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Inverted pyramid of prenatal care – is it enough? Should it be – extended inverted pyramid of prenatal care?

  • Aleksandar Ljubić EMAIL logo
Veröffentlicht/Copyright: 7. April 2017

Abstract

In recent years, the idea of the inverted pyramid of prenatal care and monitoring has emerged, for the purpose of prediction and prevention, early detection and treatment of health disorders of the fetus. Is this enough? If we analyze the period behind us, progress has been made in the field of detection of multiple pregnancies, dating of pregnancy and prenatal detection of chromosomal and structural fetal disorders, as well as a small amount of progress in terms of prediction and prevention of preeclampsia. If these disorders are the consequence of the disturbed or dysfunctional placentation, they are rooted at the time of implantation. This means that the changes that lead to the dysfunctional implantation should be sought in the pre-implantation period, in relation between the embryo and the endometrium. An extended inverted pyramid is necessary to find better results in perinatal medicine. This means that the interventions should be focused on the preconception and peri-implantation periods. The therapy should be on the subcellular and genetic level by applying the latest biotechnological procedures. It is possible that the time is approaching when the listed disorders of a pregnancy will be the indications for the application of a non stimulated in-vitro fertilization (IVF) (without ovary stimulating medication) with the use of new biotechnological achievements.

  1. Author’s statement

  2. Conflict of interest: Authors state no conflict of interest.

  3. Material and methods: Informed consent: Informed consent has been obtained from all individuals included in this study.

  4. Ethical approval: The research related to human subject use has complied with all the relevant national regulations, and institutional policies, and is in accordance with the tenets of the Helsinki Declaration, and has been approved by the authors’ institutional review board or equivalent committee.

References

[1] Nicolaides K. A model for a new pyramid of prenatal care based on the 11 to 13 weeks’ assessment. Prenat Diagn. 2011;31:3–6.10.1002/pd.2685Suche in Google Scholar

[2] Sonek JD, Cuckle HS. What will be the role of first-trimester ultrasound if cell-free DNA screening for aneuploidy becomes routine? Ultrasound Obstet Gynecol. 2014;44:621–30.10.1002/uog.14692Suche in Google Scholar

[3] Greco E, Lange A, Ushakov F, Rodriguez Calvo J, Nicolaides KH. Prediction of spontaneous preterm delivery from endocervical length at 11 to 13 weeks. Prenat Diagn. 2011;31:84–9.10.1002/pd.2640Suche in Google Scholar

[4] Poon NC, Nicolaides K. Early prediction of preeclampsia. Obstet Gynecol Int. 2014;2014:11.10.1155/2014/297397Suche in Google Scholar

[5] Akolekar R, Syngelaki A, Sarquis R, Zvanca M, Nicolaides KH. Prediction of early, intermediate and late pre-eclampsia from maternal factors, biophysical and biochemical markers at 11–13 weeks. Prenat Diagn. 2011;31:66–74.10.1002/pd.2660Suche in Google Scholar

[6] Mihailović M, Cvetković M, Ljubić A, Kosanović M, Nedeljković S, Jovanović I, et al. Selenium and malondialdehyde content and glutathione peroxidase activity in maternal and umbilical cord blood and amniotic fluid. Biol Trace Elem Res. 2000;73:47–54.10.1385/BTER:73:1:47Suche in Google Scholar

[7] Cetković A, Miljic D, Ljubić A, Patterson M, Ghatei M, Stamenković J, et al. Plasma kisspeptin levels in pregnancies with diabetes and hypertensive disease as a potential marker of placental dysfunction and adverse perinatal outcome. Endocr Res. 2012;37:78–88.10.3109/07435800.2011.639319Suche in Google Scholar PubMed

[8] Giguère Y, Charland M, Bujold E, Bernard N, Grenier S, Rousseau F, et al. Combining biochemical and ultrasonographic markers in predicting preeclampsia: a systematic review. Clin Chem. 2010;56:361–75.10.1684/abc.2011.0572Suche in Google Scholar PubMed

