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PubMed2006

Nausea and vomiting in pregnancy: maternal characteristics and risk factors.

Nausea with or without vomiting (NVP) is probably the most frequently reported medical complaint of pregnancy, but few studies have considered risk factors for its development. We used data from an ongoing epidemiological study of pregnancies in four regional centres. Mothers of infants with congenital malformations (n = 17,158) and a sample of normal infants (n = 5,329) were interviewed within 6 months of delivery by trained nurse-interviewers using a standardised questionnaire. For all risk factors investigated, odds ratios and 95% confidence intervals were calculated using multiple logistic regression, controlling for potential confounders. The cumulative incidence (risk) of NVP was 67%. The risk of NVP and its timing during pregnancy were similar for mothers of malformed and normal infants, so data were combined. No changes in the NVP risk were observed over the 20-year study period. The risk decreased with increasing age, but increased with increasing gravidity. The risk also increased with increasing number of prior miscarriages. Further, within each gravidity category, the risk was higher for twin births than for singletons. Women who reported onset of NVP after the first trimester differed demographically from women whose NVP began earlier: they were less-well educated, had lower incomes, and were more likely to be black. The finding that the number of prior pregnancies, both complete and incomplete, and number of fetuses independently appear to increase the risk of NVP suggests a fetal 'dose' effect. Together with selected demographic characteristics that differentiate early- vs. late-onset NVP, these findings warrant further investigation.

Abortion, Spontaneous↗
PubMed2002

Postpartum X-ray pelvimetry. Its use in calculating the fetal-pelvic index and predicting fetal-pelvic disproportion.

OBJECTIVE: To determine whether postpartum x-ray pelvimetry can be used to calculate the fetal-pelvic index (FPI) in future pregnancies. STUDY DESIGN: In stage I of the study, 10 gravid women, after 36 completed weeks' gestation, underwent x-ray pelvimetry before delivery. Pelvimetry was repeated within two days after delivery. Comparisons between antepartum and postpartum measurements were made using paired t tests and correlation coefficients. In stage II, 25 gravid women, after 36 completed weeks' gestation, underwent fetal ultrasound for biometry. X-ray pelvimetry was performed within two days after delivery. FPI was calculated for each pregnancy using antepartum fetal ultrasound and postpartum pelvimetry measurements. FPI calculations were correlated with the incidence of fetal-pelvic disproportion (FPD), as indicated by the requirement for cesarean section for arrest of active labor. Sensitivity, specificity and predictive value of FPI were assessed. RESULTS: In stage I, mean anteroposterior and transverse diameters of the pelvic inlet, midpelvis and pelvic outlet did not differ significantly. In stage II, the sensitivity of FPI for detecting FPD was 100%, specificity 95%, positive predictive value 80%, and negative predictive value 100%. CONCLUSION: Postpartum pelvimetry has the same association with FPD as antepartum pelvimetry. The strategy of using postpartum pelvimetry and antepartum fetal biometry to calculate FPI successfully identified 100% of the patients who ultimately required cesarean section for FPD, with a false positive rate of 5%. Pelvimetry performed postpartum in an index pregnancy may be used in future pregnancies, in combination with antepartum fetal ultrasound, to calculate FPI and predict the likelihood of FPD.

Adult↗
PubMed1996

Influence of maternal folate status on the developmental toxicity of methanol in the CD-1 mouse.

