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Awareness of pregnant women about cord blood donation
KOLMANOVÁ, Michaela
This bachelor's thesis is dedicated to donating umbilical cord blood. The thesis consists of a theoretical and practical part. The theoretical part contains a description of the placenta and its functions, umbilical cord blood, stem cells. Furthermore, the theoretical part contains a description of the technique of cord blood collection, contraindications of the collection and processing of umbilical cord blood. It also describes the education of midwives on this issue. Umbilical cord blood banks and legislative provisions are listed here. The aim of the bachelor's thesis was to find out how knowledgeable pregnant women are about this issue. A quantitative research survey was used in the practical part of this work. The questionnaire created contained 18 closed questions. The research team was pregnant women. This set consisted of 244 respondents. Of these, 155 (64%) first-time parents 89 (36%) multi-parents. Of these, 41.39% of respondents know the use of umbilical cord blood. Only 18.03% of respondents know what they need to do to be able to take umbilical cord blood. 19.67% of respondents reported the correct time of collection of umbilical cord blood. 13.52% of respondents reported that the maximum storage period of donated umbilical cord blood is 20 years. Two hypotheses were established in this work. The first hypothesis focused on whether pregnant women are given more information about this issue by a midwife or gynecologist. 5.70% of respondents received information from a midwife. 3.70% of respondents received information from a gynecologist. Statistical processing of the hypothesis has shown us that there is no difference in who gives information. Women are informed from the midwife as well as from the gynecologist. The second hypothesis was whether multi-parents are more informed about umbilical cord blood donation than first-time parents. Multi-parents accounted for 36%, and first-time parents 64%. 46.06% of multi-parents and 38.71% of first-time parents said they knew the use of umbilical cord blood. 20.22% of multi-parents and 19.35% of first-time parents know the time of collection of umbilical cord blood. 50.56% of multi-parents and 39.35% of first-time parents reported that the donation was not risky for newborns. We confirmed the second hypothesis. The results of this work show that women have very little information on the issue of umbilical cord blood donation. The midwife is a competent person, so women could be more education about this issue. This work can be used in seminars for midwives.
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Problematics of cord blood collection.
VAŇKOVÁ, Barbora
This bachelor's thesis deals with the issue of umbilical cord blood collection. Due to the focus of the work, the theoretical part describes childbirth and all periods of childbirth, the procedure of collecting umbilical cord blood after a spontaneous delivery and after delivery per sectio caesarea and possible contraindications of umbilical cord blood collection. My thesis also describes the role of a midwife as a women's educator about the possibility of collecting umbilical cord blood and the role of a midwife during childbirth, including the collection of umbilical cord blood. Last but not least, the theoretical part mentions the importance of umbilical cord blood banks and their legislation concerning and stem cell transplantation. In total, three goals were set. The first goal was to find out if midwives have knowledge about the collection of umbilical cord blood. The second goal was set to reveal whether pregnant women have enough information about umbilical cord blood collection, and the third goal was to see whether pregnant women are interested in umbilical cord blood collection. Based on the goals set, research questions were assigned to each goal. The first research question asked about the knowledge of midwives about the collection of umbilical cord blood, the second question dealt with the pregnant women's knowledge of umbilical cord blood collection and the last question examined the attitude of pregnant women to the collection of umbilical cord blood. Two research files were identified in the research survey. The first group consisted of six midwives, labeled PA1 to PA6, who worked in the delivery room for at least one year. In the second research group there were six pregnant women, marked T1 to T6, who regularly attended an antenatal clinic. The research was conducted using web programs Skype or Teams in May 2020. A qualitative method was chosen to carry out the research part, which was implemented using individual semi-structured interviews. Before the interviews began, the informants gave oral consent to data processing. The data was later analyzed and main categories and subcategories were created based on the results. After evaluating data with the midwives, 2 categories and 8 subcategories were determined. After evaluating data with pregnant women, one category and 3 subcategories were determined. The first research question examined the knowledge of midwives about the collection of umbilical cord blood. Research has shown that midwives PA2 to PA6 have sufficient information on the procedure for collecting umbilical cord blood. Midwife PA1 stated that she had never seen the collection and did not know how such a collection would be performed. On the other hand, midwife PA5 stated that earlier, up to 15 samples per month were performed at her workplace. Therefore, she was the most informed of all the midwives interviewed. The second research question examined the pregnant woman's knowledge about the collection of umbilical cord blood. Research has shown that all pregnant women knew what umbilical cord blood is, but most (T1, T2, T3 and T5) do not know how it is collected and used. The third research question was aimed at the attitude of pregnant women towards the collection of umbilical cord blood. The research found that due to the lack of information, high financial cost and storage of umbilical cord blood, women are not interested in commercial collection of umbilical cord blood. The reason why women are not interested in umbilical cord blood donation was that women would have to choose to give birth at a hospital that allows this type of collection, namely maternity hospitals in Slaný, Česká Lípa and Thomayer Hospital in Prague. Pregnant women state that these hospitals are very distant from their family and place of residence, and that is the reason why not choose these hospitals for childbirth. Only pregnant woman T2 stated that she would consider collecting blood for her own purposes.
