It is reported that expression of vascular endothelial growth factor (VEGF) in trophoblasts increases in cases with preeclampsia. Recently, we demonstrated that the lack of cyclin-dependent kinase inhibitor, p57kip2, expression in the fetus and the placenta plays a role in the development of preeclampsia-like symptoms in pregnant mice. Furthermore, we observed that VEGF mRNA and protein levels, especially VEGF164, were higher and its expression was stronger in placentas of p57kip2-null embryos than in placentas of wild-type embryos. In this study we investigated whether exogenous murine VEGF164 induced preeclampsia-like symptoms in pregnant mice, and anti-VEGF neutralized antibody could suppress these symptoms. Administration of VEGF induced hypercoagulation in the placental circulation and a significant elevation of systolic blood pressure in pregnant mice. Furthermore, we demonstrated that treatment with anti-VEGF antibody could suppress the hypercoagulability in placenta and the elevation of systolic blood pressure. These data suggest that VEGF is related to the pathophysiology of preeclampsia.
Abstract Aim Pelvic shape affects the progression of labor. The gynecoid‐type pelvis has been the most common in women, but a previous study reported that the anthropoid type has increased in Japan. The purpose of this study was to examine: (i) the current prevalence of different pelvic shapes in Japanese pregnant women; and (ii) the changes in the prevalence of the pelvic shapes over the past 50 years. Material and Methods We conducted a cross‐sectional study using descriptive analysis for the prevalence of the pelvic shape and a historical comparison to assess the changes in the proportions of pelvic shapes with Japanese data from the 1960s to the 1980s. We reviewed a total of 517 delivery records from May 2010 to August 2012 at a rural Japanese hospital where prenatal X‐ray pelvimetry had been routinely performed as local practice. We analyzed the readings of the digital imaging data in pregnant women who underwent X‐ray pelvimetry. Results We identified the X‐ray data in 326 Japanese pregnant women. The prevalence of the anthropoid, gynecoid and flat types was 151 (46.3%), 142 (43.6%), and 33 (10.1%), respectively. There were no differences in the maternal characteristics according to the pelvic shapes. The prevalence of the anthropoid‐type pelvis has increased by approximately 40% and that of the gynecoid type has decreased by 20% since the 1960s. Conclusion The prevalence of the anthropoid‐type pelvis have significantly increased in Japan. Identifying a determinant of this phenomenon requires further research.
Abstract Aim To examine the relationship between preterm birth and socioeconomic factors, past history, cervical length, cervical interleukin‐8, bacterial vaginosis, underlying diseases, use of medication, employment status, sex of the fetus and multiple pregnancy. Methods In a multicenter, prospective, observational study, 1810 J apanese women registering their future delivery were enrolled at 8 +0 to 12 +6 weeks of gestation. Data on cervical length and delivery were obtained from 1365 pregnant women. Multivariate logistic regression analysis was performed. Results Short cervical length, steroid use, multiple pregnancy and male fetus were risk factors for preterm birth before 34 weeks of gestation. Multiple pregnancy, low educational level, short cervical length and part‐timer were risk factors for preterm birth before 37 weeks of gestation. Conclusion Multiple pregnancy and cervical shortening at 20–24 weeks of gestation was a stronger risk factor for preterm birth. Any pregnant woman being part‐time employee or low educational level, having a male fetus and requiring steroid treatment should be watched for the development of preterm birth.
The purpose of this study was to establish a new coagulation index to distinguish severe preeclampsia from normal pregnancy using optimal coagulation parameters. The difference between platelet counts in early gestation and before delivery (DeltaPlt = [platelet counts before delivery] - [platelet counts in early gestation]) was calculated as an index of changes in platelet counts. Antithrombin (AT) activity, thrombin-antithrombin (TAT) complex, fibrin degradation products (FDP) D-dimer, and DeltaPlt were investigated in 72 cases of normal pregnant women in the third trimester of pregnancy and 56 cases of severe preeclampsia. The new coagulation index was calculated using multivariate logistic regression analysis. As a result, in a case using four parameters, the following formula was obtained: Y = (-0.019 x AT activity) + (0.067 x TAT) + (0.067 x D-dimer) + (-0.064 x DeltaPlt) + 0.706. According to this formula, coagulation indices in normal pregnant women and in patients with severe preeclampsia were -0.77 +/- 0.51 and 1.41 +/- 1.56, respectively (p < 0.0001). Among patients with severe preeclampsia, coagulation and fibrinolysis disorders before delivery were typical in patients terminated by cesarean section (coagulation index = 1.62 +/- 1.66) compared with those with successful vaginal delivery (coagulation index = 0.52 +/- 0.34) (p < 0.05). These facts suggest that an excessive hypercoagulable state is associated with the termination of pregnancy resulting from the aggravation of preeclampsia. From the viewpoint of coagulation and fibrinolysis disorders, the predictive value in order to decide the optimal time for the termination of pregnancy could be recommended when the coagulation index exceeded 1.20.
HOC-I ovarian cancer cells express the single-chain form of the urokinase-type plasminogen activator (uPA) and cathepsin B (cath B) on their cell surface. The significance of the expression of cell surface uPA/cath B activity to the invasive potential was examined by preincubating with uPA/cath B-modulating agents in in vitro invasion assay. The anti-uPA monoclonal antibody 394 effectively inhibited invasion in a dose-dependent manner. On the contrary, anti-cath B antibody did not affect the invasive potential of the cells. E-64, a specific inhibitor for cysteine proteases, blocked invasion as effectively as monoclonal antibody 394. The data reveal that the uPA and cysteine proteases contribute significantly to the invasive capacity of the cells. We suggest that the cysteine proteases facilitate the action of uPA, possibly by activating proenzyme uPA produced by cancer cells. Evidence for the role of a cathepsin-uPA activation cascade in HOC-I cell invasion is provided.
Placental lakes are sonolucent or hypoechoic areas in images of the placenta, usually considered a physiological dilation of intervillous space with a rather good obstetrical outcome. However, diagnostic criteria for and the clinical significance of placental lakes are yet to be completely established, because of a wide variety of ultrasound findings, especially on color Doppler examination. We experienced a case of a huge placental lake, larger than the total placental area, located in an entire retroplacental space, concomitant with several penetrations of artery type blood flow. The antenatal differential diagnosis and course of clinical management are reported.
