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Renik-Jankowska W, Buczyńska A, Sidorkiewicz I, Kosiński P, Zbucka-Krętowska M. Exploring new perspectives on congenital diaphragmatic hernia: A comprehensive review. Biochim Biophys Acta Mol Basis Dis 2024; 1870:167105. [PMID: 38428682 DOI: 10.1016/j.bbadis.2024.167105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/22/2024] [Accepted: 02/22/2024] [Indexed: 03/03/2024]
Abstract
Congenital diaphragmatic hernia (CDH) represents a developmental anomaly that profoundly impacts the embryonic development of both the respiratory and cardiovascular systems. Understanding the influences of developmental defects, their origins, and clinical consequences is of paramount importance for further research and the advancement of therapeutic strategies for this condition. In recent years, groundbreaking studies in the fields of metabolomics and genomics have significantly expanded our knowledge regarding the pathogenic mechanisms of CDH. These investigations introduce novel diagnostic and therapeutic avenues. CDH implies a scarcity of available information within this domain. Consequently, a comprehensive literature review has been undertaken to synthesize existing data, providing invaluable insights into this rare disease. Improved comprehension of the molecular underpinnings of CDH has the potential to refine diagnostic precision and therapeutic interventions, thus potentially enhancing clinical outcomes for CDH patients. The identification of potential biomarkers assumes paramount significance for early disease detection and risk assessment in CDH, facilitating prompt recognition and the implementation of appropriate interventions. The process of translating research findings into clinical practice is significantly facilitated by an exhaustive literature review. It serves as a pivotal step, enabling the integration of novel, more effective diagnostic and therapeutic modalities into the management of CDH patients.
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Affiliation(s)
- Weronika Renik-Jankowska
- Department of Gynecological Endocrinology and Adolescent Gynecology, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland.
| | - Angelika Buczyńska
- Clinical Research Centre, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland.
| | - Iwona Sidorkiewicz
- Clinical Research Support Centre, Medical University of Bialystok, ul. M. Skłodowskiej-Curie 24a, 15-276 Bialystok, Poland.
| | - Przemysław Kosiński
- Department of Obstetrics, Perinatology, and Gynecology, Medical University of Warsaw, Żwirki i Wigury 63A, 02-091 Warszawa, Poland.
| | - Monika Zbucka-Krętowska
- Department of Gynecological Endocrinology and Adolescent Gynecology, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland
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Buczyńska A, Sidorkiewicz I, Niemira M, Krętowski AJ, Węgrzyn P, Kosiński P, Zbucka-Krętowska M. Identification of MicroRNA Profiles in Fetal Spina Bifida: The Role in Pathomechanism and Diagnostic Significance. Int J Mol Sci 2024; 25:2896. [PMID: 38474143 DOI: 10.3390/ijms25052896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/16/2024] [Accepted: 02/27/2024] [Indexed: 03/14/2024] Open
Abstract
Distinct miRNA expression patterns may reflect anomalies related to fetal congenital malformations such as spinal bifida (SB). The aim of this preliminary study was to determine the maternal miRNA expression profile of women carrying fetuses with SB. Therefore, six women carrying fetuses with SB and twenty women with euploid healthy fetuses were enrolled in this study. Using NanoString technology, we evaluated the expression level of 798 miRNAs in both plasma and amniotic fluid samples. A downregulation of miR-1253, miR-1290, miR-194-5p, miR-302d-3p, miR-3144-3p, miR-4536-5p, miR-548aa + miR-548t-3p, miR-548ar-5p, miR-548n, miR-590-5p, miR-612, miR-627-5p, miR-644a, and miR-122-5p, and an upregulation of miR-320e, let-7b-5p, miR-23a-3p, miR-873-3p, and miR-30d-5p were identified in maternal amniotic fluid samples in SB when compared to the control group. The target genes of these miRNAs play a predominant role in regulating the synthesis of several biological compounds related to signaling pathways such as those regulating the pluripotency of stem cells. Moreover, the maternal plasma expression of miR-320e was increased in pregnancies with SB, and this marker could serve as a valuable non-invasive screening tool. Our results highlight the SB-specific miRNA signature and the differentially expressed miRNAs that may be involved in SB pathogenesis. Our findings emphasize the role of miRNA as a predictive factor that could potentially be useful in prenatal genetic screening for SB.
