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Different and related approaches must be considered to address consumers' concerns regarding the identification of species involved, mainly those of manufactured and derived meat products such as cured and canned meat and canned sausage. Therefore, the development of molecular techniques has been achieved by a mixture containing different shares of meat DNA. This study provided an important indication regarding the validity of the multiplex Polymerase Chain Reaction (PCR) technique in such tests. Based on the fact that the aforementioned method is qualitative; yet, the different percentages of meat DNA contained in the mixtures cannot be determined. Our current study showed that tracing back the origin of the ingredients used in food production is achievable, even if the DNA is degraded as a result of the food transformation processes. A PCR test was conducted at 35 cycles for mixtures at 100%, 75%, 50%, and 25% levels. Our results indicated that the original species of the meat products used were accurately determined in all mixtures tested by PCR technique. Therefore, we concluded that the PCR technique can be useful as a fast, easy to perform, and reliable control for adulterated consumer meat products.

Pre-eclampsia (P-EC) is a multisystem disorder exclusive to pregnancy. It complicates ~2 to 8% of all pregnancies and remains a major cause of maternal mortality. P-EC is characterized by a profound hypercoagulable state. The delicate hemostatic balance that must be maintained in the uteroplacental circulation during pregnancy makes this system vulnerable to perturbation. An abnormal hemostatic pattern occurs within the uteroplacental circulation in P-EC compared with normal pregnancy. Much recent research has focused on the epidemiological link between inherited thrombophilia and P-EC. The data suggest a weak statistical association, indicating an improbable primary role in the pathogenesis. Without clear evidence, low molecular weight heparins have been widely used to reduce recurrence of P-EC in thrombophilia-positive women. This practice now should be reviewed. Future research needs to focus on improving our basic scientific understanding of the role of the hemostatic system in human placentation.

Hyperemesis gravidarum is severe, intractable nausea and vomiting affecting 0.3-2% of pregnancies. It has a complex multifactorial aetiology. This review explores the current literature relating to the clinical manifestations, differential diagnosis, epidemiology, possible aetiology, maternal and fetal complications, and evidence-based management of hyperemesis.

Objectives Venous thromboembolism (VTE) remains a leading cause of maternal mortality. An effective predictive test would be very clinically important. Measurements of Calibrated Automated Thrombogram (CAT) parameters in the presence and absence of thrombomodulin have been correlated with risk of recurrent VTE. D-Dimers and soluble P-selectin are markers of thrombosis. We aimed to evaluate the CAT assay, D-Dimers and P-selectin as potential predictive tools for thrombosis in pregnancy. Methods The SCOPE (Screening for Pregnancy Endpoints) study is a prospective, multicentre cohort study of nulliparous women with the primary aim of developing screening tests to predict pre-eclampsia, small for gestational age infants and spontaneous preterm birth. Twenty patients with documented VTE in pregnancy or postpartum and 61 controls were identified from the SCOPE cohort (total of 5000 pregnant women). The control group was matched for age, gestation, BMI and ethnicity. CAT assay with and without presence of thrombomodulin was performed on citrated plasma collected at 15 weeks gestation, prior to any thrombotic event. Normalised thrombomodulin sensitivity ratios (n-TMsr) were calculated. D-dimers and P-selectin were also measured by ELISA. Results There were no significant difference in ETP, peak thrombin, lagtime , time to peak, n-TMsr, D-dimer or P-selectin levels between patients who subsequently developed VTE compared with those who remained thrombosis free. Standardisation of CAT assay is needed to ensure it is a clinically effective predictive tool. Conclusions CAT assay, D-dimer and P-selectin levels are not useful as predictors of VTE in a low risk population of primigravida screened at 15 weeks. Disclosures S.K. Ismail: None. L. Norris: None. A. Khashan: None. N. Simpson: None. G. Dekker: None. J. Myers: None. L. McCowan: None. L. Kenny: None. J.R. Higgins: None.

