Narrow Results

This was the first study to determine the effect of tanshinone IIA (an active ingredient in herb Danshen) on fetuses in utero under unstressed condition. Tanshinone IIA or 0.9% NaCl as control was intravenously (i.v.) administrated into pregnant ewes. Both maternal and fetal blood were analyzed for PO₂, PCO₂, SO₂%, hemoglobin, hemotecrit, glucose, lactic acid, Na⁺, K⁺, and Cl^- concentrations. Maternal and fetal heart functions were assessed by examining cardiac enzymes and cardiovascular responses. The results showed that tanshinone IIA did not alter the blood values in ewes and fetuses. Cardiac enzyme activities related to the heart remained unchanged. In cardiovascular experiments, no alternation in maternal blood pressure by tanshinone IIA was observed. However, fetal systolic pressure was slightly and significantly increased following i.v. tanshinone IIA into the mothers, while fetal diastolic pressure, mean arterial pressure, and heart rate were not changed. The results demonstrated that tanshinone IIA used during the last third of gestation did not cause the biochemical changes related to cardiac functions in both maternal and fetal sheep. Fetal oxygen metabolism remained stable in utero, providing new information for clinical use of the herb in pregnancy. That tanshinone IIA increased fetal systolic pressure may open new opportunities to study the herb in fetal medicine.

In North America, a high proportion of pregnant women use herbal medications including North American ginseng. This medicinal plant contains high amounts of triterpene saponins (ginsenosides), which are the main bioactive compounds. It is important to assess ginseng’s impact on all reproductive functions to ensure the safety of pregnant women and fetuses. In this study, we defined the concentration-responsive effects of North American alcoholic and aqueous ginseng extracts on preimplantation development in vitro and on pregnancy and post-partum development in the mouse. Two-cell mouse embryos were cultured with 5 different concentrations of whole ginseng root extracts, or ginsenosides Rb1, Rg1 and Re alone, a combinatorial ginsenoside solution and a crude polysaccharide fraction solution. Embryonic development and recovery from each treatment was assessed. To investigate the in vivo effects of ginseng extracts, female mice were gavaged with 50mg/kg/day, 500mg/kg/day or 2000mg/kg/day of either extract (treatment) or water (sham) for 2 weeks prior to mating and throughout gestation. Gestation period, litter size, pup growth and pup sex ratio were evaluated. Oral ginseng consumption did not significantly affect fertility or pregnancy in the mouse. High doses of ginseng (2000mg/kg/day) decreased maternal weight gain. Direct treatment of preimplantation embryos in vitro demonstrated that ALC and AQ extract treatment reduced development in a concentration responsive manner, while only ALC extract effects were largely reversible. Treatments with individual or combinatorial ginsenosides, or the polysaccharide fraction solution alone did not impair preimplantation development, in vitro. In conclusion, maternal oral consumption of ginseng has little negative impact on pregnancy in the mouse, however, direct exposure to ginseng extract during mouse preimplantation development in vitro is detrimental.

Background: Musculoskeletal disorders have been a major cause of disability in pregnant women. The aim of this study is to determine the effect of exercise in an aquatic environment on the musculoskeletal pain among pregnant women. Material and methods: This randomized clinical trial was conducted on 54 pregnant women aged 20–35 years. The subjects were divided into the intervention group and control groups. Women who were in 20 to 26 weeks of gestation were included in the study. The intervention was Water Exercise in Pregnancy program conducted from week 20 to week 34. The control group received standard prenatal care. Musculoskeletal complications were assessed using the Nordic questionnaires at the baseline and, 4th and 8th week of pregnancy. The intensity of pain was assessed using a visual analog scale in the two groups. Data were analyzed using descriptive and inferential statistics via the SPSS v.16. The lsmeans package was used to examine comparisons. Results: Results of the study showed that level of discomfort and musculoskeletal complications in the intervention group was significantly reduced during the 4th and 8th week of the study compared to the control group ($p<0.001$). After the intervention, intensity of musculoskeletal pain in the intervention group showed a significant decrease compared to the control group ($p<0.001$). Conclusion: Exercise in water during pregnancy can be effective to reduce musculoskeletal complications. Aquatic exercises should be developed in the exercise program for pregnant women with musculoskeletal pain.

