Serum pro-hepcidin and iron markers during uncomplicated pregnancy.
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Antimicrobial Cationic Peptides↗
Biomedical subjects
Jerzy Leibschang
Publications and source records attributed to Jerzy Leibschang.
[Prenatal diagnosis of Crouzon syndrome--actual diagnostic possibilities].
Crouzon syndrome is a cranio-facial dysostosis with autosomal dominant transmission and a birth prevalence of 16.5 per million newborns. Up till now there is no publications in polish medical journals about ultrasonic diagnosis of Crouzon syndrome or of any other craniostenosis. The development of ultrasonography, three-dimensional ultrasonography and in the last years also MRI, allows earlier detection and diagnosis of fetal malformation and enables precise evaluation of his anatomy. The aim of the study is presentatoin Crouzon syndrom diagnosed prenatally by ultrasonography and confirmed moleculary by DNA analysis. We would like to stress the diagnostic problems and the difficult decisions that we encountered.
Adult↗
[The effect of tobacco smoking during pregnancy on concentration of vitamin E in blood of mothers and their newborns in umbilical cord blood].
OBJECTIVES: Cigarette smoking during pregnancy generates free radicals and has been implicated in oxidative cellular damage. Vitamin E is natural factor protecting cells from damaging influence of free oxygen species. DESIGN: The aim of the study was to estimate the effect of tobacco smoking during pregnancy on concentration of vitamin E in blood of mother and newborns. MATERIALS AND METHODS: 147 healthy, pregnant women were divided into non-smoking (n = 85) and smoking group (n = 62) according to the concentration of cotinine in serum and urine. Level of vitamin E was measured by HPLC (high pressure liquid chromatography) method in plasma and erythrocytes of mothers and umbilical cord blood. RESULTS: We observed that, in group of women smoking during pregnancy concentration of vitamin E was lower in plasma and in erythrocytes as compared with group of non-smoking women. Also in cord blood of newborns of smoking mothers level of vitamin E was significantly lower in plasma (p < 0.01) as well as in erythrocytes (p < 0.0001) than in control group. CONCLUSION: Reduced concentration of plasma and erythrocytes vitamin E during pregnancy suggest that consumption of this antioxidant for neutralization of free radicals present in cigarette smoking is enhanced.
Adult↗
[Concentrations of cotinine in serum and urine of smoking pregnant women and in placenta and umbilical cord blood].
Concentration of cotinine, the major metabolite of nicotine in body fluids, is commonly accepted as the method which may better reflect tobacco smoke exposure than the questionnaire. In order to assess adverse fetal health effects caused by cigarette smoking it is important to study the relation between maternal and fetal exposure to tobacco smoke compounds. We determined serum and urine cotinine levels in the course of pregnancy, as well as its concentration in placenta and umbilical cord blood. In group of smoking women serum cotinine concentration was high (above 1050 microg/l) and stable in I, II and III trimester. It was correlated with amount of cotinine (about 2000 microg/g creatinine) in urine (r=0.8; p<0.0001). In serum of umbilical cord blood level of cotinine was half (range: 300-600 microg/ I) of that observed in maternal blood and was correlated with it (r=0.67; p<0.01). In placenta of smoking women mean concentration of cotinine was 57.5 ng/g tissue. In serum of non-smoking pregnant women and in blood of their babies we found trace amount of cotinine in 50% of mothers and 30% of infants. In this group concentration of cotinine in urine as well as in placenta was not detectable. The obtained results indicate that assay of cotinine by specific and inexpensive methods may be useful for monitoring of exposure to tobacco smoke both of mothers and newborns.
Adult↗
[The effect of tobacco smoking during pregnancy on concentration of malondialdehyde in blood of mothers and in umbilical cord blood].
OBJECTIVES: Maternal smoking during pregnancy is known to be associated with not only intrauterine fetal growth retardation or low birth weight but also causes disturbances in postnatal growth and development. The prime role of oxidative stress in the pathogenesis of adverse pregnancy outcomes is almost universally accepted. DESIGN: The aim of the study was to estimate the effect of tobacco smoking during pregnancy on concentration of lipid peroxidation products (malondialdehyde - MDA) in blood of mother and newborns. MATERIALS AND METHODS: 147 healthy, pregnant women were divided into non-smoking (n = 85) and smoking group (n = 62) according to questionnaire declaration and confirmed by cotinine concentration in serum and urine. Level of MDA was measured by fluorimetric method in plasma and in erythrocytes of mothers and umbilical cord blood. RESULTS: We found that, in group of women smoking during pregnancy concentration of malondialdehyde was higher in plasma and in erythrocytes when compared to group of tobacco abstinent. Also in cord blood of newborns of smoking mothers level of MDA was significantly higher in plasma (p < 0.05) as well as in erythrocytes (p < 0.01) than in control group. CONCLUSION: The presented results indicate that smoking during pregnancy may promotes free radical damage in growing fetus and newborns therefore stimulates metabolic disorders dependent on oxidative stress.
