Masamitsu Nakamura

PP13 mRNA Expression in Trophoblasts From Preeclamptic Placentas

To assess the role of placental protein 13 (PP13) in the pathogenesis of preeclampsia, the messenger RNA expression of PP13 was investigated in the trophoblasts from first and third trimester placenta. First, syncytiotrophoblasts and extravillous trophoblasts were separated from frozen section of third trimester placenta obtained from pregnant women with and without preeclampsia by laser microdissection. The PP13 levels of syncytiotrophoblasts were significantly higher than those of extravillous trophoblasts. The expression levels in syncytiotrophoblasts from the preeclampsia were significantly lower than those from normal. Next, the PP13 expression was assessed in trophoblasts from residual samples of chorionic villus sampling at 11 weeks of gestation, who subsequently developed preeclampsia. The levels in the preeclampsia group were significantly lower than those of normal cases. These findings indicate that an alteration in the PP13-messenger RNA expression in the trophoblasts may be associated with the pathogenesis of preeclampsia.

Prediction of preeclampsia by analysis of cell-free messenger RNA in maternal plasma

OBJECTIVE The purpose of this study was to predict the occurrence of preeclampsia in a series of patients at gestational week 15-20 weeks, with the use of a panel of messenger RNA markers. STUDY DESIGN Data from 62 patients with preeclampsia who were asymptomatic at the time of blood testing and 310 control subjects were analyzed. Multivariable analysis was performed with discriminant analysis. RESULTS Univariable analysis identified vascular endothelial growth factor receptor 1 as the marker with the highest detection rate; placenta-specific 1 with the lowest. Mean estimated score for preeclampsia was 9.4 for control subjects and 72.5 for subjects who experienced preeclampsia. A receiver operating characteristic curve that was obtained with the estimated score for preeclampsia as a test variable yielded a detection rate of 84% (95% CI, 71.8-91.5) at a 5% false-positive rate with an area under the curve of 0.927 (P < .001). Again, detection rate and score for each patient for classification as preeclamptic correlated with severity. CONCLUSION A panel of messenger RNA is able to detect subjects who will experience preeclampsia.

Cellular mRNA expressions of anti-oxidant factors in the blood of preeclamptic women

To assess the alterations of mRNA expressions associated with oxidative stress in the cellular component of blood from pregnant women with pre‐eclampsia.

Current status of pregnancy-related maternal mortality in Japan: a report from the Maternal Death Exploratory Committee in Japan.

Objective To clarify the problems related to maternal deaths in Japan, including the diseases themselves, causes, treatments and the hospital or regional systems. Design Descriptive study. Setting Maternal death registration system established by the Japan Association of Obstetricians and Gynecologists (JAOG). Participants Women who died during pregnancy or within a year after delivery, from 2010 to 2014, throughout Japan (N=213). Main outcome measures The preventability and problems in each maternal death. Results Maternal deaths were frequently caused by obstetric haemorrhage (23%), brain disease (16%), amniotic fluid embolism (12%), cardiovascular disease (8%) and pulmonary disease (8%). The Committee considered that it was impossible to prevent death in 51% of the cases, whereas they considered prevention in 26%, 15% and 7% of the cases to be slightly, moderately and highly possible, respectively. It was difficult to prevent maternal deaths due to amniotic fluid embolism and brain disease. In contrast, half of the deaths due to obstetric haemorrhage were considered preventable, because the peak duration between the initial symptoms and initial cardiopulmonary arrest was 1–3 h. Conclusions A range of measures, including individual education and the construction of good relationships among regional hospitals, should be established in the near future, to improve primary care for patients with maternal haemorrhage and to save the lives of mothers in Japan.

Analysis of placental weight centiles is useful to estimate cause of fetal growth restriction

Aim:  To establish a nomogram of placental weight at delivery and to clarify the associations among standardized placental weights and known risk factors of fetal growth restriction (FGR).

Evaluation of physiological alterations of the placenta through analysis of cell-free messenger ribonucleic acid concentrations of angiogenic factors

OBJECTIVE Placental messenger ribonucleic acid (mRNA) has been shown to circulate in maternal plasma. We investigated concentrations of vascular endothelial growth factor (VEGF), VEGF receptor-1 (VEGFR-1), and endoglin in subjects with preeclampsia, compared with normal pregnancies. STUDY DESIGN Peripheral blood samples were obtained from preeclampsia (n = 43) and control subjects (n = 41). Plasma ribonucleic acid was subjected to analysis by reverse transcription-polymerase chain reaction assay to examine the mRNA distribution among women with preeclampsia and control subjects during weeks 35-41 of gestation. RESULTS Concentrations of VEGF, VEGFR-1, and endoglin mRNA of women with preeclampsia were significantly increased. The mRNA values were observed to correlate directly with the severity of hypertension and proteinuria. VEGFR-1 mRNA was markedly elevated in women with preeclampsia and hemolysis, elevated liver enzymes, and low platelet syndrome. CONCLUSION The mRNA concentrations of VEGF, VEGFR-1, and endoglin were observed to correlate directly with the severity of preeclampsia.

PP13 mRNA expression in the cellular component of maternal blood as a marker for preeclampsia

To assess the PP13 expression in the cellular component of blood in both preeclamptic patients and asymptomatic pregnant women during the early second trimester.

Analysis of the ultrasonographic findings predictive of vasa previa

To clarify the ultrasonographic findings indicative of prenatal vasa previa.

Prediction of early- and late-onset pregnancy-induced hypertension using placental volume on three-dimensional ultrasound and uterine artery Doppler

To determine whether uterine artery (UtA) Doppler findings and three‐dimensional (3D) ultrasound measurement of placental volume during the first trimester allowed prediction of early‐ and late‐onset pregnancy‐induced hypertension (early PIH and late PIH).

Expression of angiogenesis-related genes in the cellular component of the blood of preeclamptic women.

The purpose of this study is to assess the changes in the expression of angiogenesis-related genes in the cellular component of the blood from preeclamptic patients. Blood samples were obtained from the preeclampsia (PE) and control participants. Cellular RNA was analyzed by reverse transcription polymerase chain reaction (PCR) to identify any angiogenesis-related genes and thereby assess the mRNA expression among women with PE and controls during weeks 35 to 41 of gestation. Significant differences were observed between PE and controls in all of the angiogenesis-related genes examined. In PE, for the increased expression of transforming growth factor-β1 (TGF-β1), endoglin and fms-like tyrosine kinase-1 (Flt-1); and the reduced expression of vascular endothelial growth factor (VEGF), placental growth factor (PlGF). fms-Like tyrosine kinase-1 and endoglin significantly correlated with the systolic pressure, while VEGF, Flt-1, and endoglin all correlated with proteinuria. An altered expression of angiogenesis-related genes was demonstrated in the cellular component of blood from preeclamptic patients. These findings indicate that this approach may offer an alternative way for evaluating the pathogenesis of PE.