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Thyroid disorders in pregnancy - immunoendocrinological and metabolic aspects
Vítková, Hana ; Jiskra, Jan (advisor) ; Kosák, Mikuláš (referee) ; Posová, Helena (referee)
Background: The immunological, hormonal and metabolic changes occur during pregnancy and increase the risk of developing some diseases. The aims of this study were: to compare serum concentrations of antibodies against C1q component of complement (anti-C1q) and mannose-binding lectin (MBL) in pregnant women with autoimmune thyroid disease (AITD) and healthy pregnant women and to compare urinary iodine concentration (UIC), neonatal thyroid stimulating hormone (TSH) and other thyroid laboratory parameters in pregnant women with gestational diabetes mellitus (GDM) and healthy pregnant women. Patients and methods: The "anti-C1q" study included 96 pregnant women with AITD and three control groups: 80 healthy pregnant women, 72 non-pregnant women with AITD and 72 healthy blood donors. The "MBL" study included 212 pregnant women with AITD and 80 healthy pregnant women, and the "urinary iodine concentration" study included 195 pregnant women with GDM and 88 healthy pregnant women. Anti-C1q and MBL concentrations were measured by ELISA, UIC by absorption spectrophotometry after previous alkaline demineralization, and other parameters by standard immunoassay. Results: The anti-C1q and MBL serum concentrations were higher in pregnant women with AITD compared to controls. The anti-C1q concentrations were...
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The influence of gestational diabetes mellitus on managememt and course of labour
Martináková, Kristýna ; Anderlová, Kateřina (advisor) ; Šimják, Patrik (referee)
The bachelor thesis deals with gestational diabetes and its influence on the management and course of labour and early neonatal adaptation. Gestational diabetes mellitus (GDM) is one of the most common perinatal complications that poses risks to both mother and fetus. The fetus is particularly at risk for diabetic fetopathy with macrosomia, which can be a complication during the labour. Depending on the compensation of diabetes and the birth weight of the baby, the mother is at risk of more severe birth injuries. The aim of this study was to determine whether gestational diabetes has an effect on the management and course of labour compared to women without diabetes. We also attempted to clarify whether mothers with gestational diabetes suffer more extensive perineal lacerations, whether the average birth weight of newborns of mothers with GDM is higher, and whether GDM is associated with poorer postpartum adaptation. These objectives were complemented by 3 hypotheses that helped to meet the stated objectives. The research part of the study consisted in retrospective collection of patient data from the MEDEA system at the Department of Gynaecology and Obstetrics, First Medical Faculty of Charles University and General University Hospital in Prague. The data were collected from November 2021 to...
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Extracellular microRNAs and their role in pathologies especially in the field of gynecology and obstetrics.
Štěrbová, Monika ; Hromadníková, Ilona (advisor) ; Balušíková, Kamila (referee)
microRNAs (miRNAs) represent a relatively newly discovered group of RNA molecules and they serve to regulate gene expression. In spite of processes of differentiation, proliferation and apoptosis, miRNAs influence the whole biological systems, such as embryogenesis, oncogenesis, and immunity. There have been a number of experiments in recent years concerning diagnoses and predictions of complications during pregnancy, and tumour growth. Extracellular miRNA molecules participating in circulation of patients are used in the non-invasive diagnostics. RNA molecules usually get into the extracellular fluid during the apoptosis process. I chose four diseases, which extracellular miRNA have diagnostic potential - preeclampsia, intrauterine growth retardation, gestational diabetes mellitus and breast cancer - for my work. An aberrant expression of different levels of various extracellular miRNAs has been reported in these diseases but the clinical use of microRNAs in the diagnosis and prediction of those still requires further research and optimization. Keywords: breast cancer, extracellular nucleic acids, fetal growth retardation, gestational diabetes mellitus, microRNA, PCR, preeclampsia
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Postpartum expression of cardiovascular disease-associated microRNAs - comparison of expression levels between plasma, plasma exosomes and whole peripheral venous blood
Ševčíková, Adéla ; Hromadníková, Ilona (advisor) ; Korabečná, Marie (referee)
MicroRNA (miRNA) are short non-coding RNA molecules that regulate gene expression at the post-transcriptional level. Many miRNAs are involved in the pathogenesis of cardiovascular diseases, which is associated with altered gene expression. This work compares miRNA gene expression profiles among various biological sources - whole peripheral venous blood (whole PB), plasma and plasma exosomes. For all tested groups combined, the expression levels of miRNA were maximal in whole PB and lowered in plasma and plasma exosomes, and the expression levels of miRNA were higher in plasma than in plasma exosomes, except miR-126-3p, which had a higher level detected in plasma exosomes compared to plasma. This work also compares expression levels of cardiovascular miRNA between women with anamnesis of gestational diabetes mellitus (GDM) and physiological gravidity 3-11 years postpartum in whole PB, plasma and plasma exosomes. In whole PB, 12 of 29 tested miRNAs were up-regulated in women with prior exposure to GDM. MiR-181a-5p was up-regulated in plasma exosomes and miR-499a-5p in plasma in women with prior exposure to GDM. The changes in whole peripheral venous blood seem to reflect the complex systemic response to the changes that occurred during the onset of GDM. Women with aberrant epigenetic profiles may...
