Fetal life is characterized by the ability to respond to environmental factors. Nutrition is the most important environmental factor influencing development processes by regulating epigenetic mechanisms. Identifying the role of dietary factors that modulate and remodel the fetal epigenome during development, including the methyl-group donors, is of great importance. Epigenetics studies inherited changes in gene expression not related to modifications in the DNA sequence. Folate metabolism regulates the supply of methyl groups; therefore, eating disorders may influence regulation of epigenetic mechanisms. The crucial role of folate in cell division and homocysteine conversion has been conclusively demonstrated. Because epigenetic processes are one of the pathways in fetal programming, abnormal folate delivery may lead to fetal abnormalities and risk of chronic diseases in adulthood. The o...

Fetal life is characterized by the ability to respond to environmental factors. Nutrition is the most important environmental factor influencing development processes by regulating epigenetic mechanisms. Identifying the role of dietary factors that modulate and remodel the fetal epigenome during development, including the methyl-group donors, is of great importance. Epigenetics studies inherited changes in gene expression not related to modifications in the DNA sequence. Folate metabolism regulates the supply of methyl groups; therefore, eating disorders may influence regulation of epigenetic mechanisms. The crucial role of folate in cell division and homocysteine conversion has been conclusively demonstrated. Because epigenetic processes are one of the pathways in fetal programming, abnormal folate delivery may lead to fetal abnormalities and risk of chronic diseases in adulthood. The o...

Adequate nutritional status of women before, during and after pregnancy is essential to avoid both obstetric and perinatal complications. Micronutrients are essential for maternal and fetal development. Pregnancy has a special metabolic demand for high quality nutrients. In addition, adequate intake of vitamins, minerals and micronutrients can directly improve the quality of breast milk. Supplements can meet the increased demand for these elements during pregnancy and lactation, reducing the risk of fetal congenital anomalies, obstetric pathologies and development of chronic diseases in adulthood. However, there is conflicting information on the efficacy and safety of nutritional supplements during pregnancy. It is important that medical personnel can provide accurate and appropriate evidence-based advice on supplementation during pregnancy, as not all pregnant women need to use suppleme...

Vitamin D is currently under investigation in many fields of medicine. It is known to have fundamental functions in calcium metabolism and bone modeling. Vitamin D deficiency defined as 25-hydroxychalciferol concentration < 20 ng/mL and is frequently observed in patients with gynecological pathologies. In the last two decades there is evidence on the association of low serum vitamin D concentrations with disorders such as diabetes mellitus and metabolic syndrome. There are increasing reports of the impact of vitamin D metabolism on the development of disorders of the female reproductive system. Vitamin D receptor and 1α-hydroxylase are present in the reproductive organs, suggesting that vitamin D may have some effect in modulating cellular functions. The detrimental effects of deficiency have been shown in patients diagnosed with polycystic ovarian syndrome, endometriosis, and leiomy...

Objective: To compare the uterocervical angle with the cervical length in the prediction of impending preterm delivery in symptomatic patients. Design: Case-control study. Institution: Central Hospital “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Patients with preterm delivery within 7 days (group A) and pregnant women with preterm delivery beyond 7 days (group B). Methods: At the time of diagnosis, the patients were evaluated using transvaginal ultrasound and were followed until delivery. Main outcome measures: General characteristics, uterocervical angle, cervical length, impending preterm delivery, and prognostic efficacy. Results: 326 patients were included, 75 women presented impending preterm delivery (group A) and 251 patients were considered as controls (group B). The patients in group A had significantly higher values of the uterocervical angle and lower cervical le...

Objective: To compare the effectiveness of transcervical Foley catheter – oxytocin with oxytocin alone for labor induction in term pregnancies. Design: Case-control study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Pregnant women undergoing cervical ripening and labor induction were randomly assigned to be treated with transcervical Foley catheter – oxytocin (group A) or oxytocin alone (group B). Main outcome measures: General characteristics, interval between beginning of induction and delivery, vaginal birth rate, maternal complications, perinatal variables, and adverse effects were evaluated. Results: There were no significant differences between groups in general characteristics (p = ns). Patients of group A showed a shorter interval between the beginning of induction and delivery compared with patients in group B (p < 0.05). There was no ...

Objective: To compare pre and post-partum sexual hormones concentrations in preeclamptic patients and in healthy normotensive pregnant women. Design: Casecontrol study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Normotensive and preeclamptic pregnant women. Methods: A total of 142 patients were selected. Ninety preeclamptic patients were selected as the study group (group A) and 71 healthy normotensive pregnant women with similar age and weight were selected as controls (group B). Blood samples were extracted from all patients before labor and immediately after diagnosis in group A to determine sexual hormones concentrations. Post-partum follow-up samples were collected at 7 days and 6 weeks later in both groups. Main outcome measures: General characteristics, concentrations of total testosterone, free testosterone, dehydroepiandrosterone sulfate,...