Herpes Virus Linked to Preterm Birth and High Blood Pressure during Pregnancy.

Trigger Gene for Muscle Development Discovered.

AUSTRALIA – Immune System Boost Cures HIV-like Infections.

AUSTRALIA – Scientists Shed New Light on How Heart Works.

AUSTRALIA – IVF Breakthrough will Increase Chance of Pregnancy.

AUSTRALIA – Study Reveals Possible Secret to Long Life.

AUSTRALIA – Australian Scientists Make Important Discovery for Safer Drugs.

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NEW ZEALAND – Laser to Help Predict Foot Ulcers in Diabetics.

PHILIPPINES – Turning School Yards into Vegetable Gardens.

TAIWAN – Key Enterovirus Breakthrough Unveiled.

OTHER REGIONS — New Heart Therapy More Effective in Women.

INDONESIA – Quintiles expands patient access for clinical trials to Indonesia.

JAPAN – Legacy Healthcare announces breakthrough clinical results in hair re-growth.

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Walking is daily physical activity and a common way of exercise during pregnancy, but morphological changes can modify the gait pattern. Biomechanical models can help in evaluating joint mechanical loads and kinetics and kinematics during gait, and provide patterns. This study aimed to describe the gait pattern during the second trimester of pregnancy and give an orientation for biomechanical modeling for pregnant women. The ankle and hip joints seem to be more overloaded, mainly in the sagittal and frontal planes, respectively. Results show that pregnant women have a similar walking pattern to the normal gait. This model construction was revealed to be appropriate for describing gait during the second trimester of pregnancy.

Most of the anatomical changes related to the body of pregnant women occur between the second and third trimesters of pregnancy. The purposes of the study were to quantify the lower limb kinetics of gait and draw a comparison between women in the second and third trimesters of pregnancy, and a nonpregnant group. Subjects and methods: A three-dimensional (3D) kinetic analysis of gait was performed in 24 pregnant and 12 nonpregnant women. Results: Between trimesters of pregnancy, a decrease in the third peak of vertical ground reaction force (GRF) in the third trimester was observed. Most of the changes found between pregnant and nonpregnant women were in the sagittal plane for hip, knee and ankle moments, which report a decrease in mechanical load of the lower limb. In frontal plane a significant decrease in ankle joint moment was found, and in the transverse plane a significant increase in hip moment was found. Joints power decreases for hip and ankle power in sagittal and frontal plane, and increases for hip power in transverse plane. The function of propulsion and mobilization appears to be related to the different changes that occur between the right leg and left. Conclusion: These results suggest that adaptations regarding muscle participation occur first (second trimester), followed by adaptations in muscle power (third trimester). Understanding the biomechanical adaptations during pregnancy may provide more information about mechanical loads, which subsequently will be helpful for prescribing exercise and rehabilitation programs, as well as for the prevention of musculoskeletal injuries.

Morphological changes are associated to pregnancy, such as weight gain and increased volume of the trunk. The soft tissue artifact can also increase with these characteristics and affect the real joint kinematics. The main objective of this study was to understand the effect of using three different constraining sets in the lower limb joints, in the amount of soft tissue artifact (STA) of pregnant women, in order to obtain the most appropriated joint set to be used in gait and in this population. The ankle, knee and hip joints were modeled respectively with the following characteristics: (1) Universal–revolute–spherical (URS), (2) spherical–revolute–spherical (SRS) and (3) spherical–spherical–spherical (SSS). The six degrees of freedom (6DOF) model was used as the basis for comparison and considered the one with the highest error associated to the STA. In pregnant women, the URS model seems to affect more the kinematic variables when compared with the 6DOF model. Assuming that the kinematic error associated with pregnant women is increased due to the STA, the URS model may be affecting more the angular kinematics of the knee joint. SSS model seems to be more appropriated to analyze gait in second trimester pregnant women.

