World Congress on Fetal and Maternal Medicine October 5-6, 2018 Osaka, Japan

Biography:

Adriano Carnerio  is currently an Oncological Surgeon of the Department of Surgery at the Federal University of Pernambuco, Brazil. He has obtained his Master's degree in Cancer and Oncology Surgery at the A.C. Camargo Cancer Center, Brazil. He is the Fellow of the Department Surgery and Cancer Hammersmith Hospital, Imperial College London 2013.

Abstract:

Background: Colorectal Cancer (CRC) is a neoplasia with high incidence and mortality rates. It had been suggested that the inflammatory response is an important CRC prognostic factor. The disordered and accelerated proliferation of neoplastic cells decreases the oxygen and nutrient supply, generating a microenvironment characterized by hypoxia, necrosis and inflammation.

Aim: This study aimed to evaluate the impact of factors associated with hypoxia, such as HIF1A (Hypoxia-Inducible Factor 1-Alpha) and VEGF (Vascular Endothelial Growth Factor) and with lipid metabolism, including PPARG (Peroxisome Proliferator-Activated Receptor-Gamma), LXRA (Liver X Receptor-Alpha) and LXRB (Liver X Receptor-Beta), on the Overall Survival (OS) of CRC patients.

Methods: This was a cohort study of 101 patients with high-risk stage II-III (TNM) CRC located above the peritoneal reflection. They were treated between 1990 and 2004 at the A.C. Camargo Cancer Center. Immunohistochemical analyses of HIF1A, VEGF, PPARG, LXRA and LXRB protein expression were performed using Tissue Microarrays (TMAs).

Results: There was an association between the presence of vascular invasion and the lack of VEGF expression (p=0.028) as well as with positive HIF1A expression and lymphatic invasion (p=0.045). The 5-year and 10-year OS rates were 76.6% and 60.2%, respectively. Patients with PPARG-positive tumors had a higher OS (p=0.018). There were no correlations between the positive expression of VEGF, HIF1A, LXRA or LXRB and OS. The Cox regression model demonstrated that the risk of death was 2.72-fold higher in patients with PPARG-negative tumors (95% CI=1.08– 6.85).

Conclusion: The PPARG expression was an independent prognostic factor for CRC tumors and might be used for risk stratification to stage II and stage III CRC patients.

Biography:

Ewa Kurowska is an Obstetrics and Gynecology Consultant in Medicover Hospital, Warsaw, Poland. She is the Head Doctor of Obstetrics and Gynecology Department.

Abstract:

Minimally invasive procedures has become preferable method of treatment because of its indubitable advantages such as less postoperative pain, short hospital stay, fast convalescence and small, invisible scars. But those advantages may become disadvantages with potential dramatic outcome at the same time, because of patients’ impression of light, small and not dangerous procedure which is not worth to be mentioned during medical interview. Frequency of uterine rupture during pregnancy is evaluated at 0.006-0.0125%. It rises during the labor to even 0.06%. The most common risk factor is previous cesarean section or other uterine surgery like myomectomy or hysteroscopic resection. As the first surgery is rather hard to miss, the next two, especially laparoscopic myomectomy can be forgotten by the patient. Because of obstetric and neonatal serious consequences we should pay very close attention to what and how we are asking patients about. We would like to present a case of primigravida, who was admitted to our Department because of short strong abdominal pain ca35 weeks of gestational age. She was in good general condition but because of rupture of the uterus and ablation of the placenta we diagnosed fetal death. Insufficiency of communications between doctor and patient may lead to fetal death and dramatic rescue patient’s procedure. We have to understand that important and obvious situations for doctor are not equal with patient’s priorities. That is why it is necessary to ask specific and simple questions during medical interview to make sure of detailed information.

Biography:

Jan Zivny has completed his M.D. in 1993 and Ph.D. in 2000 from First Medical Faculty of Charles University at Prague. He completed postdoctoral fellowship at the University of Alabama at Birmingham School of Medicine and ORISE fellowship at Food and Drug administration (FDA).  He is associate professor at the Institute of Pathological Physiology, First Faculty of Medicine, Charles University at Prague. His work focuses on the biomarkers endothelial activation in health and disease and on pathophysiology of hematological malignancies. He has published more than 40 papers in reputed journals.