Methanol, which is detoxified via a folic acid-dependent pathway, has been shown to be teratogenic in mice. Given recent observations that the level of dietary folic acid intake may be inversely related to the occurrence of select birth defects in humans, we tested the hypothesis that dietary folic acid intake would influence the developmental toxicity of methanol. Virgin female mice were fed one of three diets containing 400 (low), 600 (marginal), or 1,200 (adequate) nmol folic acid/kg diet for 5 weeks prior to and following mating. On gestation days (GD) 6-15, dams were administered by gavage either vehicle (distilled, deionized water) or methanol at 2.0 or 2.5 g/kg body weight, twice daily. On GD 18, mice were weighed and killed and the liver, kidneys, and gravid uteri removed and weighed. Implantation sites, live and dead fetuses, and resorptions were counted; fetuses were weighed individually and examined for cleft palate and exencephaly. One third of the fetuses in each litter were examined for skeletal morphology. Maternal liver folate concentrations were approximately 40-50% lower in the low dietary folic acid groups than in the marginal and adequate groups; methanol did not affect maternal liver folate concentration at term. Maternal net gestational weight gain was lowest at the lowest dietary folate level but was not affected by methanol. Gravid uterus weights were lowest in the low dietary folic acid groups exposed to the high methanol dose and the number of live fetuses per litter was lowest in the low folic acid groups. Fetal body weights were lowest in the low folic acid groups and significantly lower in the methanol groups relative to vehicle-treated animals. Fetal crown-rump lengths were shorter in the methanol-treated groups; this parameter was not affected by folic acid treatment. Both methanol and low dietary folic acid increased the incidence of cleft palate, with the highest number of affected litters in the low dietary folic acid group. These results support the concept that maternal folate status can modulate the developmental toxicity of methanol.

Abnormalities, Drug-Induced↗
PubMedDate not supplied

Catheter-directed thrombolysis for thromboembolic disease during pregnancy: a viable option.

Anticoagulation with intravenous heparin has been the standard treatment for the management of gestational thromboembolic complications. Catheter-directed thrombolysis is an encouraging approach for the treatment of thromboembolic disease and has not been previously reported during pregnancy. One gravid woman with pulmonary embolism, critically ill, and hemodynamically compromised, and two gravid women with iliofemoral venous thrombosis, who failed to respond to standard treatment with intravenous heparin, were treated with catheter-directed urokinase. All three patients experienced rapid resolution of symptoms and successful pregnancy outcomes. In our three patients, catheter-directed thrombolysis for thromboembolic disease during pregnancy allowed rapid resolution of hemodynamic abnormalities and/or resolution of thrombus. Catheter-directed thrombolysis offered a reasonably safe alternative to prolonged medical management in these young, otherwise healthy, patients. Long-term, it may prevent the postphlebitic syndrome.

Adult↗
PubMed2000

Ultrastructure of the reproductive system of the black swamp snake (Seminatrix pygaea). II. Annual oviducal cycle.

This article is the first ultrastructural study on the annual oviducal cycle in a snake. The ultrastructure of the oviduct was studied in 21 females of the viviparous natricine snake Seminatrix pygaea. Specimens were collected and sacrificed in March, May, June, July, and October from one locale in South Carolina during 1998-1999. The sample included individuals: 1) in an inactive reproductive condition, 2) mated but prior to ovulation, and 3) from early and late periods of gravidity. The oviduct possesses four distinct regions from cranial to caudal: the anterior infundibulum, the posterior infundibulum containing sperm storage tubules (SSTs), the uterus, and the vagina. The epithelium is simple throughout the oviduct and invaginations of the lining form tubular glands in all regions except the anterior infundibulum and the posterior vagina. The tubular glands are not alveolar, as reported in some other snakes, and simply represent a continuation of the oviducal lining with no additional specializations. The anterior infundibulum and vagina show the least amount of variation in relation to season or reproductive condition. In these regions, the epithelium is irregular, varying from squamous to columnar, and cells with elongate cilia alternate with secretory cells. The secretory product of the infundibulum consists largely of lipids, whereas a glycoprotein predominates in the vagina; however, both products are found in these regions and elsewhere in the oviduct. In the SST area and the anterior vagina, tubular glands are compound as well as simple. The epithelium of the SST is most active after mating, and glycoprotein vacuoles and lipid droplets are equally abundant. When present, sperm form tangled masses in the oviducal lumen and glands of the SST area. The glands of the uterus are always simple. During sperm migration, a carrier matrix composed of sloughed epithelial cells, a glycoprotein colloid, lipids, and membranous structures surround sperm in the posterior uterus. During gravidity, tubular glands, cilia, and secretory products diminish with increasing development of the fetus, and numerous capillaries abut the basal lamina of the attenuated epithelial lining of the uterus.

