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Book: Microbicides in obstetrics and gynaecology

Moodley, Jagidesa

(Best practice & research : Clinical obstetrics and gynaecology ; 26,4)

2012

Author's details	Jagidesa Moodley, guest ed
Series title	Best practice & research : Clinical obstetrics and gynaecology ; 26,4 Best practice & research Best practice & research ; Clinical obstetrics and gynaecology
Collection	Best practice & research Best practice & research ; Clinical obstetrics and gynaecology
Language	English
Size	S. 425 - 513, A13 S. : Ill., graph. Darst.
Publisher	Elsevier
Publishing place	Amsterdam u.a.
Publishing country	Netherlands
Document type	Book
HBZ-ID	HT017399407
Database	Catalogue ZB MED Medicine, Health

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Book: HIV in obstetrics & gynaecology

Moodley, Jagidesa

(Best practice & research : Clinical obstetrics and gynaecology ; 19,2)

2005

Author's details	J. Moodley, guest ed
Series title	Best practice & research : Clinical obstetrics and gynaecology ; 19,2 Best practice & research Best practice & research ; Clinical obstetrics and gynaecology
Collection	Best practice & research Best practice & research ; Clinical obstetrics and gynaecology
Language	English
Size	S. 167 - 291, A22 S.
Publisher	Elsevier
Publishing place	Amsterdam
Publishing country	Netherlands
Document type	Book
HBZ-ID	HT014357389
Database	Catalogue ZB MED Medicine, Health

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Article ; Online: Preventing maternal morbidity and mortality from preeclampsia and eclampsia particularly in low- and middle-income countries.

Ngene, Nnabuike Chibuoke / Moodley, Jagidesa

Best practice & research. Clinical obstetrics & gynaecology

2024 Volume 94, Page(s) 102473

Abstract: Preeclampsia (PE) is a complex heterogeneous disorder with overlapping clinical phenotypes that complicate diagnosis and management. Although several pathophysiological mechanisms have been proposed, placental dysfunction due to inadequate remodelling of ...

Abstract	Preeclampsia (PE) is a complex heterogeneous disorder with overlapping clinical phenotypes that complicate diagnosis and management. Although several pathophysiological mechanisms have been proposed, placental dysfunction due to inadequate remodelling of uterine spiral arteries leading to mal-perfusion and syncytiotrophoblast stress is recognized as the unifying characteristic of early-onset PE. Placental overgrowth and or premature senescence are probably the causes of late-onset PE. The frequency of PE has increased over the last few decades due to population-wide increases in risk factors viz. obesity, diabetes, multifetal pregnancies and pregnancies at an advanced maternal age. Whilst multimodal tools with components comprising risk factors, biomarkers and sonography are used for predicting PE, aspirin is most effective in preventing early-onset PE. The incidence and clinical consequences of PE and eclampsia are influenced by socioeconomic and cultural factors, therefore management strategies should involve multi-sector partnerships to mitigate the adverse outcomes.
Language	English
Publishing date	2024-02-15
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	2050090-7
ISSN	1532-1932 ; 1521-6934
ISSN (online)	1532-1932
ISSN	1521-6934
DOI	10.1016/j.bpobgyn.2024.102473
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Article: A retrospective identification of risk factors associated with fetal macrosomia.

Moodley, Terence / Moodley, Jagidesa

African journal of reproductive health

2023 Volume 26, Issue 7, Page(s) 127–134

Abstract: Despite extensive work on macrosomia, it is impossible to predict women at risk. Current prediction strategies which include clinical examination and ultrasound are imprecise. This study aims to determine the risk factors associated with macrosomia. It ... ...