Abstract:

Statement of the Problem: Complications during delivery may result in activation and injury of endothelial cells. There is limited information regarding endothelial dysfunction during pregnancy, delivery and in newborns. The purpose of this study was to explore biomarkers of endothelial injury in different modes of delivery and in newborns after delivery.

Method: The study group (Thomayer Hospital Prague, Czech Republic) consisted of mothers and their term healthy newborns after uncomplicated pregnancy and spontaneous delivery (Group A, n=24), after elective cesarean section (Group B, n=12) and after emergency cesarean section (Group C, n=13). Biomarkers were measured in cord blood and in newborns between 48 and 72 hours of life using multiplex immunoassays based Luminex®xMAP multi-analyte profiling platform. Paired t-test and Mann-Whitney test were used for statistical evaluation of the results.

Findings: Significantly higher concentrations of endocan, angiopoietin-2, VEGF and ICAM-1 were found in neonatal samples comparing to cord blood in all three groups (p<0.05). Significant differences were found in cord blood (endocan, angiopoietin-2, VEGF, endothelin-1 and endoglin) when comparing B and C groups (p<0.05).

Conclusion: We found different concentrations of endothelial markers in cord blood compared to neonatal samples. The measured markers according to the mode of delivery showed differences mainly between elective B and acute C cesarean section groups in cord blood. These results show significant changes in concentrations of several potential endothelial dysfunction markers during the first three days following delivery. Concentrations of endothelial markers may be influenced more by complication of pregnancy, e.g. hypoxia leading to acute cesarean section, than by mode of delivery itself.

Biography:

Haniyeh Bashizadeh-Fakhar has completed her PhD from Shahid Beheshti University of Medical Science, Iran. Her studies are on expression proteomics on cancer at Proteomics Research Center. She is working as an Assistant Professor in Azad University. She has published more than 15 papers in reputed journals.

Abstract:

Background & Aim: The risks of Ovarian Malignancy Algorithm (ROMA) and Human Epididymis protein 4 (HE4) appear to be the promising predictors of Epithelial Ovarian Cancer (EOC). However, conflicting results have been obtained in the diagnosis process when we compare ROMA, HE4 and CA125.

Method: The databases Medline/PubMed, Embase, Web of Science, Google Scholar, the Cochrane Library and ClinicalTrials.gov and full texts bibliographies were searched for relevant abstracts. EOC predictive value of ROMA was systematically evaluated and the predictive performance of ROMA, HE4 and CA125 were compared within the same population. In this meta-analysis, the pooled sensitivity, pooled speci­ficity, pooled AUC, pooled p-value of each tumor marker as well as pooled number of patients and healthy individuals were calculated.

Result: Based on meta-analysis of 9 studies, the total sample size was obtained, 785 patients and 667 healthy individuals. The overall estimates of ROMA for EOC predicting pre-menopausal women with 95% CI were sensitivity 86.9, specificity 085.52 and 0.9 AUC. ROMA for EOC predicting pre-menopausal women was sensitivity 90, specificity 80.84 and 0.9 AUC. The overall estimates of Ca125 and HE4 for EOC predicting with 95% CI were as follows, sensitivity (84.5 and 80.37), specificity (83.8 and 88.45) and AUC (0.85 and 0.87).

Conclusion: This meta-analysis is highlighted that ROMA can help distinguish EOC from the benign stage in post-menopausal women. ROMA is less specific but more sensitive than HE4. Both ROMA and HE4 are more specific than CA125 for EOC prediction. CA125 has a higher accuracy for diagnosis than HE4 for EOC. ROMA is a good predictor to replace CA125, but its utilization requires further exploration.

Biography:

Julie Sartori has 25 years of experience in Nursing and 5 years as a Research Assistant with projects such as the RAINE Study, Australian Fathers Study and Placenta Project. She has completed her Bachelor’s in Human Biology. She is a valuable member of the Placenta Project, which is instrumental in developing a research framework used to investigate maternal factors that can affect the growth and development of the placenta.