Animals↗
PubMed1975

Vein size in intact and hysterectomized mice during the estrous cycle and pregnancy.

The diameters of the ovarian, uterine, and femoral veins and the inferior vena cava were measured during stages of the estrous cycle in intact and hysterectomized mice and at intervals during pregnancy in mice with embryos in both uterine horns or in only the left horn. At metestrus I vein sizes were the least and were not significantly different in intact and hysterectomized mice. Ovarian and uterine veins showed the same or increased diameters at other stages of the cycle; veins enlarged progressively during pregnancy in intact mice. Non-gravid uterine horns showed little size increase as compared to gravid horns. Increases in vein diameter appeared to be correlated with local production of reproductive hormones. Evidence for transuterine migration of embryos was observed in 21 of 53 mice in which one uterine tube had been ligated or one ovary had been removed.

Animals↗
PubMed1976

Uterine vasculature of the pregnant pig: a scanning electron microscope study.

Colored cold setting acrylic cement was injected through catheters into the arteries and veins of sixteen gravid uteri obtained from pigs at various stages of pregnancy. After the cement had set hard, the reproductive tracts were macerated in concentrated acid and the vascular casts resulting were washed clean of digested tissues. Small pieces of cast were coated with gold and viewed by means of a scanning electron microscope. Early in pregnancy the capillary network consists of low parallel ranks of ridges and troughs; later, cross ridging was observed which developed in complexity as pregnancy progressed. The density of capillaries comprising the microvascular network also increased towards term. No comparable changes were noted in the relatively less well vascularized areas surrounding the mouths of the uterine glands. This technique surmounted the problems of obtaining an adequate depth of focus for viewing the capillary network of the gravid uterus with the light microscope. The relationships that the blood vessels bore to the overlying epithelial layers were discussed and the inference tentatively drawn that blood flow at the capillary level was from ridge top to trough base.

Animals↗
PubMed1977

Offspring survival, development, and operant performance following maternal ethanol consumption.

Gravid Sprague-Dawley-derived rats received 35-40% of their total calories in alcohol during pregnancy or pregnancy and the 23-day nursing period. Ethanol was administered both as the sole fluid source in a .1% saccharin solution and by twice daily subcutaneous injections. Two gravid control groups were matched for caloric and fluid intake to the experimental groups and received injections of the saline vehicle. The offspring were monitored from birth to adulthood on a variety of vital, developmental, and operant measures. Littermates of the behavioral offspring were sacrificed and necropsied at 1 and 12 months of age and the major organs examined for pathology. Differences between alcohol and control groups were found for maternal weight gain, length of gestation, number of neonatal deaths, growth retardation of offspring to postnatal Day 72, date of eye opening, distance traversed on Day 15, contingent performance in the 1st week on continuous reinforcement, fixed ratio, and timing appetitive schedules, and on number of shock initiations and ability to discriminate contingencies on punishment schedules. No gross abnormalities were observed in the major organs at necropsy.

Alcohol Drinking↗
PubMed1984

Developmental toxicity following oral administration of a high-boiling coal liquid to pregnant rats.

Heavy distillate (HD), the highest-boiling coal liquid from the solvent-refined coal-II process (SRC-II), was administered by intragastric (IG) intubation to pregnant rats. Five dose levels of HD (0.09, 0.14, 0.18, 0.36 and 0.74 g kg-1), were given daily from 12 to 16 days of gestation and the rats were killed at 20 days of gestation. Maternal body weights and weights of the liver, kidneys, spleen, adrenals, thymus, ovaries and the gravid uterus were obtained. Gravid uteri were evaluated for prenatal mortality. Live fetuses were examined for malformations and weighed; fetal lungs were excised and weighed. Maternal (extragestational) weight gains and thymic weights diminished in all groups that received the SRC material. Adrenal weights were increased in all treated animals, except for those in the lowest-dose group (0.9 g kg-1). There was significant maternal mortality at 0.74 g kg-1 and increased intrauterine mortality at doses of 0.37 and 0.74 g kg-1. Placental weight was depressed, and the incidence of fetal anomalies was increased at 0.14 g kg-1 and all higher dose levels.

