AIMThe changes of tissue inhibitor of metalloproteinase-4 (TIMP-4) expression in mouse ovary during pregnant and postpartum period were studied to investigate the role of TIMP-4 in corpus luteum (CL).

METHODSRT-PCR was used to deter mine the change of TIMP-4 mRNA and indirect immunofluorescence was used to observe the change of TIMP-4 protein. The expression of TIMP-4 mRNA was observed in various periods throughout the stage of pregnancy and postpartum day 1.

RESULTSThe expression of TIMP-4 was gradually enhanced from day 1 to day 8, reached a maximal expression at day 8, while decreased at day 11 and to the lowest level at postpartum day 1. Indirect immunofluorescence results further indicated that TIMP-4 protein was localized to CL and theca-intera cells in various periods throughout the pregnancy and postpartum day 1. In addition, the change pattern of TIMP-4 protein agreed with that of the TIMP-4 mRNA in pregnancy CL.

CONCLUSIONThe expression of TIMP-4 in mouse ovary during pregnancy and postpartum is in spatio-temporal pattern and it may be involved in the formation and function maintain of CL during pregnancy in mice.

Animals ; Female ; Mice ; Mice, Inbred Strains ; Ovary ; metabolism ; Postpartum Period ; Pregnancy ; RNA, Messenger ; genetics ; Tissue Inhibitor of Metalloproteinases ; metabolism

Hepatocellular carcinoma associated with pregnancy is rarely encountered, since hepatocellular carcinoma is usually developed after childbearing ages and severe menstrual irregularity and infertility with disturbance of estrogen metabolism is often accompanied with cirrhosis that is a most common underlying disease of primary hepatocellular carcinoma. Spontaneous hepatic rupture in pregnancy is a rare condition associated with significant maternal and perinatal mortality and could be developed related with severe preeclampsia and especially HELLP syndrome but possible related with hepatocellular carcinoma. We report a case of spontaneous hepatic rupture during the puerperium in a patient with hepatocellular carcinoma with a brief review of literatures.
Carcinoma, Hepatocellular* ; Estrogens ; Female ; Fibrosis ; HELLP Syndrome ; Humans ; Infertility ; Metabolism ; Perinatal Mortality ; Postpartum Period* ; Pre-Eclampsia ; Pregnancy ; Rupture*

Gestational diabetes mellitus (GDM) is a growing public health problem worldwide that threatens both maternal and fetal health. Identifying individuals at high risk for GDM and diabetes after GDM is particularly useful for early intervention and prevention of disease progression. In the last decades, a number of studies have used metabolomics, genomics, and proteomic approaches to investigate associations between biomolecules and GDM progression. These studies clearly demonstrate that various biomarkers reflect pathological changes in GDM. The established markers have potential use as screening and diagnostic tools in GDM and in postpartum diabetes research. In the present review, we summarize recent studies of metabolites, single-nucleotide polymorphisms, microRNAs, and proteins associated with GDM and its transition to postpartum diabetes, with a focus on their predictive value in screening and diagnosis.
Pregnancy ; Female ; Humans ; Diabetes, Gestational/genetics* ; Proteomics ; Postpartum Period ; Biomarkers/metabolism* ; MicroRNAs/genetics* ; Diabetes Mellitus, Type 2

OBJECTIVETo explore the efficacy of Tuina for postpartum lactation and work out a optimal protocol involved.

METHODSWith a randomized, controlled and clinical method, 84 primiparas were divided into a Tuina group and a control group. While patients in the control group received rooming-in conventional managements, those in the Tuina group were additionally treated with Tuina, including local manipulations on breasts combined with acupoint manipulations. The colostrum-time, lactation quantity and prolactin were observed to make the comparisons between two groups.

RESULTSThe scores of lactation quantity after 1th, 2nd, 3rd of the treatment were 1.660 +/- 0.785, 2.530 +/- 1.030, 2.880 +/- 1.171 in Tuina group and 1.270 +/- 0.533, 1.460 +/- 0.811, 1.500 +/- 0.583 in control group respectively, where there were significant differences in each time stage between two groups (all P < 0.001). The time of colostrum was (21.6 6 +/- 10.508) h in the Tuina group and (22.5 +/- 9.762) h in the control group, in which the difference was not statistically significant (P > 0.05). The levels of prolactin (314.35 +/- 110.37) ng/mL and (321.56 +/- 109.61) ng/mL in Tuina group, (385.78 +/- 85.19) ng/mL and (340.12 +/- 103.10) ng/mL in control group before and after treatment, there were no significant differences (both P > 0.05).

