Shali Mazaki-Tovi

Tel Aviv Sourasky Medical Center, Tell Afif, Tel Aviv, Israel

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Publications (178)482.27 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Omentin, a newly identified adipokine, enhances insulin mediated glucose uptake in human adipocytes, thus, inducing systemic insulin-sensitizing effect. The aims of this study were to determine whether circulating maternal omentin levels are associated with insulin resistance indices and to assess which compartment, maternal, fetal, or placental, is the source of omentin in maternal circulation. Fasting serum glucose, insulin, and omentin were determined in 25 healthy pregnant women at the third trimester, before and 3 days after elective cesarean section. Cord blood omentin was measured in the 25 term neonates. Homeostasis model assessment (HOMA) was used to evaluate insulin sensitivity before and after delivery. Antepartum maternal omentin levels were negatively correlated with insulin levels (r=–0.41, P=0.04) and positively correlated with insulin sensitivity (HOMA%S; r=0.4, P=0.04). Postpartum omentin levels were negatively correlated with maternal body mass index (r=–0.44, P=0.02). Median maternal omentin levels was comparable before and after delivery (57.2, inter-quartile range: 38.2–76.2 ng/mL vs. 53.4, 39.8–69.4 ng/mL, respectively, P=0.25) and highly correlated (r=0.83, P
    Journal of Perinatal Medicine 05/2015; 43(3). DOI:10.1515/jpm-2014-0215 · 1.36 Impact Factor
  • Yinon Gilboa · Maya Spira · Shali Mazaki-Tovi · Eyal Schiff · Eyal Sivan · Reuven Achiron ·
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    ABSTRACT: The purpose of this study was to evaluate a novel sonographic scoring system for risk assessment of complications in patients suspected of having morbidly adherent placenta. This retrospective study evaluated the association between maternal complications and a grayscale sonographic scoring system for adherent placenta before surgery. Criteria for adherent placenta included uteroplacental and uterobladder demarcation lines and the presence of lacunae. Placentas were classified into 4 stages: stage 0, normal placentation; stage 1, low probability of adherence; stage 2, moderate possibility of adherence; and stage 3, high suspicion of adherence. Placental adherence as assessed by a surgical team, estimated blood loss, and postoperative hospitalization days were determined for each group, as well as the rates of the need for packed blood cells, cryoprecipitate units, and hysterectomy. One hundred nine women were included in the study. Twenty-six (23.8%) women were given a score of stage 0, 22 (20.2%) stage 1, 28 (25.7%) stage 2, and 33 (30.3%) stage 3. Linear regression analysis demonstrated that the sonographic staging was the only variable significantly associated with the number of packed cells or cryoprecipitate units transfused (P< .001) and a clinical diagnosis of adherent placenta (P< .001). In addition, both sonographic staging and a history of cesarean delivery were significantly associated with hysterectomy (P = .01; P = .03, respectively), treatment with any blood products (P< .001; P= .01), and the duration of postoperative hospitalization (P< .001; P = .006). A scoring system based on simple grayscale parameters may be effective for antenatal risk assessment of maternal complications in cases of suspected morbidly adherent placenta. © 2015 by the American Institute of Ultrasound in Medicine.