Animals↗
PubMed2002

Pheromonal discriminations of sex, reproductive condition, and species by the lacertid lizard Podarcis hispanica.

In some vertebrate taxa, pheromones provide important information about species, sex, reproductive condition, kinship, and even individual identity. Because they possess highly developed nasal chemosensory systems, lizards are capable of many chemical discriminations, but many aspects of their pheromonal communication remain poorly understood even in major families. We report that males of a lacertid lizard, Podarcis muralis, are capable of differential response to surface chemical cues from conspecific males and females, from gravid and nongravid females, and from conspecific females and females of the closely related sympatric congener, P. bocagei carbonelli. In 60 sec trials in which stimuli from the femoral, cloacal, lateral, and upper body surfaces were presented to males on cotton swabs, males tongue-flicked at significantly higher rates to stimuli from conspecific females than males, from conspecific nongravid than gravid females, and from conspecific than heterospecific females. Responses to stimuli from conspecific males did not differ from those to distilled water. Together with previous findings that males can distinguish between chemical cues from familiar and unfamiliar males, these findings suggest that pheromones provide male P. hispanica important information regarding the presence of sexual rivals and the reproductive condition of potential mates without visually encountering other lizards. A growing body of literature indicates that lacertids are capable of sophisticated pheromonal discriminations that may play important roles in their social behavior.

Animals↗
PubMed1975

Multienzymic nature of pyruvate kinase during development of Hymenolepis diminuta (Cestoda).

H. diminuta at different stages of development contained as many as five pyruvate kinase isozymes. Four of these were unusually sensitive to allosteric activation by fructose-1,6-P2. One isozyme which occurred only in adults or near-adults was insensitive but had a relatively low Km. All were inhibited by ATP and Ca2+, none by alanine, and the pH optimum was unaffected by fructose-1,6-P2. The five isozymes were present in gravid or reproductively active proglottids. Two of them occurred after eight days growth in the rat intestine, and three after four days. These three were also present in the immature, anterior proglottids of adult parasites. Hexacanth larvae from gravid proglottids, as well as cysticercoids developing from these larvae in Tenebrio molitor, possessed only two isozymes. It was inferred from information on tissue concentrations of ADP, ATP, phosphoenolypyruvate (PEP) and on K0.5S and Km that competition between pyruvate kinase and PEP carboxykinase is probably controlled by fructose-1,6-P2 concentrations. Since H. diminuta is an obligatory fermenter in which gluconeogenesis is minimal, the probable function of its L-type pyruvate kinases is to control the specific composition of lactic, acetic and succinic acid mixtures that are excreted at different stages of development.

Adenosine Diphosphate↗
PubMed1983

Evaluation of heart malformations in B6C3F1 mouse fetuses induced by in utero exposure to methyl chloride.

