S. Mouffak, S. Berrada, Pr. M. Hassani, J. Kouach And D. Moussaoui.
Adult Still\\\'s disease (ASD) is a auto inflammatory disease so-called polygenic. ASD is a rare pathology known as benign, its diagnosis remains a diagnosis of elimination based on the set of polymorphic clinical signs (fever, rash and or arthralgia), with 2 forms, systemic and articular. Thus, in the absence of a specific diagnostic marker, the ASD remains a diagnosis of elimination.
The interaction between ASD and pregnancy is poorly known, the literature is still poor given its rarity, the number of published observations does not exceed thirty, so its discovery during pregnancy can may compromise the outcome of pregnancy, rarely a life-threatening of the mother.disease flares can occur during ASD in the 2nd trimester and in the postpartum. Corticosteroid therapy is the first-line treatment of ASD, probably more effective in systemic forms of the disease.
We recall here this pathology through the case of a patient who during 10 years of evolution of MSA, in its corticodependent systemic form, had carried out 3 pregnancies without resonance or dysgravidia.
Dr Saloni Sethi, Dr Aditi Arora, Dr Vikash Kumari Kasana, Dr Premlata Mital , Dr Ishita Agarwal, Dr Isha Ramneek and Dr Sakshi Bansal
During pregnancy calcium demand increases due to increase requirement by the developing foetus. This demand is met by dietary calcium intake. Physiological changes in pregnancy tend to lower calcium and calcium homeostasis is maintained by various hormones. The present study was done to find association of sociodemographic factors of the pregnant women with hypocalcaemia.
Material and methods: 100 women in their third trimester of pregnancy were included in the study after obtaining written informed consent. After detail history and examination, 5 ml venous blood is collected to measure serum ionic calcium. Data were entered in to MS Excel sheet and analysed.
Results: Normal serum ionic calcium range is 4.2 – 5.5 mg%. Out of 100 women 36% women had hypocalcaemia. There was no significant association between hypocalcaemia and age (p=0.8), residence (p=0.6), religion (p=0.1), socio-economic status (p=0.8). There was significant association between hypocalcaemia and literacy status (p-0.02). Women with past history of preterm birth and abortion had more risk of having hypocalcaemia. There was a negative correlation between maternal age and mean serum ionic calcium level.
Conclusion: Hypocalcaemia is common in pregnancy. Hypocalcaemia was more common in women who were above 25 years of age, muslim, illiterate, belonging to lower and middle socio-economic status and multiparous. Risk of hypocalcaemia was more in women with gestational age below 34 weeks. All women in their antenatal period should be screened for hypocalcaemia and calcium should be supplemented routinely to all women during antenatal period.
Esther Ugo Alum, Emmanuel Ifeanyi Obeagu, Okechukwu P. C. Ugwu, Chinyere Nneoma Ugwu, Daniel Ejim Uti, Awotunde O. Samson and Dorcas Ibukun Akinloye
Pregnancy demands unique nutritional necessities different from those of women who are not pregnant, involving vital roles of vitamins, minerals, and omega-3 fatty acids. These elements are pivotal for the progression of a healthy pregnancy, aiding mothers in coping with common discomforts and averting complications. Presently, supplementation recommendations for pregnant women vary across nations, prompting the need for comprehensive nutrition counseling as a pivotal aspect of prenatal care. The state of a woman\'s nutrition has a major effect on her health, the course of her pregnancy, and the welfare of her fetus and newborn. Providers of healthcare must recognize and address these distinctive nutritional requisites, advocating for tailored counseling that considers diverse factors such as availability of food, social, ethnic background, cultural dietary selections, and body mass index. Adjustments become imperative in instances of pregnancy complications like gestational diabetes. Collaboration with nutritionists or registered dietitians is instrumental in delivering effective dietary interventions. This review underscores the benefits and current guidelines for mineral, vitamin, and omega-3 fatty acid intake during pregnancy while cautioning against the adverse effects of excessive nutrient consumption and advocating for consistent nutritional guidance.
Emmanuel Ifeanyi Obeagu, Emmanuel Chinedu Onuoha and Getrude Uzoma Obeagu
Trichomonas vaginalis, a prevalent sexually transmitted parasite, poses substantial risks to maternal health during pregnancy, eliciting a multifaceted immune response crucial for host defense. Neutrophils, as primary innate immune effectors, play a pivotal role in combatting this infection within the intricate immunological landscape of pregnancy. This comprehensive review aims to elucidate the complex interplay between Trichomonas vaginalis infection and the dynamic responses of neutrophils in pregnant women, exploring mechanisms of neutrophil recruitment, activation, effector functions, and the parasite\'s evasion strategies. Insights into neutrophil dynamics and activation mechanisms reveal their essential functions in combating T. vaginalis, encompassing chemotaxis, phagocytosis, release of reactive oxygen species, and formation of neutrophil extracellular traps. Furthermore, the review discusses how pregnancy-associated immunomodulation influences neutrophil function in response to this parasitic infection. Concurrently, the elucidation of T. vaginalis evasion tactics—surface antigen variation, adhesion strategies, and immune subversion—underscores the complexity of host-parasite interactions and the challenges faced by neutrophils in eradicating the parasite. Considering the clinical implications, particularly adverse pregnancy outcomes and maternal morbidity associated with T. vaginalis infection, the review addresses current treatment modalities, management challenges during pregnancy, and potential therapeutic strategies targeting neutrophil responses and immune modulation. In conclusion, understanding the intricate interplay between T. vaginalis infection and neutrophil dynamics within pregnancy\'s immunological context provides valuable insights into potential therapeutic targets. This review advocates for further research aiming to enhance our understanding of neutrophil-parasite interactions and develop targeted interventions to ameliorate adverse outcomes associated with T. vaginalis infection in pregnant women.
