Dermatoses of Pregnancy
Vincenzo Berghella in Maternal-Fetal Evidence Based Guidelines, 2022
Skin lesions range from urticarial and edematous papules and plaques that may be annular or polycyclic to grouped (i.e. herpetiform), tense sub-epidermal blisters (Figure 45.5). Typically, lesions begin on the abdomen involving the periumbilical and umbilical skin in contrast to PEP, spreading centrifugally to the extremities including the palms and soles. As a rule, face and mucosae are spared. PG usually appears in the second and third trimester with a mean gestational age of onset that ranges from 21 to 28 weeks [53]. Although clinical course varies, there is a trend for exacerbation at the time of delivery, corresponding to the hormonal fluctuation during this period [52]. The disease usually remits within weeks to months after parturition, but a small percentage of patients have an unremitting chronic course. The disease usually recurs during subsequent pregnancies, typically earlier in onset with increased severity, and may recur with subsequent menses or oral contraceptive use [52]. The diagnosis is based on clinical, histologic, serologic, and/or immunofluorescent studies. As circulating autoantibodies are detectable in over 92% of cases, a commercially available ELISA test is becoming the confirmatory test of choice [54].
The diagnosis and management of preterm labor with intact membranes
Hung N. Winn, Frank A. Chervenak, Roberto Romero in Clinical Maternal-Fetal Medicine Online, 2021
The traditional view that has dominated the study of preterm parturition is that spontaneous labor at term and preterm labor fundamentally involves the same processes, albeit occurring at different gestational ages. Indeed, term and preterm labor share a common pathway. We have defined the “common pathway of parturition” as the anatomic, biochemical, endocrinologic, and clinical events that occur in the fetus and/or mother in both term and preterm labor (17–22). Broadly conceptualized, the common pathway of parturition can be considered to have uterine (maternal and fetal) and extrauterine components. The uterine components (which are a subject of wide attention in clinical obstetrics) include increased uterine contractility, cervical ripening, and decidual/membrane activation (17,18). The extrauterine components include endocrinologic and metabolic changes associated with labor. For example, labor is associated with increased caloric metabolic expenditures (21), and an increase in maternal and fetal cortisol (20).
The Reproductive System and Its Disorders
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss in Understanding Medical Terms, 2020
The process of giving birth is called parturition. This includes labor, which is divided into four stages, and delivery, the passage of the fetus and placenta from the genital canal into the external world. Terms associated with the birth process refer to presentation of the fetus (breech, vertex, transverse, face, cephalic, depending on which fetal structure faces the cervix) or to procedures involved (episiotomy, hysterotomy, Cesarean section). Immediately after delivery of the fetus, the secundines or "afterbirth," which includes the placenta and attached umbilical cord, are expelled as the final stage of labor. Lochia refers to the discharge of mucus, blood, and tissue debris that continues for a period of time following childbirth.
Fetal Tethered Spinal Cord: Diagnostic Features and Its Association with Congenital Anomalies
Published in Fetal and Pediatric Pathology, 2023
Xiaomei Yang, Shiyu Sun, Yizheng Ji, Yasong Xu, Li Sun, Qichang Wu
This is a retrospective observational analysis of clinical data conducted in the prenatal diagnosis department of Xiamen Maternal and Child Health Hospital from January 2014 to December 2019. Clinical data including maternal age, medical history, gestational age at ultrasound, prenatal imaging results, and postpartum pathology outcomes were collected from pregnant women who underwent abortions due to fetal malformation. A multidisciplinary consultation, including a pediatric neurosurgeon, was first conducted with the pregnant women and their family, in which potential complications and postnatal treatment options were discussed. In China, pregnancy can be terminated in any trimester if the fetus has suspected anomalies and/or genetic syndromes. In all cases, invasive prenatal diagnosis for fetal chromosomal karyotype analysis was conducted at the patient’s request prior to induced abortion. Fetal pathological examination was conducted after the parturition. This study was approved by the Medical Ethics Committee of Xiamen Maternal and Child Health Hospital (Ethics board approval number is KY-2019-065, registered date is 2019.12.31). All participants and their families were fully informed of the conduct of this study, and informed consent forms were signed.
A novel anti-NGF PEGylated Fab’ provides analgesia with lower risk of adverse effects
Published in mAbs, 2023
Yukari Koya, Hirotsugu Tanaka, Eiji Yoshimi, Nobuaki Takeshita, Shuji Morita, Hiroki Morio, Kanako Mori, Hiroshi Fushiki, Masazumi Kamohara
Groups of 5–6 pregnant female rats were intravenously administered anti-NGF Fab’-PEG (3, 10 and 30 mg/kg once every other day from GD 7 to 19), anti-NGF IgG (10, 30 and 100 mg/kg twice on GD 7 and 14) or PBS alone. The highest dose was defined as the highest dose technically possible based on the solubility of the formulation, and the middle and low doses were selected to confirm the correlation with dose. The dams were allowed to deliver spontaneously. Items observed in dams included general signs, body weight, body weight gain, food consumption, delivery observations, gestation period, gestation index, nursing behavior, and gross pathology (including the number of implantations). To determine the plasma concentration of the test antibody and the presence of anti-drug antibodies, satellite groups consisting of three pregnant females/group were included. Items observed in pups included general signs, suckling ability, body weight, body weight gain, external abnormalities, macroscopic eye conditions, pain response, live birth index, viability index, weaning index, and gross pathology (visceral abnormalities).
Can maternal hormones play a significant role in delivery mode?
Published in Journal of Obstetrics and Gynaecology, 2022
Christina Pappa, Fani Gkrozou, Evangelos Dimitriou, Orestis Tsonis, Aikaterini Kitsouli, Dimitrios Varvarousis, Vasileios Xydis, Minas Paschopoulos, Panagiotis Kitsoulis
The precise mechanism that activates the initiation and establishment of human parturition has still not been clarified. Hormonal fluctuations along with mechanical forces caused by the foetus are believed to lead to morphological alterations to promote natural vaginal childbirth (Hashem et al. 2006; Yan et al. 2015; Okunowo et al. 2017). Every pregnant woman may have different pelvic traits and a unique hormonal profile, which affect childbirth. Thus, it is imperative to clearly understand the background of delivery and pinpoint specific maternal and foetal factors that can interfere with the normal mechanism of labour, to ensure a safe delivery (Ikhena et al. 1999; Rustamova et al. 2009). Aim of our study was to evaluate the different levels of PRG, E2 and RLX during the different ways of childbirth and to assess the impact of maternal hormonal alterations and foetal size in maternal pelvis changes during different delivery modes.
Related Knowledge Centers
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