to prevent, diagnose, and manage CMV infection during pregnancy, including proper hygiene, ultrasound examination (US), magnetic resonance imaging (MRI), amniocentesis, viremia, hyperimmunoglobulin (HIG), and valacyclovir (VACV). CONCLUSIONS The current review has significant implications for addressing CMV infection in pregnancy. Specifically, it provides valuable findings on contemporary management interventions to prevent and treat CMV infection among expectant mothers. Therefore, it allows relevant stakeholders to address these critical health concerns and understand the effectiveness of the proposed prevention and treatment options.
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Affiliation(s)
- Magda Rybak-Krzyszkowska
- Department of Obstetrics, Perinatology University Hospital, 30-551 Kraków, Poland; (J.G.); (M.S.)
- Hi-Gen Centrum Medyczne, 30-552 Kraków, Poland
| | - Joanna Górecka
- Department of Obstetrics, Perinatology University Hospital, 30-551 Kraków, Poland; (J.G.); (M.S.)
| | - Hubert Huras
- Department of Obstetrics and Perinatology, Jagiellonian University Medical College, 30-551 Kraków, Poland;
| | - Magdalena Massalska-Wolska
- Clinical Department of Gynecological Endocrinology and Gynecology, University Hospital, 30-551 Kraków, Poland;
| | - Magdalena Staśkiewicz
- Department of Obstetrics, Perinatology University Hospital, 30-551 Kraków, Poland; (J.G.); (M.S.)
| | - Agnieszka Gach
- Department of Genetics, Polish Mother’s Memorial Hospital-Research Institute, 93-338 Łódź, Poland;
| | - Adrianna Kondracka
- Department of Obstetrics and Pathology of Pregnancy, Medical University of Lublin, 20-081 Lublin, Poland;
| | - Jakub Staniczek
- Department of Gynecology, Obstetrics and Gynecological Oncology, Medical University of Silesia, 40-055 Katowice, Poland;
| | - Wojciech Górczewski
- Obstetrics and Gynecology Ward, Independent Public Health Care Facility “Bl. Marta Wiecka County Hospital”, 32-700 Bochnia, Poland;
| | - Dariusz Borowski
- Clinic of Obstetrics and Gynecology, Provincial Combined Hospital in Kielce, 25-736 Kielce, Poland;
| | - Renata Jaczyńska
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland;
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital-Research Institute, 93-338 Łódź, Poland; (M.G.); (W.K.)
- Department of Gynecology and Obstetrics, Medical University of Łódź, 93-338 Łódź, Poland
| | - Waldemar Krzeszowski
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital-Research Institute, 93-338 Łódź, Poland; (M.G.); (W.K.)
- Salve Medica, 91-210 Lodz, Poland
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Zych-Krekora K, Sylwestrzak O, Grzesiak M, Krekora M. Impact of Prenatal and Postnatal Diagnosis on Parents: Psychosocial and Economic Aspects Related to Congenital Heart Defects in Children. J Clin Med 2023; 12:5773. [PMID: 37762715 PMCID: PMC10531545 DOI: 10.3390/jcm12185773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 08/12/2023] [Accepted: 08/13/2023] [Indexed: 09/29/2023] Open
Abstract
Congenital heart defects (CHD) are defects detected both prenatally and after birth. They are the most common congenital defects. Despite advances in diagnosis and treatment, CHD remain an important cause of morbidity and mortality in newborns, which has a great impact on economic aspects. It is crucial to provide a holistic approach to the care of children with CHD, including regular cardiac check-ups, appropriate drug treatment, surgical or cardiac interventions as needed, rehabilitation, psychological support, and education for patients and their families. Parents experience a variety of psychological problems. This article summarizes the influence of CHD in the psychological and economic areas.
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Affiliation(s)
- Katarzyna Zych-Krekora
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland;
| | - Oskar Sylwestrzak
- Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland; (O.S.); (M.K.)
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland;
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
| | - Michał Krekora
- Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Lodz, Poland; (O.S.); (M.K.)
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Lodz, Poland
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Zych-Krekora K, Krekora M, Grzesiak M, Sylwestrzak O. The Predictive Value of the CSA Index in the Prenatal Diagnosis of Aortic Coarctation in Ultrasound Examination Performed during the Second Trimester. J Clin Med 2023; 12:5190. [PMID: 37629232 PMCID: PMC10455770 DOI: 10.3390/jcm12165190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 07/16/2023] [Accepted: 08/02/2023] [Indexed: 08/27/2023] Open
Abstract
BACKGROUND Aortic coarctation (CoA) is the fourth most common congenital heart defect (8-10%) which occurs at a frequency of about 20-60/100,000 births. Only 22.3% of all cases appears to be diagnosed during the second trimester of pregnancy. Since the detection of prenatal aortic coarctations is very low, every effort should be made to change this situation. According to the authors of this study, the CSAi (carotid to subclavian artery index) could serve as a reliable indicator. MATERIAL AND METHODS Ninety-six fetuses from healthy, single, pregnancies, with good ultrasound visualization between 18 and 27.5 weeks of gestation, and twenty-three fetuses suspected of aortic coarctation (postnatally confirmed) were included in this study. Our first aim was to compare the current most common method of prenatal CoA diagnosis based on the measurement of the aortic z-score in the aortic isthmus using the method suggested by us-CSAi. RESULTS Logistic regression coefficients for z-score and CSAi were analyzed as predictors of coarctation occurrence. It appears that 39.4% of coarctation occurrence can be predicted on the basis of the z-score, and 93.5% on the basis of the CSAi. The cut-off value for CSAi in the study group was 0.81 (sensitivity: 95.7%, specificity 99%). Based on the ROC curve analysis, the cut-off value for the carotid to subclavian distance (mm) was determined; the risk of coarctation increased above this value. Based on the Gini index (0.867), this value was set at 2.55 (sensitivity 82.6%, specificity 93.7%). CONCLUSIONS CSAi measurement is currently the most sensitive method for aortic coarctation detection. For the purpose of our study, this method was applied in diagnostics in the second trimester of pregnancy. This method is easy, reproducible and should be widely introduced into everyday echocardiographic diagnostics of coarctation to minimize the risk of error.
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Affiliation(s)
- Katarzyna Zych-Krekora
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Łódź, Poland;
| | - Michał Krekora
- Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Łódź, Poland; (M.K.); (O.S.)
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Łódź, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Łódź, Poland;
- Department of Gynecology and Obstetrics, Medical University of Lodz, 90-419 Łódź, Poland
| | - Oskar Sylwestrzak
- Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Łódź, Poland; (M.K.); (O.S.)
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute in Lodz, 93-338 Łódź, Poland
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Sakowicz A, Bralewska M, Rybak-Krzyszkowska M, Grzesiak M, Pietrucha T. New Ideas for the Prevention and Treatment of Preeclampsia and Their Molecular Inspirations. Int J Mol Sci 2023; 24:12100. [PMID: 37569476 PMCID: PMC10418829 DOI: 10.3390/ijms241512100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023] Open
Abstract
Preeclampsia (PE) is a pregnancy-specific disorder affecting 4-10% of all expectant women. It greatly increases the risk of maternal and foetal death. Although the main symptoms generally appear after week 20 of gestation, scientific studies indicate that the mechanism underpinning PE is initiated at the beginning of gestation. It is known that the pathomechanism of preeclampsia is strongly related to inflammation and oxidative stress, which influence placentation and provoke endothelial dysfunction in the mother. However, as of yet, no "key players" regulating all these processes have been discovered. This might be why current therapeutic strategies intended for prevention or treatment are not fully effective, and the only effective method to stop the disease is the premature induction of delivery, mostly by caesarean section. Therefore, there is a need for further research into new pharmacological strategies for the treatment and prevention of preeclampsia. This review presents new preventive methods and therapies for PE not yet recommended by obstetrical and gynaecological societies. As many of these therapies are in preclinical studies or under evaluation in clinical trials, this paper reports the molecular targets of the tested agents or methods.
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Affiliation(s)
- Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland; (M.B.); (T.P.)
| | - Michalina Bralewska
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland; (M.B.); (T.P.)
| | - Magda Rybak-Krzyszkowska
- Department of Obstetrics and Perinatology, University Hospital in Krakow, 31-501 Krakow, Poland;
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital-Research Institute in Lodz, 93-338 Lodz, Poland;
- Department of Gynecology and Obstetrics, Medical University of Lodz, 93-338 Lodz, Poland
| | - Tadeusz Pietrucha
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, 90-752 Lodz, Poland; (M.B.); (T.P.)
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8
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Rybak-Krzyszkowska M, Górecka J, Huras H, Staśkiewicz M, Kondracka A, Staniczek J, Górczewski W, Borowski D, Grzesiak M, Krzeszowski W, Massalska-Wolska M, Jaczyńska R. Ultrasonographic Signs of Cytomegalovirus Infection in the Fetus-A Systematic Review of the Literature. Diagnostics (Basel) 2023; 13:2397. [PMID: 37510141 PMCID: PMC10378321 DOI: 10.3390/diagnostics13142397] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 07/02/2023] [Accepted: 07/11/2023] [Indexed: 07/30/2023] Open
Abstract
BACKGROUND congenital cytomegalovirus (cCMV) infection during pregnancy is a significant risk factor for fetal and neonatal morbidity and mortality. CMV detection is based on the traditional ultrasound (US) and MRI (magnetic resonance) approach. METHODS the present review used the PRISMA protocol for identification of studies associated with CMV infection and sonographic analysis. Various search terms were created using keywords which were used to identify references from Medline, Pubmed, PsycInfo, Scopus and Web of Science. RESULTS sonographic analysis of the cCMV infection identified several of the key features associated with fetuses. The presence of abnormal patterns of periventricular echogenicity, ventriculomegaly and intraparenchymal calcifications is indicative of CMV infection in the fetus. Hyperechogenic bowels were seen frequently. These results correlate well with MRI data, especially when targeted transvaginal fetal neurosonography was carried out. CONCLUSIONS ultrasonography is a reliable indicator of fetal anomalies, due to cCMV. Fetal brain and organ changes are conclusive indications of infection, but many of the ultrasonographic signs of fetal abnormality could be due to any viral infections; thus, further research is needed to demarcate CMV infection from others, based on the ultrasonographic approach. CMV infection should always be an indication for targeted fetal neurosonography, optimally by the transvaginal approach.
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Affiliation(s)
- Magda Rybak-Krzyszkowska
- Department of Obstetrics and Perinatology, University Hospital, 30-551 Krakow, Poland
- Hi-Gen Centrum Medyczne, 30-552 Krakow, Poland
| | - Joanna Górecka
- Department of Obstetrics and Perinatology, University Hospital, 30-551 Krakow, Poland
| | - Hubert Huras
- Department of Obstetrics and Perinatology, University Hospital, 30-551 Krakow, Poland
| | - Magdalena Staśkiewicz
- Department of Obstetrics and Perinatology, University Hospital, 30-551 Krakow, Poland
| | - Adrianna Kondracka
- Department of Obstetrics and Pathology of Pregnancy, Medical University of Lublin, 20-081 Lublin, Poland
| | - Jakub Staniczek
- Department of Gynecology, Obstetrics and Gynecologic Oncology, Medical University of Silesia, 40-055 Katowice, Poland
| | - Wojciech Górczewski
- Obstetrics and Gynecology Ward, Independent Public Healthcare Institution in Bochnia, The Blessed Marta Wiecka District Hospital, 32-700 Bochnia, Poland
| | - Dariusz Borowski
- Provincial Combined Hospital in Kielce, Clinic of Obstetrics and Gynaecology, 25-736 Kielce, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother's Memorial Hospital-Research Institute in Lodz, 93-338 Lodz, Poland
- Department of Obstetrics and Gynecology, Medical University of Lodz, 93-338 Lodz, Poland
| | - Waldemar Krzeszowski
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother's Memorial Hospital-Research Institute in Lodz, 93-338 Lodz, Poland
- Salve Medica, 91-210 Lodz, Poland
| | - Magdalena Massalska-Wolska
- Clinical Department of Gynecological Endocrinology and Gynecology, University Hospital, 30-551 Krakow, Poland
| | - Renata Jaczyńska
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, 02-091 Warsaw, Poland
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Kosińska Kaczyńska K, Rebizant B, Bednarek K, Dabrowski FA, Kajdy A, Muzyka-Placzyńska K, Filipecka-Tyczka D, Uzar P, Kwiatkowski S, Torbe A, Grzesiak M, Kaczmarek P, Żyła M, Brawura-Biskupski-Samaha R. Emergency cerclage using double-level versus single-level suture in the management of cervical insufficiency (Cervical Occlusion double-level Stitch Application, COSA): study protocol for a multicentre, non-blinded, randomised controlled trial. BMJ Open 2023; 13:e071564. [PMID: 37286317 DOI: 10.1136/bmjopen-2023-071564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/09/2023] Open
Abstract
INTRODUCTION Cervical insufficiency accounts for 15% of recurrent pregnancy losses between 16 and 28 weeks of gestation. The aim of the study is to verify the effectiveness of emergency double-level cerclage with vaginal progesterone in cervical insufficiency treatment in terms of the prevention of preterm delivery before 34 weeks of gestation. METHODS AND ANALYSIS This trial is a multicentre, non-blinded, randomised study with 1:1 allocation ratio. The study is conducted at tertiary perinatal care departments in Poland. It will include patients with cervical insufficiency with the fetal membranes visible in the open cervical canal or protruding into the vagina between 16+0 and 23+6 weeks of pregnancy. They will be randomised into two arms: emergency single-level cerclage with vaginal progesterone or double-level cerclage with vaginal progesterone. All will be administered antibiotics and indomethacin. The primary outcome is the rate of deliveries below 34+0 weeks of gestation, while secondary outcomes include gestational age at delivery, neonatal outcomes, maternal outcomes according to the Core Outcome Set for Evaluation of Interventions to Prevent Preterm Birth and cerclage procedure complications. The planned number of participants according to the power analysis is 78. ETHICS AND DISSEMINATION The study protocol was written in accordance with the Standard Protocol Items: Recommendations for Interventional Trials statement. It was created according to the requirements of the Declaration of Helsinki for Medical Research involving Human Subject. Ethical approval was obtained from the Ethics Committee of the Centre of Postgraduate Medical Education (no. 1/2022). The study protocol was approved and published by ClinicalTrials.gov (posted on 24 February 2022). All participants gave a written informed consent. After completion of the study its results will be published in a peer-reviewed English language journal. TRIAL REGISTRATION NCT05268640.
