Tomasz Gęca

Peripheral Dendritic Cells and CD4+CD25+Foxp3+ Regulatory T Cells in the First Trimester of Normal Pregnancy and in Women with Recurrent Miscarriage.

The development of pregnancy is possible due to initiation of immune response in the body of the mother resulting in immune tolerance. Miscarriage may be caused by the impaired maternal immune response to paternal alloantigens located on the surface of trophoblast and fetal cells. The aim of the study was to compare the population of circulating dendritic cells (DCs) and CD4+CD25+Foxp3+ regulatory T cells (TREGs) in the first trimester of a normal pregnancy and in women with recurrent miscarriage and an attempt to determine the relationship between these cells and the role they may play in human reproductive failures. The study was conducted in a group of 33 first trimester pregnant women with recurrent miscarriage and in a group of 20 healthy pregnant women in the first trimester of normal pregnancy. Among mononuclear cells isolated from peripheral blood, the populations of DCs and TREGs were assessed by flow cytometry. The percentage of myeloid DCs and lymphoid DCs showed no significant difference between study and control group. Older maternal age and obesity significantly reduced the pool of circulating myeloid and lymphoid DCs (R=-0.39, p=0.02). In miscarriages the percentage of circulating TREGs was significantly lower compared to normal pregnancies (p=0.003). Among the analysed factors the percentage of TREGs was the most sensitive and the most specific parameter which correlated with the pregnancy loss. The reduction in the population of circulating TREGs suggests immunoregulatory mechanisms disorder in a pregnancy complicated by miscarriage.

Prenatal diagnosis of persistent right umbilical vein – Incidence and clinical impact. A prospective study

Persistent right umbilical vein (PRUV) is usually an isolated finding but it may be accompanied by other fetal malformations.

Study on free amino acid concentrations in umbilical cord blood plasma of newborns from normoglycaemic and gestational diabetes-complicated pregnancies

Introduction and objective. Gestational diabetes mellitus is a common disease among pregnant women. The aim of the study was to compare plasma concentrations of 24 amino acids in umbilical cord blood in newborns from normoglycaemic pregnancies versus those complicated by gestational diabetes. The relationship between birth weight and length of newborns and placental concentrations of individual amino acids were also assessed. Material and methods. The study comprised 76 pregnant women at the gestational age of 37 weeks and more. The control group consisted of 31 women whose 75-g glucose load test excluded gestational diabetes mellitus. The study group encompassed 45 women with diagnosed gestational diabetes mellitus. The placental plasma concentrations of 24 amino acids were determined using ion-exchange chromatography with an automated amino acid analyser. Results. The concentrations of cysteic acid, aspartic acid, threonine, glutamic acid, cystine, and alpha-aminobutyric acid in umbilical cord blood plasma were higher in the group complicated by gestational diabetes compared to normoglycemic pregnancies; otherwise, concentrations of glutamine, alanine, valine, phenylalanine, lysine and, arginine were lower in the group complicated by gestational diabetes than in the normoglycaemic group. Conclusions. The results show that despite optimal control of carbohydrate metabolism during gestational diabetes mellitus, there are many abnormalities in the amino acids metabolism. This suggests that research on the effects of amino acids concentration in umbilical cord blood on the foetal development in gestational diabetes-complicated pregnancies should be continued.

Complementary role of magnetic resonance imaging after ultrasound examination in assessing fetal renal agenesis: a case report.

IntroductionUltrasonography is used routinely during pregnancy to screen and detect fetal abnormalities. However, there are some conditions like anhydramnios (a prevalent state in renal agenesis) or maternal obesity that may limit the diagnostic accuracy of ultrasonography. Magnetic resonance imaging has proven to be useful when ultrasound alone is insufficient to make a correct diagnosis.Case presentationWe present the case of a 22-year-old Caucasian woman who was admitted to our unit at the 26th week of gestation for a detailed anatomy scan. Anhydramnios and failure to visualize the kidneys, bladder and renal vessels were confirmed with the use of sonography in our department. Since the lack of amniotic fluid limited the acoustic window for fetal ultrasonography, a magnetic resonance imaging scan was requested to confirm suspected renal agenesis. A fetal magnetic resonance imaging scan was performed and confirmed the suspected diagnosis. A baby boy was born by breech vaginal delivery after spontaneous onset of labor at the 34th week of gestation. The boy weighed 1690g, with Apgar scores of 6 and 4 at two and five minutes respectively, and died one hour after delivery. The diagnosis of bilateral renal agenesis was confirmed on autopsy.ConclusionsThe aim of this study was to evaluate the potential contribution of magnetic resonance imaging in diagnostic procedure after inconclusive ultrasound examination during the assessment of fetal urinary tract abnormalities in the third trimester.