CONCLUSIONPostpartum Tuina on breasts could increase the quantity of lactation and delay the decreasing of the levels of prolactin, which contributes primiparas to lactate more and sooner.

Adult ; Amobarbital ; Breast ; secretion ; Breast Feeding ; Colostrum ; secretion ; Drug Combinations ; Female ; Humans ; Lactation ; Milk, Human ; secretion ; Postpartum Period ; physiology ; Prolactin ; metabolism ; Secobarbital ; Young Adult

Pregnancy induced hypertension is multifaceted syndrome with variable involvement of several key organ systems, so sensitive and specific laboratory tests for predicting severity and prognosis. and early diagnosis of this disease are required. Because heme catabolism results in equimolar production of carboxyhemoglobin, iron and bilirubin, a concomittant rise of these parameters would provide confirmation of increased heme catabolism. Microangiopathic hemolytic anemia may occurs in severe preeclampsia, but it is not known whether increased red cell turnover - occurs with mild preeclampsia as complication. The purpose of this study was to confirm that increased heme catabolism also occurs in patients with mild preeclampsia. The analysis of data was done on 23 cases with mild preeclampsia and 35 normal pregnant women, who were admitted to Yeungnam University Hospital from October 1992 to March 1993. The results were as follows. 1. The mean antepartum serum iron concentration was significantly higher in the group with mild preeclampsia (86.5+/-6.1 microg/dl) than in the controls (53.2+/-5.3 microg/dl). 2. The mean antepartum and postpartum carboxyhemoglobin concentrations were significantly higher in the group with mild preeclampsia (antepartum : 2.55+/-0.42 mg/dl, postpartum 1.21+/-0.4 mg/dl) than the controls (antepartum : 0.61+/-0.2 mg/dl, postpartum 0.53+/-0.2 mg/dl) 3. During postpartum, carboxyhemoglobin concentration in preeclampsia reduced significantly from antepartum level, but there was no difference between antepartum and postpartum carboxyhemoglobin concentrations among controls. 4. Bilirubin concentrations were similiar in both groups
Anemia, Hemolytic ; Bilirubin ; Carboxyhemoglobin* ; Early Diagnosis ; Female ; Heme ; Humans ; Hypertension, Pregnancy-Induced ; Iron* ; Metabolism ; Postpartum Period ; Pre-Eclampsia* ; Pregnancy ; Pregnant Women ; Prognosis

In this investigation, we studied the expression and localization of rat prostaglandin F (FP) receptor in uterine tissues of rats on gestational Days 10, 15, 18, 20, 21, 21.5 and postpartal Days 1 and 3 using Western blotting analysis, real-time PCR, and immunohistochemistry. A high level of immunoreactivity was observed on gestational Days 20, 21, and 21.5 with the most significant signals found on Day 20. FP receptor protein was expressed starting on gestational Day 15, and a fluctuating unsteady increase was observed until delivery. Uterine FP receptor mRNA levels were low between Days 10 and 18 of gestation (p < 0.05). The transcript level increased significantly on Day 20 and peaked on Day 21.5 just before labor (p < 0.05). There was a positive correlation between FP receptor mRNA expression and serum estradiol levels (rs = 0.78; p < 0.01) along with serum estradiol/progesterone ratios (rs = 0.79; p < 0.01). In summary, we observed an increase FP receptor expression in rat uterus with advancing gestation, a marked elevation of expression at term, and a concominant decrease during the postpartum period. These findings indicate a role for uterine FP receptors in the mediation of uterine contractility at term.
Animals ; Blotting, Western ; Female ; *Gene Expression Regulation ; Gestational Age ; Immunoglobulin G/blood ; Immunohistochemistry ; Postpartum Period/metabolism ; Pregnancy ; Rats ; Rats, Sprague-Dawley ; Real-Time Polymerase Chain Reaction ; Receptors, Prostaglandin/*genetics/metabolism ; Uterus/*metabolism

The purpose of this study was to investigate postpartum glucose testing rates in patients with gestational diabetes mellitus (GDM) and to determine factors affecting testing non-compliance in the Korean population. This was a retrospective study of 1,686 patients with GDM from 4 tertiary centers in Korea and data were obtained from medical records. Postpartum glucose testing was conducted using a 2-hr 75-g oral glucose tolerance, fasting glucose, or hemoglobin A1C test. Test results were categorized as normal, prediabetic, and diabetic. The postpartum glucose testing rate was 44.9% (757/1,686 patients); and of 757 patients, 44.1% and 18.4% had pre-diabetes and diabetes, respectively. According to the multivariate analysis, patients with a high parity, larger weight gain during pregnancy, and referral from private clinics due to reasons other than GDM treatment were less likely to receive postpartum glucose testing. However, patients who had pharmacotherapy for GDM were more likely to be screened. In this study, 55.1% of patients with GDM failed to complete postpartum glucose testing. Considering the high prevalence of diabetes (18.4%) at postpartum, clinicians should emphasize the importance of postpartum diabetes screening to patients with factors affecting testing noncompliance.
Blood Glucose/*metabolism ; Diabetes, Gestational/*blood ; Fasting ; Female ; *Glucose Tolerance Test ; Hemoglobin A, Glycosylated/metabolism ; Humans ; Mass Screening/statistics & numerical data ; Patient Compliance/statistics & numerical data ; Postpartum Period/*blood ; Pregnancy ; Republic of Korea ; Retrospective Studies ; Tertiary Care Centers

