Androgens and the androgen receptor (AR) are not only required for male reproductive function, they are also essential for female reproductive physiology. Widely expressed in female reproductive tissues, AR levels fluctuate in a regulated manner in the cycling endometrium. Female androgen production depends on the adrenal glands and expression of ...

Citation Ernerudh J, Berg G, Mjösberg J. Regulatory T Helper Cells in Pregnancy and their Roles in Systemic versus Local Immune Tolerance. Am J Reprod Immunol 2011; 66 (Suppl. 1): 31-43 Problem  During pregnancy, the maternal immune system needs to adapt in order not to reject the semi-allogenic fetus. Method  ...

Pregnancy is a unique time in a woman's life, accompanied by a variety of physiologic, anatomic and hormonal changes that can affect how oral health care is provided. However, these patients are not medically compromised and should not be denied dental treatment simply because they are pregnant. This article discusses ...

Citation Robertson SA, Chin PY, Glynn DJ, Thompson JG. Peri-Conceptual Cytokines - Setting the Trajectory for Embryo Implantation, Pregnancy and Beyond. Am J Reprod Immunol 2011; 66 (Suppl. 1): 2-10 Problem  The peri-conceptual environment influences the early embryo to impart long-term consequences for the fetus and neonate; however, the underlying ...

Introduction. Geophagy is a form of pica characterized by craving and eating of soil. The main materials ingested include anthill soils and soft stone. In this review, our objectives were to study the prevalence of geophagy in pregnancy (GiP), establish the risk factors for GiP, assess the effects of GiP ...

The management of early pregnancy loss used to be based largely in the hospital setting, but it has shifted to the outpatient setting, allowing women to remain under the care of their family physician throughout the miscarriage process. Up to 15 percent of recognized pregnancies end in miscarriage, and as ...

Summary.  Background: Recurrent pregnancy loss (RPL) is a major issue for women's health. Acquired and heritable thrombophilias are associated with RPL, this association could reflect a general prothrombotic phenotype rather than a specific thrombophilia. Antithrombotic intervention has therefore been assessed for RPL. Results: Two large randomised trials with untreated control groups showed ...

Low molecular weight heparins (LMWHs) are widely used during pregnancy since several randomized controlled trials have demonstrated their important role in preventing not only thromboembolic disease but also pregnancy complications associated with thrombophilia: recurrent pregnancy loss (RPL), fetal growth restriction (FGR), preeclampsia (PE), abruptio placentae and intrauterine fetal death (IUFD). ...

With 80% of pregnant women suffering from some degree of "morning sickness," or nausea and vomiting of pregnancy (NVP), symptom management is a major challenge. A recent Cochrane systematic review of randomized controlled trials concluded that, to date, there is no strong evidence of effectiveness for practically any therapeutic agent ...

Nurses are increasingly encountering pregnant/postpartum women with hypertensive disorders of pregnancy, of which preeclampsia is one of the most common. The Joint Commission published a Sentinel Event Alert in 2010 on prevention of maternal death. This report notes that one of the 5 leading causes of pregnancy-related mortality between 1991 ...

Pre-eclampsia is defined as new onset hypertension with proteinuria during pregnancy. Pre-eclampsia is also characterized by endothelial cell activation and dysfunction and intrauterine growth restriction. Preeclamptic women display a chronic inflammatory response characterized by elevated inflammatory cytokines, circulating monocytes, neutrophils, and T and B lymphocytes secreting autoantibodies that activate the ...

Denial of pregnancy is an important condition that is more common than expected, with an incidence at 20 weeks gestation of approximately 1 in 475. The proportion of cases persisting until delivery is about 1 in 2500, a rate similar to that of eclampsia. Denial of pregnancy poses adverse consequences ...

Inhibin and activins play major roles as paracrine and autocrine signaling molecules in reproduction and development where the main emphasis has been placed in developing potential diagnostic applications. While a role for activin assays in diagnostics has so far been unfounded, ELISAs specific for the biologically active inhibin A and ...

The association between smoking during pregnancy and adverse maternal/neonatal health outcomes is widely acknowledged, and recent health care reform has filled a much-needed gap by extending prenatal smoking cessation intervention coverage to all pregnant women on Medicaid. While more extensive coverage will improve quit rates during pregnancy, there continues to ...

In recent years, many studies have focused on the effect of oxidative stress, reactive oxygen species (ROS) and antioxidants on the male eproductive system. Under physiological conditions, sperm produces small amounts of ROS, which are needed for fertilisation, acrosome reaction and capacitation. However, if an increased production of ROS is ...

The presence of uterine myomas during pregnancy is considered a risk factor for gestation and delivery. In literature, myomas are related to spontaneous abortion, bleeding, PPROM, preterm delivery, placenta previa, placental abruption, fetal malpresentations, mechanical dystocia and high incidence of cesarean section. Laparotomic myomectomy done during pregnancy is indicated when ...

