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Trends in Molecular Medicine Aug 2021A healthy pregnancy depends on complex interrelated biological adaptations involving placentation, maternal immune responses, and hormonal homeostasis. Recent advances... (Review)
Review
A healthy pregnancy depends on complex interrelated biological adaptations involving placentation, maternal immune responses, and hormonal homeostasis. Recent advances in high-throughput technologies have provided access to multiomics biological data that, combined with clinical and social data, can provide a deeper understanding of normal and abnormal pregnancies. Integration of these heterogeneous datasets using state-of-the-art machine-learning methods can enable the prediction of short- and long-term health trajectories for a mother and offspring and the development of treatments to prevent or minimize complications. We review advanced machine-learning methods that could: provide deeper biological insights into a pregnancy not yet unveiled by current methodologies; clarify the etiologies and heterogeneity of pathologies that affect a pregnancy; and suggest the best approaches to address disparities in outcomes affecting vulnerable populations.
Topics: Biomarkers; Computational Biology; Data Mining; Disease Susceptibility; Female; Genomics; Humans; Machine Learning; Metabolomics; Models, Biological; Pregnancy; Pregnancy Complications; Pregnancy Outcome; Proteomics; Reproductive Physiological Phenomena; Risk Assessment; Risk Factors
PubMed: 33573911
DOI: 10.1016/j.molmed.2021.01.007 -
Obstetrics and Gynecology Clinics of... Mar 2021Pregnancy confers a substantially increased risk of stroke, especially during the third trimester and until 6 weeks postpartum. Hypertensive disorders of pregnancy and... (Review)
Review
Pregnancy confers a substantially increased risk of stroke, especially during the third trimester and until 6 weeks postpartum. Hypertensive disorders of pregnancy and gestational hypercoagulability are important contributors to obstetric stroke. Preeclampsia and eclampsia confer risk for future cardiovascular disease. Hemorrhagic stroke is the most common type of obstetric stroke. Ischemic stroke can result from cardiomyopathy, paradoxical embolism, posterior reversible encephalopathy, reversible cerebral vasoconstriction syndrome, and dissections. Cerebral venous sinus thrombosis is a frequent complication of pregnancy.
Topics: Aspirin; Brain Diseases; Cardiomyopathies; Cesarean Section; Eclampsia; Embolism, Paradoxical; Female; Hemorrhagic Stroke; Humans; Hypertension, Pregnancy-Induced; Intracranial Thrombosis; Ischemic Stroke; Platelet Aggregation Inhibitors; Postpartum Period; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Cardiovascular; Risk Factors; Stroke
PubMed: 33573791
DOI: 10.1016/j.ogc.2020.11.004 -
Clinical Medicine (London, England) Sep 2021Liver disease in pregnancy can be related to a pre-existing condition (such as autoimmune liver disease) or arise as a consequence of pregnancy. In women with...
Liver disease in pregnancy can be related to a pre-existing condition (such as autoimmune liver disease) or arise as a consequence of pregnancy. In women with pre-existing disease, pre-pregnancy counselling is important to discuss the potential complications that may occur during pregnancy and how best to manage these. Acute fatty liver of pregnancy and HELLP (haemolysis, elevated liver enzymes and low platelets) syndrome are pregnancy-related liver diseases and are considered obstetric emergencies. Women with liver dysfunction need appropriate investigations, including blood tests and imaging. They should be managed as part of a multidisciplinary team with obstetricians, obstetric anaesthetists, specialist midwives, gastroenterologists and obstetric physicians.
Topics: Female; HELLP Syndrome; Humans; Liver; Liver Diseases; Pregnancy; Pregnancy Complications
PubMed: 34507927
DOI: 10.7861/clinmed.2021-0497 -
Biomedicine & Pharmacotherapy =... Jan 2021Dendritic cells (DCs) play a critical immuno-modulating role in pregnancy, which requires the maternal immune system to tolerate semiallogeneic fetus and at the same... (Review)
Review
Dendritic cells (DCs) play a critical immuno-modulating role in pregnancy, which requires the maternal immune system to tolerate semiallogeneic fetus and at the same time to maintain adequate defense against pathogens. DCs interact closely with other immune components such as T cells, natural killer cells and macrophages, as well as the endocrine system to keep a pregnancy-friendly environment. Aberrant DC activities have been related to various pregnancy-associated diseases such as recurrent spontaneous abortion, preterm birth, pre-eclampsia, peripartum cardiomyopathy and infectious pregnancy complications. These findings make DCs an attractive candidate for prevention or therapy on the pregnancy-associated diseases. Here, we review recent findings that provide new insights into the roles of DCs in pregnancy and the related diseases. We also discuss the medical potentials to manipulate DCs in clinics. Whereas this is an emerging area with much work remaining, we anticipate that a better understanding of the role of DCs in maternal-fetal immunotolerance and a therapeutic manipulation of DCs will help women suffering from the pregnancy-associated diseases.