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Affiliation(s)
- Katarzyna Kosińska Kaczyńska
- Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, Warszawa, Poland
| | - Beata Rebizant
- Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, Warszawa, Poland
| | - Katarzyna Bednarek
- Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, Warszawa, Poland
| | - Filip Andrzej Dabrowski
- Department of Obstetrics, Perinatology and Neonatology, Center of Postgraduate Medical Education, Warszawa, Poland
| | - Anna Kajdy
- 1st Department of Obstetrics and Gynecology, Center of Postgraduate Medical Educatiion, Warsaw, Poland
| | | | - Dagmara Filipecka-Tyczka
- 1st Department of Obstetrics and Gynecology, Center of Postgraduate Medical Educatiion, Warsaw, Poland
| | - Piotr Uzar
- Department of Obstetrics and Gynecology, Pomeranian Medical University Szczecin, Szczecin, Poland
| | - Sebastian Kwiatkowski
- Department Obstetrics and Gynecology, Pomorski Uniwersytet Medyczny w Szczecinie, Szczecin, Zachodniopomorskie, Poland
| | - Andrzej Torbe
- Department of Obstetrics and Gynecology, Pomeranian Medical University Szczecin, Szczecin, Poland
| | - Mariusz Grzesiak
- Department of Perinatology Obstetrics and Gynecology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
| | - Piotr Kaczmarek
- Department of Perinatology Obstetrics and Gynecology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
| | - Monika Żyła
- Department of Perinatology Obstetrics and Gynecology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
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Sieroszewski P, Bomba-Opon D, Cnota W, Drosdzol-Cop A, Gogacz M, Grzesiak M, Huras H, Jakimiuk A, Kaczmarek P, Kwiatkowski S, Mierzynski R, Sawicki W, Seremak-Mrozikiewicz A, Stojko R, Wielgos M, Wender-Ozegowska E, Zimmer M, Konieczna M. Guidelines of the Polish Society of Gynecologists and Obstetricians on the diagnosis and treatment of iron deficiency and iron deficiency with anemia. Ginekol Pol 2023:VM/OJS/J/93104. [PMID: 37042329 DOI: 10.5603/gp.a2022.0153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 12/07/2022] [Indexed: 04/13/2023] Open
Affiliation(s)
- Piotr Sieroszewski
- 1st Department of Gynaecology and Obstetrics, Medical University of Lodz, Poland.
| | - Dorota Bomba-Opon
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Wojciech Cnota
- Chair and Department of Gynaecology and Obstetrics in Ruda Slaska, Medical University of Silesia in Katowice, Poland
| | - Agnieszka Drosdzol-Cop
- Chair and Department of Gynecology, Obstetrics and Oncological Gynecology, Medical University of Silesia in Katowice, Poland
| | - Marek Gogacz
- 2nd Department of Gynecology, Medical University of Lublin, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynaecology, Polish Mother's Memorial Hospital Research Institute in Lodz, Poland
| | - Hubert Huras
- Collegium Medicum, Jagiellonian University, Cracow, Poland
| | - Artur Jakimiuk
- Department of Obstetrics and Gynecology, Central Clinical Hospital of the Ministry of the Interior and Administration (MSWiA), Warsaw, Poland
| | - Piotr Kaczmarek
- Department of Perinatology, Obstetrics and Gynaecology, Polish Mother's Memorial Hospital Research Institute in Lodz, Poland
| | - Sebastian Kwiatkowski
- Departament of Obstetrics and Gynecology, Pomeranian Medical University in Szczecin, Poland
| | - Radzislaw Mierzynski
- Chair and Department of Obstetrics and Perinatology, Medical University of Lublin, Poland
| | - Wlodzimierz Sawicki
- Chair and Department of Obstetrics, Gynecology and Gynecological Oncology, Medical University of Warsaw, Poland
| | | | - Rafal Stojko
- Chair and Department of Gynecology, Obstetrics and Oncological Gynecology, Medical University of Silesia in Katowice, Poland
| | - Miroslaw Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Ewa Wender-Ozegowska
- Department of Reproduction, Chair of Obstertics, Gynecology and Gynecological Oncology, Poznan University of Medical Sciences, Poland
| | - Mariusz Zimmer
- 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, Poland
| | - Marta Konieczna
- Pathology of Pregnancy Department Medical Univeristy of Lodz, Poland
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11
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Wujcicka WI, Kacerovsky M, Krygier A, Krekora M, Kaczmarek P, Grzesiak M. Association of Single Nucleotide Polymorphisms from Angiogenesis-Related Genes, ANGPT2, TLR2 and TLR9, with Spontaneous Preterm Labor. Curr Issues Mol Biol 2022; 44:2939-2955. [PMID: 35877427 PMCID: PMC9322696 DOI: 10.3390/cimb44070203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/25/2022] [Accepted: 06/27/2022] [Indexed: 12/07/2022] Open
Abstract
In this study, we hypothesized that the changes localized at angiopoietin-2 (ANGPT2), granulocyte-macrophage colony-stimulating factor (CSF2), fms-related tyrosine kinase 1 (FLT1) and toll-like receptor (TLR) 2, TLR6 and TLR9 genes were associated with spontaneous preterm labor (PTL), as well as with possible genetic alterations on PTL-related coagulation. This case-control genetic association study aimed to identify single nucleotide polymorphisms (SNPs) for the aforementioned genes, which are correlated with genetic risk or protection against PTL in Polish women. The study was conducted in 320 patients treated between 2016 and 2020, including 160 women with PTL and 160 term controls in labor. We found that ANGPT2 rs3020221 AA homozygotes were significantly less common in PTL cases than in controls, especially after adjusting for activated partial thromboplastin time (APTT) and platelet (PLT) parameters. TC heterozygotes for TLR2 rs3804099 were associated with PTL after correcting for anemia, vaginal bleeding, and history of threatened miscarriage or PTL. TC and CC genotypes in TLR9 rs187084 were significantly less common in women with PTL, compared to the controls, after adjusting for bleeding and gestational diabetes. For the first time, it was shown that three polymorphisms-ANGPT2 rs3020221, TLR2 rs3804099 and TLR9 rs187084 -were significantly associated with PTL, adjusted by pregnancy development influencing factors.
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Affiliation(s)
- Wioletta Izabela Wujcicka
- Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother’s Memorial Hospital-Research Institute, 93-338 Lodz, Poland
- Correspondence: or ; Tel.: +48-42-271-15-20; Fax: +48-42-271-15-10
| | - Marian Kacerovsky
- Department of Obstetrics and Gynecology, University Hospital Hradec Kralove, Charles University, 500 03 Hradec Kralove, Czech Republic;
- Biomedical Research Center, University Hospital Hradec Kralove, 500 03 Hradec Kralove, Czech Republic
| | - Adrian Krygier
- Laboratory of Molecular Diagnostics and Pharmacogenomics, Department of Pharmaceutical Biochemistry and Molecular Diagnostics, Medical University of Lodz, 90-151 Lodz, Poland;
| | - Michał Krekora
- Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital-Research Institute, 93-338 Lodz, Poland;
- Department of Gynecology and Obstetrics, Medical University of Lodz, 93-338 Lodz, Poland;
| | - Piotr Kaczmarek
- Department of Gynecology, Reproduction and Fetal Therapy, and Diagnostics and Treatment of Infertility, Polish Mother’s Memorial Hospital-Research Institute, 93-338 Lodz, Poland;
| | - Mariusz Grzesiak
- Department of Gynecology and Obstetrics, Medical University of Lodz, 93-338 Lodz, Poland;
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital-Research Institute, 93-338 Lodz, Poland
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12
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Zych-Krekora K, Grzesiak M, Kaczmarek P, Perlman S, Bardin R, Gilboa Y, Krekora M. Assessment of fetal thymus size and BMI in pregnant women with diabetes. Ginekol Pol 2022:VM/OJS/J/88362. [DOI: 10.5603/gp.a2022.0020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2022] [Accepted: 03/15/2022] [Indexed: 11/25/2022] Open
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13
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Krekora M, Sokołowski Ł, Murlewska J, Zych-Krekora K, Słodki M, Grzesiak M, Gulczyńska E, Maroszyńska I, Respondek-Liberska M. Small prenatal diameter of the ascending aorta is associated with increased mortality risk in neonates with congenital diaphragmatic hernia. Arch Med Sci 2022; 19:1022-1027. [PMID: 37560725 PMCID: PMC10408014 DOI: 10.5114/aoms/147768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 03/28/2022] [Indexed: 08/11/2023] Open
Abstract
INTRODUCTION The aim of this study was to evaluate whether selected prenatal markers obtained from fetal echocardiography can predict postnatal outcome in congenital diaphragmatic hernia (CDH) patients. We also aimed to verify the prognostic value of lung-to-head ratio (LHR). MATERIAL AND METHODS The study group included 29 fetuses with CDH. We analyzed potentially prognostic parameters measured using fetal echocardiography and fetal ultrasound. The assessed parameters were compared between the group of patients with CDH who survived to discharge (n = 21) and the subset of patients who died before discharge from hospital (n = 8). RESULTS In survivors, mean z-score for ascending aorta (AAo) diameter was 0.23 ±0.98 vs. - 1.82 ±1.04 in patients who died (t-test, p = 0.0015). In survivors, the main pulmonary artery/ascending aorta ratio was 1.22 ±0.17 vs. 1.46 ±0.21 in patients who died (t-test, p = 0.017). In survivors, the LHR was 1.81 ±0.96 vs. 0.95 ±0.6 in patients who died (t-test, p = 0.019). In survivors, the observed to expected LHR was 57 ±30% vs 30 ±18% in patients who died (t-test, p = 0.018). CONCLUSIONS Narrowing of the ascending aorta in CDH fetuses is a poor prognostic factor associated with increased mortality in neonates. Our study also confirmed the prognostic value of LHR.
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Affiliation(s)
- Michał Krekora
- Department of Obstetrics and Gynaecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Łukasz Sokołowski
- Department of Obstetrics and Gynaecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
- Department for Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Julia Murlewska
- Department for Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Katarzyna Zych-Krekora
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Maciej Słodki
- Department for Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
- Faculty of Health Sciences, State University of Applied Sciences, Plock, Poland
| | - Mariusz Grzesiak
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Ewa Gulczyńska
- Department of Neonatology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Iwona Maroszyńska
- Department of Intensive Care and Congenital Malformations of Newborns and Infants, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Maria Respondek-Liberska
- Department for Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
- Department of Diagnosis and Prevention of Fetal Malformations, Medical University of Lodz, Lodz, Poland
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14
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Garí M, Grzesiak M, Krekora M, Kaczmarek P, Jankowska A, Król A, Kaleta D, Jerzyńska J, Janasik B, Kuraś R, Tartaglione AM, Calamandrei G, Hanke W, Polańska K. Prenatal exposure to neurotoxic metals and micronutrients and neurodevelopmental outcomes in early school age children from Poland. Environ Res 2022; 204:112049. [PMID: 34520749 DOI: 10.1016/j.envres.2021.112049] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/16/2021] [Accepted: 09/06/2021] [Indexed: 06/13/2023]
Abstract
Exposure to environmental factors, such as neurotoxic metals and micronutrients, during critical periods of development can contribute to long-term consequences in offspring's health, including neurodevelopmental outcomes. The aim of this study was to evaluate the association between simultaneous prenatal exposure to metals [lead (Pb), cadmium (Cd), mercury (Hg)] and micronutrients [selenium (Se), zinc (Zn), copper (Cu)] and neurodevelopmental outcomes in school-age children from the Polish Mother and Child Cohort (REPRO_PL). Metals and micronutrients concentrations were measured in cord blood (Pb, Cd, Se, Zn, Cu) and in maternal hair (Hg) collected during the 3rd trimester of pregnancy. Behavioral and emotional problems, as well as children's cognitive and psychomotor development, were assessed in 436 school-age children using the Strengths and Difficulties Questionnaire (SDQ, filled in by the mothers) and the Polish adaptation of the Intelligence and Development Scales (IDS, administered by trained psychologists). Multivariate regression models were applied after imputation of missing values, using two approaches: (i) a joint analysis taking into account all metals and micronutrients simultaneously, and (ii) an ExWAS study (single-exposure model). In the SDQ, Hyperactivity/Inattention problems and Total difficulties were associated with higher Hg concentrations in maternal hair (0.18, 95% CI: 0.05; 0.3; and 0.14, 95% CI: 0.01; 0.3, respectively), whereas Emotional symptoms were inversely associated with Se and Zn levels in cord blood (-0.13, 95% CI: -0.3; 0.004; and -0.10, 95% CI: -0.2; 0.02, respectively). In the IDS, cord blood Pb levels were found to be negatively associated with Fluid and Crystallized IQ (-0.12, 95% CI: -0.3; 0.02; and -0.14, 95% CI: -0.3; 0.007, respectively) as well as Mathematical skills (-0.15, 95% CI: -0.3; 0.01). The current research has been able to simultaneously assess the exposure to various interacting chemicals during the prenatal period. We demonstrate that prenatal co-exposures to Pb, Hg, Zn and Se have long-term influences on the neuropsychological outcome of school-age children.
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Affiliation(s)
- Mercè Garí
- Institute of Computational Biology, German Research Center for Environmental Health, Neuherberg, Germany.
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, "Polish Mother's Memorial Hospital" Research Institute, Lodz, Poland; Department of Gynecology and Obstetrics, IInd Chair of Gynecology and Obstetrics, Medical University of Lodz, Poland.
| | - Michał Krekora
- Department of Gynecology and Obstetrics, IInd Chair of Gynecology and Obstetrics, Medical University of Lodz, Poland; Department of Obstetrics and Gynecology, "Polish Mother's Memorial Hospital" Research Institute, Lodz, Poland.
| | - Piotr Kaczmarek
- Department of Perinatology, Obstetrics and Gynecology, "Polish Mother's Memorial Hospital" Research Institute, Lodz, Poland.
| | - Agnieszka Jankowska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Anna Król
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Dorota Kaleta
- Department of Hygiene and Epidemiology, Medical University of Lodz, Poland.
| | - Joanna Jerzyńska
- Department of Paediatrics and Allergy, Copernicus Memorial Hospital, Medical University of Lodz, Poland.
| | - Beata Janasik
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Renata Kuraś
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Anna Maria Tartaglione
- Centre for Behavioural Sciences and Mental Health, National Institute of Health, Rome, Italy.
| | - Gemma Calamandrei
- Centre for Behavioural Sciences and Mental Health, National Institute of Health, Rome, Italy.