Preeclampsia is a pregnancy-induced hypertensive disorder characterized by proteinuria and widespread maternal endothelial dysfunction. It remains one of the most common disorders in pregnancy and remains one of the leading causes of maternal and fetal morbidity. Recent research has revealed that placental insufficiency, resulting in hypoxia and ischemia, is a ...

Normal human pregnancy is considered a state of enhanced oxidative stress. In pregnancy, it plays important roles in embryo development, implantation, placental development and function, foetal development, and labour. However, pathologic pregnancies including gestational diabetes mellitus (GDM) are associated with a heightened level of oxidative stress, owing to both over ...

Crohn's disease and ulcerative colitis affect women in their child-bearing years. Family planning has come to be a common discussion between the gastroenterologist and the inflammatory bowel disease (IBD) patient. Disease control prior to desired conception and throughout pregnancy is the most important thing to keep in mind when caring ...

There, likely, is no more controversial issue in reproductive medicine than the effects of autoimmunity on female reproductive success. Published studies are, therefore, often biased. We performed PubMed, Google Scholar and Medline searches for the years 2000-2010 under various key words and phrases, referring to effects of autoimmunity/autoimmune diseases on ...

In investigating the immunological regulation of trophoblast invasion, emphasis is frequently placed on the constitution of the implantation site and its specific characteristics. However trophoblast cells are able of invading into not only the uterine tissue, but in the case of ectopic pregnancies also invade into other tissues, where they ...

Tocolytics are widely used to reduce uterine activity in the context of preterm labour. Growing evidence that bacterial colonization of fetal membranes and amniotic fluid triggers an inflammatory response in mother and fetus and leads to preterm labour and long term neurological and respiratory complications in the neonate also raises ...

The antepartum administration of fluorinated corticosteroids for fetal maturation represents the most important clinical contribution in the battle against prematurity. This treatment reduces the risk of neonatal death and handicap. It is also known that on corticosteroid exposure, fetuses are subjected to transiently increased physiologic and metabolic demands. Healthy fetuses ...

Smoking in pregnancy can cause serious adverse antenatal and postnatal morbidities, and a significant number of women continue to smoke in pregnancy despite these consequences. Early intervention in the form counseling from their physicians, pregnancy-specific self-help materials, counseling sessions with a health educator, and/or continued follow-up can result in better ...

Uncontrolled hyperthyroidism in pregnancy is associated with an increased risk of perinatal complications. The state of the art discussed here has been derived through a wide MEDLINE search throughout English-language literature by using a combination of words such as hyperthyroidism, propylthiouracil (PTU), methimazole, rituximab, and pregnancy to identify original related ...

Hypertensive disorders of pregnancy are a major cause of morbidity and mortality worldwide. Reliable, published individual patient data from units and countries are lacking. Without these data, clinicians are unable to benchmark their incidence, treatments and outcomes, and patient safety is unable to be routinely assessed. Available data suggest that ...

This article briefly discusses gestational physiologic changes and thereafter reviews liver diseases during pregnancy, which are divided into 3 main categories. The first category includes conditions that are unique to pregnancy and generally resolve with the termination of pregnancy, the second category includes liver diseases that are not unique to ...

Abstract Women with unintended pregnancies are more likely to experience poor pregnancy outcomes. For women with medical conditions, unintended pregnancy may worsen the condition and carry even greater risk of adverse pregnancy outcomes, including maternal and perinatal death. Although safe and highly effective contraceptive methods are available to prevent unintended ...

Hepatitis B virus (HBV) during pregnancy presents unique management challenges. Varying aspects of care must be considered, including the effects of HBV on maternal and fetal health, effects of pregnancy on the course of HBV infection, treatment of HBV during and after pregnancy, and prevention of perinatal infection. Antiretroviral therapy ...

Essential thrombocythaemia (ET) is an acquired myeloproliferative neoplasm, characterised by persistent thrombocytosis and a tendency for either thrombosis or haemorrhage. Among myeloproliferative neoplasms, ET is the most prevalent in young women, which constitute a special group due to their childbearing potential. An increased risk of fetal and maternal complications has ...

Pregnancy neither protects women from susceptibility to illness nor generally decreases drug dosage requirements of preexisting pharmacotherapy. Thus, a major concern of drug use during pregnancy is maintenance of maternal health while minimizing fetal drug exposure. Important assumptions in reproductive medicine are that fetal exposure to any medication can present ...

Although obstetrician-gynecologists recognize the importance of managing fertility for the reproductive health of individuals, many are not aware of the vital effect they can have on some of the world's most pressing issues. Unintended pregnancy is a key contributor to the rapid population growth that in turn impairs social welfare, ...

Human chorionic gonadotropin (hCG) is a 237 aminoacid glycoprotein hormone composed of two dissimilar α and β subunits noncovalently linked by charge interactions, which are both required for the biological activity of the hormone. Due to structural heterogeneity, hCG exists in biological fluids as a mixture of different isoforms, i.e., ...