    Journal of ultrasound in medicine: official journal of the American Institute of Ultrasound in Medicine 04/2015; 34(4):561-7. DOI:10.7863/ultra.34.4.561 · 1.54 Impact Factor
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    ABSTRACT: To determine whether planned vaginal delivery is associated with increased risk of perinatal mortality and morbidity in twin pregnancies complicated by a very low birth weight (VLBW) of the second twin. We conducted a retrospective cohort study of twin pregnancies in which the second twin's birth weight was 1500 grams or less. 193 twin gestations met the study criteria and patients were classified into 2 groups according to the planned mode of delivery: 1. Cesarean delivery (n=142) and 2. Vaginal delivery (n=51). In the vaginal delivery group 21 pairs were in cephalic-cephalic presentation at the time of delivery, 28 pairs were cephalic-noncephalic and 2 pairs were noncephalic-noncephalic. Composite adverse neonatal outcome was defined as the presence of neonatal mortality, respiratory distress syndrome, sepsis, necrotizing enterocolitis or intraventricular hemorrhage grade 3-4. Trial of vaginal delivery was successful for both twins in 90.5% of cephalic-cephalic twins and 96.4% in cephalic-noncephalic twins. The rate of intraventricular hemorrhage was significantly higher in the vaginal delivery group (29.4% vs. 8.5% respectively, p=0.013, adjusted OR 3.65, 95% CI 1.32-10.1). The increased risk of intraventricular hemorrhage in the vaginal delivery groups was evident in both twin A (17.6% vs. 7.0%, p=0.029) and twin B (15.7% vs. 4.9%, p=0.014), however, these differences were not significant after adjusting for possible confounders (adjusted OR 1.79, 95% CI 0.58-5.55, for twin A and adjusted OR 2.13, 95% CI 0.63-7.25, for twin B). In addition, subgroup analysis revealed that both cephalic-cephalic and cephalic-non-cephalic twins, who were delivered vaginally, had increased risk for intraventricular hemorrhage. There were no significant differences between the cesarean and vaginal delivery groups in the rates of Apgar score < 7 at 5 minutes, arterial cord pH < 7.1, composite adverse neonatal outcome and neonatal mortality. However, the rate of respiratory distress syndrome (RDS) was significantly lower in the vaginal delivery group (66.7% vs. 69%, p=0.042, OR=0.34, 95% CI 0.12-0.96). Vaginal delivery of VLBW twins is associated with an increased risk of intraventricular hemorrhage regardless of presentation. Due to the small sample size and the retrospective cohort design, large prospective randomized studies are needed. Copyright © 2015 Elsevier Inc. All rights reserved.
    American journal of obstetrics and gynecology 03/2015; 213(2). DOI:10.1016/j.ajog.2015.03.030 · 4.70 Impact Factor

