Thyroid hormones are critical for foetal neurological development and maternal health. Maternal hypothyroidism during pregnancy is associated with adverse impact on health of the mother as well as the progeny. Reduced...Thyroid hormones are critical for foetal neurological development and maternal health. Maternal hypothyroidism during pregnancy is associated with adverse impact on health of the mother as well as the progeny. Reduced thyroid hormone levels predispose the child to develop mental retardation and cognitive delay in early life. In the mother, hypothyroidism during pregnancy is associated with spontaneous abortion, placental abruption, preterm delivery and hypertensive disorders. Therefore, screening and therapeutic intervention is justified to prevent foetal as well as maternal co-morbidities. In view of impact of such a large-scale screening and intervention program on limited healthcare resources, it is debatable if a targeted rather than universal screening program will result in comparable outcomes. In addition, there is an ongoing debate regarding best evidence-based practice for the management of isolated hypothyroxinaemia, subclinical hypothyroidism and euthyroid women with autoimmune hypothyroidism. We have carried out a review of the literature; firstly, to determine whether universal screening for asymptomatic women in early pregnancy would be cost-effective. Secondly, we have retrospectively reviewed the literature to analyse the evidence regarding the impact of therapeutic intervention in women with subclinical hypothyroidism.展开更多
Malaria presents a significant global public health challenge,with severe malarial anaemia being a primary manifestation of the disease.The understanding of anaemia caused by malaria remains incomplete,making the trea...Malaria presents a significant global public health challenge,with severe malarial anaemia being a primary manifestation of the disease.The understanding of anaemia caused by malaria remains incomplete,making the treatment more complex.Iron is a crucial micronutrient essential for haemoglobin synthesis,oxygen delivery,and other vital metabolic functions in the body.It is indispensable for the growth of human beings,as well as bacteria,protozoa,and viruses in vitro and in vivo.Iron deficiency is among the most common nutritional deficiencies and can have detrimental effects during developmental stages of life.Malaria-induced iron deficiency occurs due to the hemolysis of erythrocytes and the suppression of erythropoiesis,leading to anaemia.Meeting iron requirements is particularly critical during pivotal life stages such as pregnancy,infancy,and childhood.Dietary intake alone may not suffice to meet adequate iron requirements,thus highlighting the vital role of iron supplementation.While iron supplementation can alleviate iron deficiency,it can exacerbate malaria infection by providing additional iron for the parasites.However,in the context of pregnancy and childhood,iron supplementation combined with malaria prevention and treatment has been shown to be beneficial in improving birth outcomes and ensuring proper growth and development,respectively.This review aims to identify the role and impact of iron supplementation in malaria infection during the life stages of pregnancy and childhood.展开更多
INTRODUCTION: Overt hypothyroidism in pregnancy is associated with adverse outcomes, but the effects of subclinical hypothyroidism and isolated hypothyroxinemia on pregnancy outcomes are still controversial. Subclinic...INTRODUCTION: Overt hypothyroidism in pregnancy is associated with adverse outcomes, but the effects of subclinical hypothyroidism and isolated hypothyroxinemia on pregnancy outcomes are still controversial. Subclinical hypothyroidism might be associated with preterm delivery, low Apgar score, fetal death and miscarriages and isolated hypothyroxinemia with preterm labor, high birth weight and neurocognitive deficits in children. Other studies show no association with any complications at all. In the present study we tried to estimate whether maternal subclinical hypothyroidism and isolated hypothyroxinemia are associated with complications during pregnancy in our population which represents the pregnant population of Western Greece. METHODS: In a total of 469 pregnant women, third trimester serum was assayed for thyroid-stimulating hormone (TSH) and free thyroxine (free T4). Thyroid hypofunction was defined as 1) subclinical hypothyroidism with TSH levels above 3 mIU/L for the 3rd trimester and normal free T4 and 2) isolated hypothyroxinemia with TSH levels below 3 mIU/L for the 3rd trimester and free T4 below the 5th percentile. The results were associated with birth weight, week of labor, history of miscarriages and demographic characteristics. Patients with thyroid hypofunction were compared with euthyroid patients (TSH and free T4 between normal limits). The results were analyzed with one-way ANOVA and χ2 test. RESULTS: Subclinical hypothyroidism was documented in 10.9% and isolated hypothyroxinemia in 21.7% of pregnant women. Subclinical hypothyroidism was not associated with birth weight, week of labor, or history of miscarriages. On the contrary, hypothyroxinemia was associated with high birth weight (P < 0.05). CONCLUSION: In our study, we did not find a link between subclinical hypothyroidism and adverse pregnancy outcomes. Similarly, hypothyroxinemia was not associated with pregnancy complications. However, it was associated with higher birth weight. Our studies contribute to our understanding, whether or not subclinical hypothyroidism and isolated hypothyroxinemia are associated with pregnancy adverse outcomes and whether treatment and test for hypothyroidism should become routine during pregnancy.展开更多
This study examined the situation of raising a four-month-old baby after pregnancy and childbirth during the COVID-19 pandemic. A fact-finding survey was conducted using an anonymous self-administered questionnaire fo...This study examined the situation of raising a four-month-old baby after pregnancy and childbirth during the COVID-19 pandemic. A fact-finding survey was conducted using an anonymous self-administered questionnaire for mothers and their husbands (hereinafter referred to as fathers) who came to A City, Osaka Prefecture, for health checkups of their four-month-old infants. The questionnaire was distributed to 733 mothers (252 responses). Valid responses were received from 247 participants (33.7%). The questionnaire was distributed to 733 fathers (191 responses). Valid responses were received from 184 participants (25.1%). Most participants belonged to nuclear family households. Sixty percent parents were primiparous. More than 90% parents did not participate in online parenting classes or attend childbirth. In addition, more than 80% mothers did not participate in face-to-face or online maternity classes, postpartum face-to-face visits from grandparents in the hospital, online home visits, telephone conversations, or support from non-relatives. Parents could not obtain information about childcare due to COVID-19. There were restrictions on prenatal checkups, visits, and use of facilities. Most of them resolved these problems via social media platforms, cooperating and communicating with their respective partners and relatives, and devising ways to play with their child. Health of nearly 30% mothers was affected by childcare stress and the pandemic, and they were either depressed or despondent. Approximately 70% experienced positive changes in family relationships and mindsets, such as time spent with family and cooperation received in childcare. During the COVID-19 pandemic, parents coped with various changes and problems they experienced during pregnancy, childbirth, and childcare by devising solutions based on their personal perspectives.展开更多
