To the problem of pregnant women's cholestasis

Liver disease andpregnancy usually aggravates each other. Its rather difficult to differentiate pregnant womens cholestasis from gestosis accompanied with chronic liver disease preceding pregnancy. 60 pregnant women were examined, the first group with cholestatic hepatosis, the second group with gestosis and liver disease. The practical aim o f the study was to choose righttactics o f pregnancy management, method and date o f confinement.Pregnant womens hepatosis turned out to be a complex concept: it may embrace different types o f pathological pregnancy under the single clinical diagnosis.

Penyuluhan Tentang Tanda Bahaya Kehamilan di Puskesmas Jumpandang Baru Makassar

ABSTRAK Pada umumnya 80-90 % kehamilan akan berlangsung normal dan hanya 10-12 % kehamilan yang disertai dengan penyulit atau berkembang menjadi kehamilan patologis. Kehamilan patologis tidak terjadi secara mendadak karena kehamilan dan efeknya terhadap organ tubuh berlangsung secara bertahap dan berangsur-angsur. Deteksi dini gejala dan tanda bahaya selama kehamilan merupakan upaya terbaik untuk mencegah terjadinya gangguan yang serius terhadap kehamilan ataupun keselamatan ibu hamil. Tujuan setelah penyuluhan ini, diharapkan dapat meningkatkan pengetahuan dan kesehatan masyarakat khususnya ibu hamil tentang Tanda Bahaya Kehamilan agar dapat dideteksi sesegera mungkin guna mencegah kenaikan AKI dan AKB di Puskesmas Jumpandang baru. Adapun kegiatan yang dilakukan berupa penyuluhan dalam bentuk penyampaian materi dan lefleat. Terdapat peningkatan pengetahuan dan kemampuan tentang tanda bahaya kehamilan pada masyarakat khususnya ibu hamil di Puskesmas Jumpandang Baru Makassar. Kata kunci: Tanda bahaya kehamilan, Kehamilan ABSTRACT In general, 80-90% of pregnancies will proceed normally and only 10-12% of pregnancies are accompanied by complications or develop into pathological pregnancies. Pathological pregnancy does not occur suddenly because pregnancy and its effect on the organs of the body are gradual and gradual. Early detection of symptoms and danger signs during pregnancy is the best effort to prevent serious interference with pregnancy or the safety of pregnant women. The aim after this counseling is that it is expected to increase public health and knowledge, especially for pregnant women, about Pregnancy Danger Signs so that they can be detected as soon as possible in order to prevent an increase in MMR and IMR at the new Jumpandang Baru Makassar Health Center. The activities carried out are in the form of counseling in the form of delivery of material and leaflet. There is an increase in knowledge and abilities about the danger signs of pregnancy in the community, especially pregnant women at the Jumpandang Baru Makassar Health Center. Keywords: Pregnancy Danger Sign, pregnant

Cesarean scar ectopic pregnancy: clinical case

Today, cesarean scar pregnancy is a rare type of ectopic pregnancy (1:18001: 2200). Moreover, the mortality rate in cesarean scar pregnancy is 191.2 per 100 000 cases, that 12 times exceeds the mortality rate in tubal pregnancy. In this article, we present a clinical observation of a rare case of cesarean scar pregnancy, as diagnosed by ultrasonography, in a 23-year-old patient after the cesarean surgery. The diagnosis was based on clinical, biochemical and ultrasound studies. Ultrasound played a crucial role in the determination of the fetus localization. Pathological pregnancy was eliminated by means of excision of the old scar and restoration of the uterine wall integrity. Such cases are becoming more common in connection with the increase in the frequency of caesarean sections, the improvement of technology, continuing medical education and professional development in the field of ultrasound. Knowledge of differential diagnosis can save the patient's life since the outcomes of cesarean scar pregnancy include severe complications with a possible loss of patients fertile function and immediate risk of death.

