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The survival of allogeneic fetuses during pregnancy is a rather paradoxical phenomenon with a complex mechanism. Chemokine ligand12 (CXCL12) and its receptors CXC chemokine receptor (CXCR)4 and 7 are extensively found in placenta tissues and cells, including trophoblast cells, vascular endothelial cells, and decidual stromal and decidual immune cells (eg, NK cells and regulatory T cells). Evidence has illustrated that the CXClL12/CXCR4/CXCR7 axis could enhance the cross talk at the maternal-fetal interface through multiple processes, such as invasion and placental angiogenesis, which appears to be critical signaling components in placentation and fetal outcome. In addition, an increasing number of studies have demonstrated that the CXCL12/CXCR4/CXCR7 axis also stands out for its pleiotropic roles in several pregnancy-associated diseases (eg, recurrent spontaneous abortion (RSA), pre-eclampsia (PE), and preterm labor). In the present review, the different biological properties and signaling in physiological and pathological pregnancy conditions of CXCL12/CXCR4/CXCR7 axis were discussed, with the aim of obtaining a further understanding of the regulatory mechanisms and highlighting their potential as a target for therapeutic approaches., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Problem: The complement system plays a key role in normal placentation, and delicate regulation of complement system activation is critical for successful pregnancy. Therefore, establishing a normal range of complement components during pregnancy is important for clinical evaluation and research., Methods: We performed a prospective study to investigate the normal range of complement components in circulation during different stages of pregnancy. Plasma concentrations of complement factor B (CFB), C1q, complement factor H (CFH), C3, C3c, and C4 were measured using an immunoturbidimetric assay; mannan-binding lectin (MBL), C3a, C5a, and soluble C5b-9 (sC5b-9) levels at different time points of pregnancy were determined by enzyme-linked immunosorbent assay (ELISA)., Results: A total of 733 plasma samples were collected from 362 women with a normal pregnancy and 65 samples from non-pregnant women. In the first trimester of pregnancy, the levels of CFB, CFH, MBL, C3c, C4, and C3a were 414.5 ± 85.9 mg/L (95% CI for mean: 402.4-426.6 mg/L), 381.0 ± 89.0 mg/L (95% CI for mean: 368.5-393.6 mg/L), 4274.5 ± 2752 ng/mL (95% CI for mean: 3881.1-4656.4 ng/mL), 1346.9 ± 419.8 mg/L (95% CI for mean: 1287.7-1406.0 mg/L), 357.4 ± 101.8 mg/L (95% CI for mean: 343.0-371.7 mg/L), and 182.5 ± 150.0 ng/mL (95% CI for mean: 186.9-229.1 ng/mL), respectively. The levels of C3 and C4 increased gradually throughout pregnancy. The levels of C1q, C5a, and sC5b-9 in the first and second trimesters were nearly the same as those in non-pregnant women., Conclusion: The results of this study show that pregnancy itself may influence the plasma levels of complement system components., (© 2019 The Authors. American Journal of Reproductive Immunology published by John Wiley & Sons Ltd.)

Regulatory T cells (Tregs) play a critical role in the maintenance of a pregnancy. While the kinetics of the number of peripheral blood Tregs has been satisfactorily described in mouse models, analysis of these cell populations in human pregnancy is complicated by high variability in the quantity of Tregs and inconsistencies in the markers used for detecting different types of Treg. In the light of this, we set out to investigate the kinetics of various types of Treg, including CD45RA, GARP and PD-1(+) Tregs, in the peripheral blood of pregnant women in the first, second and third trimester, and at the time of delivery. Tregs, defined as a CD4(+)CD25(++)CD127(dim)Foxp3(+) population of leucocytes, were detected using flow cytometry. Natural thymus-derived Tregs and induced Tregs in the peripheral blood were distinguished by the expression or absence of a Helios marker, respectively. Our results showed that during normal pregnancy the sizes of various Treg subpopulations varied across women and also in an individual woman did not remain constant but varied significantly, most notable being the decrease observed at the time of delivery. Helios(-) cells were significantly less frequent in the peripheral blood of healthy pregnant women than Helios(+) cells, and the majority of Tregs were Helios(+)PD-1(+) Tregs., (© 2019 The Foundation for the Scandinavian Journal of Immunology.)