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland.
| | - Kinga Polańska
- Department of Environmental and Occupational Health Hazards, Nofer Institute of Occupational Medicine, Lodz, Poland; Department of Hygiene and Epidemiology, Medical University of Lodz, Poland.
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15
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Lewandowski KC, Tadros-Zins M, Horzelski W, Grzesiak M, Lewinski A. Establishing Reference Ranges for Aldosterone, Renin and Aldosterone-to-Renin Ratio for Women in the Third-Trimester of Pregnancy. Exp Clin Endocrinol Diabetes 2022; 130:210-216. [PMID: 35114699 DOI: 10.1055/a-1467-2161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE Diagnosis of primary hyperaldosteronism in pregnancy is complicated due to lack of reference ranges for aldosterone, renin and aldosterone-to-renin ratio. We have endeavoured to establish third-trimester reference ranges for the above-mentioned parameters. DESIGN & PATIENTS We performed postural tests for aldosterone and renin (chemiluminescence immunoassay Liason® DiaSorin Inc., Italy) in 70 healthy pregnant women (age 30.53±4.51 years), at 32.38±4.25 weeks of gestation and in 22 non-pregnant healthy women (age 33.08±8.72 years). RESULTS Aldosterone reference ranges were 6.51-73.97 ng/dl and 12.33-86.38 ng/dl, for supine and upright positions, respectively and that for renin were 6.25-59.36 µIU/ml and 11.12-82.55 µIU/ml, respectively. Aldosterone and renin concentrations were higher in an upright position (p=0.000459 and p=0.00011, respectively). In contrast, aldosterone-to-renin ratio was not affected by posture (i. e. 0.497-3.084 ng/dl/µIU/ml versus 0.457-3.06 ng/dl/µIU/ml, p=0.12), but was higher (p=0.00081) than in non-pregnant controls. In comparison to manufacturer-provided non-pregnant reference range, supine aldosterone concentrations increased by 556% (lower cut-off) and 313% (upper cut-off), while upright aldosterone concentrations increased by 558% (lower cut-off) and 244% (upper cut-off). The reference range for supine renin concentrations increased by 223% (lower cut-off) and 48.7% (upper cut-off), while upright renin concentrations increased by 253% (lower cut-off) and 79% (upper cut-off). CONCLUSIONS There is an upward shift in aldosterone and renin reference ranges in the third-trimester of pregnancy accompanied by an increase in an aldosterone-to-renin ratio, that is not influenced by posture. It remains to be established whether the aldosterone-to-renin ratio may be used as a screening tool for primary hyperaldosteronism in pregnancy.
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Affiliation(s)
- Krzysztof C Lewandowski
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland.,Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland
| | - Monika Tadros-Zins
- Department of Obstetrics, Perinatology and Gynaecology; Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland
| | - Wojciech Horzelski
- Department of Mathematics and Computer Science, Universisty of Lodz, Lodz, Poland
| | - Mariusz Grzesiak
- Department of Obstetrics, Perinatology and Gynaecology; Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.,Department of Gynaecology and Obstetrics, 2nd Chair of Gynaecology and Obstetrics, Medical University of Lodz, Lodz, Poland
| | - Andrzej Lewinski
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland.,Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland
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Gilboa Y, Krekora M, Perlman S, Bardin R, Kassif E, Achiron R, Zych-Krekora K, Kaczmarek P, Grzesiak M, Kivilevitch Z. Sonographic measurement of the fetal pancreas in women with gestational diabetes. Arch Med Sci 2022; 18:382-387. [PMID: 35316899 PMCID: PMC8924846 DOI: 10.5114/aoms/140578] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 07/27/2021] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Maternal glycemic state is positively correlated with fetal insulin secretion. Randomized control studies have shown that treatment during pregnancy inhibits to some degree this glycemic effect. Our study aimed to assess fetal pancreas size in a population of treated mothers with gestational diabetes. MATERIAL AND METHODS A cross-sectional, prospective observational study was conducted. Pregnant women at 19-36 weeks of gestation with pre-gestational diabetes receiving insulin therapy or with gestational diabetes receiving either insulin or oral hypoglycemic therapy were recruited. The fetal pancreas circumference was measured and compared to the normal reference range. The Z score of the difference between measured and normal predicted mean pancreas circumference, the regression analysis throughout pregnancy, and the correlation between estimated fetal weight centile and pancreas circumference were calculated. RESULTS Ninety-one women who had gestational diabetes and thirty-four women who had pre-gestational diabetes were included in the study. For both groups, fetal pancreas circumference correlated significantly with abdominal circumference, estimated fetal weight and gestational age. The mean Z score between the predicted pancreas circumference in the group of women diagnosed with gestational diabetes and the predicted pancreas circumference in a normal population peaked at around 24 weeks of gestation (1.1) and decreased gradually afterward to a value of zero at 37 weeks. The mean Z score between the predicted pancreas circumference in the group of women with pre-gestational diabetes and the predicted pancreas circumference in a normal population constantly decreased with duration of pregnancy. It was positive until the 25th week of gestation and then presented negative values towards the term. CONCLUSIONS The presented preliminary data suggest a possible correlation between glycemic control treatment, pancreas size, and gestational age.
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Affiliation(s)
- Yinon Gilboa
- Ultrasound Unit, The Helen Schneider Women's Hospital, Rabin Medical Center, Petach Tikva, Israel
- Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
| | - Michał Krekora
- Obstetric and Gynecology Department, Research Institute Polish Mother's Memorial Hospital, Lodz, Poland
| | - Sharon Perlman
- Ultrasound Unit, The Helen Schneider Women's Hospital, Rabin Medical Center, Petach Tikva, Israel
- Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
| | - Ron Bardin
- Ultrasound Unit, The Helen Schneider Women's Hospital, Rabin Medical Center, Petach Tikva, Israel
- Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
| | - Eran Kassif
- Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
- Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center at Tel-Hashomer Ramat-Gan, Israel
| | - Reuven Achiron
- Sackler School of Medicine, Tel Aviv University Tel Aviv, Israel
- Prenatal Diagnostic Unit, Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center at Tel-Hashomer Ramat-Gan, Israel
| | - Katarzyna Zych-Krekora
- Perinatology, Obstetrics and Gynecology Department, Research Institute Polish Mother's Memorial Hospital, Lodz, Poland
| | - Piotr Kaczmarek
- Perinatology, Obstetrics and Gynecology Department, Research Institute Polish Mother's Memorial Hospital, Lodz, Poland
| | - Mariusz Grzesiak
- Perinatology, Obstetrics and Gynecology Department, Research Institute Polish Mother's Memorial Hospital, Lodz, Poland
| | - Zvi Kivilevitch
- Maccabi Health Services, Ultrasound Unit, The Negev Medical Center, Beer-Sheva, Israel
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17
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Lewandowski K, Głuchowska M, Garnysz K, Horzelski W, Grzesiak M, Lewiński A. High prevalence of early (1st trimester) gestational diabetes mellitus in Polish women is accompanied by insulin resistance similar to women with polycystic ovary syndrome (PCOS). Endokrynol Pol 2021; 73:1-7. [PMID: 34855192 DOI: 10.5603/ep.a2021.0095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/20/2021] [Indexed: 11/25/2022]
Abstract
AIMS Both pregnancy and polycystic ovary syndrome (PCOS) constitute insulin-resistant states that are associated with an increased prevalence of glucose intolerance. Some women demonstrate significant insulin resistance (IR) and develop gestational diabetes (GDM) even in 1st trimester. We compared surrogate IR indices in 1st trimester pregnant women and in women with PCOS (Rotterdam consensus criteria). SUBJECTS & METHODS We performed 75 g Oral Glucose Tolerance Test (OGTT) with insulin measurements in 106 healthy 1st trimester pregnant women at 9.9±2.6 weeks of gestation and in 418 women with PCOS. We assessed IR (HOMA-IR, QUICKI, Matsuda, Belfiore and Stumvoll indices) as well as prevalence of GDM according to the IADPSG and WHO (1999) criteria. RESULTS Despite slightly lower BMI (p=0.027) pregnant women had either similar (QUICKI, Belfiore index, Stumvoll0-120 min) or greater IR than women with PCOS (e.g. HOMA-IR 3.85±6.11 versus 2.64±2.04, p=0.002), while only Matsuda index demonstrated less IR in pregnant women (p=0.003). Correlation between IR indices in pregnant women showed marked variability ranging from r=0.334 (HOMA-IR versus Belfiore index) to r=-1.0 (HOMA-IR versus QUICKI, p<0.001). This was accompanied by high prevalence of GDM (14.2% and 9.4%, IADPSG and WHO criteria, respectively). Women with GDM diagnosed according to IADPSG criteria demonstrated greater IR than pregnant women without GDM. In women with GDM diagnosed according to WHO (1999) criteria these differences were visible only for OGTT-derived IR indices (Belfiore, Matsuda and Stumvoll0-120 index). CONCLUSIONS Depending on the choice of IR indices healthy 1st trimester pregnant women demonstrate either similar, or greater IR than women with PCOS and this is accompanied by high prevalence of early GDM. It remains to be established whether GDM screening should be performed in the 1st trimester.
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Affiliation(s)
- Krzysztof Lewandowski
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland.,Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland
| | - Monika Głuchowska
- Department of Pathology of Pregnancy, 1st Chair of Gynaecology and Obstetrics, Medical University of Lodz, Lodz, Poland
| | - Karolina Garnysz
- Department of Perinatology, Obstetrics and Gynaecology, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.,Department of Gynaecology and Obstetrics, 2nd Chair of Gynaecology and Obstetrics, Medical University of Lodz, Lodz, Poland
| | - Wojciech Horzelski
- Faculty of Mathematics and Computer Science, University of Lodz, Banacha 22, 90-238 Lodz, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynaecology, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.,Department of Gynaecology and Obstetrics, 2nd Chair of Gynaecology and Obstetrics, Medical University of Lodz, Lodz, Poland
| | - Andrzej Lewiński
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland. .,Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital - Research Institute, Lodz, Poland.
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18
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Bralewska M, Biesiada L, Grzesiak M, Rybak-Krzyszkowska M, Huras H, Gach A, Pietrucha T, Sakowicz A. Chromogranin A demonstrates higher expression in preeclamptic placentas than in normal pregnancy. BMC Pregnancy Childbirth 2021; 21:680. [PMID: 34620125 PMCID: PMC8496087 DOI: 10.1186/s12884-021-04139-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 09/20/2021] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Although preeclampsia has long been recognized as a condition affecting late pregnancy, little is known of its pathogenesis or treatment. The placenta releases a number of hormones and molecules that influence the course of pregnancy, one of which is chromogranin A, a soluble protein secreted mainly from the chromaffin cells of the adrenal medulla. Its role in pregnancy and pregnancy-related disorders remains unclear. Therefore, the main aim of the proposed study is to determine whether chromogranin A is related with the occurrence of preeclampsia. METHODS Placental samples were collected from 102 preeclamptic patients and 103 healthy controls, and Chromogranin A gene (CHGA) expression was measured using real-time RT-PCR, The RT-PCR results were verified on the protein level using ELISA. The normal distribution of the data was tested using the Shapiro-Wilk test. The clinical and personal characteristics of the groups were compared using the Student's t-test for normally-distributed data, and the χ2 test for categorical variables. The Mann-Whitney U test was used for non-normally distributed data. As the log- transformation was not suitable for the given outcomes, the Box- Cox Transformation was used to normalize data from ELISA tests and CHGA expression. Values of P < .05 were considered statistically significant. RESULTS Chromogranin A gene expression was found to be significantly higher in the study group than in controls. Protein analyses showed that although the CgA concentration in placental samples did not differ significantly, the catestatin (CST) level was significantly lower in samples obtained from women with preeclampsia, according to the controls. CONCLUSIONS FOR PRACTICE This study for the first time reveals that chromogranin A gene expression level is associated with preeclampsia. Moreover, the depletion in catestatin level, which plays a protective role in hypertension development, might be a marker of developing preeclampsia. Further studies may unravel role of Chromogranin A in the discussed disease.
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Affiliation(s)
- Michalina Bralewska
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, Lodz, Poland.
| | - Lidia Biesiada
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, Lodz, Poland
| | - Mariusz Grzesiak
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, Lodz, Poland
| | - Magda Rybak-Krzyszkowska
- Department of Obstetrics and Perinatology, University Hospital in Krakow, Kopernika 36, Krakow, Poland
| | - Hubert Huras
- Department of Obstetrics and Perinatology, University Hospital in Krakow, Kopernika 36, Krakow, Poland
| | - Agnieszka Gach
- Department of Genetics, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, Lodz, Poland
| | - Tadeusz Pietrucha
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, Lodz, Poland
| | - Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Zeligowskiego 7/9, Lodz, Poland
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19
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Socha M, Szczygieł J, Brzuska E, Sokołowska-Mikołajczyk M, Stonawski B, Grzesiak M. The effect of Roundup on embryonic development, early foxr1 and hsp70 gene expression and hatching of common carp (Cyprinus carpio L.). Theriogenology 2021; 175:163-169. [PMID: 34592515 DOI: 10.1016/j.theriogenology.2021.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 09/13/2021] [Accepted: 09/14/2021] [Indexed: 10/20/2022]
Abstract
The effects of herbicide Roundup (based on glyphosate) on the embryonic development, survival and hatching of common carp (Cyprinus carpio L.) larvae and alteration in foxr1 and hsp70 gene expression were determined. The eggs (obtained from 6 females) were fertilised and incubated in water containing 0; 1 or 10 μl L-1 of Roundup formulation. During early embryonic development (24 and 48 h post-fertilisation - hpf), Roundup caused a statistically important decrease in the embryonic survival rate of common carp. Moreover, retardation of the hatching rate was observed in the group treated with the higher concentration of Roundup at 81 to 99 hpf. At the end of the experiment (99 hpf), an important increase in number of deformed larvae was observed in both groups treated with Roundup in comparison to the control group (52.06; 16.02 and 5.08%, respectively). Significant differences in transcript of the gene foxr1 were found in Roundup-intoxicated groups in comparison to the controls. In the case of hsp70 transcripts, no important changes in exposed groups were observed. These results showed that even small, environmentally relevant amount of Roundup present in the aquatic environment is able to affect the early life stages of common carp and change the transcripts of foxr1, which may have an adverse effect on the later proper development of the reproductive system.
