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See detailAbnormal vascular architecture at the placental-maternal interface in placenta increta
CHANTRAINE, Frédéric ULg; Blacher, Silvia ULg; Berndt, Sarah et al

in American Journal of Obstetrics and Gynecology (2012), 207(3), 1881-9

Objective The objective of the study was to characterize the vascular architecture at the placental-maternal interface in pregnancies complicated by placenta increta and normal pregnancies. Study Design ... [more ▼]

Objective The objective of the study was to characterize the vascular architecture at the placental-maternal interface in pregnancies complicated by placenta increta and normal pregnancies. Study Design Vessel numbers and cross-section area density and spatial and area distributions in 13 placenta-increta placental beds were compared with 9 normal placental beds using computer-assisted image analysis of whole-slide CD31 immunolabeled sections. Results The total areas occupied by vessels in normal and placenta-increta placental beds were comparable, but vessels were significantly sparser and larger in the latter. Moreover, placenta-increta–vessel distributions (area and distance from the placental–myometrial junction) were more heterogeneous. Conclusion Size and spatial organization of the placenta-increta vascular architecture at the placental-maternal interface differed from normal and might partially explain the severe hemorrhage observed during placenta-increta deliveries. [less ▲]

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See detailSurgical intervention after transvaginal Prolift mesh repair: retrospective single-center study including 524 patients with 3 years' median follow-up
DE LANDSHEERE, Laurent ULg; Ismail, Sharif; Lucot, Jean-Philippe et al

in American Journal of Obstetrics and Gynecology (2012), 206(1), 831-837

Objective The aim of this study was to explore the nature and rate of surgical intervention after transvaginal Prolift mesh repair for pelvic organ prolapse. Study Design This was a retrospective study of ... [more ▼]

Objective The aim of this study was to explore the nature and rate of surgical intervention after transvaginal Prolift mesh repair for pelvic organ prolapse. Study Design This was a retrospective study of all patients who underwent Prolift mesh repair between January 2005 and January 2009. Patient data were obtained from medical records, and patients were telephoned to check if they had surgery in other hospitals. Results A total of 600 consecutive patients were identified. Of these, 524 patients (87.3%) were included in the study, with a median follow-up duration of 38 months (range, 15–63). Global reoperation rate was 11.6%. Indications of intervention were surgery for urinary incontinence (6.9%), mesh-related complications (3.6%), or prolapse recurrence (3%). Conclusion The global reoperation rate after transvaginal Prolift mesh repair was 11.6%, with urinary incontinence surgery being the most common indication. Rates of mesh complications and prolapse recurrence are relatively low in an experienced team. [less ▲]

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See detailNicotine restores endothelial dysfunction caused by excess sFlt1 and sEng in an in vitro model of preeclamptic vascular endothelium: a possible therapeutic role of nicotinic acetylcholine receptor (nAChR) agonists for preeclampsia.
Mimura, Kazuya; Tomimatsu, Takuji; Sharentuya, Namuxila et al

in American Journal of Obstetrics and Gynecology (2010), 202(5), 4641-6

OBJECTIVE: In this study we tested the hypothesis that nicotine restores proangiogenic functions to endothelial cells pretreated with soluble fms-like tyrosine kinase 1 and/or soluble endoglin. STUDY ... [more ▼]