CYP2C and CYP2 J enzymes, commonly named as cytochrome P450 (CYP) epoxygenases, convert arachidonic acid to four regioisomeric epoxyeicosatrienoic acids (EETs), biologically active eicosanoids with many functions in organism. EETs are rapidly hydrolysed to less active dihydroxyeicosatrienoic acids (DHETs) by soluble epoxide hydrolase (sEH). We investigated spatio-temporal expression pattern of CYP2C8, CYP2C9, CYP2 J2 and sEH in normal human placenta by immunohistochemical method. In the villous trophoblast, CYP2C8 was the most abundant protein. Its expression is higher than the CYP2C9 and CYP2 J2 in the cytotrophoblast in the embryonic stage of development and remains higher in syncytiotrophoblast of term placenta. Unlike to CYP2C8, CYP2C9 and CYP2 J2 expression decrease in term placenta. sEH expression increases with gestation age and is strictly limited to cytotrophoblast in embryonic and foetal stages of the development. Moreover, CYP2C8 shows more intensive staining than the other protein monitored in Hofbauer cells in villous stroma. Specific information regarding the exact role of EETs and DHETs functions in a normal placenta is still unknown. Based on CYP epoxygenases and sEH localization and well known information about the functions of placental structures during development, we suggest that these enzymes could play different roles in various cell populations in the placenta. As the placenta is absolutely crucial for prenatal development, arachidonic acid is essential part of human nutrient and CYP epoxygenases expression can be affected by xenobiotics, further investigation of the exact role of CYP epoxygenases, sEH, and their metabolites in normal pregnancy and under pathological conditions is needed., (Copyright © 2018 Elsevier GmbH. All rights reserved.)

The most abundant lymphocyte present in decidual tissue is the CD8(+) T cell. It has been shown that most decidual CD8(+) T cells have an effector-memory phenotype, but expressed reduced levels of perforin and granzyme B compared with the peripheral CD8(+) effector-memory T cells. The specificity of these CD8(+) memory T cells has yet to be determined. One hypothesis is that the decidual memory T cells are virus-specific T cells that should protect the fetus against incoming pathogens. As virus-specific CD8(+) memory T cells can cross-react with human leukocyte alloantigens, an alternative, but not mutually exclusive, hypothesis is that these CD8(+) T cells are fetus-specific. Using virus-specific tetramers, we found increased percentages of virus-specific CD8(+) T cells in decidual tissue compared with peripheral blood after uncomplicated pregnancy. So far, no evidence has been obtained for a cross-reactive response of these virus-specific T cells to fetal human leukocyte antigens. These results suggest that the virus-specific memory T cells accumulate in the placenta to protect the fetus from a harmful infection., (Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.)

Background: The development of the foetal kidneys can be monitored during the entire pregnancy by measuring their length and comparing them to typical charts. The ultrasonogram is thought to be a useful tool for assessing kidney growth and anomalies in foetuses, and it can help with the early detection and treatment of some kidney-related disorders. Objectives: 1. To perform obstetric USG in healthy women with uncomplicated pregnancy between 20 weeks and term gestation to determine correlation between fetal kidney length and gestational age. 2. To derive nomogram for estimating the gestational age of fetus from ultrasonographically measured fetal kidney length. 3. To assess the accuracy of fetal kidney length measurement in determining the Material & Methods: Study Design: Hospital based observational study. Study area: Department of Obstetrics & Gynecology, Narayana medical college and hospital, tertiary care center at Nellore, Andhra Pradesh. Study Period: April 2022 - March 2023. Study population: Pregnant women with uncomplicated pregnancy more than 20 weeks Attending Antenatal Outpatient department. Sample size: Study consisted a total of 100 subjects. Sampling Technique: Simple Random technique. Study tools and Data collection procedure: All the statutory requirements under PNDT act were followed and form F was obtained from all the patients. All the relevant clinical history was obtained and the correct LMP was confirmed. Transabdominal ultrasonography was performed with patient in supine position. Good acoustics coupling was obtained using synthetic ultrasound gel. Ultrasonography is done using Siemens Sonoline or Philips HD 7 ultra sound scanner using a 3.5-12MHz transducers, images were recorded in the thermal films using the digital camera Results: The association between the fetal measurements and FK GA. The correlation was best for FK GA versus AC (r: 0.876) and least for BPD (r: 0.808). All the correlation was statistically significant. Conclusion: FKL is reasonably a precise parameter for estimating GA. Measurement of FKL will prove significant when other biometric parameters failed to be measured in certain situations like engaged/fixed head and when head is not in correct plane. Hence, FKL can be used as a reliable parameter for determination of gestational age. [ABSTRACT FROM AUTHOR]