Low molecular weight heparin (LMWH) prophylaxis has been recommended for morbidly obese pregnant women (40kg/m(2)). There is very little data on the anticoagulant effects of LMWH in this group. We investigated two different dosing regimens; fixed dose and weight-adjusted dose on the anticoagulant effects of the LMWH tinzaparin used for thromboprophylaxis in obese pregnant women.Twenty morbidly obese pregnant women were started on a fixed dose of tinzaparin (4,500 iu/day) at 32weeks gestation and then changed to a weight-adjusted dose (75iu/kg/day) for the remainder of their pregnancy. Four-hour post LMWH, venous bloods were taken after each initial dose and repeated every two weeks until delivery. Twenty normal weight women who did not receive LMWH at the same gestation were used as controls.Prior to LMWH prophylaxis, tissue factor pathway inhibitor (TFPI) levels in the obese group at 32weeks were significantly lower (p0.001) and endogenous thrombin potential (ETP) and peak thrombin levels in obese group were significantly higher, compared with controls (p0.0001; p0.001). There was no significant difference between ETP levels before and after fixed LMWH. However, ETP levels were significantly lower post weight-adjusted dose compared with post fixed dose. There was a significant effect of LMWH on TFPI levels, (p0.0001). ETP correlated positively with total body weight prior to LMWH (r=0.631) (p0.05) and at fixed dose (r=0.578) (p0.05).Morbidly obese pregnant women have increased thrombin generation and reduced natural anticoagulant in third trimester. This prothrombotic state was more effectively attenuated by weight-adjusted than fixed LMWH doses.

Caesarean section (CS) is a significant risk factor for venous thromboembolism.. Low molecular weight heparin (LMWH) is commonly used for thromboprophylaxis post emergency caesarean delivery. However, no consensus exists regarding LMWH thromboprophylaxis following elective caesarean section. Measures of thrombin formation may indicate the full anticoagulant activity of LMWH in this setting.Anti-Xa, tissue factor pathway inhibitor (TFPI), thrombin anti-thrombin complex (TAT) and endogenous thrombin potential (ETP) were measured in twenty healthy women who received 4,500 IU tinzaparin 6 hours post CS (CS1), twenty women who received 4,500 IU tinzaparin at 10-12 hours post delivery (CS2) and twenty women post spontaneous vaginal delivery (SVD).Prior to initiation of LMWH, TAT levels at 6 hours post delivery were significantly higher in the CS1 and CS2 groups than the SVD group (P0.002); TAT levels were significantly reduced up to 24 hours post LMWH treatment despite declining anti-Xa levels (P0.001). In CS1, peak thrombin and ETP were significantly reduced following LMWH prophylaxis (P0.0001; P0.002) and reverted to pre-delivery levels 10 hours post LMWH. TFPI levels mirror anti-Xa levels during the 24 hours following LMWH treatment in CS1 group with peak levels coinciding with peak anti-Xa levels 4 hours post injection.In women post caesarean section, anti-Xa levels do not reflect the full anticoagulant effects of LMWH. In-vivo thrombin production (TAT) is effectively reduced even when anti-Xa levels are negligible. LMWH thromboprophylaxis in this healthy cohort of patients appears to have a sustained effect in reducing excess thrombin production post elective caesarean section.

Background LMWH prophylaxis has been recommended for morbidly obese pregnant women (>40 kg/m 2 ). However, no data exists on the anticoagulant effects of LMWH in this group. Aim We investigated different dosing regimens; fixed dose versus weight adjusted dose on the anticoagulant effects of the LMWH, tinzaparin used for thromboprophylaxis in obese pregnant women. Method Twenty morbidly obese pregnant women were started on a fixed dose of tinzaparin (4,500 iu/day)at 30 weeks gestation and then changed to a weight adjusted dose (75 iu/kg/day) for the remainder of their pregnancy. Four hour post dose venous blood were taken after each initial dose and repeated every 2 weeks until delivery. Twenty normal weight women at the same gestation were used as controls. Result Prior to LMWH prophylaxis, TFPI levels in the obese group at 30 weeks were significantly lower (p Within the obese group, there was no significant difference between ETP levels before and after fixed LMWH dose. However, ETP levels were significantly lower post weight-adjusted dose (75 iu/kg tinzaparin) compared with post fixed dose. There was a significant effect of LMWH on TFPI levels, (p Conclusion Morbidly obese pregnant women have increased thrombin generation and reduced natural anticoagulant in third trimester. The prothrombotic state in pregnant morbidly obese women was substantially attenuated by weight adjusted but not at fixed LMWH doses.