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Affiliation(s)
- Angelika Buczyńska
- Clinical Research Centre, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Iwona Sidorkiewicz
- Clinical Research Support Centre, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Magdalena Niemira
- Clinical Research Centre, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Adam Jacek Krętowski
- Clinical Research Centre, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland
- Department of Endocrinology, Diabetology and Internal Medicine, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland
| | - Piotr Węgrzyn
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, 63A Zwirki i Wigury, 02-091 Warsaw, Poland
| | - Przemysław Kosiński
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, 63A Zwirki i Wigury, 02-091 Warsaw, Poland
| | - Monika Zbucka-Krętowska
- Department of Gynecological Endocrinology and Adolescent Gynecology, Medical University of Bialystok, M. Sklodowskiej-Curie 24a, 15-276 Bialystok, Poland
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Kuchnowska D, Luterek K, Węgrzyn P, Kosiński P. Review of the Evaluation of Pulmonary Hypoplasia as an Important Determinant of Clinical Outcomes in Infants with Congenital Diaphragmatic Hernia. Med Sci Monit 2024; 30:e943259. [PMID: 38419323 PMCID: PMC10913292 DOI: 10.12659/msm.943259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 12/29/2023] [Indexed: 03/02/2024] Open
Abstract
Pulmonary hypoplasia is one of main causes of neonatal mortality and morbidity in patients with congenital diaphragmatic hernia. With most cases diagnosed prenatally, the emphasis is put on prediction of the severity of this defect. Several attempts are made to reduce the mortality and provide optimal prenatal and postnatal care. Appropriate estimation of risk of pulmonary hypoplasia also provides an important inclusion criterion for prenatal intervention. The main tool used for the detection and prediction of pulmonary hypoplasia is ultrasound, with an increasing number of available formulas to estimate the risk of occurrence of this phenomenon and complication associated with it. For most of the formulas used in this measurement method, the main limitations are either gestational-age dependency or limited research. Other imaging methods used to assess the risk of pulmonary hypoplasia involve magnetic resonance imaging and vascular assessment of affected lungs. The limitation in these remains the limited accessibility. Currently, the most widely used indexes are observed-to-expected lungs-to-head ratio and presence of liver herniation. These are the 2 most commonly used measurement methods, as they are the basis for patient qualification for fetoscopic endoluminal tracheal occlusion. This article aims to review the evaluation of pulmonary hypoplasia or hypoplastic lung disease as an important determinant of clinical outcomes in infants with congenital diaphragmatic hernia. In this review, we emphasize the importance of early prenatal diagnosis of congenital diaphragmatic hernia and present a summary of different methods of prenatal risk assessment of lung hypoplasia in congenital diaphragmatic hernia.
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Niemyjska-Dmoch W, Kosiński P, Węgrzyn P, Luterek K, Jezela-Stanek A. Intrahepatic cholestasis of pregnancy and theory of inheritance of the disease. Literature review. J Matern Fetal Neonatal Med 2023; 36:2279020. [PMID: 37945319 DOI: 10.1080/14767058.2023.2279020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
Intrahepatic cholestasis during pregnancy is associated with a higher risk of prenatal and maternal complications. There are several new publications and guidelines on the detection and thresholds of intrahepatic cholestasis during pregnancy. However, the genetic background of this disease has rarely been investigated. This is a comprehensive review of the roles of genes in intrahepatic cholestasis during pregnancy.
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Affiliation(s)
- Weronika Niemyjska-Dmoch
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Przemysław Kosiński
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Piotr Węgrzyn
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Katarzyna Luterek
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Jezela-Stanek
- Department of Genetics and Clinical Immunology, National Institute of Tuberculosis and Lung Diseases, Warsaw, Poland
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Mazanowska N, Jarmużek-Orska P, Pietrzak B, Pazik J, Jabiry-Zieniewicz Z, Kosiński P. First-Trimester Biochemical Serum Markers in Female Kidney Transplant Recipients-The Impact of Graft Function. Int J Environ Res Public Health 2022; 19:16352. [PMID: 36498421 PMCID: PMC9740865 DOI: 10.3390/ijerph192316352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Revised: 11/27/2022] [Accepted: 12/02/2022] [Indexed: 06/17/2023]
Abstract
Data on serum biochemistry markers as a component of the first-trimester screening test in pregnant kidney graft recipients are limited. In the absence of a separate validated algorithm, biochemical testing is commonly used in the first-trimester screening in kidney transplant recipients. Therefore, the study aimed to analyze first-trimester serum biochemical markers and the first trimester combined screening results in pregnant kidney graft recipients. A retrospective study was carried out in pregnant women who underwent the first-trimester combined screening test performed per the Fetal Medicine Foundation (FMF) protocol in 2009−2020. The study group included 27 pregnancies in kidney graft transplant recipients, and the control group was 110 patients with normal kidney function, matched according to age, body mass index (BMI), and gestational age. The biochemical serum markers (free beta-human chorionic gonadotropin [beta-hCG] and pregnancy-associated plasma protein A [PAPP-A]) were evaluated using the FMF-approved Roche Elecsys® assay and exhibited as multiples of the median (MoM) values. Data on first-trimester screening test results, perinatal outcomes, and graft function (assessed using serum creatinine concentrations) were analyzed. The analysis of first-trimester screening parameters revealed no difference in nuchal translucency (NT) measurements and uterine artery flow. However, free beta-hCG MoM and PAPP-A values were higher in posttransplant pregnancies than in controls: 3.47 ± 2.08 vs. 1.38 ± 0.85 (p = 0.035) and 1.46 ± 0.81 vs. 0.98 ± 0.57 (p = 0.007), respectively. The false positive rate of trisomy 21 (T21) screening in graft recipients was 25.9% vs. 3% in the controls. The free β-hCG MoM values positively correlated with serum creatinine levels before (r = 0.653; p < 0.001), during (r = 0.619; p = 0.001), and after pregnancy (r = 0.697; p < 0.001). There was a statistically significant negative correlation for PAPP-A MoM values for postpartum serum creatinine concentration (r = −0.424, p = 0.035). Our results show significantly higher serum concentrations of free beta-hCG and PAPP-A in posttransplant pregnancies than in healthy controls, confirmed when exhibited as MoM values and their association with graft function was assessed by serum creatinine concentration. Taking those changes into account would reduce the high number of false positive test results in this group. The validated first-trimester screening algorithm that considers altered kidney function in pregnant kidney graft recipients remains to be developed.