Abstract:

The quest to understand human conception and subsequent gestational development has evolved significantly over the past 2000 years. This collective knowledge has now culminated in the reproductive revolution of the 21^st century and is crucial to human reproductive development. Current research examining pre and post conception mechanisms, have allowed greater insight into the physiological cascade of events that result in successful pregnancy. These studies also highlight the impact of control mechanisms such as cytoplasmic inheritance and epigenetic regulation on birth outcomes. Human pregnancy is considered viable after three essential processes have occurred, fertilization, implantation and placentation. Preparation for fertilization involves a complex interplay between the maternal pituitary, ovarian and uterine axis. Implantation and placentation results from a complex cascade of events that are orchestrated by fetal, maternal and paternal biochemical signaling. Approximately 75% of unsuccessful pregnancies are lost during the early stages of conceptual development. This is primarily due to inability of the conceptus to attach and implant within the endometrial lining or erroneous modifications during normal trophoblastic differentiation. As part of the placenta project pregnant women from Perth, Western Australia, were recruited from private and public hospitals, with pregnancies resulting from both natural and assisted conceptions. Data will be presented from 630 participants, collected from Maternal Health Questionnaires, gross placental examination and maternal - neonatal medical records. A preliminary examination of current research data has resulted in new information that supports existing reproductive theories and encourages further examination of placental tissue. Using a conceptual approach, maternal factors will be used to highlight the importance of early reproductive mechanisms and the role of the placenta in successful pregnancy, prenatal development and potential long-term health outcome.

Biography:

Hisham Al Matubsi has completed his Graduation in Kuwait University in 1986 and postdoctoral studies in Victoria University, Australia in 1997. He is currently the professor of physiology in Al Mareefa College for Science and Technology.

Abstract:

To evaluate plasma Kisspeptin-10 (KP-10) and assess its relation to altered reproductive hormones in preeclamptic pregnant women. First time pregnant women n=100 at 20 weeks of gestation participated in this study and divided into pre eclamptics n=60 and normotensives n=40. KP-10, Luteinizing Hormone (LH), Follicle Stimulating Hormone (FSH), beta-Human Chorionic Gonadotropin (β-HCG), Estradiol (E₂) and Progesterone (PRG) were evaluated during second and third trimesters of pregnancy for all women. Kisspeptin-10 levels were reduced in PE women compared with normotensive pregnancies. In 2^nd trimester, area under Receiver-Operator Characteristic (ROC) curve was 0.662, positive and negative predictive values were 32.8 and 94.6 and test sensitivity and specificity were 55% and 87.5%, respectively. In the 3^rd trimester, area under ROC curve was 0.747 positive and negative predictive values were 22.2 and 97.3 and test sensitivity and specificity were 83.3% and 67.5%, respectively. In PE patients, plasma KP-10 demonstrated inverse correlation with E₂ (during the 2^nd trimester), LH and FSH (during the 3^rd trimester) and positively correlated with β-HCG (during the 3^rd trimester). Relatively high KP-10 sensitivity with the largest area under the ROC curves during 2^nd and 3^rd trimester of pregnancy, suggesting that is statistically acceptable as a diagnostic screening tool to rule out the PE especially in 3^rd trimester.

Biography:

Mohammed Ashraf Puthiyachirakkal has completed his Medical School and Pediatric Residency from India. He has completed his Pediatric Residency from Brookdale hospital New York and Neonatal fellowship from Metrohealth Medical Center, Cleveland, Ohio and worked as Attending Neonatologist in Mercy St Vincent Medical center, Toledo. He also worked as Consultant Pediatrician and Neonatologist in Al Zahra Hospital Sharjah.

Abstract:

Human being harbors 100 trillions of microbes in the gastrointestinal tract, which is very diverse and dynamic. The microbiota starts to develop even in the fetal state and continue to develop to reach the adult level by 2-3 years of life. There are various factors involved in the colonization of these bacteria. These microbiota have role in the metabolism, immunologic development, epigenetic effects, act as energy sources, help in synthesis of vitamins, amino acid, have antimicrobial properties and detoxification effects. Alteration in the microbiota, dysbiosis is believed to be responsible for the development of allergic diseases, late onset sepsis, NEC, obesity and Type 1 diabetes. It is very crucial to understand the colonization process and the factors modulating the microbiota so that we can prevent the intestinal dysbiosis and future developments of the physical and behavioral problems.

Biography:

Ewa Kurowska is an Obstetrics and Gynecology Consultant in Medicover Hospital, Warsaw, Poland. She is the Head Doctor of Obstetrics and Gynecology Department.