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Affiliation(s)
- M Socha
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059, Krakow, Poland.
| | - J Szczygieł
- Institute of Ichthyobiology and Aquaculture in Gołysz, Polish Academy of Sciences, Zaborze, Kalinowa 2, 43-520, Chybie, Poland
| | - E Brzuska
- Institute of Ichthyobiology and Aquaculture in Gołysz, Polish Academy of Sciences, Zaborze, Kalinowa 2, 43-520, Chybie, Poland
| | - M Sokołowska-Mikołajczyk
- Department of Animal Nutrition and Biotechnology, and Fisheries, University of Agriculture in Krakow, Al. A. Mickiewicza 24/28, 30-059, Krakow, Poland
| | - B Stonawski
- Institute of Ichthyobiology and Aquaculture in Gołysz, Polish Academy of Sciences, Zaborze, Kalinowa 2, 43-520, Chybie, Poland
| | - M Grzesiak
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387, Krakow, Poland
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20
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D'Ambrosio J, Malopolska M, Tuz R, Schwarz T, Ekanayake DL, Ahmadi B, Nowicki J, Tomaszewska E, Grzesiak M, Bartlewski P. Corrigendum to: 43 Correlates of reproductive tract anatomy and uterine histomorphometrics with fertility in swine. Reprod Fertil Dev 2021; 33:682. [PMID: 38600657 DOI: 10.1071/rdv33n2ab43_co] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/12/2024] Open
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21
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Kaminska K, Grzesiak M. The relationship between vitamin D 3 and insulin in polycystic ovary syndrome - a critical review. J Physiol Pharmacol 2021; 72. [PMID: 34099581 DOI: 10.26402/jpp.2021.1.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 02/26/2021] [Indexed: 11/03/2022]
Abstract
Polycystic ovary syndrome (PCOS) is the most common endocrine disorder affecting women of reproductive age. It is characterized by hormonal, reproductive and metabolic disturbances, including hyperandrogenism, altered gonadotropin level, ovarian cysts and ovulatory dysfunction as well as insulin resistance, hyperinsulinemia and dyslipidemia. It was shown that increased insulin concentration is a plausible factor in the pathogenesis of PCOS. Insulin leads to overstimulation of ovarian theca cells to androgen biosynthesis and contributes to insulin resistance in tissues such as muscle, liver, adipose tissue and ovary of PCOS patients. Noteworthy, recent studies suggested that supplementation with vitamin D3 may be an alternative therapy increasing insulin sensitivity and thereby improving reproductive parameters in PCOS women. Indeed, various action of vitamin D3 on the ovarian, hormonal and metabolic features observed in PCOS were presented. Many studies reported therapeutic effects of vitamin D3, but some research found a lack of influence or contradicted these findings. Therefore, the aim of this review was to summarize the available evidence about vitamin D3 and insulin interaction in PCOS, and discusses the potential usefulness of VD3 in PCOS treatment.
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Affiliation(s)
- K Kaminska
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Cracow, Cracow, Poland
| | - M Grzesiak
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Cracow, Cracow, Poland.
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22
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D'Ambrosio J, Malopolska M, Tuz R, Schwarz T, Ekanayake L, Ahmadi B, Nowicki J, Tomaszewska E, Grzesiak M, Bartlewski P. 43 Correlates of reproductive tract anatomy and uterine histomorphometrics with fertility in swine. Reprod Fertil Dev 2021. [DOI: 10.1071/rdv33n2ab43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Economic potential of the swine industry hinges upon the reproductive performance of sows, which may be enhanced by improving uterine capacity, a component trait of litter size and piglet productivity. Previous attempts at characterising morphological traits indicative of high uterine volume have not been completely successful, resulting in the continued need for a reliable method of predicting reproductive value to improve production efficiency of the sow. Hence, the main objective of this study was to scrutinize macro- and micro-morphology of the sow’s reproductive tract for quantitative correlations with fertility indices. Reproductive records from Polish Landrace×Polish Large White sows (mean±s.e.m. parity: 4.3±0.6, range: 2–8) were used to examine the associations between fertility and ovarian/uterine morphology (n=34) or uterine histomorphometry (n=10) posthumously. Simple linear regression was performed to determine the relationship between anatomical or histological parameters and various measures of reproductive performance. Several measures related to the ovary, including right and left ovarian weight (r=0.50, P=0.005, and r=0.49, P=0.006, respectively), were positively correlated with the litter size, whereas left ovarian number of corpora lutea (r=−0.38, P=0.04) was negatively correlated with the mean litter size. Analysis of histomorphological characteristics of the uterine wall collected during the luteal phase of the oestrous cycle revealed correlations between mean litter size and myometrial vascular content (r=0.75, P=0.03), the proportion of myometrial stroma (r=−0.68, P=0.03), and the variability of endometrial thickness (r=−0.72, P=0.02) in sows. Eight ovarian, vaginal, and uterine characteristics were significantly correlated with mean lifetime numbers of live born and stillborn piglets/litter or the last litter size before slaughter. In conclusion, several anatomical and histomorphological metrics that relate to reproductive performance of swine may be used to inform production protocols and as a tool for selection of elite breeding sows, warranting future research into noninvasive or minimally invasive techniques for obtaining such measures.
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23
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Zych-Krekora K, Krekora M, Słodki M, Grzesiak M, Kaczmarek P, Zeman K, Respondek-Liberska M. Nomograms of the fetal thymus for clinical practice. Arch Med Sci 2021; 17:1657-1662. [PMID: 34900046 PMCID: PMC8641501 DOI: 10.5114/aoms.2019.86189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 05/10/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION The fetal thymus may be visualized using ultrasonography (USG) and is typically located in the mediastinum. In the past years, the size of the fetal thymus has served not only as a marker of genetic or heart defects but also as a predictive factor for intrauterine growth restriction, premature birth, preeclampsia, chorioamnionitis or even neonatal sepsis. MATERIAL AND METHODS A total of 410 fetuses were qualified for the study. Fetuses with heart defects were excluded from the study. The fetal thymus was evaluated with ultrasonography between the 14th and 40th week of gestation. After obtaining a standard transverse view encompassing the three great vessels, thymus measurements were attempted, i.e. maximal transverse diameter, circumference and surface area. Linear regression was used for statistical analysis, yielding 3 models, each with a different dependent variable. The confidence interval for each model was set at 80% to aid the comparison with centile grid growth charts for neonates and children. The test was regarded as statistically significant when p < 0.05. RESULTS From a total of 410 fetuses the thymus transverse diameter, circumference and area were successfully measured in 410, 320 and 330 cases, respectively. The probabilities are lower than 0.0005 for each model, which means that each model is quite statistically significant. CONCLUSIONS The coverage of healthy thymus nomograms in the fetal population may be the basis for the identification of fetuses at risk of hypoplasia or thymic hyperplasia, which seems particularly important from the point of view of the detection of potential inborn immunological disorders.
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Affiliation(s)
- Katarzyna Zych-Krekora
- Obstetrics, Perinatology and Gynecology Department, Research Institute Polish Mother’s Memorial Hospital, Lodz, Poland
| | - Michał Krekora
- Obstetrics, Perinatology and Gynecology Department, Research Institute Polish Mother’s Memorial Hospital, Lodz, Poland
| | - Maciej Słodki
- Faculty of Health Sciences, The State University of Applied Sciences, Plock, Poland
| | - Mariusz Grzesiak
- Obstetrics, Perinatology and Gynecology Department, Research Institute Polish Mother’s Memorial Hospital, Lodz, Poland
| | - Piotr Kaczmarek
- Obstetrics, Perinatology and Gynecology Department, Research Institute Polish Mother’s Memorial Hospital, Lodz, Poland
| | - Krzysztof Zeman
- Pediatrics, Immunology and Nephrology Department, Research Institute Polish Mother’s Memorial Hospital, Lodz, Poland
| | - Maria Respondek-Liberska
- Prenatal Cardiology Department, Research Institute Polish Mother’s Memorial Hospital, Lodz, Poland
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24
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Lewandowski KC, Garnysz K, Horzelski W, Kawalec J, Budzen K, Grzesiak M, Lewinski A. Subclinical thyroid dysfunction in the first trimester of pregnancy: 'Disease' versus physiological (pulsatile) variation in TSH concentrations. Clin Endocrinol (Oxf) 2020; 93:739-745. [PMID: 32430942 DOI: 10.1111/cen.14256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/21/2020] [Accepted: 04/23/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND There is no universal consensus regarding cut-off points for TSH in pregnancy, so concentrations of 2.5 or 4.0 mIU/L were suggested for first trimester (Endocrine Society [2012] and ATA [2017] guidelines, respectively). Yet, the impact of physiological variation in TSH secretion has not been assessed. SUBJECTS AND METHODS We assessed baseline concentrations of free T4, free T3 and TSH at 30-minute intervals (between 7.00 and 9.00 hours) in 110 healthy pregnant women, age 30.2 ± 6.0 years, 9.9 ± 2.4 weeks of gestation, and in 19 female controls, age 28.9 ± 10.7. RESULTS Mean TSH concentrations in pregnant women were 1.62 ± 1.26 mIU/L and on average varied by 39.5% (dispersion between the highest and the lowest TSH), with no difference in TSH variation between pregnant women and controls. Taking into account the highest TSH out of five consecutive measurements, TSH >2.5 mIU/L and TSH above 4.0 mIU/L were found in 23 (20.9%) and 10 (9.1%) pregnant women, respectively. In contrast, when the lowest TSH value was considered, then concentrations of TSH >2.5 mIU/L and >4.0 mIU/L were found in 14 (12.7%) and 4 (3.6%) women, respectively. This discrepancy was even more pronounced in aTPO-negative subjects (21 [21.2%] vs 8 [8.1%] women, for TSH >2.5 mIU/L, and six [6.06%] vs one [1.01%], for TSH >4.0 mIU/L). Furthermore, either six (5.4%) or 10 (9.1%) women had TSH concentrations below 0.1 mIU/L. CONCLUSIONS In a significant number of patients, diagnosis of subclinical thyroid dysfunction could be erroneously made not as a result of 'disease', but as a result of physiological variation in TSH concentrations.
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Affiliation(s)
- Krzysztof C Lewandowski
- Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
| | - Karolina Garnysz
- Department of Perinatology, Obstetrics and Gynaecology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
| | - Wojciech Horzelski
- Faculty of Mathematics and Computer Science, University of Lodz, Lodz, Poland
| | - Joanna Kawalec
- Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
| | - Karolina Budzen
- Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynaecology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
- Department of Gynaecology and Obstetrics, 2nd Chair of Gynaecology and Obstetrics, Medical University of Lodz, Lodz, Poland
| | - Andrzej Lewinski
- Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
- Department of Endocrinology and Metabolic Diseases, Medical University of Lodz, Lodz, Poland
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25
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Lewandowski KC, Biesiada L, Grzesiak M, Sakowicz A. C-Peptide and leptin system in dichorionic, small and appropriate for gestational age twins-possible link to metabolic programming? Nutr Diabetes 2020; 10:29. [PMID: 32778645 PMCID: PMC7417567 DOI: 10.1038/s41387-020-00131-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 07/13/2020] [Accepted: 07/22/2020] [Indexed: 12/05/2022] Open
Abstract
Children born small for gestational age (SGA) are at increased risk of future glucose intolerance and type 2 diabetes, possibly after due intrauterine metabolic programming. Soluble leptin receptor (SLR) limits leptin access to signal-transducing membrane receptors. The present study examines whether SGA and appropriate for gestational age (AGA) twins differ with regard to their C-peptide, glucose and leptin systems. The markers C-peptide, glucose, fetal leptin, and SLR in cord blood were assessed in children from dichorionic twin pregnancies at delivery. In 32 cases, weight differed by >15% between twins: one demonstrated Intrauterine Growth Retardation (IUGR) (<10th percentile-SGA), while the other did not (AGAI). The other 67 pairs presented appropriate weight for gestational age (AGAII). Placental leptin and placental leptin receptor content were also assessed. Despite the same concentrations of glucose, the SGA twins maintained a higher level of C-peptide [44.48 pmol/l vs. 20.91 pmol/l, p < 0.05] than the AGAI co-twins, higher HOMA index, calculated as [C-peptide] x [Glucose] (p = 0.045), in cord blood, and a higher level of SLR [SGA vs AGAI—mean: 28.63 ng/ml vs. 19.91 ng/ml, p < 0.01], without any differences in total leptin (p = 0.37). However, SGA placentas demonstrated higher leptin level [130.1 pg/100 g total protein vs 83.8 pg/100 g total protein, p = 0.03], without differences in placental leptin receptor (p = 0.66). SGA/IUGR twins demonstrate relative insulin resistance accompanied by decreased fetal and increased placental leptin signaling. We speculate that relative insulin resistance and changes in the leptin system might be the first evidence of processes promoting deleterious metabolic programming for post-natal life.
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Affiliation(s)
- Krzysztof C Lewandowski
- Department of Endocrinology and Metabolic Diseases, Polish Mothers' Memorial Hospital-Research Institute, Lodz, Poland.,Medical University of Lodz, Department of Endocrinology and Metabolic Diseases, Lodz, Poland
| | - L Biesiada
- Department of Obstetrics and Gynecology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
| | - M Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
| | - A Sakowicz
- Medical University of Lodz, Department of Medical Biotechnology, Lodz, Poland.
