12 research outputs found
Abstract 4002: Uptake of cervical cancer screening among HIV positive women at a tertiary healthcare center in Nigeria
No full textAbstract 4002: Uptake of cervical cancer screening among HIV positive women at a tertiary healthcare center in Nigeria
No full textComparison of Serum Calcium Level in Hypertensive and Normotensive Pregnant Women
No full textBackground: Calcium deficiency in pregnancy is linked to the risk of development of hypertensive disorders of pregnancy. At present,hypertensive disorders of pregnancy are among leading causes of maternal death in Nigeria. This study was aimed to compare the serumcalcium level of women with hypertensive disorders of pregnancy and normotensive controls.
Methodology: This was a comparative descriptive study among patients with hypertensive disorders of pregnancy (45 pre‑eclampsia [PE] and 45 gestational hypertension [GH]) and comparative group of 45 normotensive pregnant women at Federal Medical Center, Abeokuta.
Results: The serum calcium level in normotensive controls (mean ± standard deviation) was 2.64 ± 1.38 mmol/l, women with GH was 2.39 ± 1.15 mmol/l, and PE was 2.08 ± 0.76 mmol/l (P = 0.065). Hypocalcemia was found to have an incidence rate of 33% in normotensive controls, 51.1% among GH, and 51.1% among PE.
Conclusion: Pregnant women with hypertensive disorders of pregnancy showed nonsignificant difference in mean serum calcium level.
Keywords: Calcium, gestational hypertension, hypertensive, normotensive, preeclampsi
A Comparative Study of Local Dietary Intake Among Subjects with Hypertensive Disorders of Pregnancy Attending Antenatal Care
No full textBackground: Hypertensive disorders of pregnancy remain among the most significant causes of pregnancy-related complications. The research by the Dietary Approaches to Stop Hypertension (DASH) group revealed that non-pharmacological measures and intervention such as diet can be used to control blood pressure. Objective: This study was completed to determine the frequency of consumption of local food among females who were pregnant and their relationship with pregnancy-related hypertensive disorders. Methods: This was a descriptive research study of females who were pregnant with pre-eclampsia (PE) and gestational hypertension (GH) who presented at the Federal Medical Centre (FMC), Abeokuta, Nigeria. During the study period (September–October 2019) at the tertiary healthcare centre, 45 subjects who were pregnant were select from a PE and GH group, and matched with 45 patients with normotension. Comparison of bean meal onsumption (gbegiri) and bone meal (gbure-oloboro) consumption in subjects who were pregnant did not reveal statistically significant differences in those with PE and GH. Results: The findings reveal a statistically significant difference in milk consumption between females who were pregnant with mild and severe PE (p=0.019). There was also a statistically significant difference in subjects with mild and severe GH who consumed milk (p=0.003)
Appendectomy in the Gynecological Setting: Intraoperative Findings and Corresponding Histopathology
No full text<i>Background/Aims:</i> To evaluate the intraoperative findings and corresponding histopathology associated with appendectomies performed during benign gynecological surgery. <i>Methods:</i> Retrospective case series. <i>Results:</i> Twenty-two appendectomies were performed from 2002 through 2008 at Hutzel Women’s Hospital due to intraoperative findings of inflammation or erythema (n = 8), periappendiceal adhesions (n = 5), injury to the appendix or mesoappendix (n = 2), fecalith (n = 2), dilation of the appendix (n = 1), adnexal mass involving the appendix (n = 1), and suspected lipoma (n = 1). Final pathology was consistent with significant findings such as acute inflammation, periappendicitis, and adhesions or endometriosis involving the appendix in 68.2% of cases. <i>Conclusion:</i> In the benign gynecological setting, appendectomies were primarily performed due to inflammation or erythema. In the majority of cases, significant appendiceal pathology was confirmed.</jats:p
Efficacy of Admission Cardiotocography in Early Stage of Labour in Predicting Perinatal Outcome among Parturients in a Tertiary Health Facility in Ogun State, Southwest Nigeria
No full textBackground: Some fetuses will present with hypoxia at admission into the labour room and may not be able to withstand the stress of frequent and adequate uterine contractions. Admission cardiotocography (CTG) in early labour has been thought to be useful in detecting babies with such conditions therefore affording the obstetrician early intervention to prevent adverse perinatal outcome.
