Research Interests:
Research Interests:
Research Interests:
Research Interests:
s / Placenta 35 (2014) A1eA112 A85 P2.74. PLACENTAL PROTEIN 13 (PP13) SHOWS BENEFICIAL EFFECTS ON THE MATERNAL VASCULATURE IN PREGNANT RATS: POTENTIAL BENEFITS IN PREECLAMPSIA AND IUGR Sveinbjorn Gizurarson , Hamutal Meiri , Berthold... more
s / Placenta 35 (2014) A1eA112 A85 P2.74. PLACENTAL PROTEIN 13 (PP13) SHOWS BENEFICIAL EFFECTS ON THE MATERNAL VASCULATURE IN PREGNANT RATS: POTENTIAL BENEFITS IN PREECLAMPSIA AND IUGR Sveinbjorn Gizurarson , Hamutal Meiri , Berthold Huppertz , Marei Sammar , George Osol e University of Iceland, Reykjavik, Iceland; b Telemarpe Ltd, Tel Aviv, Israel; Medical University of Graz, Graz, Austria; ORT Braude College, Karmiel, Israel; University of Vermont, Burlington,
Research Interests:
Research Interests: Genetics, Medicine, Pregnancy, Placenta, Preeclampsia, and 3 moreMolecular sciences, Fetus, and Gestation
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests: Obstetrics, Medicine, Humans, Female, Index, and 15 moreLogistic Regression Analysis, Gynecology, Adult, Biological markers, Gestational Age, First Trimester, Case Control Study, Gestation, Area Under the Curve, Enzyme Linked Immunosorbent Assay, Case Control Studies, Arteries, Eclampsia, Galectins, and Paediatrics and reproductive medicine
Introduction: Preeclampsia (PE) is a major obstetric complication affecting 3-5% of pregnancies and a major contributor to fetal and maternal morbidity and mortality. The level of placental growth factor (PLGF) >150pg/ml in the third... more
Introduction: Preeclampsia (PE) is a major obstetric complication affecting 3-5% of pregnancies and a major contributor to fetal and maternal morbidity and mortality. The level of placental growth factor (PLGF) >150pg/ml in the third trimester was reported to predict PE occurrence within the next 14 days. Aims: We have conducted a preliminary study among pregnant Israeli women in order to evaluate whether maternal serum PLGF test at admission with suspected PE could rule-out the risk for developing PE. Methods: We prospectively enrolled pregnant women who were admitted to the high-risk pregnancy department at Shamir Medical Center with suspected PE. The women signed an informed consent form and blood samples were drawn, separated into serum, and taken for PLGF immuno-diagnostic test. All women with suspected PE were managed according to local protocol. The medical staff was blinded regarding PLGF results. All patients' computerized medical records, including developing of PE within 14 days and patients' computerized medical records were collected and a telephone interview was held to verify whether post charging events occurred. Results: Of the 29 women who were enrolled in the study, the group with PLGF<150 pg/ml included 19 women, who had mean PLGF=44.7pg/ml [(95%CI: 6.5-95.3], of which 14 developed PE (positive predictive value 73.7%). There were ten women in the PLGF>150pg/ml group, with mean PLGF=528.7 pg/ml [(95% CI:168-1300, P<0.001)] of which one developed PE (negative predictive value 90%). The sensitivity for ruling out PE by PLGF>150pg/ml was 93%, and the specificity=64.3. Conclusions: Incorporating blood testing of PLGF into the evaluation triage of pregnant women in Israel who admitted to the delivery clinic with suspected development of PE has generated high efficacy and negative predictive value (NPV) as was previously published Our findings are in accordance with results reported elsewhere but need validation in Israel with larger studies. Discussion: Assuming that at least 7% of ~184,450 (2018) live births in Israel are admitted to the high risk departments for evaluating suspected PE, implementing a PLGF test has a cost-benefit ratio of ~1/8.28 with a cost of NIS 2.52M for test performance of all women attending the delivery clinic with suspected PE over saving NIS 21.37M on unnecessary hospital days.