Disseminated intravascular coagulation (DIC)is a clinical syndrome caused by various etiologies and characterized by systemic activation of blood coagulation,leading to vessel thrombosis,organ dysfunction,and severe b...Disseminated intravascular coagulation (DIC)is a clinical syndrome caused by various etiologies and characterized by systemic activation of blood coagulation,leading to vessel thrombosis,organ dysfunction,and severe bleeding.^([1])DIC represents a life-threatening condition that is the endpoint of uncontrolled systemic activation of the disease.Once it enters the stage of malignant DIC,the patient’s death becomes unavoidable.DIC always occurs as a secondary disorder and is commonly associated with postpartum hemorrhage,followed by hypertensive disorders,acute fatty liver of pregnancy,sepsis,and amniotic fluid embolism (AFE).^([2])In clinical obstetrics,DIC often occurs during delivery or postpartum.展开更多
Gingival hyperplasia or gingival overgrowth, which is a common trait of gingival disease, is characterized by an increase in the size of the gingiva. Gingival hyperplasia according to past reports has numerous etiolog...Gingival hyperplasia or gingival overgrowth, which is a common trait of gingival disease, is characterized by an increase in the size of the gingiva. Gingival hyperplasia according to past reports has numerous etiological factors one of which is pregnancy due to increased hormone levels. Although pregnancy does not directly cause gingival hyperplasia, it may catalyze local etiological factors. Objectives: To determine the frequency and clinical aspects of gingival hyperplasia during pregnancy. Methodology: We conducted a cross sectional descriptive study from November 2021 to June 2022 at the Yaoundé Gyneco-Obstetrics and Pediatrics Hospital. Data were collected using a pretested questionnaire and clinical assessments done using dental consultation kits. Data were analyzed with the International Business Machine Statistical Package for Social Sciences (IBM SPSS) version 21.0 software. Results: We recruited 231 eligible participants for our study. Of 231, 101 (43.7%) had gingival hyperplasia. Most of our study population were between 20 - 40 years old and gingival hyperplasia was most commonly found in the 3<sup>rd</sup> trimester (60.7%). We reported that 31.3% of our population had a plaque score 2 and only 7.8% had consulted a dentist during pregnancy. We also observed that 93.3% of our population manifested a mild/moderate form of the disease while 6.9% had a severe form. Our study showed that 72.3% and 27.3% had a localized and generalized form of the disease, respectively. Conclusion: We concluded that gingival hyperplasia is a common pathology in pregnant women. It is most found in the third trimester. It presents more commonly as a localized form, and degree of severity is mostly moderate.展开更多
To investigate the role of nutrients intake during pregnancy with longitudinal development of rhinitis,asthma,eczema,wheeze,and food allergy in offspring.The PubMed,Embase,and Cochrane library were searched for articl...To investigate the role of nutrients intake during pregnancy with longitudinal development of rhinitis,asthma,eczema,wheeze,and food allergy in offspring.The PubMed,Embase,and Cochrane library were searched for articles published throughout May 2022.The pooled effect estimate were presented using relative risk and calculated by the random-effects model.Twenty-three prospective cohort studies enrolling 210817 individuals were included.The risk of wheeze in offspring were lowered when high vitamin D,vitamin E,zinc,and milk intakes during pregnancy,whereas high meat intake during pregnancy could induce additional risk of wheeze in offspring.Moreover,highβ-carotene and magnesium intakes during pregnancy were related to lower eczema risk in offspring,whereas eczema risk in offspring was increased for pregnant women with high intake of butter and margarine.Finally,the asthma risk in offspring could protect against for pregnant women with high intake of vitamin D and apple,whereas high folic acid during pregnancy could produce excess asthma risk in offspring.This study provides the summary evidences regarding the role of nutrients intake during pregnancy and subsequent risk of rhinitis,asthma,eczema,wheeze,and food allergy,and further effective intervention strategies should be employed to improve childhood allergic diseases.展开更多
Background: The two most common types of cephalalgia in women are migraine and tension-type cephalalgia. Cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficul...Background: The two most common types of cephalalgia in women are migraine and tension-type cephalalgia. Cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Objectives: To investigate the prevalence and the characteristics of maternal cephalalgia during pregnancy and early postpartum and identify associated risk factors. Study Design: This study was conducted between May 2012 and August 2012. The study population comprised 170 mothers. The interviews were conducted in a postnatal ward during the first postpartum week and information on the characteristics of maternal cephalalgia before and during pregnancy was collected. Data regarding previous history of cephalalgia, pregnancy and postpartum health history, as well as the mode of delivery were also recorded. Mothers were given a cephalalgia diary in order to record medication use, as well as cephalalgia attack frequency, severity (5-level scale) and duration. The following surveys were administered: Edinburgh Postnatal Depression Scale (EPDS), Mediterranean Diet Score (Medi Score), International Physical Activity Questionnaire (IPAQ) and Women Abuse Screening Tool (WAST) within the first week postpartum. Statistical analyses were performed using SPSS 19. The level of statistical significance was set at p Results: Maternal self-reported cephalalgia in pregnancy and early postpartum was significantly associated with scores in EPDS (depressive symptoms) (p = 0.005), hypertension (p Conclusion: Pregnancy and early postpartum is a graceful period in women with cephalalgia. However, cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Further studies should elucidate the safety and recommended use of cephalalgia medication during pregnancy and breastfeeding.展开更多
Background: Gestational formation of new urolithiasis is rare yet the impact of inappropriate gestational calcium and vitamin D supplementation (Ca/DS) is underestimated. Patients and Methods: we retrospectively evalu...Background: Gestational formation of new urolithiasis is rare yet the impact of inappropriate gestational calcium and vitamin D supplementation (Ca/DS) is underestimated. Patients and Methods: we retrospectively evaluated 75 pregnant women with history of UL, yet were stable for >2 years on dietary restrictions, for new UL after Ca/DS. Results: During the past 5 years 21 (48%) of those who had received Ca/DS had developed UL and all had high Vitamin D with hypercalcemia while the remaining 31 patients, without Ca/DS, did not have UL and maintained normal vitamin D urinary calcium without need for supplementation. Overt UL was evident by 30th weeks of gestations and most were diagnosed by ultrasonography and managed by medical expulsive therapy. Conclusion: in patients with history of UL, prudent use of Ca/DS is indicated to avoid new UL.展开更多
BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute symptoms.Currently,surgical interv...BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute symptoms.Currently,surgical interventions utilized among these patients is poorly studied.AIM To evaluate the surgical indications,timing,perioperative precautions and postoperative complications of PAs during pregnancy and to provide comprehensive guidance.METHODS Six patients with PAs who underwent surgical treatment during pregnancy at Peking Union Medical College Hospital between January 1990 and June 2021 were recruited for this study.Another 35 pregnant patients who were profiled in the literature were included in our analysis.RESULTS The 41 enrolled patients had acute symptoms including visual field defects,severe headaches or vision loss that required emergency pituitary surgeries.PA apoplexies were found in 23 patients.The majority of patients(55.9%)underwent surgery in the second trimester of pregnancy.A multidisciplinary team was involved in patient care from the preoperative period through the postpartum period.With the exception of 1 patient who underwent an induced abortion and 1 fetus that died due to a nuchal cord,39 patients delivered successfully.Among them,37 fetuses were healthy until the most recent follow-up.CONCLUSION PA surgery during pregnancy is effective and safe during the second and third trimesters.Pregnant patients requiring emergency PA surgery require multidisciplinary evaluation and healthcare management.展开更多
