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Biomedical subjects

U Ekblad

Publications and source records attributed to U Ekblad.

At least 19 recordsLinked to original sources
PubMed1999

Prediction of pre-eclampsia with maternal mid-trimester total renin, inhibin A, AFP and free beta-hCG levels.

We wanted to study if maternal serum mid-trimester total renin, inhibin A, AFP or free beta-hCG levels predict the development of pre-eclampsia. Maternal serum alpha-fetoprotein (AFP) and human chorion gonadotrophin (beta-hCG) were evaluated in the screening programme for Down syndrome in 4356 patients prospectively. Data on pregnancy outcome were available in 1242 women. Pregnancy-induced hypertension (PIH) developed in 69 women, 282 women with uneventful pregnancy outcome were selected for controls. Serum total renin and inhibin A levels were measured retrospectively in the trisomy screening samples of 69 and 30 patients who later developed PIH, and in 282 and 7 patients, respectively, who had an uneventful pregnancy outcome. No significant differences were found in the levels of maternal mid-trimester serum total renin, inhibin A or free beta-hCG levels between PIH and healthy women. The multiples of the median (MoM) of AFP values were significantly higher in the subgroup of patients who later developed severe pre-eclampsia than in patients with mild pre-eclampsia or gestational hypertension and healthy pregnant women. Maternal mid-trimester serum levels of total renin, inhibin A and free beta-hCG are not predictive for development of PIH. High mid-trimester serum AFP values may help in the prediction of severe pre-eclampsia.

Adult↗
PubMed1998

Polycystic ovaries in women with gestational diabetes.

OBJECTIVE: To examine the occurrence of polycystic ovaries (PCO) in women with gestational diabetes mellitus (GDM). METHODS: This was a retrospective comparative study of ultrasonographic findings of ovaries in 31 women with GDM and 30 healthy controls matched according to maternal age and body mass index (BMI). Women who presented evidence of impaired glucose tolerance during pregnancy were excluded from the control group. Transvaginal ultrasonographic examination was performed during the follicular phase of the menstrual cycle, after breast-feeding had been discontinued. RESULTS: Polycystic ovary was a more frequent finding among women with GDM than among controls: 14 women with GDM (44%) and two controls exhibited PCO. No differences were found in BMI before pregnancy or in the weight gain during pregnancy between the groups. No difference was observed in the mean birth weight of the infants between the study groups. CONCLUSION: Polycystic ovaries were a common finding among women with GDM. The data suggest that women with PCO are at risk for developing GDM and should be screened accordingly.

Adult↗
PubMed1998

Expression of nitric oxide synthase in normal and preeclamptic placental tissue and effects of glyceryl trinitrate and shear stress on placental blood flow.

BACKGROUND: To study the expression of constitutively expressed nitric oxide synthase (cNOS) as well as the effects of glyceryl trinitrate (GTN) and shear stress on normal and preeclamptic placental tissue. METHODS: The expression of cNOS was studied using NADPH diaphorase activity reaction in seven normal and four preeclamptic placentas. The effect of GTN (n = 5) and shear stress induced by increasing the flow rate in the perfusion system (n = 5) was studied using an in vitro placental perfusion method. RESULTS: No difference in the distribution of cNOS in placental tissue was found between preeclamptic and normal pregnancies. Shear stress did not affect the production of nitric oxide metabolites. GTN was able to dilate placental vasculature. CONCLUSIONS: cNOS derived from syncytiotrophoblasts may not contribute to the development of preeclampsia. Placental vasculature responds to nitric oxide by vasodilation.

Blood Flow Velocity↗
PubMed1998

The effect of vitamin C and E on placental lipid peroxidation and antioxidative enzymes in perfused placenta.