  • American Journal of Obstetrics and Gynecology 01/2015; 212(1):S375-S376. DOI:10.1016/j.ajog.2014.10.981 · 4.70 Impact Factor
  • Daniel Lantsberg · Yoav Yinon · Mordechai Dulitzky · Eyal Sivan · Eyal Shif · Shali Mazaki-Tovi ·

    American Journal of Obstetrics and Gynecology 01/2015; 212(1):S234-S235. DOI:10.1016/j.ajog.2014.10.504 · 4.70 Impact Factor
  • Keren Ofir · Anat Pardo · Ram Mazkereth · Eyal Sivan · Eyal Schiff · Shali Mazaki-Tovi · Yoav Yinon ·

    American Journal of Obstetrics and Gynecology 01/2015; 212(1):S181-S182. DOI:10.1016/j.ajog.2014.10.389 · 4.70 Impact Factor
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    ABSTRACT: Low molecular weight heparin (LMWH) has been shown to be effective in decreasing the recurrence of placenta-mediated complications of pregnant women. The aim of this study was to determine the effect of LMWH on circulating levels of soluble fms-like tyrosine kinase-1 (sFlt-1), soluble endoglin (sEng) and placental growth factor (PLGF) in pregnant women who required anticoagulation therapy. A longitudinal prospective cohort study was performed including pregnant women in whom anticoagulation therapy by LMWH during pregnancy was clinically indicated (n = 33). Healthy pregnant women, matched for gestational age, who did not require thromboprophylaxis served as controls (n = 29). Maternal plasma samples were obtained throughout gestation every 4 weeks and stored at -70 °C. Maternal plasma concentrations of sFlt-1, sEng and PLGF were determined by ELISA and compared between the two groups. Patients treated with LMWH had significantly increased circulatory levels of PLGF during the third trimester compared with controls (28-34 weeks: 719.2 pg/ml vs 558.6 pg/ml at, p < 0.01; 35-40 weeks: 975.6 pg/ml vs 511.2 pg/ml, p < 0.01, respectively). In contrast, circulatory levels of sFlt-1 and sEng were similar between the LMWH treatment group and controls throughout gestation. Consistent with these findings, the ratio of sFlt-1/PLGF was lower in patients treated with LMWH compared to controls (28-34 weeks: 1.9 vs 7.2, p < 0.05; 35-40 weeks: 5 vs 12.9, p < 0.05, respectively). Anticoagulation treatment of pregnant women with LMWH is associated with a pro-angiogenic state. These findings may explain the effectiveness of LMWH in the prevention of placenta-mediated complications of pregnancy. Copyright © 2014 Elsevier Ltd. All rights reserved.
    Placenta 12/2014; 36(2). DOI:10.1016/j.placenta.2014.12.008 · 2.71 Impact Factor
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    ABSTRACT: Multifetal pregnancy reduction (MPR) of triplets to twins results in improved pregnancy outcomes compared with triplet gestations managed expectantly. Perinatal outcomes of early transvaginal MPR from triplets to twins were compared with reduction from triplets to singletons. Seventy-four trichorionic triplet pregnancies that underwent early transvaginal MPR at 6–8 weeks gestation were included. Cases were divided into two groups according to the initial procedure: reduction to twin (n = 55) or to singleton (n = 19) gestations. Infants from triplet pregnancies reduced to twins were delivered earlier (36.6 versus 37.9 weeks; P = 0.04) and had lower mean birth weights (2364 g versus 2748 g; P = 0.02) compared with those from triplets reduced to singleton gestations. The rates of pregnancy loss before 24 weeks (3.6% versus 5.3%), as well as of preterm delivery before 32 and 34 weeks of gestation (0% versus 5.3% and 7.3% versus 5.3%, respectively) were similar between the twin and singleton pregnancies. No significant difference was found in the prevalence of gestational diabetes (15.1% versus 5.6%) or gestational hypertension (24.5% versus 16.7%) between the groups. Selective reduction of triplet pregnancies to singleton rather than twin gestations is associated with improved outcomes.
    Reproductive biomedicine online 12/2014; 29(6). DOI:10.1016/j.rbmo.2014.09.003 · 3.02 Impact Factor
  • Shali Mazaki-Tovi · Edi Vaisbuch · Roberto Romero ·

