Browsing by Subject "Pregnancy"
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Item A Textbook of Obstetrics(W.B. Saunders and Company, 1906-01-01) Hirst, BartonItem Abortion and its treatment, from the stand-point of Practical Experience.(D. Appleton and Company, 1890-01-01) Porter, P.; Thomas, T.Item Angiotensin II type 1 receptor agonistic autoantibody blockade improves postpartum hypertension and cardiac mitochondrial function in rat model of preeclampsia(BioMed Central Ltd., 2021-11-02) Booz, George W.; Kennedy, Daniel; Bowling, Michael; Robinson, Taprieka; Azubuike, Daniel; Fisher, Brandon; Brooks, Karen; Chinthakuntla, Pooja; Hoang, Ngoc H.; Hosler, Jonathan P.; Cunningham, Mark W., Jr.Women with preeclampsia (PE) have a greater risk of developing hypertension, cardiovascular disease (CVD), and renal disease later in life. Angiotensin II type I receptor agonistic autoantibodies (AT1-AAs) are elevated in women with PE during pregnancy and up to 2-year postpartum (PP), and in the reduced uterine perfusion pressure (RUPP) rat model of PE. Blockade of AT1-AA with a specific 7 amino acid peptide binding sequence ('n7AAc') improves pathophysiology observed in RUPP rats; however, the long-term effects of AT1-AA inhibition in PP is unknown. Pregnant Sprague Dawley rats were divided into three groups: normal pregnant (NP) (n = 16), RUPP (n = 15), and RUPP + 'n7AAc' (n = 16). Gestational day 14, RUPP surgery was performed and 'n7AAc' (144 mug/day) administered via osmotic minipump. At 10-week PP, mean arterial pressure (MAP), renal glomerular filtration rate (GFR) and cardiac functions, and cardiac mitochondria function were assessed. MAP was elevated PP in RUPP vs. NP (126 +/- 4 vs. 116 +/- 3 mmHg, p < 0.05), but was normalized in in RUPP + 'n7AAc' (109 +/- 3 mmHg) vs. RUPP (p < 0.05). PP heart size was reduced by RUPP + 'n7AAc' vs. RUPP rats (p < 0.05). Complex IV protein abundance and enzymatic activity, along with glutamate/malate-driven respiration (complexes I, III, and IV), were reduced in the heart of RUPP vs. NP rats which was prevented with 'n7AAc'. AT1-AA inhibition during pregnancy not only improves blood pressure and pathophysiology of PE in rats during pregnancy, but also long-term changes in blood pressure, cardiac hypertrophy, and cardiac mitochondrial function PP.Item Case Histories in Obstetrics(W.M. Leonard, Publisher, 1914-01-01) DeNormandie, RobertItem Complications of Pregnancy(D. Appleton and Company, 1923-01-01) Davis, EdwardItem King's Manual of Obstetrics(Lea Brothers & Co., 1909-01-01) King, A.F.Item Maternal and fetal mitochondrial gene dysregulation in hypertensive disorders of pregnancy(American Physiological Society, 2023-05-15) Ricci, Contessa A.; Reid, Danielle M.; Sun, Jie; Santillan, Donna A.; Santillan, Mark K.; Phillips, Nicole R.; Goulopoulou, StylianiMitochondrial dysfunction has been implicated in pregnancy-induced hypertension (PIH). The role of mitochondrial gene dysregulation in PIH, and consequences for maternal-fetal interactions, remain elusive. Here, we investigated mitochondrial gene expression and dysregulation in maternal and placental tissues from pregnancies with and without PIH; further, we measured circulating mitochondrial DNA (mtDNA) mutational load, an index of mtDNA integrity. Differential gene expression analysis followed by Time Course Gene Set Analysis (TcGSA) was conducted on publicly available high throughput sequencing transcriptomic data sets. Mutational load analysis was carried out on peripheral mononuclear blood cells from healthy pregnant individuals and individuals with preeclampsia. Thirty mitochondrial differentially expressed genes (mtDEGs) were detected in the maternal cell-free circulating transcriptome, whereas nine were detected in placental transcriptome from pregnancies with PIH. In PIH pregnancies, maternal mitochondrial dysregulation was associated with pathways involved in inflammation, cell death/survival, and placental development, whereas fetal mitochondrial dysregulation was associated with increased production of extracellular vesicles (EVs) at term. Mothers with preeclampsia did not exhibit a significantly different degree of mtDNA mutational load. Our findings support the involvement of maternal mitochondrial dysregulation in the pathophysiology of PIH and suggest that mitochondria may mediate maternal-fetal interactions during healthy pregnancy.NEW & NOTEWORTHY This study identifies aberrant maternal and fetal expression of mitochondrial genes in pregnancies with gestational hypertension and preeclampsia. Mitochondrial gene dysregulation may be a common etiological factor contributing to the development of de novo hypertension in pregnancy-associated hypertensive disorders.Item Moderation effects of serotype on dengue severity across pregnancy status in Mexico(BioMed Central Ltd., 2023-03-11) Annan, Esther; Nguyen, Uyen-Sa