C57BL/6 female mice impregnated by C3H males mice to produce B6C3F1 fetuses were exposed daily for six hr to atmospheres containing 0, 250, 500, or 750 ppm methyl chloride, from gestation day 6 to gestation day 18. There were 74 to 77 females with copulation plugs per exposure concentration. Females exposed to 750 ppm ethyl chloride exhibited ataxia commencing on the seventh day of exposure (gestation day 12). They also showed hypersensitivity to touch or sound, tremors and convulsions. Six females in the 750 ppm group died and one was euthanized in extremis prior to scheduled sacrifice. On gestation day 18, all other females were euthanized for evaluation. Only dams exposed to 750 ppm exhibited significant decrease in body weight by gestation day 18, weight gain during the gestation period, and absolute weight gain (weight gain minus gravid uterine weight) versus controls. There were no treatment related-effects on these parameters in the other exposure groups. None of the groups exhibited exposure-related differences in pregnancy rate, gravid uterine weight, or maternal liver weight. There were no differences in the numbers of implantations, resorption, dead fetuses, nonlive (dead plus resorbed) fetuses, live fetuses, sex-ratio, or mean fetal body weight per litter. There was a significant exposure-related increase in the number and percentage of affected (nonlive plus malformed) fetuses per litter with the incidence of affected fetuses in the 750 ppm group significantly higher than controls. There was a statistically significant increase in the incidence of heart defects in the 500 and 750 ppm group relative to controls. Of the 37 fetuses in the study with heart defects, 23 were females, 14 were males. The heart defects observed included: absent or abnormal tricuspid valve, reduced number of papillary muscles and/or chordae tendineae on the right side, small right ventricle, globular heart, and white spots in the left ventricular wall. Multiple malformations were observed in one fetus from the 500 ppm group and in three fetuses in the 750 ppm group. It is concluded that methyl chloride inhalation exposure to pregnant C57BL/6 mice from gestation day 6 through gestation day 17 resulted in maternal toxicity only at the 750 ppm exposure concentration and was teratogenic to B6C3F1 conceptuses at exposure concentrations of 750 and 500 ppm, leading to fetal heart malformations. No evidence of embryo or fetotoxicity other than teratogenicity was seen at any of the exposure concentrations employed. No maternal, embryo or fetotoxicity or teratogenicity was associated with exposure of mice, during critical periods of embryo and fetal development, to 250 ppm of methyl chloride.

Abnormalities, Drug-Induced↗
PubMed1984

Novel accessory skull bone in fetal rats after exposure to aspirin.

Aspirin was administered by oral gavage to 25 gravid Sprague-Dawley rats on gestation day 10, as a single dose of 500 mg/kg, in a concentration of 50 mg/ml. The aspirin was suspended in a mixture of 0.5% w/v hydroxypropylmethylcellulose (Methocel E-4M) and 0.1% w/v polysorbate 80 (Tween 80). A control group of 25 gravid rats was given 10 ml/kg/day of the suspending vehicle alone, by oral gavage, on gestation days 6 through 15. C-sections were performed on gestation day 20. Approximately two-thirds of the fetuses were processed for skeletal examination with Alizarin Red S; the remaining fetuses were placed in Bouin's solution. Examination of the fetal skeletal specimens from the aspirin-treated group revealed a 20% fetal (43% litter) incidence of an accessory skull bone, located between the nasal and frontal bones. This structure ranged in size from a small, barely discernible, circular ossification site (less than 0.5 mm) to a relatively large, bilobate bone (approximately 2 mm). This anomaly has not been previously reported in fetal rats.

Abnormalities, Drug-Induced↗
PubMed1987

Secular rates and correlates for gastroschisis in California (1968-1977).

This study reports on an epidemiological investigation of gastroschisis using birth certificate data from California for the period of 1968-1977. Gastroschisis has been reported to be on the increase in a number of countries. The distribution of the 166 California gastroschisis cases reported during this time period indicated a clear upward secular trend (P less than .001) with the rate per 1,000 increasing from .006 in 1968 to .089 by 1977. This secular trend was observed in every maternal age group and for gravidity level 1. Gastroschisis also occurred more frequently among younger mothers (P less than .001) and low gravidity mothers (P less than .001). Omphalocele, another eventration defect, was also examined but did not display an upward secular trend.

Abdominal Muscles↗
PubMed1990

Developmental toxicity of orally administered 2',3'-dideoxycytidine in mice.

2',3'-Dideoxycytidine (DDC), a potent inhibitor of human immunodeficiency virus (HIV), is presently undergoing clinical trials as a promising anti-AIDS drug. Since there are very limited published animal toxicity data available, and nucleoside analogues are being considered for treatment of HIV-infected pregnant women, a study was conducted in mice to investigate the potential adverse developmental effects of this drug. DDC, suspended in 0.5% methyl cellulose, was administered via gavage twice per day during gestation days (gd) 6 through 15 to C57Bl/6N mice in a total dose of 0, 200, 400, 1,000, or 2,000 mg/kg/day. Maternal weight gain during the gestation and treatment period, as well as gravid uterine weight, decreased significantly in the 2,000 mg group, but weight gain, corrected for gravid uterine weight, was not affected by DDC. The percent resorptions per litter increased significantly in the highest dose group, and there were fewer live litters because of complete litter resorption in six dams. Among litters with live fetuses, the mean litter size was significantly reduced in the 2,000 mg group. Average fetal body weight per litter decreased significantly in the 1,000 and 2,000 mg groups. The number of fetuses with any malformation, the number of litters with one or more malformed fetuses and the percent of malformed fetuses per litter increased significantly in the 1,000 and 2,000 mg groups. There was an increase in malformations at 400 mg/kg/day; however, it was not statistically significant. In conclusion, DDC produced developmental toxicity (malformations, reduced fetal body weight, and resorptions) in the absence of overt maternal toxicity except for body weight changes due to resorptions and reduced fetal weights.

