Adhesions at repeat cesarean delivery: is there a personal impact?

Purpose: The rise in the rate of cesarean deliveries highlights complications related to adhesion formation. This study evaluated whether the incidence and severity of adhesions secondary to repeat cesarean deliveries are a consequence of repeated surgeries or due to an individual's propensity to develop adhesions.

Methods: A retrospective chart review was conducted for 160 patients who had more than two repeat cesarean deliveries in a single teaching hospital.

Obstetric and neonatal outcomes after preterm premature rupture of membranes among women carrying group B streptococcus.

Objective: To evaluate whether carriers of group B streptococcus (GBS) have adverse obstetric and neonatal outcomes when preterm premature rupture of membranes (PPROM) occurs.

Methods: In a retrospective study, data were reviewed for women with a singleton pregnancy and PPROM before 34 weeks who attended the Meir Medical Center, Kfar Saba, Israel, between 2005 and 2012. All women received roxithromycin for 1 week, and ampicillin until GBS culture results were available.

Retained placental tissue as an emerging cause for malpractice claims.

Background: Removal of retained placental tissue postpartum and retained products of conception (RPOC) abortion is done by uterine curettage or hysteroscopy. Trauma to the endometrium from surgical procedures, primarily curettage, can cause intrauterine adhesions (Asherman's syndrome) and subsequent infertility. The incidence of malpractice claims relating to intrauterine adhesions is rising, justifying reevaluation of the optimal way of handling these complications.

Telomere shortening in intra uterine growth restriction placentas.

Introduction: Placentas from pregnancies complicated with IUGR (intrauterine growth restriction) express altered telomere homeostasis. In the current study, we examined mechanisms of telomere shortening in these placentas.

Methods: Placental biopsies from 15 IUGR and 15 healthy control pregnancies were examined.

Senescence in amniocytes and placentas from trisomy 21 pregnancies.

Objective: Senescence has been described as a stable cell proliferation arrest resulting from the progression of primary human fibroblasts through a finite number of population doublings in vitro. Accelerated telomere shortening was observed in pregnancies complicated by intrauterine growth restriction, in placentas of diabetic mothers and trisomy 21 amniocytes. We hypothesized that under conditions of stress, telomeres in placentas will be shorter and there will be more cells with the senescence phenotype.

Is it necessary to induce labor in cases of intrauterine growth restriction at term?

Objectives: Infants with intrauterine growth restriction (IUGR) have increased morbidity and mortality. The decision whether to induce labor at term or to expectantly manage these pregnancies is controversial. The aim of this study was to assess the outcomes of these two management strategies in term pregnancies.

Endoreduplication in cervical trophoblast cells from normal pregnancies.

Objective: Fetal cells represented by extravillous trophoblasts (EVT) obtained from the cervix by a minimally invasive procedure are important for prenatal diagnosis in early pregnancies. Endoreduplication is a duplication of chromosomes without mitosis, leading to polyploidy that might represent increased cellular metabolic activity. In this study, we estimated the normal prevalence of polyploid trophoblasts exfoliated to the cervix between 5 and 13 weeks of gestation.

A comparison of surface acquired uterine electromyography and intrauterine pressure catheter to assess uterine activity.

Objective: Intrauterine pressure catheter (IUPC) is the primary device used to evaluate uterine activity. In contrast to the IUPC, electrical uterine myography (EUM) enables noninvasive measurement of frequency, intensity, and tone of contractions. The aim of this study was to determine the accuracy of EUM compared to IUPC.

TERC telomerase subunit gene copy number in placentas from pregnancies complicated with intrauterine growth restriction.

Introduction: intrauterine growth restriction (IUGR) is a significant cause of both short- and long-term morbidity and mortality. IUGR secondary to placental dysfunction is correlated with telomere shortening. Telomerase is an enzyme complex that elongates telomeres.

Telomeres are shorter in placental trophoblasts of pregnancies complicated with intrauterine growth restriction (IUGR).

Objective: Telomeres are nucleoprotein structures located at the termini of chromosomes, and protect them from fusion and degradation. Telomeres are progressively shortened with each mitotic cycle and by environmental factors. We hypothesized that antepartum stress can lead to accelerated telomere shortening in placental trophoblasts, and plays a role in intrauterine growth restriction (IUGR).

Telomere aggregates in amniocytes with karyotype of balanced chromosomal rearrangements.

Telomeres are TTAGGG repetitions at the ends of chromosomes. Functioning telomeres are essential for normal segregation and maintenance of chromosomes during mitotic and meiotic divisions. Dysfunctional telomeres support the survival of aneuploid cells, a characteristic of many human malignancies.

Prenatal diagnosis of trisomy 21 through detection of trophoblasts in cervical smears.

Background: Fetal cells exfoliate in the uterine cavity during early pregnancy and are a potential source of material for NIPD.

Aims: This study was designed to test the hypothesis that fetal cells obtained from the uterine cervix during the first trimester of pregnancy could be utilized for prenatal diagnosis of chromosomal aneuploidy.

Study Design: Fetal cells retrieved from the distal endocervical canal during the first trimester of pregnancy were hybridized with chromosome 21 specific FISH probes and analyzed with an automated fluorescence microscope.