[9] Duley L, Henderson-Smart DJ, Meher S, King JF. Antiplatelet agents in preventing pre-eclampsia. Cohrane. 2007;2.10.1002/14651858.CD004659.pub2Suche in Google Scholar PubMed

[10] Karagiannis G, Akolekar R, Sarquis R, Wright D, Nicolaides K. Prediction of small-for-gestation neonates from biophysical and biochemical markers at 11–13 weeks. Fetal Diagn Ther. 2011;29:148–54.10.1159/000321694Suche in Google Scholar PubMed

[11] Urato AC, Norwitz ER. A guide towards pre-pregnancy management of defective implantation and placentation. Best Pract Res Clin Obstet Gynaecol. 2011;25:367–87.10.1016/j.bpobgyn.2011.01.003Suche in Google Scholar

[12] Leach M, Aitken R, Sacks G. Sperm DNA fragmentation abnormalities in men from couples with a history of recurrent miscarriage. Aust N Z J Obstet Gynaecol. 2015;55:379–3.10.1111/ajo.12373Suche in Google Scholar

[13] Gil M, Shalom V, Carreras S. Sperm selection using magnetic activated cell sorting (MACS) in assisted reproduction: a systematic review and meta-analysis. J Assist Reprod Genet. 2013;30:479–85.10.1007/s10815-013-9962-8Suche in Google Scholar

[14] Evgeni E, Byron A. Human sperm DNA fragmentation and its correlation with conventional semen parameters. J Reprod Infertil. 2014;15:2–14.Suche in Google Scholar

[15] Wong CC, Loewke KE, Bossert NL, Behr B, De Jonge CJ, Baer TM, et al. Non-invasive imaging of human embryos before embryonic genome activation pre- dicts development to the blastocyst stage. Nat Biotechnol. 2010;28:1115–21.10.1038/nbt.1686Suche in Google Scholar

[16] Seli E, Robert C, Sirard MA. OMICS in assisted reproduction: possibilities and pitfalls. Mol Hum Reprod. 2010;16:513–30.10.1093/molehr/gaq041Suche in Google Scholar

[17] Menezo Y, Elder K, Benkhalifa S, Dale B. DNA methylation and gene expression in IVF. Reprod Biomed Online. 2010;20:709–10.10.1016/j.rbmo.2010.02.016Suche in Google Scholar

[18] Nagy ZP, Jones-Colon S, Roos P, Botros L, Greco E, Dasig J, et al. Metabolomic assessment of oocyte viability. Reprod Biomed Online. 2009;18:219–25.10.1016/S1472-6483(10)60259-3Suche in Google Scholar

[19] Tejera A, Herero J, de Los Santos MJ, Garrido N, Ramsing N, Meseguer M. Oxygen consumption is a quality marker for human oocyte competence conditioned by ovarian stimulation regimens. Fertil Steril. 2011;96:618–23.10.1016/j.fertnstert.2011.06.059Suche in Google Scholar PubMed

[20] Cheng Y, Feng Y, Jansson L, Sato Y, Deguchi M, Kawamura K, et al. Actin polymerization-enhancing drugs promote ovarian follicle growth mediated by the Hippo signaling effector YAP. FASEB J. 2015;29:2423–30.10.1096/fj.14-267856Suche in Google Scholar PubMed PubMed Central

[21] Johnson J, Canning J, Kaneko T, Pru JK, Tilly JL. Germline stem cells and follicular renewal in the postnatal mammalian ovary. Nature. 2004;428:145–50.10.1038/nature02316Suche in Google Scholar PubMed

[22] Hayashi K, Ogushi S, Kurimoto K, Shimamoto S, Ohta H, Saitou M. Offspring from oocytes derived from in vitro primordial germ cell-like cells in mice. Science. 2012;338:971–5.10.1126/science.1226889Suche in Google Scholar

[23] Edessy M. Successful autologous stem cell therapy of premature ovarian failure. Egyptian J Histol. 2013;36: 114–126.10.15406/mojwh.2015.01.00013Suche in Google Scholar