Abstract	Despite extensive work on macrosomia, it is impossible to predict women at risk. Current prediction strategies which include clinical examination and ultrasound are imprecise. This study aims to determine the risk factors associated with macrosomia. It was a descriptive, retrospective chart review of women delivered of macrosomic neonates over a two-year period from 2015-2016. Detailed clinical and demographic information was recorded. Statistical analysis was carried out using SPSS (version 25.0 IBM, Armonk, New York, USA). Of 22 244 singleton deliveries, 415 were macrosomic infants (1.9%). The mean birth weight for macrosomic infants was 4.39 ± 0.43 (range 4-5.15) kg and males were more in number and weight. Macrosomic infants occurred more in age groups 25-29 years and peaked with BMI ≥30 kg/m2. Majority were cesarean sections compared to vaginal deliveries (56.6% vs 43.4%; p=0.006) respectively. Vaginal delivery of macrosomic infants was associated with complications. Significant differences were found between fetal macrosomia and clinical characteristics such as body mass index, parity, advanced maternal age, and male fetal sex. Hypoglycaemia was most frequent in infants born to non-diabetic mothers (98.1%). Antenatal risk factors are important in the prediction of macrosomia, but fetal and maternal outcome depends on labour management.
MeSH term(s)	Infant, Newborn ; Infant ; Pregnancy ; Female ; Male ; Humans ; Adult ; Fetal Macrosomia/epidemiology ; Fetal Macrosomia/complications ; Retrospective Studies ; Birth Weight ; Risk Factors ; Parity
Language	English
Publishing date	2023-08-16
Publishing country	Nigeria
Document type	Journal Article
ZDB-ID	2111906-5
ISSN	1118-4841
ISSN	1118-4841
DOI	10.29063/ajrh2022/v26i7.13
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Article ; Online: COVID-19 death: A novel method of improving its identification when a patient has multiple diagnoses.

Ngene, Nnabuike C / Moodley, Jagidesa

Southern African journal of infectious diseases

2022 Volume 37, Issue 1, Page(s) 349

Abstract: Assigning a primary cause of death to a deceased patient who had multiple principal diagnoses including coronavirus disease 2019 (COVID-19) is challenging because of the difficulty in selecting the most appropriate cause. To proffer a solution, the ... ...

Abstract	Assigning a primary cause of death to a deceased patient who had multiple principal diagnoses including coronavirus disease 2019 (COVID-19) is challenging because of the difficulty in selecting the most appropriate cause. To proffer a solution, the authors reviewed the literature on assigning a primary cause of death. In 2015, the Nnabuike-Jagidesa (NJ) model II was devised to improve the International Classification of Diseases and related health problems, 10th revision (ICD-10) guideline on how to assign a primary cause of death. The NJ model II stipulates that when there are multiple diagnoses with no plausible explanation that one of the illnesses could have resulted in the other clinical conditions, the single most appropriate primary cause of death is the condition with the highest case fatality ratio in that setting. In the index report, the authors opine that if the case fatality ratios are similar, the following objective criteria (listed in the order of priority) should be used to assign a primary cause of death: condition with the highest infection fatality ratio, condition that was the main indication for the last acute surgical or invasive procedure performed (during the course of the same ill-health) before the death and the disease that theoretically affects the highest number of body organs. Additionally, a clinical descriptor should be used when none of the objective criteria are satisfied. This novel approach, termed the
Language	English
Publishing date	2022-04-26
Publishing country	South Africa
Document type	Journal Article
ZDB-ID	3046282-4
ISSN	2313-1810 ; 2312-0053
ISSN (online)	2313-1810
ISSN	2312-0053
DOI	10.4102/sajid.v37i1.349
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Article ; Online: Fatal pulmonary oedema associated with severe pre-eclampsia: challenges and lessons.

Ngene, Nnabuike Chibuoke / Moodley, Jagidesa

Cardiovascular journal of Africa

2022 Volume 33, Issue 5, Page(s) 273–276

Abstract: Pre-eclampsia complicated by pulmonary oedema, severe hypertension, tachycardia and desaturation is a devastating condition. A comprehensive understanding of the aetiopathogenesis during such an emergency is challenging in the absence of functional and ... ...