BACKGROUND: To investigate placental lipid peroxidation products and antioxidative enzymes after vitamin C and/or E infusions into the maternal circulation of normal and preeclamptic placentas perfused in vitro. METHODS: Placentas from 29 normal and six preeclamptic women delivered between 27 and 41 weeks of gestation were used in the study. RESULTS: Neither vitamin C (500 microM) nor vitamin E (50 microM) had any effect on placental lipid peroxidation or antioxidative enzymes in normal placentas. Vitamin C infused in preeclamptic placentas decreased peroxidation potential, as an indicator of lipid peroxidation to the same level it was in normal placentas (812 vs. 649 mV/mgprot; p=0.420). The activity of superoxide dismutase (SOD) was lower (1350 vs. 2030 ng/mgprot; p=0.023) in preeclamptic placentas, and the activities of glutathione peroxidase (0.22 vs. 0.08 micromol/min x mgprot; p=0.010) and glutathione-S-transferase (19.8 vs. 13.1 micromol/min x mgprot; p=0.016) were higher in preeclamptic compared to normal placentas. CONCLUSION: In this study, based on in vitro perfused normal and preeclamptic placentas, exogenous antioxidative vitamins had no effect on lipid peroxidation or endogenous antioxidative enzymes in normal placenta, but reduced placental lipid peroxidation and could potentiate the activity of some endogenous placental antioxidative enzymes in preeclamptic placenta.

Ascorbic Acid↗
PubMed1997

Type I diabetic pregnancy and subclinical human papillomavirus infection.

It has been suggested that diabetic pregnancy is an immunosuppressive state. To determine whether the possible immunosuppression in pregnant diabetics might result in an increased risk for human papillomavirus (HPV) infection, we studied exfoliated cells from the uterine cervix, vagina, and posterior commissure of the vulva by means of dot blot hybridization with use of a probe cocktail of HPV types 11, 16, and 18 under low stringency and by means of consensus primer-mediated polymerase chain reaction (PCR) targeted to the HPV L1 and E1 regions. For this study, samples from 31 pregnant diabetics whose glucose levels had been reasonably well controlled were analyzed during the first trimester; samples from 27 of these patients were analyzed again during the third trimester. Fifty-one healthy pregnant women were included as controls. Only one of the pregnant diabetics was positive for HPV DNA. The L1 PCR products of the first and third trimester samples from this patient were sequenced, and both were found to represent HPV 61. Three of the pregnant controls were positive for HPV: two were positive for HPV 16, and one was positive for HPV 6. The 95% confidence limits for the prevalence of HPV were calculated to be 0.1%-16.7% for the diabetics and 1.2%-16.2% for the controls. The 95% confidence limits for the difference between the groups were -11.6%-6.3%. These results suggest that pregnant diabetics do not have an increased risk of developing HPV infection, at least when their glucose levels remain well controlled.

Adult↗
PubMed1996

Sleep in multiple pregnancy: breathing patterns, oxygenation, and periodic leg movements.

OBJECTIVES: Our goal was to study whether multiple pregnancy at the third trimester predisposes to breathing disturbances and arterial oxyhemoglobin desaturation during sleep. STUDY DESIGN: Nocturnal breathing, oxygenation, and movement activity were studied in 10 mothers: 8 with twins, 1 with triplets, and 1 with quadruplets. RESULTS: No obstructive and few central sleep apnea episodes were observed. Four subjects had episodes of increased respiratory resistance, but only one, the mother with quadruplets, was significantly affected. Arterial oxyhemoglobin saturation was always maintained above 90%. Periodic leg movements were present in all mothers, with a frequency range of 3.7 to 49.7 movements per hour. CONCLUSIONS: In spite of the large uterus in multiple pregnancy, nocturnal breathing and oxygenation are well maintained. Increased motor activity and frequent awakenings suggest poor sleep quality, which may be further compromised by intensive periodic leg movements.

Adult↗
PubMed1996

Lipid peroxidation and antioxidants in normal and pre-eclamptic pregnancies.