Adult↗
[Twin pregnancies and their outcome at the Department of Obstetrics and Gynecology, Institute of Mother and Child in Warsaw, in the period of 1993-2000].
OBJECTIVE: The aim of this study was to analyse the course of twin pregnancies delivered at the Department of Obstetrics and Gynaecology, Institute of Mother and Child in Warsaw, from 1993 to 2000. MATERIALS AND METHODS: The medical documentation of women with twin pregnancy was looked into. Such parameters as mode of conception, maternal age and parity were taken into account. The data concerning the duration of pregnancy, mode of delivery, birth weight and condition of newly born infants were retrospectively reviewed. RESULTS: There a total of 232 (1.46%) twin pregnancies out of 15,869 births. A gradual increase in absolute number of twin deliveries and a relative increase of multiple pregnancies due to the use of assisted reproduction techniques was observed. The tendency to end twin pregnancies by caesarean section was detected. Although the perinatal care improved over the years, a small decrease of mean gestational age at delivery was observed. No significant difference in neonatal outcome in relation to the mode of delivery in researched material was noticed. CONCLUSIONS: The number of twin pregnancies due to the use of assisted reproduction techniques is on the increase. A percentage of women delivering for the first time has risen among women with twin pregnancy. Twin pregnancies are often ended by caesarean section and the frequency of caesarean sections has increased over time.
Academies and Institutes↗
[Cervical pregnancy].
Until quite recently the diagnosis of cervical pregnancy was an indication for hysterectomy, because of mortality among patients with cervical pregnancy, coming up to 60%. During last 15 years methods of conservative therapy has developed in order to avoid the necessity of hysterectomy and to keep patient's fertility. Among these the most promising method is using of methotrexate (MTX), which is now the most commonly used agent in case of conservative forms for the treatment of cervical pregnancies. It should be stressed successful in treatment of cervical pregnancy in women, who wish to remain fertile, depends on early and proper diagnosis. MTX can be administered up to 13 weeks of gestation, with the highest efficacy between 6-8 weeks of pregnancy. We reported a case of cervical pregnancy treated successfully with methotrexate therapy combined with curettage of the cervical canal and uterine cavity. Serial beta HCG serum determination and ultrasonography were used to diagnose the pregnancy and to monitor therapy. Treatment was effective and the patient reproductive capability was preserved.
Abortifacient Agents, Nonsteroidal↗
[The effect of vitamin, macro and microelement supplementation on markers of iron status in blood of pregnant women].
Interest in assessing iron status in the population of women during their child-bearing age has grown recently both in terms of detecting iron stores and evaluating whether they are sufficient to meet increasing needs during pregnancy. The fact that iron deficiency anaemia often develops in pregnancy indicates that that iron stores and dietary iron are insufficient to requirements and iron supplementation is needed. The aim of the present study was to determine the effect of vitamin, macro and microelement supplementation on iron status of pregnant women and of their newborns. It is shown that serum total iron concentration in the group of women without supplementation decreased in the III trimester to 60% of that observed after 12 weeks of pregnancy (p < 0.0001). In supplemented group the decrease was not statistically significant. Increased value of transferin in III trimester in comparison to the I trimester by 38% (p < 0.0001) and by 55% (p < 0.0001) respectively in non supplemented and supplemented groups were found. It was accompanied by significant increase of total iron-binding capacity (TIBC) (p < 0.0001). In both studied groups the level of ferritin was lower in the III than in the I trimester. In serum of women without supplementation, ferritin concentration decreased by 35% (p < 0.003); whereas in supplemented group it was statistically insignificant. In serum of umbilical cord blood concentration of total iron, transferin and ferritin were similar in newborns of both groups of mothers. The above results suggested that vitamin, macro and microelement supplementation of pregnant women improved iron status in mothers and in their children. It seems that administration Vibovitmama formula can be recommended as a dietary supplement in pregnancy in order to prevent subclinical deficiency of iron.
Adult↗
[The effect of vitamin-mineral supplementation on vitamins D, A (beta-carotene) and E concentration in blood of matched maternal-cord pairs].
