Analysis of dorsal pitting in the os publis in an extensive sample of modern American females

Pubic bones from 486 modern American females between the ages of 13 and 99 were studied in an attempt to explore the relationship between the degree of dorsal pitting and the following variables: (1) number of full term pregnancies, (2) inteval since last pregnancy, (3) age of decedent.A statistical association was found between the number of full term pregnancies and the degree of dorsal pitting. However, the correlation is not strong; 17 females reported as being nulliparous have "medium to large" dorsal changes whereas 22 females having from one to five full term pregnancies have an absence of dorsal changes. Females who had their last child 15 or more years prior to death are more apt to have "medium to large" dorsal changes than are females who have more recently given birth. This effect appears to be independent of the number of full term pregnancies, but is probably related to age. When the data are analyzed by multiple regression analaysis, it is found that age and number of pregnancies are most important in predicting the degree of pitting and the effect of the interval on pitting is not significant. Age is found to be an important variable independent of the number of full term pregnancies. In nulliparas, an absence of dorsal pitting is far more frequently found in females younger than 30 than in those over 30.     

The pubic scars of gestation and parturition in a group of pre-Columbian and colonial Peruvian mummies

The pubic scars of pregnancy and parturition as reported in the anthropological literature are a variant of the recognized clinical entity, osteitis pubis. The os pubis from 86 pre-Columbian and colonial Peruvian mummies were examined for this entity. Osteitis pubis was found in 13 pre-Columbian females (72.3%) and 19 colonial Indians (57.6%). Four of the colonial women were buried with newborn children and one had a four-month-old fetus in utero. This type of study has application in paleopathology and forensic medicine to show possible frequency of pregnancy in a population, but must be refined and quantitated to achieve any more than this. This study is of further interest as it demonstrates that racial groups have apparently a wide difference in frequency of this particular lesion of the pubic symphysis, a matter for further investigation.     

A re-examination of parturition scars on the human female pelvis

Pits, cavities and depressions located on the dorsal surface of the pubic symphysis of females have been attributed to the trauma of parturition. Earlier research based on human skeletal remains provides inadequate information on the individual's obstetrical history. The 68 female pubic bones that were studied had comprehensive medical records indicating whether or not each female had given birth. Fourteen and one-half percent of the females who had not given birth exhibited trace to small scarring of the pubic symphysis and 23.4% of the females who had not given birth exhibited medium to large scarring. It is suggested that bony changes previously used as an indicator of child bearing must be re-examined in light of the fact that “birth scarring” has been found in women known not to have had children.     

Evaluation of the obstetric significance of some pelvic characters in an 18th century British sample of known parity status.

The excavations at Christ Church, Spitalfields (1984-86) produced a sample of 968 human skeletons which were interred between 1729 and 1859. Of these, 387 were recovered in association with coffin plates stating name, age at death, and date of death. There are 138 adult females in the named sample and the obstetric histories of 94 have been reconstructed from historical documentation. Such variables as birth spacing, number of children, and age at first and last births are known for the majority of this sample. Any individual about whose history there is any doubt has been excluded from the analysis. A middle-class group, they were largely of high nutritional status and, by the standards of the day, lived in sanitary and comfortable conditions. Both males and females have a mean age at death of 56 years. The presence or absence, the typology, the severity, the width and the length of the preauricular sulcus, the presence or absence and the number of pits on the dorsal aspect of the pubic body, sulci along the anterior sacrum adjacent to the auricular facet, and the extension of the pubic tubercle were evaluated in relation to the obstetric histories of these females. Statistical analysis has demonstrated a relationship between the presence of pubic tubercle extension and parity status and between the degree of extension and the number of children borne (P < .02). Statistically there is no significant relationship (P > .05) between either the preauricular sulcus or pubic pitting and parity status. Sacral scarring is significantly associated (P < .05) with parity status, but as it was evident in only eight females it has little practical application. Sample sizes are small, and it must be considered that statistical evaluation of larger samples might detect associations between variables not demonstrated here. There is no significant relationship between any of the cortical variants under consideration and age at death.     

