Mirjana Bogavac

Alternative treatment of vaginal infections – in vitro antimicrobial and toxic effects of Coriandrum sativum L. and Thymus vulgaris L. essential oils

The aims of study were to examine the antibacterial potential of two commercial essential oils (EOs) from coriander (Coriandrum sativum L.) and thyme (Thymus vulgaris L.) against vaginal clinical strains of bacteria and yeast and their chemical composition.

Biomarkers of oxidative stress in amniotic fluid and complications in pregnancy

Objective. In this study, we tried to determine whether the activities of the primary antioxidant enzymes are detectable in amniotic fluid and whether they can be used as early biomarkers of complications in pregnancy such as pregnancy-induced hypertension (PIH), gestational diabetes mellitus (GDM), and bacterial vaginosis. Methods. This was a prospective study in which amniotic fluid was taken between 16 and 19 week of gestation. In all, 161 pregnant women were divided into two groups: study group – patients with the treated local infection, PIH, and GDM, and control group – healthy pregnant women. Levels of reduced glutathione (GSH) and activities of supeoxide dismutase (SOD), glutathione peroxidase (GSH-Px), glutathione reductase (GSHR), glutathione S-transpherase (GST), xanthine oxidase (XOD) and lipid peroxidation (LP) were determined spectrophotometrically in amniotic fluid samples. Results. Concentration of malondialdehyde varied greatly between investigated groups. XOD and SOD activities, though very low, were present in amniotic fluid samples. Also, enzymes of glutathione cycle and GSH concentrations were detectable and showed certain variations. Conclusion. Parameters of oxidative stress in amniotic fluid could be altered in certain pathological conditions. Their use as clinical biomarkers is limited due to great variations of amniotic fluid volume between patients which gives favor to hemolysate or serum of pregnant women.

Erythropoietin in amniotic fluid as a potential marker in distinction between growth restricted and constitutionally small fetuses.

Abstract Objective: To determine if there is any difference in amniotic fluid erythropoietin (EPO) concentration between fetuses small for gestational age (SGA) and appropriate for gestational age (AGA), and between the constitutionally small (CSF) and growth-restricted (GRF) fetuses. Methods: EPO concentrations in the amniotic fluid samples were determined by EpoELISA test in 38 pregnancies with SGA and 15 pregnancies with AGA fetuses. In the SGA group we measured Ponderal index (PI) and skin-fold thickness (SFT). If PI and/or SFT were below 10th percentile the neonate was GRF. If both PI and SFT were above 10th percentile the neonate was CSF. Results: Higher levels of EPO were detected in the SGA in comparison to the AGA fetuses (p < 0.01). EPO concentration was higher in GRF compared to CSF (p < 0.05). The EPO cut-off level between SGA and AGA was 6.81 IU/L (sensitivity 92.3%; specificity 73.3%), and between GRF and CSF was 9.8 IU/L (sensitivity 81%; specificity 80%). Conclusion: The preliminary results of this study suggest that amniotic fluid erythropoietin concentration is elevated in growth-restricted fetuses and could potentially be used for distinction between growth restricted and constitutionally small fetuses. Confirmation of these results on a larger group of pregnant women is needed.

Lipid peroxidation in the first trimester of pregnancy.

Aim: To determine the existence and level of oxidative stress caused by lipid peroxidation in pregnancy. Methods: The research was conducted as prospective examination that included 60 healthy women (age 18–45). The women included in the examination were divided into two groups. The group I (N-31) included women in the first trimester of normal, healthy pregnancy. The group II included healthy nongravid women (N-29). Concentrations of markers of lipid peroxidation malondialdehyde (MDA) and thiobarbituric acid (TBARS) were determined using commercial ELISA tests OxiSelect™ TBARS Assay Kit and OxiSelect™ MDA ELISA Kit. Results: The results of this research indicate that the concentrations of the markers of lipid peroxidation TBARS and MDA are detectable in both groups. Higher mean values of MDA (>20 pmol/mg) were measured in the group of pregnant women, than in the group of nongravid women. The results indicate that mean values of TBARS markers are lower in pregnant women (≤50 µM) than in nongravid women (>100 µM). Conclusion: The marker of lipid peroxidation MDA proved to be a sensitive marker for following lipid peroxidation during pregnancy, therefore it can be considered as a good predictor of possible complications during pregnancy.

Mid-pregnancy interleukins levels in serum and amniotic fluid as predictors of preterm delivery.

Abstract Objectives: To find out if determination of IL-4, IL-13 and IL-6 in amniotic fluid (AF) and serum in mid-pregnancy can be used as predictors of preterm delivery. Material and methods: The research has comprised 88 pregnant women at 16-24 weeks of gestation, who were subjected to early amniocentesis. Levels of interleukins were determined by ELISA tests. Pregnant women had been monitored untill termination of pregnancy and divided in two groups: 68 term and 20 preterm deliveries. Results: IL-13 was not detectable at all in serum and amniotic fluid samples. IL-4 was not detectable in serum samples of both groups of women and it was detectable only in small number (20 % - 27 %) of AF samples. There was no statistically significant difference (p=0.665) in the mean values of AF IL-4 levels between the examined groups of women. Detectability for IL-6 was very low in serum specimens, while in AF it was detectable in 100% of cases and its levels was significantly higher (p<0.001) in preterm delivery group. Conclusions: The results obtained in this study suggest that the AF mid-pregnancy levels of IL-6 higher than 132 pg/ml may indicate preterm delivery.

