RESUMEN
This article presents a review of scientific literature concerning adverse effect of tobacco smoking on concentration of the pregnancy-associated plasma protein A (PAPP-A) in pregnant women. PAPP-A is produced in great amounts during pregnancy by the syncytiotrofoblast, but can be also detected in a variety of cell types such as fibroblasts, osteoblasts and vascular smooth muscle cells (VSMC). We describe the structure of PAPP-A and its function as an insulin-like growth factor binding proteins (IGFBPs) protease with a focus on data obtained in tobacco smoking pregnant women. We also discuss the results of studies indicating a correlation between smoking and deficit of PAPP-A in the first trimester of pregnancy. The review summarizes possible mechanisms relating tobacco smoking to the changes of PAPP-A concentration during pregnancy.
Asunto(s)
Complicaciones del Embarazo/sangre , Proteína Plasmática A Asociada al Embarazo/metabolismo , Fumar/sangre , Adulto , Femenino , Humanos , Embarazo , Primer Trimestre del Embarazo , Proteína Plasmática A Asociada al Embarazo/química , Proteína Plasmática A Asociada al Embarazo/deficienciaRESUMEN
A combination of maternal serum levels of free beta human chorionic gonadotropin (free beta hCG) and pregnancy-associated plasma protein-A (PAPP-A) and fetal nuchal transluency thickness (fetal NT) has been shown to be an effective approach to screening for fetal trisomies in the first trimestr of pregnancy. A maternal smoking habit is known to influence these serum markers in singleton pregnancies however it has not been yet completely explained. The aim of this study was the investigation of PAPP-A and beta hCG concentrations in smoking women in the first trimester of pregnancy. The study comprised 215 women between 11th and 14th weeks of gestation: 135 cigarette smokers (age range 19-43 years) and 80 nonsmokers (age range 21-42 years). Only normal singleton pregnancies were included. Smoking women were divided into two groups: 75 women smoking during all along the first trimester and 60 women, who stopped smoking before 6 week of gestation. Maternal serum levels of PAPP-A and beta hCG were measured with the KRYPTOR rapid random-access immunoassay analyser (Brahms GmbH, Germany) using time-resolved amplified cryptate emission technology (TRACE). Combinated fetal nuchal translucency (NT), maternal age and biochemical risk estimates were calculated using the Fetal Medicine Foundation risk algorithm. We observed the lower of PAPP-A median values in both smoking groups by about 20% than in nonsmokers (0.86 MoM; 0.84 MoM versus 1.04 MoM; p < 0.01). We also indicated the lower values of beta hCG in smoking women in comparison to the nonsmoking controls, but this difference was not statistically significant. The concentrations of PAPP-A as well as beta hCG were similar in both groups of smoking women. Further studies will be continued to assessment of smoking influence before conception on maternal serum PAPP-A and beta hCG in the first trimester of pregnancy.
Asunto(s)
Gonadotropina Coriónica Humana de Subunidad beta/sangre , Complicaciones del Embarazo/sangre , Primer Trimestre del Embarazo/sangre , Proteína Plasmática A Asociada al Embarazo/metabolismo , Fumar/sangre , Adulto , Biomarcadores/sangre , Monitoreo del Ambiente , Femenino , Humanos , Embarazo , Adulto JovenRESUMEN
UNLABELLED: Evaluation of pregnancy-associated plasma protein A (PAPP-A) and free beta subunit of human chorionic gonadotropin (beta hCG) levels and sonographic assessment of fetal nuchal translucency (NT) in singleton pregnancies between 11 and 14 weeks of gestation--Poland's multi-centers research. OBJECTIVES: Pregnancy-associated plasma protein A has been reported to be low in Down syndrome affected pregnancies during the first trimester of pregnancy. Enlarged nuchal translucency (NT) is observed in about 80% of fetuses affected with chromosomal abnormalities and congenital heart defects (CHD). MATERIAL AND METHODS: The aim of this study were to determine value and the medians of free beta-human chorionic gonadotropin (beta-hCG) and pregnancy associated plasma protein-A (PAPP-A) and nuchal translucency thickness in the first trimester in a prospective study of a non-selected Polish population. RESULTS: All examinations have been performed according to the Fetal Medicine Foundation (FMF) rules. We have included 800 women between 11 weeks 0 days and 13 weeks 6 days gestation into a biochemical examination. Women booked into the clinic were offered screening, using a combination of maternal serum free beta-hCG and pregnancy-associated plasma protein-A (PAPP-A) and fetal nuchal translucency thickness. The maternal serum were measured using the Kryptor analyzer (Brahms Diagnostica). All pregnant women have been divided into 2 groups younger than (first group) and older than (second group) 35 years of age. CONCLUSIONS: Nomogrames for free beta-hCG and PAPP-A levels in physiological pregnancy between 11(+0) and 13(6) weeks were determined in the examined population. A positive correlation between PAPP-A and CRL levels, as well as a weak negative correlation between free beta-hCG and CRL, were demonstrated.
