Maged Costantine1, George Saade1, Egle Bytautiene Prewit1. 1UTMB, Galveston, TX, 2Baylor College of Medicine, Houston, TX. OBJECTIVE: Nicotine is an ...
Poster Session I
ajog.org 260 Maternal nicotine exposure and antioxidant capacity in the brains of offspring Holly E. Dunn1, Karin Fox2, Talar Kechichian1, Huaizhi Yin1, Maged Costantine1, George Saade1, Egle Bytautiene Prewit1 1
UTMB, Galveston, TX, 2Baylor College of Medicine, Houston, TX
OBJECTIVE: Nicotine is an emerging teratogen and a potent oxidant
as it readily crosses the placenta and compromises the development of critical neural pathways in the developing brain, which is thought to be the cause of many of the adverse neurobehavioral outcomes in the offspring of women who smoke during pregnancy. We hypothesize that the oxidative stress to the brains caused by prenatal nicotine exposure (PNE) is linked to reduced translation of the antioxidant enzymes catalase (Cat), superoxide dismutase (SOD), and glutathione peroxidase (GPx). STUDY DESIGN: Timed pregnant C57B1/6 mice were exposed to 200mcg/ml nicotine base and a 2% saccharin solution (PNE group) or 2% saccharin placebo (CTR group) via the Drinking in the Dark protocol throughout gestation and until weaning. Quantitative realtime RT-PCR, Western blot, and enzyme activity analyses were performed on brain samples from female (CTR n¼6, PNE n¼13) and male pups (CTR n¼11, PNE n¼14) collected at 6 months of age. Student t-test or Mann-Whitney test were used for statistical analysis as appropriate (signiﬁcance: P < 0.05). RESULTS: Cat mRNA levels were signiﬁcantly increased in PNE males when compared to CTR group (P¼0.003). An increased Cat activity was found in both PNE males and females when compared to CTR animals (P¼0.002 and P¼0.04, respectively). SOD protein levels were signiﬁcantly higher PNE females versus placebo females (P¼0.03). GPx mRNA was signiﬁcantly lower in PNE males as compared to CTRs (P¼0.04). The protein levels of GPx 92kDa subunit was increased while 23kDa subunit was decreased in PNE males as compared to CTR groups (P¼0.02 and P¼0.03, respectively). No other differences between the PNE and CTR groups were found. CONCLUSION: Prenatal and early postnatal exposure to PNE has varying effects on gene expression, protein levels and activity of the antioxidant enzymes Cat, SOD, and GPx in rodent offspring. Contrary to our hypothesis, the most effects were upregulated. It is possible that PNE due to maternal intake results in augmentation of antioxidant enzyme protective function in the offspring. Further studies are needed to determine the clinical consequences of these effects.
261 Evaluating pelvic floor disruption following vaginal delivery using three-dimensional transperineal ultrasound Lina Salman1, Dan Valsky2, Yuval Lavy2, Simcha Yagel2, Drorith Hochner-Celnikier2 1
Helen Schneider’s Hospital For Women, Rabin Medical Center, Petach Tikva, Israel, 2Department of Obstetrics and Gynecology, Hadassah University Hospital Mount Scopus, Jerusalem, Israel
OBJECTIVE: We aimed to assess the incidence and risk factors for Pelvic Floor Disruption (PFD) in primiparous women after their ﬁrst Vaginal Delivery (VD) using three-dimensional transperineal ultrasound (3D-TPUS). STUDY DESIGN: This is a prospective-cohort study. Primiparous women, 10-14 months after their ﬁrst VD were reached by phone and invited to our ultrasound unit for an assessment including 3DTPUS and completing St. Marks Incontinence Score (SMIS) questionnaire (ﬁgure 1). 3D-TPUS was performed by ultrasound specialists who were blinded to information regarding delivery, risk factors for PFD and SMIS results. Inclusion criteria included: primiparity, VD, singleton, birth weight > 3000 grams, women who did not give birth since the studied delivery and were not pregnant again. Exclusion criteria included: women who suffered from anal incontinence prior to the studied pregnancy. Primary outcome was assessing the incidence and risk factors for PFD using 3D-TPUS. Secondary outcome was evaluating clinical degree of incontinence using SMIS. Data regarding labor and delivery were extracted from electronic medical records. RESULTS: Overall 26 women participated. They underwent 3D-TPUS and were evaluated using SMIS. Incidence of PFD following VD in primiparous women was 23% (6 patients). Of which, 5 patients had levator ani disruption and one patient had anal sphincter disruption (ﬁgure 2). The patient with anal sphincter injury demonstrated using 3D-TPUS was diagnosed during labor as having third degree perineal tear (3C) with immediate surgical repair. In assessing different risk factors, epidural anesthesia during delivery was found to be signiﬁcantly protective from PFD (P < 0.05). Prolonged second stage of labor and prolonged pregnancy was higher in women diagnosed with PFD, however, this was not statistically signiﬁcant. As for clinical evaluation of incontinence, positive SMIS score was higher in women with sonographically diagnosed PFD. CONCLUSION: PFD following ﬁrst VD is not a rare ﬁnding. 3D-TPUS helps to diagnose PFD in women with so called “uneventful” delivery.
Supplement to JANUARY 2017 American Journal of Obstetrics & Gynecology