BACKGROUND Hysteromyoma is not a rare tumor among pregnant women.During pregnancy,the symptoms caused by hysteromyoma can be improved through conservative treatment in most cases.However,in order to ensure the safety ...BACKGROUND Hysteromyoma is not a rare tumor among pregnant women.During pregnancy,the symptoms caused by hysteromyoma can be improved through conservative treatment in most cases.However,in order to ensure the safety of mothers and children,surgeries are necessary in some special cases.CASE SUMMARY We report a case of pregnancy complicated with hysteromyoma red degeneration.The patient had peritonitis after sudden abdominal pain during the 20th week of pregnancy.Laparoscopic exploration suggested rupture and bleeding of hysteromyoma,which were improved after drainage and an anti-inflammatory treatment.A cesarean section was performed after full term.This case shows the complications of rupture after red degeneration of hysteromyoma during pregnancy.CONCLUSION We should be alert to rupture of hysteromyoma during pregnancy,and active laparoscopic exploration is essential to improve the prognosis of such patients.展开更多
Traditional medicine(TM)has been more popular among pregnant women worldwide and has played a significant part in maternal health-care services in many nations.Herbs,herbal preparations,and finished herbal products al...Traditional medicine(TM)has been more popular among pregnant women worldwide and has played a significant part in maternal health-care services in many nations.Herbs,herbal preparations,and finished herbal products all contain active substances that are derived from plant parts or other plant components that are thought to have medicinal advantages.To diagnose,prevent,and treat illnesses as well as to enhance general well-being,about 80%of people use a variety of TM,including herbal remedies.A systematic search of Google Scholar and PubMed was performed utilizing an established scoping review framework by Joanna Briggs Institute from January 2012 to December 2022.A consequent title and abstract review of articles published on TM in the African context were completed.Of over 15,000 published studies identified,15 meeting the inclusion criteria were integrated into the following seven categorical themes:prevalence of TM use,source of information on TM use,reasons for use of TM,route of administration,common herbs used in pregnancy and labor,the effect of herbs used in pregnancy and labor,and predictors of use of TM.The studies reviewed were primarily in the context of an African setting on the use of TM regarding herbal medicine.Of all the articles,the highest number of studies was conducted in Zimbabwe.This review shows increased use of TM by women during pregnancy and labor with a reported prevalence rate varying from 12%to 60%.However,a decrease in use in the third trimester of pregnancy was reported.The most frequent source of information on the use of TM was from family and friends,while age,parity,education,and income were factors affecting use.In conclusion,the participants do not often disclose the use of TM during their antenatal attendance and the reason for use was accessibility and cost.Therefore,there is a need for further study on the safety and efficacy of TM use in pregnancy and labor.展开更多
Traditional medicine(TM)has played an essential part in maternity services around the world,which has led to increased utilization among pregnant women.Herbs,herbal preparations,and completed herbal products are examp...Traditional medicine(TM)has played an essential part in maternity services around the world,which has led to increased utilization among pregnant women.Herbs,herbal preparations,and completed herbal products are examples of TMs that contain active substances such as plant parts or other plant components that are thought to have therapeutic advantages.This study review aimed to identify the herbs commonly used,reasons for use,and effect of use,to make adequate recommendations on herbal medicine use as a remedy for pregnancy and labor.Incorporating evidence from reviews,personal correspondence,and diaries,this study demonstrates that about 80%of people used TM such as herbal remedies for sickness diagnosis,prevention,treatment,and promotion of general well‑being.Due to its accessibility,cost,and availability,TM is usually used by expectant mothers.Examples of TM used in pregnancy and labor include honey,aloe,raspberry,jute mallow,and hibiscus leaves.It is important to note that its use in pregnancy and labor can be beneficial or harmful to both mother and child.Lack of standardization,financial risk,lack of safety,and effectiveness are challenges to TM.There is a need of creating awareness of the safe use and effects of TM in pregnancy and labor through the provision of health education programs for women in the community.展开更多
BACKGROUND Repetitive transcranial magnetic stimulation(rTMS)is a form of magnetic stimulation therapy used to treat depression,migraine,and motor function impairment in patients with stroke.As there is little researc...BACKGROUND Repetitive transcranial magnetic stimulation(rTMS)is a form of magnetic stimulation therapy used to treat depression,migraine,and motor function impairment in patients with stroke.As there is little research on the effects of rTMS in pregnant women,it is not widely used in these patients.This case report aimed to demonstrate the safety of rTMS in pregnant patients.CASE SUMMARY After much consideration,we applied rTMS to treat recent stroke and hemiplegia in a 34-year-old pregnant woman.The patient received 45 sessions of lowfrequency treatment over the course of 10 wk.We closely monitored the mother and fetus for potential side effects;the results showed significant improvement in the patient's motor function,with no harmful effects on the mother or fetus during pregnancy or after delivery.The patient’s fine motor and walking functions improved after treatment.This case is the first instance of a stroke patient treated with rTMS during pregnancy.CONCLUSION This case demonstrates that rTMS could be used to improve motor function recovery in stroke patients during pregnancy.展开更多
BACKGROUND Renal tubular acidosis(RTA)is a renal cause of non-anion-gap metabolic acidosis characterized by low urinary ammonia excretion.This condition has a low prevalence,and various congenital and acquired etiolog...BACKGROUND Renal tubular acidosis(RTA)is a renal cause of non-anion-gap metabolic acidosis characterized by low urinary ammonia excretion.This condition has a low prevalence,and various congenital and acquired etiologies.To date,only a few cases of idiopathic RTA uncovered during pregnancy have been reported.CASE SUMMARY A previously healthy 32-year-old Korean woman at 30 wk of gestation was admitted to Pusan National University Hospital with preterm labor.At admission,the patient presented with hypokalemia,non-anion-gap metabolic acidosis,and nephrocalcinosis.Distal RTA was diagnosed based on laboratory blood and urine findings and imaging examinations.Various tests,including next-generation gene sequencing panels for nephropathy,were performed to determine the etiology of the disease,which indicated that it was idiopathic.The patient received sodium bicarbonate and potassium chloride supplementation.After 3 wk,she delivered a baby who was subsequently diagnosed with corpus callosum agenesis and colpocephaly.During regular follow-ups for 6 mo postpartum,her hypokalemia and metabolic acidosis were gradually resolved,and medications eventually discontinued.CONCLUSION Herein we describe a case of idiopathic distal RTA discovered during pregnancy.Hypokalemia and metabolic acidosis resolved spontaneously after delivery.展开更多
BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP a...BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP are now diagnosed early and can be managed safely.However,some atypical patients are misdiagnosed,and their surgical risks are underestimated,increasing the risk of fatal hemorrhage.CASE SUMMARY A 27-year-old Asian woman visited our institution because of abnormal pregnancy,and she was diagnosed with a hydatidiform mole through transvaginal ultrasound(TVS).Under hysteroscopy,a large amount of placental tissue was found in the scar of the lower uterine segment,and a sudden massive hemorrhage occurred during the removal process.The bilateral internal iliac arteries were temporarily blocked under laparoscopy,and scar resection and repair were rapidly performed.She was discharged in good condition 5 d after the operation.CONCLUSION Although TVS is widely used in the diagnosis of CSP,delays in the diagnosis of atypical CSP remain.Surgical treatment following internal iliac artery temporary occlusion may be an appropriate management method for unanticipated massive hemorrhage during CSP surgery.展开更多
BACKGROUND:Agitation is a common presentation within emergent departments(EDs).Agitation during pregnancy should be treated as an obstetric emergency,as the distress may jeopardize both the patient and fetus.The safet...BACKGROUND:Agitation is a common presentation within emergent departments(EDs).Agitation during pregnancy should be treated as an obstetric emergency,as the distress may jeopardize both the patient and fetus.The safety of psychotropic medications in the reproductive age female has not been well established.This review aimed to explore a summary of general agitation recommendations with an emphasis on ED management of agitation during pregnancy.METHODS:A literature review was conducted to explore the pathophysiology of acute agitation and devise a preferred treatment plan for ED management of acute agitation in the reproductive age or pregnant female.RESULTS:While nonpharmacological management is preferred,ED visits for agitation often require medical management.Medication should be selected based on the etiology of agitation and the clinical setting to avoid major adverse effects.Adverse effects are common in pregnant females.For mild to moderate agitation in pregnancy,diphenhydramine is an effective sedating agent with minimal adverse effects.In moderate to severe agitation,high-potency typical psychotropics are preferred due to their neutral effects on hemodynamics.Haloperidol has become the most frequently utilized psychotropic for agitation during pregnancy.Second generation psychotropics are often utilized as second-line therapy,including risperidone.Benzodiazepines and ketamine have demonstrated adverse fetal outcomes.CONCLUSION:While randomized control studies cannot be ethically conducted on pregnant patients requiring sedation,animal models and epidemiologic studies have demonstrated the effects of psychotropic medication exposure in utero.As the fetal risk associated with multiple doses of psychotropic medications remains unknown,weighing the risks and benefits of each agent,while utilizing the lowest effective dose remains critical in the treatment of acute agitation within the EDs.展开更多
Osteogenesis imperfecta(OI)is a primary bone fragility disorder with an estimated prevalence of 1/15,000 births and is a hereditary syndrome characterized by one or more of the following:fractures,blue sclerae,impaire...Osteogenesis imperfecta(OI)is a primary bone fragility disorder with an estimated prevalence of 1/15,000 births and is a hereditary syndrome characterized by one or more of the following:fractures,blue sclerae,impaired hearing,defective dentition,and hyperlaxibility throughout life.[1,2]We report a pregnant woman with type II OI and review her prenatal counseling,diagnosis,and pregnancy management to assist obstetricians in understanding the disease and managing it in emergency situations.展开更多
Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not ...Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ<sup>2</sup> test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.展开更多
Integrins are a highly complex family of receptors that, when expressed on the surface of cells, can mediate reciprocal cell-to-cell and cell-to-extracellular matrix(ECM) interactions leading to assembly of integrin a...Integrins are a highly complex family of receptors that, when expressed on the surface of cells, can mediate reciprocal cell-to-cell and cell-to-extracellular matrix(ECM) interactions leading to assembly of integrin adhesion complexes(IACs) that initiate many signaling functions both at the membrane and deeper within the cytoplasm to coordinate processes including cell adhesion, migration, proliferation, survival, differentiation, and metabolism. All metazoan organisms possess integrins, and it is generally agreed that integrins were associated with the evolution of multicellularity, being essential for the association of cells with their neighbors and surroundings, during embryonic development and many aspects of cellular and molecular biology. Integrins have important roles in many aspects of embryonic development, normal physiology, and disease processes with a multitude of functions discovered and elucidated for integrins that directly influence many areas of biology and medicine, including mammalian pregnancy, in particular implantation of the blastocyst to the uterine wall, subsequent placentation and conceptus(embryo/fetus and associated placental membranes) development. This review provides a succinct overview of integrin structure, ligand binding, and signaling followed with a concise overview of embryonic development, implantation, and early placentation in pigs, sheep, humans, and mice as an example for rodents. A brief timeline of the initial localization of integrin subunits to the uterine luminal epithelium(LE) and conceptus trophoblast is then presented, followed by sequential summaries of integrin expression and function during gestation in pigs, sheep, humans, and rodents. As appropriate for this journal, summaries of integrin expression and function during gestation in pigs and sheep are in depth, whereas summaries for humans and rodents are brief. Because similar models to those illustrated in Fig. 1, 2, 3, 4, 5 and 6 are present throughout the scientific literature, the illustrations in this manuscript are drafted as Viking imagery for entertainment purposes.展开更多
文摘Thyroid hormones are critical for foetal neurological development and maternal health. Maternal hypothyroidism during pregnancy is associated with adverse impact on health of the mother as well as the progeny. Reduced thyroid hormone levels predispose the child to develop mental retardation and cognitive delay in early life. In the mother, hypothyroidism during pregnancy is associated with spontaneous abortion, placental abruption, preterm delivery and hypertensive disorders. Therefore, screening and therapeutic intervention is justified to prevent foetal as well as maternal co-morbidities. In view of impact of such a large-scale screening and intervention program on limited healthcare resources, it is debatable if a targeted rather than universal screening program will result in comparable outcomes. In addition, there is an ongoing debate regarding best evidence-based practice for the management of isolated hypothyroxinaemia, subclinical hypothyroidism and euthyroid women with autoimmune hypothyroidism. We have carried out a review of the literature; firstly, to determine whether universal screening for asymptomatic women in early pregnancy would be cost-effective. Secondly, we have retrospectively reviewed the literature to analyse the evidence regarding the impact of therapeutic intervention in women with subclinical hypothyroidism.
