29 research outputs found
Sonographic fetal weight estimation in normal and overweight/obese healthy term pregnant women by gestation-adjusted projection (GAP) method
No full textPurpose: The objective of this study is to assess the ultrasound accuracy in fetal weight estimation related to the time distance between the actual weight recorded at delivery and the period of sonography among normal and overweight/obese pregnant women within 3 weeks prior birth at term. Methods: Four-hundred and ninety patients with healthy pregnancy were studied in a cohort study. The absolute percent error in estimation was achieved by gestation-adjusted projection method from Hadlock model for weight calculation as measure of accuracy. The mean percentage error variation over the weeks was correlated to maternal body mass index (BMI, Kg/m2) at ultrasound. The relationship between BMI and ultrasound performance was assessed by linear regression. Results: The overall proportion of supposed sonographic estimated fetal weight at birth within ±10 % of the birth weight significantly declines over the weeks (P = .016). The trend toward a progressive deterioration in ultrasound accuracy is not statistically significant for normal weight women (P = .272) but it is for over-weight/obese (P = .044). On univariate analysis, the absolute percent error and absolute error are positively related to BMI. Conclusions: Accuracy is related to the week at ultrasound scan with a gradual deterioration over the time and it worsens with increasing distance in days between the date of ultrasounds and delivery. The deterioration is greater for BMI ≥ 25
Amniotic fluid stem cell exosomes: Therapeutic perspective
No full textIt is widely accepted that the therapeutic potential of stem cells can be largely mediated by paracrine factors, also included into exosomes. Thus, stem cell-derived exosomes represent a major therapeutic option in regenerative medicine avoiding, if compared to stem cells graft, abnormal differentiation and tumor formation. Exosomes derived from mesenchymal stem cells (MSC) induce damaged tissue repair, and can also exert immunomodulatory effects on the differentiation, activation and function of different lymphocytes. Therefore, MSC exosomes can be considered as a potential treatment for inflammatory diseases and also an ideal candidate for allogeneic therapy due to their low immunogenicity. Amniotic fluid stem cells (AFSCs) are broadly multipotent, can be expanded in culture, and can be easily cryopreserved in cellular banks. In this study, morphology, phenotype, and protein content of exosomes released into amniotic fluid in vivo and from AFSC during in vitro culture (conditioned medium) were examined. We found that AFSC-derived exosomes present different molecules than amniotic fluid ones, some of them involved in immunomodulation, such transforming growth factor beta and hepatic growth factors. The immunomodulatory effect of AFSC's exosomes on peripheral blood mononuclear cells stimulated with phytohemagglutinin was compared to that of the supernatant produced by such conditioned media deprived of exosomes. We present evidence that the principal effect of AFSC conditioned media (without exosomes) is the induction of apoptosis in lymphocytes, whereas exposure to AFSC-derived exosomes decreases the lymphocyte's proliferation, supporting the hypothesis that the entire secretome of stem cells differently affects immune-response. © 2017 BioFactors, 44(2):158â167, 2018
RETRACTED: Correlations between parameters of glycaemic variability and foetal growth, neonatal hypoglycaemia and hyperbilirubinemia in women with gestational diabetes.
