Jesús Florido

Plasma levels of β-endorphin and ACTH during labor and immediate puerperium

Abstract We measured concentrations of β-endorphin (β-EP) and adrenocorticotropic hormone (ACTH) in maternal peripheral plasma during dilation, the expulsive period and immediate puerperium, and in the umbilical vein. Plasma levels of both peptides increased markedly and were directly correlated during labor, and decreased 24 h after birth; they were no longer correlated during immediate puerperium. In the umbilical vein, β-EP and ACTH were also directly correlated. Moreover, the concentration of each of the two peptides in maternal plasma during the expulsive period was correlated with the corresponding concentration in umbilical vein. We discuss the importance of placental corticotropin-releasing factor in the regulation of maternal and fetal stress.

Effects of obesity and gestational diabetes mellitus on placental phospholipids.

Gestational diabetes mellitus (GDM) is associated with adverse effects in the offspring. The composition of placental glycerophospholipids (GPL) is known to be altered in GDM and might reflect an aberrant fatty acid transfer across the placenta and thus affect the foetal body composition. The aim of this study was to investigate possible effects of obesity and GDM, respectively, on placental GPL species composition. We investigated molecular species of phosphatidylcholine (PC), phosphatidylethanolamine (PE) and phosphatidylserine (PS) in term placentas from controls (lean non-diabetic, body-mass-index [BMI] 18-24.9k g/m(2), n=31), obese non-diabetics (BMI ≥30 kg/m(2), n=17) and lean diabetics (n=15), using liquid chromatography - triple quadrupole mass spectrometry. PE(16:0/22:6) and PE(18:0/20:4) were increased in GDM and decreased species were PC(18:0/20:3), PC(18:1/20:3) and PS(18:0/18:2). A consistent difference between BMI related changes and changes caused by GDM was not observed. Arachidonic acid percentages of cord blood correlated with placental PC(16:0/20:4), whereas foetal docosahexaenoic acid correlated to placental PE species. Furthermore, a positive correlation of placental weight was found to levels of PE containing arachidonic acid. We demonstrated that obesity and GDM are associated with decreased dihomo-gamma-linolenic acid and increased arachidonic acid and docosahexaenoic acid contents of placental GPL, with unknown consequences for the foetus. PC(16:0/20:4) was identified as the major component for the supply of arachidonic acid to the foetal circulation, whereas PE containing arachidonic acid was found to be associated to the placental and infant growth.

Analysis of fetal breathing movements at 30–38 weeks of gestation

Abstract Aims: This study reports the changes in patterns of fetal breathing movements recorded with a photogrammetric method in three successive periods of gestation. Methods: Respiratory movements were studied in fetuses of 28 healthy women with uncomplicated pregnancies of 30–38 weeks of gestation. Women were divided into three groups according to gestational age of the fetus: 30–32 weeks, 7 fetuses; 33–36 weeks, 9 fetuses; and 37–38 weeks, 12 fetuses. Sonographic images of the fetuses were recorded on videotape, digitized (1 image per 0.12 s) and analyzed with specially developed software. Results: The proportion of fetuses in each age group for which movements were detectable was similar in all three groups, as was the frequency of movements. Duration of a complete respiratory cycle, the inspiratory phase and the expiratory phase tended to be shorter at 33–36 weeks of gestation than in younger and older fetuses. Fetuses in the 30–32-week group had slower breathing rates than fetuses in the two older groups. Conclusions: The photogrammetric technique revealed differences in some patterns of fetal breathing movements between weeks 30–32, 33–36 and 37–38 of gestation. The data provide a sound basis for relating changes in fetal breathing movements with physiological and anatomical changes that occur as the respiratory system matures.

A New Approach to Oxidative Stress and Inflammatory Signaling during Labour in Healthy Mothers and Neonates

The objective of the current study was to investigate for the first time and simultaneously the oxidative stress and inflammatory signaling induced during the delivery in healthy mothers and their neonates. 56 mothers with normal gestational course and spontaneous delivery were selected. Blood samples were taken from mother (before and after delivery) both from vein and artery of umbilical cord. Lower antioxidant enzymes activities were observed in neonates compared with their mothers and lower oxidative stress in umbilical cord artery with respect to vein. There was an overexpression of inflammatory cytokines in the mother, such as IL-6 and TNF-α, and, in addition, PGE2 was also increased. Neonates showed lower levels of IL-6 and TNF-α and higher values of sTNF-RII and PGE2 in comparison with their mothers. Parturition increases oxidative damage in the mother, although the indicators of oxidative damage were lower in umbilical cord artery with respect to umbilical vein. The overexpression of inflammatory cytokines reveals that fetus suffers its own inflammatory process during parturition.