Research Interests:
ABSTRACTObjectiveTo evaluate the accuracy of predicting the risk of developing pre‐eclampsia (PE) according to first‐trimester maternal demographic characteristics, medical history and biomarkers using artificial‐intelligence and... more
ABSTRACTObjectiveTo evaluate the accuracy of predicting the risk of developing pre‐eclampsia (PE) according to first‐trimester maternal demographic characteristics, medical history and biomarkers using artificial‐intelligence and machine‐learning methods.MethodsThe data were derived from prospective non‐interventional screening for PE at 11–13 weeks' gestation at two maternity hospitals in the UK. The data were divided into three subsets. The first set, including 30 437 subjects, was used to develop the training process, the second set of 10 000 subjects was utilized to optimize the machine‐learning hyperparameters and the third set of 20 352 subjects was coded and used for model validation. An artificial neural network was used to predict from the demographic characteristics and medical history the prior risk that was then combined with biomarker values to determine the risk of PE and preterm PE with delivery at &lt; 37 weeks' gestation. An additional network was trained without including race as input. Biomarkers included uterine artery pulsatility index (UtA‐PI), mean arterial blood pressure (MAP), placental growth factor (PlGF) and pregnancy‐associated plasma protein‐A. All markers were entered using raw values without conversion into standardized multiples of the median. The prediction accuracy was estimated using the area under the receiver‐operating‐characteristics curve (AUC). We further computed the detection rate at 10%, 20% and 40% false‐positive rates (FPR). The impact of taking aspirin was also added. Shapley values were calculated to evaluate the contribution of each parameter to the prediction of risk. We used a non‐parametric test to compare the expected AUC with the one obtained when we randomly scrambled the labels and kept the predictions. For the general prediction, we performed 10 000 permutations of the labels. When the AUC was higher than the one obtained in all 10 000 permutations, we reported a P‐value of &lt; 0.0001. For the race‐specific analysis, we performed 1000 permutations. When the AUC was higher than the AUC in permutations, we reported a P‐value of &lt; 0.001.ResultsThe detection rate for preterm PE vs no PE, at a 10% FPR, was 53.3% when screening by maternal factors only, and the corresponding AUC was 0.816; these increased to 75.3% and 0.909, respectively, with the addition of biomarkers into the model. Information on race was important for the prediction accuracy; when race was not used to train the model, at a 10% FPR, the detection rate of preterm PE vs no PE decreased to 34.5–45.5% (for different races) when screening by maternal factors only and to 55.0–62.1% when biomarkers were added. The major predictors of PE were high MAP and UtA‐PI, and low PlGF. The accuracy of prediction of all PE cases was lower than that for preterm PE. Aspirin use was recommended for cases who were at high risk of preterm PE. The AUC of all PE vs no PE was 0.770 when screening by maternal factors and 0.817 when the biomarkers were added; the respective detection rates, at a 10% FPR, were 41.3% and 52.9%.ConclusionsScreening for PE using a non‐linear machine‐learning‐based approach does not require a population‐based normalization, and its performance is similar to that of logistic regression. Removing race information from the model reduces its prediction accuracy, especially for the non‐white populations when only maternal factors are considered. © 2022 International Society of Ultrasound in Obstetrics and Gynecology.
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests: Obstetrics, Medicine, Pregnancy, Humans, Preeclampsia, and 15 moreFemale, American, High risk pregnancy, Adult, Biological markers, Gestational Age, Gestation, Area Under Curve, Predictive value of tests, Prenatal Care, Pregnancy Outcome, Case Control Studies, Pre Eclampsia, High risk, and Paediatrics and reproductive medicine
Research Interests:
Research Interests:
Research Interests:
Research Interests:
Research Interests: Medicine and Gynecology
Research Interests:
Research Interests:
Research Interests:
Research Interests: Biophysics, Chemistry, Medicine, Multidisciplinary, Ion Channels, and 15 moreAnimals, Leakage Current, EELS, Monoclonal Antibodies, Potassium, Fluorescent Antibody Technique, Rats, Sodium, Sodium channel, Sciatic Nerve, Monoclonal Antibody, Membrane Potential, Action Potentials, In Vitro Techniques, and Nerve fibers
Research Interests:
Research Interests:
Research Interests: Obstetrics, Medicine, Pregnancy, Humans, Placenta, and 15 morePreeclampsia, Female, HELLP Syndrome, Clinical Sciences, Newborn Infant, Adult, Fetus, Umbilical Cord, Body Fluids, Preterm Delivery, Premature Birth, Case Control Studies, Pre Eclampsia, Galectins, and Paediatrics and reproductive medicine
Monoclonal antibodies were generated against native eel electroplax sodium channels in their natural membrane. These antibodies block nerve conduction in rat central (optic) and peripheral (sciatic) nerve. The antibody binding to eel... more
Monoclonal antibodies were generated against native eel electroplax sodium channels in their natural membrane. These antibodies block nerve conduction in rat central (optic) and peripheral (sciatic) nerve. The antibody binding to eel electroplax membrane fragments and to rat brain synaptosomes can be modulated by neurotoxins. Thus it implies that active sites of the sodium channels are immunogenic in their natural membrane. Unlike the antibodies described in the past, our antibodies recognize antigenic determinants which are associated with the physiological activity of the channel and have been conserved through evolution.