Animals↗
PubMed1992

Pregnancy outcomes after weekly oral administration of ethanol during gestation in the pig-tailed macaque: comparing early gestational exposure to full gestational exposure.

An oral dose of 1.8 g/kg ethanol given once per week throughout gestation to gravid pig-tailed macaques (Macaca nemestrina) has been established previously as teratogenic. This study was designed to use this nonhuman primate model to mimic a common problematic human circumstance in which women intermittently abuse alcohol into early pregnancy, realize that they are in fact pregnant, and then want to know the chance that the conceptus is harmed. In order to evaluate this situation, gravid macaques were assigned to one of four dosing cohorts. Animals were given the 1.8 gm/kg dose of ethanol once per week for the first 3, 6, or 24 weeks (full gestation) of pregnancy. Control animals received an isocaloric, isovolemic sucrose solution once per week for 24 weeks. The pregnancies were carefully monitored and the infants were comprehensively evaluated for the first 24 months of life. This paper describes the pregnancies while subsequent papers will describe the infants. Peak plasma ethanol levels ranged from 175 to 250 mg/dl. Weekly maternal exposure to this intoxicating dose of ethanol, starting early in pregnancy, did not influence risk of pregnancy failure during the first 30 days of gestation but appeared to be associated with an increased risk of abortion occurring between gestational days 30 and 160. Of the pregnancies that were successfully carried to full term, the potentially teratogenic dose of ethanol did not alter pregnancy outcome in any clinically significant way.

Abortion, Spontaneous↗
PubMed2002

Descriptive epidemiology of anal atresia in Hawaii, 1986-1999.

BACKGROUND: Anal atresia is one of the more common birth defects affecting the gastrointestinal tract. This study examined the relationship between anal atresia and selected demographic and clinical factors in Hawaii. METHODS: Data were obtained from a population-based birth defects registry and included all cases of anal atresia identified in Hawaii among 1986-1999 deliveries. RESULTS: There were 124 cases of anal atresia, resulting in a rate of 4.38 per 10,000 live births and fetal deaths (95% confidence interval (CI) 3.65-5.23). Cases consisted of 115 (92.7%) live births, 6 (4.8%) fetal deaths, and 3 (2.4%) elective terminations. Chromosomal abnormalities were reported for 10 (8.1%) of the cases, 7 of which were trisomy 21. Family history of anal atresia was reported for 3 (2.4%) of the cases. No secular trend in anal atresia rates was identified (p=0.617). Risk of anal atresia was highest for the 25-29-year maternal age group and lower among younger and older maternal age groups. Risk for anal atresia was lower for females (relative risk (RR) 0.69 95% CI 0.51-0.91) and higher for live births with a birth weight less than 3,000 grams (RR 2.75, 95% CI 2.08-3.56) or less than 38 weeks' gestation (RR 3.90, 95% CI 2.88-5.15) and for multiple births (RR 3.34, 95% CI 1.44-6.57). Anal atresia rates did not vary significantly by maternal race/ethnicity, residence at delivery, gravidity, or prenatal care. CONCLUSIONS: Anal atresia risk was associated with maternal age, infant/fetus sex, birth weight, gestational age, and plurality but not maternal race/ethnicity, residence at delivery, gravidity, or prenatal care. Except for maternal age, these findings are consistent with the literature.

Anus, Imperforate↗