Lipid peroxidation has been suggested as a pathogenetic factor of pre-eclampsia. In this study we measured lipid peroxidation products and the counteracting antioxidant functions in maternal serum and placental tissue in normal pregnancy and pre-eclampsia. Placentae and maternal serum from 15 normal and 15 pre-eclamptic pregnancies were collected. Lipid peroxidation was measured as peroxidation potential, thiobarbituric acid reacting substances (TBARS) and conjugated diene onuble bonds. The antioxidative capacity was measured as the activity of superoxide dismutase, glucose 6-phosphate-dehydrogenase, glutathione peroxidase and glutathione transferase and the concentration of placental vitamin E. Placental lipid peroxidation was higher in pre-eclampsia than in normal pregnancy, when measured by peroxidation potential and TBARS (P = 0.002 and P = 0.027, respectively). The activity of placental superoxide dismutase (P = 0.003) and glucose 6-phosphate-dehydrogenase (P = 0.019) was significantly lower in pre-eclampsia than in normal pregnancy. There were no significant differences in the activity of glutathione peroxidase, glutathione-S-transferase or vitamin E level between the study groups. The peroxyl radical trapping capacity (TRAP) was higher (P = 0.013) in the serum of pre-eclamptic than control patients. Lipid peroxidation is increased and the activity of antioxidant enzymes superoxide dismutase and glucose 6-phosphate-dehydrogenase are decreased in pre-eclamptic placenta. The TRAP is high in the serum of pre-eclamptic patients.

Adult↗
PubMed1996

Bacterial 16S rDNA polymerase chain reaction in the detection of intra-amniotic infection.

OBJECTIVE: Bacterial polymerase chain reaction (PCR) was used to detect early subclinical intraamhiotic infection. We used universal primers which amplify a DNA fragment of 16S ribosomal DNA (rDNA) from all known bacteria and sequenced the positive samples to identify the bacterial species. DESIGN: Transabdominally obtained amniotic fluid samples from 20 pregnant women with prelabour rupture of the fetal membranes (PROM), showing no signs of clinical infection, and 16 control samples were analysed with universal bacterial PCR. In addition, routine bacterial culture and amniotic fluid glucose were studied. RESULTS: Out of 20 PROM patients, five were positive in the PCR. PCR detected Ureaplasma urealyticum in two cases, Haemophilus influenzae in one case, Streptococcus oralis in one case and Fusobacterium sp. in one case. Only two of these were positive in a routine bacterial culture. Both were multibacterial infections, which caused discrepancies between the PCR and culture results. Two patients developed infectious complications: both were identified with the PCR assay. Amniotic fluid glucose was lower in PCR positive patients compared with PCR negative patients. CONCLUSION: Bacterial 16S rDNA PCR, in properly controlled conditions, promises to be a fast and reliable test for early intra-amniotic infection especially concerning Ureaplasma urealyticum.

Amniotic Fluid↗
PubMed1996

Increase in vasoactive prostaglandin E production after perfusion in human placental cotyledons.

Studies from our laboratory indicate that prostaglandins may be mediators of at least some of the teratogenic actions of ethanol in both mouse and human tissue model systems. The present studies were designed to evaluate the relationship between ethanol and prostaglandin E (PGE) production in isolated human placental cotyledons. Placentas were obtained immediately after cesarean section delivery. A fetal artery supplying a single cotyledon was identified and cannulated, and the isolated cotyledon was placed in a perfusion chamber where maternal circulation was established and dual circulation continued throughout the perfusion procedure. Antipyrine clearance, oxygen consumption, and placental production of human chorionic gonadotropin were measured to verify tissue viability. PGE levels of the perfusate were measured by radioimmunoassay. Study 1 evaluates the effect of perfusion with 25 and 100 mM ethanol on placental PGE production. It was found that PGE production increased after perfusion with 25 mM ethanol, but not during the perfusion period per se. The paradigm for study 2 was identical to that of study 1, with the addition of a buffer washout period after 100-mM ethanol perfusion. Again, results indicate that perfusate PGE levels were increased in the buffer washout periods after the 25-mM and the 100-mM ethanol perfusions. The effect was not concentration dependent. An increase in circulating PGE associated with ethanol administration may be teratogenic actions and represent a potential mechanism underlying at least some aspects of fetal alcohol syndrome.