INTRODUCTIONWomen with previous gestational diabetes mellitus (PGDM) are at increased risk of future glucose intolerance. This study aimed to determine the prevalence of prediabetes and type 2 diabetes mellitus (T2DM), and the associated antenatal and historical risk factors among women with PGDM.

METHODSThis was a cross-sectional study conducted at University Malaya Medical Centre, Kuala Lumpur, Malaysia. A 75-g 2-hour oral glucose tolerance test was performed in a cohort of multiethnic women with PGDM. Body mass index, waist and hip circumferences, fasting lipid profile and blood pressure were obtained. Data pertaining to the index gestational diabetes mellitus (GDM) were obtained from medical records and interviews.

RESULTS448 women were enrolled in the study. The prevalence of prediabetes and T2DM was 26.2% and 35.5%, respectively. On multinomial logistic regression analysis, fasting plasma glucose at diagnosis of index GDM and duration lapse after index GDM were shown to be significantly higher in women with isolated impaired fasting glucose (IFG), combined IFG/impaired glucose tolerance and T2DM, as compared to women with normal glucose tolerance (p < 0.05). 2-hour plasma glucose at diagnosis of index GDM was significantly higher only in women who progressed to T2DM when compared to those that remained normal glucose tolerant (p < 0.05).

CONCLUSIONIn this study, duration lapse after index GDM, fasting plasma glucose and 2-hour plasma glucose at diagnosis of index GDM were important risk factors for early identification of women at high risk for future glucose intolerance. These may be useful for developing potential preventive strategies.

Adult ; Blood Glucose ; metabolism ; Body Mass Index ; Cross-Sectional Studies ; Diabetes, Gestational ; blood ; Female ; Glucose Intolerance ; blood ; epidemiology ; etiology ; Glucose Tolerance Test ; Humans ; Malaysia ; epidemiology ; Postpartum Period ; blood ; Prediabetic State ; epidemiology ; etiology ; Pregnancy ; Prevalence ; Risk Factors

BACKGROUND: Gestational diabetes mellitus (GDM) is a hyperglycemic condition caused by increased insulin resistance and impaired insulin secretion during pregnancy. It is known to be temporary, but it can cause perinatal complications in the mother and baby. Additionally, it may progress to type 2 diabetes mellitus (T2DM). In the present study, we evaluated the risk factors for complications and progression to T2DM in patients with GDM. METHODS: The study included 130 pregnant women who were diagnosed with GDM at gestational weeks 24-28 in 2011. Body mass index and the levels of glucose, total cholesterol, lipoproteins, and coagulation factors (von Willebrand factor and plasminogen activator inhibitor-1) were assessed in all patients. RESULTS: The level of high-density lipoprotein (HDL) was significantly lower and the triglyceride/HDL ratio and coagulation factor levels were significantly higher in the group of patients with perinatal complications compared to those in the group of patients without complications. After delivery, the level of HDL was lower and the value of homeostasis model assessment of insulin resistance (HOMA-IR) was higher in women with impaired glucose metabolism compared to those in women with normal glucose metabolism. In logistic regression analysis, perinatal complications were independently associated with HDL and PAI-1 levels (OR = 0.929 and 1.101, respectively). CONCLUSION: The findings of our study show that the levels of HDL and coagulation factors are notable risk factors of perinatal complications. Additionally, we showed that lower HDL level may influence the progression to T2DM. Large-scale population studies are needed to verify our findings.
Blood Coagulation Factors ; Body Mass Index ; Cholesterol ; Diabetes Mellitus* ; Diabetes Mellitus, Type 2 ; Diabetes, Gestational* ; Female ; Glucose ; Homeostasis ; Humans ; Insulin ; Insulin Resistance ; Lipoproteins ; Lipoproteins, HDL ; Logistic Models ; Metabolism ; Mothers ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Postpartum Period* ; Pregnancy ; Pregnant Women ; Risk Factors* ; von Willebrand Factor