Abstract	Pre-eclampsia complicated by pulmonary oedema, severe hypertension, tachycardia and desaturation is a devastating condition. A comprehensive understanding of the aetiopathogenesis during such an emergency is challenging in the absence of functional and responsive point-of-care imaging, and laboratory and other critical-care services. An unbooked 26-year-old gravida 3 para 1+1 presented to a primary healthcare clinic with features of pre-eclampsia, severe hypertension and pulmonary oedema. The only available antihypertensive drug, methyldopa, was administered. The patient was transferred to a district hospital and subsequently referred to a tertiary hospital. On arrival, she was booked for caesarean delivery and in the maternity ward a central venous pressure (CVP) line was inserted. The patient developed pneumothorax and died in the intensive care unit undelivered. This case highlights many lessons, which are discussed. If CVP monitoring is indicated before caesarean delivery, consideration must be given to line insertion in the operating room to facilitate rapid delivery should the patient's condition deteriorate.
MeSH term(s)	Female ; Pregnancy ; Humans ; Adult ; Pre-Eclampsia/diagnosis ; Pre-Eclampsia/drug therapy ; Pulmonary Edema/diagnostic imaging ; Pulmonary Edema/etiology ; Antihypertensive Agents/therapeutic use ; Methyldopa ; Hypertension/drug therapy
Chemical Substances	Antihypertensive Agents ; Methyldopa (56LH93261Y)
Language	English
Publishing date	2022-02-17
Publishing country	South Africa
Document type	Case Reports
ZDB-ID	2383233-2
ISSN	1680-0745 ; 1996-3467 ; 1015-9657 ; 1995-1892
ISSN (online)	1680-0745 ; 1996-3467
ISSN	1015-9657 ; 1995-1892
DOI	10.5830/CVJA-2021-064
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Article: Inequality in health care services in urban and rural settings in South Africa.

Ngene, Nnabuike C / Khaliq, Olive P / Moodley, Jagidesa

African journal of reproductive health

2023 Volume 27, Issue 5s, Page(s) 87–95

Abstract: In low- and middle-income countries, urban and rural settings are distinct communities with the latter being more likely to have limited resources, particularly in health care services. We assessed the inequality in health care services in urban and ... ...

Abstract	In low- and middle-income countries, urban and rural settings are distinct communities with the latter being more likely to have limited resources, particularly in health care services. We assessed the inequality in health care services in urban and rural settings in South Africa, highlighting the disparities between public and private health services, given that the latter are located mainly in urban settings. Rural settings suffer the highest inequality in the availability of drugs and supplies, overcrowding of health care facilities, delays in transporting patients, inadequate emergency medical services, and lack of experienced health care professionals. Rural settings also preferentially have a shortage of various levels of health care services, and increased security threats by criminals. In addition to specific remedies, the overarching key to solving these challenges is socio-economic growth, as well as visionary and compassionate leadership with integrity and accountability, which ensures policy development, implementation, monitoring, and evaluation.
MeSH term(s)	Humans ; South Africa ; Health Services ; Health Services Accessibility ; Health Facilities ; Rural Health Services
Language	English
Publishing date	2023-08-16
Publishing country	Nigeria
Document type	Journal Article ; Review
ZDB-ID	2111906-5
ISSN	1118-4841
ISSN	1118-4841
DOI	10.29063/ajrh2023/v27i5s.11
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Article ; Online: The role and expression of pro/antiangiogenic factors and microRNAs in gestational hypertension and pre-eclampsia.

Soobryan, Nerolen / Kumar, Ajit / Moodley, Jagidesa / Mackraj, Irene

European journal of obstetrics, gynecology, and reproductive biology

2023 Volume 290, Page(s) 38–42

Abstract: Objective: Pre-eclampsia and gestational hypertension are two common hypertensive disorders of pregnancy with pre-eclampsia accounting for high foetal and maternal morbidity and mortality rate. These disorders have an unknown aetiology and their ... ...

