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Eine frühe intrauterine fetale (Fehl-)Programmierung hat nicht nur Auswirkungen auf die kardiovaskuläre und metabolische Regulation im späteren Leben, auch die reproduktive Funktion kann dadurch beeinflusst werden. Eine intrauterine Wachstumsretardierung kann mit einer vorzeitigen Reifung der gonadalen Funktion und einer Vorverlegung der Pubertät und des Menarchealters verbunden sein. Sowohl die Entwicklung von Ovarien und äusseren Genitalien selbst als auch die neurodendokrine Regulation der hypothalamisch-hypophysär-ovariellen Achse werden insbesondere durch pränatale Androgeneffekte ungünstig beeinflusst, sodass im späteren Leben häufiger ein polyzystisches Ovarsyndrom mit Hyperandrogenämie und Ovulationsstörungen auftritt. Diese tierexperimentell klar nachweisbaren Zusammenhänge bedürfen jedoch noch weiterer Belege durch epidemiologische und klinische Untersuchungen am Menschen.

Pregnancy is one of the most challenging experiences for the immune system. It entails the confrontation and cooperation of maternal cells with allogeneic (sperm) and semi-allogeneic (fetal) cells and factors. On the one hand, it must actively acquire a specific tolerance towards the foreign cells and organism (the fetus) to avoid harming reactions, while recognizing the very same to support and control their development and growth. On the other hand, the immune system simultaneously may not reduce its capability to defend mother and fetus from microorganisms and pathogens. Almost all branches of the immune system are claimed to react and adapt in order to fulfill these complex duties. In this review, current knowledge concerning the most important cellular and soluble immunological components in the decidua is presented. Special regards are made to decidual NK, T and dendritic cells as well as to trophoblast cells, representing the fetal counterpart of most bilateral interactions. Furthermore, the role and functions of soluble factors, including HLA-G, PIBF, IDO and a variety of cytokines, are described.

The antiphospholipid syndrome (APS) is an autoimmune disease characterized by the appearance of antiphospholipid antibodies (APA) and at least one clinical manifestation like venous and arterial th

Objective: To observe the influence of maternal betamethasone administration for fetal lung maturation on the arterial, venous and intracardiac blood flow of the fetus and the uterine arteries. Methods: Twenty-seven women with singleton pregnancies were examined before the first, and 30 min and 8, 24, 48 and 72 h after the second of two single doses of 8 mg of betamethasone. We recorded blood flow velocity waveforms of the umbilical artery (UA), the middle cerebral artery, the uterine arteries, the ductus venosus, the inferior vena cava and the right hepatic vein, the pulmonary trunk, the ductus arteriosus and the right and left intraventricular inflow of the heart. Results: The resistance index of the UA showed a significant transient decrease 30 min (p = 0.024) after the second betamethasone dose. The peak systolic velocity of the ductus arteriosus increased significantly 30 min after the 2nd dose (p = 0.009) and then returned to non-significant values. No significant change was observed in any of the other vessels. Conclusion: Betamethasone causes short-term changes in fetal blood flow. However, this effect seems to be mild and reversible and does not appear to contraindicate the use of corticosteroids to promote fetal lung maturation.

Immature and adult female rats were bilaterally implanted in the medial preoptic area (MPOA) or hypothalamic ventromedial-arcuate region (VMAR) with the dopamine (DA) antagonist, pimozide, or the DA agonist, apomorphine, and the sensitivity to the LH-inhibiting effect of a subcutaneous injection of estradiol benzoate (EB), the onset of puberty and ovarian cyclicity were investigated. Diminution of the inhibitory effect of EB on LH secretion was recorded in ovariectomized immature and adult females implanted in the MPOA with pimozide. This response was not obtained in rats implanted in the VMAR. In contrast, medial preoptic, but not intrahypothalamic, implantation of agar pellets containing apomorphine resulted in enhanced sensitivity to estrogen both prepubertally and during the ovarian cycle. The sensitizing effect of apomorphine was completely prevented in prepubertal rats by pretreatment with EB for 6 days. Bilateral implantation of pimozide-agar pellets in the MPOA of 28-day-old intact females induced significant advancement of the onset of puberty, whereas sexual maturation was not affected by daily subcutaneous injections of the DA antagonist from day 28 till the day of vaginal opening. In adult 4-day-cyclic rats fitted with guide cannulae, the forthcoming ovulation was delayed for about 7 days as compared to the controls implanted with agar if apomorphine was placed in the MPOA from the morning of metestrus to the morning of diestrus. Similar implants located in the VMAR were ineffective in this regard. The results suggest that: (1) low DA activity in the MPOA reduces and high activity enhances the sensitivity of the negative estrogen feedback in immature and adult female rats.(ABSTRACT TRUNCATED AT 250 WORDS)