Gestational Trophoblastic Neoplasia Following Molar Ectopic Pregnancy A Case Report

BACKGROUND: Ectopic molar pregnancy is a gestational trophoblastic disease (GTD) of rare occurrence and therefore not always remembered as a diagnostic possibility.CASE: We describe a case of molar ectopic pregnancy in a primiparous woman who developed gestational trophoblastic neoplasia and required chemotherapy to achieve remission.CONCLUSION This case stresses the important role of histopathologic examination in establishing a diagnosis of ectopic molar pregnancy. Moreover, close follow-up of human chorionic gonadotropin levels is required when a GTD is suspected. (J Reprod Med 2008;53:579-582)

Abortamento na adolescência: um estudo epidemiológico

O presente trabalho foi desenvolvido no Hospital Maternidade Santa Izabel da cidade de Bauru, São Paulo, Brasil, e teve como objetivo investigar o abortamento na adolescência e compará-lo com o das mulheres adultas. Os indicadores buscaram traçar o perfil epidemiológico das mulheres internadas, por meio de dados coletados em prontuários, entre aquelas com diagnóstico de aborto, independente da forma clínica, entre os anos de 2000 a 2003. O total de abortamentos registrados foi de 2.286, sendo 459 (20,08%) na faixa etária da adolescência e a forma completa foi significativamente maior nas adolescentes quando comparada às das mulheres adultas; segundo o ano de análise, constatou-se decréscimo de ocorrência entre as adolescentes, com maior incidência em 2000 (30,50%), seguida dos anos de 2001 (25,05%), 2002 (23,53%) e 2003 (20,92%), sendo que as adolescentes apresentaram tendência a permanecer dois ou mais dias hospitalizadas. Enfatiza-se a implementação de políticas e programas direcionados à saúde sexual e reprodutiva e suas co-morbidades.

Progesterone-based estrous synchronization protocols in non-suckled and suckled primiparous Bos indicus beef cows

In Experiment 1, effects of an intravaginal progesterone insert (CIDR) for synchronization of estrus in non-suckled cycling primiparous Bos indicus beef cows were evaluated. Cows received either no treatment (Control), prostaglandin F(2 alpha) (PGF), or CIDR (6 d)+prostaglandin F(2 alpha) (CIDR+PGF). There were greater (P<0.05) percentages of cows inseminated and pregnant in 4 d of breeding season in CIDR+PGF (81.6%; 48.7%) than in PGF (53.8%; 32.5%) and Control cows (14.6%; 8.5%). In Experiment 2, efficacy of a treatment with CIDR (6 d)+prostaglandin F(2 alpha)+48 h temporary weaning (CIDR+PGF+TW) associated or not with equine chorionic gonadotropin (eCG) for synchronization of estrus in suckled primiparous B. indicus beef cows was evaluated. Cows were assigned to receive either no treatment (Control), CIDR+PGF+TW, CIDR+PGF+TW+200 IU of eCG, or CIDR+PGF+IW+400 IU of eCG. There were greater (P<0.05) percentages of insemination and pregnancy in 4 d of breeding season in treatment groups (47.0%; 27.5%) than in Control cows(4.5%; 3.0%) and in cows treated with eCG (50.9%; 29.4%) than in cows treated only with CIDR+PGF+TW (39.4%: 23.7%). No effects of eCG dosage were detected. The percentage of cows inseminated and pregnant in a 30 d breeding season were greater (P<0.05) in cows assigned to synchronization treatments (53.3%; 37.2%) than in Control cows (35.3%; 21.4%). In the beginning of the BS, non-suckled primiparous cows treated with CIDR+PGF with estrous cycles having been initiated following calving had greater estrous detection and pregnancy rates than PGF and Control cows, and suckled primiparous cows had improved estrous detection and pregnancy rates when eCG was associated with CIDR+PGF+TW. (C) 2009 Elsevier B.V. All rights reserved.

