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Byline: Mikitaka Obara, Hideto Hirano, Masaki Ogawa, Hiromitsu Tsubaki, Yuko Yoshida, Satoshi Miyauchi, Toshinobu Tanaka Keywords: Cervical mucus; cervical ripening; chondroitin sulfate; hyaluronidase; threatened premature labor Abstract: Objective: This study was undertaken to investigate changes in chondroitin sulfate levels in the cervix and the physiologic role of chondroitin sulfate isomers in the process of cervical ripening. Study Design: Uterine cervical mucus samples were obtained from 57 women (7 nonpregnant women, 19 at preterm gestation, 9 at term gestation, 16 during the first stage of term labor, and 6 with threatened premature labor). Chondroitin sulfate isomer (chondroitin 0-sulfate, 4-sulfate, and 6-sulfate) concentrations in cervical mucus were measured by high-performance liquid chromatography. The effect of exogenous chondroitin sulfate on hyaluronidase activity in cervical mucus was evaluated by gel permeation chromatography of fluorolabeled hyaluronic acid. Results: Chondroitin sulfate concentrations in cervical mucus were increased significantly (P < .05) in the threatened premature labor group compared with the preterm and term groups. However, the same finding was not observed in the first stage of term labor. Exogenous chondroitin sulfate inhibited hyaluronidase activity in mucus. Conclusion: Chondroitin sulfate may defend against cervical ripening in threatened premature labor.(Am J Obstet Gynecol 2000;182:334-9.) Author Affiliation: Akita and Tokyo, Japan From the Department of Obstetrics and Gynecology, Akita University School of Medicine,.sup.a and the Tokyo Research Institute, Seikagaku Corporation..sup.b Article History: Received 3 March 1999; Revised 27 August 1999; Accepted 2 September 1999 Article Note: (footnote) [star] Reprint requests: Mikitaka Obara, MD, Department of Obstetrics and Gynecology, Akita University School of Medicine, Akita, 010-8543 Japan.

The placentas of women with preeclamptic pregnancies do not appear to manufacture normal amounts of very-low-density lipoprotein (VLDL) receptors or low-density lipoprotein LDL receptors. Researchers measured amounts of LDL- and VLDL-receptor messenger RNA (mRNA) in placental tissue from each trimester of normal pregnancies and the third trimester of preeclamptic pregnancies. VLDL- and LDL-receptor mRNA transmits information from the nucleus to the cytoplasm directing manufacture of these receptors. Amounts of both LDL- and VLDL-receptor mRNA increased in healthy pregnancies over time, and mRNA levels were decreased in preeclamptic pregnancies. Abnormal lipid metabolism may play a role in preeclampsia.

A case is reported in which calcifications within the brain of a fetus of 36.5 gestational weeks' age were noted on computed tomography and magnetic resonance imaging (two methods of fetal imaging that provide very precise views of the brain). Such calcifications occur only rarely, and are characteristic of severe congenital cytomegalovirus infection of the brain. The brain ventricles (spaces in the brain through which fluid circulates) had appeared enlarged earlier in pregnancy when examined with ultrasound. Analysis of blood samples from the mother showed the presence of cytomegalovirus, which was also present in the amniotic fluid in which the fetus floats. Tests of the infant revealed that it was also infected. The baby was delivered after 39.5 weeks' gestation, and showed signs of psychomotor retardation (abnormal reflexes and inability to perform age-specific movements) and spasticity (muscle impairment). Detection of cerebral calcifications in fetuses by noninvasive tests such as those reported is a valuable alternative to more invasive methods. (Consumer Summary produced by Reliance Medical Information, Inc.)