Adult↗
PubMed1995

A rapid and safe method to detect fetal parvovirus B19 infection in amniotic fluid by polymerase chain reaction: report of a case.

Molecular amplification of parvovirus B19 DNA in an amniotic fluid sample was used to confirm the etiologic agent of a case with fetal hydrops. The polymerase chain reaction (PCR) method used is easy and fast to perform. We have a 2-year experience on its use in clinical parvovirus B19 diagnosis. The results are available within 1 day of sampling. In addition to strict laboratory standards, the use of two different sets of PCR primers and probes confirms positive findings. Positive parvovirus PCR on amniotic fluid confirms fetal parvovirus infection in cases of fetal nonimmune hydrops. Intrauterine transfusions may be necessary in cases with severe fetal anemia.

Adult↗
PubMed1995

Biological agents and pregnancy.

Pregnant women are exposed to many biological, eg microbial, agents, which are potentially harmful to the fetus. The reported rates of vertical transmission of hepatitis B and human immunodeficiency virus vary between 3 to 90% and 0 to 65%, respectively. The susceptibility to hepatitis B and human immunodeficiency infection is increased in pregnant physicians, midwives, and nurses because of the bloodborne nature of these viruses. Also, TORCH (toxoplasmosis-rubella-cytomegalovirus-herpes) infections, acquired during pregnancy, may result in congenital infection, and serious sequelae in the neonatal period or years after birth. Schoolteachers and daycare personnel have an increased risk of perinatal varicella, "fifth disease," and mumps. Perinatal listeriosis affects one in 20,000 births and may result in fetal wastage. Because of the risk of the possibility of vertical transmission, immunization during pregnancy with live virus vaccines is not recommended.

Bacterial Infections↗
PubMed1994

Comparison of intravaginal and two intracervical prostaglandin E2 gels in pre-induction of labour.

A randomized study was undertaken to compare the effect of vaginal (1 mg of dinoprostone/2.5 ml gel) and intracervical (0.5 mg of dinoprostone in 2.5 ml of two different vehicles) on induction of labor and perinatal outcome. Sixty women (n = 20/20/20) who presented with an unfavorable cervix and a specific indication for the induction of labor participated in the study. There were no significant differences between the groups with respect to maternal age, weight, parity, gestational length or Bishop scores before prostaglandin E2 preinduction. Labour was induced with prostaglandin gel alone in twenty-two patients and with oxytocin infusion on the following morning after gel application in seven patients; altogether the rate of successful induction was 48.3%. The rate of uterine hyperstimulation was 16.7% with most cases in the groups receiving intracervical prostaglandin E2. Neonatal asphyxia diagnosed with umbilical vein and artery blood gas analysis was seen in eleven neonates who were delivered by labor induced with prostaglandin gel alone (50%). Prostaglandin pre-induction decreases the need for Cesarean sections in complicated pregnancies, but because of the risk of uterine hyperstimulation and neonatal asphyxia prostaglandins should be used only with specific indications.

Administration, Intravaginal↗
PubMed1994

Pregnancy in women over forty.

A retrospective review of the 289 women over the age of 40 years and delivering at the Turku University Central Hospital between 1986-1990 is presented. Forty-seven women were nulliparous and 242 multiparous. The proportion of women over 40 of all parturients during this time period was 2.1%. Infertility was treated in 12% of couples. There were three multifetal pregnancies, all spontaneous. 88% of the women had a first trimester amniocentesis or chorion villus biopsy for fetal chromosomal analysis. The most common pregnancy-related complications were prematurity (11%), gestational diabetes (8%), pre-eclampsia (7%) and infectious diseases (11%). The rate of Caesarean section was high, 26% (among the primipara 36%). The perinatal mortality rate was very low, 3.4 per thousand, and neonatal mortality rate 6.8 per thousand. The incidence of congenital anomalies was 2%, and most of these anomalies were cardiac. Large-for-date babies were overpresented in this population and primipara had a higher rate of small-for-gestational age babies than in the normal population. Although advanced maternal age alone does not carry major risks of abnormal pregnancy outcome, the higher frequency of complications among some subgroups may explain the high rate of Caesarean sections in this population.