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Affiliation(s)
- Natalia Mazanowska
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, pl. Starynkiewicza 1/3, 02-015 Warszawa, Poland
| | - Patrycja Jarmużek-Orska
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, pl. Starynkiewicza 1/3, 02-015 Warszawa, Poland
| | - Bronisława Pietrzak
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, pl. Starynkiewicza 1/3, 02-015 Warszawa, Poland
| | - Joanna Pazik
- Department of Transplantation Medicine and Nephrology, Medical University of Warsaw, 02-015 Warszawa, Poland
| | - Zoulikha Jabiry-Zieniewicz
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, pl. Starynkiewicza 1/3, 02-015 Warszawa, Poland
| | - Przemysław Kosiński
- Department of Obstetrics, Perinatology and Gynecology, Medical University of Warsaw, 02-091 Warszawa, Poland
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Van Calster B, Benachi A, Nicolaides KH, Gratacos E, Berg C, Persico N, Gardener GJ, Belfort M, Ville Y, Ryan G, Johnson A, Sago H, Kosiński P, Bagolan P, Van Mieghem T, DeKoninck PLJ, Russo FM, Hooper SB, Deprest JA. The randomized Tracheal Occlusion To Accelerate Lung growth (TOTAL)-trials on fetal surgery for congenital diaphragmatic hernia: reanalysis using pooled data. Am J Obstet Gynecol 2022; 226:560.e1-560.e24. [PMID: 34808130 DOI: 10.1016/j.ajog.2021.11.1351] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 11/15/2021] [Accepted: 11/15/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Two randomized controlled trials compared the neonatal and infant outcomes after fetoscopic endoluminal tracheal occlusion with expectant prenatal management in fetuses with severe and moderate isolated congenital diaphragmatic hernia, respectively. Fetoscopic endoluminal tracheal occlusion was carried out at 27+0 to 29+6 weeks' gestation (referred to as "early") for severe and at 30+0 to 31+6 weeks ("late") for moderate hypoplasia. The reported absolute increase in the survival to discharge was 13% (95% confidence interval, -1 to 28; P=.059) and 25% (95% confidence interval, 6-46; P=.0091) for moderate and severe hypoplasia. OBJECTIVE Data from the 2 trials were pooled to study the heterogeneity of the treatment effect by observed over expected lung-to-head ratio and explore the effect of gestational age at balloon insertion. STUDY DESIGN Individual participant data from the 2 trials were reanalyzed. Women were assessed between 2008 and 2020 at 14 experienced fetoscopic endoluminal tracheal occlusion centers and were randomized in a 1:1 ratio to either expectant management or fetoscopic endoluminal tracheal occlusion. All received standardized postnatal management. The combined data involved 287 patients (196 with moderate hypoplasia and 91 with severe hypoplasia). The primary endpoint was survival to discharge from the neonatal intensive care unit. The secondary endpoints were survival to 6 months of age, survival to 6 months without oxygen supplementation, and gestational age at live birth. Penalized regression was used with the following covariates: intervention (fetoscopic endoluminal tracheal occlusion vs expectant), early balloon insertion (yes vs no), observed over expected lung-to-head ratio, liver herniation (yes vs no), and trial (severe vs moderate). The interaction between intervention and the observed over expected lung-to-head ratio was evaluated to study treatment effect heterogeneity. RESULTS For survival to discharge, the adjusted odds ratio of fetoscopic endoluminal tracheal occlusion was 1.78 (95% confidence interval, 1.05-3.01; P=.031). The additional effect of early balloon insertion was highly uncertain (adjusted odds ratio, 1.53; 95% confidence interval, 0.60-3.91; P=.370). When combining these 2 effects, the adjusted odds ratio of fetoscopic endoluminal tracheal occlusion with early balloon insertion was 2.73 (95% confidence interval, 1.15-6.49). The results for survival to 6 months and survival to 6 months without oxygen dependence were comparable. The gestational age at delivery was on average 1.7 weeks earlier (95% confidence interval, 1.1-2.3) following fetoscopic endoluminal tracheal occlusion with late insertion and 3.2 weeks earlier (95% confidence interval, 2.3-4.1) following fetoscopic endoluminal tracheal occlusion with early insertion compared with expectant management. There was no evidence that the effect of fetoscopic endoluminal tracheal occlusion depended on the observed over expected lung-to-head ratio for any of the endpoints. CONCLUSION This analysis suggests that fetoscopic endoluminal tracheal occlusion increases survival for both moderate and severe lung hypoplasia. The difference between the results for the Tracheal Occlusion To Accelerate Lung growth trials, when considered apart, may be because of the difference in the time point of balloon insertion. However, the effect of the time point of balloon insertion could not be robustly assessed because of a small sample size and the confounding effect of disease severity. Fetoscopic endoluminal tracheal occlusion with early balloon insertion in particular strongly increases the risk for preterm delivery.