Abstract:

Cardiac arrhythmia during the pregnancy is although the risk factor is well described but is still a huge problem, because it influences two persons, mother and the fetus. The incidence of these events is estimated at 1, 2 per 1000 and 50% of them are asymptomatic. The treatment might be not needed with mild symptoms, but in some cases pharmacotherapy as a compromise between potential benefits and adverse effect on the fetus is not successful, especially in life-threatened situations. We would like to present a case of healthy women, who underwent cardio version in her second pregnancy and two in her third, all of them effective but had to have cesarean section as the result of third incident of atrial fibrillation in the last pregnancy. Although the risk factors of cardiac arrhythmia are well described, it is still the big concern how to point out and successfully manage with the pregnant women. This multidisciplinary problem demands perfect cooperation of many specialists, obstetrician, cardiologists and neonatologists with instant access to the operating theatre. Hemodynamically significant arrhythmia treated with electric cardio version seems to be safe treatment option during pregnancy. Limited data based on case reports and clinical experiences needs to be confirmed with further investigations on bigger groups of patients.

Biography:

Andreea I Gorcea is a Senior Consultant in Obstetrics’ Gynecology and Fetal Medicine Specialist at the Centre for Excellence in Maternal Fetal Medicine, Institute for Mother and Child Health Alessandrescu-Rusescu in Bucharest, Romania. She has completed her PhD in Obstetrics’ Gynecology. Her interest is in maternal-fetal medicine and fetal surgery. She completed her Fellowship and FMF Diploma in Fetal Medicine at Fetal Medicine Research Institute, Fetal Medicine Foundation, London, UK. She has the FMF Certification in first trimester and second trimester screening for chromosomal abnormalities, cardiac fetal scans, invasive procedures, anomaly scans, growth scans, screening for preeclampsia and premature birth. She has worked on her research studies in different hospitals across UK; King’s College Hospital London, University College Hospital London, North Middlesex Hospital London, Homerton University Hospital London, Medway Maritime Hospital, Southend University Hospital and Princess Royal University Hospital Orpington.

Abstract:

Statement of Problem: The vein of Galen aneurysm represents a complex malformation including multiple arteriovenous fistulae located at the midline of the brain, close to midbrain. Even rare, VGA is the most common diagnosed vascular prenatal malformation of the brain. In fact, VGA is a persistency and dilatation of the precursor of vein of Galen, the median prosencephalic vein of Markowski.

Methodology: 32 year pregnant woman, G2P1, 23 weeks, was referred to our FMU for an amniocentesis due to an increased nuchal fold at the anomaly scan. The second opinion scan detected a large cystic structure above the thalamus in the midline of the brain, close to the third ventricle, with turbulent color Doppler flow, high velocity/low resistance.

Results: Additional finding was the presence of cardiomegaly as a direct sign of cardiac failure. Taking into account the early gestational age, the magnitude of the shunt and the associated factors (cardiomegaly, enlarged neck veins) the couple was counseled about the poor prognosis due to imminent cardiac insufficiency (early signs), leading to a high rate of intrapartum and postpartum morbidity and mortality or the potential mental and physical impairment.

Conclusion: VGA is a rare condition with high morbidity and mortality rates when associated with other complications/abnormalities. The prognosis is directly linked to these complications. The particularity of the case is the earliest diagnosis of this condition until now (23 weeks), usually diagnosed in the third trimester and the magnitude of the shunt with early signs of cardiac failure.

Biography:

Mohamed Abudabbous is a Senior Consultant and Co-Director in the Department of Obstetrics and Gynecology in University Hospital of Muhlenkreiskliniken, Lubeck. He received his Board degree from the University Hospital of Cologne, Germany and completed Postdoctoral Fellowship in Urogynecology and Reconstruction Surgery in 2015. He is interested in fetomaternal medicine. He started his Fetomaternal Medicine Subspeciality training in MKK (Muhlenkreiskliniken) by Dr. Albert Neff in 2017.

Abstract:

Objective: The aim of this study was to compare the clinical effectiveness and quicker recovery between minimally invasive surgery and traditional open techniques of hysterectomy (AH=Abdominal Hysterectomy, VH=Vaginal Hysterectomy, TLH=Total Laparoscopic Hysterectomy, LAVH=Laparoscopic-Assisted Vaginal Hysterectomy and LASH=Laparoscopic Supracervical Hysterectomy).                             

Method: Between January 2015 and August 2018, 421 patients underwent to hysterectomy due to benign and malign diseases. The data were retrospectively collected from patients’ records and analyzed anonymously. The evaluated data included hospital stay, operating time and complication rate.

