Lecture 32 - Pregnancy

Question 1

What are factors that contribute to preeclampsia

Answer 1

• anti angiogenic response
• altered immune response
• abnormal trophoblast invasion
• oxygen disruption

Question 2

what contributes to increased inflammation

Answer 2

• reduced treg population
• circulating syncytiotrophoblast microfragments are increased in preeclamptic women
• STBMs increase superoxide anion in leukocytes
• STBMs linked to endothelial dysfunction and maternal symptoms of preeclampsia

Question 3

What is rheumatoid arthritis

Answer 3

• autoimmune disease involves both Th1 and Th2
• initiated by CD4 T cells
• systemic inflammatory disease
• chronic inflammation of joints and tissues around joints

Question 4

What occurs with rheumatoid arthritis in pregnancy

Answer 4

• 20-40% of women achieve remission by third trimester
• worsening of symptoms in 25% of women
• affects specific immunity
• increased numbers of Tregs and levels of IL10 in third trimester
• postpartum flares

Question 5

What is APS

Answer 5

• caused by an autoimmune response to phospholipids
• often results in increased blood clots
• preventative treatments include blood thinners, heparin or low dose aspirin

Question 6

Pathogenesis of APS and miscarriage

Answer 6

• APS may interact with platelets and cause microvascualr thrombosis
• binds to cytotrophoblasts

Question 7

How does influenza effect pregnancy

Answer 7

• higher risk for severe disease, hospitalization and death
• increased rates of preterm birth, intrauterine growth restriction and fetal death

Question 8

What are the risks with SARS-COV-2 and pregnancy

Answer 8

• increased ICU admission, gestational diabetes, preeclampsia, c-sections, preterm birth and increased CRP
• rarely reported as vertically transmitted but there is damage to the placenta