OBJECTIVE: In this study we tested the hypothesis that nicotine restores proangiogenic functions to endothelial cells pretreated with soluble fms-like tyrosine kinase 1 and/or soluble endoglin. STUDY DESIGN: Wound healing assay and tube formation assay were performed using human umbilical vein endothelial cells treated with nicotine (10(-9) to 10(-6) M), and with various combinations of soluble fms-like tyrosine kinase 1 (100 ng/mL), soluble endoglin (100 ng/mL), and nicotine (10(-7) M). Enzyme-linked immunosorbent assay was performed to measure vascular endothelial growth factor, placental growth factor, and transforming growth factor-beta1 concentrations in the conditioned media treated with nicotine (10(-9) to 10(-6) M). RESULTS: Nicotine significantly facilitated endothelial migration and tube formation. By contrast, soluble fms-like tyrosine kinase 1 and/or soluble endoglin suppressed these endothelial functions. Nicotine restored these soluble fms-like tyrosine kinase 1 and/or soluble endoglin-reduced endothelial functions. Placental growth factor, but not transforming growth factor-beta1, production was significantly stimulated by the presence of nicotine. Vascular endothelial growth factor was undetectable. CONCLUSION: Our results suggest a possible mechanism for the protective effects of cigarette smoking against preeclampsia, thus proposing a therapeutic potential of nicotine or other nicotinic acetylcholine receptor agonists for preeclampsia. [less ▲]

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See detailThe effect of tumor-associated protein RCAS1 gene silencing on blood pressure and urinary protein excretion in pregnant mouse: a pilot study.
Tskitishvili, Ekaterine ULg; Nakamura, Hitomi; Kinugasa-Taniguchi, Yukiko et al

in American Journal of Obstetrics and Gynecology (2010), 203(4), 3646-36412

OBJECTIVE: The level of tumor-associated receptor-binding cancer antigen that is expressed on SiSo cells (RCAS1) is decreased significantly in preeclamptic pregnancies. We hypothesized that RCAS1 protein ... [more ▼]

OBJECTIVE: The level of tumor-associated receptor-binding cancer antigen that is expressed on SiSo cells (RCAS1) is decreased significantly in preeclamptic pregnancies. We hypothesized that RCAS1 protein gene silencing might affect blood pressure and proteinuria in pregnant mice. STUDY DESIGN: On postcoital day 7.5, pregnant imprinting control region mice were subjected to the transfer of small interfering RNA (siRNA) against RCAS1 protein into the uterine cavity with the use of a hemagglutinating virus Japan envelope. Scramble siRNA was used as a negative control. Blood pressure and urine albumin/creatinine measurements were performed. The effect of the transferred siRNA was examined in uterine samples on postcoital day 8.5 with the use of Western blotting and immunohistochemistry analyses. RESULTS: In the RCAS1 siRNA group, blood pressure significantly raised on postcoital days 9.5, 10.5, 11.5, and 15.5, whereas urine albumin/creatinine ratio was significantly increased on postcoital day 9.5 CONCLUSION: Our results suggest the importance of RCAS1 protein in the pathophysiologic condition of preeclampsia. [less ▲]

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See detailIs planned vaginal delivery for breech presentation at term still an option? Results of an observational prospective survey in France and Belgium
Goffinet, F.; Carayol, M.; Foidart, Jean-Michel ULg et al

in American Journal of Obstetrics and Gynecology (2006), 194(4), 1002-1011

Objective: A large trial published in 2000 concluded that planned vaginal delivery of term breech births is associated with high neonatal risks. Because the obstetric practices in that study differed from ... [more ▼]

Objective: A large trial published in 2000 concluded that planned vaginal delivery of term breech births is associated with high neonatal risks. Because the obstetric practices in that study differed from those in Countries where planned vaginal delivery is still common, we conducted an observational prospective study to describe neonatal Outcome according to the planned mode of delivery for term breech births in 2 such countries. Study design: Observational prospective study with an intent-to-treat analysis to compare the groups for which cesarean and vaginal deliveries were planned. Associations between the outcome and planned mode of delivery were controlled for confounding by multivariate analysis. The main outcome measure was a variable that combined fetal and neonatal mortality and severe neonatal morbidity. The study Population consisted of 8105 pregnant women delivering singleton fetuses in breech presentation at term in 138 French and 36 Belgian maternity units. Results: Cesarean delivery was planned for 5579 women (68.8%) and vaginal delivery for 2526 (31.2%). Of the women with planned vaginal deliveries, 1796 delivered vaginally (71.0%). The rate of the combined neonatal outcome measure was low in the overall population (1.59%; 95%, Cl [1.33-1.89]) and in the planned vaginal delivery group (1.60%; 95% CI [1.14-2.17]). It did not differ significantly between the planned vaginal and cesarean delivery groups (unadjusted odds ratio 1.10, 95% CI [0.75-1.61]), even after controlling for confounding variables (adjusted odds ratio 1.40, 95% CI [0.89-2.23]). Conclusion: In places where planned vaginal delivery is a common practice and when strict criteria are met before and during labor, planned vaginal delivery of singleton fetuses in breech presentation at term remains a safe option that can be offered to women. (C) 2006 Mosby, Inc. All rights reserved. [less ▲]