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Comparison of cytokine production by leukocytes from newborns of healthy and allergic mothers
Dusilová, Adéla ; Hrdý, Jiří (advisor) ; Janatková, Ivana (referee)
The increasing incidence of children suffering from allergic diseases could be caused by sensitization of immature immune system during the intrauterine development. Several important scientific papers have demonstrated the ability of cord blood cells to respond by elevated proliferation activity after stimulation by common allergens. Following these findings, present study follows the production of cytokines which play a role in the pro- and anti-allergenic tuning of the immune system. Umbilical cord blood cells were stimulated with polyclonal activators (phytohaemagglutinin) and common allergens (ovalbumin, timothy grass, birch, mite). Subsequently, cytokine production was monitored using selected methods that reflect different stages of cell activation - at the level of mRNA by quantitative real time PCR (qRT-PCR), by flow cytometry detection of the presence of intracellular cytokines in different cell subpopulations and by ELISA measurement of cytokines in CBMC culture supernatants. The results obtained point to a very weak ability of these common allergens (timothy grass, birch, mite, ovalbumin) to stimulate CBMC to produce cytokines observed by all of these methodological procedures. Although we did not observe significant differences in CBMC cytokine production (IL-2, IL-4, IL-10, IL-12,...
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Immunologic Characteristics of Cord Blood in Children with Increased Risk of Allergy Development Preventive Use of Probiotics
Hrdý, Jiří ; Prokešová, Ludmila (advisor) ; Tlaskalová - Hogenová, Helena (referee) ; Ulčová-Gallová, Zdeňka (referee)
Allergy is one of the most common diseases. Identification of early prognostic markers pointing to an increased risk of allergy development is therefore of increasing importance. Cord blood represents an easily attainable clinical material for searching for prognostic markers signalizing future allergy development. Proportions of Th1 cytokines, Th2 cytokines and regulatory cytokines were tested in cord blood of children of allergic mothers (children in relatively high risk of allergy development) in comparison with cord blood of children of healthy mothers (low risk children). Also the activities of lymphocytes, dendritic cells (DC) and regulatory cells (Tregs) were compared in children of healthy and allergic mothers. The generally increased activity of both in vitro stimulated and non-stimulated mononuclear cord blood leukocytes was proved in children of allergic mothers in comparison with low risk children. The increased activity of DC of high risk children was detectable only after polyclonal stimulation. Significantly less pronounced functional properties of cord blood Tregs were found in children of allergic mothers when compared with children of healthy mothers. The increased reactivity of lymphocytes and DC together with the decreased activity of Tregs can support an easier...
