STUDY QUESTIONHow is endometriosis associated with adverse maternal, fetal and neonatal outcomes of pregnancy?SUMMARY ANSWERWomen with endometriosis are at elevated risk for serious and important adverse maternal (pre-eclampsia, gestational diabetes, placenta praevia and Cesarean section) and fetal or neonatal outcomes (preterm birth, PPROM, small for gestational age, stillbirth and neonatal death).WHAT IS KNOWN ALREADYA number of studies have shown an association between endometriosis and certain adverse maternal and fetal outcomes, but the results have been conflicting with potential for confounding by the use of assisted reproductive technology.STUDY DESIGN, SIZE, DURATIONA systematic review and meta-analysis of observational studies (1 January 1990–31 December 2017) that evaluated the effect of endometriosis on maternal, fetal and neonatal outcomes was conducted.PARTICIPANTS/MATERIALS, SETTING, METHODSStudies were considered for inclusion if they were prospective or retrospective cohort or case–control studies; included women greater than 20 weeks gestational age with endometriosis; included a control group of gravid women without endometriosis; and, reported at least one of the outcomes of interest. Each study was reviewed for inclusion, data were extracted and risk of bias was assessed by two independent reviewers.MAIN RESULTS AND THE ROLE OF CHANCEThe search strategy identified 33 studies (sample size, n = 3 280 488) for inclusion. Compared with women without endometriosis, women with endometriosis had higher odds of pre-eclampsia (odds ratio [OR] = 1.18 [1.01–1.39]), gestational hypertension and/or pre-eclampsia (OR = 1.21 [1.05–1.39]), gestational diabetes (OR = 1.26 [1.03–1.55]), gestational cholestasis (OR = 4.87 [1.85–12.83]), placenta praevia (OR = 3.31 [2.37, 4.63]), antepartum hemorrhage (OR = 1.69 [1.38–2.07]), antepartum hospital admissions (OR = 3.18 [2.60–3.87]), malpresentation (OR = 1.71 [1.34, 2.18]), labor dystocia (OR = 1.45 [1.04–2.01]) and cesarean section (OR = 1.86 [1.51–2.29]). Fetuses and neonates of women with endometriosis were also more likely to have preterm premature rupture of membranes (OR = 2.33 [1.39–3.90]), preterm birth (OR = 1.70 [1.40–2.06]), small for gestational age <10th% (OR = 1.28 [1.11–1.49]), NICU admission (OR = 1.39 [1.08–1.78]), stillbirth (OR = 1.29 [1.10, 1.52]) and neonatal death (MOR = 1.78 [1.46–2.16]). Among the subgroup of women who conceived spontaneously, endometriosis was found to be associated with placenta praevia, cesarean section, preterm birth and low birth weight. Among the subgroup of women who conceived with the use of assisted reproductive technology, endometriosis was found to be associated with placenta praevia and preterm birth.LIMITATIONS, REASONS FOR CAUTIONAs with any systematic review, the review is limited by the quality of the included studies. The diagnosis for endometriosis and the selection of comparison groups were not uniform across studies. However, the effect of potential misclassification would be bias towards the nul...

This study identifies baseline demographic differences between women with and without endometriosis and suggests that women affected by endometriosis have an independently elevated risk of placenta previa in pregnancy.

Previous studies have shown that the SecY plug is displaced from the center of the SecYEG channel during polypeptide translocation. The structural and functional consequences of the deletion of the plug are now examined. Both in vivo and in vitro observations indicate that the plug domain is not essential to the function of the translocon. In fact, deletion of the plug confers to the cell and to the membranes a Prl-like phenotype: reduced proton-motive force dependence of translocation, increased membrane insertion of SecA, diminished requirement for functional leader peptide, and weakened SecYEG subunit association. Although the plug domain does not seem essential, locking the plug in the center of the channel inactivates the translocon. Thus, the SecY plug is important to regulate the activity of the channel and to confer specificity to the translocation reaction. We propose that the plug contributes to the gating mechanism of the channel by maintaining the structure of the SecYEG complex in a compact closed state.

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On page 1283, the complementation assay presented in Fig. 1B ADDITIONS AND CORRECTIONS This paper is available online at www.jbc.orgWe suggest that subscribers photocopy these corrections and insert the photocopies in the original publication at the location of the original article. Authors are urged to introduce these corrections into any reprints they distribute. Secondary (abstract) services are urged to carry notice of these corrections as prominently as they carried the original abstracts.

Objective: To determine the prevalence of drugs for comprehensive management of preeclampsia in national essential medicine lists (EMLs) in low and middle income countries (LMICs) Methods:We collected EMLs from the 144 LMICs identi ed by the World Bank through broad-based Internet searches and in collaboration with the World Health Organization We identi ed therapies for hypertension, eclampsia, preeclampsia complications (eg, pulmonary edema, thrombosis), preterm birth, and labour induction contained in the EMLs Resuts:In 91 EMLs obtained from 144 LMICs, the most commonly listed parenteral antihypertensive therapies were verapamil (637%), hydralazine (615%), sodium nitroprusside (483%), and propranolol (396%) The most prevalent oral antihypertensive therapies were nifedipine (956%), methyldopa (934%), propranolol (901%), and atenolol (879%) For eclampsia/ preeclampsia, magnesium sulphate was present in 846% of EMLs and calcium gluconate in 857% For pulmonary edema, most EMLs (945%) listed oral furosemide, for thrombosis 923% listed heparin, for acceleration of fetal pulmonary maturity 901% listed parenteral dexamethasone, and for labour induction 978% listed oxytocin or a prostanoid (usually misoprostol, 407%) Concusion: EMLs of LMICs provide comprehensive coverage of preeclampsia pharmacotherapy These EMLs may be used as advocacy tools to ensure the availability of these therapies within each country RésuméObjectif : Déterminer la prévalence des médicaments permettant la prise en charge exhaustive de la prééclampsie au sein des listes de médicaments essentiels (LME) nationales des pays ne disposant que d'un revenu faible ou moyen (PRFM)Méthodes : Nous avons regroupé les LME des 144 PRFM identi és par la Banque mondiale par l'intermédiaire de recherches généralisées sur Internet et en collaboration avec l'Organisation mondiale de la santé Nous avons identi é, au sein des LME, les traitements visant l'hypertension, l'éclampsie, les complications de la prééclampsie (p ex oedème pulmonaire, thrombose), l'accouchement préterme et le déclenchement du travailRésutats : Au sein des 91 LME obtenues auprès de 144 PRFM, les traitements antihypertenseurs parentéraux apparaissant le plus couramment ont été les suivants : vérapamil (63,7 %), hydralazine (61,5 %), nitroprussiate de sodium (48,3 %) et propranolol (39,6 %) Les traitements antihypertenseurs oraux les plus prévalents ont été les suivants : nifédipine (95,6 %), méthyldopa 216 l MARCH JOGC MARS 2013 OBSTETRICS (93,4 %), propranolol (90,1 %) et aténolol (87,9 %) Pour ce qui est de l'éclampsie / la prééclampsie, le sulfate de magnésium gurait dans 84,6 % des LME et le gluconate de calcium, dans 85,7 % de celles-ci Pour ce qui est de l'oedème pulmonaire, le furosémide oral gurait dans la plupart des LME (94,5 %); pour ce qui est de la thrombose, l'héparine gurait dans 92,3 % des LME; pour ce qui est de l'accélération de la maturité pulmonaire foetale, la dexaméthasone parentérale gurait dans 90,1 % des LME; et pour ce qui es...

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