The first-line methods used to diagnose placenta accreta are ultrasound and Doppler. A large number of studies have shown that their diagnostic accuracy is variable. Some investigators have suggested that placental messenger RNA (mRNA) may be a useful predictive marker for hysterectomy among patients with placenta previa associated with placenta accreta.This prospective study investigated whether the concentration of cell-free placental mRNA was a useful predictive marker for detection of placental invasion in women with placenta accreta and whether knowledge of the concentration could improve the diagnostic accuracy of ultrasound and color Doppler. The participants were 35 singleton pregnant women of more than 28 weeks' gestation who were at risk for placenta accreta. All study subjects underwent ultrasound and color Doppler assessment. The study was conducted at an antenatal care clinic at a university hospital in Egypt between 2007 and 2009. Maternal plasma concentrations of cell-free mRNA were measured using a one-step quantitative real-time reverse transcription polymerase chain reaction assay. Based on the cesarean and/or histological diagnosis, the study subjects were divided into 2 following groups: women with (n ϭ 28) and without (n ϭ 7) placenta accreta. The median MoM (multiples of the median) value of cell-free placental mRNA was calculated in both groups.Compared to women without placenta accreta, those with accreta had a significantly higher median MoM value of cell-free placental mRNA (6.50 vs. 2.60, P Ͻ 0.001).In addition, cell-free placental mRNA values were significantly higher among patients with placenta increta or percreta compared to those with simple accreta diagnosed at cesarean delivery (P Ͻ 0.002). Insignificant increases in cell-free placental mRNA levels were observed in 6 women with a false-positive diagnosis of placenta accreta on ultrasound.These findings suggest that measurement of cell-free placental mRNA in maternal plasma may increase the predictive diagnostic accuracy of ultrasound and color Doppler for placental invasion in pregnant women with suspected placenta accreta. However, the small sample size makes it difficult to draw a definite conclusion from this study. ABSTRACTA number of studies have linked agrichemical exposure in pregnancy to a remarkable increase in the incidence of gastroschisis and other birth defects. Several organic chemicals, solvents, teratogens, and cyclooxygenase inhibitors, specifically related to agricultural exposure, may be associated with the reported 2-fold increase in the prevalence of 412 Obstetrical and Gynecological Survey 414 Obstetrical and Gynecological Survey Preconception and Prenatal Care 417 ABSTRACTIt has been generally recommended that a woman with an uncomplicated pregnancy receive 2 ultrasound examinations during gestation. For largely unexplained reasons, the number of such examinations performed during a single pregnancy has markedly increased. Some investigators have suggested that the increase reflects changes in maternal risk...

BackgroundBronchopulmonary dysplasia (BPD) presents a major threat of very preterm birth and treatment options are still limited. Stem cells from different sources have been used successfully in experimental BPD, induced by postnatal hyperoxia.ObjectivesWe investigated the effect of umbilical cord blood mononuclear cells (MNCs) in a new double-hit mouse model of BPD.MethodsFor the double-hit, date mated mice were subjected to hypoxia and thereafter the offspring was exposed to hyperoxia. Human umbilical cord blood MNCs were given intraperitoneally by day P7. As outcome variables were defined: physical development (auxology), lung structure (histomorphometry), expression of markers for lung maturation and inflammation on mRNA and protein level. Pre- and postnatal normoxic pups and sham treated double-hit pups served as control groups.ResultsCompared to normoxic controls, sham treated double-hit animals showed impaired physical and lung development with reduced alveolarization and increased thickness of septa. Electron microscopy revealed reduced volume density of lamellar bodies. Pulmonary expression of mRNA for surfactant proteins B and C, Mtor and Crabp1 was reduced. Expression of Igf1 was increased. Treatment with umbilical cord blood MNCs normalized thickness of septa and mRNA expression of Mtor to levels of normoxic controls. Tgfb3 mRNA expression and pro-inflammatory IL-1β protein concentration were decreased.ConclusionThe results of our study demonstrate the therapeutic potential of umbilical cord blood MNCs in a new double-hit model of BPD in newborn mice. We found improved lung structure and effects on molecular level. Further studies are needed to address the role of systemic administration of MNCs in experimental BPD.

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Epidemiological findings indicating an impaired male prognosis in neonatal lung disorders which can at least in part be explained by above described experimental findings. Increased estrogen concentrations in females acting via ER-β may be a key for understanding these findings.

Our study indicates that TTN is strongly related to elective cesarean section and low GA. Furthermore, the absence of exposure to labor contractions is associated with increased risk and severe course of TTN at term, with longer duration of oxygen supplementation.