The aim of the present study was to investigate the effect of Vibovitmama supplementation on status of fat soluble vitamins D, A (beta-carotene) and E in blood of pregnant women and in umbilical cord blood of their children. In group taking Vibovitmama serum concentration of vitamin D, was higher by 10% than in the placebo group was observed. However it was within the normal range and was not statistically significant. Supplementation affected vitamin D concentration in serum of cord blood. It was higher by 20% in the group taking vitamin preparation than in group taking placebo and was statistically significant (p < 0.05). Retinol and beta-carotene in plasma increased during pregnancy by 15% and 25% (p < 0.002) respectively in placebo and supplemented group. In umbilical cord blood in the group taking Vibovitmama, concentration of vitamin A was 1.52 micromol/L and of beta-carotene 1.86 micromol/L versus 1.45 micromol/L and 1.79 micro/L found in group of placebo. In plasma level, vitamin E was higher in late pregnancy than in the I trimester (by about 40%) and was not modified by vitamins supplementation. In erythrocytes the concentration of tocopherol increased by 18% in placebo and by 25% in group taking Vibovitmama. In the plasma of cord blood level of vitamin E was not modified by supplementation, whereas in red blood cells it was slightly increased (by 10%) but not statistically significant. Our results suggest that vitamin-mineral supplementation of pregnant women improved status of fat soluble vitamins in mothers and their children.
Adult↗
[The effect of vitamin-mineral supplementation on the level of MDA and activity of glutathione peroxidase and superoxide dismutase in blood of matched maternal-cord pairs].
The aim of the present study was to investigate the effect of VIBOVITmama (Polfa Kutno S.A.) supplementation on lipid peroxidation (MDA) and activity of superoxide dismutase (SOD) and selenium-dependent glutathione peroxidase (GPx) in blood of pregnant women and in umbilical cord blood of their children. It is shown, that MDA concentration in plasma increased during pregnancy in both studied groups; however in vitamin-mineral C supplemented women it was lower (p < 0.05) than in placebo (p < 0.005). In erythrocytes MDA level was within the same range in both groups, but in women taking vibovit it was (in late pregnancy) lower by 10% than in trimester I. Activity of GPx in red blood cells decreased during pregnancy. In placebo the fall was two-fold more intensive (16%) than in the supplemented group (p < 0.005). Activity of erythrocytes SOD slightly increased (5%) in placebo, whereas in the group taking the formula it decreased (4%) but not statistically significant. MDA level in plasma of cord blood was not modified by supplementation, but in red blood cells was lowered by 20% (97.3 nmol/gHb-supplemented vs 116.3 nmol/gHb-placebo) which was observed. In erythrocytes of umbilical cord blood activity of GPx was higher in newborns of women taking vibovit (31.9 U/gHb) than in the control group (29.7 U/gHb), whereas activity of SOD was similar. Our result suggested that vitamin-mineral supplementation of pregnant women improved antioxidant status in mothers and their children. It seems that in order to prevent oxidative damage VIBOVITmama formula can be recommended as a supplement diet in pregnant women.
Adult↗
[Effect of vitamin-mineral supplementation on the status of some microelements in pregnant women].
We studied the effect of VIBOVITmama (Polfa Kutno S.A.) supplementation on the course of pregnancy duration, delivery and puerperium and also the status of zinc, copper and selenium in the blood of matched maternal-cord pairs. Healthy pregnant women (n=138) were divided by a double blinded trial into a test group taking vitamin and mineral supplementation containing 15 mg of zinc, 2 mg of copper and 20 microg of selenium and a control group taking placebo. Course of pregnancy, delivery and puerperium were analyzed, as well as concentration of bioelements in the blood serum of pregnant women in the I, II, and II trimester and in umbilical cord blood of their children. In the study group we noted fewer by 1.45% cases of pregnancy induced hypertension and a much higher rate of natural deliveries (75%) in comparison to the control group (53%). During pregnancy in the supplemented group a 1% increase of zinc serum concentration was found. In the control group zinc concentration decreased by 7% (p < 0.005). Insignificant differences in serum concentration of copper and selenium was observed between the study group and controls. In umbilical cord blood the differences in the concentration of the above microelements were also insignificant. The results allow for the statement that VIBOVITmama supplementation stabilizes the zinc, copper and selenium levels in blood of pregnant women without the risk of overdosing, especially with reference to selenium.
Adult↗
[Dietary assessment of pregnant women--vitamin and mineral supplementation--justified or not?].