Emmanuel Ifeanyi Obeagu, Getrude Uzoma Obeagu and Emmanuel Chinedu Onuoha
The immune system\'s intricate interplay with tissue regeneration during pregnancy stands as a captivating field of scientific inquiry, offering profound insights into both maternal physiology and regenerative medicine. This review synthesizes current knowledge on the multifaceted roles of the immune system in orchestrating tissue repair throughout gestation. From the establishment of pregnancy to fetal development, an array of immune cells, cytokines, and signaling pathways collaborates to create a conducive environment for tissue regeneration. Throughout pregnancy, the immune system demonstrates a delicate equilibrium, balancing tolerance towards the fetus while ensuring protection against pathogens. Key immune cell populations such as macrophages, natural killer cells, and regulatory T cells dynamically contribute to tissue repair by modulating inflammation and promoting angiogenesis. Furthermore, cytokines and growth factors, including interleukins and TGF-?, play pivotal roles in regulating cell behavior and extracellular matrix remodeling, thereby influencing tissue regeneration. Understanding these immune-mediated mechanisms in pregnancy has significant implications for regenerative medicine. Insights gleaned from the unique immune adaptations during gestation offer potential avenues for innovative therapeutic interventions in wound healing, organ regeneration, and various pathological conditions.
Vascular endothelial growth factor (VEGF) serves as a central mediator of vascular remodeling and neovascularization, essential components for successful pregnancy. This review aims to elucidate the diverse functions of VEGF in maternal vascular adaptations and placental development across the gestational timeline. Understanding the pivotal role of VEGF in maintaining vascular integrity, supporting placental function, and ensuring fetal nourishment is fundamental for comprehending the intricacies of pregnancy physiology and addressing pregnancy-associated disorders. Throughout pregnancy, the maternal circulatory system undergoes dynamic changes orchestrated by VEGF to accommodate the growing demands of the developing fetus. This section delineates VEGF\'s role in orchestrating vasodilation, angiogenesis, and increased vascular permeability, thereby optimizing blood flow to the placenta and sustaining adequate fetal oxygen and nutrient supply. Critical to fetal nourishment and development, the placenta relies significantly on VEGF-mediated processes for its formation and functionality. This segment explores VEGF\'s influence on trophoblast invasion, placental vascularization, and the establishment of an efficient maternal-fetal interface. It elucidates the impact of VEGF on regulating fetal growth, nutrient exchange, and the prevention of pregnancy-related complications. Disruptions in VEGF signaling pathways have been associated with various pregnancy complications, including preeclampsia, intrauterine growth restriction (IUGR), and gestational diabetes. This section delves into the clinical implications of aberrant VEGF expression and function, highlighting their significance in early diagnosis, risk assessment, and potential therapeutic interventions targeting VEGF pathways. Emerging therapeutic strategies aimed at modulating VEGF signaling pathways present promising avenues for managing pregnancy-related complications. This section examines potential interventions, including VEGF supplementation, receptor modulation, and innovative gene therapies, offering insights into their potential for mitigating adverse pregnancy outcomes associated with VEGF dysregulation. VEGF emerges as a fundamental player in orchestrating maternal vascular adaptations, placental development, and fetal growth regulation throughout pregnancy. A deeper comprehension of VEGF\'s multifaceted roles not only enhances our understanding of reproductive physiology but also unveils potential avenues for targeted interventions to improve maternal and fetal health outcomes.
Emmanuel Ifeanyi Obeagu and Getrude Uzoma Obeagu and Hauwa Ali Buhari
Pregnancy in women with sickle cell anemia presents a unique clinical scenario, entailing intricate management strategies due to the inherent challenges posed by hemolysis and vaso-occlusive events. The convergence of the pathophysiological complexities of sickle cell anemia and the physiological changes during gestation underscores the significance of addressing hemolysis in pregnant individuals with this hemoglobinopathy. This paper synthesizes current understanding and clinical perspectives on the impact of hemolysis in pregnant women with sickle cell anemia, exploring its implications on maternal health, fetal well-being, and strategies for optimized care. Emphasis is placed on elucidating the underlying mechanisms, delineating maternal and fetal complications, and outlining current management approaches. Furthermore, this review highlights emerging interventions and future directions aimed at improving maternal and fetal outcomes in this challenging clinical scenario. By comprehensively addressing the intricacies of hemolysis in pregnant women with sickle cell anemia, this review aims to provide insights that guide clinicians and researchers toward enhancing care and ensuring better maternal-fetal health in this vulnerable population.
Emmanuel Ifeanyi Obeagu and Getrude Uzoma Obeagu and Festus Uchechukwu Onuigwe
Oxygen deprivation, or hypoxia, during pregnancy poses a multifaceted challenge to maternal and fetal well-being, significantly impacting gestational outcomes. This comprehensive review endeavors to elucidate the intricate mechanisms and consequences of hypoxia on maternal health within the context of pregnancy. Through an exploration of the complex interplay between oxygen insufficiency, placental function, and maternal physiology, this review aims to unravel the far-reaching implications of hypoxia on pregnancy outcomes. The discourse encompasses the pivotal role of hypoxia in precipitating various pregnancy complications such as preeclampsia, gestational hypoxia, and intrauterine growth restriction (IUGR), shedding light on their underlying pathophysiological processes and potential therapeutic avenues. By synthesizing current knowledge, this review aims to advance our comprehension of hypoxia\'s impact on maternal health during gestation, fostering the development of targeted interventions to alleviate adverse outcomes associated with oxygen deprivation in pregnancy.