Objective: To compare serum brain natriuretic peptide concentrations in preeclamptic patients and healthy normotensive pregnant women. Design: Case-control study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: A total of 180 patients were selected. Ninety preeclamptic patients were selected as the study group (group A) and 90 healthy normotensive pregnant women with the same age and body mass index as the study group were selected as controls (group B). Methods: Blood samples were extracted from all patients before labor and immediately after diagnosis in group A to determine serum cerebral natriuretic peptide concentrations. Main outcome results: General characteristics, serum brain natriuretic peptide concentrations and diagnostic efficacy. Results: There was a statistically significant difference in serum brain natriuretic peptide concentrations be...

Objective: To establish the usefulness of cervicovaginal interleukin-6 concentrations for the prediction of preterm delivery. Design: Case-control study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Patients with preterm delivery (group A), as cases, and pregnant women with term delivery (group B), considered as controls. Interventions: Cervicovaginal secretion samples were obtained from both the external cervical os and vaginal fornix between 24 and 28 weeks of pregnancy. All patients were followed until delivery. Main outcome results: General characteristics, cervicovaginal interleukin-6 concentrations, and prognostic efficacy. Results: Mean gestational age at measurement of interleukin-6 cervicovaginal concentrations was 26.2 +/- 1.1 weeks in group A and 25.9 +/- 1.1 weeks in group B (p = ns). There were no significant differences in maternal age...

Objective: To establish the usefulness of plasma concentrations of angiopoietin-2 in the second trimester of pregnancy as a predictor of the development of preeclampsia. Design: Case-control study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Nulliparous pregnant women. Interventions: 504 nulliparous women between 17-20 weeks pregnant who assisted to prenatal control were studied; 41 developed preeclampsia and were considered cases (group A) and 463 did not develop preeclampsia and were considered controls (group B). Main outcome measures: General characteristics, plasma angiopoietin-2 concentrations and prognosis efficacy. Results: There were no significant differences in maternal age, gestational age and systolic and diastolic blood pressure at the moment of ultrasound evaluation (p = ns). Gestational age at diagnosis of preeclampsia in group A wa...

Objective: To compare the uterocervical angle with the cervical length in the prediction of impending preterm delivery in symptomatic patients. Design: Case-control study. Institution: Central Hospital “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Patients with preterm delivery within 7 days (group A) and pregnant women with preterm delivery beyond 7 days (group B). Methods: At the time of diagnosis, the patients were evaluated using transvaginal ultrasound and were followed until delivery. Main outcome measures: General characteristics, uterocervical angle, cervical length, impending preterm delivery, and prognostic efficacy. Results: 326 patients were included, 75 women presented impending preterm delivery (group A) and 251 patients were considered as controls (group B). The patients in group A had significantly higher values of the uterocervical angle and lower cervical le...

Objective: To establish the usefulness of cervicovaginal interleukin-6 concentrations for the prediction of preterm delivery. Design: Case-control study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Patients with preterm delivery (group A), as cases, and pregnant women with term delivery (group B), considered as controls. Interventions: Cervicovaginal secretion samples were obtained from both the external cervical os and vaginal fornix between 24 and 28 weeks of pregnancy. All patients were followed until delivery. Main outcome results: General characteristics, cervicovaginal interleukin-6 concentrations, and prognostic efficacy. Results: Mean gestational age at measurement of interleukin-6 cervicovaginal concentrations was 26.2 +/- 1.1 weeks in group A and 25.9 +/- 1.1 weeks in group B (p = ns). There were no significant differences in maternal age...

Objective: To compare serum brain natriuretic peptide concentrations in preeclamptic patients and healthy normotensive pregnant women. Design: Case-control study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: A total of 180 patients were selected. Ninety preeclamptic patients were selected as the study group (group A) and 90 healthy normotensive pregnant women with the same age and body mass index as the study group were selected as controls (group B). Methods: Blood samples were extracted from all patients before labor and immediately after diagnosis in group A to determine serum cerebral natriuretic peptide concentrations. Main outcome results: General characteristics, serum brain natriuretic peptide concentrations and diagnostic efficacy. Results: There was a statistically significant difference in serum brain natriuretic peptide concentrations be...

Objective: To establish the usefulness of plasma concentrations of angiopoietin-2 in the second trimester of pregnancy as a predictor of the development of preeclampsia. Design: Case-control study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Nulliparous pregnant women. Interventions: 504 nulliparous women between 17-20 weeks pregnant who assisted to prenatal control were studied; 41 developed preeclampsia and were considered cases (group A) and 463 did not develop preeclampsia and were considered controls (group B). Main outcome measures: General characteristics, plasma angiopoietin-2 concentrations and prognosis efficacy. Results: There were no significant differences in maternal age, gestational age and systolic and diastolic blood pressure at the moment of ultrasound evaluation (p = ns). Gestational age at diagnosis of preeclampsia in group A wa...