Aim: This study aims to determine the predictive value of admission cardiotocogram in early labour in the early detection of fetal hypoxia and its adverse perinatal outcome.
Patients,Materials and Methods: It was a prospective cross‑sectional study among low‑ and high‑risk pregnant women in a tertiary health institution in Abeokuta, Southwest Nigeria. Two hundred participants with singleton fetus in cephalic presentation were recruited consecutively at term in early first stage of labour and were subjected to 20 min admission CTG (ACTG). The resulting cardiotocograms were classified into reactive, suspicious or pathological and further management was based on the cardiotocogram findings. Perinatal outcomes were assessed and statistical analysis done using IBM SPSS version 20. The main outcome measures were mode of delivery and perinatal outcome using Apgar scores, neonatal pulse oximetry, and neonatal unit (NNU) admission.
Results: Seventy percent of the participants were multipara, 42% were aged between 26 and 30 years. Suspicious and pathological CTGs were 9% and 1%, respectively. Operative delivery, birth asphyxia, and NNU admission of babies were more common among the non‑reactive (suspicious/pathological) CTG groups compared to reactive CTG group. The test, in predicting perinatal asphyxia, has low sensitivity (42.86%) and positive predictive values (15%) but high specificity (91.19%) and negative predictive values (97.78)
Conclusion: ACTG is a simple, noninvasive screening tool in labour. It is highly effective in predicting fetuses unlikely to develop birth asphyxia but not so effective at predicting those likely to develop asphyxia. The test should be used with caution
Immunosequencing and Profiling of T Cells at the Maternal–Fetal Interface of Women with Preterm Labor and Chronic Chorioamnionitis
No full textT cells are implicated in the pathophysiology of preterm labor and birth, the leading cause of neonatal morbidity and mortality worldwide. Specifically, maternal decidual T cells infiltrate the chorioamniotic membranes in chronic chorioamnionitis (CCA), a placental lesion considered to reflect maternal anti-fetal rejection, leading to preterm labor and birth. However, the phenotype and TCR repertoire of decidual T cells in women with preterm labor and CCA have not been investigated. In this study, we used phenotyping, TCR sequencing, and functional assays to elucidate the molecular characteristics and Ag specificity of T cells infiltrating the chorioamniotic membranes in women with CCA who underwent term or preterm labor. Phenotyping indicated distinct enrichment of human decidual effector memory T cell subsets in cases of preterm labor with CCA without altered regulatory T cell proportions. TCR sequencing revealed that the T cell repertoire of CCA is characterized by increased TCR richness and decreased clonal expansion in women with preterm labor. We identified 15 clones associated with CCA and compared these against established TCR databases, reporting that infiltrating T cells may possess specificity for maternal and fetal Ags, but not common viral Ags. Functional assays demonstrated that choriodecidual T cells can respond to maternal and fetal Ags. Collectively, our findings provide, to our knowledge, novel insight into the complex processes underlying chronic placental inflammation and further support a role for effector T cells in the mechanisms of disease for preterm labor and birth. Moreover, this work further strengthens the contribution of adaptive immunity to the syndromic nature of preterm labor and birth.National Institute of Child Health and Human Development of the National Institutes of Health (NIH), University of Virginia, No. 2R01HD051498-06A
The Bony pelvis scars of parturition and factors Influencing their manifestation
No full textIncludes abstract.Includes bibliographical references.The aim of this study was to measure and describe the range of variation of several sites on the pelvis reported to display parturition scarring in a skeletal sample of 391 individuals (230 males and 161 females). The scar features, body and pelvic dimensions were compared according to the sex, age and time period of origin of the individuals. Correlation tests were performed to identify potential relationships between scar features, while Principal Component Analysis was used to assess the influence of body and pelvic size on scar manifestation
Deciphering maternal-fetal cross-talk in the human placenta during parturition using single-cell RNA sequencing