    Fetal and Maternal Medicine Review 11/2014; 24(04):232-259. DOI:10.1017/S0965539514000011
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    ABSTRACT: Objective To determine the prevalence of placental complications in patients conceived through donor versus autologous oocytes. Study Design A retrospective cohort study including two groups of patients who conceived through in vitro fertilization using: 1) donor oocyte (n=139) and 2) autologous oocyte (n=126). Only singleton gestations were included .The rate of placental complications including preeclampsia, gestational hypertension and intra uterine growth restriction (IUGR) was compared between these two groups. Results The women who conceived using donor oocytes were older compared to women who conceived using autologous oocytes (median maternal age 45 vs 41, p<0.01). The rate of hypertensive diseases of pregnancy including gestational hypertension and preeclampsia was significantly higher in ovum donor recipients compared with women conceived with autologous oocytes (25% vs 10%, p<0.01). Similarly, the rate of IUGR was also higher among patients conceived through oocytes donation although it did not reach statistical significance (9.3% vs 4%, p=0.08). When maternal age was restricted to ≤45 years, the rate of hypertensive diseases of pregnancy remained significantly higher among ovum donor compared to autologous oocyte recipients (22% vs 10%, p=0.02). Adjustment for maternal age, gravidity, parity and chronic hypertension revealed that oocyte donation was independently associated with higher rate of hypertensive diseases of pregnancy (P=0.01). Conclusions Patients conceived through oocytes donation have an increased risk for placental complications of pregnancy. These findings support the "immunological theory" suggesting that immunological intolerance between the mother and the fetus may play an important role in the pathogenesis of preeclampsia.
    American journal of obstetrics and gynecology 10/2014; 211(4). DOI:10.1016/j.ajog.2014.03.044 · 4.70 Impact Factor
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    ABSTRACT: Objective: Magnesium sulfate (MgSO4) administered to women at risk for preterm delivery decreases the risk of cerebral palsy in their children. However, the neuroprotective effect of MgSO4 has not been shown in twin gestations. Thus, the aim of this study was to determine the maternal serum levels of magnesium in twin vs. singleton pregnancies following intravenous treatment of MgSO4. Methods: Case control study including two groups of pregnant women who received intravenous MgSO4: (1) twin gestations (n=83) and (2) singleton pregnancies (n=83). Maternal serum magnesium levels 6 and 24 h after initiation of treatment were determined in both groups. Results: Maternal serum levels of magnesium were significantly lower among patients with twin gestations compared to those with singleton ones 6 h after initiation of treatment (4.6 vs. 4.8 mg/dL, P=0.003). In addition, the rate of pregnant women who obtained therapeutic levels 6 h after initiation of treatment was significantly lower in twin gestations than in singleton ones (36% vs. 58%, P=0.008). Multiple regression analysis revealed that twin gestations were independently and significantly associated with low maternal serum magnesium levels. Conclusions: Maternal serum concentrations of magnesium are lower in twin pregnancies than in singleton ones following MgSO4 treatment, which might explain the decreased neuroprotective effect of MgSO4 reported in twin pregnancies.
    American Journal of Obstetrics and Gynecology 09/2014; 208(1). DOI:10.1515/jpm-2014-0158 · 4.70 Impact Factor
  • M. Fishel-Bartal · S. Mazaki-Tovi · B. Weisz · B. Chayen · S. Lipitz · Y. Yinon ·

    Ultrasound in Obstetrics and Gynecology 09/2014; 44(S1):136-136. DOI:10.1002/uog.13932 · 3.85 Impact Factor