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The Influence of a Lifestyle of Women with Anamnesis of Gestational Diabetes Mellitus on Manifestation of Diabetes Mellitus Type 2
Dittrichová, Jana ; Anderlová, Kateřina (advisor) ; Krejčí, Hana (referee)
1 Abstract: The present thesis is focused on a lifestyle of women with anamnesis of Gestational Diabetes and on the way in which this lifestyle influences manifestation of Type 2 Diabetes. The goal of the thesis is to describe the ways in which women with anamnesis of Gestational Diabetes in the period 1-11 years after delivery behave preventively in order that Type 2 Diabetes would not occur - to describe their diet and movement activities as well as to discover, if they have their blood sugar level checked regularly. By means of questionnaire survey, it has been discovered that women with anamnesis of Gestational Diabetes consume not-sweetened beverages, coffee, vegetable and fruits, on the other hand it would be convenient, if they would eliminate secondary processed food, red meat, sweets and fried meal and increase intake of nuts, fish and cereals. 83 % of women engage in a movement activity at least 3 times a week. 52 % had come for blood sugar level examination (oGTT) after delivery and another 12 % had their blood sugar level checked during regular medical examination. Nevertheless, many respondents are not regularly monitored anymore. Women with anamnesis of Gestational Diabetes, in the case of which blood sugar level examination (oGTT) detected Prediabetes or Type 2 Diabetes, consume too much...
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Gestational diabetes mellitus - influence on the course of labor induction
Janů, Lucie ; Šimják, Patrik (advisor) ; Čábela, Radek (referee)
This bachelor thesis deals with gestational diabetes mellitus and its influence on the course of induction of labor. Gestational diabetes is a disorder of glucose metabolism occurring during pregnancy that disappears spontaneously in the puerperium. It has a fundamental influence on childbirth and increases the risk of numerous obstetric complications. In many women who suffer from gestational diabetes, it is necessary to induce labor from various indications. It is a preventive method using artificial induction of uterine activity to terminate the pregnancy if its continuation increases the risk of possible damage to the mother or the fetus. The study aimed to determine whether GDM affects the course of labor induction compared to women to whom labor was induced from other indications. We intended to find out whether GDM affects the perinatal and neonatal results of labor induction. We also set 12 hypotheses that helped us to fulfill the goals of our work. The research part of the work was retrospective and examined the labor induction in women performed at the Department of Gynecology and Obstetrics, First Faculty of Medicine, Charles University and General University Hospital in Prague between December 2019 and January 2021. We obtained the data to monitor the course and results of labor...
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Gestational diabetes mellitus and its effect on women diet after childbirth.
Kadečková, Klára ; Anderlová, Kateřina (advisor) ; Krejčí, Hana (referee)
Women treated during pregnancy with gestational diabetes mellitus have 40-60% higher risk of developing type 2 diabetes, obesity and cardiovascular disease later in life. Development prevention of these diseases is rational diet with reduced carbohydrates intake, weight reduc- tion and regular exercise. Women with history of gestational diabetes should be still moni- tored regularly after childbirth. My bachelor thesis looks into diet of women after childbirth, who were monitored with ges- tational diabetes mellitus during pregnancy and its effect on development of type 2 diabetes. The goal of thesis is to evaluate influence of the diet during gestational diabetes on diet after childbirth. Evaluation will be based on questionnaire survey with respondents from two groups. First group is made up of women attending appointments in collection center of Gen- eral University Hospital in Prague for oral glucose tolerance test. Second group are women who came for checkup to diabetologist in Department of Obstetrics and Gynecology of the First Faculty of Medicine and General University Hospital just few days after childbirth. Survey results will be processed and evaluated. Conclusion forms recommendations on how to im- prove motivation of women with history of gestational diabetes to maintain healthy diet...
