Potential Role of Placental Klotho in the Pathogenesis of Preeclampsia.

The aim of this study was to analyze the placental expression and allele status of promoter region of Klotho in association with preeclampsia, which represents the most common hypertensive disease of pregnancy. Klotho mRNA and protein levels were determined using real-time PCR and Western blot, respectively, in placental tissue samples obtained from 34 patients affected with preeclampsia and 34 controls. A PCR-based genotyping analysis was carried out in the promoter region of Klotho gene.

Prediction, medical illness and the risk of pre-eclampsia.

Preeclampsia, the leading cause of maternal and perinatal morbidity and mortality, has been recently considered not only a pregnancy disease but also a risk factor for developing diseases later in life. Preeclampsia is becoming a disease of interest to internists and not just obstetricians. Women who have had preeclampsia seem to be at higher risk of premature death, mortality from ischemic heart disease, cardiovascular diseases including ischemic heart disease and hypertension, fatal and non-fatal stroke, venous thromboembolism.

Early and late-onset pre-eclampsia.

There is discrepancy in the literature on the definitions of severe and early-onset pre-eclampsia. We aimed to determine those definitions for clinical purposes and to introduce them in the classification of the hypertensive disorders of pregnancy forpublication purposes. We circulated a questionnaire to the International Committee of the International Society for the Study of Hypertension in Pregnancy focusing on the thresholds for defining severe preeclampsia and the gestation at which to define early-onset preeclampsia, and on the definition and inclusion of the HELLPsyndrome or other clinical features in severe preeclampsia.

Placental expression of endothelial and inducible nitric oxide synthase and NO metabolism in gestational hypertension: a case-control study.

Objective: Hypertension is one of the most common medical disorders in pregnancy and a role of nitric oxide (NO) metabolism has been described. Thus, the present work aimed at determining placental gene expression of eNOS and iNOS, to measure NO and ONOO(-) levels in patients with gestational hypertension (GH).

Methods: Fifteen patients with GH and 15 healthy pregnant controls were enrolled in the study.

Tranilast, an orally active antiallergic compound, inhibits extracellular matrix production in human uterine leiomyoma and myometrial cells.

Objective: To determine the effect of tranilast (an antiallergic drug known to suppress fibrosis or to stabilize mast cells) on extracellular matrix production in human leiomyoma and myometrial cells.

Design: Laboratory study.

Setting: University-affiliated laboratory.

Oxytocin, its antagonist Atosiban, and preterm labor: a role for placental nitric oxide.

Objective: The aim of the present study was to understand the role played by Atosiban, an oxytocin receptor antagonist, on trophoblastic human cells, and the molecular bases of its efficacy and safety in the treatment of preterm labor. NO, peroxinitrite production and NOS expression have been evaluated on placenta obtained from term and preterm labors.

Patients And Methods: We studied trophoblast cells isolated from selected placental tissue from 20 controls and 20 preterm patients after cesarean sections.

Coasting, embryo development and outcomes of blastocyst transfer: a case-control study.

This study compared the effect on blastocyst development and clinical outcome of coasting in women at increased risk of moderate-severe ovarian hyperstimulation syndrome (OHSS; n=389) with a control group matched for age and basal FSH that did not undergo coasting (n=386) in IVF/intracytoplasmic sperm injection (ICSI) cycles. The main outcome measures were rate of blastocyst development and live birth. More cycles progressed to the blastocyst stage in the coasted group (n=169) compared with the control group (n=83; 43.

Management of leiomyomas in perimenopausal women.

Uterine leiomyomas, commonly called fibroids, are the leading indication for hysterectomy in the United States. Incidence increases with age from menarche to perimenopause. Regardless of their generally benign neoplastic character, uterine fibroids are responsible for significant morbidity in a large proportion of women of reproductive age.

Number and size of uterine fibroids and obstetric outcomes.

Objective: Estimating the impact of sonographically identified multiple or large (≥5 cm in diameter) fibroids on obstetric outcomes.