Preliminary analysis of the protein profile in saliva during physiological term and preterm delivery

From a clinical point of view, easily obtainable and useful markers of a particular pathological status are required for appropriate diagnosis and treatment. Analysis of the proteomic profile of saliva may allow for the selection of potential marker of preterm delivery in humans. Saliva samples were collected from 12 patients diagnosed with threatened preterm delivery and 10 controls with uncomplicated pregnancies at the same gestational age. Samples were analysed using 2D electrophoresis. Based on statistical analysis, spots of interest were selected and collected from gels. Subsequently, spots were decoloured and proteins were identified by mass spectrometry using the matrix assisted laser desorption ionization-time of flight technique. The results of identification were compared with the Swiss-Prot database. A total of 1,393 spots were detected in the present study with 59 significantly different between control and preterm samples. Increased intensity of staining of 32 spots was observed in the premature delivery group compared with control patients and 27 spots were stained more intensely in the control group compared with the premature delivery group. A total of nine spots, which were significantly different between examined samples were identified and three of them exhibited increased intensity of staining in premature delivery group compared with controls, including dedicator of cytokinesis protein 1, metallothionein-2, guanylyl cyclase-activating protein 1. The six remaining spots included, epithelial-stromal interaction protein 1, serum albumin, tyrosine-tRNA ligase, cytoplasmic, protein chibby homolog 3, leukemia inhibitory factor receptor and adenosylhomocysteinase 3, and exhibited increased intensity of staining in healthy controls compared with premature delivery group. Further studies with an increased number of patients and identification of the complete protein profile are required to confirm the results of the present study and applicability of saliva as a source of disease biomarkers.

Chromosomal abnormalities in a decade of prenatal testing at the Department of Obstetrics and Pathology of Pregnancy Medical University of Lublin

Abstract Introduction. Chromosomal abnormalities, one of the leading causes of pregnancy complications, attract attention of both researchers and clinicians. They use two approaches to identify chromosomal abnormalities, namely screening and diagnostic tests. Ultrasonography is a very reliable screening and diagnostic tool, but the only way to determine if there are any chromosomal defects in the fetus, is performing one of invasive diagnostics tests chorionic villus sampling (CVS), cordocentesis or amniocentesis. Unfortunately, these invasive diagnostic procedures carry a potentially high risk of complications. Using amniocentesis means a procedure-related miscarriage risk at a rate of about 0.5-1%. Aim. The aim of this paper was to present our own experience, results in performing amniocentesis and a review of the literature. Material and methods. During a 10-year period 237 mid-trimester, transabdominal amniocenteses were performed. Results. The follow-up revealed one spontaneous abortion within seven days after the procedure. Premature delivery occurred in fourteen cases (two of them with chromosomal abnormalities). No neonatal deaths related to amniocentesis were noticed. Chromosomal abnormalities were detected in 33 patients. Conclusions. In the group with chromosomal abnormalities the main indications to perform amniocentesis were: improper ultrasound scan and the first trimester biochemical, noninvasive screening tests. This is a proof that modern, non-invasive procedures like the first-trimester ultrasound scan and biochemical tests should be made available to every pregnant woman and not only to mothers’ aged >35 years or those with a poor obstetrics history.

Wpływ zastosowania żelu położniczego podczas porodu na satysfakcję porodową rodzących

Objective. The objective of the presented study was to discover whether the use of an obstetric gel safe for mother and child during labour exerts an effect on woman›s satisfaction with childbirth. Material and method. The study included 45 primaparous women – 22 in whom obstetric gel was applied were qualified into the study group, and a control group covering 23 women whose delivery proceeded without the use of a gel. Satisfaction with the course of childbirth was evaluated using the following research instruments: the Visual Analogue Scale-VAS, and a questionnaire designed by the author. Results. No statistically significant differences in evaluations concerning satisfaction with the course of delivery, exhaustion after delivery and pain intensity during the second stage of labour were observed between the study and control groups. Conclusion. Application of an obstetric gel during the second stage of delivery did not significantly affect the womens’ satisfaction with childbirth.