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26
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Sakowicz A, Bralewska M, Pietrucha T, Habrowska-Górczyńska DE, Piastowska-Ciesielska AW, Gach A, Rybak-Krzyszkowska M, Witas PJ, Huras H, Grzesiak M, Biesiada L. Canonical, Non-Canonical and Atypical Pathways of Nuclear Factor кb Activation in Preeclampsia. Int J Mol Sci 2020; 21:E5574. [PMID: 32759710 PMCID: PMC7432517 DOI: 10.3390/ijms21155574] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2020] [Revised: 07/30/2020] [Accepted: 07/31/2020] [Indexed: 01/31/2023] Open
Abstract
Although higher nuclear factor κB (NFκB) expression and activity is observed in preeclamptic placentas, its mechanism of activation is unknown. This is the first study to investigate whether the canonical, non-canonical, or atypical NFκB activation pathways may be responsible for the higher activation of NFκB observed in preeclamptic placentas. The study included 268 cases (130 preeclamptic women and 138 controls). We studied the expression of the genes coding for NFκB activators (NIK, IKKα, IKKβ, and CK2α) and inhibitors (IκBα and IκBβ) using RT-PCR in real time. The RT-PCR results were verified on the protein level using ELISA and Western blot. To determine the efficiency of the pathways, the ratios of activator(s) to one of the inhibitors (IκBα or IκBβ) were calculated for each studied pathway. The preeclamptic placentas demonstrated significantly lower IKKα and CK2α but higher IκBα and IκBβ protein levels. In addition, the calculated activator(s) to inhibitor (IκBα or IκBβ) ratios suggested that all studied pathways might be downregulated in preeclamptic placentas. Our results indicate that preeclamptic placentas may demonstrate mechanisms of NFκB activation other than the canonical, non-canonical, and atypical forms. In these mechanisms, inhibitors of NFκB may play a key role. These observations broaden the existing knowledge regarding the molecular background of preeclampsia development.
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Affiliation(s)
- Agata Sakowicz
- Medical University of Lodz, Department of Medical Biotechnology, 90-752 Lodz, Poland; (M.B.); (T.P.)
| | - Michalina Bralewska
- Medical University of Lodz, Department of Medical Biotechnology, 90-752 Lodz, Poland; (M.B.); (T.P.)
| | - Tadeusz Pietrucha
- Medical University of Lodz, Department of Medical Biotechnology, 90-752 Lodz, Poland; (M.B.); (T.P.)
| | | | | | - Agnieszka Gach
- Department of Genetics, Polish Mother’s Memorial Hospital-Research Institute in Lodz, 93-338 Lodz, Poland;
| | - Magda Rybak-Krzyszkowska
- Department of Obstetrics and Perinatology, University Hospital in Krakow, 31-501 Krakow, Poland; (M.R.-K.); (H.H.)
| | - Piotr J Witas
- Medical University of Lodz, Department of Haemostatic Disorders, 92-215 Lodz, Poland;
| | - Hubert Huras
- Department of Obstetrics and Perinatology, University Hospital in Krakow, 31-501 Krakow, Poland; (M.R.-K.); (H.H.)
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother’s Memorial Hospital-Research Institute in Lodz, 93-338 Lodz, Poland;
- Medical University of Lodz, Department of Obstetrics and Gynecology, 93-338 Lodz, Poland
| | - Lidia Biesiada
- Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital-Research Institute, 93-338 Lodz, Poland;
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Kostrzewa M, Głowacka E, Stetkiewicz T, Grzesiak M, Szyłło K, Stachowiak G, Wilczyński JR. Is serum anti-Müllerian hormone (AMH) assay a satisfactory measure for ovarian reserve estimation? A comparison of serum and peritoneal fluid AMH levels. ADV CLIN EXP MED 2020; 29:853-856. [PMID: 32735089 DOI: 10.17219/acem/121010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
BACKGROUND Clinical cases have been reported with women who got pregnant with confirmed low serum anti-Müllerian hormone (AMH) concentrations, thus demonstrating that low serum AMH concentration cut-points could be fairly specific for poor ovarian response (POR) to gonadotrophin stimulation, but not for pregnancy. That observation prompted the question whether serum AMH concentration accurately corresponded to the whole amount of AMH secreted by granulosa cells. OBJECTIVES To measure AMH levels in peritoneal fluid and their correlations with serum AMH concentrations. MATERIAL AND METHODS The reported study involved 48 female patients, aged 18-40 years, diagnosed with benign ovarian cysts and qualified for a laparoscopic cystectomy. Prior to surgery, the ovarian reserve was assessed using serum AMH concentration assay. The peritoneal fluid was also collected during the laparoscopy and AMH concentrations in peritoneal fluid were measured. RESULTS The AMH present in the peritoneal fluid strongly correlated with AMH levels in blood serum (r = 0.54; p < 0.001) and higher serum AMH concentrations corresponded to higher AMH concentrations in the peritoneal fluid. There was also a significant correlation between AMH levels in serum and in peritoneal fluid, collected from patients with endometrioma and other benign cysts (r = 0.61; p = 0.001 vs r = 0.43; p = 0.03). CONCLUSIONS The AMH is present in the peritoneal fluid and its concentrations significantly correlate with AMH levels in serum. The assessment of AMH concentration in the peritoneal fluid may be a valuable complement to the evaluation of ovarian reserve and the diagnosis of infertility after adnexal surgery.
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Affiliation(s)
- Marta Kostrzewa
- Department of Operative Gynecology and Gynecologic Oncology, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - Ewa Głowacka
- Laboratory Diagnostics Center, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - Tomasz Stetkiewicz
- Department of Operative Gynecology and Gynecologic Oncology, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and Gynecology, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - Krzysztof Szyłło
- Department of Operative Gynecology and Gynecologic Oncology, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
| | - Grzegorz Stachowiak
- Department of Operative Gynecology and Gynecologic Oncology, Polish Mother's Memorial Hospital Research Institute, Łódź, Poland
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Grzesiak M, Popiolek K, Knapczyk-Stwora K. Extracellular vesicles in follicular fluid of sexually mature gilts' ovarian antral follicles - identification and proteomic analysis. J Physiol Pharmacol 2020; 71. [PMID: 32554848 DOI: 10.26402/jpp.2020.1.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 02/28/2020] [Indexed: 11/03/2022]
Abstract
Ovarian follicular growth and development involves extensive bidirectional cell-to-cell communication between somatic cells and the oocyte. Recently it has been found that extracellular vesicles (EVs) represent a new mechanism of the communication inside the ovarian follicle. The present research shows for the first time the presence of EVs in follicular fluid of small (SFs), medium (MFs) and large (LFs) antral follicles of sexually mature gilts using nanoparticle tracking analysis and Western blot. The highest (P = 0.0338) concentration of EVs was found in follicular fluid of MFs, as compared to LFs and SFs. Furthermore, nanoparticle tracking analysis showed the existence of the population of particles in follicular fluid of all analyzed follicles, which resembles exosomes. That was confirmed by the abundance of exosomal markers, CD9 and CD63, in those samples. The proteomic analysis of EVs from MFs using the nano-liquid chromatography-matrix-assisted laser deposition/ionization time-of-flight mass spectrometry allows to identify 249 proteins that predominantly indicated binding function and catalytic activity. Most of them belong also to the group of cytoskeleton and extracellular matrix proteins (ECM) suggesting their role in the building of cell components. Functional annotation predicted association of identified proteins with processes crucial for follicle development and function, as well as ovulation and corpus luteum formation. Therefore, EVs through their protein cargo might regulate follicle development in sexually mature gilts.
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Affiliation(s)
- M Grzesiak
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Cracow, Cracow, Poland.
| | - K Popiolek
- Department of Animal Physiology and Endocrinology, University of Agriculture, Cracow, Poland
| | - K Knapczyk-Stwora
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Cracow, Cracow, Poland
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Abstract
Vitamin D3 is well-known as a major regulator of calcium and phosphorus homeostasis. A growing body of evidence highlights its crucial role in the regulation of reproductive processes in females. The role of vitamin D3 in the female reproductive tract has been extensively investigated because its receptor is abundant in reproductive organs, including ovary. Importantly, besides expression of vitamin D3 receptor, the ovary is an extrarenal site of vitamin D3 metabolism. The influence of vitamin D3 on follicular development and ovarian steroidogenesis has been investigated. Furthermore, vitamin D3 deficiency has also been associated with polycystic ovary syndrome, premature ovarian failure and ovarian cancer. The objective of this review is to summarize our knowledge about the contribution of vitamin D3 to physiological and pathological processes within the ovary.
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Affiliation(s)
- M Grzesiak
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Krakow, Poland.
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Kostrzewa M, Żyła M, Garnysz K, Kaczmarek B, Szyłło K, Grzesiak M. Anti‐Müllerian hormone as a marker of abortion in the first trimester of spontaneous pregnancy. Int J Gynaecol Obstet 2020; 149:66-70. [DOI: 10.1002/ijgo.13104] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Revised: 11/10/2019] [Accepted: 01/21/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Marta Kostrzewa
- Department of Operative Gynecology and Gynecologic OncologyPolish Mother's Memorial Hospital Research Institute Łódź Poland
| | - Monika Żyła
- Department of Operative Gynecology and Gynecologic OncologyPolish Mother's Memorial Hospital Research Institute Łódź Poland
| | - Karolina Garnysz
- Department of Perinatology, Obstetrics and GynecologyPolish Mother's Memorial Hospital Research Institute Łódź Poland
| | - Beata Kaczmarek
- Department of Perinatology, Obstetrics and GynecologyPolish Mother's Memorial Hospital Research Institute Łódź Poland
| | - Krzysztof Szyłło
- Department of Operative Gynecology and Gynecologic OncologyPolish Mother's Memorial Hospital Research Institute Łódź Poland
| | - Mariusz Grzesiak
- Department of Perinatology, Obstetrics and GynecologyPolish Mother's Memorial Hospital Research Institute Łódź Poland
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Sechman A, Grzegorzewska AK, Grzesiak M, Kozubek A, Katarzyńska-Banasik D, Kowalik K, Hrabia A. Nitrophenols suppress steroidogenesis in prehierarchical chicken ovarian follicles by targeting STAR, HSD3B1, and CYP19A1 and downregulating LH and estrogen receptor expression. Domest Anim Endocrinol 2020; 70:106378. [PMID: 31514021 DOI: 10.1016/j.domaniend.2019.07.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 07/17/2019] [Accepted: 07/17/2019] [Indexed: 12/18/2022]
Abstract
To assess the effects of 4-nitrophenol (PNP) and 3-methyl-4-nitrophenol (PNMC) on steroidogenesis in the chicken ovary, white (WF, 1-4 mm) and yellowish (YF, 4-8 mm) prehierarchical follicles were incubated in a medium supplemented with PNP or PNMC (10-8-10-4 M), ovine LH (oLH; 10 ng/mL), and combinations of oLH with PNP or PNMC (10-6 M). Testosterone (T) and estradiol (E2) concentrations in media and mRNA expression for steroidogenic proteins (STAR, HSD3B1, and CYP19A1), and LH receptors (LHR), estrogen receptor α (ESR1) and β (ESR2) in follicles were determined by RIA and real-time qPCR, respectively. PNP and PNMC decreased T and E2 secretion by the WF and YF, and oLH-stimulated T secretion from these follicles. PNP decreased basal STAR and HSD3B1 mRNA levels both in the WF and YF, and CYP19A1 mRNAs in the WF. PNP reduced oLH-affected mRNA expression of these genes in the YF. PNMC inhibited basal STAR, HSD3B1, and CYP19A1 mRNA expression in the WF, but not in the YF. PNMC reduced oLH-stimulated STAR and CYP19A1 expression in the YF and WF, respectively. PNP decreased basal mRNA expression of LHR, ESR1, and ESR2 in the WF, but it increased ESR1 and ESR2 mRNA levels in the YF. PNMC reduced both basal and oLH-affected LHR, ESR1, and ESR2 mRNA expression in the WF; however, it did not influence expression of these genes in the YF. We suggest that nitrophenols by influencing sex steroid synthesis and transcription of LH and estrogen receptors in prehierarchical ovarian follicles may impair their development and selection to the preovulatory hierarchy.
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Affiliation(s)
- A Sechman
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland.
| | - A K Grzegorzewska
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland
| | - M Grzesiak
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland
| | - A Kozubek
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland
| | - D Katarzyńska-Banasik
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland
| | - K Kowalik
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland
| | - A Hrabia
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland
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Witek P, Grzesiak M, Koziorowski M, Slomczynska M, Knapczyk-Stwora K. Effect of neonatal exposure to endocrine-active compounds on plasma lipid and steroid concentrations, and morphology of luteal tissue in the adult pig. Domest Anim Endocrinol 2020; 70:106381. [PMID: 31479927 DOI: 10.1016/j.domaniend.2019.07.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2018] [Revised: 05/30/2019] [Accepted: 07/19/2019] [Indexed: 11/21/2022]
Abstract
To study the long-term impact of neonatal exposure to endocrine-active compounds (EACs) on plasma lipid profiles, steroid concentrations, and morphology of porcine luteal tissue, piglets were injected with testosterone propionate (TP), flutamide (FLU), 4-tert-octylphenol, ICI 182,780 (ICI), methoxychlor, or corn oil (controls) between postnatal days 1 and 10 (n = 5/group). Blood samples and corpora lutea were obtained from sexually mature gilts. The investigated compounds differentially affected plasma lipid and steroid concentrations. Moreover, we demonstrated hypertrophy of luteal cells after neonatal EAC administration. In addition, a predominant abundance of lipid droplets was found in luteal cells of TP-, FLU-, and ICI-treated animals. It seems that the pathways leading to changes in the plasma lipid profile may contribute to the development of long-term alterations that have the potential to affect luteal steroidogenic capability in pigs.
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Affiliation(s)
- P Witek
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland
| | - M Grzesiak
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland
| | - M Koziorowski
- Department of Physiology and Reproduction of Animals, Institute of Biotechnology, University of Rzeszow, Werynia 502, 36-100 Kolbuszowa, Poland
| | - M Slomczynska
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland
| | - K Knapczyk-Stwora
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland.