Topics: Adoptive Transfer; Animals; Dendritic Cells; Female; Genetic Therapy; Histocompatibility, Maternal-Fetal; Humans; Immune Tolerance; Maternal-Fetal Exchange; Pregnancy; Pregnancy Complications; Risk Factors; Signal Transduction
PubMed: 33378991
DOI: 10.1016/j.biopha.2020.110921 -
Cirugia Y Cirujanos 2022Biliary pathology is a common disorder during pregnancy and its complications can put the pregnancy at risk.
INTRODUCTION
Biliary pathology is a common disorder during pregnancy and its complications can put the pregnancy at risk.
MATERIAL AND METHODS
A retrospective study of laparoscopic cholecystectomies in pregnant women was carried out during the period from January 2017 to April 2020 at Hospital Universitario "Dr. José Eleuterio González".
RESULTS
A total of 46 cases were obtained, only 3 patients had product loss, 1 immediately after surgery, second at 8 weeks' gestation, and the third due to complications of gestational hypertension.
CONCLUSION
Pancreatic-biliary cases during pregnancy are high risk for gestation, so it is preferable to perform laparoscopic cholecystectomy in selected cases were arising complications.
Topics: Cholecystectomy, Laparoscopic; Female; Gestational Age; Humans; Pregnancy; Pregnancy Complications; Retrospective Studies
PubMed: 35120103
DOI: 10.24875/CIRU.20001053 -
Current Oncology Reports Feb 2020Cancer diagnosis in young pregnant women challenges oncological decision-making. The International Network on Cancer, Infertility and Pregnancy (INCIP) aims to build on... (Review)
Review
PURPOSE OF REVIEW
Cancer diagnosis in young pregnant women challenges oncological decision-making. The International Network on Cancer, Infertility and Pregnancy (INCIP) aims to build on clinical recommendations based on worldwide collaborative research.
RECENT FINDINGS
A pregnancy may complicate diagnostic and therapeutic oncological options, as the unborn child must be protected from potentially hazardous exposures. Pregnant patients should as much as possible be treated as non-pregnant patients, in order to preserve maternal prognosis. Some approaches need adaptations when compared with standard treatment for fetal reasons. Depending on the gestational age, surgery, radiotherapy, and chemotherapy are possible during pregnancy. A multidisciplinary approach is the best guarantee for experience-driven decisions. A setting with a high-risk obstetrical unit is strongly advised to safeguard fetal growth and health. Research wise, the INCIP invests in clinical follow-up of children, as cardiac function, neurodevelopment, cancer occurrence, and fertility theoretically may be affected. Furthermore, parental psychological coping strategies, (epi)genetic alterations, and pathophysiological placental changes secondary to cancer (treatment) are topics of ongoing research. Further international research is needed to provide patients diagnosed with cancer during pregnancy with the best individualized management plan to optimize obstetrical and oncological care.
Topics: Adaptation, Psychological; Female; Humans; Infant, Newborn; Infertility, Female; Internationality; Neoplasms; Patient Care Team; Placenta Diseases; Pregnancy; Pregnancy Complications, Neoplastic; Pregnancy Outcome; Registries
PubMed: 32025953
DOI: 10.1007/s11912-020-0862-7 -
Tissue & Cell Aug 2022Preeclampsia is a common pregnancy complication, characterized by hypertension, proteinuria, or other organ or system lesions that appear after 20 weeks of gestation.... (Review)
Review
Preeclampsia is a common pregnancy complication, characterized by hypertension, proteinuria, or other organ or system lesions that appear after 20 weeks of gestation. Preeclampsia, a systemic multisystem disease of placental origin, is also one of the leading causes of maternal mortality. Serious complications such as HELLP syndrome and placental abruption that occur in patients with preeclampsia without active treatment will be life threatening. In recent years, extracellular vesicles, especially those derived from mesenchymal stem cells, have been widely used in the treatment of various diseases due to their excellent anti-inflammatory, tissue regeneration-promoting, and immunomodulatory properties. In this review, we attempt to summarize recent advances in the use of different sources of extracellular vesicles for the treatment of preeclampsia, and also describe the biological pathways and molecules involved in each study. Extracellular vesicle therapy has a good repair effect on trophoblast and endothelial system, and is a promising treatment for preeclampsia.
