thromboxane-a2 and Birth-Weight

Recurrent miscarriage is a major women's health problem. Aspirin and heparin have been shown to have potentially beneficial effects on trophoblast implantation. However, few published data on this issue are available from developing countries.. An open clinical trial was conducted at the Department of Obstetrics and Gynecology at Misurata Teaching Hospital in Libya from January 2009 to December 2010 to investigate the effects of treatment with low dose aspirin (LDA) versus treatment with low-molecular-weight-heparin (LMWH) in combination with LDA on patients with a history of recurrent miscarriages. A total of 150 women were enrolled in the study. Women were eligible for the study if they had a history of three or more consecutive miscarriages. Participants were randomly assigned to receive either LDA (75 mg daily) alone or a combination of LDA and LMWH (75 women per treatment group). The primary outcomes were the rate of miscarriages and live births for each group.. Compared with the group who received LDA alone, the combination group had a significantly lower number of miscarriages (22/75 [29%] vs. 43/75 [47%], P < 0.001) and had a significantly higher number of live births (53/75 [71%] vs. 32/75 [42%], P < 0.001). Two preterm infants in the LDA group and three in the combination group were admitted to the neonatal intensive care unit. There were no significant differences in the mean (SD) birth weights of neonates born in either group (2955.4 ± 560 vs. 3050 ± 540 g for the LDA and combination groups, respectively, P = 0.444). There were no congenital abnormalities detected in either group.. The combination of LDA and LMWH is better than LDA alone for the maintenance of pregnancy in patients with recurrent first trimester miscarriage.. NCT01917799.

Topics: Abortion, Habitual; Adult; Aspirin; Birth Weight; Embryo Implantation; Enoxaparin; Female; Fibrinolytic Agents; Humans; Infant, Newborn; Libya; Pre-Eclampsia; Pregnancy; Pregnancy Complications, Hematologic; Pregnancy Outcome; Prostaglandins I; Thrombophilia; Thromboxane A2; Trophoblasts; Vasodilation; Young Adult

In a controlled, nonrandomized trial a treatment group of 24 multigravid women with a history of at least two previous pregnancies, all complicated by idiopathic fetal growth retardation and placental infarction, received 1 to 1.6 mg/kg aspirin and 225 mg dipyridamole daily from 16 to 34 weeks' gestation in a total of 30 pregnancies. The end-point measure of the study was birth weight related to gestational age. Results obtained in the treatment group were compared with those in 27 pregnancies of a control group of 24 multigravid women with a similar history of recurrent fetal growth retardation who received comparable antenatal care without low dose aspirin and dipyridamole. Fetal growth retardation occurred in 61% of the control pregnancies and in only 13% of treated pregnancies; severe fetal growth retardation was not observed in treated pregnancies, but it occurred in 27% of the control group. In treated women, platelet cyclo-oxygenase activity was suppressed to 5% to 10% of its pretreatment level, but no effect on vascular prostacyclin production was demonstrated. Treatment did not produce adverse effects in mothers or infants. Low-dose aspirin and dipyridamole direct prostacyclin/thromboxane A2 balance in pregnancy to the dominance of prostacyclin and may thus prevent idiopathic uteroplacental insufficiency and fetal growth retardation in high-risk patients.

Topics: Adult; Aspirin; Birth Weight; Clinical Trials as Topic; Dipyridamole; Epoprostenol; Female; Fetal Growth Retardation; Humans; Infant, Newborn; Pregnancy; Recurrence; Thromboxane A2

