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Historically, studies on the endocrinology of pregnancy and parturition in horses have made major contributions of relevance to mammals in general. Recent use of liquid chromatography mass spectrometry, measuring multiple steroid hormones simultaneously in blood, foetal and placental tissues throughout normal gestation, and in mares with experimentally induced placentitis, has advanced our current understanding of many of the unusual strategies seen during gestation and at foaling. This includes the stimulation of luteal steroidogeneisis by equine chorionic gonadotropin (eCG) from the endometrial cups, resulting in additional androgen and oestrogen secretion. Progesterone declines as the endometrial cups and eCG disappears, replaced by 5α-dihydroprogesterone (DHP), a potent equine progesterone receptor (PR) agonist, as the chorioallantoic placenta develops. Placental steroidogenesis thereafter is influenced by foetal pregnenolone and dehydroepiandrosterone secretion, providing substrate for 5α-pregnane and oestrogen synthesis, an unusual example of a 'foeto-placental unit'. Foetal gonadal dehydroepiandrosterone fuels placental oestrone sulphate secretion, peaking at higher concentrations in mares than any other species known, declining steadily thereafter to term. Additional 5α-reduced (DHP) metabolites increase from mid-gestation to peak concentrations 3-5 days before foaling, declining prepartum, most likely as a result of selective loss of placental SRD5A1 (5α-reductase) expression and activity. Similar changes occur in mares with experimentally induced placentitis, which is also associated with a decreased ratio of equine PR-B:PR-A in myometrium, suggesting that progestin withdrawal is both systemic (pregnanes) and local (receptor-dependent) in mares. In addition, some steroids detected during equine pregnancy by immuno-assay are not detected by mass spectrometry, further illustrating the immense value of this technology.
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http://dx.doi.org/10.1530/REP-19-0179 | DOI Listing |
BJOG
September 2025
Department of Obstetrics and Gynaecology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Objective: To estimate the effect on healthcare resource use after introducing the World Health Organization diagnostic criteria (WHO-2013) for gestational diabetes mellitus (GDM) compared to former criteria in Sweden (SWE-GDM).
Design: A cost-analysis alongside the Changing Diagnostic Criteria for Gestational Diabetes (CDC4G) randomised controlled trial.
Setting: Sweden, with risk-factor based screening for GDM.
Cien Saude Colet
August 2025
Universidade Federal do Maranhão. Imperatriz MA Brasil.
The purpose of this study was to analyze the social representations attributed by postpartum women regarding obstetric violence in childbirth and birth settings. This qualitative study is grounded in Social Representations Theory and involved postpartum women attending a university hospital. Data were collected through free associations to the trigger term "obstetric violence" organized using IRaMuTeQ software.
View Article and Find Full Text PDFA A Pract
September 2025
Department of Anesthesiology, Ospedale San Giovanni, Ente Ospedaliero Cantonale, Bellinzona, Switzerland.
Childbirth-Related Posttraumatic Stress Disorder (CB-PTSD) can arise even after low-risk deliveries. This case report describes a 35-year-old woman who, despite a medically uncomplicated vaginal birth, developed severe CB-PTSD after being denied neuraxial analgesia and receiving remifentanil-PCA (remi-PCA) to manage pain. Her distress stemmed from inadequate pain relief, dissociation, and loss of control, exacerbated by unmet expectations for epidural analgesia.
View Article and Find Full Text PDFNurs Health Sci
September 2025
Department of Midwifery, Health Sciences Faculty, Istanbul University-Cerrahpasa, Istanbul, Türkiye.
Understanding how women describe their birth experiences through metaphors can help healthcare teams improve their communication, emotional support, and care delivery. This study examined how first-time mothers' birth metaphors evolved over time. This prospective qualitative study used a phenomenological approach with semistructured in-depth interviews of 50 primiparous women who gave birth in Konya between March and July 2024.
View Article and Find Full Text PDFActa Obstet Gynecol Scand
September 2025
Unit of Gynecological Oncology, Department of Oncology, KU Leuven, Leuven, Belgium.
Introduction: Vulvovaginal cancer in pregnancy is rare. Limited data complicate decision-making and patient counseling. Our review, coupled with new case data, fills a current gap in the literature and provides practical insights.
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