Result: Compared to all other methods the hospital stay after the AH (6, 9 days) was significantly longer. The duration of hospital stay after the LASH (3, 0 days) and the TLH (3, 1 day) were significantly shorter than those of the VH (4, 0 days). The operating time of the VH (96 min), the TLH (118 min) and the LASH (124 min) were notably shorter compared to the AH (144 min) and the LAVH (142 min). The hemoglobin decrease at the TLH was significantly lower compared to the LASH (1.49 g/dl) and VH (1.60 g/dl). However, the AH demonstrates a higher hemoglobin decrease than other techniques (1.90 g/dl). The complication rate constituted 5.3% at the AH 1.3% intraoperative, 4% postoperative and 4.2% at the VH 0.5% intraoperative, 3.7% postoperative. The LH presented a complication rate of 2.8% (LAVH 3.9%, TLH 2.6% and LASH 0.9%).

Conclusion: The VH and the LH are superior to the AH in case of benign and low stage malignant diseases. Concerning small uteri, multipara or in combination with vaginal interventions, the VH was feasible. The LH, in particular the TLH and the LASH, are best alternatives to the AH in whom a VH was not possible. The LAVH is reserved to special situations. The comparison of LASH and TLH shows that the LASH has a lower complication rate.

Biography:

Hakimeh Zali has completed her PhD in Applied Proteomics from Shahid Beheshti University. She is currently working as an Assistant Professor in the School of Advanced Technology in Medicine, Shahid Beheshti University of Medical Sciences. She has published more than 55 papers in reputed journals.

Abstract:

Colorectal Cancer (CRC) is a heterogeneous disease which leads to clinical and pathological diversity in tumors that result in genetic and biological heterogeneity. These diversity leads to see divergence in response and drug resistance. Even in those tumors with similar histopathological features could be seen different responses. Genetic basis and genetic interaction with environment which is related to patients’ life style leads into variable specific molecular features for colorectal cancer. Classifying the patients into separate groups which could suggest the best therapeutic approach in the field of personalized medicine in where dividing the patients based on genetic and epigenetic factors susceptible for specific disease. In this study, we are going to determined genetic factors that cause heterogeneity in colorectal cancer Iranian patients in metastatic stage with different responses to EGFR inhibitors. We have been evaluated 70 patients in metastatic stages who were candidate for EGFR inhibitors in threes big city during 3 years. Patients selected based on molecular and pathological characteristics with N-Ras, K-Ras and BRAF wild-type genes, then all candidate patients have been administrated cetuximab. At least one year followed up illustrated more than 70% of patients with non-responding. We collected the paraffin pathological blocks to find the genes related drug resistance in Iranian population suffers from CRC. This ongoing study will reveal the genetic signs of CRC in Iranian population and also determine the personalized administration EGFR inhibitors.

Biography:

Adjunct Professor and Coordinator of the Oncology Discipline of the Faculty of Medicine and Hospital das Clínicas, UFMG. Clinical Director of Personnel. Precision and Custom Oncology. Specialist in Oncology and Hematology, Fox Chase Cancer Center (USA). Master in Gynecology. PhD in Gastroenterology. Post-Doctorate in Genetics. Coordinator of the GBOP: Brazilian Group of Precision Oncology.

Abstract:

The two most important scientific developments of the past decade regarding therapies for patients with non-small cell lung cancer (NSCLC) are the ability to exploit particular genetic mutations with targeted therapies and the discovery of drugs that can help the patient's own immune system attack the cancer. Despite these advances, many patients do not yet benefit from either approach. To maximize patient benefit, clinicians and pathologists will need to rationally apply the growing scientific knowledge to best characterize a patient's tumor and possible driver mutations. A growing understanding of host-tumor immune interactions will hopefully help expand our therapeutic options. The still elusive identification of immunotherapy biomarkers will hopefully help identify patients most likely to derive a therapeutic response to immune checkpoint inhibitors, and promises to be an important field of study for years to come. More recent studies have shown that patients with high mutational burden NSCLC treated with anti-PD-1 presented a lower likelihood of progressive disease. Further analyses have suggested that taking into account mutational process and intratumoral heterogeneity could improve the prediction. Recent studies have described the incidence of MSI across a broad cancer spectrum using computational software programs and NGS data. Some trials have documented that solid tumors such as gastroesophageal and breast cancer with mismatch repair deficiency (dMMR) treated with immunotherapy resulted in remarkable responses. These articles are highly relevant because the US Food and Drug Administration (FDA) approved pembrolizumab in May 2017 for the treatment of all unresectable or metastatic cancer with MSI/dMMR irrespective of tissue origin. It was the first time that any therapy had been approved for cancers that share a specific genetic feature irrespective of site of origin. Furthermore, in late July, nivolumab was approved for MSI/dMMR metastatic colorectal cancer. The FDA approvals are based on studies showing disease control rates of 70% to 90% in patients with colorectal cancer and noncolorectal MSI/dMMR cancers, most of whom with disease that was refractory to standard chemotherapy upon entering these trials.