Hyaluronan involvement in the changes of mouse interpubic tissue during late pregnancy and post-partum

The present work quantifies hyaluronan (HA) during the late pregnancy and post-partum in order to provide a better understanding of the role of HA in the adaptations that occur in the pubic symphysis during this period. HA was quantified in situ (histochemically) and in interpubic tissue extracts by fluorimetric assay. Samples were taken from virgin mice and from pregnant animals at various stages of pregnancy: 12th-18th days into pregnancy, the day of delivery (D19) and the 3rd and 5th day post-partum. The quantitative fluorimetric analysis indicated a gradual increase of HA in the interpubic tissue throughout late pregnancy (2.4-14.6 microg/mg dry weight). This was followed by a decrease beginning on D19 (12.4 microg/mg), reaching close to virgin levels (2.2 microg/mg) on the 5th day post-partum. The same optical density changes could be seen in the HA staining. Furthermore, the histochemical analysis demonstrated the presence of HA both in the extracellular matrix of the tissue and within its cells. Such results indicate that the extracellular presence of HA may contribute to the transformation of the symphysis into a flexible structure. In addition, HA's intracellular presence (until the 18th day of pregnancy) may contribute to cellular proliferation. Finally, during parturition and on the 5th day post-partum, HA may contribute to the maintenance of the myofibroblastic phenotype of ligament cells, aiding the ligament involution after parturition.     

The relationship of the pre-auricular groove of the ilium to pregnancy

Two forms of pre-auricular groove may be distinguished on the iliac bone. One form occurs in both male and female, and marks the attachment of the inferior part of the ventral sacro-iliac ligament. The second form is found only in some female pelves. It resembles the markings of pregnancy and childbirth on the posterior aspect of the public symphysis, and like them is a result of the physiological and pathological changes occurring at the site of attachment of the pelvic joint ligaments during this time. However, because of the greater strain borne by the sacro-iliac joints, the pre-auricular groove, in conjunction with the marking of the interosseous ligament of the joint, is a more sensitive indicator of past pregnancy and childbirth than is the pubic bone.     

Recovery of the pubic symphysis on primiparous young and multiparous senescent mice at postpartum

It has been observed that parturition has a significant effect on female skeletal architecture and that age alters musculoskeletal tissues and their functions. We therefore hypothesized that multiparity affects the recovery of the pubic symphysis in senescent mice at postpartum and the morphology of the interpubic tissues. The pubic symphysis of primiparous young, virgin senescent (VS) and multiparous senescent (MS) Swiss mice was examined by light microscopy, transmission electron microscopy, morphometric analysis and immunohistochemistry. The mouse pubic symphysis was remodeled during the first pregnancy: the cellular phenotype and morphology changed to ensure a structurally safe birth canal, followed by recovery of the interpubic articulation after birth. The morphology of the pubic symphysis in the VS group was maintained in a state similar to that observed in virgin young mice. In contrast, MS mice exhibited an interpubic ligament characterized by extended fibrocyte-like cells, an opened interpubic articulation gap, compacted and thin collagen fibrils and scarce galectin-3-positive cells. Thus, we found that the cellular and extracellular characteristics of the pubic symphysis were altered by multiparity in senescent mice. These particular tissue characteristics of the MS group might be associated with an impaired recovery process at postpartum. Thus, a better understanding of the alterations that occur in the birth canal, including the pubic symphysis, due to multiparity in reproductively aged mice may contribute to our comprehension of the biological mechanisms that modify the skeleton and pelvic ligaments and even play a role in the murine model of pelvic organ prolapse.     

P2X receptors in the rat uterine cervix,lumbosacral dorsal root ganglia,and spinal cord during pregnancy

ATP, an intracellular energy source, is released from cells during tissue stress, damage, or inflammation. The P2X subtype of the ATP receptor is expressed in rat dorsal root ganglion (DRG) cells, spinal cord dorsal horn, and axons in peripheral tissues. ATP binding to P2X receptors on nociceptors generates signals that can be interpreted as pain from damaged tissue. We have hypothesized that tissue stress or damage in the uterine cervix during late pregnancy and parturition can lead to ATP release and sensory signaling via P2X receptors. Consequently, we have examined sensory pathways from the cervix in nonpregnant and pregnant rats for the presence of purinoceptors. Antiserum against the P2X₃-receptor subtype showed P2X₃- receptor immunoreactivity in axon-like structures of the cervix, in small and medium-sized neurons in the L6/S1 DRG, and in lamina II of the L6/S1 spinal cord segments. Retrograde tracing confirmed the projections of axons of P2X₃-receptor-immunoreactive DRG neurons to the cervix. Some P2X₃-receptor-positive DRG neurons also expressed estrogen receptor- immunoreactivity and expressed the phosphorylated form of cyclic AMP response-element-binding protein at parturition. Western blots showed a trend toward increases of P2X₃-receptor protein between pregnancy (day 10) and parturition (day 22–23) in the cervix, but no significant changes in the DRG or spinal cord. Since serum estrogen rises over pregnancy, estrogen may influence purinoceptors in these DRG neurons. We suggest that receptors responsive to ATP are expressed in uterine cervical afferent nerves that transmit sensory information to the spinal cord at parturition.     