The Timing of Cord Clamping and Oxidative Stress in Term Newborns

BACKGROUND: Clamping and cutting of the umbilical cord is the most prevalent of all operations, but the optimal timing of cord clamping is controversial, with different timings offering advantages and disadvantages. This study, for the first time, compares the influence of early and late cord clamping in correlation with oxidative stress and inflammation signaling, Because cord clamping timing may have a significant influence on placenta-to-infant blood transfer, thereby modifying oxygenation of maternal and fetal tissues, and on the transfer of inflammatory mediators throughout the placenta. METHODS: Sixty-four pregnant subjects were selected at the Gynecology and Obstetrics Services Department of the Clinico San Cecilio Hospital, Granada, Spain, based on disease-free women who experienced a normal course of pregnancy and a spontaneous, vaginal, single delivery. Half of the subjects had deliveries with early-clamped newborn infants (at 10 s), and the other half had late-clamped deliveries (at 2 min). RESULTS: Erythrocyte catalase activity was significantly greater in the late-clamped group than in the early-clamped group (P < .01 for the umbilical vein and P < .001 for the artery). The values for superoxide dismutase, total antioxidant status, and soluble tumor necrosis factor receptor II were all significantly higher in the late-clamped group compared with the early-clamped group (P < .01, P < .001, and P < .001, respectively). CONCLUSIONS: The results suggest a beneficial effect of late cord clamping, produced by an increase in antioxidant capacity and moderation of the inflammatory-mediated effects induced during delivery of term neonates.

Plasma concentrations of beta-endorphin and adrenocorticotropic hormone in women with and without childbirth preparation

We studied plasma concentrations of beta-endorphin (beta-EP) and adrenocorticotropic hormone (ACTH) during dilation, expulsion and immediate puerperium in 47 primiparous women with an uneventful pregnancy and spontaneous vaginal delivery. Twenty-five women had received childbirth preparation with the Lamaze method, and 22 had received no preparation. Mean concentrations of beta-EP from the beginning of labor until puerperium were higher in women who had received preparation, but there was no significant difference between the two groups. When behavior during labor was evaluated regardless of which group the patient was assigned to, women whose behavior was unsatisfactory has significantly higher concentrations of ACTH at all times during childbirth. We discuss the role of childbirth preparation as a way to enhance beta-EP secretion. Levels of ACTH, on the other hand, appear to be more closely related with behavior during labor, regardless of whether the mother received preparation.

Analysis of measurement process of placental volume in early pregnancy: an interobserver reliability study.

Abstract Objective: To examine concordance among results obtained in measurement process of first-trimester placental volume using 3D ultrasound and eXtended Imaging Virtual Organ Computed-aided AnaLysis (XI-VOCAL®, 3DXITM, Medison, Seoul, Korea) image analysis by three different operators. Methods: Twenty first-trimester normal pregnancy cases were selected for placental volume measuring using a Medison SA 8000 Live Prime® (Medison, Seoul, Korea) with a convex volumetric multifrequency abdominal probe. Images were processed and studied independently by three operators with different grade of training. Each operator obtained 50 slices per case. Thus, this study is based on 1000 measurements that have generated four different sets of placental volume determinations based on 5, 10, 15, and 20 slices, respectively. Results of measurement process were analyzed using reliability coefficients. Results: There was a good degree of concordance in the placental length values obtained by all operators and not depend from the number of cuts measured [intraclass correlation coefficient (ICC)=0.734]. However, the number of cuts is important to obtain a placental volume with more accuracy. Reliability coefficients were low when determining placental volume adjusted to placental length (ICC=0.293), but combined results of the two operators that were trained in the same way showed higher coefficients of reliability (ICC=0.682), and therefore, greater concordance when comparing with the operator that was not trained in the same way. Conclusion: Higher coefficients of reliability guarantee high grades of concordance in the results among operators when measuring placental volumes independently, however, contouring process introduces high variability. Training in how to best use the image analysis software effectively assists in getting higher coefficients of reliability.

Umbilical cord serum lipids between early and late clamping in full-term newborns. A systematic assignment treatment group

Abstract Objective: The aim of the current study was to determine any relationship between the timing of clamping of the umbilical cord and the lipid levels circulating in umbilical artery and vein. Methods: We studied a clinical trial with systematic assignment in 229 single-fetus full-term deliveries with normal gestational course and spontaneous delivery; out of these, 111 were subjected to early clamping (EC, within 10 s of delivery) and 118 to late clamping (LC, at 2 min). In all cases, total cholesterol (TC), triglycerides (TG), and phospholipids were measured in sera from umbilical artery and vein. Results: TC and TG values were significantly higher in the EC group than in the LC group in both umbilical artery and vein. Comparing values between umbilical artery and vein in the two clamping groups, in the EC group, all studied lipids TC, TG and phospholipids were significantly higher in vein than in artery. In the LC group, only TC was higher in vein. Conclusion: Umbilical cord lipid levels are related to the timing of umbilical cord clamping, finding which is noteworthy, because they are essential component of postnatal development. Our study confirms that delivery acts as an important modifier of fetal lipid levels.

A MULTISCALE MECHANICAL MODEL FOR THE CERVICAL TISSUE

A multi-scale constitutive model for the nonpregnant cervical tissue is presented. The mechanical response of the cervix is described by a model which takes into account material properties at different structural hierarchies of tissue through a multi-scale coupling scheme. The model introduces the deformation mechanisms of collagen fibrils at the nanoscale into a macroscopic description of the mechanical behavior of tissue continuum. The composition of soft tissues like cervical tissue consists of a distribution of cells embedded in an extracellular matrix (ECM). The microstructure of cervical ECM is composed of dense, hydrated and highly cross-linked collagen network embedded in a viscous proteoglycan ground substance. The mechanical behavior of cervix can be largely due to different constituents of its extracellular matrix, and the collagen fibers are the major responsible for its mechanical strength [M. House, 2009]. So the proposed model considers the stroma as the maximum responsible for the mechanical strength of the cervix.