Short telomeres may play a role in placental dysfunction in preeclampsia and intrauterine growth restriction.

Objective: Telomeres shorten and aggregate with cellular senescence and oxidative stress. Telomerase and its catalytic component human telomerase reverse-transcriptase regulate telomere length. The pathogenesis of preeclampsia and intrauterine growth restriction involves hypoxic stress.

Who should be offered fetal echocardiography? One center's experience with 3965 cases.

Background: Although the comprehensive evaluation of the fetal heart includes echocardiography by an experienced pediatric cardiologist, economic constraints sometimes dictate the need to select patients.

Objectives: To analyze the usefulness of fetal echocardiography in the detection of congenital heart disease according to the referral indication.

Methods: This retrospective survey relates to all 3965 FE studies performed in our center from January 2000 to December 2004.

Maternal serum triple marker levels in immigrants to Israel from Ethiopia.

Objectives: To determine if Ethiopian immigrants have similar triple marker levels as the general Israeli population.

Material And Methods: Second-trimester maternal serum results on 346 Ethiopians were obtained from records of 36,309 women. Two series were constructed for comparison among patients screened between 2000 and 2001 ('old group') and 2005 and 2007 ('new group').

Telomere aggregate formation in placenta specimens of pregnancies complicated with pre-eclampsia.

Telomeres are specific repetitive DNA sequences that cap and stabilize the ends of chromosomes. Functional telomeres are essential for the normal segregation and maintenance of chromosomes during mitotic and meiotic division. Pre-eclampsia, a pregnancy-specific syndrome of increased blood pressure accompanied by proteinuria, is often associated with growth deficiency in the fetus.

Telomere aggregates in trisomy 21 amniocytes.

Trisomy 21 is the most common chromosomal abnormality among persons with intellectual disability, with a live birth rate of 1 in 800-1,000. As such, this abnormality may serve as a model for human disorders that result from supernumerary copies of a genomic region. Down syndrome carries an increased risk of developing acute leukemia and other malignancies.

Telomere capture in hepatitis C infection.

Broken chromosomes can acquire new telomeres by "telomere capture" (TC), and it has become possible to investigate the terminus in cytogenetically visible telomere rearrangements. The TC phenomenon was observed in malignant conditions. We evaluated the TC rate in hepatitis C virus (HCV) patients compared to non-Hodgkin's lymphoma patients, as well as relative to a control group.

Nulliparity, fertility treatments and twins: a time for rethinking.

Objective: To evaluate the risk that nulliparity poses to the outcome of twin pregnancies, an issue that gained importance due to the rise of twin gestations following assisted reproduction interventions.

Design: A prospective cohort study.

Setting And Patient(s): Between January 1, 2004, and January 7, 2008, we prospectively enrolled all pregnancies achieved by assisted reproduction techniques and including ovulation induction, which successfully completed the first trimester.

Adverse outcome of pregnancies with extremely high levels of maternal serum human chorionic gonadotropin.

Background: The associated risk of elevated levels of maternal serum human chorionic gonadotropin (MShCG) with pregnancy complications was reported in many studies. However, the outcome of pregnancies with extremely high levels of MShCG was never independently studied.

Methods: We report on 6 out of 45,990 studied patients with extremely high levels of MShCG (>15 multiples of the medians) analyzed during the second trimester.

Random aneuploidy in chronic hepatitis C patients.

Hepatitis C virus (HCV) has been recently recognized as a potential cause of B-cell lymphoma. Both chronic hepatitis B and C with or without cirrhosis represent major preneoplastic conditions, and the majority of hepatocellular carcinomas arise in these pathological settings. According to the aneuploidy-cancer theory, carcinogenesis is initiated by random aneuploidy, which is either induced by carcinogens or arises spontaneously.

Prenatal diagnosis of pericentric inversion in homologues of chromosome 9: a decision dilemma.

Pericentric inversion of one chromosome 9 [inv(9)] is considered a polymorphic variation and is one of the most common forms of autosomal inversion diagnosed prenatally in amniocytes. Yet its clinical significance remains uncertain. Most publications suggest that this finding is insignificant.

Previous aneuploidic offspring in a young woman does not increase the risk for somatic random aneuploidy in subsequent pregnancies.

Unlabelled: The cause of aneuploidy in fetuses of young women is not fully understood. As such women are considered to be at risk of repeating the "error", it is customary to recommend chromosomal evaluation (karyotyping) in subsequent pregnancies. Individuals predisposed to meiotic nondisjunction exhibit aneuploidy in their mitotic cells (mosaicism).

Molecular cytogenetic characteristics of Down syndrome newborns.

Down syndrome (DS) is a multifactorial disorder with a high predisposition to leukemia and other malignancies. A change in the replication pattern from synchronous in normal genes to asynchronous in DS amniocytes has previously been reported. The objective of this study was to evaluate additional molecular cytogenetic factors which could re-emphasize the high correlation between DS cells and genetic instability.

Hyponatremia and preeclampsia.

A 33-year-old healthy woman, gravida 1 with twins pregnancy was admitted with mild preeclampsia and unusual hyponatremia which resolved promptly postpartum. This is the seventh reported case of hyponatremia complicating preeclampsia, four of the patients carried twins and four had nephrotic syndrome.