Abstract	Objective: Pre-eclampsia and gestational hypertension are two common hypertensive disorders of pregnancy with pre-eclampsia accounting for high foetal and maternal morbidity and mortality rate. These disorders have an unknown aetiology and their hypertensive and end-organ pathophysiology may present too late in pregnancy. This makes the identification of early detection and differentiation markers vital. MicroRNAs have strongly been associated with pregnancy and their imbalance has been associated with the angiogenic dysregulation seen in pre-eclampsia. This study assesses the expression of pro- and antiangiogenic factors and their corresponding microRNAs in the maternal circulation of patients with pre-eclampsia and gestational hypertension. Study design: We analyzed angiogenic factors expression (sEng, TGF-β, VEGF) normalized against housekeeping gene β-actin and microRNAs (miRs: 210, 29B, 126) normalized against miR U6, potentially associated with pre-eclampsia and gestational hypertension using the targeted qPCR technique. These analytes were examined from early-onset (<34 weeks) (EOPE) (n = 12), late-onset (>34 weeks) (LOPE) (n = 12) pre-eclampsia, gestational hypertension (GH) (n = 12) and two gestationally matched normotensive groups (NG1 and 2) (n = 12) each in South African women of African ancestry. Group comparisons of experimental vs. control groups were assessed using t-test analysis for significance and represented as fold change expression. Results: The relative expression in group comparisons showed significant (p < 0.05) fold change of VEGF, TGF-β, sEng and miR126 in the EOPE vs. NG1. The GH vs. NG1 exhibited significant changes in VEGF, TGF-β, miR126, miR210 and miR29B. The LOPE vs. NG2 showed significant relative expression in all the angiogenic factors (VEGF, TGF-β and sEng). The GH vs. NG2 showed significant expression in VEGF and miR29B. The LOPE vs. EOPE showed significant fold changes in VEGF and miR210. Finally, only the GH vs. EOPE showed significant differences in miR210 and miR29B (p < 0.05). Conclusion: This study provides better insights into angiogenic factors and microRNAs specificity to the subtypes of gestational hypertensive disorders in pregnancy. Relative expression analysis of angiogenic factors and microRNAs showed possible novel characteristics of gestational hypertension, and potential common molecular and pathological profiles with pre-eclampsia. Furthermore, we postulate that sEng and miR29B could be early detection markers for pre-eclampsia and gestational hypertension, respectively.
MeSH term(s)	Pregnancy ; Humans ; Female ; Pre-Eclampsia/diagnosis ; Hypertension, Pregnancy-Induced/genetics ; MicroRNAs ; Vascular Endothelial Growth Factor A ; Transforming Growth Factor beta
Chemical Substances	MicroRNAs ; Vascular Endothelial Growth Factor A ; eosinylphosphatidylethanolamine ; Transforming Growth Factor beta
Language	English
Publishing date	2023-09-12
Publishing country	Ireland
Document type	Journal Article
ZDB-ID	190605-7
ISSN	1872-7654 ; 0301-2115 ; 0028-2243
ISSN (online)	1872-7654
ISSN	0301-2115 ; 0028-2243
DOI	10.1016/j.ejogrb.2023.09.012
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Zs.A 837: Show issues

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Article ; Online: Differential expression of the angiotensin receptors (AT1, AT2, and AT4) in the placental bed of HIV-infected preeclamptic women of African ancestry.

Singh, Shoohana / Moodley, Jagidesa / Naicker, Thajasvarie

Hypertension research : official journal of the Japanese Society of Hypertension

2023 Volume 46, Issue 8, Page(s) 1970–1982

Abstract: The Renin-Angiotensin-Aldosterone System (RAAS) is implicated in the pathophysiology of preeclampsia (PE). There is a paucity of data on uteroplacental angiotensin receptors AT1-2 and 4. We evaluated the immunoexpression of AT1R, AT2R, and AT4R within ... ...