Objective: To compare pre and post-partum sexual hormones concentrations in preeclamptic patients and in healthy normotensive pregnant women. Design: Casecontrol study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Normotensive and preeclamptic pregnant women. Methods: A total of 142 patients were selected. Ninety preeclamptic patients were selected as the study group (group A) and 71 healthy normotensive pregnant women with similar age and weight were selected as controls (group B). Blood samples were extracted from all patients before labor and immediately after diagnosis in group A to determine sexual hormones concentrations. Post-partum follow-up samples were collected at 7 days and 6 weeks later in both groups. Main outcome measures: General characteristics, concentrations of total testosterone, free testosterone, dehydroepiandrosterone sulfate,...

Objective: To compare the effectiveness of transcervical Foley catheter – oxytocin with oxytocin alone for labor induction in term pregnancies. Design: Case-control study. Setting: Hospital Central “Dr. Urquinaona”, Maracaibo, Venezuela. Participants: Pregnant women undergoing cervical ripening and labor induction were randomly assigned to be treated with transcervical Foley catheter – oxytocin (group A) or oxytocin alone (group B). Main outcome measures: General characteristics, interval between beginning of induction and delivery, vaginal birth rate, maternal complications, perinatal variables, and adverse effects were evaluated. Results: There were no significant differences between groups in general characteristics (p = ns). Patients of group A showed a shorter interval between the beginning of induction and delivery compared with patients in group B (p < 0.05). There was ...

Objective: To establish the usefulness of red cell distribution width in the second trimester of pregnancy as a predictor of the development of preeclampsia. Design: Case-control study. Institution: Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela. Participants: Pregnant women between 17 and 20 weeks who attended prenatal consultation and were followed up until to term. Methods: Blood samples were taken and followed up until delivery to establish if they developed preeclampsia. Main outcome measures: General characteristics, values of red cell distribution width and prognostic efficacy. Results: Cases were 41 pregnant women who developed preeclampsia (group A) and 463 pregnant women were considered as controls (group B). No statistically significant differences were found in maternal age, gestational age, and systolic and diastolic blood pressure at the time of ultrasound (p = ns)...

Objective: To establish the usefulness of leukocyte count and neutrophil/lymphocyte ratio in the second trimester of pregnancy as a predictor of the development of preeclampsia. Design: Case-control study. Institution: Hospital Central "Dr. Urquinaona", Venezuela. Participants: Pregnant women between 17 and 20 weeks who attended prenatal consultation and were followed up to term. Methods: Blood samples were taken from the pregnant women who were followed until delivery to establish whether they developed preeclampsia. Main outcome measures: General characteristics of the patients, values of leukocytes, neutrophils, lymphocytes, neutrophil/lymphocyte ratio and prognostic efficacy. Results: Of the 504 patients selected, 41 pregnant women developed preeclampsia (group A) and 463 pregnant women were considered as controls (group B). No statistically significant differences were found in over...

Objective: To establish the usefulness of cervical vascularization indices in theprediction of impending preterm labor. Design: Case-control study. Institution:"Dr. Urquinaona" Central Hospital, Maracaibo, Venezuela. Participants: Patientswith preterm delivery within 7 days (group A) and pregnant women with pretermdelivery beyond 7 days (group B). Methods: Pregnant women were evaluated usingtransvaginal ultrasound and followed until delivery. Main outcome measures:General characteristics, cervical vascularity indices (vascularity index, flow indexand vascularity / flow index), impending preterm delivery, and prognostic efficacy.Results: A total of 350 patients were included, 75 women presented imminentpreterm labor (group A) and 251 patients were considered as controls (group B).Patients in group A had significantly lower values of vascularization index and flowindex compared to group B ...

Objective: To establish the usefulness of fetal cerebellar transverse diametermeasurement for the prediction of gestational age. Design: Prospective, longitudinal,cohort study. Institution: Hospital Central "Dr. Urquinaona", Maracaibo, Venezuela.Participants: Women with low-risk singleton pregnancies, between 14 and 40weeks of gestation. Methods: Biparietal diameter, abdominal circumference, femurlength, and transverse diameter of the fetal cerebellum were measured during theduration of pregnancy. Main outcome measures: Prediction of gestational age bymeasurement of the transverse diameter of the cerebellum. Results: Data from 215pregnant women were selected. A total of 3,858 total evaluations were performed,with the lowest number of evaluations 131 at 18 weeks and the highest number 157at 28 weeks. The transverse diameter of the cerebellum presented strong, positive,and significant corr...