Aim: To determine the gestational age‐related changes in cervical gland length in relation to cervical length (CL) in normal singleton pregnancies. Methods: We studied 363 women with an uncomplicated singleton pregnancy (188 nulliparous and 175 multiparous women with one or more previous transvaginal deliveries). A total of 1138 cervical gland and CLs were measured longitudinally at 17–36 weeks of gestation using transvaginal ultrasonography along the curvature from the external os to the lower uterine segment and the internal end of the cervical gland area (CGA), respectively. Gestational age‐related changes in cervical gland and CLs and their relationships were analyzed using a linear mixed model. Results: Cervical gland and CLs decreased in different ways with advancing gestation depending on parity, and their changes were related to each other. The CGAs in nulliparous women were longer than those in multiparous women at 17–25 weeks of gestation (p < 0.05), but with no differences thereafter. CLs in multiparous women were different from those in nulliparous women at 17–23 and 35–36 weeks (p < 0.05), but there were no differences at 24–34 weeks. The cervix did not shorten compared with the CGA throughout the observational periods in nulliparous and multiparous women. Conclusions: Shortening of the cervix indicates changes to the lower uterine segment in normal pregnancies. The cervical gland region can be a useful marker representing the true cervix beyond 25 weeks of gestation, irrespective of parity. [ABSTRACT FROM AUTHOR]

This study was aimed at investigating the adaptive changes in myocardial work (MyW) during normal pregnancy. Sequential 2D standard and speckle-tracking echocardiography was performed on 41 pregnant women in each gestational trimester and 4 to 11 mo after delivery. Thirty-eight age-matched, healthy, non-pregnant women served as controls. Four components of MyW—global myocardial work index (GWI), constructive work (GCW), wasted work (GWW) and work efficiency (GWE)—were calculated. GWI began to decline early in the first trimester and remained at a low level until delivery; GCW gradually decreased with gestational progression and reached its lowest level in the third trimester. When compared with the values for non-pregnant women and those postpartum, GWE and GWW remained unchanged in gestation. This study provides normal ranges of MyW during pregnancy. Despite the adapted decrease in GWI and GCW, the myocardium manages to work efficiently in the healthy pregnancy with drastic hemodynamic alternations. [ABSTRACT FROM AUTHOR]

• The reference range of PA in normal pregnancy was evaluated. • PA increased more significantly in normal pregnancy than that in the controls. • Linear correlations were found between PA and Alb, PDW. It was recently shown that abnormal platelet aggregation (PA) had played a critical role in some adverse pregnancies. Till now reference range for PA in normal pregnancy has not been determined. Furthermore, few study has been conducted to explore the factors related to PA. Our study was performed to assess the reference range of PA in normal pregnancy (150 participants in the second trimester), and to determine whether it differs from that of the controls (38 nonpregnant participants). In addition, this study explored the factors related to PA. The results showed that PA was significantly higher in normal pregnancy than that in the controls (84.40% vs. 80.7%, respectively, P = 0.013). The reference interval for PA in normal pregnancy was 74.75%-94.77%. Hemoglobin (Hb), platelet counts (PLT) and albumin (Alb) were significant lower in normal pregnancy than those in the control group. Moreover, it was found that PA was positively correlated with PLT (r = 0.263, P < 0.001), and negatively correlated with platelet distribution width (PDW) (r = -0.342, P < 0.001) and mean platelet volume (r = -0.296, P < 0.001). Linear correlations between PA and Alb, PDW were proved by linear regression model (LRM). In conclusion, PA was enhanced in normal pregnancy, and Alb and PDW might be the possible contributing factors to PA. [ABSTRACT FROM AUTHOR]

