Hyperphagia during pregnancy, despite rising concentrations of the satiety hormone leptin, suggests that a state of leptin resistance develops. This study investigated the satiety response and hypothalamic responses to leptin during pregnancy in the mouse. Pregnant (day 13) and nonpregnant mice received an i.p. injection of either leptin or vehicle and then 24-h food intake was measured. Further groups of pregnant and nonpregnant mice were perfused 2 h after leptin or vehicle injections and brains were processed for pSTAT3 and pSTAT5 immunohistochemistry. Leptin treatment significantly decreased food intake in nonpregnant mice. In pregnant mice, however, leptin treatment did not suppress food intake, indicating a state of leptin resistance. In the arcuate nucleus, leptin treatment increased the number of cells positive for pSTAT3, a marker of leptin activity, to a similar degree in both nonpregnant and pregnant mice. In the ventromedial nucleus (VMN), the leptin-induced increase in pSTAT3-positive cell number was significantly reduced in pregnant mice compared to that in nonpregnant mice. In nonpregnant mice, leptin treatment had no effect on the number of pSTAT5-positive cells, suggesting that in this animal model, leptin does not act through STAT5. In pregnant mice, basal levels of pSTAT5 were higher than in nonpregnant mice, and leptin treatment led to a decrease in the number of pSTAT5-positive cells in the hypothalamus. Overall, these results demonstrate that during pregnancy in the mouse, a state of leptin resistance develops, and this is associated with a reduced sensitivity of the VMN to leptin.Reproduction (2012) 144 83-90
General practitioners in NZ are not providing optimal preconception care. This research highlights the need for a public health message encouraging preconception counselling and better education of GPs on the topic. This should start with promotion of the Ministry of Health guidance.
Induction of labour using a balloon catheter is common practice throughout the world, often used in high-risk pregnancies due to the improved safety profile for the fetus compared with pharmacological methods. This report outlines the case of a 2500 mL antepartum haemorrhage on placement of a Foley catheter through the cervix at a secondary obstetric unit in New Zealand. An emergency caesarean section was carried out 20 min after the bleeding onset. No obvious cause for the bleeding was identified at caesarean. The mother required a blood transfusion, but otherwise, did well clinically; the infant required resuscitation at birth and went on to suffer a left middle cerebral artery stroke. At 6 months, he is assumed to have recovered with no long-term sequelae. A literature review has highlighted this was an unprecedented event. We hope to raise awareness of this rare catastrophic adverse outcome given the prevalence of balloon catheter induction.
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