Early Prophylactic Enoxaparin for the Prevention of Preeclampsia and Intrauterine Growth Restriction: A Randomized Trial.

Background: Preeclampsia (PE) and intrauterine growth restriction (IUGR) are major causes of maternal and perinatal morbidity and mortality. Previous studies have shown that intervention with low-dose aspirin resulted in a reduction in the occurrence of preterm PE. However, no data are currently available on the effect of low-molecular-weight heparin (LMWH) for the prevention of pregnancy complications in women enrolled at first trimester screening.

Placenta-related complications in women carrying a foetus with congenital heart disease.

Introduction: Recent studies pointed to an intrinsically angiogenic imbalance in CHD in the maternal and foetal circulation suggestive of impaired placentation.

Objectives: To assess whether pregnant women with a CHD foetus are at greater risk of placenta-related complications.

Methods: Perinatal results of women with a CDH foetus were compared with those of a non-selected population followed up at our centre.

Angiogenic Gene Expression in Down Syndrome Fetal Hearts.

Introduction: Forty percent of Down syndrome (DS) fetuses have congenital heart defects (CHD). An abnormal angiogenic environment has been described in euploid fetuses with CHD. However, the underlying pathophysiologic pathway that contributes to CHD in DS remains unknown.

Prevalence of antibody to Bordetella pertussis in neonates and prevalence of recent pertussis infection in pregnant women in Catalonia (Spain) in 2003 and 2013.

Background: Infections because of Bordetella pertussis still occur in infants and adults in European countries, despite vaccination coverage against pertussis being high.

Methods: IgG antibody titers to pertussis toxin (anti-PT) were assessed using an enzyme-linked immunosorbent assay test (Serion ELISA classic) in 353 cord blood samples from neonates of a representative sample of pregnant women obtained in Catalonia (Spain) in 2013. Neonates with anti-PT titers ≤ 40 international units (IU)/mL were considered to be unprotected against pertussis.

Maternal and foetal angiogenic imbalance in congenital heart defects.

Aims: Animal models showed that angiogenesis is related to abnormal heart development. Our objectives were to ascertain whether a relationship exists between congenital heart defects (CHDs) and angiogenic/anti-angiogenic imbalance in maternal and foetal blood and study the expression of angiogenic factors in the foetal heart.

Methods And Results: Maternal and cord blood placental growth factor (PlGF), soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng) were compared in 65 cases of CHD and 204 normal controls.

Arabin cervical pessary to prevent preterm birth in severe twin-to-twin transfusion syndrome treated by laser surgery.

Objectives: To describe the outcome of patients with twin-to-twin transfusion syndrome and cervical length ≤ 25 mm, treated with laser and an Arabin cervical pessary.

Methods: Retrospective analysis of a consecutive series of all cases with severe twin-to-twin transfusion syndrome who underwent laser surgery: a group with cervical length above 25 mm (group A) and two groups who had a cervical length of 25 mm or less prior to the procedure. The first 8 cases (group B) were managed expectantly and the next 8 cases had a cervical pessary inserted immediately after laser surgery (group C).

Telomeric repeat-containing RNA and telomerase in human fetal oocytes.

Study Question: What is the distribution of telomeric repeat-containing RNA (TERRA) and of telomerase in human fetal oocytes?

Summary Answer: TERRA forms discrete foci at telomeres of human fetal oocytes and it co-localizes with both the shelterin component telomeric repeat-binding factor 2 (TRF2) and the catalytic subunit of human telomerase at the telomeres of meiotic chromosomes.

What Is Known Already: TERRA is a structural element of the telomeric chromatin that has been described in somatic cells of many different eukaryote species. The telomerase enzyme is inactive in adult somatic cells but is active in germ cells, stem cells and in the majority of tumors; however, its distribution in oocytes is still unknown.

Smoking during pregnancy: changes in mid-gestation angiogenic factors in women at risk of developing preeclampsia according to uterine artery Doppler findings.

Objectives: To ascertain whether angiogenic factors are altered in smokers at increased risk of preeclampsia (PE) according to uterine artery Doppler (UAD) assessment.

Methods: Uterine artery mean pulsatility index (PI), maternal placental growth factor (PlGF), and soluble fms-like tyrosine kinase-1 (sFlt-1) serum levels were measured in 125 healthy pregnant women at 24 weeks of gestation. Smoking status was determined based on cotinine levels in maternal blood.

Are we ready for a new look at the diagnosis of premature rupture of membranes?

Premature rupture of membranes is a significant contributor to preterm birth with its associated short- and long-term complications. The absence of a standard approach to its management places a burden on the clinicians' ability to promptly and accurately diagnose premature rupture of membranes. For the last half century, there have been no significant changes in the way premature ruptured membranes is diagnosed.

Maternal history and uterine artery Doppler in the assessment of risk for development of early- and late-onset preeclampsia and intrauterine growth restriction.

Objective. To examine the value of one-step uterine artery Doppler at 20 weeks of gestation in the prediction pre-eclampsia (PE) and/or intrauterine growth restriction (IUGR). Methods.

Introital ultrasonography: a comparison of women with stress incontinence due to urethral hypermobility and continent women.

Objective: To determine if there is a variable on introital ultrasonography (IUS) that can be used to distinguish between women with stress urinary incontinence (SUI) due to urethral hypermobility (UH) and continent women.

Patients And Methods: This single-centre, prospective, blind, cohort, observational study comprised 383 women (245 continent and 138 incontinent) who were all appropriately informed volunteers selected according to the inclusion criteria. IUS with a convex probe was performed on all women; the measurement plane was standardized and coordinates were obtained at rest and on straining.

Feasibility of retroviral vector-mediated in utero gene transfer to the fetal rabbit.

Objectives: Successful treatment or prevention of severe hereditary diseases could conceivably be achieved by genetic intervention early in development. Viral vector-mediated fetal gene transfer is proving a valuable tool to test the above concept in relevant animal models. Although the pregnant rabbit is a well-recognized model for fetal therapy, few preclinical assays have used it to validate fetal gene transfer approaches.

Atherogenic lipoprotein subfraction profile in preeclamptic women with and without high triglycerides: different pathophysiologic subsets in preeclampsia.

Abnormal lipid metabolism has been proposed as a pathogenic factor of preeclampsia, although whether it is a constant feature in all preeclamptic patients is unclear. We assessed whether plasma triglyceride (TG) levels can distinguish a subgroup of preeclamptic women with alterations in lipoprotein profile from those with normal lipid metabolism and can be used to identify 2 distinct pathogenic groups in preeclampsia. This prospective study included 34 women with preeclampsia and 23 healthy pregnant women.

A comprehensive study of oxidative stress and antioxidant status in preeclampsia and normal pregnancy.

Oxidative stress has been increasingly postulated as a major contributor to endothelial dysfunction in preeclampsia (PE), although evidence supporting this hypothesis remains inconsistent. This study aimed to analyze in depth the potential role of oxidative stress as a mechanism underlying endothelial damage in PE and the pregnant woman's susceptibility to the disease. To this end, indicative markers of lipoperoxidation and protein oxidation and changes in antioxidant defense systems were measured in blood samples from 53 women with PE and 30 healthy pregnant controls.

Increased susceptibility to low density lipoprotein oxidation in women with a history of pre-eclampsia.

Objectives: To evaluate the susceptibility to oxidation of low density lipoprotein (LDL) in women with a history of pre-eclampsia.

Design: A case-control study.

Setting: The departments of obstetrics and gynaecology at two university teaching hospitals.