Background: On a clinical level, preeclampsia and atherosclerotic cardiovascular disease share common risk factors. Carotid intima media thickness (CIMT) is ultrasound-based imaging, non-invasive, simple, and reproducible method of subclinical atherosclerosis evaluation. Nowadays, there were studies concerning of CIMT among preeclamptic women, although the results were different. Objective: To prove that CIMT among women with histories of preeclampsia was greater compared to normal pregnancy. Methods: We conducted a meta-analysis of studies that reported CIMT, in women who had preeclampsia and had normal pregnancy. Studies were identified through three databases: PubMed, Google Scholar, and SAGE Journals with publication year of 2010–2020. Heterogeneity was assessed using the I2 statistic. Standardized mean difference was used as measured of effect size. Results: Nine eligible studies were included in the meta-analysis. This meta-analysis consisted of 439 women with preeclampsia histories and 526 women with normal pregnancy histories. Women who had preeclampsia had significantly higher CIMT compared to those with normal pregnancy with standardized mean difference −0.38 and 95% confidence interval (CI) −0.68 to −0.07 (p=0.02). Conclusion: CIMT was greater among women with histories of preeclampsia compared to normal pregnancy. Trial registration: PROSPERO CRD42021228825 [ABSTRACT FROM AUTHOR]

In this post hoc study, arachidonic acid (AA)-induced platelet aggregation during pregnancy with and without acetylsalicylic acid (ASA) treatment was studied in 323 women with unexplained recurrent first-trimester miscarriage and in 59 healthy women with normal pregnancies. All women had normal AA-induced platelet aggregation in the non-pregnant state. Women with recurrent miscarriage were treated with 75 mg ASA or placebo daily. AA-induced platelet aggregation was measured with multiple electrode impedance aggregometry and presented in units (U), where 1 U = 10 aggregation units x minutes. There were no significant differences in platelet aggregation between placebo-treated women with recurrent miscarriage and healthy women. The mean differences were -0.7 (95%CI; −7.0; 5.6) U in the non-pregnant state, 3.8 (95%CI; −4.6; 12.2) U during the late first trimester and 1.7 (95%CI; −6.7; 10.3) U and 4.1 (95%CI; −3.9; 12.0) U during the early and late third trimester, respectively. ASA reduced platelet aggregation by median −84.0% (Q1; Q3; −89.8; −76.3), −79.9% (−84.7; −69.2) and −75.7% (−83.5; −49.5), respectively, during pregnancy. The degree of inhibition by ASA decreased during the third trimester (p <.0001). There were two (1.9%) complete non-responders to ASA and 32.1% with a partial response. The rate of subsequent miscarriage was not affected by ASA, which did not seem to influence the rate of early miscarriage if treatment was initiated when a viable pregnancy was detectable by ultrasound. [ABSTRACT FROM AUTHOR]

Background and Objective: In pregnancies complicated by preeclampsia, it seems that failure of trophoblast invasion and induction of placental inflammation can lead to the production of biomarkers, one of which is CA-125. The aim of this study is to investigate serum CA-125 levels in non-severe and severe preeclampsia and compare it with normal pregnancy. Methods: This retrospective case-control study was conducted on 30 women with normal pregnancy, 27 women with mild preeclampsia and 30 women with severe preeclampsia referring to the midwifery clinic of Shahid Motahari Hospital in Urmia who met the inclusion criteria. The data evaluated in this study included gestational age, systolic and diastolic blood pressure, platelet, AST, ALT, serum creatinine, serum uric acid, serum CA-125 levels, urinary protein level and birth weight. Venous blood samples were collected at delivery for complete blood count, creatinine, uric acid and CA-125 concentration from all participants. Then the results were compared. Findings: The results of the present study showed that the mean CA-125 of women in the control group was 17.83±5.37 u/ml, in the mild preeclampsia group was 40.64±12.40 and in the severe preeclampsia group was 71.73±48.90, which indicates that this value is high in mild preeclampsia compared to the control group as well as severe preeclampsia compared to the other two groups. Statistical comparisons showed that there is a significant relationship between serum CA-125 levels in women with normal pregnancy and non-severe and severe preeclampsia (p<0.001). Conclusion: The results of the present study showed that CA-125 is associated with the occurrence of preeclampsia (mild and severe) and can be helpful as a marker in the diagnosis of preeclampsia, especially its severe type. Moreover, due to the relationship between this marker and a wide range of other variables, paying attention to its serum level along with other paraclinical variables can be helpful in better diagnosis and management of patients. [ABSTRACT FROM AUTHOR]