Biography:

Siok Chang is a Medical Scientist in the Department of Anatomical Pathology, St Vincent’s Hospital Melbourne, Australia. She has completed her Master of Laboratory Medicine from Royal Melbourne Institute of Technology. She is currently working at St Vincent’s Hospital.

Kenna Pham has completed her Master of Laboratory Medicine from Royal Melbourne Institute of Technology in 2003. She has practiced laboratory medicine in both the private and public sectors. She is a Medical Scientist at St. Vincent’s Hospital Melbourne, Australia. Her research interest is in Fluorescence In Situ Hybridization (FISH).

Abstract:

In the last decade, the evolution of personalized medicine has made a significant impact on cancer diagnosis, prognosis, prevention and therapeutics. Personalized medicine is defined as an emerging model to tailor medical treatment based on individual’s molecular traits. The technological advancement of molecular diagnostic techniques like Next Generation Sequencing (NGS) and Fluorescence In Situ Hybridization (FISH) allows the expansion of the concept of personalized medicine. Lung cancer is currently the world leading cancer-related mortality and there is extensive ongoing genomic research and studies on it. Hence, it is not surprising that Non-Small Cell Lung Carcinoma (NSCLC), the most common subtype of lung cancer has impressively high number of discovered actionable driver mutation genes compare to other type of cancer. Historically, patients with NSCLC were commonly treated with platinum-based cytotoxic chemotherapy. The discovery of significant driver mutation genes in NSCLC like EGFR, ALK and ROS1 has dramatically revolutionized the landscape of NSCLC treatment. The emergence of targeted therapies based on individual molecular tumor profiling enables NSCLC patients to be treated with lower toxicity and improved prognosis, hence better quality of life. The efficacy of various targeted treatments confirms that there is an increasingly important role of personalized medicine.

Biography:

Daria Skuratovskaia has her research study in the field of genetic studies of the metabolic syndrome, its complications and also study of polymorphic variants of adipokine and cytokine genes responsible for the formation of insulin resistance in obesity.

Abstract:

Mitochondrial DNA (mtDNA) encodes core subunits of oxidative phosphorylation complex and as a result of a complex regulatory crosstalk between nuclear and mitochondrial genomes the total number of mtDNA copies fits the requirements of each cell type. Deviations from the optimal number of mtDNA copies are expected to be deleterious and thus can cause some diseases and aging. The reasons of potential deviations in mtDNA copies might be genetic or environmental such as hormonal imbalance in non-hereditary diseases. We studied 193 individuals (69 men; 124 women) who were divided into two cohorts, with and without obesity. Five types of tissues were analyzed from each individual peripheral venous blood, liver, Subcutaneous Adipose Tissues (SAT) and Visceral Adipose Tissue (VAT) from both greater omentum and mesenterium. The absolute mtDNA copies per cell were measured by droplet digital PCR and were significantly lower in peripheral blood than in the other tissues examined 228±31 in peripheral blood, 1158±151 in liver, 1312±142 in greater omentum, 1161±86 in mesenterium and 1418±219 in SAT. The Body Mass Index (BMI) correlates positively with the mtDNA copies in SAT and negatively with peripheral blood mtDNA copies. There are positive correlations between greater omentum and mesenterium mtDNA copies (cor=0.44, p<0.05) and between SAT and greater omentum (cor=0.48, p<0.05). Multiple regression model revealed that blood and SAT mtDNA copy number affect the change in BMI (Multiple R²: 0.44, adjusted R²: 0.34, p-value: 0.004). Thus, we revealed positive relationships between BMI and mtDNA copies in SAT and fat depots, but negative relationship between BMI and mtDNA copies in peripheral venous blood.

Biography:

Jan Janota has completed his PhD and Postdoctoral studies in Charles University, Prague. He is currently the Head of Department of Neonatology in Thomayer Hospital, Prague and Associated Professor of Pediatrics in Charles University, Prague. He is focused on neonatology, neonatal infections and systemic inflammation. He has published more than 30 papers in reputed journals.