The aim of the study was to assess the dietary intake of energy and nutrients of pregnant women in the Outpatient Clinic of Obstetrics and Gynecology of National Research Institute of Mother and Child in Warsaw. The nutrient intake, the average daily food rations and their nutritional value were evaluated on the basis of recall and record of 7-days menus. The average daily food intake was compared to the recommendations for the first and second half of pregnancy. It was found, that 44% of women changed dietary habits during pregnancy. The nutritional value of their daily food intake was closer to recommendations in the first half of pregnancy than in the second half. The food intake of pregnant women with supplementation (S-group) and taking placebo (NS-group) were also compared. In the first half of pregnancy the average food intake of women from S-group and NS-group was similar. In the second half of pregnancy the nutrient intake of S-group women was closer to recommendations than in the second group. However the deficiency of certain B vitamins and microelements (calcium, iron, zinc, magnesium) occurred in both groups. The intake of vitamin A, sodium and phosphorus exceeded the recommendations. The results of the study support the need of supplementation in the pregnant women diets with microelements and vitamins.
Adult↗
[Total radical trapping antioxidants parameters on plasma in smoking and non-smoking matched maternal-cord pairs].
Oxidative stress in smoking pregnant women is assumed to be enhanced by oxidants and free radicals of tobacco smoke. Therefore we studied the effect of cigarette smoking during pregnancy on plasma total radical trapping antioxidants parameters (TRAP) in mothers and their babies. Pregnant women were selected into the groups according to concentration of cotinine in serum. TRAP was determined by method of Wayner et al. using oxygen electrode (YSI Model 5331). The plasma concentration of TRAP was lower in smoking pregnant women than in tobacco abstinent group (533.0 micromol/l vs 600.0 micromol/l in I trimester, 578.0 micromol/l vs 583.5 micromol/l in II trimester and 583.5 micromol/l vs 589.0 micromol/l in III trimester. The differences were statistically significant in first and second trimester (p<0.05). Value of TRAP in umbilical cord blood from newborns of smoking mothers was significantly lower and amounted only 74% of that observed in non-smoking ones (366.5 micromol/l vs 492.0 micromol/l; p<0.001). Plasma level of TRAP was significantly correlated with serum concentration of cotinine both in smoking pregnant women (r=-0.32; p<0.01) and in umbilical cord blood of their children (r=-0.49; p<0.01). Our results indicate that smoking depletes plasma TRAP in mothers and their babies. Decreased level of total plasma antioxidants parameters may have a negative effect on antioxidant protection systems in neonates.
Antioxidants↗
[Usefulness of determination of granulocyte elastase plasma level, c-reactive protein and white blood cell count in prediction in intrauterine infection in pregnant women after PROM].
UNLABELLED: The main markers of intrauterine infection: C-reactive protein and white blood cell count are dependent on medical management as steroids or antibiotics therapy. Granulocyte elastase is independent variable from influence of tocolysis, steroids, antibiotics, chemiotherapeutics, hours since PROM. The aim of the study was to evaluate and compare the usefulness of determination granulocyte elastase, (EG) C-reactive protein (CRP) and white blood cell count (WBC) in prediction of chorioamninitis in pregnant women after premature rupture of fetal membranes. MATERIALS AND METHODS: 67 women with single pregnancy between 24-36 week of gestation after PPROM were included into the study group. All women were managed expectantly (tocolysis, antibiotics, steroids, intravaginal chemiotherapeutics, bed rest), maternal and fetal (KTG, USG) vital signs were monitored every day. EG, CRP and WBC blood test were performed every day. Histopathologic examinations of all placentas were performed for chorioamnionitis confirmation or exclusion. Normal range for EG--88 micrograms/l, CRP--15 micrograms/l, WBC--15 x 10(9). RESULTS: The usefulness of granulocyte elastase plasma serial determination as biochemical marker of chorioamnionitis in cases of PPROM was confirmed: sensitivity--100%, specificity--33%, PPV--64.9%, NPV--100% in comparison with CRP: sensitivity--27%, specificity--80%, PPV--62.5%, NPV--47% and white blood cell count: sensitivity--27%, specificity--66.7%, PPV--50%, NPV-42.5%. CONCLUSIONS: We confirmed statistical correlation (p < 0.001) between granulocyte elastase plasma level > 88 micrograms/l and histological signs of intrauterine infection in pregnant women after PPROM. Granulocyte elastase determination in plasma is most sensitive indicator of histologic confirmed chorioamnionitis.
Adult↗
[Thyroid function in pregnant women with pregnancy induced hypertension].