Use of oocyte transfer in a commercial breeding program for mares with reproductive abnormalities

In some mares with lesions of the reproductive tract, embryo collection and survival rates are low or collection of embryos is not feasible. For these mares, oocyte transfer has been proposed as a method to induce pregnancies. In this report, a method for oocyte transfer in mares and results of oocyte transfer performed over 2 breeding seasons, using mares with long histories of subfertility and various reproductive lesions, are described.Human chorionic gonadotropin or an implant containing a gonadotropin-releasing hormone analog was used to initiate follicular and oocyte maturation. Oocytes were collected by means of transvaginal ultrasound-guided follicular aspiration. Following follicular aspiration, cumulus oocyte complexes were evaluated for cumulus expansion and signs of atresia; immature oocytes were cultured in vitro to allow maturation. The recipient's ovary and uterine tube (oviduct) were exposed through a flank laparotomy with the horse standing, and the oocyte was slowly deposited within the oviduct. Oocyte transfer was attempted in 38 mares between 9 and 30 years old during 2 successive breeding seasons. All mares had a history of reproductive failure while in breeding and embryo transfer programs. Twenty pregnancies were induced. Fourteen of the pregnant mares delivered live foals. Results suggest that oocyte transfer can be a successful method for inducing pregnancy in subfertile mares in a commercial setting..

Early embryonic death in mares: clinical and hormonal aspects

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effects of leucine supplemented diet on intestinal absorption in tumor bearing pregnant rats

Background: It is known that amino acid oxidation is increased in tumor-bearing rat muscles and that leucine is an important ketogenic amino acid that provides energy to the skeletal muscle.Methods: To evaluate the effects of a leucine supplemented diet on the intestinal absorption alterations produced by Walker 256, growing pregnant rats were distributed into six groups. Three pregnant groups received a normal protein diet (18% protein):pregnant (N), tumor-bearing (WN), pair-fed rats (Np). Three other pregnant groups were fed a diet supplemented with 3% leucine (15% protein plus 3% leucine):leucine (L), tumor-bearing (WL) and pair-fed with leucine (Lp). Non pregnant rats (C), which received a normal protein diet, were used as a control group. After 20 days, the animals were submitted to intestinal perfusion to measure leucine, methionine and glucose absorption.Results: Tumor-bearing pregnant rats showed impairment in food intake, body weight gain and muscle protein content, which were less accentuated in WL than in WN rats. These metabolic changes led to reduction in both fetal and tumor development. Leucine absorption slightly increased in WN group. In spite of having a significant decrease in leucine and methionine absorption compared to L, the WL group has shown a higher absorption rate of methionine than WN group, probably due to the ingestion of the leucine supplemented diet inducing this amino acid uptake. Glucose absorption was reduced in both tumor-bearing groups.Conclusions: Leucine supplementation during pregnancy in tumor-bearing rats promoted high leucine absorption, increasing the availability of the amino acid for neoplasic cells and, mainly, for fetus and host utilization. This may have contributed to the better preservation of body weight gain, food intake and muscle protein observed in the supplemented rats in relation to the non-supplemented ones.

Hypertensive disorders in pregnant women with diabetes mellitus

The present study was performed to assess the rate of hypertensive complications in diabetic pregnant patients and the influence of White's classification and the quality of the diabetic control. This study included 169 diabetic pregnant women who had delivered at the University Hospital of Botucatu Brazil from 1980 to 1981. The hypertensive disorders occurred in 29.8% of the cases. The incidence of the hypertensive process was the same in all classes of diabetic patients, and it was independent of the glycemic control. In patients with gestational diabetes (classes A and AB), chronic hypertension was the commnest type found; in patients with short-term diabetes (classes B and C) pregnancy-induced hypertension (PIH) and chronic hypertension with superimposed PIH was the most frequent type, and diabetic patients with vasculopathies (classes D-R) had preeclampsia and chronic hypertension with superimposed preeclampsia as the commonest type found.

Aspectos psicossociais da gravidez na adolescência: relatos de mães adolescentes

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Hydrallantois in a female dog: a case report

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Three-Dimensional Sonographic Assessment of Placental Volume and Vascularization in Pregnancies Complicated by Hypertensive Disorders