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Affiliation(s)
- Ben Van Calster
- Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium; Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands; EPI-center, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Alexandra Benachi
- Department of Obstetrics and Gynaecology of the Hospital Antoine Béclère, Université Paris Saclay, Clamart, France
| | | | | | | | - Nicola Persico
- Hospital Maggiore Policlinico IRCCS, University of Milan, Milan, Italy
| | | | - Michael Belfort
- Texas Children's Hospital, Baylor College of Medicine Houston, TX
| | | | - Greg Ryan
- Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | | | - Haruhiko Sago
- National Center for Child Health and Development, Tokyo, Japan
| | - Przemysław Kosiński
- First Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Pietro Bagolan
- Medical and Surgical Department of the Fetus-Newborn-Infant, Bambino Gesù Children's Hospital, Research Institute, Rome, Italy
| | - Tim Van Mieghem
- Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium; Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Philip L J DeKoninck
- Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium; Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Francesca M Russo
- Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium; Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium
| | - Stuart B Hooper
- The Ritchie Centre, Hudson Institute for Medical Research, Department of Obstetrics and Gynaecology, Monash University, Melbourne, Australia
| | - Jan A Deprest
- Department of Development and Regeneration, Cluster Woman and Child, KU Leuven, Leuven, Belgium; Clinical Department of Obstetrics and Gynaecology, University Hospitals Leuven, Leuven, Belgium; Institute for Women's Health, University College London Hospital, London, United Kingdom.
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Lipa M, Goławski K, Kosiński P, Wielgoś M, Bomba-Opoń D. Placenta praevia - does it really affect intrauterine fetal growth? J Matern Fetal Neonatal Med 2020; 35:3898-3902. [PMID: 33183106 DOI: 10.1080/14767058.2020.1843152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
PURPOSE Placenta praevia affects about 0.5% of pregnancies and due to constant increase in operative deliveries may become an important, clinical challenge throughout the next decades. Location of the placental plate within lower uterine segment is associated with increased risk of adverse perinatal outcomes. There were several reports pointing increased risk of small-for-gestational-age (SGA)/fetal growth restriction (FGR) in patients affected with abnormal location of the placenta. On the other hand, some studies ended up with opposite conclusions. MATERIALS AND METHODS Due to ambiguous results we have undertaken a case-control study to investigate intrauterine growth among this group. We ran a pilot study to precisely define maternal, obstetrical and neonatal characteristics in order to avoid cofounders. Our study incorporated 56 patients in singleton pregnancies affected with placenta praevia and 124 patients in the control group (between 35 and 37 weeks of gestation). RESULTS Nonetheless, there were no statistical differences in the birthweight between the study and control group (2882.5 g vs. 2805 g, p = ns). Moreover, rates of the newborns with birthweight corresponding <10th percentile and >90th did not differ significantly. Even further analysis that included parity did not reveal any differences between both groups. CONCLUSION Placenta praevia does not affect the intrauterine growth and shall not be considered as a risk factor for SGA/FGR. In patients affected with abnormal location of the placenta additional scans for fetal well-being assessment are not indicated.