D. T.; Trevino, Jesus; Wan Yaacob, Wan F.; Mangla, Sherry; Pathak, Ashok K.; Nandy, Rajesh; Haque, UbydulBACKGROUND: Pregnancy increases a woman's risk of severe dengue. To the best of our knowledge, the moderation effect of the dengue serotype among pregnant women has not been studied in Mexico. This study explores how pregnancy interacted with the dengue serotype from 2012 to 2020 in Mexico. METHOD: Information from 2469 notifying health units in Mexican municipalities was used for this cross-sectional analysis. Multiple logistic regression with interaction effects was chosen as the final model and sensitivity analysis was done to assess potential exposure misclassification of pregnancy status. RESULTS: Pregnant women were found to have higher odds of severe dengue [1.50 (95% CI 1.41, 1.59)]. The odds of dengue severity varied for pregnant women with DENV-1 [1.45, (95% CI 1.21, 1.74)], DENV-2 [1.33, (95% CI 1.18, 1.53)] and DENV-4 [3.78, (95% CI 1.14, 12.59)]. While the odds of severe dengue were generally higher for pregnant women compared with non-pregnant women with DENV-1 and DENV-2, the odds of disease severity were much higher for those infected with the DENV-4 serotype. CONCLUSION: The effect of pregnancy on severe dengue is moderated by the dengue serotype. Future studies on genetic diversification may potentially elucidate this serotype-specific effect among pregnant women in Mexico.Item Obstetrics: A Text-Book for the Use of Students and Practitioners(D. Appleton and Company, 1917-01-01) Williams, J.Item Operative Gynecology(C.V. Mosby Company, 1915-01-01) Crossen, HarryItem OSTEOPATHIC MANIPULATIVE TREATMENT FOR LOW BACK PAIN DURING PREGNANCY: A CASE REPORT(2013-04-12) Hanley, KellyPurpose: In 2010 Licciardone et al. published the landmark paper "Osteopathic manipulative treatment of back pain and related symptoms during pregnancy: a randomized controlled trial" in the American Journal of Obstetrics and Gynecology. They found that osteopathic manipulative treatment (OMT) was effective at slowing or halting the deterioration of back-specific functioning during pregnancy. Since this publication there is been an increase in interest among physicians in the use of OMT as a treatment for back pain during pregnancy. The purpose of this case report is to demonstrate a pregnant patient with low back pain who was successfully treated with OMT. Methods: This case report consisted of a review of a patient's medical file. Results: A 19-year old G1P0 Caucasian female presented at an osteopathic manipulative medicine clinic at 21 weeks gestation for a three month history of low back pain. The patient was found to have somatic dysfunctions of the cervical, thoracic, and lumbar spine, as well as the pelvis and sacrum. She was treated with a variety of OMT techniques and reported reduced pain both immediately after treatment and at her 10 day follow-up appointment. Conclusions: Low back pain is a common complaint among pregnant women and can be treated with OMT to reduce pain and improve function. Osteopathic physicians should continue to offer OMT to their obstetric patients because of its proven effectiveness.Item Outlines of Obstetrics(Fairchild & Company, 1892-01-01) Jewett, CharlesItem OVARIAN ECTOPIC PREGNANCY: AN UNUSUAL PRESENTATION AND TREATMENT(2013-04-12) Spring-Robbins, ChandraPurpose: The purpose of this case report is to share a case of ovarian ectopic pregnancy and its complicated management. Ovarian ectopic pregnancies are rare, with an incidence of 1/7000 pregnancies. Management needs to consider future childbearing, ovarian preservation and hemodynamic stability. Methods: Involved a retrospective chart review of the management of a patient with a ruptured ovarian ectopic pregnancy. A literature review was undertaken for management points. Results: A 39 year old gravida 2, para 0102 presented to the Emergency Department and was diagnosed with likely hemoperitoneum and possible rupturing ectopic pregnancy. She was taken to the operating room and an ovarian ectopic noted laparoscopically and confirmed by pathologist on frozen section. An ovarian wedge resection performed and patient discharged home. She had persistently elevated human chorionic gonadotropin (hCG) level and was given methotrexate for presumed microscopically remaining chorionic villi. Her hormone level eventually declined to zero. Conclusions: Ovarian ectopic pregnancies are much more rare than those in the fallopian tubes. The management of them can be complicated by desire for ovarian preservation, significant hemoperitoneum if ruptured and persistent chorionic villi if the ovary is left behind.Item Reduced Maternal Circulating Cell-Free Mitochondrial DNA Is Associated With the Development of Preeclampsia(American Heart Association, Inc., 2022-01-11) Cushen, Spencer C.; Ricci, Contessa A.; Bradshaw, Jessica