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See detailShunting the intervillous space: New concepts in human uteroplacentat vascularization
Schaaps, Jean-Pierre ULg; Tsatsaris, Vassilis; Goffin, Frédéric ULg et al

in American Journal of Obstetrics and Gynecology (2005), 192(1), 323-332

Objective: It is supposed that the intervillous space. is not perfused by maternal blood during the first trimester, suggesting vascular shunts in the myometrium. We therefore attempted to provide ... [more ▼]

Objective: It is supposed that the intervillous space. is not perfused by maternal blood during the first trimester, suggesting vascular shunts in the myometrium. We therefore attempted to provide arguments for a functional vascular anastomotic network located in the placental bed during human pregnancy. Study design: Three-dimensional (3D) sonogyraphy, laboratory analyses. and anatomic studies (hysterectomy specimens, uteroplacental vascular cast) were performed. Results: Color Doppler showed a vascular network with anastomotic aspect located in the placental bed. A vascular cast of a uterus. obtained after postpartum hemorrhage. demonstrated a vascular anastomotic network in the myometrium. Higher Po-2 levels in the uterine vein compared with the intervillous space confirmed the functional nature of this Shunt. Low resistances in the uterine arteries during the first week after delivery suggested that this vascular network remains functional after placental expulsion. Conclusion: Our studies have yielded functional and anatomic evidence of an arteriovenous Shunt located in the subplacental myometrium. (C) 2005 Elsevier Inc. All rights reserved. [less ▲]

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See detailHigh intraepithelial expression of estrogen and progesterone receptors in the transformation zone of the uterine cervix
Remoue, Franck; Jacobs, Nathalie ULg; Miot, Valérie et al

in American Journal of Obstetrics and Gynecology (2003), 189(6), 1660-1665

OBJECTIVE: Because sex hormones may be involved in tumor initiation and progression, we analyzed the presence of hormone receptors in the transformation zone of the uterine cervix where the majority of ... [more ▼]

OBJECTIVE: Because sex hormones may be involved in tumor initiation and progression, we analyzed the presence of hormone receptors in the transformation zone of the uterine cervix where the majority of human papillomavirus infections and associated (pre)neoplastic lesions develop. STUDY DESIGN: By using 23 total hysterectomy samples from young women who underwent surgery for noncervical benign uterine disease, we analyzed, by immunohistologic techniques, the in situ expression of estrogen (E-2-R) and progesterone (P-4-R) receptors in the transformation zone and ectocervix of the same women. RESULTS: The expression of estrogen receptors and progesterone receptors is significantly higher in the transformation zone compared with the ectocervix. Immunohistochemical localization indicated that hormone receptor-positive cells are mainly observed in (para)basal and intermediate cell layers in both the transformation zone and ectocervical epithelium. When transformation zone samples were segregated into epithelial tissues with a predominantly mature (7/23 samples) or immature (16/23 samples) squamous metaplasia, only biopsy specimens with immature squamous metaplasia showed a significantly higher density of hormone receptor-positive cells compared with ectocervical epithelium (P < .01). CONCLUSION: Our results suggest that the cervical transformation zone may be at increased risk of the development of cancer because of a high sensitivity to sex hormone regulation. (Am J Obstet Gynecol 2003; 189:1660-5.) [less ▲]

