Viable triplet pregnancy coexisting with a complete molar pregnancy.
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ABSTRACT:
SUBMITTER: Polonsky A
PROVIDER: S-EPMC4771857 | biostudies-other | 2016 Mar
REPOSITORIES: biostudies-other
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Project description:PurposeTo identify predictors of complete miscarriage after expectant management or misoprostol treatment of non-viable early pregnancy in women with vaginal bleeding.MethodsThis was a planned secondary analysis of data from a published randomized controlled trial comparing expectant management with vaginal single dose of 800 µg misoprostol treatment of women with embryonic or anembryonic miscarriage. Predefined variables-serum-progesterone, serum-β-human chorionic gonadotropin, parity, previous vaginal deliveries, gestational age, clinical symptoms (bleeding and pain), mean diameter and shape of the gestational sac, crown-rump-length, type of miscarriage, and presence of blood flow in the intervillous space-were tested as predictors of treatment success (no gestational sac in the uterine cavity and maximum anterior-posterior intracavitary diameter was ≤ 15 mm as measured with transvaginal ultrasound on a sagittal view) in univariable and multivariable logistic regression.ResultsVariables from 174 women (83 expectant management versus 91 misoprostol) were analyzed for prediction of complete miscarriage at ≤ 17 days. In patients managed expectantly, the rate of complete miscarriage was 62.7% (32/51) in embryonic miscarriages versus 37.5% (12/32) in anembryonic miscarriages (P = 0.02). In multivariable logistic regression, the likelihood of success increased with increasing gestational age, increasing crown-rump-length and decreasing gestational sac diameter. Misoprostol treatment was successful in 80.0% (73/91). No variable predicted success of misoprostol treatment.ConclusionsComplete miscarriage after expectant management is significantly more likely in embryonic miscarriage than in anembryonic miscarriage. Gestational age, crown-rump-length, and gestational sac diameter are independent predictors of success of expectant management. Predictors of treatment success may help counselling women with early miscarriage.
| S-EPMC7524815 | biostudies-literature
Project description:Heterotopic pregnancy is defined as the occurrence of simultaneous intrauterine and extrauterine pregnancies. It is a rare, potentially life-threatening condition and infrequent in natural conceptions. Here, we report a case of spontaneous heterotopic triplet pregnancy with ruptured cornual ectopic pregnancy and simultaneous twin intrauterine pregnancies at 18 weeks of gestation. The event led to miscarriage of all fetuses from both the ectopic and the intrauterine twin pregnancies.
| S-EPMC7086425 | biostudies-literature
Project description:•At high hCG levels in molar pregnancies, a "hook effect" can cause an artificially negative value.•Delay in diagnosis of a molar pregnancy due to the "hook effect" can lead to severe complications.•Suspicion of a molar pregnancy should be communicated so a diluted sample is used to quantify hCG.
| S-EPMC5475266 | biostudies-other
Project description:BackgroundPreterm birth complicates almost all triplet pregnancies and no preventive strategy has proven effective.ObjectiveTo determine, using individual patient data (IPD) meta-analysis, whether the outcome of triplet pregnancy is affected by prophylactic administration of 17-hydroxyprogesterone caproate (17OHPc).Search strategyWe searched literature databases, trial registries and references in published articles.Selection criteriaRandomised controlled trials (RCTs) of progestogens versus control that included women with triplet pregnancies.Data collection and analysisInvestigators from identified RCTs collaborated on the protocol and contributed their IPD. The primary outcome was a composite measure of adverse perinatal outcome. The secondary outcome was the rate of birth before 32 weeks of gestation. Other pre-specified outcomes included randomisation-to-delivery interval and rates of birth at <24, <28 and <34 weeks of gestation.Main resultsThree RCTs of 17OHPc versus placebo included 232 mothers with triplet pregnancies and their 696 offspring. Risk-of-bias scores and between-study heterogeneity were low. Baseline characteristics were comparable between 17OHPc and placebo groups. The rate of the composite adverse perinatal outcome was similar among those treated with 17OHPc and those treated with placebo (34 and 35%, respectively; risk ratio [RR] 0.98, 95% confidence interval [95% CI] 0.79-1.2). The rate of birth at <32 weeks was also similar in the two groups (35 and 38%, respectively; RR 0.92, 95% CI 0.55-1.56). There were no significant between-group differences in perinatal mortality rate, randomisation-to-delivery interval, or other specified outcomes.ConclusionProphylactic 17OHPc given to mothers with triplet pregnancies had no significant impact on perinatal outcome or pregnancy duration.Tweetable abstract17-Hydroxyprogesterone caproate had no significant impact on the outcome or duration of triplet pregnancy.