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Identification of biomarkers involved in the pathophysiology of gestational diabetes mellitus.
Šimják, Patrik ; Pařízek, Antonín (advisor) ; Karásek, David (referee) ; Novotný, Zdeněk (referee)
Identification of biomarkers involved in the pathophysiology of gestational diabetes mellitus ABSTRACT Gestational diabetes mellitus is a disorder of glucose metabolism that occurs in pregnancy and resolves after delivery. Increasing production of pregnancy-related hormones leads to insulin resistance which is not adequately compensated by increased insulin secretion. Since obesity is an important risk factor for gestational diabetes and is also associated with adipose tissue dysfunction and increased peripheral insulin resistance, the question arises as to what extent is the adipose tissue involved in the development of gestational diabetes. The first part of the thesis focuses on the identification of changes in plasma concentration and mRNA expression of adipokines fetuin A, fetuin B and FGF21. In our study we did not show that the presence of gestational diabetes significantly influenced the plasma concentration of fetuin A, fetuin B and FGF21 during pregnancy. An important finding was that women who had pregnancy complicated with gestational diabetes had a significantly higher concentration of FGF21 several months after delivery in comparison to healthy pregnant women. We have been able to demonstrate the production of fetuin A in the placenta and fetuin B in perineal and subcutaneous tissue. However,...
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First-trimester screening of pregnancy-related complications using plasma exosomal C19MC microRNAs
Špačková, Kamila ; Hromadníková, Ilona (advisor) ; Daňková, Pavlína (referee)
Pregnancy-related complications such as gestational hypertension, preeclampsia, fetal growth restriction, gestational diabetes mellitus, spontaneous preterm birth, and preterm premature rupture of membranes may have severe consequences for both the mother and the child. The development of reliable early screening methods for pregnancy-related complications has therefore been a long-term goal of obstetrics. New possibilities for prenatal diagnostics have opened with the discovery of circulating microRNAs in maternal plasma. MicroRNAs are short, noncoding, 21 to 23 nucleotides long, single-strand RNAs whose main function is to regulate gene expression. During pregnancy, both common and unique miRNAs are expressed by the placenta, amongst them the miRNAs of the C19MC cluster. Several C19MC miRNAs have been shown to display a different expression profile associated with certain pregnancy-related complications. This thesis identifies the plasma exosomal profiles of six C19MC miRNAs (miR-516-5p, miR-517-5p, miR-518b, miR-520a-5p, miR-520h, and miR-525-5p) in patients in their first trimester of gestation who later developed pregnancy-related complications, and compares them with profiles in patients with normal pregnancies.
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The risk of type 2 diabetes in women treated for gestational diabetes
Cvejnová, Michaela ; Anderlová, Kateřina (advisor) ; Krejčí, Hana (referee)
This bachelor's thesis deals with the subject of gestational diabetes mellitus (GDM), the most common metabolic disorder in pregnancy. GDM is a carbohydrate metabolism disorder that develops during pregnancy and disappears after delivery. GDM is associated with a lot of complications and risks for both mother and child. For this reason, it is very important to make an early diagnosis of GDM and start timely treatment, which includes lifestyle changes, regular physical activity, or drug therapy. The theoretical part summarizes current information on GDM. In the practical part, follow-up OGTT data obtained 3 - 6 months after delivery were analysed. The aim of the thesis was to assess OGTT results through a statistical analysis of data of women treated for GDM diagnosed in 2016 and 2017. Retrospective processing of medical records was done. It was found that 75 patients (48.1%) had positive follow-up OGTT results after delivery, out of which 70 patients (93.3%) had elevated fasting blood glucose. 7 patients (9.3%) had increased glycaemia at 120 minutes after the test. Positive OGTT results fell into the pre-diabetic range. Only a very small percentage of women undergo follow-up OGTT after delivery, although nearly half of them have positive OGTT results. Risk factors such as higher BMI before...
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