Report of the National High Blood Pressure Education Program Working Group on High Blood Pressure in Pregnancy

PUMA, a novel proapoptotic gene, is induced by p53.

The discovery of the first neurotransmitter — acetylcholine — was soon followed by the discovery of its hydrolysing enzyme, acetylcholinesterase. The role of acetylcholinesterase in terminating acetylcholine-mediated neurotransmission made it the focus of intense research for much of the past century. But the complexity of acetylcholinesterase gene regulation and recent evidence for some of the long-suspected 'non-classical' actions of this enzyme have more recently driven a profound revolution in acetylcholinesterase research. Although our understanding of the additional roles of acetylcholinesterase is incomplete, the time is ripe to summarize the evidence on a remarkable diversity of acetylcholinesterase functions.

Acetylcholinesterase New roles for an old actor

http://n-acetylaspartate.com/PDF%20files/NAA%20Review.pdf

N-Acetylaspartate in the CNS: From neurodiagnostics to neurobiology

Objective To compare the perinatal outcome of singleton and twin pregnancies between natural and assisted conceptions. Design Systematic review of controlled studies published 1985-2002. Studies reviewed 25 studies were included of which 17 had matched and 8 had non-matched controls. Main outcome measures Very preterm birth, preterm birth, very low birth weight, low birth weight, small for gestational age, caesarean section, admission to neonatal intensive care unit, and perinatal mortality. Results For singletons, studies with matched controls indicated a relative risk of 3.27 (95% confidence interval 2.03 to 5.28) for very preterm ( < 32 weeks) and 2.04 (1.80 to 2.32) for preterm ( < 37 weeks) birth in pregnancies after assisted conception. Relative risks were 3.00 (2.07 to 4.36) for very low birth weight ( < 1500 g), 1.70 (1.50 to 1.92) for low birth weight ( < 2500 g), 1.40 (1.15 to 1.71) for small for gestational age, 1.54 (1.44 to 1.66) for caesarean section, 1.27 (1.16 to 1.40) for admission to a neonatal intensive care unit, and 1.68 (1.11 to 2.55) for perinatal mortality. Results of the non-matched studies were similar. In matched studies of twin gestations, relative risks were 0.95 (0.78 to 1.15) for very preterm birth, 1.07 (1.02 to 1.13) for preterm birth, 0.89 (0.74 to 1.07) for very low birth weight, 1.03 (0.99 to 1.08) for low birth weight, 1.27 (0.97 to 1.65) for small for gestational age, 1.21 (1.11 to 1.32) for caesarean section, 1.05 (1.01 to 1.09) for admission to a neonatal intensive care unit, and 0.58 (0.44 to 0.77) for perinatal mortality. The non-matched studies mostly showed similar trends. Conclusions Singleton pregnancies from assisted reproduction have a significantly worse perinatal outcome than non-assisted singleton pregnancies, but this is less so for twin pregnancies. In twin pregnancies, perinatal mortality is about 40% lower after assisted compared with natural conception.

https://www.bmj.com/content/bmj/328/7434/261.full.pdf

Perinatal outcome of singletons and twins after assisted conception: a systematic review of controlled studies

Background Obstetrical complications such as severe preeclampsia, abruptio placentae, fetal growth retardation, and stillbirth are associated with intervillous or spiral-artery thrombosis and inadequate placental perfusion. Whether these complications are associated with an increased frequency of thrombophilic mutations is not known. Methods We studied 110 women who had one of the above-mentioned obstetrical complications and 110 women who had one or more normal pregnancies. The women were tested several days after delivery for the mutation of adenine to guanine at nucleotide 506 in the factor V gene (factor V Leiden), the mutation of cytosine to thymine at nucleotide 677 in the gene encoding methylenetetrahydrofolate reductase, and the mutation of guanine to adenine at nucleotide 20210 in the prothrombin gene. Two to three months after delivery the women were tested for deficiency of protein C, protein S, or antithrombin III and for the presence of anticardiolipin antibodies. Results The mutation at nucl...

https://www.nejm.org/doi/pdf/10.1056/NEJM199901073400102

Increased frequency of genetic thrombophilia in women with complications of pregnancy.

The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program

Increased frequency of genetic thrombophilia in women with complications of pregnancy

Severe preeclampsia and high frequency of genetic thrombophilic mutations

BACKGROUND: We investigated whether hereditary thrombophilia is more prevalent in women with recurrent IVF-embryo transfer failures. METHODS: This case‐control study was conducted in an academic tertiary care hospital and compared 45 women with a history of four or more failed IVF cycles (group A) with 44 apparently healthy women matched for age and ethnic origin (group B). All participants were tested for inherited thrombophilias: mutations of prothrombin, factor V Leiden and methylene tetrahydrofolate reductase (MTHFR), and protein C, protein S and antithrombin III deficiencies. RESULTS: Excluding homozygotic MTHFR, the incidence of thrombophilia in group A, was 26.7% compared with 9.1% in group B (P = 0.003; odds ratio 2.9; 95% confidence interval 1.02‐8.4). The incidence of thrombophilia in women with unexplained infertility in group A was 42.9% (9/21), compared with 18.2% in group B (P < 0.002). CONCLUSIONS: These data suggest that inherited thrombophilia may play a role in the aetiology of repeated IVF failures, particularly in the subgroup with unexplained fertility.

/pdf/increased-rates-of-thrombophilia-in-women-with-repeated-ivf-2ndu59sixc.pdf

Joseph B. Lessing

Papers

Increased frequency of genetic thrombophilia in women with complications of pregnancy.

The effect of antioxidant treatment on human spermatozoa and fertilization rate in an in vitro fertilization program

Increased frequency of genetic thrombophilia in women with complications of pregnancy

Severe preeclampsia and high frequency of genetic thrombophilic mutations

Increased rates of thrombophilia in women with repeated IVF failures