Gene expression patterns of insulin-like growth factor 1, insulin-like growth factor 2 and insulin-like growth factor binding protein 3 in human placenta from pregnancies with intrauterine growth restriction

Introduction: In this study, we compared insulin-like growth factor (IGF)-gene expression patterns and characteristics of glucose and insulin metabolism in human placenta from pregnancies with or without intrauterine growth restriction (IUGR). Materials and methods: We compared 101 human placentas from intrauterine growth restriction pregnancies to those of 140 normal pregnancies treated at our department in a one-year period. We have also assessed the serum glucose and insulin levels of the IUGR and control groups. Several possible predicting factors of IUGR were also investigated. Results: Risk for IUGR was suggested by gestational weight gain and gestational increase in maternal body mass index (BMI) as well as maternal birthweight. In pregnancies without IUGR, umbilical cord glucose and insulin levels were significantly higher than in pregnancies with IUGR. In placentas from pregnancies with IUGR an overexpression of the IGF-2 and the insulin-like growth factor binding protein (IGFBP)-3 genes was found. In placentas from pregnancies with male fetal gender we found a significant overexpression of the IGF-2 gene. Discussion: Gestational weight gain and BMI increase seem to predict the development of IUGR. Insulin and carbohydrate metabolism are also impaired in IUGR fetuses. In the placentas from pregnancies with IUGR, IGF-2 is overexpressed reflecting its physiological role in optimizing energy distribution in a low-energy environment

Nem kommunikáló rudimenter szarvban kialakult terhesség sikeres eltávolítása laparoszkópia útján = Successful laparoscopic management of a non-communicating rudimentary horn pregnancy

A csökevényes méhszarv terhessége ritka kórkép, legjelentősebb veszélye az életveszélyes hasűri vérzéssel járó ruptura. Hüvelyi ultrahangvizsgálat segítségével még tünetmentes, korai állapotban lehetséges a felismerés. A diagnózist követően a csökevényes méhszarv és az abban elhelyezkedő terhesség laparoszkópos reszekciója javasolt, az érintett oldali kürt eltávolításával együtt. A szerzők egy rudimenter szarvban kialakult, 9 hetes terhességgel jelentkező beteg esetét ismertetik, amelyet laparoszkópia segítségével sikeresen oldottak meg. | Pregnancy in a rudimentary horn is a rare entity with the most significant risk of life-threatening intraabdominal bleeding caused by rupture. With the use of vaginal ultrasonography, an early diagnosis can be made before symptoms occur. Management consists of laparoscopic resection of the rudimentary horn with the pregnancy and the ipsilateral tube. Authors present a case of a 9-week pregnancy successfully treated with laparoscopic resection

Nem kommunikáló rudimenter szarvban kialakult terhesség sikeres eltávolítása laparoszkópia útján [Successful laparoscopic management of a non-communicating rudimentary horn pregnancy]

Pregnancy in a rudimentary horn is a rare entity with the most signifi cant risk of life-threatening intraabdominal bleeding caused by rupture. With the use of vaginal ultrasonography, an early diagnosis can be made before symptoms occur. Management consists of laparoscopic resection of the rudimentary horn with the pregnancy and the ipsilateral tube. Authors present a case of a 9-week pregnancy successfully treated with laparoscopic resection

Non-syndromic malformations of the central nervous system in twin pregnancies: diagnostic and other clinical features of importance

OBJECTIVE: The incidence of central nervous system malformations is higher among twins. Our aim was to summarize information about these malformations in twin pregnancies. STUDY DESIGN: Based on a sample originating from the biggest genetic centre in Hungary between January 1990 and December 2008, we examined the data of 42 twin pregnancies associated with non-syndromic malformations of the central nervous system. RESULTS: The involvement of monozygotic fetuses and dizygotic ones of the same gender was found to be 62.5%. Usually only one of the fetuses was affected (57.1%), while the other one was healthy. The male-to-female ratio was 0.75. Identical and fraternal twins were found in 68.4% and 31.6% of the cases, respectively. In the pregnancies of our study the malformation was diagnosed before the 24th gestational week in 90% of the cases. Polyhydramnios (54.8%) was the most commonly associated non-central nervous system malformation. CONCLUSION: Our findings suggest that, in addition to placentation and gestational age, the position of the affected fetus with relation to the uterine orifice is of great importance in determining whether selective abortion is an option in deciding about the outcome of pregnancies affected by craniospinal malformation

Fetopathological investigations after induced abortions performed in mid-term gemini pregnancies

Multiple pregnancies present a special obstetric condition whose importance has increased due to the spread of assisted reproductive techniques. We have processed the fetopathological data of 43 abortions induced in mid-term gemini pregnancies, owing to malformations affecting one or both fetuses. 67.4% of the gemini pregnancies were conceived naturally and 32.6% by assisted reproduction techniques. The most commonly occurring malformations affected the fetuses' cardiovascular and central nervous systems. Positive histories could be detected in 23% of the cases. The male-to-female ratio was found to be 1.14. In the majority of the cases with central nervous system malformation, fetus "A" was affected (85.7%). In 29.4% of the cases, monochorionic placentation was established. Ultrasonography and fetopatological findings yielded perfectly matching results in 78.9% of the cases. The incidence of fetal malformations is probably not higher among fetuses conceived by assisted reproduction techniques compared to the ones conceived naturally. Fetal central nervous system malformations usually affect fetus "A". Based on the results of the fetopathological examinations, ultrasonography is a reliable method in the diagnostics of malformations affecting twin fetuses. Fetal echocardiography is indicated simply because of the pregnancy being a multiple one