Abstract:

Statement of the Problem: Complications during delivery may result in activation and injury of endothelial cells. There is limited information regarding endothelial dysfunction during pregnancy, delivery and in newborns. The purpose of this study was to explore biomarkers of endothelial injury in different modes of delivery and in newborns after delivery.

Method: The study group (Thomayer Hospital Prague, Czech Republic) consisted of mothers and their term healthy newborns after uncomplicated pregnancy and spontaneous delivery (Group A, n=24), after elective cesarean section (Group B, n=12) and after emergency cesarean section (Group C, n=13). Biomarkers were measured in cord blood and in newborns between 48 and 72 hours of life using multiplex immunoassays based Luminex®xMAP multi-analyte profiling platform. Paired t-test and Mann-Whitney test were used for statistical evaluation of the results.

Findings: Significantly higher concentrations of endocan, angiopoietin-2, VEGF and ICAM-1 were found in neonatal samples comparing to cord blood in all three groups (p<0.05). Significant differences were found in cord blood (endocan, angiopoietin-2, VEGF, endothelin-1 and endoglin) when comparing B and C groups (p<0.05).

Conclusion: We found different concentrations of endothelial markers in cord blood compared to neonatal samples. The measured markers according to the mode of delivery showed differences mainly between elective B and acute C cesarean section groups in cord blood. These results show significant changes in concentrations of several potential endothelial dysfunction markers during the first three days following delivery. Concentrations of endothelial markers may be influenced more by complication of pregnancy, e.g. hypoxia leading to acute cesarean section, than by mode of delivery itself.

Biography:

Katarzyna Stefanska is currently working as a Doctor and Teacher at the Department of Obstetrics of Medical University of Gdansk, Poland. She is interested in perinatology and fetal-maternal medicine, especially in pregnancy induced hypertension-the immunology of PIH, the importance of HLA eplets mother-fetus incompatibility in the pathogenesis of PIH and rare diseases coexisting with PIH-mastocytosis.

Abstract:

Arterial hypertension, associated with increased risk of perinatal complications and both maternal and neonatal mortality is diagnosed in 5-10% of pregnant women in Poland. This group includes approximately 5-7% of women with pregnancy induced hypertension, 5-7% of patients with preeclampsia and 1% of individuals with chronic arterial hypertension. Mastocytosis is a myeloproliferative disorders caused by the abnormal proliferation and infiltration of the mast cells in various organs, mainly bone marrow, skin, liver spleen, lymph nodes. The most important clinical symptoms of mastocytosis are related to the symptoms caused by the mast cell mediators release leading to flush, hypotension and in some cases anaphylactic reactions. A 27-year-old primipara at 25 weeks of gestation was admitted to the Obstetrical Department of the Medical University of Gdansk due to PIH. The patient had a 7-year history of systemic mastocytosis suffered from urticaria pigmentosa. Indolent systemic mastocytosis was diagnosed based on 3 minor WHO criteria (tryptase level, D816V KIT mutation, CD2 and CD25 expression on the bone marrow mast cells). She also suffered from grade 3 anaphylactic reactions according to the Mueller scale caused by food and physical factors. The result shows protein loss in urine (5.68 g/day), concomitant decrease in serum concentrations of total protein (59 g/l) and albumins (28 g/l), and an increase of fibrinogen and d-dimer levels. Preeclampsia was diagnosed and treated both pharmacologically and conservatively. The loss of protein was compensated by intravenous infusion of human albumin. FGR was documented on fetal ultrasound. The centralization of fetal circulation was revealed on Doppler ultrasound. Due to preeclampsia, proteinuria and the premises for a possible stillbirth, cesarean section was conducted under spinal anesthesia at 26 weeks of gestation. Early puerperium was complicated by the presence of persistent arterial hypertension and edema. The neonate died at 22 days of life, due to extreme prematurity, circulatory failure and grade 3 intra ventricular hemorrhages. The hypertensive disorders of pregnancy still remain leading causes of maternal and perinatal morbidity and mortality. Mastocytosis is perceived as a medical management dilemma because of its potential for unpredictably heightened mast cell activity in response to various physiologic states including pregnancy. We conclude that proper treatment in pregnant females requires close cooperation of an obstetrician with other medical specialists.