| S-EPMC5896762 | biostudies-literature
Project description:Mutations in the maternal effect gene NLRP7 cause biparental hydatidiform mole (HYDM1). HYDM1 is characterized by abnormal growth of placenta and lack of proper embryonic development. The molar tissues are characterized by abnormal methylation patterns at differentially methylated regions (DMRs) of imprinted genes. It is not known whether this occurs before or after fertilization, but the high specificity of this defect to the maternal allele indicates a possible maternal germ line-specific effect. To better understand the unknown molecular mechanism leading to HYDM1, we performed a yeast two-hybrid screen against an ovarian library using NLRP7 as bait. We identified the transcriptional repressor ZBTB16 as an interacting protein of NLRP7 and verified this interaction in mammalian cells by immunoprecipitation and confocal microscopy. Native protein analysis detected NLRP7 and ZBTB16 in a 480kD protein complex and both proteins co-localize in the cytoplasm in juxtanuclear aggregates. HYDM1-causing mutations in NLRP7 did not show altered patterns of interaction with ZBTB16. Hence, the biological significance of the NLRP7-ZBTB16 interaction remains to be revealed. However, a clear effect of harvesting ZBTB16 to the cytoplasm when the NLRP7 protein is overexpressed may be linked to the pathology of the molar pregnancy disease.
| S-EPMC4488268 | biostudies-literature
Project description:A complete hydatidiform mole (CHM) is a common disease known to develop post-molar gestational trophoblast neoplasia (GTN). However, the details of the molecular biological mechanisms underlying the progression to post-molar GTN from hydatidiform moles are still largely unknown. In this study, we performed RNA sequencing (RNA-seq) using archival fresh frozen tissues of patients with CHM and compared the gene expression profiles of patients who achieved spontaneous remission and those who developed post-molar GTN after the evacuation.
2024-12-21 | GSE252906 | GEO
Project description: Not available
| S-EPMC4228011 | biostudies-literature
Project description:OBJECTIVE:To validate the ability of serum kisspeptin-54 to discriminate between first-trimester viable pregnancies and miscarriages. DESIGN:Case-control study. SETTING:Academic medical centers. PATIENT(S):Women with confirmed viable intrauterine pregnancy (IUP) at estimated gestational age 6-10 weeks (n = 20), women with confirmed miscarriage (spontaneous abortion [SAB]) at estimated gestational age 6-10 weeks (n = 20), and nonpregnant women (n = 19). INTERVENTION(S):Collection of serum samples from women with confirmed IUP, SAB, and nonpregnant women for the measurement of serum kisspeptin and serum hCG levels. MAIN OUTCOME MEASURE(S):Serum kisspeptin and hCG. RESULT(S):The limit of detection was 0.024 ng/mL; intra- and interassay coefficients of variation were 5.1% and 8.6%, respectively. Kisspeptin levels differed between the pregnant and nonpregnant state and by viability. Kisspeptin levels were positively associated with gestational age. There was also a significant positive association with hCG in SAB, but not in IUP. CONCLUSION(S):Plasma levels of kisspeptin have been suggested as a biomarker for miscarriage. This study demonstrates kisspeptin assay stability in serum and its potential clinical utility as a biomarker for early pregnancy viability.
| S-EPMC5771501 | biostudies-literature
Project description:PURPOSE: Partial molar pregnancies are rare conceptions characterized by having 69 rather than 46 chromosomes, the additional chromosome complement usually occurring as a result of fertilization of the ovum by two sperm. Although assisted conception with intracytoplasmic sperm injection (ICSI) should prevent the development of a partial molar pregnancy, occasional cases have been described after assisted conception using ICSI. The objective of this study was to investigate the cause of partial molar pregnancy in a couple who had undertaken assisted conception with ICSI. METHODS: Fluorescent microsatellite genotyping of DNA from the couple and tissue from their partial molar pregnancy was performed in order to confirm diagnosis and investigate the origin of the additional chromosome set. RESULTS: Genotyping confirmed that the partial molar tissue was triploid with an additional chromosome complement from the father. Genotyping of additional loci proximal to the centromere demonstrated that the two paternal sets of chromosomes originated in a single sperm with a double complement of paternal DNA resulting from non-reduction at the second meiotic division. CONCLUSIONS: This study confirms that partial molar pregnancy may occur after assisted conception with ICSI and that this occurs as a result of fertilization with a diploid sperm.
| S-EPMC3696443 | biostudies-literature
Project description:Triplet-triplet annihilation (TTA) is a spin-allowed conversion of two triplet states into one singlet excited state, which provides an efficient route to generate a photon of higher frequency than the incident light. Multiple energy transfer steps between absorbing (sensitizer) and emitting (annihilator) molecular species are involved in the TTA based photon upconversion process. TTA compounds have recently been studied for solar energy applications, even though the maximum upconversion efficiency of 50 % is yet to be achieved. With the aid of quantum calculations and based on a few key requirements, several design principles have been established to develop the well-functioning annihilators. However, a complete molecular level understanding of triplet fusion dynamics is still missing. In this work, we have employed multi-reference electronic structure methods along with quantum dynamics to obtain a detailed and fundamental understanding of TTA mechanism in naphthalene. Our results suggest that the TTA process in naphthalene is mediated by conical intersections. In addition, we have explored the triplet fusion dynamics under the influence of strong light-matter coupling and found an increase of the TTA based upconversion efficiency.
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