Methods: Retrospective cohort study of 219 women with uterine fibroids (identified on a routine second-trimester ultrasound survey over a 3-year period, 2010-2012) and their age-matched controls. Inclusion criteria were singleton pregnancy, delivery at >24 weeks of gestation and no pathological conditions (chronic hypertension, gestational diabetes or pre-existing diabetes mellitus, uterine anomalies or fetal malformations).

Role of activin-A and myostatin and their signaling pathway in human myometrial and leiomyoma cell function.

Context: Uterine leiomyomas are highly prevalent benign tumors of premenopausal women and the most common indication for hysterectomy. However, the exact etiology of this tumor is not fully understood.

Objective: The objective of the study was to evaluate the role of activin-A and myostatin and their signaling pathways in human myometrial and leiomyoma cells.

Gynecologic laparoscopy in patients aged 65 or more: feasibility and safety in the presence of increased comorbidity.

Objectives: To evaluate the feasibility, operative outcome and postoperative complications of laparoscopic gynaecologic surgery in patients aged 65 or more, with increased comorbidity and obesity.

Study Design: The medical records of patients aged 65 or more with uterine or ovarian disease admitted to minimally invasive gynecologic surgery units from January 2009 to December 2011 were retrospectively analyzed in an observational cohort study. Surgical outcomes of the laparoscopic cohort (n=65) were compared with the outcomes of those who had laparotomy (n=67) at general gynecologic surgery units, and evaluated with respect to indication for surgery, medical comorbidity and obesity.

Uterine fibroids: pathogenesis and interactions with endometrium and endomyometrial junction.

Uterine leiomyomas (fibroids or myomas) are benign tumors of uterus and clinically apparent in a large part of reproductive aged women. Clinically, they present with a variety of symptoms: excessive menstrual bleeding, dysmenorrhoea and intermenstrual bleeding, chronic pelvic pain, and pressure symptoms such as a sensation of bloatedness, increased urinary frequency, and bowel disturbance. In addition, they may compromise reproductive functions, possibly contributing to subfertility, early pregnancy loss, and later pregnancy complications.

The impact of loop electrosurgical excision procedure (LEEP) for CIN 2,3 on spontaneous preterm delivery in twin pregnancies by assisted reproductive technique: preliminary data.

The objective of this study was to compare the frequency of spontaneous preterm delivery before 35 weeks in 7 dichorionic twin pregnancies obtained after loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 2,3 with respect to 21 twin pregnancies without previous cervical treatment. All the pregnancies were obtained after assisted reproduction techniques (ART). Same age at delivery was observed between two groups (p = 0.

Female fetuses are more reactive when mother eats chocolate.

Objective: The aim of our study was to analyze whether there is a gender difference in the effects of maternal chocolate ingestion (80% cocoa) on the fetus, as expressed by the fetal heart rate (FHR).

Study Design: One hundred pregnant women with uncomplicated term gestation, matched for age and parity, underwent computerized FHR recording before and after eating 30 g of 80% cocoa chocolate; 46 carried a male fetus, and 54 carried a female. Computerized cardiotocography parameters (baseline FHR in beats per minute, number of contractions/hour, fetal movements/hour, accelerations of at least 15 bpm for 15 s, episodes of high variation/min and short-term variation in ms) were expressed as the mean and SD.

PP008. Placental klotho gene in preeclampsia.

Introduction: An aging-suppressor gene, klotho, is a candidate factor for vascular disease because its deficiency leads to impaired endothelium-dependent vasodilation and impaired angiogenesis. This protein is involved in several metabolic pathways such as the insulin-like growth factor 1 (IGF-1), apoptosis, angiotensin-II-induced events in the kidney and oxidative stress.

Objectives: The aim of this study was to determine the difference of klotho genotiping and expression in the placentas of women with normal and preeclamptic pregnancies.

