Extracellular matrix (ECM) turnover is characterized by a unique balance between matrix metalloproteinases’ degradation activity and their natural inhibition by collagen specific tissue inhibitors. Human uterine ECM is a complex structure, majorly consisting of proteins as fibrillar collagen types I and III, fibronectin, and laminin. Collagenases are enzymes from the matrix metalloproteinases’ family, which are predominantly involved in fibrillar collagen types I and III degradation. They are mainly represented by matrix metalloproteinase-1, -13 (MMP-1, -13), naturally inhibited by tissue inhibitors (TIMP-1, -2). The collagen structure of the uterus has been shown to be impaired in women with preeclampsia. This is a result of MMPs/TIMPs dysregulation interplay. This review article summarizes the actual available research data in the literature about the role of MMP-1, MMP-13 and TIMP-1, and TIMP-2 in collagen types I and III turnover in healthy and complicated pregnancy. Their potential use as circulating markers for diagnosis, prognosis, and monitoring of the development of preeclampsia is discussed as well.
Background: Мatrix metalloproteinase-2 (MMP-2) is an enzye from the gelatinases family involved mainly in collagen degradation. It is also known as a key regulator of normal vascular remodelling during a healthy pregnancy. Failure of regulation of MMP-2 has been associated with abnormal vasodilation, placentation, uterine expansion and development of preeclampsia (PE). Aims: (1) determine serum MMP-2 levels in women with PE and healthy pregnancy, (2) evaluate mean uterine arteries Doppler pulsatility index (UtA PI) and (3) investigate the a possible association between these parameters. Materials and methods: This was a case-control study. Fifty-five women with PE (mean age 24.9 ± 6 years) and a control group of 35 women with normal pregnancies (mean age 24.7 ± 5.4 years) were examined. An enzyme-linked immunosorbent assay (ELISA) was used to determine serum levels of MMP-2. Mean UtA PI were evaluated by Doppler velocimetry. Results: Serum ММР-2 levels in preeclampsia were significantly higher than in women with normal pregnancy 11.7 (9.1÷15.5) vs. 7.7 ng/ml (6.5÷13.4) (p = 0.016). Mean UtA PI was significantly higher in preeclampsia than in healthy pregnant women: 1.12 (0.82÷1.5) vs. 0.75 (0.69÷0.85); (p = 0.024). ММР-2 correlated with UtA PI (r = 0.214; p = 0.043). Cutoff value at 14 ng/ml for MMP-2 was found to discriminate between PE and healthy pregnancy. Conclusion: Our data showed an association between serum MMP-2 and Mean UtA PI. We suggest that MMP-2 could have a potential imply on maternal uterine arteries’ structure, favoring their constriction, increased resistance and abnormal uterine vascular remodeling. Further studies are warranted to clarify whether determination of MMP-2 cutoff value might contribute in the diagnosic work-out strategy for PE.
Summary The aim of the study was to develop the norms for physical growth (birth weight-, birth height- and head circumference- for age) of the full-term babies born from singleton pregnancy in UMHAT „Dr. G. Stranski” – Pleven (total, by gender and gestational age at birth). A cross-sectional study was carried-out in 2017; 1092 live infants born from singleton pregnancy between 38 and 42 weeks were included in the study. We obtained information about three anthropometric measurements (birth weight-, birth height- and head circumference-for age). Data were processed by SPSS v.24.0. Norm group ranges (3, 5 and 7 groups) were developed for three indicators using percentile methods. Kruskal-Wallis test was used. The mean birth weight- and height-for age were higher for baby boys (P50, 3280 g and 50 cm) compared with baby girls (P50, 3150 g and 49 cm). Baby boys and girls weighed <2570 g at birth fell into the group ,,very slow growth” (P3). A ,,very fast growth” (P97) was found in baby boys weighed >4120 g at birth (vs. >3870 g for baby girls). Norm group ranges allow to identify the newborns with a higher risk and to focus efforts and health resources to them; it should be updated periodically.
To study the role of the obstetric risk factors for low birth weight and preterm birth. A case-control study was carried out in 2017 at the University Hospital-Pleven; 1212 women in childbirth and 1212 live-born babies after single pregnancies were included in the study. The live-born infants were divided into two groups. The cases included the preterm low-birthweight (PLBW) newborns weighing less than 2500 grams (g). The controls included full-term newborns with normal birth weight (FTNBW). The role of 8 obstetric risk factors (RFs) on PLBW was studied (maternal age, type of birth, amniotic fluid deficiency and congenital abnormalities, maternal pelvic size abnormalities, placental abnormalities, abnormalities of fetal membranes, umbilical cord abnormalities, and presentation of the fetus). The obstetric RFs were significantly associated with PLBW. Risk of PLBW is significantly higher (p=0.001) in breech presentation (exp (β)=6.622), placental abnormalities (exp (β)=5.556), maternal pelvic size abnormalities (exp (β)=4.426) and amniotic fluid deficiency and congenital abnormalities (exp (β)=2.903). The results of that study can be useful for effecting prevention programing of pregnancy and prematurity.
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