Background: To investigate the clinical effect of modified Baihe Gujin Decoction in treatment of cough during pregnancy.

Methods: A total of 31 pregnant women with cough were recruited from First Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine and Shanghai Qingpu District Hospital of Traditional Chinese Medicine from February 2016 to June 2020. The patients were treated with modified Baihe Gujin Decoction for two weeks according to their unique symptoms and signs. The cough symptoms were evaluated and the symptom scores were calculated at Day 0 (time of enrollment), Day 7, and Day 14, respectively.

Results: Of 31 cases, 4 cases were clinically cured and 24 cases showed marked improvement, with 3 cases showing no improvement.

Conclusions: Modified Baihe Gujin Decoction can significantly improve the symptoms of cough during pregnancy.

Zika virus infection during pregnancy can have devastating effects on the foetus leading to congenital Zika syndrome. It is relevant therefore for couples living in countries with endemic Zika virus to understand the strategies they can utilise to reduce the chance of infection. In addition, couples planning pregnancy, or who are already pregnant, travelling to countries with Zika virus need to be informed of the potential risk and implications for future reproductive planning.

Background and objective: Day-5 blastocyst embryos are usually chosen for assisted reproductive therapy. We compared the reproductive outcomes of the euploid blastocysts developed on Day 5 versus Day 6.

Methods: This single-center, retrospective observational study analyzed patients aged 25–45 years, who underwent intracytoplasmic sperm injection from December 2014 to November 2018. Depending on the day of trophectoderm biopsy, patients were categorized into Day-5 and Day-6 groups. Percentages of euploid embryos were calculated for both groups, and elective single euploid blastocysts were transferred in a frozen embryo transfer (FET) cycles. The study endpoints were the comparisons of the reproductive outcomes including clinical pregnancy rate (CPR), implantation rate (IR), miscarriage rate (MR), and live birth rate (LBR) between Day-5 and Day-6 euploid FET groups.

Results: A total of 801 embryos from 184 patients were evaluated [Day 5 ($n=769$); Day 6 ($n=32$); 42.45% were euploid] with the rate of euploidy in Day-5 and Day-6 groups at 42.52% and 40.62%, respectively. A total of 126 patients underwent FET with 126 elective single euploid embryos (Day 5: 117; Day 6: 9). For Day-5 versus Day-6 groups, a significantly higher IR (61.54% vs. 44.44%; $p=0.0531$), CPR (61.54% vs. 44.44%; $p=0.0531$), and LBR (61.54% vs. 33.33%; $p=0.0014$) were reported. Multivariate analysis on ANOVA suggested, comparable pregnancy rates at Day 5 and Day 6 ($p=0.728$).

Conclusions: Day-5 euploid blastocysts seem to offer better reproductive outcomes than Day-6 euploid blastocysts. Further research is recommended to evaluate the reproductive outcomes of Day-6 blastocysts.

Oogenesis in mammalian females, including humans, is arrested prior to birth. Females, therefore, are born with a limited number of primary oocytes. This is in direct contrast to males in whom spermatogenesis continues during the entire lifespan following puberty. Here, we discuss possible evolutionary advantages that this confers and contrast this with age-related decline in oocyte quality that results in diminished fertility with advancing maternal age. We believe that a better understanding of these processes would be helpful in developing strategies to preserve fertility as maternal age increases, especially in the context of the current demographic shift with more and more women seeking fertility treatment at advanced age.