Abstract	The Renin-Angiotensin-Aldosterone System (RAAS) is implicated in the pathophysiology of preeclampsia (PE). There is a paucity of data on uteroplacental angiotensin receptors AT1-2 and 4. We evaluated the immunoexpression of AT1R, AT2R, and AT4R within the placental bed of PE vs. normotensive (N) pregnancies stratified by HIV status. Placental bed (PB) biopsies (n = 180) were obtained from N and PE women. Both groups were stratified by HIV status and gestational age into early-and late onset-PE. Immuno-labeling of AT1R, AT2R, and AT4R was quantified using morphometric image analysis. Immunostaining of PB endothelial cells (EC) and smooth muscle cells of spiral arteries (VSMC) displayed an upregulation of AT1R expression compared to the N group (p < 0.0001). Downregulation of AT2R and AT4R expression was observed in PE vs. N group (p = 0.0042 and p < 0.0001), respectively. AT2R immunoexpression declined between HIV+ve and HIV-ve groups, while AT1R and AT4R displayed an increase. An increase in AT1R expression was noted in the EOPE-ve/+ve and LOPE-ve/+ve compared to N-ve/N+ve. In contrast, AT2R and AT4R expression decreased in EOPE-ve/+ve and LOPE-ve/+ve compared to N-ve/N+ve. We demonstrate a significant downregulation of AT2R and AT4R with a concomitant elevated AT1R immunoexpression within PB of HIV-infected PE women. In addition, a decline in AT2R and AT4R with an increase in AT1R immunoexpression in PE, EOPE, and LOPE vs. normotensive pregnancies, irrespective of HIV status. Thus highlighting differential immunoexpression of uteroplacental RAAS receptors based on pregnancy type, HIV status, and gestational age.
MeSH term(s)	Female ; Humans ; Pregnancy ; Receptors, Angiotensin/metabolism ; Placenta/metabolism ; Pre-Eclampsia/metabolism ; Endothelial Cells/metabolism ; Receptor, Angiotensin, Type 1/metabolism ; Receptor, Angiotensin, Type 2/metabolism ; HIV Infections
Chemical Substances	Receptors, Angiotensin ; eosinylphosphatidylethanolamine ; Receptor, Angiotensin, Type 1 ; Receptor, Angiotensin, Type 2
Language	English
Publishing date	2023-06-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1175297-x
ISSN	1348-4214 ; 0916-9636
ISSN (online)	1348-4214
ISSN	0916-9636
DOI	10.1038/s41440-023-01314-x
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Zs.A 3898: Show issues

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Article ; Online: Immunoexpression of neuropilin-1 in the chorionic villi of HIV-infected preeclamptic South African women of African ancestry.

Naidoo, Nitalia / Abel, Tashlen / Moodley, Jagidesa / Naicker, Thajasvarie

Histochemistry and cell biology

2023 Volume 160, Issue 4, Page(s) 307–319

Abstract: Neuropilin-1 (NRP-1) is an essential regulator of maternal immune tolerance, placentation, and angiogenesis. Its dysregulation in preeclampsia (PE) and human immunodeficiency virus (HIV) infection implicates NRP-1 in disease susceptibility and ... ...

Abstract	Neuropilin-1 (NRP-1) is an essential regulator of maternal immune tolerance, placentation, and angiogenesis. Its dysregulation in preeclampsia (PE) and human immunodeficiency virus (HIV) infection implicates NRP-1 in disease susceptibility and progression. Therefore, this study investigates placental NRP-1 immunoexpression in HIV-complicated preeclamptic pregnancies in South African women of African ancestry receiving antiretroviral therapy. Immunohistochemistry of recombinant anti-neuropilin-1 antibody was performed on placental tissue from 30 normotensive and 60 early onset (EOPE) and late-onset (LOPE) preeclamptic women stratified by HIV status. Qualitative analysis of NRP-1 immunostaining within the chorionic villi revealed a predominant localization in trophoblasts and syncytial knots as well as endothelial, fibroblast-like, and Hofbauer cells. Following morphometric evaluation, we report that PE and HIV infection and/or antiretroviral usage independently downregulate placental NRP-1 immunoexpression; however, as a comorbidity, this decline is further augmented within the conducting and exchange villi. Furthermore, reduced immunoexpression of NRP-1 in EOPE compared with LOPE villi may be due to maternal-fetal maladaptation. It is plausible that the decreased NRP-1 immunoexpression in PE placentae facilitates syncytiotrophoblast apoptosis and subsequent deportation of NRP-1 into the maternal circulation, contributing to the anti-angiogenic milieu of PE. We hypothesize that the intense NRP-1 immunoreactivity observed in Hofbauer cells at the maternal-fetal interface may contribute to the natural prevention mechanism of HIV vertical transmission.
MeSH term(s)	Female ; Humans ; Pregnancy ; Chorionic Villi ; HIV Infections/drug therapy ; HIV Infections/complications ; Neuropilin-1 ; Placenta ; Pre-Eclampsia ; South Africa ; Trophoblasts
Chemical Substances	eosinylphosphatidylethanolamine ; Neuropilin-1 (144713-63-3) ; NRP1 protein, human
Language	English
Publishing date	2023-06-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	1222930-1
ISSN	1432-119X ; 0301-5564 ; 0948-6143
ISSN (online)	1432-119X
ISSN	0301-5564 ; 0948-6143
DOI	10.1007/s00418-023-02213-5
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