文摘Malaria presents a significant global public health challenge,with severe malarial anaemia being a primary manifestation of the disease.The understanding of anaemia caused by malaria remains incomplete,making the treatment more complex.Iron is a crucial micronutrient essential for haemoglobin synthesis,oxygen delivery,and other vital metabolic functions in the body.It is indispensable for the growth of human beings,as well as bacteria,protozoa,and viruses in vitro and in vivo.Iron deficiency is among the most common nutritional deficiencies and can have detrimental effects during developmental stages of life.Malaria-induced iron deficiency occurs due to the hemolysis of erythrocytes and the suppression of erythropoiesis,leading to anaemia.Meeting iron requirements is particularly critical during pivotal life stages such as pregnancy,infancy,and childhood.Dietary intake alone may not suffice to meet adequate iron requirements,thus highlighting the vital role of iron supplementation.While iron supplementation can alleviate iron deficiency,it can exacerbate malaria infection by providing additional iron for the parasites.However,in the context of pregnancy and childhood,iron supplementation combined with malaria prevention and treatment has been shown to be beneficial in improving birth outcomes and ensuring proper growth and development,respectively.This review aims to identify the role and impact of iron supplementation in malaria infection during the life stages of pregnancy and childhood.
文摘INTRODUCTION: Overt hypothyroidism in pregnancy is associated with adverse outcomes, but the effects of subclinical hypothyroidism and isolated hypothyroxinemia on pregnancy outcomes are still controversial. Subclinical hypothyroidism might be associated with preterm delivery, low Apgar score, fetal death and miscarriages and isolated hypothyroxinemia with preterm labor, high birth weight and neurocognitive deficits in children. Other studies show no association with any complications at all. In the present study we tried to estimate whether maternal subclinical hypothyroidism and isolated hypothyroxinemia are associated with complications during pregnancy in our population which represents the pregnant population of Western Greece. METHODS: In a total of 469 pregnant women, third trimester serum was assayed for thyroid-stimulating hormone (TSH) and free thyroxine (free T4). Thyroid hypofunction was defined as 1) subclinical hypothyroidism with TSH levels above 3 mIU/L for the 3rd trimester and normal free T4 and 2) isolated hypothyroxinemia with TSH levels below 3 mIU/L for the 3rd trimester and free T4 below the 5th percentile. The results were associated with birth weight, week of labor, history of miscarriages and demographic characteristics. Patients with thyroid hypofunction were compared with euthyroid patients (TSH and free T4 between normal limits). The results were analyzed with one-way ANOVA and χ2 test. RESULTS: Subclinical hypothyroidism was documented in 10.9% and isolated hypothyroxinemia in 21.7% of pregnant women. Subclinical hypothyroidism was not associated with birth weight, week of labor, or history of miscarriages. On the contrary, hypothyroxinemia was associated with high birth weight (P < 0.05). CONCLUSION: In our study, we did not find a link between subclinical hypothyroidism and adverse pregnancy outcomes. Similarly, hypothyroxinemia was not associated with pregnancy complications. However, it was associated with higher birth weight. Our studies contribute to our understanding, whether or not subclinical hypothyroidism and isolated hypothyroxinemia are associated with pregnancy adverse outcomes and whether treatment and test for hypothyroidism should become routine during pregnancy.
文摘This study examined the situation of raising a four-month-old baby after pregnancy and childbirth during the COVID-19 pandemic. A fact-finding survey was conducted using an anonymous self-administered questionnaire for mothers and their husbands (hereinafter referred to as fathers) who came to A City, Osaka Prefecture, for health checkups of their four-month-old infants. The questionnaire was distributed to 733 mothers (252 responses). Valid responses were received from 247 participants (33.7%). The questionnaire was distributed to 733 fathers (191 responses). Valid responses were received from 184 participants (25.1%). Most participants belonged to nuclear family households. Sixty percent parents were primiparous. More than 90% parents did not participate in online parenting classes or attend childbirth. In addition, more than 80% mothers did not participate in face-to-face or online maternity classes, postpartum face-to-face visits from grandparents in the hospital, online home visits, telephone conversations, or support from non-relatives. Parents could not obtain information about childcare due to COVID-19. There were restrictions on prenatal checkups, visits, and use of facilities. Most of them resolved these problems via social media platforms, cooperating and communicating with their respective partners and relatives, and devising ways to play with their child. Health of nearly 30% mothers was affected by childcare stress and the pandemic, and they were either depressed or despondent. Approximately 70% experienced positive changes in family relationships and mindsets, such as time spent with family and cooperation received in childcare. During the COVID-19 pandemic, parents coped with various changes and problems they experienced during pregnancy, childbirth, and childcare by devising solutions based on their personal perspectives.