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See detailA Prenatal Trisomy 21 Screening Program Using Alpha-Fetoprotein, Human Chorionic Gonadotropin, and Free Estriol Assays on Maternal Dried Blood
Verloes, Alain ULg; Schoos, Roland ULg; Herens, Christian ULg et al

in American Journal of Obstetrics and Gynecology (1995), 172(1, Pt 1), 167-74

OBJECTIVE: The feasibility of large-scale Down syndrome maternal screening with dried blood samples and nonradioactive methods was examined. STUDY DESIGN: A prospective observation study was performed on ... [more ▼]

OBJECTIVE: The feasibility of large-scale Down syndrome maternal screening with dried blood samples and nonradioactive methods was examined. STUDY DESIGN: A prospective observation study was performed on a nonselected population of 11,241 pregnant women sampled between January 1991 and September 1992, between 14 and 24 weeks' gestation (ultrasonographic scanning available for 91.6%), through a multicenter collaborative network. Enzyme-linked immunosorbent assays for alpha-fetoprotein, human chorionic gonadotropin, and free estriol were performed on dried blood samples. Risk determination was made with an in-house software implementing the multivariate gaussian log likelihood method. RESULTS: A total of 10,450 samples were eligible for the study. Mean age at term was 27.9 years. A total of 6.84% of the patients were > or = 35 years old with a prior risk of trisomy 21 > 1:350. The general positive rate of our sample was 8.15%. After calculation 31.7% with prior risk > 1:350 were still in the high-risk group; 6.36% of the low-risk group were found to be at high risk for Down syndrome. Fifteen trisomic pregnancies were observed, of which 11 had a calculated risk higher than the selected cutoff value (1:350). The overall detection rate was 73%, specificity was 92%, and positive predictive power was 1.2%. CONCLUSION: Our pilot study has shown performances within the range of conventional serum screening programs. Dried blood assays are a handy alternative to serum assays. Blot paper cards represent a simple method of sampling, well fitted for large population screening. Combined with nonradioactive methods, this method appears to be both low cost and effective. The current work apparently is the first large-scale Down screening program performed with dried blood. [less ▲]

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See detailEffects of ethinyl estradiol combined with desogestrel and cyproterone acetate on glucose tolerance and insulin response to an oral glucose load: a one-year randomized, prospective, comparative trial.
Jandrain, Bernard ULg; Humblet, Dominique ULg; Jaminet, C. B. et al

in American Journal of Obstetrics and Gynecology (1990), 163(1 Pt 2), 378-81

To investigate the effects of two slightly estrogen-dominant, monophasic, low-dose oral contraceptives on carbohydrate metabolism, 40 healthy young women were randomly allocated to receive either 30 ... [more ▼]

To investigate the effects of two slightly estrogen-dominant, monophasic, low-dose oral contraceptives on carbohydrate metabolism, 40 healthy young women were randomly allocated to receive either 30 micrograms of ethinyl estradiol + 150 micrograms of desogestrel, a 19-nortestosterone-derived progestin (Marvelon; n = 21) or 35 micrograms of ethinyl estradiol + 2 mg of cyproterone acetate, a 17-acetoxyprogesterone derivative (Diane-35; n = (19) for a prospective observation period of 1 year. At baseline, 6, and 12 months, blood glucose, plasma insulin, and plasma C-peptide levels were measured during an oral glucose tolerance test. Although the changes were absent (Marvelon) or minimal (Diane-35) at 6 months, both groups had a slight increase in blood glucose levels at 12 months; overall glucose tolerance remaining, however, within the normal range. Plasma insulin levels remained unchanged in the Diane-35-group, which suggested increased insulin resistance, but were significantly decreased in the Marvelon group despite significant rises in plasma C-peptide levels. Comparison of plasma C-peptide and insulin changes suggests enhanced pancreatic insulin secretion and increased hepatic insulin metabolism with both Marvelon and Diane-35. [less ▲]

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