No full textLabor is a complex physiological process requiring a well-orchestrated dialogue between the mother and fetus. However, the cellular contributions and communications that facilitate maternal-fetal cross-talk in labor have not been fully elucidated. Here, single-cell RNA sequencing (scRNA-seq) was applied to decipher maternal-fetal signaling in the human placenta during term labor. First, a single-cell atlas of the human placenta was established, demonstrating that maternal and fetal cell types underwent changes in transcriptomic activity during labor. Cell types most affected by labor were fetal stromal and maternal decidual cells in the chorioamniotic membranes (CAMs) and maternal and fetal myeloid cells in the placenta. Cell-cell interaction analyses showed that CAM and placental cell types participated in labor-driven maternal and fetal signaling, including the collagen, C-X-C motif ligand (CXCL), tumor necrosis factor (TNF), galectin, and interleukin-6 (IL-6) pathways. Integration of scRNA-seq data with publicly available bulk transcriptomic data showed that placenta-derived scRNA-seq signatures could be monitored in the maternal circulation throughout gestation and in labor. Moreover, comparative analysis revealed that placenta-derived signatures in term labor were mirrored by those in spontaneous preterm labor and birth. Furthermore, we demonstrated that early in gestation, labor-specific, placenta-derived signatures could be detected in the circulation of women destined to undergo spontaneous preterm birth, with either intact or prelabor ruptured membranes. Collectively, our findings provide insight into the maternal-fetal cross-talk of human parturition and suggest that placenta-derived single-cell signatures can aid in the development of noninvasive biomarkers for the prediction of preterm birth
Proteomic Profiles of Maternal Plasma Extracellular Vesicles for Prediction of Preeclampsia
No full textProblemPreeclampsia is a heterogeneous syndrome of diverse etiologies and molecular pathways leading to distinct clinical subtypes. Herein, we aimed to characterize the extracellular vesicle (EV)-associated and soluble fractions of the maternal plasma proteome in patients with preeclampsia and to assess their value for disease prediction.Method of StudyThis case–control study included 24 women with term preeclampsia, 23 women with preterm preeclampsia, and 94 healthy pregnant controls. Blood samples were collected from cases on average 7 weeks before the diagnosis of preeclampsia and were matched to control samples. Soluble and EV fractions were separated from maternal plasma; EVs were confirmed by cryo-EM, NanoSight, and flow cytometry; and 82 proteins were analyzed with bead-based, multiplexed immunoassays. Quantile regression analysis and random forest models were implemented to evaluate protein concentration differences and their predictive accuracy. Preeclampsia subgroups defined by molecular profiles were identified by hierarchical cluster analysis. Significance was set at p < 0.05 or false discovery rate-adjusted q < 0.1.ResultsIn preterm preeclampsia, PlGF, PTX3, and VEGFR-1 displayed differential abundance in both soluble and EV fractions, whereas angiogenin, CD40L, endoglin, galectin-1, IL-27, CCL19, and TIMP1 were changed only in the soluble fraction (q < 0.1). The direction of changes in the EV fraction was consistent with that in the soluble fraction for nine proteins. In term preeclampsia, CCL3 had increased abundance in both fractions (q < 0.1). The combined EV and soluble fraction proteomic profiles predicted preterm and term preeclampsia with an AUC of 78% (95% CI, 66%–90%) and 68% (95% CI, 56%–80%), respectively. Three clusters of preeclampsia featuring distinct clinical characteristics and placental pathology were identified based on combined protein data.ConclusionsOur findings reveal distinct alterations of the maternal EV-associated and soluble plasma proteome in preterm and term preeclampsia and identify molecular subgroups of patients with distinct clinical and placental histopathologic features.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/195157/1/aji13928-sup-0001-figureS1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/195157/2/aji13928-sup-0002-figureS2.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/195157/3/aji13928-sup-0003-figureS3.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/195157/4/aji13928-sup-0004-figureS4.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/195157/5/aji13928-sup-0006-tableS5.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/195157/6/aji13928.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/195157/7/aji13928_am.pd