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Suliburska J, Kocyłowski R, Grzesiak M, Gaj Z, Chan B, von Kaisenberg C, Lamers Y. Evaluation of folate concentration in amniotic fluid and maternal and umbilical cord blood during labor. Arch Med Sci 2019; 15:1425-1432. [PMID: 31749870 PMCID: PMC6855149 DOI: 10.5114/aoms.2018.78776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Accepted: 09/08/2018] [Indexed: 12/30/2022] Open
Abstract
INTRODUCTION Folate is required for fetal, placental and maternal tissue growth during pregnancy. A decline in maternal circulating folate concentrations and an increase in total homocysteine (a non-specific indicator of folate deficiency) have been observed with the progression of pregnancy. However, the role of folate in the third trimester of pregnancy is not clear and folate status in late pregnancy has not so far been widely analyzed. The main aim of this retrospective cross-sectional study was to determine the folate concentrations in amniotic fluid and in maternal and umbilical cord blood serum derived during delivery. MATERIAL AND METHODS This study was conducted on 175 pregnant Polish women (white/Caucasian) aged between 17 and 42 years. Only pregnancies without birth defects were included in this study. Amniotic fluid, maternal serum, and umbilical cord blood samples were collected during vaginal delivery or cesarean section. Folate concentration was determined using a microbiological assay. RESULTS Strong correlations were observed between the concentrations of folate in amniotic fluid and maternal serum (rho = 0.67, p < 0.001) and amniotic fluid and cord blood serum (rho = 0.49, p < 0.001) and between maternal serum and cord blood serum (rho = 0.67, p < 0.001). Folate concentrations in amniotic fluid were significantly associated with maternal age (rho = 0.19, p < 0.05). Pre-pregnancy body mass index and maternal weight/neonatal birth weight ratio were independent predictors of folate concentrations in maternal serum (β = 0.33, p < 0.05; β = -0.19, p < 0.05) and amniotic fluid (β = 0.28, p < 0.05; β = -0.19, p < 0.05) in late pregnancy. CONCLUSIONS Folate concentrations in amniotic fluid are associated with maternal and neonatal folate status peripartum in healthy women.
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Affiliation(s)
- Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poznan, Poland
| | - Rafał Kocyłowski
- Department of Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Mariusz Grzesiak
- Department of Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Zuzanna Gaj
- Department of Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Benny Chan
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Constantin von Kaisenberg
- Klinik für Frauenheilkunde und Geburtshilfe Pränatalmedizin (MVZ) Medizinische Hochschule Hannover, Germany
| | - Yvonne Lamers
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, British Columbia, Canada
- British Columbia Children’s Hospital Research Institute, Vancouver, British Columbia, Canada
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Kocyłowski R, Grzesiak M, Gaj Z, Lorenc W, Bakinowska E, Barałkiewicz D, von Kaisenberg CS, Suliburska J. Evaluation of Essential and Toxic Elements in Amniotic Fluid and Maternal Serum at Birth. Biol Trace Elem Res 2019; 189:45-54. [PMID: 30097982 PMCID: PMC6443612 DOI: 10.1007/s12011-018-1471-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 08/02/2018] [Indexed: 12/12/2022]
Abstract
The objective of this study was to determine the concentration and the reference ranges of essential and toxic elements in amniotic fluid (AF) and maternal serum (MS) at birth. This study was conducted among 175 healthy pregnant Caucasian European women aged 18-42. AF and maternal blood samples were collected during delivery. An inductively coupled plasma mass spectrometry (ICP-MS) technique was used to determine the levels of Mg, Co, Cu, Zn, Sr, Cd, Ba, Pb, U, Ca, Cr, Al, Mn, V, Fe, As, Se and Sb in AF and MS. The range of reference values was calculated for all analyzed elements in the serum and AF. The mean concentrations of elements, except Pb, were generally higher in MS than in AF. Multiple regression analysis showed that the maternal/newborn body mass (MBM/NBM) ratio was a strong negative predictor (among maternal age and gravidity) of Mg concentration in amniotic fluid. In the serum, MBN/NBM ratio was a strong positive predictor of Cu concentration. Moreover, regression analysis showed that maternal age was an independent positive predictor of the Se level in maternal serum. The reference value ranges of 18 essential and toxic elements were established in AF and MS among a population of healthy pregnant Polish women at delivery. The level of Mg, Co, Cu, Ca and Se in AF and MS can be determined by maternal age and MBM/NBM ratio. These results can be useful in counseling individuals with pregnancies affected by exposure to one of the parameters under investigation.
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Affiliation(s)
- Rafał Kocyłowski
- Department of Obstretrics, Perinatology and Gynecology, Polish Mother’s Memorial Hospital-Research Institute, ul. Rzgowska 281/289, 93-338 Łódz, Poland
- PreMediCare New Med Medical Centre, ul. Drużbickiego 13, 61-693 Poznań, Poland
| | - Mariusz Grzesiak
- Department of Obstretrics, Perinatology and Gynecology, Polish Mother’s Memorial Hospital-Research Institute, ul. Rzgowska 281/289, 93-338 Łódz, Poland
| | - Zuzanna Gaj
- Department of Obstretrics, Perinatology and Gynecology, Polish Mother’s Memorial Hospital-Research Institute, ul. Rzgowska 281/289, 93-338 Łódz, Poland
- Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother’s Memorial Hospital-Research Institute, ul. Rzgowska 281/289, 93-338 Łódz, Poland
| | - Wiktor Lorenc
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznań, ul. Umultowska 89b, 61-614 Poznan, Poland
| | - Ewa Bakinowska
- Institute of Mathematics, Poznan University of Technology, 5 M. Skłodowska-Curie Square, 60-965 Poznan, Poland
| | - Danuta Barałkiewicz
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznań, ul. Umultowska 89b, 61-614 Poznan, Poland
| | | | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624 Poznań, Poland
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Biesiada L, Sakowicz A, Grzesiak M, Borowiec M, Lisowska M, Pietrucha T, von Kaisenberg C, Lewandowski K. Identification of placental genes linked to selective intrauterine growth restriction (IUGR) in dichorionic twin pregnancies: gene expression profiling study. Hum Genet 2019; 138:649-659. [PMID: 31041507 PMCID: PMC6554264 DOI: 10.1007/s00439-019-02016-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 04/16/2019] [Indexed: 11/28/2022]
Abstract
A linkage of dichorionic (DC) twin pregnancies with selective intrauterine growth restriction (IUGR) to alterations in placental gene expression is unclear. The aim of the study was to identify placental genes related to hypoxia, adipogenesis and human growth which may contribute to IUGR development. The study group (IUGR/AGA) comprised dichorionic (DC) twin pregnancies, where the weight of the twins differed by > 15%; in addition, one twin was small for gestational age (< 10th percentile-SGA) (IUGR) while the other was appropriate for gestational age (> 10th percentile-AGA). In the control group (AGA/AGA), both fetuses were AGA and their weights differed by < 15%. In the first step (selection), placental expression of 260 genes was analysed by commercial PCR profiler array or qPCR primer assay between six pairs of IUGR/AGA twins. In the second stage (verification), the expression of 20 genes with fold change (FC) > 1.5 selected from the first stage was investigated for 75 DC pregnancies: 23 IUGR/AGA vs. 52 AGA/AGA. The expression of Angiopoetin 2, Leptin and Kruppel-like factor 4 was significantly higher, and Glis Family Zinc Finger 3 was lower, in placentas of SGA fetuses (FC = 3.3; 4.4; 1.6; and - 1.8, respectively; p < 0.05). The dysregulation of gene expression related to angiogenesis and growth factors in placentas of twins born from IUGR/AGA pregnancies suggest that these alternations might represent biological fetal adaptation to the uteral condition. Moreover, DC twin pregnancies may be a good model to identify the differences in placental gene expression between SGA and AGA fetuses.
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Affiliation(s)
- Lidia Biesiada
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, Lodz, Poland.
| | - Agata Sakowicz
- Department of Medical Biotechnology, Medical University of Lodz, Lodz, Poland
| | - Mariusz Grzesiak
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital-Research Institute in Lodz, Rzgowska 281/289, Lodz, Poland
| | - Maciej Borowiec
- Department of Clinical Genetic, Medical University of Lodz, Lodz, Poland
| | - Michalina Lisowska
- Department of Medical Biotechnology, Medical University of Lodz, Lodz, Poland
| | - Tadeusz Pietrucha
- Department of Medical Biotechnology, Medical University of Lodz, Lodz, Poland
| | | | - Krzysztof Lewandowski
- Department of Endocrinology and Metabolic Diseases, Polish Mother's Memorial Hospital-Research Institute in Lodz, Lodz, Poland
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Lewicka I, Kocyłowski R, Grzesiak M, Gaj Z, Sajnóg A, Barałkiewicz D, von Kaisenberg C, Suliburska J. Relationship between pre-pregnancy body mass index and mineral concentrations in serum and amniotic fluid in pregnant women during labor. J Trace Elem Med Biol 2019; 52:136-142. [PMID: 30732874 DOI: 10.1016/j.jtemb.2018.12.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 11/10/2018] [Accepted: 12/13/2018] [Indexed: 12/16/2022]
Abstract
The aim of the study was to determine the correlations between body mass index (BMI) values before pregnancy and the concentrations of selected elements (Mg, Co, Cu, Zn, Sr, Cd, Ba, Pb, U, Ca, Cr, Al, Mn, V, Fe) in blood serum and amniotic fluid (AF) in pregnant women. Elemental analysis of serum and amniotic fluid in 225 Polish women (Caucasian/white) showed a relationship between the concentration of minerals in the above-mentioned samples and the pre-pregnancy BMI. Analysis of blood serum was performed by using ICP-MS and it demonstrated that iron concentration was significantly lower in overweight and obese women. Being underweight in pregnant women was associated with a significantly lower concentration of magnesium and cobalt in the blood serum. Both underweight and overweight women were associated with significantly lower concentrations of calcium and strontium in the blood serum. The concentration of cobalt was significantly higher in underweight women. The concentration of lead in the blood serum of overweight and obese women was significantly higher than in other groups. Analysis of the AF showed that the concentration of copper was significantly lower in overweight and obese women, and the concentration of manganese and vanadium significantly higher than in other groups of women. A deficiency in essential minerals and an excess of heavy metals in women may be associated with abnormal body weight and this is important in the etiopathogenesis of pregnancy and fetal development disorders.
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Affiliation(s)
- Iwona Lewicka
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624 Poznań, Poland.
| | - Rafał Kocyłowski
- Department of Obstetric, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska281/289, 93-338 Łódz, Poland; PreMediCare New Med Medical Centre, ul. Drużbickiego 13, 61-693 Poznań, Poland.
| | - Mariusz Grzesiak
- Department of Obstetric, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska281/289, 93-338 Łódz, Poland.
| | - Zuzanna Gaj
- Department of Obstetric, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska281/289, 93-338 Łódz, Poland; Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother's Memorial Hospital-Research Institute, ul. Rzgowska281/289, Łódz, 93-338, Poland.
| | - Adam Sajnóg
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznań, ul. Umultowska89b, 61-614 Poznan, Poland.
| | - Danuta Barałkiewicz
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznań, ul. Umultowska89b, 61-614 Poznan, Poland.
| | - Constantin von Kaisenberg
- Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624 Poznań, Poland.
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Kocylowski R, Grzesiak M, Gaj Z, Lorenc W, Bakinowska E, Barałkiewicz D, von Kaisenberg CS, Lamers Y, Suliburska J. Associations between the Level of Trace Elements and Minerals and Folate in Maternal Serum and Amniotic Fluid and Congenital Abnormalities. Nutrients 2019; 11:E328. [PMID: 30717440 PMCID: PMC6413094 DOI: 10.3390/nu11020328] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 01/24/2019] [Accepted: 01/28/2019] [Indexed: 12/27/2022] Open
Abstract
Congenital birth defects may result in a critical condition affecting the baby, including severe fetal/neonatal handicap and mortality. Several studies have shown that genetic, nutritional, and environmental factors may have an impact on fetal development and neonatal health. The relevance of essential and toxic elements on fetal development has not yet been fully investigated, and the results of recent research indicate that these elements may be crucial in the assessment of the risk of malformations in neonates. We determined the association between essential and toxic elements and the level of folate in maternal serum (MS) and amniotic fluid (AF), along with neonatal abnormalities. A total of 258 pregnant Polish women in the age group of 17⁻42 years participated in this study. AF and MS were collected during vaginal delivery or during cesarean section. An inductively coupled plasma mass spectrometry technique was used to determine the levels of various elements in AF and MS. The results of this exploratory study indicate that the levels of essential and toxic elements are associated with fetal and newborn anatomical abnormalities and growth disorders.
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Affiliation(s)
- Rafal Kocylowski
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
- PreMediCare New Med Medical Center, ul. Drużbickiego 13, 61-693 Poznan, Poland.
| | - Mariusz Grzesiak
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
| | - Zuzanna Gaj
- Department of Obstetrics, Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
- Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother's Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Lodz, Poland.
| | - Wiktor Lorenc
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznan, ul. Umultowska 89b, 61-614 Poznan, Poland.
| | - Ewa Bakinowska
- Institute of Mathematics, Poznan University of Technology, ul. Piotrowo 3A, 60-965 Poznan, Poland.
| | - Danuta Barałkiewicz
- Department of Trace Element Analysis by Spectroscopy Method, Faculty of Chemistry, Adam Mickiewicz University in Poznan, ul. Umultowska 89b, 61-614 Poznan, Poland.
| | - Constantin S von Kaisenberg
- Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Str. 1, D-30625 Hannover, Germany.
| | - Yvonne Lamers
- Food, Nutrition and Health Program, Faculty of Land and Food Systems, The University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
- British Columbia Children's Hospital Research Institute, Vancouver, BC V5Z 4H4, Canada.
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, Poznan, Poland, ul. Wojska Polskiego 31, 60-624 Poznan, Poland.
