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Serum activin A and inhibin A. New clinical markers for hydatidiform mole
No full textBACKGROUND. Although human placenta is a well established, rich source of
proteins, hCG is the only measurement available to date in diagnosing the occurrence
of the hydatidiform mole. Serum levels of a new placental protein, immunoreactive
inhibin, were high in molar pregnancy, but the inhibin assay never
became of clinical use, due to its low specificity and reliability. Since specific assays
are now available for inhibin A, inhibin B, and activin A, the current study
evaluated whether and which of these placental proteins is increased in presence
of a molar pregnancy.
METHODS. Serum inhibin A, inhibin B, activin A, and hCG levels were assayed in:
A) 6 women with molar pregnancies, before and after evacuation; B) 37 healthy
pregnant women; and C) 22 healthy nonpregnant women.
RESULTS. Women with partial hydatidiform moles had significantly higher serum
levels of inhibin A (P 0.001) and activin A (P 0.001) than healthy pregnant
women, several fold higher than the 95% confidence interval of control values.
After evacuation, the levels of both inhibin A (P 0.001) and activin A (P 0.05)
declined significantly to the levels of nonpregnant controls. Molar hCG concentrations
were significantly higher than in normal pregnancy (P 0.001), but some
values within the 95% confidence interval of normal values. Despite a significant
decrease (P 0.05) after evacuation, hCG levels were still higher than in nonpregnant
women.
CONCLUSIONS. The present data strongly suggest that serum inhibin A and activin
A measurement may be of value in diagnosis and short-term follow-up of molar
pregnanc
15. Il ritardato accrescimento intrauterino del feto: una causa delle disabilità neuro-motorie. In:
No full textChanges in inhibins and activin secretion in healthy and pathological pregnancies
No full textInhibin-related proteins are involved in the control of the feto-maternal communication required to maintain pregnancy.
Human placenta, decidua, and fetal membranes are the major sites of production and secretion of activin A, inhibin A and inhibin
B in maternal serum, amniotic fluid, and cord blood. The availability of suitable assays developed in the last years has enabled
the measurement of inhibins and activin A in their dimeric forms, in order to investigate their role in physiological conditions of
pregnancy. The studies conducted on inhibin-related proteins and human pregnancy suggested the possibility of an involvement
of inhibin A and activin A in the pathogenesis of gestational diseases. In fact, several lines of evidence underline the potential role
and the clinical usefulness of inhibin-related proteins measurement in the diagnosis, prevention, prognosis and follow-up of
different gestational pathologies such as early pregnancy viability, Down’s syndrome, fetal demise, pre-eclampsia, pregnancy-induced
hypertension, preterm delivery and intrauterine growth restriction. The measurement of inhibin A and activin A into the
biological fluids of pregnancy will offer in the future, further possibilities in the early diagnosis, prediction, and monitoring
diseases of pregnancy
Uterine and fetal cerebral Doppler predict the outcome of third-trimester small-for-gestational age fetuses with normal umbilical artery Doppler
No full textObjective
To assess the value of different admission tests in
predicting the outcome of small-for-gestational age (SGA) fetuses
with normal Doppler waveforms in the umbilical artery.
Methods
Criteria for admission into this retrospective study
included: singleton pregnancy with a birth weight < 10th
centile; absence of severe maternal complications; no evidence
of fetal anomalies on the sonogram; normal umbilical artery
Doppler; and availability of complete follow-up. At the first
antenatal sonogram classifying the fetus as SGA, Doppler analysis
of the uterine and middle cerebral arteries was performed
and amniotic fluid volume was assessed. Outcome variables
included adverse perinatal outcome (perinatal death, severe
morbidity) and emergency Cesarean section for fetal distress.
Results
Two hundred and thirty-one pregnancies were included
in the study. The mean
±
standard deriation birth weight and
gestational age at delivery were 2222
±
502 g and 37.3
±
2.9
weeks, respectively. In 37 cases (16%), an emergency
Cesarean section was performed. There was one intrauterine
death and three fetuses delivered by emergency Cesarean
section developed severe morbidity. Logistic regression
demonstrated that abnormal velocimetry of the uterine
arteries and fetal middle cerebral artery were independently
correlated with the occurrence of Cesarean section.
Conclusions
SGA fetuses with normal umbilical artery
Doppler waveforms and abnormal uterine arteries and fetal
middle cerebral artery waveforms have an increased risk
of developing distress and being delivered by emergency
Cesarean section. Particularly when both uterine and
fetal cerebral waveforms are altered at the same time, the risk
is exceedingly high (86%) and delivery as soon as fetal
maturity is achieved seems advisable. On the other hand,
when both vessels have normal waveforms, the chances of fetal
distress are small (4%) and expectant management is the
most reasonable choice
A danazol-loaded intrauterine device decreases dysmenorrhea, pelvic pain, and dyspareunia associated with endometriosis
No full textA danazol-loaded intrauterine device (IUD) containing 300-400 mg of danazol was inserted for 6 months in a group of women (n = 18) (median age 36.6 years; age range: 30 to 46 years) with a histologic diagnosis of endometriosis, referred for recurrent pelvic pain. Dysmenorrhea, dyspareunia, and pelvic pain significantly decreased after the first month, with a persistent effect during the 6 months of IUD insertion. These results show that a danazol-loaded IUD is an effective conservative therapy for patients with endometriosis-related pelvic pain. © 2004 by American Society for Reproductive Medicine
Pre-eclampsia with fetal growth restriction: placental and serum activin A and inhibin A levels.
No full text- …