We have investigated the effects of moderate global undernutrition during gestation in the rat on the blood pressure of male and female offspring, and on the development of systemic vascular function. Pregnant Wistar rats were nutritionally restricted (R) by feeding with 70% of the normal gestation-matched dietary intake from 0 to 18 days gestation.R offspring were growth retarded at birth but of similar weight to controls (C) at 20 days. Systolic and/or diastolic and mean arterial blood pressures, measured directly by femoral artery catheter, were elevated from 60 days onward in male R offspring (mean arterial pressure: day 60, P < 0.01; day 100, P < 0.05; day 200, P < 0.005, R vs. C), and from 100 days onward in female R offspring (mean arterial pressure day 100 and day 200, P < 0.05; R vs. C). Maximal constriction to phenylephrine (PE) (P < 0.05) and to noradrenaline (NA) (P < 0.05) was reduced in isolated femoral arteries of day 20 R pups. These differences did not persist into adulthood. In male adult R offspring (200 days), maximal vasoconstriction to the thromboxane A2 mimetic, U46619 (P < 0.05) and sensitivity to potassium (P < 0.01) were enhanced. Moderate maternal undernutrition in rat gestation adversely affects cardiovascular function in the offspring. These abnormalities increase with age and are more pronounced in males.

Topics: 15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5,13-dienoic Acid; Animals; Birth Weight; Blood Pressure; Diet; Energy Intake; Female; Gestational Age; Hypertension; Male; Muscle, Smooth, Vascular; Norepinephrine; Organ Size; Phenylephrine; Potassium; Pregnancy; Rats; Rats, Wistar; Thromboxane A2; Vascular Diseases; Vasoconstrictor Agents

Prostacyclin has a vasodilating effect on pulmonary vessels, whereas thromboxane A2 results in vasoconstriction. This study was designed to test the hypothesis that recurrent central apneas in preterm infants are correlated with a reduced prostacyclin to thromboxane A2 ratio. Twelve preterm infants with clinical events of apneas were matched with 12 control infants. Urinary concentration of 2,3-dinor-6-keto-PGF1alpha and 2,3-dinor-TxB2 was determined, and the ratio correlated with the number of central apneas (>20s) measured in overnight polygraphy. The number of central apneas >20s/12h was 97.4 (SE 7.8) in the study group, and 47.3 (SE 6.6) in the control group (p = 0.001). There was a significant correlation between the number of central apneas and the 2,3-dinor-6-keto-PGF1alpha/2,3-dinor-TxB2-ratio in all infants combined (r = -0.72, p < 0.0001) as well as in the two subject groups. Central apneas in premature infants are correlated with an decreased prostacyclin to thromboxane A2 ratio. The underlying pathomechanism may be increased intrapulmonary shunts with reflexive central apneas due to reduced pulmonary oxygenation.

Topics: 6-Ketoprostaglandin F1 alpha; Apnea; Birth Weight; Epoprostenol; Gestational Age; Humans; Infant, Newborn; Infant, Premature; Polysomnography; Prostaglandins F; Thromboxane A2; Thromboxane B2

The maintenance of adequate maternal-fetal circulation is essential for fetal growth. The circulation appears to be controlled by local prostanoid synthesis which may affect the vascular tone. With a view to examining this possibility, the present study was designed to evaluate the umbilical circulation serially in vivo by means of pulse doppler flowmetry. After delivery, the cord vasculature and the placenta were studied in vitro for the synthesis and release of prostacyclin (PGI2) and thromboxane A2 (TxA2). The resistance index (RI) showed a significant negative correlation to the birth weight (n = 15, r = - 0.70, p less than 0.01) and a positive correlation to the maternal arterial pressure (r = 0.56, p less than 0.05). PGI2 synthesis was highest in the umbilical artery, then in the umbilical vein, and lowest in the placenta. TxA2 tended to be higher in the umbilical artery of light-for-date neonates, showing a negative correlation with the birth weight (r = - 0.56, p less than 0.05). RI showed a significant correlation with the PGI2/TxA2 ratio. These results indicate that the balance between PGI2 and TxA2 influences cord circulation and in turn fetal growth.

Topics: Adult; Birth Weight; Blood Flow Velocity; Embryonic and Fetal Development; Epoprostenol; Female; Humans; Infant, Newborn; Placenta; Pregnancy; Thromboxane A2; Ultrasonography; Umbilical Arteries; Umbilical Veins; Vascular Resistance