Phenotypic modulation of fibroblastic cells in mice pubic symphysis during pregnancy,partum and postpartum

In many species, the cartilaginous pubic symphysis of the pregnant female is gradually replaced by a fibrous connective tissue, forming a flexible and elastic interpubic ligament. This newly formed ligament is responsible for the separation of the pubic bones, enabling safe delivery of the young. Following labor, the ligament undergoes rapid involution. To our knowledge, no previous work has focused on the phenotypic modulation that is responsible for the changes present at the interpubic ligament throughout the relaxation and closing of the symphysis. The purpose of this study was to investigate the ultrastructural features and immunophenotype of the peculiar cell type found in the pubic symphysis of cycling, pregnant and postpartum mice. In particular, immunohistochemistry studies were conducted on the expressions of the cytoskeletal proteins desmin, vimentin and -smooth muscle actin (-SMA). During pregnancy, the pubic symphysis cells always expressed -SMA, whereas the expression of vimentin and desmin was transient from early pregnancy to postpartum. Furthermore, the expression patterns of these three cytoskeletal proteins were distinct. Cells present in the medial region of the mouse symphysis in cycling and at D12 displayed ultrastructural features characteristic of a typical fibroblast. In contrast, during the last week of pregnancy and in postpartum these cells acquired ultrastructural features representative of a myofibroblast; for example, a fibronexus and a contractile apparatus were found to be present lying in close contact with the extracellular collagenous and elastic system fibrils. Taken together, these results strongly suggest a contractile function for these cells which might contribute to support of the varying mechanical stresses present during pubic bone movement.This work was supported by grants from Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES). This paper is part of a thesis submitted to the Department of Histology and Embryology of the Biology Institute State University of Campinas, in partial fulfillment of the requirements for the Masters degree.     

The mouse pubic symphysis as a remodeling system: morphometrical analysis of proliferation and cell death during pregnancy, partus and postpartum

Marked changes in mice pubic symphysis occur by the end of pregnancy. Tissue remodeling involves a dynamic balance between cell proliferation and programmed cell death as well as changes in the extracellular matrix components. Therefore, it is important to consider both of these cellular behaviors when investigating the mechanism that regulates interpubic tissue remodeling, growth during late pregnancy and partus ensuring involution during the postpartum period. Proliferating and programmed death cells were identified by immunohistochemistry (proliferating cell nuclear antigen and TUNEL detection, respectively) and the rates at which these processes occurred were determined by morphometric analysis. The results demonstrated that cellular proliferation was intense during the period of ligament formation, from D15 to D18, thereafter abruptly declining on D19. From parturition (D19) onwards, an ever-increasing decline in the cellular proliferation levels could be observed. The quantitative analyses of cellular death showed opposite results when compared to cellular proliferation. During early pregnancy the cycle of cellular renovation was clearly proliferative and during late mouse pregnancy the cycle was directed by programmed cellular death. Although the high levels of cellular death during postpartum involution could be shown by the TUNEL-positive cells, we were unable to observed picnotic nucleus at the light microscopy.     

Evaluating the diagnostic significance of nuclear grooves in thyroid fine needle aspirates with a semiquantitative approach

OBJECTIVE: To clarify the diagnostic significance of nuclear grooves in thyroid fine needle aspirates, to search for other associated nuclear features and to identify possible diagnostic pitfalls. STUDY DESIGN: In total, 67 fine needle aspiration cases were retrospectively reviewed for selected nuclear features, including grooves, intranuclear cytoplasmic invaginations, enlargement, pleomorphism and status of nucleoli. A semiquantitative method was used to estimate the percentage of nuclear grooves in 5 high-power fields with the most frequent nuclear grooves. RESULTS: Unequivocal intranuclear cytoplasmic invaginations were a specific diagnostic feature of papillary carcinoma. In the absence of intranuclear cytoplasmic invaginations, the presence of > or = 20% nuclear grooves was virtually diagnostic of thyroid neoplasms, predominantly papillary carcinoma. Less than 10% of nuclear grooves virtually eliminated the possibility of papillary carcinoma. However, 10-19% of nuclear grooves may be seen in papillary carcinoma and benign lesions; therefore, such cases fell into the diagnostic category of "atypical cytology" or "indeterminate" cytology. Nuclear enlargement with elongation was a readily identifiable feature usually associated with nuclear grooves. Significant pleomorphism was more commonly seen in papillary carcinoma than in benign lesions. CONCLUSION: A semiquantitative method is helpful when nuclear grooves are encountered in thyroid cytology in the absence of other diagnostic features. It can significantly improve the diagnostic specificity of nuclear grooves for papillary carcinoma.     