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Polanska K, Hanke W, Pawlas N, Wesolowska E, Jankowska A, Jagodic M, Mazej D, Dominowska J, Grzesiak M, Mirabella F, Chiarotti F, Calamandrei G. Sex-Dependent Impact of Low-Level Lead Exposure during Prenatal Period on Child Psychomotor Functions. Int J Environ Res Public Health 2018; 15:ijerph15102263. [PMID: 30332762 PMCID: PMC6210236 DOI: 10.3390/ijerph15102263] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 10/09/2018] [Accepted: 10/12/2018] [Indexed: 12/18/2022]
Abstract
The impact of exposure to lead on child neurodevelopment has been well established. However, sex differences in vulnerability are still not fully explained. We aimed at evaluating the effect of a low-level lead exposure, as measured between 20 to 24 weeks of pregnancy and in cord blood, on developmental scores up to 24 months of age in 402 children from the Polish Mother and Child Cohort (REPRO_PL). Additionally, sex-dependent susceptibility to lead at this very early stage of psychomotor development was assessed. The blood lead levels were analyzed using inductively coupled plasma mass spectrometry (ICP-MS). In order to estimate the children’s neurodevelopment, the Bayley Scales of Infant and Toddler Development was applied. The geometric mean (GM) for blood lead level during 20–24 weeks of pregnancy was 0.99 ± 0.15 µg/dL and, in the cord blood, it was 0.96 ± 0.16 µg/dL. There was no statistically significant impact of lead exposure during prenatal period on the girls’ psychomotor abilities. Among the boys, we observed lower scores for cognitive functions, along with increasing cord blood lead levels (β = −2.07; p = 0.04), whereas the results for the language and motor abilities were not statistically significant (p > 0.05). Our findings show that fetal exposure to very low lead levels might affect early cognitive domain, with boys being more susceptible than girls. Education on health, higher public awareness, as well as intervention programs, along with relevant regulations, are still needed to reduce risks for the vulnerable population subgroups.
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Affiliation(s)
- Kinga Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Natalia Pawlas
- Chair and Department of Pharmacology, Medical University of Silesia, School of Medicine with Division of Dentistry in Zabrze, 41 808 Zabrze, Poland.
| | - Ewelina Wesolowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Agnieszka Jankowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Marta Jagodic
- Department of Environmental Sciences, Jožef Stefan Institute, SI-1000 Ljubljana, Slovenia.
| | - Darja Mazej
- Department of Environmental Sciences, Jožef Stefan Institute, SI-1000 Ljubljana, Slovenia.
| | - Jolanta Dominowska
- Department of Teaching Midwifery, Medical University of Lodz, 90-419 Lodz, Poland.
| | - Mariusz Grzesiak
- Obstetrics, Perinatology and Gynecology Department, Polish Mother's Memorial Hospital Research Institute, 93-338 Lodz, Poland.
| | - Fiorino Mirabella
- Center for Behavioral Sciences and Mental Health, National Institute of Health, I-00161 Rome, Italy.
| | - Flavia Chiarotti
- Center for Behavioral Sciences and Mental Health, National Institute of Health, I-00161 Rome, Italy.
| | - Gemma Calamandrei
- Center for Behavioral Sciences and Mental Health, National Institute of Health, I-00161 Rome, Italy.
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Pasternok M, Nocun A, Knafel A, Grzesiak M, Orzechowski M, Konarska K, Ludwin A, Ludwin I, Zymroz P, Parzynska A, Wiechec M. "Y Sign" at the Level of the 3-Vessel and Trachea View: An Effective Fetal Marker of Aortic Dextroposition Anomalies in the First Trimester. J Ultrasound Med 2018; 37:1869-1880. [PMID: 29280176 DOI: 10.1002/jum.14533] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/28/2017] [Revised: 09/22/2017] [Accepted: 10/09/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES The "Y sign" at the level of the 3-vessel and trachea view corresponds to thinning of main pulmonary artery and arterial duct and a dilated transverse aortic arch. The purpose of this study was to evaluate the Y sign for the diagnosis of aortic dextroposition anomalies at the time of the first-trimester scan and to assess the screening performance of only the Y sign, only abnormal left axis deviation (axis sign), and their combination for the diagnosis of aortic dextroposition anomalies. METHODS A prospective evaluation of 6025 pregnant women undergoing first-trimester ultrasonography was conducted. The cardiac axis was measured in all examined patients and considered abnormal (positive axis sign) at greater than 57 °. The frequency of the Y sign and the axis sign was assessed for this population, and their screening performance for the diagnosis of aortic dextroposition anomalies was calculated. RESULTS A total of 5775 patients fulfilled the inclusion criteria. Aortic dextroposition anomalies were diagnosed in 17 cases (tetralogy of Fallot in 8 and Fallot-like double-outlet right ventricle in 9). The Y sign was found in 18 of 5775 (0.3%) fetuses examined, of which 7 of 18 were confirmed with tetralogy of Fallot, 9 of 18 with a Fallot-like double-outlet right ventricle, and 2 of 18 with pulmonary stenosis. A positive axis sign of greater than 57 ° was found in 20 fetuses, including 4 with normal heart anatomy. The sensitivity values of the Y sign, the axis sign, and their combination were 94%, 76%, and 94%, respectively. CONCLUSIONS Visualization of the Y sign should increase the suspicion of aortic dextroposition anomalies in the late first trimester. The screening performance of the Y sign alone and in combination with an abnormal cardiac axis was high and may aid in the early diagnosis of aortic dextroposition anomalies in the fetus.
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Affiliation(s)
| | | | - Anna Knafel
- Departments of Gynecology and Obstetrics, Jagiellonian University, Krakow, Poland
| | - Mariusz Grzesiak
- Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | | | - Katarzyna Konarska
- Departments of Pediatric Cardiology, Jagiellonian University, Krakow, Poland
| | - Artur Ludwin
- Dobreusg Ultrasound Group Practice, Krakow, Poland
| | - Inga Ludwin
- Dobreusg Ultrasound Group Practice, Krakow, Poland
| | - Piotr Zymroz
- Department of Gynecology and Obstetrics, Frederic Chopin Clinical District Hospital No. 1, Rzeszow, Poland
| | - Anna Parzynska
- Departments of Gynecology and Obstetrics, Jagiellonian University, Krakow, Poland
| | - Marcin Wiechec
- Dobreusg Ultrasound Group Practice, Krakow, Poland
- Departments of Gynecology and Obstetrics, Jagiellonian University, Krakow, Poland
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Grzesiak M, Michalik A, Rak A, Knapczyk-Stwora K, Pieczonka A. The expression of autophagy-related proteins within the corpus luteum lifespan in pigs. Domest Anim Endocrinol 2018; 64:9-16. [PMID: 29698908 DOI: 10.1016/j.domaniend.2018.03.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2017] [Revised: 03/13/2018] [Accepted: 03/26/2018] [Indexed: 12/28/2022]
Abstract
Autophagy is a cellular process that involves the degradation of intracellular components. Recent studies suggested a role for autophagy in corpus luteum (CL) regression; however, a complete understanding of its contribution to CL function remains unclear. The present research using porcine CLs obtained from gilts at the early (CL1, n = 5), middle (CL2, n = 5), and late (CL3, n = 5) luteal phase of the estrous cycle aimed to assess the incidence of autophagy during CL development. The stages of collected CLs were verified through morphological analysis and intraluteal progesterone concentration. The presence of autophagosomes was assessed using transmission electron microscopy, and the expression of autophagic markers was examined at mRNA (BECN1 and Lamp1) and protein (Beclin 1, LC3-II, and Lamp 1) levels. Lamp 1 immunolocalization was also performed in luteal tissue. Double-membrane autophagosomes and autophagy-related proteins were found in all examined CLs. Interestingly, there was a greater expression of Beclin 1 (P = 0.005 and P = 0.025) and Lamp 1 (P = 0.009 and P = 0.032) protein in CL3 as compared with CL1 and CL2. In addition, the presence of autolysosomes in CL3 indicated advanced autophagy at that developmental stage. Overall, the occurrence of autophagy throughout CL development and regression suggests it has a role in the regulation of CL lifespan in pigs. In the early and mature CL, autophagy is proposed to promote luteal formation and function, whereas in the late CL, it may participate in luteal regression.
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Affiliation(s)
- M Grzesiak
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland.
| | - A Michalik
- Department of Developmental Biology and Morphology of Invertebrates, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland
| | - A Rak
- Department of Physiology and Toxicology of Reproduction, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland
| | - K Knapczyk-Stwora
- Department of Endocrinology, Institute of Zoology and Biomedical Research, Jagiellonian University in Krakow, Gronostajowa 9, 30-387 Krakow, Poland
| | - A Pieczonka
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Al. Mickiewicza 24/28, 30-059 Krakow, Poland
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Gromadzinska J, Polanska K, Kozlowska L, Mikolajewska K, Stelmach I, Jerzyńska J, Stelmach W, Grzesiak M, Hanke W, Wasowicz W. Vitamins A and E during Pregnancy and Allergy Symptoms in an Early Childhood-Lack of Association with Tobacco Smoke Exposure. Int J Environ Res Public Health 2018; 15:ijerph15061245. [PMID: 29895780 PMCID: PMC6025152 DOI: 10.3390/ijerph15061245] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 05/30/2018] [Accepted: 06/07/2018] [Indexed: 01/07/2023]
Abstract
Epidemiological studies have suggested an association between maternal antioxidant levels during pregnancy and development of allergic diseases in their offspring. The aim of the study was to determine plasma vitamins A and E concentration in the 1st trimester of pregnancy, at delivery and in cord blood and to search for a relationship with allergy in up to 2-year-old children who were prenatally exposed or not exposed to tobacco smoke. The study participants included 252 mother-child pairs from Polish Mother and Child Cohort. Vitamin concentrations were measured using the HPLC-UV method, smoking status—as saliva cotinine level using the HPLC-MS/MS technique. Children’s health status was assessed using a questionnaire and pediatricians/allergists examination. Cord plasma vitamin concentrations were significantly lower than their levels in maternal plasma in the 1sttrimester and at delivery (p < 0.001). Significantly higher concentrations of vitamin E have been shown to occur during the 1st trimester of pregnancy in plasma of the women who have actively/passively smoked cigarettes compared to the non-smokers (p < 0.02). Multivariate analysis with inclusion of a variety of confounding factors have not indicated any statistically significant associations between β-carotene, vitamins A and E and the risk of food allergy, atopic dermatitis and wheezing in their children up to 2 years of age. The interaction between smoking during pregnancy and vitamins levels on the risk of allergy was not statistically significant (p < 0.4). The relationship between plasma concentration of vitamins A and E, and the risk of allergy in their young children has not been demonstrated.
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Affiliation(s)
- Jolanta Gromadzinska
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Kinga Polanska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Lucyna Kozlowska
- Department of Dietetics, Faculty of Human Nutrition, 02-776 Warsaw, Poland.
| | - Karolina Mikolajewska
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Iwona Stelmach
- Department of Pediatrics and Allergy, Medical University of Lodz, 90-329 Lodz, Poland.
| | - Joanna Jerzyńska
- Department of Pediatrics and Allergy, Medical University of Lodz, 90-329 Lodz, Poland.
| | - Włodzimierz Stelmach
- Department of Social and Preventive Medicine, Medical University of Lodz, 90-647 Lodz, Poland.
| | - Mariusz Grzesiak
- Obstetrics, Perinatology and Gynecology Department, Polish Mother's Memorial Hospital-Research Institute, 93-338 Lodz, Poland.
| | - Wojciech Hanke
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
| | - Wojciech Wasowicz
- Department of Biological and Environmental Monitoring, Nofer Institute of Occupational Medicine, 91-348 Lodz, Poland.
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Czajkowski K, Helwich E, Preis K, Grzesiak M, Krekora M, Gulczyńska E, Kornacka K, Zeman K, Maroszyńska I, Respondek-Liberska M. Recommendations “Cardio-Prenatal 2017” From Poland. Prenatal Cardiology 2018. [DOI: 10.1515/pcard-2018-0001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
On 27.10.2017, in the course of the CARDIO-PRENATAL Conference at the Polish Mother’s Memorial Institute and Health Centre in Lodz, we presented, among others, the following problems:
classification of prenatal heart defects, fetal hemodynamic status evaluation in the third trimester, expected neonate’s clinical condition, planned procedures to be conducted just after birth and also planned medical staff to be present in the delivery room. Here are our main recommendations following the meeting and discussion.