基金supported by a grant from Scientific Research Foundation of the National Health Commission (WKJ-ZJ-2126)。
文摘Disseminated intravascular coagulation (DIC)is a clinical syndrome caused by various etiologies and characterized by systemic activation of blood coagulation,leading to vessel thrombosis,organ dysfunction,and severe bleeding.^([1])DIC represents a life-threatening condition that is the endpoint of uncontrolled systemic activation of the disease.Once it enters the stage of malignant DIC,the patient’s death becomes unavoidable.DIC always occurs as a secondary disorder and is commonly associated with postpartum hemorrhage,followed by hypertensive disorders,acute fatty liver of pregnancy,sepsis,and amniotic fluid embolism (AFE).^([2])In clinical obstetrics,DIC often occurs during delivery or postpartum.
文摘Gingival hyperplasia or gingival overgrowth, which is a common trait of gingival disease, is characterized by an increase in the size of the gingiva. Gingival hyperplasia according to past reports has numerous etiological factors one of which is pregnancy due to increased hormone levels. Although pregnancy does not directly cause gingival hyperplasia, it may catalyze local etiological factors. Objectives: To determine the frequency and clinical aspects of gingival hyperplasia during pregnancy. Methodology: We conducted a cross sectional descriptive study from November 2021 to June 2022 at the Yaoundé Gyneco-Obstetrics and Pediatrics Hospital. Data were collected using a pretested questionnaire and clinical assessments done using dental consultation kits. Data were analyzed with the International Business Machine Statistical Package for Social Sciences (IBM SPSS) version 21.0 software. Results: We recruited 231 eligible participants for our study. Of 231, 101 (43.7%) had gingival hyperplasia. Most of our study population were between 20 - 40 years old and gingival hyperplasia was most commonly found in the 3<sup>rd</sup> trimester (60.7%). We reported that 31.3% of our population had a plaque score 2 and only 7.8% had consulted a dentist during pregnancy. We also observed that 93.3% of our population manifested a mild/moderate form of the disease while 6.9% had a severe form. Our study showed that 72.3% and 27.3% had a localized and generalized form of the disease, respectively. Conclusion: We concluded that gingival hyperplasia is a common pathology in pregnant women. It is most found in the third trimester. It presents more commonly as a localized form, and degree of severity is mostly moderate.
基金supported by CAMS Innovation Fund for Medical Science(CIFMS 2019-I2M-5-024)。
文摘To investigate the role of nutrients intake during pregnancy with longitudinal development of rhinitis,asthma,eczema,wheeze,and food allergy in offspring.The PubMed,Embase,and Cochrane library were searched for articles published throughout May 2022.The pooled effect estimate were presented using relative risk and calculated by the random-effects model.Twenty-three prospective cohort studies enrolling 210817 individuals were included.The risk of wheeze in offspring were lowered when high vitamin D,vitamin E,zinc,and milk intakes during pregnancy,whereas high meat intake during pregnancy could induce additional risk of wheeze in offspring.Moreover,highβ-carotene and magnesium intakes during pregnancy were related to lower eczema risk in offspring,whereas eczema risk in offspring was increased for pregnant women with high intake of butter and margarine.Finally,the asthma risk in offspring could protect against for pregnant women with high intake of vitamin D and apple,whereas high folic acid during pregnancy could produce excess asthma risk in offspring.This study provides the summary evidences regarding the role of nutrients intake during pregnancy and subsequent risk of rhinitis,asthma,eczema,wheeze,and food allergy,and further effective intervention strategies should be employed to improve childhood allergic diseases.
文摘Background: The two most common types of cephalalgia in women are migraine and tension-type cephalalgia. Cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Objectives: To investigate the prevalence and the characteristics of maternal cephalalgia during pregnancy and early postpartum and identify associated risk factors. Study Design: This study was conducted between May 2012 and August 2012. The study population comprised 170 mothers. The interviews were conducted in a postnatal ward during the first postpartum week and information on the characteristics of maternal cephalalgia before and during pregnancy was collected. Data regarding previous history of cephalalgia, pregnancy and postpartum health history, as well as the mode of delivery were also recorded. Mothers were given a cephalalgia diary in order to record medication use, as well as cephalalgia attack frequency, severity (5-level scale) and duration. The following surveys were administered: Edinburgh Postnatal Depression Scale (EPDS), Mediterranean Diet Score (Medi Score), International Physical Activity Questionnaire (IPAQ) and Women Abuse Screening Tool (WAST) within the first week postpartum. Statistical analyses were performed using SPSS 19. The level of statistical significance was set at p Results: Maternal self-reported cephalalgia in pregnancy and early postpartum was significantly associated with scores in EPDS (depressive symptoms) (p = 0.005), hypertension (p Conclusion: Pregnancy and early postpartum is a graceful period in women with cephalalgia. However, cephalalgia is associated with an increased risk of developing pregnancy complications or psychological difficulties. Further studies should elucidate the safety and recommended use of cephalalgia medication during pregnancy and breastfeeding.
文摘Background: Gestational formation of new urolithiasis is rare yet the impact of inappropriate gestational calcium and vitamin D supplementation (Ca/DS) is underestimated. Patients and Methods: we retrospectively evaluated 75 pregnant women with history of UL, yet were stable for >2 years on dietary restrictions, for new UL after Ca/DS. Results: During the past 5 years 21 (48%) of those who had received Ca/DS had developed UL and all had high Vitamin D with hypercalcemia while the remaining 31 patients, without Ca/DS, did not have UL and maintained normal vitamin D urinary calcium without need for supplementation. Overt UL was evident by 30th weeks of gestations and most were diagnosed by ultrasonography and managed by medical expulsive therapy. Conclusion: in patients with history of UL, prudent use of Ca/DS is indicated to avoid new UL.
文摘BACKGROUND Although conservative treatment is typically recommended for pregnant patients with pituitary adenoma(PA),surgical treatment is occasionally necessary for those with acute symptoms.Currently,surgical interventions utilized among these patients is poorly studied.AIM To evaluate the surgical indications,timing,perioperative precautions and postoperative complications of PAs during pregnancy and to provide comprehensive guidance.METHODS Six patients with PAs who underwent surgical treatment during pregnancy at Peking Union Medical College Hospital between January 1990 and June 2021 were recruited for this study.Another 35 pregnant patients who were profiled in the literature were included in our analysis.RESULTS The 41 enrolled patients had acute symptoms including visual field defects,severe headaches or vision loss that required emergency pituitary surgeries.PA apoplexies were found in 23 patients.The majority of patients(55.9%)underwent surgery in the second trimester of pregnancy.A multidisciplinary team was involved in patient care from the preoperative period through the postpartum period.With the exception of 1 patient who underwent an induced abortion and 1 fetus that died due to a nuchal cord,39 patients delivered successfully.Among them,37 fetuses were healthy until the most recent follow-up.CONCLUSION PA surgery during pregnancy is effective and safe during the second and third trimesters.Pregnant patients requiring emergency PA surgery require multidisciplinary evaluation and healthcare management.