Decidual leukocytes make up approximately 30% of all decidual stromal cells in early pregnancy, of which 70% are uterine natural killer (uNK) cells. uNK cells are phenotypically distinct from peripheral blood NK cells, being CD56${}^{\text{bright}}$CD16${}^{-}$. A recent single-cell sequencing project of the decidua identified three subsets of uNK cells, but we are yet to determine how they differ functionally. Several roles for uNK cells in implantation are starting to emerge including biosensing of poor-quality embryos, killing of bacteria infected trophoblast, spiral artery remodeling, and regulation of trophoblast invasion. Altered numbers of uNK cells have been identified in several pathological conditions, but whether this is causative of the condition is currently unclear.

Background and Aims: Extracytoplasmic oocyte abnormalities such as Large Perivitelline Space (LPVS) and Fragmented Polar Body (FrPB) are frequently detected in human oocytes during IVF procedures. The purpose of this research is to determine the relationship of LPVS, FrPB, and their combination on embryo quality and pregnancy loss.

Method: The 36 positive pregnancy cases from under 40 years old patients that underwent ICSI using normospermia at RS Pondok Indah IVF Centre were observed. Patients were stimulated with r-FSH utilizing an antagonist protocol for 10-11 days, then r-HCG was administered as a trigger 36 hours before retrieval. Oocytes were classified as follows: (a) normal, (b) large perivitelline space (LPVS), (c) polar body fragmentation (FrPB), and (d) a combination of LPVS and FrPB. The Shapiro-Wilk and Kruskal-Wallis tests were used to determine the effect between each of the categories of oocyte with D3 and D5 embryo quality, along with pregnancy loss.

Results: The results indicate that there was no significant distinction among the groups in terms of embryo quality on D3 and D5, as well as pregnancy loss (p=0.187, 0.881, and 0.561, respectively).

Conclusion: It could have been concluded that LPVS, FrPB, and their combination have no impact on embryo quality and pregnancy loss.

Rheumatic diseases occur commonly in patients of childbearing age. The compatibility of different Disease Modifying Anti-Rheumatic Drugs (DMARDs) during pregnancy and lactation can affect the management decision when treating these patients. With the development of promising biologics DMARDs (bDMARDs) and targeted synthetic DMARDs (tsDMARDs) in various rheumatic diseases, their safety in pregnancy and lactation is an issue for both patients and clinicians. Recently, three different guidelines on the compatibility of DMARDs during pregnancy and lactation has been published by ACR, EULAR and BSR respectively. This article summarizes their recommendations on the management of patients on DMARDs during pregnancy and lactation.

Takayasu vasculitis (TAK) is a form of large vessel vasculitis clinically manifesting as pulseless disease or hypertension. It is more common in South East Asia and Japan, India, and Mexico [1]. It is increasingly being recognized due to increased awareness among medical fraternity and better imaging modalities. Undetected hypertension, pulselessness, and syncope are more common symptoms and presentation during pregnancy is unusual and can lead to bad obstetric outcomes. Recent evidences support the use of tocilizumab for inducing remission in Takayasu arteritis. We report this rare case of vasculitis presenting in pregnancy as malignant hypertension. A 20-year-old pregnant woman (45 days) presented with headache and nausea but no fever. She had a history of intermittent claudication of legs for the past 3 years but not evaluated. During examination, pulses were felt normally and blood pressure (BP) 180/110, no murmurs in cardiac auscultation, but she had abdominal bruit (renal vessels). Other systems were normal. Echocardiogram (ECHO) showed dilated ascending aorta. Doppler of renal vessels showed narrowing of renal arteries. Unfortunately, she had to undergo termination of pregnancy (high BP in spite of antihypertensives). Her computed tomography (CT) angiogram showed features of TAK with type 5 pattern–she had methylprednisolone infusion 500 mg daily for 3 days, followed by injection tocilizumab 400 mg monthly 3 doses. Once remission was achieved, she had recanalization by percutaneous transluminal angioplasty of right renal artery. She is currently maintained on aspirin and telmisartan. Awareness of causes of high BP, inputs by radiologist, cardiologist, and rheumatologist and understanding by the patient and family helped to achieve good outcome albeit the miscarriage.