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Affiliation(s)
- Michał Lipa
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Ksawery Goławski
- 1st Department of Obstetrics and Gynecology, Students' Scientific Group, Medical University of Warsaw, Warsaw, Poland
| | - Przemysław Kosiński
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Mirosław Wielgoś
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
| | - Dorota Bomba-Opoń
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Warsaw, Poland
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Pappaccogli M, Prejbisz A, Ciurică S, Bruno RM, Aniszczuk-Hybiak A, Bracalente I, De Backer T, Debiève F, Delmotte P, Di Monaco S, Jarraya F, Gordin D, Kosiński P, Kroon AA, Maas AHEM, Marcon D, Minuz P, Montagud-Marrahi E, Pasquet A, Poch E, Rabbia F, Stergiou GS, Tikkanen I, Toubiana L, Vinck W, Warchoł-Celińska E, Van der Niepen P, de Leeuw P, Januszewicz A, Persu A. Pregnancy-Related Complications in Patients With Fibromuscular Dysplasia: A Report From the European/International Fibromuscular Dysplasia Registry. Hypertension 2020; 76:545-553. [PMID: 32639884 DOI: 10.1161/hypertensionaha.120.15349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Current literature suggests a higher risk of pregnancy-related complications in patients with renal fibromuscular dysplasia (FMD). The aim of our study was to assess the nature and prevalence of pregnancy-related complications in patients subsequently diagnosed with FMD. A call for participation was sent to centers contributing to the European/International FMD Registry. Patients with at least 1 pregnancy were included. Data on pregnancy were collected through medical files and FMD characteristics through the European/International FMD Registry. Data from 534 pregnancies were obtained in 237 patients. Despite the fact that, in 96% of cases, FMD was not diagnosed before pregnancy, 40% of women (n=93) experienced pregnancy-related complications, mostly gestational hypertension (25%) and preterm birth (20%), while preeclampsia was reported in only 7.5%. Only 1 patient experienced arterial dissection and another patient an aneurysm rupture. When compared with patients without pregnancy-related complications, patients with complicated pregnancies were younger at FMD diagnosis (43 versus 51 years old; P<0.001) and had a lower prevalence of cerebrovascular FMD (30% versus 52%; P=0.003) but underwent more often renal revascularization (63% versus 40%, P<0.001). In conclusion, the prevalence of pregnancy-related complications such as gestational hypertension and preterm birth was high in patients with FMD, probably related to the severity of renal FMD. However, the prevalence of preeclampsia and arterial complications was low/moderate. These findings emphasize the need to screen hypertensive women for FMD to ensure revascularization before pregnancy if indicated and appropriate follow-up during pregnancy, without discouraging patients with FMD from considering pregnancy.
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Affiliation(s)
- Marco Pappaccogli
- From the Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Italy (M.P., S.D.M., F.R.).,Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (M.P., S.D.M., A. Pasquet, A. Persu).,Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (M.P., S.D.M., A. Pasquet, A. Persu)
| | - Aleksander Prejbisz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland (A. Prejbisz, A.A.-H., E.W.-C., A.J.)
| | - Simina Ciurică
- Cardiology Department, Marie Curie Civil Hospital, CHU Charleroi, Lodelinsart, Belgium (S.C.)
| | - Rosa Maria Bruno
- Department of Clinical and Experimental Medicine University of Pisa, Italy (R.M.B., I.B.).,INSERM U970 Team 7, Paris Cardiovascular Research Centre - PARCC & Université de Paris, Paris, France (R.M.B.)
| | - Anna Aniszczuk-Hybiak
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland (A. Prejbisz, A.A.-H., E.W.-C., A.J.)
| | - Irene Bracalente
- Department of Clinical and Experimental Medicine University of Pisa, Italy (R.M.B., I.B.)
| | - Tine De Backer
- Department of Cardiovascular Diseases, University Hospital Ghent, Belgium (T.D.B.)
| | - Frédéric Debiève
- Obstetrics Department, Cliniques Universitaires Saint-Luc, Brussels, Belgium (F.D.)
| | | | - Silvia Di Monaco
- From the Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Italy (M.P., S.D.M., F.R.).,Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (M.P., S.D.M., A. Pasquet, A. Persu).,Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (M.P., S.D.M., A. Pasquet, A. Persu)
| | - Faiçal Jarraya
- Service de Néphrologie, CHU Hédi Chaker, Sfax, Tunisie/Unité de Recherche 12ES14 Pathologie rénale, Faculté de medicine, Sfax (F.J.)
| | - Daniel Gordin
- Helsinki Hypertension Centre of Excellence (D.G., I.T.), University of Helsinki, Helsinki University Hospital, Finland.,Abdominal Center Nephrology (D.G., I.T.), University of Helsinki, Helsinki University Hospital, Finland.,Folkhälsan Institute of Genetics, Folkhälsan Research Center, Biomedicum Helsinki, Finland (D.G.)
| | - Przemysław Kosiński
- Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland (P.K.)
| | - Abraham A Kroon
- Department of Internal Medicine, Division of General Internal Medicine, Section Vascular Medicine (A.A.K., P.d.L.), Maastricht University Medical Centre, Maastricht University, the Netherlands.,CARIM School for Cardiovascular Diseases (A.A.K., P.d.L.), Maastricht University Medical Centre, Maastricht University, the Netherlands
| | - Angela H E M Maas
- Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands (A.H.E.M.M.)