Physiological alterations occur in many organ systems during pregnancy. These changes are necessary for the adaptation to pregnancy-specific physiological processes in mother and fetus, and the placenta plays a critical role in the maintenance of homeostasis in pregnancy. Dysregulation of these functional feto-maternal interactions leads to severe complications. There have ...

The uterine epithelium provides the interface between an embryo and its mother during pregnancy. Calcium-dependent cadherins are adherens junction proteins that undergo major shifts in the uterine epithelium to facilitate the communication between maternal cells and the embryonic milieu during implantation in mammals. They are, therefore, important in trophoblast invasion ...

Abstract Preterm pregnancies account for approximately 10% of the total pregnancies and are associated with low birth weight (LBW) babies. Recent studies have shown that LBW babies are at an increased risk of developing brain disorders such as cognitive dysfunction and psychiatric disorders. Maternal nutrition, particularly, micronutrients involved in one-carbon ...

Nearly half of all pregnancies in the United States are unintended. These pregnancies likely represent a substantial cost to taxpayers, but national-level estimates of these public costs have been lacking. Taxpayer spending on unintended pregnancy is measured by multiplying estimates of the 2001 incidence of publicly financed unintended pregnancy outcomes ...

Recently there is an increasing interest in aspects of a more specific immunoregulation during pregnancy. Understanding these mechanism might have a broader application not only for reproductive immunology but also in general for biology and medicine. Especially the induction, already before conception, of feto-specific T cells with a possibly regulatory ...

With widespread use of ultrasound in early pregnancy, incidental adnexal masses are detected frequently. This article reviews the differential diagnosis, appropriate evaluation, and current treatment options for adnexal masses in pregnancy. With the increased sophistication of ultrasound, observation has become a more viable option. However, for those masses suspicious for ...

Dysgerminomas are the most common of primitive germ cell tumors of the ovary, accounting for 1-5% of all ovarian malignancies. The reproductive age group females are most commonly affected, thereby causing problems in conception and if pregnancy occurs, it leads to feto-maternal compromise. It is extremely rare to have a ...

Crohn disease and ulcerative colitis commonly affect women in their childbearing years. Fortunately, advances in the field of inflammatory bowel disease have made successful pregnancy outcomes a reality for many women. These advances have led to family planning as a common discussion between gastroenterologists and inflammatory bowel disease patients. Common ...

Due to the advances in cardiovascular care of children born with congenital heart disease (CHD), the population of adults with congenital heart disease (ACHD) has increased substantially over the past 60 years. Similarly, the number of women with CHD who reach child-bearing age has also increased. With this reality comes ...

Cardiovascular diseases arise during 0,2% to 4% of all pregnancies in the industrialized world. In Germany, this type of complication, which is sometimes lethal, affects approximately 30 000 pregnant women per year. We performed a simple literature search in the NCBI databases for publications that appeared from 2008 to 2010 ...

Pregnancy-induced hypertension constitutes a major cause of morbidity and mortality in developing nations and it complicates about 6-8% of pregnancies. Severe preeclampsia poses a dilemma for the anesthesiologist especially in emergency situations where caesarean deliveries are planned for uninvestigated or partially investigated parturients. This article is aimed to review the ...

Several large randomized controlled clinical trials failed to find that standard periodontal therapy during pregnancy reduces the incidence of adverse pregnancy outcomes (eg, preterm birth and low birthweight). However, treating periodontal disease during pregnancy may be too late to reduce the inflammation that is related to the adverse pregnancy outcomes. ...

It has been estimated that up to 3.8% of breast cancers may be diagnosed in women who are pregnant, with an estimated 1 in 3000-3500 deliveries occurring in women with breast cancer. Owing to the lack of large randomized trials available to guide our clinical practice, our decisions regarding adjuvant ...

Pancreatic β-cell mass adapts to changing insulin demands in the body. One of the most amazing reversible β-cell adaptations occurs during pregnancy and postpartum conditions. During pregnancy, the increase in maternal insulin resistance is compensated by maternal β-cell hyperplasia and hyperfunctionality to maintain normal blood glucose. Although the cellular mechanisms ...

Treating psychiatric disorders during pregnancy poses a challenge. Both medication and maternal illness may have adverse effect on the fetus and balancing the risks and benefits of symptoms and treatments is crucial. Medications may affect the fetus adversely, especially in the first trimester. Electroconvulsive therapy (ECT) is not known to ...

Pre-eclampsia (raised blood pressure and proteinuria) complicates 2% to 8% of pregnancies, and raises morbidity and mortality in the mother and child. Pre-eclampsia is more common in women with multiple pregnancy and in those who have conditions associated with microvascular disease. METHODS AND OUTCOMES: We conducted a systematic review and ...

Preeclampsia is a major cause of maternal and fetal morbidity and mortality worldwide, however, its etiology remains unclear. Abnormal placental angiogenesis during pregnancy resulting from high levels of anti-angiogenic factors, soluble Flt1 (sFlt1) and soluble endoglin (sEng), has been implicated in preeclampsia pathogenesis. Accumulating evidence also points to a role ...