Objectives-The purpose of this study was to evaluate the association between placental volumes, placental vascularity, and hypertensive disorders in pregnancy.Methods A prospective case-control study was conducted between April 2011 and July 2012. Placental volumes and vascularity were evaluated by 3-dimensional sonographic, 3-dimensional power Doppler histographic, and 2-dimensional color Doppler studies. Pregnant women were classified as normotensive or hypertensive and stratified by the nature of their hypertensive disorders. The following variables were evaluated: observed-to-expected placental volume ratio, placental volume-to-estimated fetal weight ratio, placental vascular indices, and pulsatility indices of the right and left uterine and umbilical arteries.Results Sixty-six healthy pregnant women and 62 pregnant women with hypertensive disorders were evaluated (matched by maternal age, gestational age at sonography, and parity). Placental volumes were not reduced in pregnancy in women with hypertensive disorders (P > .05). Conversely, reduced placental vascularization indices (vascularization index and vascularization-flow index) were observed in pregnancies complicated by hypertensive disorders (P < .01; P < .01), especially in patients with superimposed preeclampsia (P = .04; P = .02). A weak correlation was observed between placental volumes, placental vascular indices, and Doppler studies of the uterine and umbilical arteries.Conclusions Pregnancies complicated by hypertensive disorders are associated with reduced placental vascularity but not with reduced placental volumes. These findings are independent of changes in uterine artery Doppler studies. Future studies of the prediction of preeclampsia may focus on placental vascularity in combination with results of Doppler studies of the uterine arteries.

Triplex Doppler Ultrassonography in Prenatal of Pregnant Bitches

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Polymorphisms in endothelial nitric oxide synthase gene in early and late severe preeclampsia

Preeclampsia (PE) is characterized by hypertension and proteinuria, occurring after the 20th week of pregnancy in women who have had no previous symptoms. The disease progresses with generalized vasoconstriction and endothelial dysfunction. Clinically, it is important to diagnose the severe form of the disease (sPE), in which blood pressure and proteinuria are much higher. Recently, the gestational age (GA) of the onset of PE has led to the classification of this disease as early (GA <34 weeks) and late (GA >= 34 weeks). Several genetic polymorphisms affecting endothelial nitric oxide synthase (eNOS) levels or function were described, including G894T (Glu298Asp), VNTR b/a (variable-number 27-bp tandem repeat) and T-786C (promoter) polymorphisms. Thus, the aim of this study was to compare the distribution of G894T, VNTR b/a and T-786C polymorphisms and their haplotypes in Brazilian early and late sPE, as well as in normotensive pregnant. A total of 201 women were evaluated, 53 with early sPE, 45 with late sPE and 103 as normotensive pregnant women. The frequency of 894T allele was higher in late sPE vs normotensive pregnant, and 894TT genotype was higher in late sPE vs early sPE and normotensive pregnant. For VNTR b/a polymorphism, higher frequencies of aa genotype and a allele were observed in early sPE vs late sPE and normotensive pregnant. Besides, the frequency of haplotype T-b-C was higher in late sPE vs early sPE and normotensive pregnant. Considering the results found for eNOS polymorphisms, it is possible to suggest that the functional alterations induced by these two polymorphisms may influence the time of severe PE onset, although both alterations are putatively associated with low NO bioavailability. However, other studies are necessary to validate these findings and clarify this issue. (C) 2014 Elsevier Inc. All rights reserved.

Mineral metabolism in singleton and twin-pregnant dairy goats

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Low frequency of Y anomaly detected in Australian Brahman cow-herds

Indicine cattle have lower reproductive performance in comparison to taurine. A chromosomal anomaly characterized by the presence Y markers in females was reported and associated with infertility in cattle. The aim of this study was to investigate the occurrence of the anomaly in Brahman cows. Brahman cows (n = 929) were genotyped for a Y chromosome specific region using real time-PCR. Only six out of 929 cows had the anomaly (0.6%). The anomaly frequency was much lower in Brahman cows than in the crossbred population, in which it was first detected. It also seems that the anomaly doesn't affect pregnancy in the population. Due to the low frequency, association analyses couldn't be executed. Further, SNP signal of the pseudoautosomal boundary region of the Y chromosome was investigated using HD SNP chip. Pooled DNA of non-pregnant and pregnant cows were compared and no difference in SNP allele frequency was observed. Results suggest that the anomaly had a very low frequency in this Australian Brahman population and had no effect on reproduction. Further studies comparing pregnant cows and cows that failed to conceive should be executed after better assembly and annotation of the Y chromosome in cattle.

Correlates of sports practice, occupational and leisure-time physical activity in Brazilian adolescents

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)