| | - Denise Marcon
- Department of Medicine, Unit of General Medicine and Hypertension, University of Verona, Italy (D.M., P.M.)
| | - Pietro Minuz
- Department of Medicine, Unit of General Medicine and Hypertension, University of Verona, Italy (D.M., P.M.)
| | | | - Agnès Pasquet
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (M.P., S.D.M., A. Pasquet, A. Persu).,Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (M.P., S.D.M., A. Pasquet, A. Persu)
| | - Esteban Poch
- Service de Cardiologie, CHU Ambroise Paré, Mons, Belgium (P.D.)
| | - Franco Rabbia
- From the Division of Internal Medicine and Hypertension Unit, Department of Medical Sciences, University of Turin, Italy (M.P., S.D.M., F.R.)
| | - George S Stergiou
- Hypertension Center STRIDE-7, School of Medicine, Third Department of Medicine, Sotiria Hospital, National and Kapodistrian University of Athens, Greece (G.S.S.)
| | - Ilkka Tikkanen
- Helsinki Hypertension Centre of Excellence (D.G., I.T.), University of Helsinki, Helsinki University Hospital, Finland.,Abdominal Center Nephrology (D.G., I.T.), University of Helsinki, Helsinki University Hospital, Finland.,Minerva Institute for Medical Research, Helsinki, Finland (I.T.)
| | - Laurent Toubiana
- Sorbonne Université, Université Paris 13, Sorbonne Paris Cité, INSERM, UMR_S1142, LIMICS, IRSAN, France (L.T.)
| | - Wouter Vinck
- Endocrinology Department, Saint-Augustinus Hospital, Wilrijk, Belgium (W.V.)
| | - Ewa Warchoł-Celińska
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland (A. Prejbisz, A.A.-H., E.W.-C., A.J.)
| | - Patricia Van der Niepen
- Department of Nephrology and Hypertension, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Belgium (P.V.d.N.)
| | - Peter de Leeuw
- Department of Internal Medicine, Division of General Internal Medicine, Section Vascular Medicine (A.A.K., P.d.L.), Maastricht University Medical Centre, Maastricht University, the Netherlands.,CARIM School for Cardiovascular Diseases (A.A.K., P.d.L.), Maastricht University Medical Centre, Maastricht University, the Netherlands
| | - Andrzej Januszewicz
- Department of Hypertension, National Institute of Cardiology, Warsaw, Poland (A. Prejbisz, A.A.-H., E.W.-C., A.J.)
| | - Alexandre Persu
- Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (M.P., S.D.M., A. Pasquet, A. Persu).,Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (M.P., S.D.M., A. Pasquet, A. Persu)
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Kosinska-Kaczynska K, Dabrowski FA, Mazanowska N, Kosiński P, Skórka A, Kostrzewa G, Michalak E, Górnicka B, Płaza O, Zgliczynska M, Wielgos M. Post-zygotic diploidization of triploidy in human is possible? - a case of triploid partial molar pregnancy resulting in a premature live-born diploid female infant. Neuro Endocrinol Lett 2019; 40:227-232. [PMID: 32112547] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 10/12/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE During the treatment of our patient we found that reports covering possible complications and their treatment are very scarce. Due to advancement in ultrasound diagnosis most of molar pregnancies are terminated in first trimester of pregnancy. There is the gap in knowledge concerning pregnancy complications in case of partial mole discovered in advanced pregnancy. This is why we incorporated extensive and up-to-date review of literature in our manuscript. METHOD We described a case of previously healthy, 25 year old primigravida who delivered live daughter at 27 weeks of gestation, complicated with unusual ultrasound appearance of the placenta, severe hypotrophy, and subsequent post-partum eclampsia. RESULTS Healthy diploid female infant, now two years old and healthy mother taking care of her. CONCLUSIONS In clinical practice early diagnosis of this complication usually lead to pregnancy termination. In modern medicine, decisions should be based on evidence and patient-doctor mutual understanding. Termination of pregnancy with suspicion of molar placenta can be specially difficult in gestation in older nulliparous women or after ART. We sincerely hope that this report will be useful for physicians across the world in counseling and treating their patients.