Early pregnancy angiogenic proteins levels and pregnancy related hypertensive disorders

Abstract Introduction: Normal placental vascular development depends on multiple interactions of many regulatory molecules including pro and antiangiogenic proteins. It is considered that these vascular modulators might be one of the factors responsible for development hypertensive disorders in pregnancy. Objective: To evaluate and compare the early pregnancy (11–14 week of gestation) serum level of angiogenic proteins sFlt1, VEGF i PIGF between different types of pregnancy related hypertensive disorders. Materials and methods: The study included 177 pregnant women between 11 and 14 weeks of gestation, divided into four study subgroups (preeclampsia group-41, gestational hypertension group-31, chronic hypertension group-32 and miscarriage group-19) and control group-54. Blood samples (serum) were taken for measuring sFlt1, VEGF i PIGF by a quantitative ELISA technique and measuring other biochemical and hematological parameters. Results: Significantly higher levels of sFlt1 were in the subgroups with preeclampsia and miscarriages, significantly lower level of VEGF in the all study subgroups and lover level of PIGF were in miscarriage group. In the groups with chronic and gestational hypertension there were higher level of sFlt1 and lover level of VEGF than in the control group, but the differences did not reach statistical significance. Conclusion: Early pregnancy imbalance between antiangiogenic protein sFlt1 and proangiogenic molecules VEGF and PIGF could have impact on pathophysiology of placental disorders which leads to development of pregnancy related hypertensive disorders.

Biochemical and Physiological Characteristics of Neonates Born to Mothers with Diabetes During Gestation

Biochemical and Physiological Characteristics of Neonates Born to Mothers with Diabetes During Gestation The aim of this study was to investigate how glucose homeostasis disorders influence biochemical homeostasis and fetal maturation. A prospective randomized study included 102 infants: 31 newborns of mothers with glucose homeostasis disorders (Group I) and 71 newborns of healthy mothers (Group II). In the pregnant women, the mean age, body weight and height, BMI, parity, duration of the disease and the mode of labor were estimated. The following procedures were performed in each newborn infant: physical examination, determination of Apgar score, measurements of birth weight and length, estimation of neurological status, clinical estimation of gestational age, ECG and ultrasonography of the brain, as well as the basic hematologic, biochemical and microbiological analyses. Newborn infants of diabetic pregnancies were small for gestational age and of high birth weight. The levels of Na+, K+ and Cl- ions did not show significant differences between the investigated groups, whereas the levels of total Ca and Mg were significantly decreased (2.18±0.59 and 0.65±0.17 mmol/L) (p<0.001) in the investigated group relative to the control group (2.42±0.53 and 0.81±0.09 mmol/L). The newborn infants of diabetic pregnancies presented with significantly decreased values of phosphates, bicarbonates and pH, whereas the difference in total osmolality was not statistically significant. The level of glucose at birth in the infants of diabetic mothers was lower (2.91±0.51 mmol/L) (p<0.001) than in the infants of healthy pregnancies (3.94±0.29 mmol/L). Glycemia lower than 2 mmol/L was recorded in 6.5% of infants of the investigated group. The level of bilirubin was significantly increased (209.71±56.66 mmol/L) (p<0.001) in infants of diabetic mothers compared to those of the healthy ones (155.70±61.14 mmol/L), like the incidence of clinically manifested hyperbilirubinemia. Disorders of maternal glucose homeostasis cause biochemical disorders such as hypoglycemia, hypocalcemia, hyperbilirubinemia, hypomagne semia and are associated with impaired maturation and congenital malformations of the fetus. Biohemijske i Fiziološke Karakteristike Novorođenčadi iz Dijabetičnih Trudnoća Cilj rada je utvrditi kako poremećaj homeostaze glukoze utiče na biohemijsku homeostazu i maturaciju ploda. Prospektivnim i randomiziranim ispitivanjem obuhvaćena su 102 novorođenčeta, 31 novorođenče majki sa poremećajem homeostaze glukoze (I grupa) i 71 novorođenče zdravih majki (II grupa). Trudnicama je određena prosečna starost, telesna visina, telesna težina, BMI, paritet, dužina trajanja bolesti i praćen je način porođaja. Svakom novorođenčetu urađen je fizikalni pregled, određen Apgar skor, neurološki status, izmerena telesna težina i dužina, obavljena kli nička procena gestacijske starosti, EKG i ultrazvučni pregled mozga kao i osnovne hematološke, biohemijske i mikrobiološke analize. Novorođenčad iz dijabetičnih trudnoća manje su gestacijske starosti i veće telesne težine. Nivo jona Na+, K+ i Cl- ne pokazuje značajne razlike između ispitivanih grupa, dok je nivo ukupnog Ca i Mg značajno (p<0,001) niži (2,18±0,59 i 0,65±0,17 mmol/L) u ispitivanoj u odnosu na kontrolnu grupu (2,42±0,53 i 0,81±0,09 mmol/L). Kod novorođenčadi iz dijabetičnih trudnoća nalazimo i značajno niže vrednosti fosfata, bikarbonata i pH, dok razlika u ukupnom osmolalitetu nije značajna. Nivo glukoze po rođenju je niži (p<0,001) kod novorođenčadi iz dijabetičnih (2,91±0,51 mmol/L) nego zdravih (3,94±0,29 mmol/L) trudnoća. U ispitivanoj grupi 6,5% novorođenčadi imalo je glikemiju manju od 2 mmol/L. Nivo bilirubina značajno je (p<0,001) veći kod dijabetične (209,71±56,66 mmol/L) nego zdrave (155,70±61,14 mmol/L) novorođenčadi, kao i incidenca klinički manifestne hiperbilirubinemije. Poremećaj homeostaze glukoze majke uzrok je biohemijskih poremećaja: hipoglikemije, hipokalcemije, hiperbilirubinemije, hipomagnezijemije, a povezan je i sa usporenom maturacijom i kongenitalnim malformacijama ploda.