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Immunoregulatory characteristics of immune cells of children of allergic and non-allergic mothers and the possibility of their modulation with probiotic E. coli strain O83:K24:H31
Černý, Viktor ; Hrdý, Jiří (advisor) ; Tlaskalová - Hogenová, Helena (referee) ; Černá, Marie (referee)
Due to high incidence, medical and socioeconomic burden and impact on individual quality of life and productivity, allergic disorders are a crucial issue for 21st century immunology. Much still remains to be elucidated, particularly regarding the very early processes in allergy development. In order to introduce timely, effective preventive measures, novel, more reliable predictive factors of allergy risk also need to be established. Dysregulation of proper balance between the branches of immune response, particularly unwarranted dominance of Th2, is the underlying cause of allergy. After birth, new immune balance needs to be established to prepare the neonate for adequate reactivity towards newly encountered environmental stimuli. Regulatory T cells (Treg) play a central role in finely setting this balance and inducing tolerance towards harmless environmental antigens, including allergens. Interactions with external factors, most importantly microbiota, modulate this process during the early postnatal "window of opportunity." Analysis of cord blood Treg of children of allergic mothers uncovered decreased presence of function-associated surface markers and lower production of IL-10. Furthermore, decreased proportion of Helios- induced Treg was observed in children with higher risk of allergy....
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The expression profile of cardiovascular disease associated microRNAs in pregnancies with clinical manifestation of gestational hypertension, preeclampsia and intrauterine growth restriction
Bohatá, Jana ; Hromadníková, Ilona (advisor) ; Korabečná, Marie (referee)
MicroRNA (miRNA) are small non-coding 21-23 nucleotides long one strand RNAs. They are among the major posttranscriptional regulators of gene expression that regulate both physiological and pathological processes. Some of microRNAs, amount of their expression respectively, are specific only for certain type of tissue or pathological condition. The hypothesis for my diploma thesis was that gene expression of 28 cardiovascular disease associated microRNAs (miR-1-3p, miR-16-5p, miR-17-5p, miR- 20a-5p, miR-20b-5p, miR-21-5p, miR-23a-3p, miR-24-3p, miR-26a-5p, miR-29a-3p, miR-92a-3p, miR-100-5p, miR-103a-3p, miR-125b-5p, miR-126-3p, miR-130b-3p, miR-133a-3p, miR-143-3p, miR-145-5p, miR-146a-5p, miR-181-5p, miR-195-5p, miR- 199a-5p, miR-210-3p, miR-221-3p, miR-342-3p, miR-499a-5p, miR-574-3p) would differ in umbilical cord blood between groups of women with physiological pregnancies (FG), gestational hypertension (GH), preeclampsia (PE) and fetal growth restriciton (FGR). The studied cohort consisted of 184 pregnant women involving 44 controls, 47 GH pregnancies, 56 PE pregnancies and 37 FGR pregnancies. Relative quantification of microRNAs was performed by quantitative real-time PCR. Results showed a trend to miR-195-5p down-regulation in umbilical cord blood of GH patients. On the other hand, mild PE...
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Different capacity of in vitro generated monocyte-derived dendritic cells of newborns of healthy and allergic mothers to prime immune responses
Súkeníková, Lenka ; Hrdý, Jiří (advisor) ; Javorková, Eliška (referee)
(EN) Reduced microbial stimulation of an immature neonatal immune system can lead to a poor balance adjustment of immune responses, thus contributing to the development of allergic diseases, whose incidence continues to rise. One of the promising precautionary measures seems to be an early preventive administration of probiotic bacteria to pregnant or nursing mothers, or to newborns. Previous works have described a beneficial effect of Escherichia coli O83:K24:H31 (E. coli O83) in the prevention of allergic diseases. In order to contribute to the clarification of E. coli O83 effects on the neonatal immune system, its immune- modulating properties were tested in vitro on umbilical cord blood cells. The ability of E. coli O83 to support the maturation of in vitro-derived dendritic cells from cord blood precursors (moDCs) of the children of healthy (children with a relatively low risk of allergy) and allergic (children at a relatively high risk of developing allergies) mothers was tracked by flow cytometry, qPCR and ELISA. Probiotic bacteria-stimulated moDCs were subsequently cultured with autologous naive CD4+ T lymphocytes and immune response polarization was also characterised by flow cytometry, qPCR, and ELISA. It was evident from the results that E. coli O83 promoted moDCs maturation. The presence of...