Research Interests:
Research Interests: Genetics, Obstetrics, Medicine, Birth Weight, Complication, and 15 moreHumans, Low Birth Weight, Female, Clinical Sciences, Newborn Infant, Gynecology, Adult, Biological markers, Gestational Age, Gestation, Fetal death, Intrauterine Growth Restriction, Case Control Studies, Galectins, and Fetal Growth Retardation
Research Interests: Endocrinology, Andrology, Biology, Escherichia coli, Female, and 15 moreAnimals, Amniotic Fluid, Clinical Sciences, Fetal Growth Restriction, Gestational Age, Amino Acid Sequence, Base Sequence, Gestation, Body Fluids, Enzyme Linked Immunosorbent Assay, Arachidonic Acid, Full Length Movies, Dynamic Range, Galectins, and Fetal Growth Retardation
Research Interests: Obstetrics, Medicine, Prospective studies, Pregnancy, Humans, and 15 morePlacenta, Preeclampsia, Female, Adult, Gestational Age, Gestation, Enzyme Linked Immunosorbent Assay, Predictive value of tests, Intrauterine Growth Restriction, Case Control Studies, Pre Eclampsia, Galectins, Paediatrics and reproductive medicine, Fetal Growth Retardation, and Obstetric Labor Premature
Research Interests: Obstetrics, Incidence Geometry, Medicine, Pregnancy, Humans, and 15 moreHypertension, Placebo, Preeclampsia, Female, Incidence, High risk pregnancy, Aspirin, Newborn Infant, Adult, New England Journalof Medicine, Pre Eclampsia, Eclampsia, Medical and Health Sciences, Paediatrics and reproductive medicine, and Intention to treat analysis
Research Interests: Obstetrics and Medicine
Research Interests:
link_to_subscribed_fulltex
Research Interests:
Objective—the objective of this study was to assess the accuracy of placental growth factor (PlGF), soluble Fms-like Tyrosine Kinase 1 (sFlt-1), and endoglin (sEng) in the diagnosis of suspected preeclampsia (PE) with and without fetal... more
Objective—the objective of this study was to assess the accuracy of placental growth factor (PlGF), soluble Fms-like Tyrosine Kinase 1 (sFlt-1), and endoglin (sEng) in the diagnosis of suspected preeclampsia (PE) with and without fetal growth restriction (FGR) near delivery. Methods—this is a secondary analysis of a dataset of 125 pregnant women presenting at the high risk pregnancy clinic with suspected PE, FGR or PE + FGR in the University Medical Center of Slovenia. The dataset included 31 PE cases, 16 FGR cases, 42 PE + FGR cases, 15 cases who developed with unrelated complications before 37 weeks (wks) (PTD), and 21 unaffected controls who delivered a healthy baby at term. We also analyzed a sub-group of women who delivered early ( 90%. For PE + FGR, the PPV value approached 100%, especially for early cases, and can thus be implemented in clinical management. Neither NPV nor PPV were high enough for managing all cases of PE. There was no added value in measuring the PlGF/(sFlt-...
Research Interests:
Research Interests:
OBJECTIVE We examined the potential value of combining ultrasound and non-invasive prenatal screening (NIPS) of maternal blood to screen for major aneuploidies as an early approach before selective fetal reduction from twin pregnancy to... more
OBJECTIVE We examined the potential value of combining ultrasound and non-invasive prenatal screening (NIPS) of maternal blood to screen for major aneuploidies as an early approach before selective fetal reduction from twin pregnancy to singleton. STUDY DESIGN The sample was composed of pregnant women with di-chorionic di-amniotic twins who chose to undergo fetal reduction to singleton at 12-24 weeks of gestation. These women were asked to provide a blood sample for cell-free fetal DNA (cffDNA) testing prior to fetal reduction. RESULTS A total of 24 pregnant women with a twin pregnancy prior to fetal reduction to singleton were enrolled. There were 8 cases with structural anomalies (33.3%) in one twin that dictated fetal reduction. The proportion of patients who underwent selective fetal reduction for fetal abnormalities was larger than in several other studies. The NIPS identified 1 case of Trisomy 13 (4.2%). The other 15 cases (62.5%) had no structural or chromosomal anomalies. The decision to undergo elective reduction of twin pregnancy to singleton was made for social reasons or upon the parents' request. Given the 33% of structural anomalies in the cohort, a cost analysis indicated that this procedure was 6.6-fold less expensive (vs. 4.6-fold with 4% structural anomalies in other publications) than conducting invasive procedures for the entire cohort. CONCLUSION The findings suggest that an early anatomical scan and cffDNA can increase the overall safety margin and reduce interventional procedures before elective reduction of twin pregnancy to singleton. However, a larger cohort is needed to confirm these results.
Research Interests:
Research Interests:
Research Interests:
ABSTRACT