Topics: Extracellular Vesicles; Female; Humans; Placenta; Pre-Eclampsia; Pregnancy; Trophoblasts
PubMed: 35777290
DOI: 10.1016/j.tice.2022.101860 -
CMAJ : Canadian Medical Association... Nov 2021
Topics: Cardiomyopathies; Echocardiography; Female; Heart Failure; Humans; Pregnancy; Pregnancy Complications, Cardiovascular; Puerperal Disorders; Referral and Consultation; Risk
PubMed: 34782377
DOI: 10.1503/cmaj.210468 -
Biochimica Et Biophysica Acta.... Feb 2020In recent years, the vascular endothelium has gained attention as a key player in the initiation and development of pregnancy disorders. Endothelium acts as an endocrine... (Review)
Review
In recent years, the vascular endothelium has gained attention as a key player in the initiation and development of pregnancy disorders. Endothelium acts as an endocrine organ that preserves the homeostatic balance by responding to changes in metabolic status. However, in metabolic disorders, endothelial cells adopt a dysfunctional function, losing their normal responsiveness. During pregnancy, several metabolic changes occur, in which endothelial function decisively participates. Similarly, when pregnancy metabolic disorders occur, endothelial dysfunction plays a key role in pathogenesis. This review outlines the main findings regarding endothelial dysfunction in three main metabolic pathological conditions observed during pregnancy: gestational diabetes, hypertensive disorders, and obesity and hyperlipidemia. Organ, histological and cellular characteristics were thoroughly described. Also, we focused in discussing the underlying molecular mechanisms involved in the cellular signaling pathways that mediate responses in these pathological conditions.
Topics: Animals; Diabetes, Gestational; Eclampsia; Endothelial Cells; Endothelium, Vascular; Female; Homeostasis; Humans; Hyperlipidemias; Hypertension, Pregnancy-Induced; Lipids; Metabolic Diseases; Obesity, Maternal; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Signal Transduction
PubMed: 30794867
DOI: 10.1016/j.bbadis.2019.02.009 -
Psychiatria Danubina 2021Depression is the most prevalent mood disorder among pregnant women. Only 50% of women seek intervention during gestation. Untreated during pregnancy, depression can...
Depression is the most prevalent mood disorder among pregnant women. Only 50% of women seek intervention during gestation. Untreated during pregnancy, depression can induce obstetric and neonatal complications, most commonly, anhedonia, suboptimal weight gain, suicidal behavior, pre-term birth, and/or spontaneous miscarriage. The babies more often suffer cognitive deficits, low birth weight, and growth delay. The mothers subsequently also experience an increased risk for significant degrees of postpartum depression. Those with relatively milder cases of depression should initially receive psychotherapy. Otherwise, there are many antidepressant medications available for the pharmacotherapy of depression. However, treating pregnant females with depression is a challenge because of potential teratogenic effects caused by many pharmaceuticals. Physicians should know the recommended guidelines for treating depressed women during a time of gestation. It is crucial to identify women suffering from depression during pregnancy, and electing those that warrant pharmacotherapy while picking the best and safest medication is a complex process with paramount significance. Before prescribing an antidepressant drug, explain the advantages and disadvantages of the interventions. Whenever prescribing during these circumstances, more than conventionally close obstetric, emotional, and medication monitoring is to be provided. This would also include an emphasis on diet, exercise, psychotherapy, and avoidance of any non-critical medicinal or other substance exposures.
Topics: Antidepressive Agents; Depression, Postpartum; Exercise; Female; Humans; Infant, Newborn; Pregnancy; Pregnancy Complications; Pregnant Women
PubMed: 34185734
DOI: 10.24869/psyd.2021.147