Cesarean Section↗
PubMed1994

Spontaneous rupture of liver during pregnancy.

Spontaneous rupture of the hepatic capsule and subsequent massive intra-abdominal bleeding is a rare but life-threatening complication of pregnancy, which is often associated with pregnancy-induced hypertension. High maternal and fetal mortality rates have been reported. We describe a case with massive intra-abdominal bleeding. The diagnosis and treatment of this condition are discussed.

Adult↗
PubMed1992

Maternal weight, weight gain during pregnancy and pregnancy outcome.

OBJECTIVE: To evaluate the effects of abnormal maternal weight or weight gain on pregnancy outcome. METHOD: Records for 191 mothers with abnormal prepregnancy weight (> or = 20%) above, or under, ideal body weight for height) or weight gain > or = 20 kg, or < or = 5 kg during pregnancy were reviewed. The control group consisted of 166 mothers with normal prepregnancy weight and normal weight gain during pregnancy. Data on mothers and their infants were analyzed by one-way analysis of variance. RESULTS: Obese women and mothers with excessive weight gain during pregnancy had an increased incidence of induced labor (P < or = 0.05) and tendency for emergency cesarean sections during the delivery. Obese women had more large-for-date babies than controls (P < or = 0.05). Weight gain < or = 5 kg during pregnancy was most common in slightly obese women and did not carry any special obstetric or neonatal risk. Underweight women had a significant risk for delivering a small-for-data baby. CONCLUSION: Obese women and women with excessive weight gain during pregnancy need special follow-up and counseling during pregnancy and delivery. Underweight women may need prepregnancy nutritional counseling to guarantee normal fetal growth. In developed countries suboptimal weight gain (< or = 5 kg) during pregnancy seems not to need any medical intervention.

Adult↗
PubMed1991

Aspirin dose-dependently reduces alcohol-induced birth defects and prostaglandin E levels in mice.

The purpose of the present study was threefold. The first purpose was to determine if aspirin (ASA) decreases alcohol-induced birth defects in mice in a dose-dependent fashion. The second purpose was to see if the antagonism of alcohol-induced birth defects afforded by ASA pretreatment was related to dose-dependent decreases in prostaglandin E (PGE) levels in uterine/embryo tissue. The third purpose was to determine if ASA pretreatment altered maternal blood alcohol level. In experiments 1 and 2, pregnant C57BL/6J mice were administered ASA (0, 18.75, 37.5, 75, 150, or 300 mg/kg) on gestation day 10. One hour following the subcutaneous injection of ASA, mice received alcohol (5.8 g/kg) or an isocaloric sucrose solution intragastrically. In experiment 1 the incidence of birth defects was assessed in fetuses delivered by caesarean section on gestation day 19. In experiment 2 uterine/embryo tissue samples were collected on gestation day 10 1 hr following alcohol intubation for subsequent PGE analysis. In experiment 3 blood samples were taken at five time points following alcohol intubation from separate groups of alcohol-treated pregnant mice pretreated with 150 mg/kg ASA or vehicle. The results from the three experiments indicated that 1) ASA dose-dependently reduced the frequency of alcohol-induced birth defects in fetuses examined at gestation day 19, (2) ASA decreased the levels of PGE in gestation day 10 uterine/embryo tissue in a similar dose-dependent fashion, and 3) ASA pretreatment did not significantly influence maternal blood alcohol levels. These results provide additional support for the hypothesis that PGs may play an important role in mediating the teratogenic actions of alcohol.

Abnormalities, Drug-Induced↗