Background Perturbation of the uteroplacental haemostasis has been implicated in placenta mediated pregnancy complications in thrombophilic women. LMWH may be effective in altering local thrombin production in the uteroplacental compartment. Aim We determined the effects of LMWH (tinzaparin) on the peripheral, uteroplacental and fetal circulation and on haemostatic gene and antigen expression in placental tissue. Method Eight women on antenatal LMWH prophylaxis (tinzaparin 75 IU/kg) due to moderate risk of VTE undergoing caesarean section (CS) and a control group of 15 healthy pregnant women undergoing CS had venous blood taken from the peripheral and uterine vein before delivery of placenta. Simultaneously, cord venous blood and placental biopsy was collected. Tissue factor pathway inhibitor (TFPI), thrombin antithrombin (TAT) and endogenous thrombin potential (ETP) were measured. Real-time PCR and ELISA were used to quantify mRNA and protein expression of TFPI and TF in placental tissue. Results TAT levels within uterine vein are significantly higher compared to maternal peripheral circulation in both the control group (P Conclusion TAT is reduced in uteroplacental circulation in thrombophilic women on LMWH prophylaxis and this is mirrored by decreased ETP in uteroplacental circulation. LMWH may be effective in reducing in- vivo thrombin production in the uteroplacental circulation of thrombophilic women.

Assisted reproductive technologies (ART) have been widely used in couples suffering from infertility. The clinical pregnancy rate is low, varying from 20 to 35% per cycle started. The role of antithrombotic drugs in improving pregnancy rate is controversial, although some Fertility Clinics have adopted different protocols either in thrombophilic and non-thrombophilic women. Between March 1998 and July 2011 we prospectively evaluated a cohort of 1107 women approaching ART (2214 cycles) consecutively referred to our Thrombosis Unit (S. Giovanni R.). All were investigated for inherited and acquired thrombophilias. Median follow-up was 34.53 months (range 2–143 months). At the enrolment, 327 women (29.5%) have experienced 946 ART cycles. One hundred twenty-two (37.3%) women obtained a clinical pregnancy (176 pregnancies), with 21 (16%) live-born children. Overall, 115 (10.4%) women carried al least one thrombophilia (45 the FVL, 57 the PTm, 13 severe thrombophilias). After screening, 595 (53.8%) underwent at least 1 attempt (1268 cycles, 27 lost to follow-up). In 424 (33.4%) cycles an antithrombotic prophylaxis (342 treated with aspirin, 66 with LMWH, 16 with aspirin+LMWH) was used. Pregnancy rate was 21.4% (265/1241 cycles) with 171 (13.8%) live-born children. Clinical pregnancies were not significantly different in treated vs untreated cycles (p: 0.42, OR: 1.1, 95% CI: 0.8–1.5). The rate of live-born was not significantly different in treated vs untreated cycles (p: 0.73, OR: 0.9, 95% CI: 0.6–1.3) prophylaxis. Overall, 7 thrombotic events (3 PE, 3 DVT, 1 arterial thrombosis; 6 of them in untreated women) were observed. Among them, 4 (0.3%, 2 DVT, 2 PE) occurred after screening, only 1 during LMWH prophylaxis. In women undergoing ART procedures, the use of antithrombotic prophylaxis is not associated with an improved pregnancy rate or live-born children. Thrombotic complications are less frequent in women receiving an antithrombotic prophylaxis