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Affiliation(s)
| | - Filip A Dabrowski
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
| | - Natalia Mazanowska
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
| | - Przemysław Kosiński
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
| | - Agata Skórka
- Department of Pediatrics, Medical University of Warsaw; Department of Medical Genetics, The Children's Memorial Health Institute, Poland
| | - Grażyna Kostrzewa
- Department of Forensic Medicine, Medical University of Warsaw, Poland
| | - Elżbieta Michalak
- Department of Pathology, Institute of Mother and Child, Warsaw, Poland
| | - Barbara Górnicka
- Department of Pathology, Medical University of Warsaw, Warsaw, Poland
| | - Olga Płaza
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Magdalena Zgliczynska
- Students Scientific Association at the 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Mirosław Wielgos
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, , Poland
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Prejbisz A, Dobrowolski P, Kosiński P, Bomba-Opoń D, Adamczak M, Bekiesińska-Figatowska M, Kądziela J, Konopka A, Kostka-Jeziorny K, Kurnatowska I, Leszczyńska-Gorzelak B, Litwin M, Olszanecka A, Orczykowski M, Poniedziałek-Czajkowska E, Sobieszczańska-Małek M, Stolarz-Skrzypek K, Szczepaniak-Chicheł L, Szyndler A, Wolf J, Wielgoś M, Hoffman P, Januszewicz A. Management of hypertension in pregnancy — prevention, diagnosis, treatment and long-term prognosis. A position statement of the Polish Society of Hypertension, Polish Cardiac Society and Polish Society of Gynaecologists and Obstetricians. Arterial Hypertension 2019. [DOI: 10.5603/ah.a2019.0011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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11
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Prejbisz A, Dobrowolski P, Kosiński P, Bomba-Opoń D, Adamczak M, Bekiesińska-Figatowska M, Kądziela J, Konopka A, Kostka-Jeziorny K, Kurnatowska I, Leszczyńska-Gorzelak B, Litwin M, Olszanecka A, Orczykowski M, Poniedziałek-Czajkowska E, Sobieszczańska-Małek M, Stolarz-Skrzypek K, Szczepaniak-Chicheł L, Szyndler A, Wolf J, Wielgoś M, Hoffman P, Januszewicz A. Management of hypertension in pregnancy: prevention, diagnosis, treatment and long‑term prognosis. Kardiol Pol 2019; 77:757-806. [DOI: 10.33963/kp.14904] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Korniluk A, Kosiński P, Wielgoś M. Intraoperative damage to the urinary bladder during cesarean section - literature review. Ginekol Pol 2018; 88:161-165. [PMID: 28397207 DOI: 10.5603/gp.a2017.0031] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2017] [Accepted: 02/20/2017] [Indexed: 11/25/2022] Open
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Dobrowolski P, Januszewicz M, Klisiewicz A, Prejbisz A, Warchoł-Celińska E, Michałowska I, Florczak E, Kożuch K, Hanus K, Aniszczuk-Hybiak A, Witowicz H, Witkowski A, Kądziela J, Kabat M, Madej K, Nazarewski S, Tykarski A, Stryczyński Ł, Szczerbo-Trojanowska M, Światłowski Ł, Kosiński P, Widecka K, Januszewicz A, Hoffman P. Echocardiographic assessment of left ventricular morphology and function in patients with fibromuscular dysplasia. J Hypertens 2018. [DOI: 10.1097/hjh.0000000000001706] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Kosiński P, Wielgoś M. Congenital diaphragmatic hernia: pathogenesis, prenatal diagnosis and management — literature review. Ginekol Pol 2017; 88:24-30. [DOI: 10.5603/gp.a2017.0005] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2016] [Accepted: 12/06/2016] [Indexed: 11/25/2022] Open
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Kosiński P, Luterek K, Wielgoś M. Diaphragmatic hernia as an early ultrasound manifestation of Apert syndrome. Ginekol Pol 2016; 87:830. [DOI: 10.5603/gp.2016.0097] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 10/25/2016] [Indexed: 11/25/2022] Open
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Kosiński P, Bomba-Opoń DA, Wielgoś M. First trimester erythropoietin (EPO) serum concentration as a potential marker for abnormal placentation disorders. Reference values for erythropoietin (EPO) concentration at 11-13⁺⁶ weeks of gestation. J Perinat Med 2016; 44:187-93. [PMID: 25938218 DOI: 10.1515/jpm-2015-0079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2015] [Accepted: 03/20/2015] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To investigate the possible effect of abnormal placentation disorders such as preeclampsia (PE), pregnancy induced hypertension (PIH) and intrauterine growth restriction (IUGR) on erythropoietin (EPO) serum concentration in women in the first trimester of pregnancy. MATERIAL AND METHODS A prospective study was performed in a group of pregnant women between 11 and 13⁺⁶ weeks' gestation. Serum concentration of EPO, beta HCG, PAPP-A and PlGF was measured. Mean arterial pressure (MAP) and uterine artery pulsatility index was calculated. RESULTS A group of 198 analyzed patients was divided into three groups depending on pregnancy outcome: abnormal placentation group (n=30), macrosomia (n=13) and control group (n=155). EPO concentrations between the three groups of patients revealed that they differ significantly (F=15.172, P<0.001). EPO concentration is significantly higher in abnormal placentation patients compared to the control group (P<0.001) and macrosomia group (P=0.004). The most significant increase in EPO concentration was detected within patients with PIH. Also the uterine artery pulsatility index was positively correlated with EPO concentration (P<0.01). CONCLUSIONS First-trimester maternal EPO concentration might be considered as a possible marker of abnormal placentation disorders and should be given more attention in future prospective studies.