文摘BACKGROUND Hysteromyoma is not a rare tumor among pregnant women.During pregnancy,the symptoms caused by hysteromyoma can be improved through conservative treatment in most cases.However,in order to ensure the safety of mothers and children,surgeries are necessary in some special cases.CASE SUMMARY We report a case of pregnancy complicated with hysteromyoma red degeneration.The patient had peritonitis after sudden abdominal pain during the 20th week of pregnancy.Laparoscopic exploration suggested rupture and bleeding of hysteromyoma,which were improved after drainage and an anti-inflammatory treatment.A cesarean section was performed after full term.This case shows the complications of rupture after red degeneration of hysteromyoma during pregnancy.CONCLUSION We should be alert to rupture of hysteromyoma during pregnancy,and active laparoscopic exploration is essential to improve the prognosis of such patients.
文摘Traditional medicine(TM)has been more popular among pregnant women worldwide and has played a significant part in maternal health-care services in many nations.Herbs,herbal preparations,and finished herbal products all contain active substances that are derived from plant parts or other plant components that are thought to have medicinal advantages.To diagnose,prevent,and treat illnesses as well as to enhance general well-being,about 80%of people use a variety of TM,including herbal remedies.A systematic search of Google Scholar and PubMed was performed utilizing an established scoping review framework by Joanna Briggs Institute from January 2012 to December 2022.A consequent title and abstract review of articles published on TM in the African context were completed.Of over 15,000 published studies identified,15 meeting the inclusion criteria were integrated into the following seven categorical themes:prevalence of TM use,source of information on TM use,reasons for use of TM,route of administration,common herbs used in pregnancy and labor,the effect of herbs used in pregnancy and labor,and predictors of use of TM.The studies reviewed were primarily in the context of an African setting on the use of TM regarding herbal medicine.Of all the articles,the highest number of studies was conducted in Zimbabwe.This review shows increased use of TM by women during pregnancy and labor with a reported prevalence rate varying from 12%to 60%.However,a decrease in use in the third trimester of pregnancy was reported.The most frequent source of information on the use of TM was from family and friends,while age,parity,education,and income were factors affecting use.In conclusion,the participants do not often disclose the use of TM during their antenatal attendance and the reason for use was accessibility and cost.Therefore,there is a need for further study on the safety and efficacy of TM use in pregnancy and labor.
文摘Traditional medicine(TM)has played an essential part in maternity services around the world,which has led to increased utilization among pregnant women.Herbs,herbal preparations,and completed herbal products are examples of TMs that contain active substances such as plant parts or other plant components that are thought to have therapeutic advantages.This study review aimed to identify the herbs commonly used,reasons for use,and effect of use,to make adequate recommendations on herbal medicine use as a remedy for pregnancy and labor.Incorporating evidence from reviews,personal correspondence,and diaries,this study demonstrates that about 80%of people used TM such as herbal remedies for sickness diagnosis,prevention,treatment,and promotion of general well‑being.Due to its accessibility,cost,and availability,TM is usually used by expectant mothers.Examples of TM used in pregnancy and labor include honey,aloe,raspberry,jute mallow,and hibiscus leaves.It is important to note that its use in pregnancy and labor can be beneficial or harmful to both mother and child.Lack of standardization,financial risk,lack of safety,and effectiveness are challenges to TM.There is a need of creating awareness of the safe use and effects of TM in pregnancy and labor through the provision of health education programs for women in the community.
文摘BACKGROUND Repetitive transcranial magnetic stimulation(rTMS)is a form of magnetic stimulation therapy used to treat depression,migraine,and motor function impairment in patients with stroke.As there is little research on the effects of rTMS in pregnant women,it is not widely used in these patients.This case report aimed to demonstrate the safety of rTMS in pregnant patients.CASE SUMMARY After much consideration,we applied rTMS to treat recent stroke and hemiplegia in a 34-year-old pregnant woman.The patient received 45 sessions of lowfrequency treatment over the course of 10 wk.We closely monitored the mother and fetus for potential side effects;the results showed significant improvement in the patient's motor function,with no harmful effects on the mother or fetus during pregnancy or after delivery.The patient’s fine motor and walking functions improved after treatment.This case is the first instance of a stroke patient treated with rTMS during pregnancy.CONCLUSION This case demonstrates that rTMS could be used to improve motor function recovery in stroke patients during pregnancy.
基金Supported by Clinical Research Grant from Pusan National University Hospital in 2022.
文摘BACKGROUND Renal tubular acidosis(RTA)is a renal cause of non-anion-gap metabolic acidosis characterized by low urinary ammonia excretion.This condition has a low prevalence,and various congenital and acquired etiologies.To date,only a few cases of idiopathic RTA uncovered during pregnancy have been reported.CASE SUMMARY A previously healthy 32-year-old Korean woman at 30 wk of gestation was admitted to Pusan National University Hospital with preterm labor.At admission,the patient presented with hypokalemia,non-anion-gap metabolic acidosis,and nephrocalcinosis.Distal RTA was diagnosed based on laboratory blood and urine findings and imaging examinations.Various tests,including next-generation gene sequencing panels for nephropathy,were performed to determine the etiology of the disease,which indicated that it was idiopathic.The patient received sodium bicarbonate and potassium chloride supplementation.After 3 wk,she delivered a baby who was subsequently diagnosed with corpus callosum agenesis and colpocephaly.During regular follow-ups for 6 mo postpartum,her hypokalemia and metabolic acidosis were gradually resolved,and medications eventually discontinued.CONCLUSION Herein we describe a case of idiopathic distal RTA discovered during pregnancy.Hypokalemia and metabolic acidosis resolved spontaneously after delivery.