Elastic fiber assembly in the adult mouse pubic symphysis during pregnancy and postpartum

Impairment of pelvic organ support has been described in mice with genetic modifications of the proteins involved in elastogenesis, such as lysyl oxidase-like 1 (LOXL1) and fibulin 5. During pregnancy, elastic fiber-enriched pelvic tissues are modified to allow safe delivery. In addition, the mouse pubic symphysis is remodeled in a hormone-controlled process that entails the modification of the fibrocartilage into an interpubic ligament (IpL) and the relaxation of this ligament. After first parturition, recovery occurs to ensure pelvic tissue homeostasis. Because ligaments are the main supports of the pelvic organs, this study aimed to evaluate elastogenesis in the IpL during mouse pregnancy and postpartum. Accordingly, virgin, pregnant, and postpartum C57BL/6 mice were studied using light, confocal, and transmission electron microscopy as well as Western blots and real-time PCR. Female mice exhibited the separation of the pubic bones and the formation, relaxation, and postpartum recovery of the IpL. By the time the IpL was formed, the elastic fibers had increased in profile length and diameter, and they consisted of small conglomerates of amorphous material distributed among the bundles of microfibrils. Our analyses also indicated that elastin/tropoelastin, fibrillin 1, LOXL1/Loxl1, and fibulin 5 were spatially and temporally regulated, suggesting that these molecules may contribute to the synthesis of new elastic fibers during IpL development. Overall, this work revealed that adult elastogenesis may be important to assure the elasticity of the pelvic girdle during preparation for parturition and postpartum recovery. This finding may contribute to our understanding of pathological processes involving elastogenesis in the reproductive tract.     

Serum and urinary hormones during pregnancy and the peri- and postpartum period in an Asian elephant (Elephas,maximus)

Blood and urine samples were collected weekly from an Asian elephant (Elephas maximus) for 10 months before conception, throughout pregnancy, and for 10 months after parturition. Additional daily samples were collected for 41 days before through 10 days after parturition to define endocrine events during the peripartum period. During gestation, serum progesterone concentrations increased gradually and, after ～13 weeks, were higher (P < 0.05) than those observed during the nonpregnant luteal phase. Concentrations peaked at ～12 months of gestation, gradually declined during the last month, and then decreased sharply to nondetectable levels 2 days before parturition. A 12 week lactational anestrus was observed before cyclicity resumed. The urinary profile of progestagen excretion paralleled that of circulating progesterone (r = 0.79; P < 0.05); however, radioimmunoassay of HPLC-separated fractions of urinary eluates indicated that this immunoactivity was not associated with native progesterone. After remaining basal through the first 16 weeks of gestation, serum prolactin concentrations increased to 100-fold about midterm and remained elevated until after parturition. Neither serum nor urinary cortisol concentrations were altered during pregnancy, but both increased markedly the day after parturition and remained elevated above prepartum levels for several weeks thereafter. These data indicate that analysis of serum prolactin can confirm pregnancy in the Asian elephant after ～4 months of gestation and that daily monitoring of serum or urinary progestagens is useful for predicting parturition. © 1995 Wiley-Liss, Inc.

1 This article is a US Government work and, as such, is in the public domain in the United States of America.

     

The structure of the human symphysis pubis with special consideration of parturition and its sequelae

Review of the structure of the symphysis pubis, based on my extensive study of the pelvic joints ('31) shows changes from age, function, pregnancy hormones and stress of parturition. Primary physiologic shearing clefts and secondary traumatic clefts in cartilage are more frequent in females. Inter-digitations in the young osteocartilaginous border secure the vulnerable growth cartilage against increasing shearing forces. The retropubic eminence, ligamentous or cartilaginous, forms earlier in females, later, due to bony lipping in males, secondary to extrusion of disc cartilage. Ovarian and placental hormones in pregnancy cause remodeling and resorption of the posterior margin of the pubic facette and adjacent cortex, making a (variably) deep bony groove for greatly hypertrophied transverse ligaments. Delivery of a mature infant produces traumatic changes leading to extrusion of torn fibrocartilage in any direction, progressively loosening the symphysis, producing cartilage nodules, cysts and reactive bone formation. Older age degenerative arthritis is more frequent in parous females.     