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Wielgoś M, Kosiński P. Procedura FETO - List do Redakcji. Ginekol Pol 2014. [DOI: 10.17772/gp/556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kosiński P, Kozłowski S, Lipa M, Wielgoś M, Bomba-Opoń D, Kaczyński B, Zbucka-Krętowska M, Ławicki S, Szmitkowski M, Wołczyński S, Samaha R. Reference values for placental growth factor (PlGF) concentration and uterine artery Doppler pulsatility index (PI) at 11–13+6 weeks of gestation in the Polish population. Ginekol Pol 2014; 85:488-93. [DOI: 10.17772/gp/1758] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Kosiński P, Bomba-Opoń D, Biskupski Samaha RB, Wielgoś M. Suitable application of selected biochemical and biophysical markers during the first trimester screening. Neuro Endocrinol Lett 2014; 35:440-444. [PMID: 25433851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 10/05/2014] [Indexed: 06/04/2023]
Abstract
Normal trophoblast growth is one of the more important stages of early pregnancy that has a deciding factor on its later development and normal outcome. Identifying pregnant women who have a high risk of complications connected to hypertension during pregnancy is currently one of the most important tasks of perinatal medicine. Abnormal placentation is related not only to the appearance of preeclampsia, but also to many other complications, such as premature placental abruption, intrauterine fetal demise, and intrauterine growth restriction. Preeclampsia and eclampsia are one of the major causes of maternal morbidity and mortality and appear in about 5% of all pregnancies. Clinical symptoms are a far-removed consequence of abnormal placentation. When they become visible, it is definitely too late for preventive action, and there is essentially no effective treatment. New research data suggests that a chance of prophylactic intervention might exist as early as in the first trimester of the pregnancy. One of the clinically documented possibilities is to apply low doses of acetylsalicylic acid before the 16th week of gestation. Despite the great importance of the placenta in the physiology of pregnancy, not much attention has been paid to the way it functions. This paper reviews selected biochemical and biophysical markers which are, or could be, used in clinical practice in the future.
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Affiliation(s)
- Przemysław Kosiński
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | - Dorota Bomba-Opoń
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
| | | | - Mirosław Wielgoś
- 1st Department of Obstetrics and Gynecology, Medical University of Warsaw, Poland
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Giebułtowicz J, Wroczyński P, Kosiński P, Pietrzak B. The activity of salivary aldehyde dehydrogenase during the menstrual cycle and pregnancy. Arch Oral Biol 2012; 58:261-5. [PMID: 23245858 DOI: 10.1016/j.archoralbio.2012.11.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2011] [Revised: 10/21/2012] [Accepted: 11/13/2012] [Indexed: 01/16/2023]
Abstract
OBJECTIVE The aim of the present study was to describe the changes in the activity of ALDH3A1 in saliva in relation to the menstrual cycle and pregnancy. We also measured major salivary antioxidants, salivary peroxidase (SPO) activity and uric acid (UA) concentration. DESIGN Fasting saliva samples were collected from 63 women with uncomplicated pregnancies and from 39 healthy women of reproductive age, but not pregnant. Saliva samples were also collected from 10 healthy women with regular menstrual cycles in the early follicular, the mid-cycle and the mid-luteal phase during one menstrual cycle. SPO and ALDH3A1 activity was determined fluorimetrically, whereas UA concentration photometrically. RESULTS The ALDH3A1 did not vary significantly among phases of menstrual cycle. However, the enzyme activity decreased with the length of pregnancy and in the third trimester is significantly lower than that in the saliva of non-pregnant women. CONCLUSIONS Lower concentration of UA and in the third trimester the activity of ALDH3A1 in saliva of pregnant women could be a risk factor of, e.g. oral pathologies.
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Affiliation(s)
- Joanna Giebułtowicz
- Department of Bioanalysis and Drugs Analysis, Faculty of Pharmacy, Medical University of Warsaw, 1 Banacha Street, PL-02097 Warsaw, Poland.
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Kosiński P, Bomba-Opoń DA, Szymusik I, Mazanowska N, Kamiński P, Zieniewicz Z, Wielgoś M. Pregnancy in patients with cancer. Ginekol Pol 2011; 82:546-549. [PMID: 21913435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
We analyzed 12 cases of pregnant women divided into two separate groups: tumor diagnosed and treated before pregnancy and tumor diagnosed during pregnancy. Increasing number of simultaneous incidence of cancer and pregnancy is probably related to higher childbearing age. Our results suggest that cancer diagnosed both during and before pregnancy does not necessarily result in poor maternal and neonatal outcome.
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Affiliation(s)
- Przemysław Kosiński
- 1st Department of Obstetrics and Gynaecology, Medical University of Warsaw, Poland
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