Bacterial vaginosis and biomarkers of oxidative stress in amniotic fluid

Objective: In this study we tried to determine if the activities of the primary antioxidant enzymes are detectable in amniotic fluid and if they can be used as early biomarkers of complications in pregnancy connected with bacterial vaginosis. Methods: This was a prospective study in which amniotic fluid was taken between 16 and 19 weeks of gestation. 161 pregnant women were divided into two groups: study group—patients with the treated local infection and control group—healthy pregnant women. Levels of reduced glutathione, and the activities of glutathione peroxidase, glutathione reductase, glutathione S-transpherase, xanthine oxidase, superoxide dismutase and lipid peroxidation were determined spectrophotometrically in amniotic fluid samples. Results: Concentration of malonyldialdehide (product of lipid peroxidation) varied greatly between investigated groups. Xanthine oxidase and superoxide dismutase activities, though very low, were present in amniotic fluid samples. Also, enzymes of glutathione cycle and reduced glutathione concentrations were detectable and showed certain variations. Conclusion: Although, biomarkers of antioxidant activity are present in the amniotic fluid, they are not differrent between women with and without bacterial vaginosis.

Unusual high rate of asymptomatic maternal parvovirus B19 infection associated with severe fetal outcome

Objective. To study the role of asymptomatic maternal parvo B19 infection in severe fetal outcome in Province of Vojvodina. Methods. One hundred seventy-six pregnant women (13–25 weeks of gestation) were divided in two groups – patients with symptoms of imminent spontaneous abortion and poor pregnancy outcome and patients with normal course of pregnancy. Double serum samples were analyzed to quantify IgM and IgG to parvovirus B19. Results. Among pregnant women with symptoms of spontaneous abortion, we found significantly higher percentage of acute parvovirus B19 infection. Conclusions. Asymptomatic parvo B19 infection is associated with poor fetal outcome much more than we presumed previously.

Serum magnesium level in the first trimester of pregnancy as a predictor of pre-eclampsia – a pilot study

ABSTRACT Objectives: The aim of this study was to evaluate the importance of serum concentration of magnesium (Mg) in the first trimester of pregnancy for predicting pre-eclampsia (PE). Methods: This prospective study included 403 pregnant women over 18, with singleton pregnancy (from 11 to 14 weeks of pregnancy). The subjects were divided into a group who subsequently developed PE (PEKT) (n = 61), and a group of healthy pregnancies with no complications and with normal outcomes (TNT) (n = 342). In the first trimester, urea, creatinine, uric acid, Mg, free beta subunit of human chorionic gonadotrophin, plasma protein A related to pregnancy, and C-reactive protein were determined. We followed all subjects until the end of pregnancy. Results: Serum Mg is significantly lower in PEKT than in TNT group (p < 0.001). The serum first trimester Mg level cutoff at ≤0.81 mmol/L had a sensitivity of 77.0% and specificity of 71.6% for the detection of women with PEKT. The level of serum Mg has the strongest significant positive correlation (p < 0.05) with the week of gestational outcomes (R = 0.442), weight (R = 0.416), and Apgar score (R = 0.343) of the newborns, and the strongest significant negative correlation with the number of miscarriages (R = −0.413), serum creatinine (R = −0.471), and the number of pregnancies (R = −0.326). The week of gestational outcome is predicted with the greatest reliability by the serum Mg. Conclusions: Serum Mg level during the first trimester of pregnancy is a significant prediction tool for PE and could also play an important role in predicting the week of gestational outcome and birth weight of newborns.