L.; Silzer, Talisa K.; Blessing, Alexandra M.; Sun, Jie; Zhou, Zhengyang; Scroggins, Sabrina M.; Santillan, Mark K.; Santillan, Donna A.; Phillips, Nicole R.; Goulopoulou, StylianiBackground Circulating cell-free mitochondrial DNA (ccf-mtDNA) is a damage-associated molecular pattern that reflects cell stress responses and tissue damage, but little is known about ccf-mtDNA in preeclampsia. The main objectives of this study were to determine (1) absolute concentrations of ccf-mtDNA in plasma and mitochondrial DNA content in peripheral blood mononuclear cells and (2) forms of ccf-mtDNA transport in blood from women with preeclampsia and healthy controls. In addition, we sought to establish the association between aberrance in circulating DNA-related metrics, including ccf-mtDNA and DNA clearance mechanisms, and the clinical diagnosis of preeclampsia using bootstrapped penalized logistic regression. Methods and Results Absolute concentrations of ccf-mtDNA were reduced in plasma from women with preeclampsia compared with healthy controls (P0.05). While the pattern of reduced ccf-mtDNA in patients with preeclampsia remained, DNA isolation from plasma using membrane lysis buffer resulted in 1000-fold higher ccf-mtDNA concentrations in the preeclampsia group (P=0.0014) and 430-fold higher ccf-mtDNA concentrations in the control group (P<0.0001). Plasma from women with preeclampsia did not induce greater Toll-like receptor-9-induced nuclear factor kappa-light-chain enhancer of activated B cells-dependent responses in human embryonic kidney 293 cells overexpressing the human TLR-9 gene (P>0.05). Penalized regression analysis showed that women with preeclampsia were more likely to have lower concentrations of ccf-mtDNA as well as higher concentrations of nuclear DNA and DNase I compared with their matched controls. Conclusions Women with preeclampsia have aberrant circulating DNA dynamics, including reduced ccf-mtDNA concentrations and DNA clearance mechanisms, compared with gestational age-matched healthy pregnant women.Item Synergy 2008: Annual Research Report(2008-01-01)Item The influence of spatial patterns and dengue serotype on dengue fever severity in Mexico(2022-08) Annan, Esther; Haque, Ubydul; Nguyen, Uyen-Sa D.T.; Nandy, Rajesh R.Low socioeconomic status (SES), high temperature, and increasing rainfall patterns are associated with an increase in the number of dengue case counts. However, the effect of climatic variables on individual dengue virus (DENV) serotypes have not been explored in prior literature. Furthermore, there is a knowledge gap about the extent to which serotype count affects the rate of severe dengue in Mexico. A principal components analysis was used to determine the poverty indices across Mexico. Conditional autoregressive Bayesian models were used to determine the effect of poverty and climatic variables on the rate of serotype distribution and severe dengue in Mexico. A unit increase in poverty increased the rate of DENV-1, DENV-2, DENV-3, and DENV-4 by 8.4%, 5%, 16%, and 13.8% respectively. An increase in one case attributable to DENV-1, DENV-2, DENV-3, and DENV-4 was independently associated with an increase in the rate of severe dengue by 0.02%, 0.1%, 0.03%, and 5.8% respectively. Hotspots of all DENV serotypes and severe dengue were associated mostly with coastal regions in Mexico. The Southeast region experienced higher humidity, a higher poverty index, and a lower average altitude. The association of these climatic parameters with severe dengue puts states like Oaxaca at increased risk of a higher number of severe dengue cases. Pregnancy increases a woman's risk of severe dengue. To the best of our knowledge, the moderation effect of dengue serotype among pregnant women has not been studied in Mexico. This study explores how pregnancy interacts with dengue serotype from 2012 to 2020 in Mexico. Information from 2,469 notifying health units in Mexican municipalities was used for the analysis. Multiple logistic regression with interaction effects was chosen as the final model and sensitivity analysis was done to assess potential exposure misclassification of pregnancy status. Pregnant women were found to have higher odds of severe dengue [1.50 (95% CI: 1.41, 1.59)]. The odds of dengue severity varied for pregnant women with DENV-1 [1.45, (95% CI: 1.21, 1.74)], DENV-2 [1.33, (95% CI:1.18, 1.53)] and DENV-4 [3.78, (95% CI: 1.14, 12.59)]. While the odds of severe dengue were generally higher for pregnant women compared with non-pregnant women with DENV-1 and DENV-2, the odds of disease severity were much higher for those infected with the DENV-4 serotype. Future studies on genetic diversification and phylogeny may potentially elucidate this serotype-specific effect among pregnant women in Mexico.Item The Principles and Practice of Obstetrics(W.B. Saunders and Company, 1915-01-01) DeLee, Joseph