Reduced or absent cytotrophoblast invasion of the maternal uterine spiral arterioles is a common clinical finding in studies of pregnancies complicated by preeclampsia, suggesting that the mechanisms mediating invasion of these cells is perturbed. The placenta initially develops in a low oxygen environment of 1-2% oxygen until after the 10th week of pregnancy. During this time oxygen concentration exerts a major influence over trophoblast activity and, hypoxia inducible factors are proposed to be one of many key regulators of first trimester trophoblast behaviour. We used a global gene expression microarray approach to identify signalling pathways and hypoxia-responsive genes of interest involved in invasion of the first trimester trophoblast cell line HTR8/SVneo under hypoxic conditions where HIF-1 was active. Additionally, first trimester placental samples from different gestational age groups were labelled with anti HIF-1α and HIF-2α to evaluate whether HIFs are differentially expressed and localised across two periods of placental development: (1) early first trimester characterised by hypoxia (6-8 weeks) and (2) late first trimester after initiation of maternal blood flow into the placenta (10-12 weeks). Invasion of HTR8/SVneo was assessed in real-time and was significantly increased in 1% compared with 5% and 21% oxygen and did not differ between 5% and 21% oxygen treatments. Eighty-eight genes were differentially expressed between cells cultured in 1% oxygen (where HIF-1α protein was localised to the nucleus) and 5% oxygen (where HIF-1α was mainly cytoplasmic). 65% of the genes were predicted to contain HIF-1α:HIF-1β transcription factor binding sites. While HIF-2α staining intensity in trophoblasts of late first trimester placenta was higher than early first trimester (+57%) the percentage of positively stained trophoblast nuclei did not differ between the two time points. There was no difference in the expression level of any of the hypoxia responsive genes of interest, IGFBP3, P4HA1, P4HA2, ANGPTL4 and MMP1 between early and late first trimester placenta. While HIF-1α and its downstream targets are clearly induced in HTR8/SVneo during in vitro hypoxic conditions, it appears that hypoxia inducible factors and genes are not altered throughout the first 7-12 weeks of placental development, during which the onset of maternal blood flow to the intervillous space takes place.
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Transplant Proc
January 2025
Department of Surgery, Tulane University, New Orleans, Louisiana. Electronic address:
Background: Organ procurement from brain-dead pregnant women is rare and typically occurs postfetal delivery. In this case report, we describe organ procurement from a brain-dead woman in her third trimester of pregnancy with a nonviable fetus remaining in utero.
Case Summary: We report a 33-year-old woman at 38 weeks gestation who suffered anoxic brain injury following cardiac arrest due to suspected opioid overdose.
We report a case of Zika virus (ZIKV) infection in a pregnant woman from Denmark who traveled to Thailand during her first trimester. Late in the second trimester, severe microcephaly was diagnosed in the fetus, and ZIKV infection was confirmed. Travelers and clinicians should be aware of ongoing ZIKV risk in Thailand.
View Article and Find Full Text PDFPregnancy Hypertens
January 2025
Emory University School of Medicine, Department of Gynecology and Obstetrics, 550 Peachtree Street, NE, Atlanta, GA 30308, USA.
Objectives: We investigated whether a smaller reduction in 2nd trimester blood pressure (BP) is associated with the development of gestational hypertensive disease.
Study Design: We conducted a retrospective cohort study utilizing a clinical database at an urban safety-net hospital. Individuals ages 18-40 with a singleton gestation and 1st trimester prenatal care were included.
Obstet Gynecol Surv
December 2024
Professor, Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, Little Rock, AR; Professor, Obstetrics and Gynecology, Virginia Tech Carilion School of Medicine, Roanoke, VA.
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View Article and Find Full Text PDFCase Rep Obstet Gynecol
December 2024
Department of Obstetrics and Gynecology, Jimma University School of Medicine, Jimma, Ethiopia.
Fetal limb anomaly presentation varies greatly. It can present as amelia (complete absence of skeletal part of one or more limb), meromelia (partial absence of skeletal part of one or more limb), phocomelia (only rudimentary limb formed), and minor limb disorders like polydactyly. The complete absence of the four fetal limbs is extremely rare.
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