[24] Callejo J, Salvador C, González-Nuñez S, Almeida L, Rodriguez L, Marqués L, et al. Live birth in a woman without ovaries after autograft of frozen-thawed ovarian tissue combined with growth factors. J Ovarian Res. 2013;6:33–6.10.1186/1757-2215-6-33Suche in Google Scholar

[25] Smeets HJM. Preventing the transmission of mitochondrial DNA disorders: Selecting the good guys or kicking out the bad guys. Reprod BioMed Online. 2013;27:599–610.10.1016/j.rbmo.2013.08.007Suche in Google Scholar

[26] Amato P, Tachibana M, Sparman M, Mitalipov. Three-parent in vitro fertilization: gene replacement for the prevention of inherited mitochondrial diseases. Fertil Steril. 2014;101:31–5.10.1016/j.fertnstert.2013.11.030Suche in Google Scholar

[27] Mitalipov S, Wolf DP. Clinical and ethical implications of mitochondrial gene transfer. Trends Endocrinol Metab. 2014;25:5–7.10.1016/j.tem.2013.09.001Suche in Google Scholar

[28] Kawamura K, Cheng Y, Suzuki N, Deguchi M, Sato Y, Takae S, et al. Hippo signaling disruption and Akt stimulation of ovarian follicles for infertility treatment. Proc Natl Acad Sci USA. 2013;110:17474–9.10.1073/pnas.1312830110Suche in Google Scholar

[29] Ljubić et al. Autologous ovarian in vitro activation with ultrasound-guided orthotopic re-transplantation. Am j Clin Exp Obstst Gynecol. 2017. (In press)Suche in Google Scholar

[30] Stephenson MD, Fluker MR. Treatment of repeated unexplained in vitro fertilization failure with intravenous immunoglobulin: a randomized, placebo-controlled Canadian trial. Fertil Steril. 2000;74:1108–13.10.1016/S0015-0282(00)01622-8Suche in Google Scholar

[31] Stern C, Chamley L, Norris H, Hale L, Baker HW. A randomized, double-blind, placebo-controlled trial of heparin and aspirin for women with in vitro fertilization implantation failure and antiphospholipid or antinuclear antibodies. Fertil Steril. 2003;80:376–83.10.1016/S0015-0282(03)00610-1Suche in Google Scholar

[32] Boomsma CM, Keay SD, Macklon NS. Peri-implantation glucocorticoid administration for assisted reproductive technology cycles. Cochrane Data Base Syst Rev. 2007:CD005996.10.1002/14651858.CD005996.pub2Suche in Google Scholar PubMed

[33] Gelbaya TA, Kyrgiou M, Li TC, Stern C, Nardo LG. Low-dose aspirin for in vitro fertilization: a systematic review and meta-analysis. Hum Reprod Update. 2007;13:357–64.10.1093/humupd/dmm005Suche in Google Scholar PubMed

[34] Sumarac-Dumanovic M, Apostolovic M, Janjetovic K, Jeremic D, Popadic D, Ljubic A, et al. Downregulation of autophagy gene expression in endometria from women with polycystic ovary syndrome. Mol Cell Endocrinol. 2017;440:116–24.10.1016/j.mce.2016.11.009Suche in Google Scholar PubMed

[35] Yoshioka S, Fujiwara H, Nakayma T, Kosaka K, Mori T, Fujii S. Intrauterine administration of autologous peripheral blood mononuclear cells promotes implantation rates in patients with repeated failure of IVF-embryo transfer. Hum Reprod. 2006;21:3290–4.10.1093/humrep/del312Suche in Google Scholar PubMed

[36] Makrigiannakis A, Zoumakis E, Kalantaridou S, Coutifaris C, Margioris AN, Coukos G, et al. Corticotropin-releasing hormone promotes blastocyst implantation and early maternal tolerance. Nat Immunol. 2001;2:1018–24.10.1038/ni719Suche in Google Scholar PubMed

[37] Gleicher N, Kim A, Michaeli T, Lee HJ, Shohat-Tal A, Lazzaroni E, et al. Granulocyte colony-stimulating factor and endometrium. Human Reprod. 2013;28:172–7.10.1093/humrep/des370Suche in Google Scholar PubMed