No full textThe diagnosis of gestational diabetes mellitus (GDM) is important to prevent maternal and neonatal complications. This study aimed to investigate the feasibility of parameters of glycaemic variability to predict neonatal complications in women with GDM. A retrospective study was conducted on pregnant women tested positive at the oral glucose tolerance test (OGTT) during 16-18 or 24-28 weeks of gestation. Glycaemic measures were extracted from patients' glucometers and expanded to obtain parameters of glycaemic variability. Data on pregnancy outcomes were obtained from clinical folders. Descriptive group-level analysis was used to assess trends in glycaemic measures and foetal outcomes. Twelve patients were included and analysed, accounting for 111 weeks of observations. The analysis of trends in parameters of glycaemic variability showed spikes of glycaemic mean, high blood glucose index and J-index at 30-31 weeks of gestation for cases with foetal macrosomia, defined as foetal growth >90° percentile, neonatal hypoglycaemia and hyperbilirubinemia. Specific trends in parameters of glycaemic variability observed at third trimester correlate with foetal outcomes. Further research is awaited to provide evidence that monitoring of glycaemic variability trends could be more clinically informative and useful than standard glycaemic checks to manage women with GDM at delivery
Biochemical analysis of catecholamine and cortisol for the evaluation of the fetal distress in third trimester stillbirths
No full textBackground Stress hormones like catecholamine and cortisol are thought to reflect the magnitude of physical stress in adults and were studied in relationship to the cause of death and agony time. Intrauterine distress, intrapartum events, and modes of delivery can affect the fetal endocrine stress response, as reflected by biochemical analyses. The aim of the present study was to evaluate the role of catecholamines and cortisol as markers of ante-mortem fetal distress. The role of cortisol as a marker of circadian timing of delivery was also assessed. Methods A 2-year prospective cohort-comparison inclusion of stillbirths and newborns took place with collection of antemortem data, labor parameters, neonatal outcome, post-mortem data and blood samples. Stillbirths were classified as acute or chronic on the basis of a multidisciplinary evaluation. Heart blood of stillbirths and cord blood of newborns were analyzed by high pressure liquid chromatography (HPLC) for adrenaline and noradrenaline and by immunoassay for cortisol determination. Results Fifteen stillbirths and 46 newborns, as a comparison group, delivered by spontaneous vaginal birth, elective, and emergency cesarean sections were included. Stillbirths' main cause of death was cord thrombosis. Levels of adrenaline and noradrenaline (median: 14,188 pg/ml and 230.5 pg/ml, respectively) were significantly higher (p < 0.001) in stillbirths than in newborns and were also higher in acute compared to chronic distress. Cortisol levels were significantly higher (p < 0.05) in spontaneous vaginal delivery (median: 18.2 mu g/dl) compared to elective cesarean sections (median: 3.8 mu g/dl). No difference in cortisol concentrations was detected between newborns delivered at morning and at afternoon/evening. Conclusion Our results suggest that the biochemical measurement of adrenaline and noradrenaline levels might reflect a marked physical stress response during the process of death in stillbirths. On the contrary, the elevation of cortisol levels could mirror the elevation in maternal cortisol level during vaginal delivery. For the post-mortem evaluation of stillbirths, the analysis of CA levels could provide additional data on the duration of distress, useful to integrate the forensic diagnosis
Sustainable and Health-Protecting Food Ingredients from Bioprocessed Food by-Products and Wastes
No full textDietary inadequacy and nutrition-related non-communicable diseases (N-NCDs) represent two main issues for the whole society, urgently requesting solutions from researchers, policy-makers, and other stakeholders involved in the health and food system. Food by-products and wastes (FBPW) represent a global problem of increasing severity, widely recognized as an important unsustainability hotspot, with high socio-economic and environmental costs. Yet, recycling and up-cycling of FBPW to produce functional foods could represent a solution to dietary inadequacy and risk of N-NCDs onset. Bioprocessing of FBPW with selected microorganisms appears to be a relatively cheap strategy to yield molecules (or rather molecules mixtures) that may be used to fortify/enrich food, as well as to formulate dietary supplements. This review, conjugating human health and sustainability in relation to food, describes the state-of-the-art of the use of yeasts, molds, and lactic acid bacteria for producing value-added compounds from FBPW. Challenges related to FBPW bioprocessing prior to their use in food regard will be also discussed: (i) loss of product functionality upon scale-up of recovery process; (ii) finding logistic solutions to the intrinsic perishability of the majority of FBPW; (iii) inserting up-cycling of FBPW in an appropriate legislative framework; (iv) increasing consumer acceptability of food and dietary supplements derived from FBPW
DEVELOPMENT OF A NOVEL METHOD FOR AMNIOTIC FLUID STEM CELL STORAGE
No full textBackground - Current procedures for collection of human
Amniotic Fluid Stem Cells (hAFSCs) imply that amniotic fluid cells were
cultured in flask for two weeks, than can be devoted to research purpose.