PURPOSE: The aim of this study was to achieve a control model of cardiac and respiratory function through key indicators established in a comparative analysis between the results of the initial and final pulse tests for women with normal pregnancies. METHODS: The research was done among 111 women, all Bulgarians. We used: functional tests for assessing the effects of our own original Recreational Wellness program with a specific focus on pregnant women. We measured the intensity of the tool branded under the name of the co-author Nesheva. RESULTS: During our own original Recreational Wellness program was established data by specific tests and the analysis has shown that the average values (Mean ± SD) of the measured indicators, in the six lessons are statistically different (p <0.05). These indicators are interpreted as optimal prenatal improvement of health care, but probably our Recreational Wellness program also favours the maintenance of Wellness lifestyle during all period of pregnancy. CONCLUSIONS: The results in our study are in support of establishing a system for assessing information to improve health care during the period of a normal pregnancy. This specific instrument is a reliable basis for validating standards for regulated inclusion in Recreational Wellness activity programs. [ABSTRACT FROM AUTHOR]

Background: Probiotic supplementation has been shown to be beneficial and is now widely promoted as an auxiliary medicine for maternal health, but the underlying mechanism is still unclear. Thus, this study aimed to explore the effects of probiotic supplementation on the placental autophagy-related proteins LC3 and Beclin1.Method: A population-based cohort of specimens was collected under sterile conditions from 37 healthy nulliparous pregnant women who underwent systemic examination and delivered at the First Affiliated Hospital of Jinan University (Guangzhou, China). At 32 weeks of gestation, the pregnant women in the probiotic group were orally supplemented with golden bifid, and the pregnant women in the control group received no probiotic. Pregnant women with pregnancy-associated complications were excluded in the follow-up period, and 25 pregnant women undergoing spontaneous delivery were enrolled. The placental tissue specimens were collected at term. Western blotting was used to detect the protein expression, and qRT-PCR was used to detect the mRNA expression of the placental autophagy-related proteins LC3 and Beclin1.Results: ①There was no significant difference in the expression levels of either LC3 or Beclin1 protein between the two groups (P > 0.05). ②Probiotic supplementation induced a modest but not significant decrease in the content of LC3-mRNA with a significant decrease in the content of Beclin1-mRNA (P < 0.05).Conclusion: Our study indicates that probiotic supplementation may reduce Beclin1-mRNA levels. [ABSTRACT FROM AUTHOR]

Aim: The objective of the study is to evaluate the normal physiological changes in values of major hematological parameters occur during the normal pregnancy Method: Blood samples (5ml EDTA) were taken voluntarily after consent obtained from from 50 healthy pregnant women from 20 to 40 year s old who presented themselves at Khartoum teaching during their regularly follow-up. Questionnaires and direct interview were used to collect demographic and clinical data. CBC and part differential (WBC, RBC, Hb, PCV, and platelets), were measured by Sysmex and the plasma clotting time PT and PTT were measured by coagulometer. Results: W'BCs mean value was 7.580 cell/mm, RBCs mean value was 4.1 × l012/L, Hb mean value was 11.79 g/dL, Platelets mean value was 256 × 109/L, PT mean value of the study group was 13.40 seconds and PTT mean value was 36.20 seconds. Conclusion: It can be concluded that no statistical significance in RBCs, HB, platelets. PT and PTT between pregnant women in the three different trimesters while white WBCs count showed different decreased but not statistical significant among the three groups, the highest value was round in the second group followed by the third group and the lowest value found in the first group. [ABSTRACT FROM AUTHOR]