[38] Chang Y, Li J, Chen Y, Wei L, Yang X, Shi Y, et al. Autologous platelet-rich plasma promotes endometrial growth and improves pregnancy outcomeduring in vitro fertilization. Int J Clin Exp Med. 2015;8:1286–90.Suche in Google Scholar

[39] Schoolcraft WB, Fragouli E, Stevens J, Munne S, Katz-Jaffe MG, Wells D. Clinical application of comprehensive chromosomal screening at the blastocyst stage. Fertil Steril. 2010;94:1700–6.10.1016/j.fertnstert.2009.10.015Suche in Google Scholar PubMed

[40] Schoolcraft WB, Treff NR, Stevens JM, Ferry K, Katz-Jaffe M, Scott RT Jr. Live birth outcome with trophectoderm biopsy, blastocyst vitrification, and single-nucleotide polymorphism microarray-based comprehensive chromosome screening in infertile patients. Fertil Steril. 2011;96:638–40.10.1016/j.fertnstert.2011.06.049Suche in Google Scholar PubMed

[41] Bisignano A, Wells D, Harton G, Munne S. PGD and aneuploidy screening for 24 chromosomes: advantages and disadvantages of competing platforms. Reprod Biomed Online. 2011;23:677–85.10.1016/j.rbmo.2011.05.017Suche in Google Scholar PubMed

Received: 2016-12-29
Accepted: 2017-03-01
Published Online: 2017-04-07
Published in Print: 2018-09-25

©2018 Walter de Gruyter GmbH, Berlin/Boston

Artikel in diesem Heft

  1. Frontmatter
  2. Editorial
  3. Antenatal and prepregnancy care – prevention of perinatal morbidity and mortality
  4. Review article
  5. Fetal interventional procedures and surgeries: a practical approach
  6. Opinion paper
  7. Inverted pyramid of prenatal care – is it enough? Should it be – extended inverted pyramid of prenatal care?
  8. Research articles
  9. Expectant management in di-chorionic pregnancies complicated by discordant anomalous twin
  10. Pregnancy outcomes among patients with recurrent pregnancy loss and uterine anatomic abnormalities
  11. Early postnatal echocardiographic assessment of pulmonary blood flow in newborns with congenital diaphragmatic hernia
  12. Sonographic prediction of small and large for gestational age in breech-presenting fetuses
  13. Comparison of fetal weight distribution improved by paternal height by Spanish standard versus Intergrowth 21st standard
  14. Can early ultrasonography explain the lower miscarriage rates in twin as compared to singleton pregnancies following assisted reproduction?
  15. Pregnancy outcomes among patients with recurrent pregnancy loss and chromosomal aberration (CA) without PGD
  16. Regular research articles
  17. Induction of labor in twin gestation: can we predict success?
  18. Low dose aspirin for preventing fetal growth restriction: a randomised trial
  19. Mid-pregnancy cervical length as a risk factor for cesarean section in women with twin pregnancies
  20. Efficacy of three different regimens in recovery of bowel function following elective cesarean section: a randomized trial
  21. Obstetrical, maternal and neonatal outcomes in pregnancies affected by muscular dystrophy
  22. Fetal brain development in diabetic pregnancies and normal controls
  23. Body composition in preterm infants with intrauterine growth restriction: a cohort study
  24. Commentary
  25. Professionally responsible management of gynecologic cancer in pregnancy when clinical resources are unavoidably limited
  26. Letters to the Editor
  27. Erroneous conclusion due to mis-calculation of data: reply to Rai SE, Sidhu AK, Krishnan RJ. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis. J Perinat Med 2017
  28. Reply to: Letter to the Editor by Stritzke A and Shah PS. Transfusion-associated necrotizing enterocolitis re-evaluated: a systematic review and meta-analysis
  29. Congenital Zika syndrome in non-endemic regions
  30. Reply to: Congenital Zika syndrome in non-endemic regions: A neuroimaging pattern-based approach
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