基金Supported by Medical Health Science and Technology Project of Zhejiang Province,China,No.2020ZH003。
文摘BACKGROUND Cesarean scar pregnancy(CSP)is rare but may result in uterine rupture during pregnancy or massive hemorrhage during abortion procedures.Awareness of this condition is increasing,and most patients with CSP are now diagnosed early and can be managed safely.However,some atypical patients are misdiagnosed,and their surgical risks are underestimated,increasing the risk of fatal hemorrhage.CASE SUMMARY A 27-year-old Asian woman visited our institution because of abnormal pregnancy,and she was diagnosed with a hydatidiform mole through transvaginal ultrasound(TVS).Under hysteroscopy,a large amount of placental tissue was found in the scar of the lower uterine segment,and a sudden massive hemorrhage occurred during the removal process.The bilateral internal iliac arteries were temporarily blocked under laparoscopy,and scar resection and repair were rapidly performed.She was discharged in good condition 5 d after the operation.CONCLUSION Although TVS is widely used in the diagnosis of CSP,delays in the diagnosis of atypical CSP remain.Surgical treatment following internal iliac artery temporary occlusion may be an appropriate management method for unanticipated massive hemorrhage during CSP surgery.
文摘BACKGROUND:Agitation is a common presentation within emergent departments(EDs).Agitation during pregnancy should be treated as an obstetric emergency,as the distress may jeopardize both the patient and fetus.The safety of psychotropic medications in the reproductive age female has not been well established.This review aimed to explore a summary of general agitation recommendations with an emphasis on ED management of agitation during pregnancy.METHODS:A literature review was conducted to explore the pathophysiology of acute agitation and devise a preferred treatment plan for ED management of acute agitation in the reproductive age or pregnant female.RESULTS:While nonpharmacological management is preferred,ED visits for agitation often require medical management.Medication should be selected based on the etiology of agitation and the clinical setting to avoid major adverse effects.Adverse effects are common in pregnant females.For mild to moderate agitation in pregnancy,diphenhydramine is an effective sedating agent with minimal adverse effects.In moderate to severe agitation,high-potency typical psychotropics are preferred due to their neutral effects on hemodynamics.Haloperidol has become the most frequently utilized psychotropic for agitation during pregnancy.Second generation psychotropics are often utilized as second-line therapy,including risperidone.Benzodiazepines and ketamine have demonstrated adverse fetal outcomes.CONCLUSION:While randomized control studies cannot be ethically conducted on pregnant patients requiring sedation,animal models and epidemiologic studies have demonstrated the effects of psychotropic medication exposure in utero.As the fetal risk associated with multiple doses of psychotropic medications remains unknown,weighing the risks and benefits of each agent,while utilizing the lowest effective dose remains critical in the treatment of acute agitation within the EDs.
文摘Osteogenesis imperfecta(OI)is a primary bone fragility disorder with an estimated prevalence of 1/15,000 births and is a hereditary syndrome characterized by one or more of the following:fractures,blue sclerae,impaired hearing,defective dentition,and hyperlaxibility throughout life.[1,2]We report a pregnant woman with type II OI and review her prenatal counseling,diagnosis,and pregnancy management to assist obstetricians in understanding the disease and managing it in emergency situations.
文摘Background: The coronavirus disease (COVID-19) pandemic has impacted perinatal women’s mental health. However, protective factors associated with depression among pregnant Japanese women during the pandemic have not been reported. Purpose: The present study investigated the risk and protective factors associated with depression and anxiety among pregnant women during the COVID-19 pandemic. Methods: An online questionnaire was administered to 157 pregnant women between October 2022 and May 2023 at two general hospitals in Japan. The Japanese versions of the Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) were used to assess symptoms of depression and anxiety. The χ<sup>2</sup> test or Fisher’s exact test and multivariate logistic regression model were used to examine factors associated with depression and anxiety among pregnant women. Results: Overall, 47.1% and 35.7% of the pregnant women reported depressive and anxiety symptoms, respectively. A “history of mental illness” was a risk factor for depression and anxiety among pregnant women during the COVID-19 pandemic. Additionally, unmarried status was a risk factor for anxiety among pregnant women, whereas outdoor and indoor exercises were protective factors against depression and anxiety, respectively. Conclusions: Exercise may have protected pregnant women from depression and anxiety during the COVID-19 pandemic. Encouraging exercise may help maintain the mental health of pregnant women who do not have exercise restrictions.
基金supported by USDA-NRICGP 98-35203-6337 to FWB.and RCB,NRSA DHHS/NIH 1-F32-HDO 8501 O1A1 to GAJ,USDA-NRI 2006-35203-17199 to GAJ and Kayla J.BaylessUSDA National Institute of Food and Agriculture Research Initiative Competitive Fellowship Grant no.2012-67011-19892 to James W.Frank and GAJ+1 种基金Agriculture and Food Research Initiative Competitive Grant no.2016-67015-24955 from the USDA National Institute of Food and Agriculture to GAJ and FWBNational Institutes of Health Grant 1R21HD071468-01 to GAJ and KJB。
文摘Integrins are a highly complex family of receptors that, when expressed on the surface of cells, can mediate reciprocal cell-to-cell and cell-to-extracellular matrix(ECM) interactions leading to assembly of integrin adhesion complexes(IACs) that initiate many signaling functions both at the membrane and deeper within the cytoplasm to coordinate processes including cell adhesion, migration, proliferation, survival, differentiation, and metabolism. All metazoan organisms possess integrins, and it is generally agreed that integrins were associated with the evolution of multicellularity, being essential for the association of cells with their neighbors and surroundings, during embryonic development and many aspects of cellular and molecular biology. Integrins have important roles in many aspects of embryonic development, normal physiology, and disease processes with a multitude of functions discovered and elucidated for integrins that directly influence many areas of biology and medicine, including mammalian pregnancy, in particular implantation of the blastocyst to the uterine wall, subsequent placentation and conceptus(embryo/fetus and associated placental membranes) development. This review provides a succinct overview of integrin structure, ligand binding, and signaling followed with a concise overview of embryonic development, implantation, and early placentation in pigs, sheep, humans, and mice as an example for rodents. A brief timeline of the initial localization of integrin subunits to the uterine luminal epithelium(LE) and conceptus trophoblast is then presented, followed by sequential summaries of integrin expression and function during gestation in pigs, sheep, humans, and rodents. As appropriate for this journal, summaries of integrin expression and function during gestation in pigs and sheep are in depth, whereas summaries for humans and rodents are brief. Because similar models to those illustrated in Fig. 1, 2, 3, 4, 5 and 6 are present throughout the scientific literature, the illustrations in this manuscript are drafted as Viking imagery for entertainment purposes.