Background: Spontaneous miscarriages are common pregnancy complications which result in psychological and emotional burden in the affected women. It is therefore necessary to identify biomarkers that can predict pregnancy outcome in women with threatened miscarriages so as to assist in their counselling and management. Methods: The study compared levels of maternal serum CA125 in 65 pregnancies with threatened miscarriages (study group) with 65 normal intrauterine pregnancies (control group) between 6 weeks and 19 weeks + 6 days gestation using an enzyme linked immunosorbent assay (ELISA) technique. Results: The mean age of the study and control groups were 29.5 ± 0.14 years and 30.1 ± 0.14 years, respectively. The mean serum CA125 in the study group was 30.1 ± 1.1 IU/mL while that of the control group was 22.9 ± 1.2 IU/mL and this was statistically significant (P = 0.0001). The mean serum CA125 level in the women whose pregnancies were aborted (aborters) was 34.8 ± 1.4 IU/mL while the mean value among those whose pregnancies continued till term (non-aborters) was 27.3 ± 1.2 IU/mL. This was statistically significant (P = 0.001). Further analysis using CA125 ≥36.2 IU/mL (mean value of serum CA125 among aborters + 1 standard deviation) as a threshold for intrauterine pregnancies that eventually got aborted showed a sensitivity of 66.7%, specificity of 83.3%, positive predictive value of 55.6%, negative predictive value of 88.9% and the diagnostic effectiveness (accuracy) was 79.4%. Conclusion: The measurement of serum CA125 is a useful predictor of pregnancy outcome in threatened miscarriages. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the importance of serum concentration of magnesium (Mg) in the first trimester of pregnancy for predicting pre-eclampsia (PE).Methods: This prospective study included 403 pregnant women over 18, with singleton pregnancy (from 11 to 14 weeks of pregnancy). The subjects were divided into a group who subsequently developed PE (PEKT) (n = 61), and a group of healthy pregnancies with no complications and with normal outcomes (TNT) (n = 342). In the first trimester, urea, creatinine, uric acid, Mg, free beta subunit of human chorionic gonadotrophin, plasma protein A related to pregnancy, and C-reactive protein were determined. We followed all subjects until the end of pregnancy.Results: Serum Mg is significantly lower in PEKT than in TNT group (p < 0.001). The serum first trimester Mg level cutoff at ≤0.81 mmol/L had a sensitivity of 77.0% and specificity of 71.6% for the detection of women with PEKT. The level of serum Mg has the strongest significant positive correlation (p < 0.05) with the week of gestational outcomes (R = 0.442), weight (R = 0.416), and Apgar score (R = 0.343) of the newborns, and the strongest significant negative correlation with the number of miscarriages (R = -0.413), serum creatinine (R = -0.471), and the number of pregnancies (R = -0.326). The week of gestational outcome is predicted with the greatest reliability by the serum Mg.Conclusions: Serum Mg level during the first trimester of pregnancy is a significant prediction tool for PE and could also play an important role in predicting the week of gestational outcome and birth weight of newborns. [ABSTRACT FROM AUTHOR]

Background: Preeclampsia is still become main cause of maternal and perinatal morbidity and mortality in addition to bleeding and infection. Preeclampsia is a pregnancy complication that occurs in about 5-10% and become main cause of maternal and fetal mortality and morbidity. The etiology and pathogenesis of preeclampsia syndrome have not fully understood. Autophagy and apoptosis is thought to play a role in the pathogenesis of preeclampsia. This research was done to see the difference in the expression of LC3 and Caspase 3 in normal pregnancy, early onset preeclampsia (EOP) and late onset preeclampsia (LOP) groups. Methods: This was a cross sectional study, research was conducted in February until May 2014. Immunohistochemical examination of the placenta was done to assess the expression of LC3 and caspase 3. Results: Expression of LC3 in EOP was higher than LOP and normal pregnancies expression of Caspase 3 in EOP was higher than LOP and normal pregnancy expression of Caspase 3 in EOP was higher than normal pregnancy. Conclusions: There was no difference between expression of LC3 in normal pregnancy, EOP and LOP but there was a difference between expression of Caspase 3 in normal pregnancy, EOP and LOP. There was a difference between expression of Caspase 3 in normal pregnancy and LOP. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Recent studies have shown increased RBC aggregation and no difference in plasma viscosity in the presence of markedly lower hematocrit in women at term compared to non-pregnant women. Little is known about the outcome of blood rheological parameters and red blood cell (RBC) deformability particularly in the course of normal pregnancy. METHODS: During a 36 months interval 1.913 blood samples were randomly collected from a total of 945 pregnant women in the course of their pregnancy (n = 1.259) and during puerperium (upto 1 week; n = 654). Next to the blood count, hemorheological parameters including red blood cell (RBC) -aggregation (stasis E0; low shear E1), -deformability (low, moderate and high shear conditions) and plasma viscosity (pv) were assessed. Plasma viscosity (pv) was examined using KSPV 1 Fresenius, RBC aggregation (stasis: E0 and low shear: E1) using MA1-Aggregometer; Myrenne and RBC deformability (def) was determined by Rheodyn SSD Diffractometer, Myrenne, Roetgen, Germany were tested. In some of these women laboratory results prior to pregnancy (n = 145) were available which were compared with those during pregnancy. RESULTS: Mean maternal pv remained unchanged within each trimester and compared to the values before pregnancy and during early puerperium (Range of means: 1.18–1.20 mPa S). In contrast, RBC agg (E0 and E1) was markedly higher in the 2nd (21.8 ± 7.0 and 28.9 ± 9.4; p < 0.001) and 3rd trimester (18.74 ± 8.4 and 28.2 ± 9.4; p < 0.01) compared to the values before pregnancy (16.4 ± 6.4 and 20 ± 7.5) and during 1st trimester (17.49 ± 6.5 and 22.4 ± 7.4). There was a stat. significant temporary reduction in RBC def. under all shear rate conditions during 2nd trimester compared to the values before pregnancy which remained significantly lower during 3rd trimester only under high shear rates. An increase RBC agg was stat. significantly inversely correlated with reduced RBC def being most pronounced under low shear rate conditions. While RBC rigidity was stat. significantly correlated with higher hematocrit values there was only a weak correlation between RBC agg and haematocrit (E0: r = –0.084; p = 0.03; E1: r = –0.06; p = 0.1). Pv was not correlated with haematocrit or RBC def but stat. significantly correlated with RBC agg. CONCLUSIONS: Blood rheological changes manifest during 1st trimester, and fairly remain unchanged during 2nd trimester until term. Physiologic hemodilution and increasing hypercoagulability is accompanied by high RBC -aggregation and – rigidity during 2nd trimester while plasma viscosity remains nearly unaffected throughout normal pregnancy. [ABSTRACT FROM AUTHOR]