However, hAFSCs could be retrieved directly from a small amount of
amniotic fluid that can be obtained at the time of diagnostic
amniocentesis. The aim of the study was to verify if a direct freezing of
amniotic fluid cells is able to maintain and / or improve the potential
of the sub-population of stem cells. Methods - We compared the potential
of the hAFSCs depending on the moment in which they are frozen, cells
obtained directly from amniotic fluid aspiration (D samples) and cells
cultured in flask before freezing (C samples). Colony-forming-unit
ability, proliferation, morphology, stemness-related marker expression,
senescence, apoptosis, and differentiation potential of C and D samples
were compared. Results - hAFSCs isolated from D samples expressed MSC
markers until later passages, had a good proliferation rate, and
exhibited differentiation capacity similar to hAFSCs of C samples.
Interestingly, the direct freezing induce a higher concentration of cells
positive for pluripotency stem cell markers, without teratoma formation
in vivo.
Conclusions - This study suggests that minimal processing may be adequate
for the banking of amniotic fluid cells, avoiding in vitro passages
before the storage and exposure to high oxygen concentration affecting
stem cell properties. This technique might be a reasonable approach in
terms of costs and for the process of accreditation in GMP for a stem
cell bank
Fetal Presentation of Mediastinal Immature Teratoma: Ultrasound, Autopsy and Cytogenetic Findings
No full textTeratomas are the most common congenital tumors, occurring along the midline or paraxial sites, or uncommonly, the mediastinum. Teratomas are classified as mature, containing only differentiated tissues from the three germinal layers; and immature, which also present with neuroectodermal elements, ependymal rosettes, and immature mesenchyme. Herein, we describe a new case of fetal mediastinal immature teratoma detected at 21 weeks of gestational age (wga) + 1 day with thorough cytogenetic analysis. Ultrasound (US) showed a solid and cystic mass located in the anterior mediastinum, measuring 1.8 × 1.3 cm with no signs of hydrops. At 22 wga, US showed a mass of 2.4 cm in diameter and moderate pericardial effusions. Although the prenatal risks and available therapeutic strategies were explained to the parents, they opted for termination of pregnancy. Histology showed an immature teratoma, Norris grade 2. Karyotype on the fetus and tumor exhibited a chromosomal asset of 46,XX. The fetal outcome in the case of mediastinal teratoma relies on the development of hydrops due to mass compression of vessels and heart failure. Prenatal US diagnosis and close fetal monitoring are paramount in planning adequate treatment, such as in utero surgery, ex utero intrapartum therapy (EXIT) procedure, and surgical excision after birth
<i>Klebsiella variicola</i> Infection in a Second Trimester Twin Pregnancy: An Underreported Cause of Chorioamnionitis
No full textBackground and Clinical Significance: Klebisella variicola belongs to the Klebsiella pneumoniae complex. It is a Gram-negative, facultative anaerobic, and nonmotile bacillus, mainly isolated in plants. However, as an emerging human pathogen, it has been isolated in immunocompromised patients with urinary tract infections, pneumonia, and bacteremia. K. variicola infection in pregnancy, responsible for acute chorioamnionitis, has never been reported. Case Presentation: We present a case of a twin pregnancy at 17 + 5 weeks in which chorioamnionitis and fetal inflammatory responses such as funisitis and chorionic vasculitis were due to an ascending infection of K. variicola. The pathogen was isolated postmortem in fetal blood and tissues and the placenta using MALDI-ToF mass spectrometry (MALDI-ToF MS). The accuracy of this microbiological diagnosis sheds further light on the epidemiology and virulence of K. variicola in the prenatal setting. Conclusions: In the case of miscarriage, microbiological investigations on the fetus should always be recommended to identify the exact microorganism in order to target the medical treatment and manage subsequent pregnancies