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Affiliation(s)
| | - Ewa Helwich
- National Consultant in Charge of Neonatology, Łódź , Poland
| | - Krzysztof Preis
- Provincial Consultant in Charge of Gynaecology & Obstetrics, Gdańsk , Poland
| | - Mariusz Grzesiak
- Provincial Consultant in Charge of Gynaecology & Obstetrics, Łódź , Poland
| | - Michał Krekora
- Deputy Head of the Clinics of Obstetrics & Gynaecology of the Polish Mother’s Memorial Hospital in Łódź , Poland
| | - Ewa Gulczyńska
- Provincial Consultant in Charge of Neonatology, Łódź , Poland
| | | | - Krzysztof Zeman
- Provincial Consultant in Charge of Immunology, Łódź , Poland
| | - Iwona Maroszyńska
- Chairwoman of the Łódź Branch of the Polish Society of Neonatology, Łódź , Poland
| | - Maria Respondek-Liberska
- President of Association for the Development of Prenatal Cardiology, Head of Prenatal Cardiology of the Polish Mother’s Memorial Hospital in Łódź, Head of Fetal Malformations Department, Medical University of Lodz , Poland
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Maierean SM, Mikhailidis DP, Toth PP, Grzesiak M, Mazidi M, Maciejewski M, Banach M. The potential role of statins in preeclampsia and dyslipidemia during gestation: a narrative review. Expert Opin Investig Drugs 2018; 27:427-435. [DOI: 10.1080/13543784.2018.1465927] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
| | - Dimitri P. Mikhailidis
- Department of Clinical Biochemistry, University College London Medical School, University College London (UCL), London, UK
| | - Peter P. Toth
- Department of Preventive Cardiology, CGH Medical Center, Sterling, IL, USA
- Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mariusz Grzesiak
- Department of Gynecology and Obstetrics, Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
| | - Moshen Mazidi
- Department of Biology and Biological Engineering, Food and Nutrition Science, Chalmers University of Technology, Gothenburg, Sweden
| | - Marek Maciejewski
- Department of Cardiology, Chair of Cardiology and Cardiac Surgery Medical University of Lodz, Lodz, Poland
| | - Maciej Banach
- Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
- Cardiovascular Research Centre, University of Zielona-Gora, Zielona-Gora, Poland
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Kocyłowski R, Lewicka I, Grzesiak M, Gaj Z, Oszukowski P, von Kaisenberg C, Suliburska J. Evaluation of Mineral Concentrations in Maternal Serum Before and After Birth and in Newborn Cord Blood Postpartum-Preliminary Study. Biol Trace Elem Res 2018; 182:217-223. [PMID: 28762093 PMCID: PMC5838124 DOI: 10.1007/s12011-017-1109-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/26/2017] [Indexed: 12/28/2022]
Abstract
The mineral levels in maternal serum change during pregnancy and may be correlated with those of newborn cord blood. The aim of this study was to evaluate the concentrations of calcium (Ca), magnesium (Mg), zinc (Zn), iron (Fe), and copper (Cu) in maternal blood before and after delivery and in umbilical cord vein and artery serum. The study was carried out in 64 Caucasian pregnant women who delivered in a district hospital in Greater Poland region, aged 28.1 ± 5.4 years, with a mean gestational age of 39.2 ± 1.3 weeks. Blood samples were taken from women 2-8 h before delivery and immediately after childbirth. The umbilical cord artery and vein blood of newborns was obtained immediately after childbirth. The levels of minerals in serum were determined by flame atomic absorption spectrometry. A significant drop in the concentrations of Mg (17.71 ± 1.51 vs 17.07 ± 1.61 μg/ml; p < 0.007), Fe (1.08 ± 0.46 vs 0.82 ± 0.35 μg/ml; p < 0.0004), and Zn (0.63 ± 0.17 vs 0.46 ± 0.16; p < 0.0001) in maternal serum was found after delivery. Moreover, higher levels of Ca, Fe, and Zn and lower levels of Cu were observed in the umbilical vein (Ca: 102.80 ± 7.80 μg/ml; p < 0.0001, Fe: 1.96 ± 0.43 μg/ml; p < 0.0001, Zn: 0.65 ± 0.16 μg/ml; p < 0.0001, Cu: 0.36 ± 0.09 μg/ml; p < 0.0001) and in the umbilical artery cord blood (Ca: 98.07 ± 8.18 μg/ml; p < 0.0001, Fe: 1.63 ± 0.30 μg/ml; p < 0.0001, Zn: 0.65 ± 0.15 μg/ml; p < 0.0001, and Cu: 0.36 ± 0.10 μg/ml; p < 0.0001) compared to the maternal serum (Ca: 85.05 ± 10.76 μg/ml, Fe: 0.82 ± 0.35 μg/ml, Zn: 0.46 ± 0.16 μg/ml, and Cu: 1.90 ± 0.35 μg/ml). Fe levels in the cord artery serum negatively correlated with blood loss during delivery (R = -0.48; p = 0.01), while the Ca concentration in the maternal serum after birth decreased with the age of the women (R = -0.25; p = 0.03). In conclusion, it seems that the process of birth alters the mineral levels in pregnant women's blood. Moreover, it was found that blood loss and the age of the mother are associated with mineral concentrations in the maternal serum and cord artery blood.
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Affiliation(s)
- Rafał Kocyłowski
- Department of Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Łódź, Poland
- PreMediCare New Med Medical Centre, ul. Drużbickiego 13, 61-693 Poznań, Poland
| | - Iwona Lewicka
- Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624 Poznań, Poland
| | - Mariusz Grzesiak
- Department of Gynecology and Obstetrics, Polish Mother’s Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Łódź, Poland
| | - Zuzanna Gaj
- Department of Gynecology and Obstetrics, Polish Mother’s Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Łódź, Poland
- Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother’s Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Łódź, Poland
| | - Przemysław Oszukowski
- Department of Perinatology and Gynecology, Polish Mother’s Memorial Hospital Research Institute, ul. Rzgowska 281/289, 93-338 Łódź, Poland
| | - Constantin von Kaisenberg
- Department of Obstetrics and Gynecology, Hannover Medical School, Carl-Neuberg-Str. 1, 30625 Hannover, Germany
| | - Joanna Suliburska
- Department of Human Nutrition and Hygiene, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624 Poznań, Poland
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Kocyłowski R, Lewicka I, Grzesiak M, Gaj Z, Sobańska A, Poznaniak J, von Kaisenberg C, Suliburska J. Assessment of dietary intake and mineral status in pregnant women. Arch Gynecol Obstet 2018. [PMID: 29541858 PMCID: PMC5945726 DOI: 10.1007/s00404-018-4744-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Purpose To evaluate the dietary intake of pregnant women and their nutritional status of Ca, Mg, Fe, Zn, and Cu, as the nutritional status of pregnant women is an important factor for the proper progression of a pregnancy and the development and health of the foetus. Methods The study was conducted on 108 pregnant women ages 18–42, at 6–32 weeks of gestation. We used a questionnaire and a 24-h recall nutrition interview. Hair samples were taken for testing and the level of each mineral was assessed using atomic absorption spectrometry. The results were analysed using the Dietetyk and Statistica 10 software. Results Low levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid intake were seen in the pregnant women, with the use of dietary supplements significantly increasing their intake of Fe, Zn, and folic acid. The concentration of zinc and magnesium in the women’s hair was shown to be affected by their age and, in the case of magnesium, by the week of pregnancy. Conclusions It was observed that the diet of pregnant women is characterised by low levels of Fe, Zn, Ca, Mg, vitamin D, and folic acid. Dietary supplementation with vitamins and minerals significantly increases the daily Fe and folic acid intake in pregnant women. The concentration of Zn and Mg in hair depends on the age of pregnant women and Mg level in the hair of women decreases during pregnancy.
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Affiliation(s)
- Rafał Kocyłowski
- Department of Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.,PreMediCare New Med Medical Centre, Poznan, Poland
| | - Iwona Lewicka
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624, Poznan, Poland
| | - Mariusz Grzesiak
- Department of Gynecology and Obstetrics, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland
| | - Zuzanna Gaj
- Department of Perinatology and Gynecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.,Scientific Laboratory of the Center of Medical Laboratory Diagnostics and Screening, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland
| | - Anna Sobańska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624, Poznan, Poland
| | - Joanna Poznaniak
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624, Poznan, Poland
| | - Constantin von Kaisenberg
- Department of Obstetrics, Gynecology and Reproductive Medicine, Hannover Medical School, Hannover, Germany
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences, ul. Wojska Polskiego 31, 60-624, Poznan, Poland.
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Herian M, Luck MR, Grzesiak M. The influence of testosterone on the expression and function of vitamin D(3) receptor (VDR) protein in the porcine ovarian follicle. Physiol Res 2018. [PMID: 29527916 DOI: 10.33549/physiolres.933762] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Recently it has been shown that vitamin D(3) acting via its cognate receptor (VDR) regulates the growth, differentiation and function of female reproductive tissues including ovary. The aim of the study was to examine the effect of testosterone (T) and its antagonist 2-hydroxyflutamide (HF) on VDR protein expression and function in porcine ovarian follicles. Medium size antral follicles expressing great amount of androgen receptors and represent high steroidogenic activity were used in this research. After 6 h incubation of whole follicles with T, HF or T+HF, immunohistochemical analysis of VDR revealed its nuclear localization in granulosa and theca interna cells in control and experimental groups. The expression of VDR protein was shown as a band of 48 kDa. There were no significant differences between either experimental group and the control. T influenced the function of VDR through decreased formation of VDR/RXR (retinoid X receptor) complexes (P<0.05) in both granulosa and theca interna cells, but HF abolished this effect only in granulosa cells (P<0.05). These results suggest that androgens regulate the response of follicular cells to vitamin D3 in pigs ovary via regulation of VDR transcriptional activity.
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Affiliation(s)
- M Herian
- Department of Animal Physiology and Endocrinology, University of Agriculture in Krakow, Krakow, Poland.
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Respondek-Liberska M, Węgrzynowski J, Oszukowski P, Gulczyńska E, Nykiel E, Jakubowski L, Grzesiak M, Czichos E, Romanowicz H. Fetal Macrosomia, Polyhydramnios and Cardiac Anomalies may be Helpful to Predict Poor Outcome in Neonate – Case Report of a Possible Fetal Rasopathy with Sonographic and Neonatal Findings and Genetic Evaluation. Prenatal Cardiology 2018. [DOI: 10.1515/pcard-2017-0011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Abstract
This is a case report about very rare findings in 2nd half of pregnancy (after normal 1 trimester scan ) at 18th week of gestation fetal macrosomia was detected unrelated to maternal diabetes, and acceleration fetal growth later on with unusual cardiac abnormalities (fetal cardiomegaly, cardiomyopathy, partial abnormal venous connection ). Progressive features of congestive heart failure with polyhydramnios in a fetus with estimated 5500 g predicted a poor outcome and severe neonatal condition, which was presented and discussed with the parents to be. Casearean section was performed at 33rd weeks of gestation due to maternal dyscomfort, severe legs edema and her tachypnoe. Baby boy was delivered with birth weight of 5050g, Apgar 4 with mutiple tumors. Conservative care was introduced and neonated died on the 3rd day. Differential diagnosis was discussed with special attention to Costello syndrome however without proved by genetic make-up from neonatal blood.
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Affiliation(s)
- Maria Respondek-Liberska
- Department of Diagnoses and Prevention Fetal Malformations, Medical University of Lodz, Lodz , Poland
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital Research Institute, Lodz , Poland
| | | | - Przemysław Oszukowski
- Ginecology & Perinatology Clinic, Polish Mother's Memorial Hospital Research Institute , Lodz , Poland
| | - Ewa Gulczyńska
- Neonatology Clinic, Polish Mother's Memorial Hospital Research Institute, Lodz , Poland
| | - Elżbieta Nykiel
- Genetics Department, Polish Mother’s Memorial Hospital Research Institute, Lodz , Poland
| | - Lucjusz Jakubowski
- Genetics Department, Polish Mother’s Memorial Hospital Research Institute, Lodz , Poland
| | - Mariusz Grzesiak
- Obstetrics and Gynecology Clinic, Polish Mother’s Memorial Hospital Research Institute, Lodz , Poland
| | - Ewa Czichos
- Clinical Pathomorphology Department, Polish Mother’s Memorial Hospital Research Institute, Lodz , Poland
| | - Hanna Romanowicz
- Clinical Pathomorphology Department, Polish Mother’s Memorial Hospital Research Institute, Lodz , Poland
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48
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Strzelecka I, Słodki M, Zych-Krekora K, Krekora M, Grzesiak M, Maroszyńska I, Respondek-Liberska M. Retrospective Analysis of Preterm Neonates with Congenital Heart Defects Delivered by Cesarean Section: Unfavourable Outcomes a Necessity for Fetal Cardiology Education During Obstetrical Training? Prenatal Cardiology 2018. [DOI: 10.1515/pcard-2017-0008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction: Congenital heart defects are the most frequent reason for deaths during the neonatal and early infancy periods. The aim of this study was to retrospectively analyze singleton pregnancy outcomes of premature neonates with congenital cardiac defects delivered by Cesarean section. Materials and methods: A retrospective analysis was performed on 10,800 fetuses evaluated in our referral fetal cardiac center between 2010 and 2016. A group of 58 singleton pregnancies was selected with the following criteria: fetal heart defect, Cesarean section (C-section), and gestation of 37 weeks or less. Exclusion criteria included labor outside of our hospital and multiple pregnancy. Results: Isolated heart defects constituted 74,1% (43 cases) of the analysed data set. The majority of newborns were delivered at 36 weeks of gestation (43,1%), with an average of 33,6 weeks. In one case (1,7%), C-section took place at 22nd week. Birth weight of newborns < 2500g constituted 51,7% (30 cases). Neonatal deaths occurred in 60,3% (35 cases). Conclusions: Preterm neonates with congenital heart defect, delivered by C-section in our reference centre, during 2010 to 2016, had generally poor outcomes and high mortality rate. The average hospital stay of surviving neonates was approximately two months. An improvement of knowledge about prenatal cardiology is necessary in obstetrician management with fetuses with congenital heart diseases.
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Affiliation(s)
- Iwona Strzelecka
- Department of Prophylaxis and Diagnosis of Congenital Diseases, Medical University of Lodz, Lodz , Poland
| | - Maciej Słodki
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital, Lodz , Poland
- Faculty of Health Sciences. The State University of Applied Sciences in Plock , Poland
| | | | - Michał Krekora
- Poland.Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital, Lodz , Poland
| | - Mariusz Grzesiak
- Poland.Department of Obstetrics and Gynecology, Polish Mother’s Memorial Hospital, Lodz , Poland
| | - Iwona Maroszyńska
- Department of Intensive Care and Congenital Malformations of Newborns and Infants, Polish Mother’s Memorial Hospital, Lodz , Poland
| | - Maria Respondek-Liberska
- Department of Prophylaxis and Diagnosis of Congenital Diseases, Medical University of Lodz , Poland
- Department of Prenatal Cardiology, Polish Mother’s Memorial Hospital, Lodz , Poland
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49
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Krekora M, Zych-Krekora K, Słodki M, Grzesiak M, Respondek-Liberska M. The course of pregnancy and delivery in a patient with malaria. Ginekol Pol 2017; 88:574-575. [PMID: 29192419 DOI: 10.5603/gp.a2017.0103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 07/10/2017] [Indexed: 11/25/2022] Open
Abstract
Malaria is one of the most common lethal parasitic diseases. Infection is transmitted when an infected female mosquito bites a human introducing the sporozoites into human blood. The article presents the course of pregnancy and delivery in a patient complicated by Plasmodium infection. The patient had repetitive several trips to Tanzania over a short time period before she developed the condition. She had been taking antimalarial medication (proguanil-atovaquone) in a prophylactic dose during and after her first travel to Tanzania. Following her first return to Poland she experienced infection-related symptoms.
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Affiliation(s)
| | - Katarzyna Zych-Krekora
- Mother's Memorial Hospital Research Institute in Łódź, Rzgowska 281/289, 93-338, Lodz, Poland.
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50
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Lewicka I, Kocyłowski R, Grzesiak M, Gaj Z, Oszukowski P, Suliburska J. Selected trace elements concentrations in pregnancy and their possible role — literature review. Ginekol Pol 2017; 88:509-514. [DOI: 10.5603/gp.a2017.0093] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2017] [Revised: 08/14/2017] [Accepted: 08/17/2017] [Indexed: 11/25/2022] Open
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