High iNOS mRNA and protein localization during late pregnancy suggest a role for nitric oxide in mouse pubic symphysis relaxation

Remodeling and relaxation of the mouse pubic symphysis (PS) are central events in parturition. The mouse PS remodels in a hormone-controlled process that involves the modification of the fibrocartilage into an interpubic ligament (IpL), followed by its relaxation prior to parturition. It is recognized that nitric oxide synthase (NOS) and consequently nitric oxide (NO) generation play important roles in extracellular matrix modification, and may promote cytoskeleton changes that contribute to the remodeling of connective tissue, which precedes the onset of labor. To our knowledge, no studies thus far have investigated inducible nitric oxide synthase (iNOS) expression, protein localization, and NO generation in the mouse PS during pregnancy. In this work, we used a combination of the immunolocalization of iNOS, its relative mRNA expression, and NO production to examine the possible involvement of iNOS in remodeling and relaxation of the mouse IpL during late pregnancy. The presence of iNOS was observed in chondrocytes and fibroblast-like cells in the interpubic tissues. In addition, iNOS mRNA and NO production were higher during preterm labor on Day 19 of pregnancy (D19) than NO production on D18 or in virgin groups. The significant increase in iNOS mRNA expression and NO generation from the partially relaxed IpL at D18 to the completely relaxed IpL at D19 may indicate that NO plays an important role in late pregnancy during relaxation of the mouse IpL.     

女性耻骨背部凹痕与生育关系初探

对130例女性耻骨观察结果表明,在未生育的79例女性耻骨中,6例出现小到大的背部凹痕。而在51例生育过的耻骨中,33例无凹痕。最后一次生育到死亡间隔15年以上者比15年以下者,凹痕出现率高一倍。全部标本中,25岁以下者未见凹痕。耻骨背部凹痕的出现与年龄关系较明显。     

小熊猫妊娠期粪便中孕酮、雌二醇的水平变化

2000年3—8月在成都动物园和成都大熊猫繁育研究基地,用放射免疫分析法测定了6只雌性小熊猫粪样中孕酮（P）和雌二醇（E2）的水平变化,同时对其繁殖行为进行了观察。研究结果表明,交配后的雌体粪样中E2浓度下降至基础水平,P浓度在30d后上升至150ng／g以上;怀孕雌体在妊娠期粪样中P水平在200ng／g以上,P峰值可以达500ng／g以上;假妊娠者粪样中P水平一般不超过150ng／g,P峰值在200ng／g以下;雌体产前半个月孕酮迅速下降,E2缓慢上升,产后P保持在基础水平。这意味着可通过测定粪便中P水平进行早孕诊断、产期预测和真假妊娠判断。根据行为观察和粪样激素分析可知,雌兽妊娠期为123—128d（X=124,N=5）,产仔率为1．8／胎（N=5）。     

Lactogenesis in the rat: an ultrastructural study of the initiation of the secretory process.

Three specimens were taken from mammary glands of rats killed on the 18th and 21st days of pregnancy and on the 1st day of lactation. Ultrastructural features of the tissue were compared among rats within and between the two stages of development. The similarity among specimens from the same rats made feasible a comparison of serial biopsies obtained every 4 hr, starting on the afternoon of the 21st day of pregnancy. From the 18th to the 21st days of pregnancy, a marked increase in the amount of rough endoplasmic reticulum occurred. The alveolar cells of rats killed on both days and in biopsies obtained at 17 and 13 hr before partuirtion contained abundant small lipid droplets and vacuoles containing many protein granules with little clear fluid (stasis vacuoles). Alveolar lumina were distended with secretion by 17 hr before parturition. Between 8 and 12 hr. before parturition, the accumulated protein and lipid were rapidly extruded from the alveolar cells despite evidence of continued biosynthesis. It is suggested that active transport processes are initiated independently of milk synthesis before parturition.     

Changes of large molecular weight hyaluronan and versican in the mouse pubic symphysis through pregnancy

During pregnancy, the mouse pubic symphysis undergoes expansion and remodeling resulting in formation of a flexible and elastic interpubic ligament allowing passage of a term fetus. In the current study, we sought to identify and characterize components of the extracellular matrix that likely play an important role in elongation and flexibility of the interpubic ligament during parturition. Mouse pubic symphyses and interpubic ligaments collected at time points during pregnancy and postpartum were utilized to evaluate collagen type, collagen content, processing and solubility, matricellular protein, and proteoglycan expression and quantitative assessment of all glycosaminoglycans. These studies revealed increased gene expression for hyaluronan synthase 1, hyaluronan synthase 2, and versican on Gestation Day 18 as well as a decline in protein expression for the versican-degrading protease a disintegrin-like and metalloprotease with thrombospondin type 1 (ADAMTS1) motif. These findings suggest that the primary mediators of increased elongation and flexibility of the interpubic ligament at term result from increased synthesis and reduced metabolism of viscoelasticity-promoting molecules such as high molecular weight hyaluronan and versican.