Bioenergetics adaptations and redox homeostasis in pregnancy and related disorders

Pregnancy is a challenging physiological process that involves maternal adaptations to the increasing energetics demands imposed by the growing conceptus. Failure to adapt to these requirements may result in serious health complications for the mother and the baby. The mitochondria are biosynthetic and energy-producing organelles supporting the augmented energetic demands of pregnancy. Evidence suggests that placental mitochondria display a dynamic phenotype through gestation. At early stages of pregnancy placental mitochondria are mainly responsible for the generation of metabolic intermediates and reactive oxygen species (ROS), while at later stages of gestation, the placental mitochondria exhibit high rates of oxygen consumption. This review describes the metabolic fingerprint of the placental mitochondria at different stages of pregnancy and summarises key signs of mitochondrial dysfunction in pathological pregnancy conditions, including preeclampsia, gestational diabetes and intrauterine growth restriction (IUGR). So far, the effects of placental-driven metabolic changes governing the metabolic adaptations occurring in different maternal tissues in both, healthy and pathological pregnancies, remain to be uncovered. Understanding the function and molecular aspects of the adaptations occurring in placental and maternal tissue’s mitochondria will unveil potential targets for further therapeutic exploration that could address pregnancy-related disorders. Targeting mitochondrial metabolism is an emerging approach for regulating mitochondrial bioenergetics. This review will also describe the potential therapeutic use of compounds with a recognised effect on mitochondria, for the management of preeclampsia.

Complement in structure and immune homeostasis in placenta

Aberrant complement activation can induce “thrombo-inflammation” attacks to host tissue. Beside kidney and blood vessel, the placenta is also susceptible to these attacks. Complement dysregulation is recently classified as one of the new mechanisms leading to pregnancy disorders. Studies have indicated that dampening complement activation can ameliorate pregnancy outcomes. During pregnancy, the mother’s immune system is finely domesticated to accept the semi-allogeneic fetal antigens. As an important part of the innate immune system, some interesting changes have also taken place in complement system during pregnancy. The complement proteins are highly expressed in placenta, and their split products are increased. They are tuned in maintain placental immunity and structural homeostasis. An abundance of evidence shew that complement protein deficiency lead to autoimmunity disease and pathological pregnancy marked by excessive inflammation. Although complement suppressing strategies have been proven effective in treating some pathological pregnancy in individual case studies. we should take the dual role of the complement into consideration that fully and completely inhibit of complement may not be a wise choice.

A case of malignant neoplasm, which has developed from the elements of the villous cover (Desidoma malignum autorum)

In the last time, the attention of obstetricians, gynecologists and pathologists has been drawn to a special kind of neoplasm that primarily develops in the uterine cavity or tubes on the soil of a former normal or pathological pregnancy and is characterized by extreme malignancy.

Influence of Estrogens on Uterine Vascular Adaptation in Normal and Preeclamptic Pregnancies

During pregnancy, the maternal cardiovascular system undergoes significant changes, including increased heart rate, cardiac output, plasma volume, and uteroplacental blood flow (UPBF) that are required for a successful pregnancy outcome. The increased UPBF is secondary to profound circumferential growth that extends from the downstream small spiral arteries to the upstream conduit main uterine artery. Although some of the mechanisms underlying uterine vascular remodeling are, in part, known, the factors that drive the remodeling are less clear. That higher circulating levels of estrogens are positively correlated with gestational uterine vascular remodeling suggests their involvement in this process. Estrogens binding to the estrogen receptors expressed in cytotrophoblast cells and in the uterine artery wall stimulate an outward hypertrophic remodeling of uterine vasculature. In preeclampsia, generally lower concentrations of estrogens limit the proper uterine remodeling, thereby reducing UPBF increases and restricting the growth of the fetus. This review aims to report estrogenic regulation of the maternal uterine circulatory adaptation in physiological and pathological pregnancy that favors vasodilation, and to consider the underlying molecular mechanisms by which estrogens regulate uteroplacental hemodynamics.