OBJECTIVE: The aim of this study is to investigate thyroid's function in pregnant women with pregnancy induced hypertension. MATERIALS AND METHODS: 42 pregnant women with PIH diagnosed after 20 weeks of gestation (between 22-30 hbd) were hospitalized in Department of Obstetrics and Gynecology of Mother and Child Institute in Warsaw. This group consisted 20 multiparous and 22 primiparous. We measured thyroid hormone levels: TSH, fT4, fT3 and TBG. RESULTS: In 8 pregnant women (5 primiparous and 3 multiparous) thyroid function was normal (normal level of TSH, fT3, fT4) and middle blood pressure in term of beginning of the study was 155/100 mmHg. 34 pregnant women (19 primiparous and 15 multiparous) had abnormal thyroid function. 3 (1 primiparous and 2 multiparous) pregnant women of this group had subclinical hyperthyroidism (middle blood pressure in the beginning of the study was 155/105) and 31 (21 primiparous and 10 multiparous) had fT4 and fT3 levels lower then normal range with normal TBG levels. In this group only one patient TSH level was higher then 5 mlU/l, which allows to recognize overt hypothyroidism. In other cases the results indicate the subclinical hypothyroidism. The middle blood pressure was 140/95 mmHg. CONCLUSION: 1. Thyroid dysfunction in pregnant women was concluded in 78.2% of tested group. 2. Subclinical hypothyroidism was concluded the most frequent in the tested group. 3. The middle blood pressure at the term of beginning of the study was the lowest in pregnant women with hypothyroidism. 4. The thyroid function tests should be performed in all pregnant women with PIH.
Adult↗
[The prevalence of Toxoplasma gondii infection among 2016 pregnant women and their children in the Institute of Mother and Child in Warsaw].
During the year 2000 a screening was performed to estimate the frequency of Toxoplasma gondii infections in 2016 pregnant women and their children in the Department of Gynaecology and Obstetrics and in the Outpatient Clinic of the Institute of Mother and Child in Warsaw. The study was based on identifying IgG and IgM specific antibodies. All tests were done in the Department of Immunology. Women with serologically diagnosed primary infection were offered further follow up, antibiotic therapy and care during delivery in the Institute of Mother and Child. Children born by infected mothers were examined serologically and observed in terms of congenital abnormality. There were 1294 (64.19%) seronegative; 722 (35.81%) were infected before pregnancy (the presence of IgG antibodies). Five women with previous seronegative results (0.29%) were diagnosed as having primary infection during pregnancy. Congenital infection, confirmed serologically, was recognized in 3 newborn infants.
Animals↗
[Fibrinolytic therapy of pulmonary embolism in pregnant women].
Fibrinolytic therapy has an established position in the treatment of pulmonary embolism. Its use has proven to decrease patients' mortality. However, in pregnant women such treatment is considered risky, due to possible fatal haemorrhagic events. In spite of such disadvantages, fibrinolytic therapy has been used in pregnant women with good results: from definite improvement of clinical status to complete recovery. No severe haemorrhagic events were observed in these cases and overall mortality was significantly decreased. These findings show that the use of fibrinolytic therapy in emergency situations is an efficient and safe method, when applied in accordance with standard procedures. In this publication we present the general review of current knowledge regarding the use of fibrinolytic therapy in pregnant women.
Anticoagulants↗
[External cephalic version at term].
About 3 - 4 % of all pregnancies reach term with a foetus in the breech presentation. Because of higher risk of complications for mother and foetus during the vaginal breech birth, only 50% of patients try to deliver vaginally - at the end 40 - 70% of labours are finished by caesarean section. In other cases planned caesarean sections are performed, and finally 10 - 20% of patients with breech presentation at term deliver vaginally. Prenatal mortality and serious complications after breech vaginal birth are 5% and after planned caesarean section 1.6%. This is the reason why the caesarean section is chosen as a final way of delivery with breech presentation. At present, after a period of increasing percentage of caesarean section one can observe a tendency to decrease this number. One of the procedures performed to decrease the number of complications and cost of perinatal management is external cephalic version (ECV). An indication to ECV is breech presentation at term, while there is no contraindication to ECV. Multiple pregnancy, significant third - trimester bleeding, uteroplacental insufficiency, IUGR, oligohydramnion, PROM, PIH, nonreassuring foetal monitoring patterns and all contraindications to vaginal birth are concerned to execute ECV. The real number of patients with breech presentation at term, after ECV, is according to the literature about 1 - 1.5%. The risk of serious complications during ECV, which are the indications for urgent caesarean section, is 1 - 3%. The risk of intrauterine death of foetus after ECV is about 0.0001%. According to the literature it appears that ECV at term seems to be useful and it is safe both for the mother and the foetus and helps to avoid a significant number of caesarean sections.
Breech Presentation↗