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Different characteristics of cord blood cells of newborns of healthy and allergic mothers
Vlasáková, Kateřina ; Hrdý, Jiří (advisor) ; Hájková, Michaela (referee)
The prevalence of allergy is increasing and it is becoming a serious problem not on- ly in medicine, but also in social and economic terms. The most effective way to minimize the development of allergic diseases is preventive measures. In recent years, many studies have attempted to confirm or rebut the hypothesis that early administration of probiotic bacteria to newborns and pregnant women before birth could have preventive effects on the development of allergy. In the Czech Republic, the probiotic strain Escherichia coli O83:K24:H31 (EC O83), being registered with the State Health Institute for Drug Control under the name Colinfant Newborn, has long been used to prevent allergies and paediatri- cians have long been known and used it against various diarrhoea. The aim of this work was to elucidate the effect of EC O83 on CBMC (cord blood mononuclear cells) and to compare the ability of CBMC of healthy mothers (children with a relatively low risk of developing allergic disease) and allergic mothers (children at high risk of developing allergies) to form cytokines in response to EC O83 stimulation. Phytohemagglutinin was used as a positive control, Escherichia coli Nissle 1917 was used as a reference probiotic strain, which is much more known abroad than EC O83. Cytokine production was detected by...
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The role of neuroactive steroids in pregnancy and their importance in prenatal diagnosticsSteroidogenesis in the third trimester of pregnancy and mechanisms leading to the start of labor
Pašková, Andrea ; Pařízek, Antonín (advisor) ; Procházka, Martin (referee) ; Tošner, Jindřich (referee)
Steroid hormones act through two mechanisms. The first is the classical genomic level, which acts at a relatively slow pace from hours to days. The second non-genomic mechanism of steroid activity can influence cellular function during seconds or even milliseconds. During pregnancy both mechanisms take place. Steroid hormones that act non-genomically and influence neuronal excitability are called neuroactive steroids. The aim of this study was to measure the levels of steroid hormones and examine their relationship to the physiology and pathophysiology of pregnancy. The physiological importance of increased placental progesterone production, lowered production of 5B-pregnanone steroids and increased activity of steroid sulfotransferase with gestational age have been intensely discussed. On the basis of our results, we have proposed an alternative mechanism of maternal progesterone synthesis during pregnancy (progesterone, or the gestagen stabilizing activity of the myometrium = continuation of pregnancy). In contrast to previous results our observations indicate that gestagens arise from precursors in the fetus (from pregnenolone sulfate). This mechanism is closely connected with the distribution of placental oxido-reductase. Data from this study show an increasing trend in the conversion of...
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Immunologic Characteristics of Cord Blood in Children with Increased Risk of Allergy Development Preventive Use of Probiotics
Hrdý, Jiří ; Prokešová, Ludmila (advisor) ; Tlaskalová - Hogenová, Helena (referee) ; Ulčová-Gallová, Zdeňka (referee)
Allergy is one of the most common diseases. Identification of early prognostic markers pointing to an increased risk of allergy development is therefore of increasing importance. Cord blood represents an easily attainable clinical material for searching for prognostic markers signalizing future allergy development. Proportions of Th1 cytokines, Th2 cytokines and regulatory cytokines were tested in cord blood of children of allergic mothers (children in relatively high risk of allergy development) in comparison with cord blood of children of healthy mothers (low risk children). Also the activities of lymphocytes, dendritic cells (DC) and regulatory cells (Tregs) were compared in children of healthy and allergic mothers. The generally increased activity of both in vitro stimulated and non-stimulated mononuclear cord blood leukocytes was proved in children of allergic mothers in comparison with low risk children. The increased activity of DC of high risk children was detectable only after polyclonal stimulation. Significantly less pronounced functional properties of cord blood Tregs were found in children of allergic mothers when compared with children of healthy mothers. The increased reactivity of lymphocytes and DC together with the decreased activity of Tregs can support an easier...
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