Asunto(s)
Gonadotropina Coriónica Humana de Subunidad beta/sangre , Síndrome de Down/diagnóstico , Enfermedades Fetales/diagnóstico , Medida de Translucencia Nucal , Proteína Plasmática A Asociada al Embarazo/análisis , Adulto , Factores de Edad , Femenino , Humanos , Recién Nacido , Polonia , Embarazo , Complicaciones del Embarazo/diagnóstico , Primer Trimestre del Embarazo , Embarazo de Alto Riesgo , Diagnóstico Prenatal/métodos , Valores de Referencia , Sensibilidad y EspecificidadRESUMEN
BACKGROUND: Gynecological examination and transvaginal ultrasound are difficult or impossible in girls and young women who have not started their sexual life. CT is not a method of choice in this age group because of the ionizing radiation and iodine-containing contrast media. MRI is chosen then. MATERIAL/METHODS: Pelvic MRI was performed in 15 patients aged 9-19 years with suspected ovarian mass after they had had unclear gynecological and sonographic examinations. 1.5 T MRI systems were used. SE,T(F)SE and SPIR sequences were applied in T1- and T2-weighted images in three planes. Contrast media were administered in 7 patients. RESULTS: In a group of 3 girls with acute abdominal pain, polycystic ovaries, ovarian hemorrhagic cyst, and fibroma of the ovary were diagnosed. In a group of 11 patients with chronic abdominal pain, dermoid cysts of the ovaries were found in 7 cases, in one bilateral and accompanied by ectopic kidney. In 2 patients, serous cysts were diagnosed. In 2 cases an ovarian origin of the mass was excluded: multilocular cystic lesion in the presacral region and a hydatid mole were revealed. A neoplastic ovarian mass was diagnosed in a girl with increasing circumference of the abdomen. The accuracy of MRI in localizing lesions was 100%. Its accuracy in precisely characterizing lesions was 83.3%. CONCLUSIONS: Magnetic resonance imaging, with its noninvasiveness, high spatial resolution, and tissue specificity, is a method of choice in the diagnosis or exclusion of ovarian pathology in children and adolescents.
Asunto(s)
Imagen por Resonancia Magnética/métodos , Enfermedades del Ovario , Adolescente , Niño , Femenino , Humanos , Enfermedades del Ovario/diagnóstico , Enfermedades del Ovario/diagnóstico por imagen , Enfermedades del Ovario/patología , Radiografía , Sensibilidad y EspecificidadRESUMEN
An improvement in prenatal screening for chromosomal defects in the first trimester of pregnancy has been achieved by combining sonography and biochemical markers. Among these markers exist the metalloproteinase pregnancy-associated plasma protein-A (PAPP-A) which promotes cell growth by proteolytic cleavage of insulin-like growth factor binding proteins (IGFBPs) causing the release of IGFs. The reduced level of PAPP-A in smokers in first-trimester has been reported previously. However, smoking influence on maternal level of PAPP-A during pregnancy has not been completely determined. The aim of this preliminary study was the investigation of PAPP-A concentrations in smoking women in the first- and third-trimester of pregnancy. The study comprised 40 pregnant women: 20 nonsmokers and 20 cigarette smokers. Only normal singleton pregnancies were included. Maternal serum levels of PAPP-A were measured with the KRYPTOR rapid random-access immunoassay analyser (Brahms GmbH, Germany) using time-resolved amplified cryptate emission technology (TRACE). In first-trimester of pregnancy we observed the lower of PAPP-A median values in smokers (2.77 IU/L, range 1.12-9.28 IU/L) by 24% than in nonsmokers (3.64 IU/L, range 1.68-6.79 IU/L). Next, we indicated that in third-trimester of pregnancy the PAPP-A median values were lower in smokers (48.45 IU/L, range 15.18-176.2 IU/L) until by 50% in comparison to the controls (96.56 IU/L, range 25.59-164.0 IU/L). Further studies will be continued to assessment the influence of some components from tobacco smoke on maternal serum PAPP-A in all trimesters of pregnancy.
Asunto(s)
Proteína Plasmática A Asociada al Embarazo/análisis , Fumar/efectos adversos , Fumar/sangre , Adulto , Femenino , Humanos , Embarazo , Primer Trimestre del Embarazo/sangreRESUMEN
Crouzon syndrome is a cranio-facial dysostosis with autosomal dominant transmission and a birth prevalence of 16.5 per million newborns. Up till now there is no publications in polish medical journals about ultrasonic diagnosis of Crouzon syndrome or of any other craniostenosis. The development of ultrasonography, three-dimensional ultrasonography and in the last years also MRI, allows earlier detection and diagnosis of fetal malformation and enables precise evaluation of his anatomy. The aim of the study is presentatoin Crouzon syndrom diagnosed prenatally by ultrasonography and confirmed moleculary by DNA analysis. We would like to stress the diagnostic problems and the difficult decisions that we encountered.
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Disostosis Craneofacial/diagnóstico por imagen , Disostosis Craneofacial/genética , Receptor Tipo 2 de Factor de Crecimiento de Fibroblastos/genética , Ultrasonografía Prenatal , Adulto , ADN/análisis , Diagnóstico Diferencial , Femenino , Humanos , Recién Nacido , Masculino , EmbarazoRESUMEN
Author discusses methods of magnetic resonance imaging and in status in the prenatal diagnosis as well as the impact of examination on the management plan for treatment of fetus and newborn.
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Imagen por Resonancia Magnética/métodos , Diagnóstico Prenatal/métodos , Femenino , Enfermedades Fetales/diagnóstico , Humanos , EmbarazoRESUMEN
During the year 2000 a screening was performed to estimate the frequency of Toxoplasma gondii infections in 2016 pregnant women and their children in the Department of Gynaecology and Obstetrics and in the Outpatient Clinic of the Institute of Mother and Child in Warsaw. The study was based on identifying IgG and IgM specific antibodies. All tests were done in the Department of Immunology. Women with serologically diagnosed primary infection were offered further follow up, antibiotic therapy and care during delivery in the Institute of Mother and Child. Children born by infected mothers were examined serologically and observed in terms of congenital abnormality. There were 1294 (64.19%) seronegative; 722 (35.81%) were infected before pregnancy (the presence of IgG antibodies). Five women with previous seronegative results (0.29%) were diagnosed as having primary infection during pregnancy. Congenital infection, confirmed serologically, was recognized in 3 newborn infants.