Introduction to ISSHP new classification of preeclampsia.

The classification of the hypertensive disorders of pregnancy has always been a crucial point, especially in the scientific literature, to compare results from different series. Some of the classes have been reviewed during time, and some new ones have been added, paralleling the increased knowledge of the diseases and syndromes. Among the interests of a society there is the sharing of a common language and the guidance to give to scientific authors and editors for better presentation of their results and outcomes.

The correlation between fetal bradycardia area in the second stage of labor and acidemia at birth.

Objective: To quantify fetal bradycardia in the second stage of labor and to determine the threshold of the area that correlates with neonatal acidemia.

Method: We analyzed the cardiotocograms of 33 women with single pregnancy and term spontaneous labor who presented fetal bradycardia in the second stage of labor. We retrospectively calculated the fetal bradycardia area in the last 60 min before delivery with an upper limit of 90 bpm and correlated the area with neonatal pH.

The effects of different concentrations of cocoa in the chocolate intaken by the mother on fetal heart rate.

Objective: To analyze the effects of different concentrations (30% and 80%) of cocoa on fetal heart rate (FHR).

Study Design: One hundred pregnant women with uncomplicated gestation, matched for age and parity, underwent computerized FHR recording before and after the consumption of 30 g of 30% and 80% cocoa chocolate. After 1 week, those who had received 30% were shifted to 80% and vice versa to have a crossover.

Perinatal outcomes in oocyte donor pregnancies.

Objective: To assess the obstetric outcomes of pregnancy following intracytoplasmic sperm injection (ICSI) using donor oocytes.

Methods: Twenty-six deliveries from oocyte donor ICSI (d-ICSI) were compared to the next two consecutive deliveries from homologous ICSI (h-ICSI group) (n = 52) and with the two consecutive deliveries from women older than 40 years (Advanced Maternal Age: AMA) (n = 52). We evaluated the occurrence of gestational hypertension (GH), preeclampsia (PE), fetal growth restriction (IUGR), gestational diabetes mellitus (GDM), preterm premature rupture of membranes (pPROM), preterm birth, placental anomalies, mode of delivery, hemorrhage, gestational age at birth and birth weight.

Uterine leiomyoma: available medical treatments and new possible therapeutic options.

Context: Uterine leiomyomas (fibroids or myomas) are benign tumors of the uterus and are clinically apparent in up to 25% of reproductive-age women. Heavy or abnormal uterine bleeding, pelvic pain or pressure, infertility, and recurrent pregnancy loss are generally associated with leiomyoma. Although surgical and radiological therapies are frequently used for the management of this tumor, medical therapies are considered the first-line treatment of leiomyoma.

The definition of severe and early-onset preeclampsia. Statements from the International Society for the Study of Hypertension in Pregnancy (ISSHP).

Objective: There is discrepancy in the literature on the definitions of severe and early-onset pre-eclampsia. We aimed to determine those definitions for clinical purposes and to introduce them in the classification of the hypertensive disorders of pregnancy for publication purposes.

Methods: We circulated a questionnaire to the International Committee of the International Society for the Study of Hypertension in Pregnancy focusing on the thresholds for defining severe preeclampsia and the gestation at which to define early-onset preeclampsia, and on the definition and inclusion of the HELLP syndrome or other clinical features in severe preeclampsia.

Preeclampsia: No longer solely a pregnancy disease.

Preeclampsia, the leading cause of maternal and perinatal morbidity and mortality, has been recently considered not only a pregnancy disease but also a risk factor for developing diseases later in life. Preeclampsia is becoming a disease of interest to internists and not just obstetricians. Women who have had preeclampsia seem to be at higher risk of premature death, mortality from ischemic heart disease, cardiovascular diseases including ischemic heart disease and hypertension, fatal and non-fatal stroke, venous thromboembolism, renal failure, type 2 diabetes mellitus, hypothyroidism, and cognitive defects, although they appear surprisingly protected from cancer.