This study was carried out, to determine the association between the steroid hormones concentration increase and creatinine clearance during pregnancy and to make observations on the pattern of change in renal function in the late puerperium. This study included 330 apparently healthy normotensive female subjects, made up of seventy each trimesters of pregnancy with seventy (70) women at six weeks post-partum. Fifty (50) non-pregnant women of child bearing age served as controls. Blood and urine samples were collected from each woman during the first, second and third trimesters of pregnancy and during the late puerperium. Serum and urine creatinine, were determined by colorimetric methods. Serum electrolyte profile was determined by Ion Selective Electrode method using automated machine, while the hormonal assays were done using Elecsys 2010 autoanalyzer. The results of both creatinine clearance and the hormonal assay showed significant increase during pregnancy. However, the correlation analysis did not reveal any significant relationship among groups. There were significant differences in the changes observed in other parameters within the trimesters and the puerperium. The increase in creatinine clearance above the normal level during the postpartum period, despite the rapid clearance of the hormones shows that renal function became more efficient, in order to clear excess fluid and electrolytes that the body accumulated during pregnancy. Therefore, the increase in progesterone and 17ß-estradiol may not have direct roles in the increase in creatinine clearance during pregnancy. [ABSTRACT FROM AUTHOR]

The survival of allogeneic fetus during pregnancy contradicts the laws of immune responses. Behind this paradoxical phenomenon, the mechanism is quite complex. Indoleamine‐2,3‐dioxygenase (IDO) is the first and rate‐limiting enzyme of tryptophan catabolism. Emerging evidence shows that IDO is expressed at the maternal‐fetal interface, including trophoblast cells, decidual stroma cells, decidual immune cells (eg, natural killer cells, T cells, and macrophages), and vascular endothelial cells of decidua and chorion. Moreover, the expression and activity of IDO are different among non‐pregnant, normal pregnant, and pathological pregnant conditions. IDO plays important roles in normal pregnancy through immune suppression and regulation of fetal invasion and circulation. However, the abnormal expression and dysfunction of IDO are associated with some pathological pregnancies (including recurrent spontaneous abortion, preeclampsia, preterm labor, and fetal growth restriction). [ABSTRACT FROM AUTHOR]

Introduction: Newborn birth weight is a major indicator of health. Although it is influenced by many conditions that affect maternal and feto-placental units, several sociocultural, religious, and geographical factors cannot be ignored. Considering this, the present study was conducted in a tertiary hospital in Khammam, Telangana to determine the average birth weight in normal pregnancy at term. Materials and Methods: All the babies, born following normal pregnancy from January 2013 to June 2015, were included in this study to establish their birth weight. Babies born without being affected by any factor influencing fetal weight were considered for the study. Some exclusion criteria such as short maternal height and teenage pregnancy were considered in this study. Results: There were 633 cases in the study group, out of which 226 were primipara and 407 were multipara. Average birth weight for all cases was 2790 g. Average birth weight for the first born babies was 2770 g, whereas in later born, it was 2800 g. Average birth weight of male newborn babies was 2860 g, whereas it was 2710 g for female newborn babies. Conclusion: Abnormal birth weight leads to many complications, both immediate and remote. However, to predict and manage such complications, one must know the average newborn birth weight. This study is the first of its kind in rural Telangana. [ABSTRACT FROM AUTHOR]