  • American Journal of Obstetrics and Gynecology 01/2014; 210(1):S329-S330. DOI:10.1016/j.ajog.2013.10.707 · 4.70 Impact Factor
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    ABSTRACT: To determine the neonatal outcome at late prematurity of uncomplicated monochorionic (MC) twin pregnancies. A retrospective cohort study of 166 patients with uncomplicated MC diamniotic twins delivered between 34 and37 weeks of gestation at a single tertiary center. The study population was classified into four groups according to the gestational age at delivery: (1) 34 weeks, (2) 35 weeks, (3) 36 weeks and (4) 37 weeks. Neonatal outcome measures were compared between the groups. Neonatal morbidity was significantly higher at 34 weeks of gestation compared to the other three groups including respiratory distress syndrome, oxygen requirement, hypothermia and hyperbilirubinemia. Moreover, the rate of admission to the special care unit and need for phototherapy were significantly higher in newborns born at 36 weeks compared to 37 weeks of gestation (p = 0.02 and 0.03 respectively). Multiple regression analysis revealed that the risk for adverse neonatal outcome was significantly associated with gestational age at delivery. Of note, there were no fetal or neonatal deaths in our cohort. The risk of neonatal morbidity of uncomplicated MC twins delivered at 34-37 weeks of gestation significantly decreases with advanced gestation. Therefore, under close fetal surveillance, uncomplicated MC twin pregnancies should be delivered at 37 weeks of gestation.
    American Journal of Obstetrics and Gynecology 01/2014; 210(1):S101-S102. DOI:10.1016/j.ajog.2013.10.213 · 4.70 Impact Factor
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    ABSTRACT: Objectives: Chemerin, a novel adipocytokine, has been implicated in major metabolic and inflammatory processes. Study aims were to determine whether circulating maternal chemerin concentration (1) differs between pregnant and non-pregnant women, (2) changes as a function of gestational age, and (3) correlates with maternal insulin resistance. In addition, we investigated which compartment, maternal, fetal or placental, is the source of chemerin in maternal circulation. Methods: The study included three groups: Non-pregnant (n=18), pregnant women in the first trimester (n=19) and pregnant women in the third trimester (n=33). Chemerin was measured in cord blood and in maternal serum samples taken before and after delivery. Chemerin mRNA expression was evaluated in fetal and human adult tissues. Results: Chemerin serum concentration was significantly higher in pregnant women in the third trimester than in non-pregnant and pregnant women in the first trimester. Chemerin concentration positively correlated with body mass index (BMI) and insulin resistance. Antenatal chemerin concentration was significantly lower than that during the postpartum period. Neonatal chemerin did not correlate with maternal one. Chemerin mRNA expression was abundant in fetal and adult liver and omental fat, but relatively low in placenta. Conclusions: Chemerin is increased during normal gestation and is associated with maternal BMI and insulin resistance. Maternal tissues, possibly liver and adipose tissue, contribute to the increased maternal chemerin concentration.
    Journal of Perinatal Medicine 12/2013; 42(3):1-8. DOI:10.1515/jpm-2013-0166 · 1.36 Impact Factor
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    ABSTRACT: To determine maternal plasma levels of soluble vascular endothelial growth factor receptor-1 (sVEGFR-1), placental growth factor (PLGF) and soluble endoglin (sEng) in monochorionic diamniotic (MC/DA) twin pregnancies complicated by twin to twin transfusion syndrome (TTTS) or selective intra-uterine growth restriction (sIUGR). A longitudinal cohort study of pregnant women with MC/DA twins who were classified into 3 groups: 1. Uncomplicated MC/DA twins (n=22) 2. TTTS (n=23) and 3. sIUGR (n=15). Maternal plasma samples were obtained between 13-20 and 21-28 weeks of gestation and cord blood samples were collected at delivery. Maternal plasma concentrations of sVEGFR-1, PLGF and sEng, as well as cord blood levels of sVEGFR-1were measured by ELISA. Maternal plasma levels of sVEGFR-1 and sEng were significantly higher in patients with TTTS at the early and late second trimester compared to normal monochorionic pregnancies (p<0.01). In contrast, in the sIUGR group, sVEGFR-1 and sEng levels were significantly higher only at the late second trimester (p<0.05). PLGF levels were significantly lower at the early and late second trimester in both TTTS and sIUGR compared to controls (p<0.01). Plasma concentrations of sVEGFR-1 were significantly higher among TTTS pregnancies compared to sIUGR at the late second trimester (p=0.027). Cord blood levels of sVEGFR-1 were significantly higher in the smaller IUGR twin compared to the normal co-twin. Monochorionic pregnancies complicated by TTTS and sIUGR are characterized by decreased angiogenic activity. The disparity in severity of the anti-angiogenic state between TTTS and sIUGR suggests that these two conditions may represent a continuum.
    American journal of obstetrics and gynecology 09/2013; 210(2). DOI:10.1016/j.ajog.2013.09.022 · 4.70 Impact Factor
  • Yoav Yinon · Elad Ben Meir · Boaz Weisz · Eyal Schiff · Shali Mazaki-Tovi · Shlomo Lipitz ·

    American Journal of Obstetrics and Gynecology 01/2013; 208(1):S83. DOI:10.1016/j.ajog.2012.10.334 · 4.70 Impact Factor

  • American Journal of Obstetrics and Gynecology 01/2013; 208(1):S265. DOI:10.1016/j.ajog.2012.10.789 · 4.70 Impact Factor

  • American Journal of Obstetrics and Gynecology 01/2013; 208(1):S99. DOI:10.1016/j.ajog.2012.10.377 · 4.70 Impact Factor
  • Benny Brandt · Shali Mazaki-Tovi · Yoav Yinon · Eyal Schiff · Rina Hemi · Hannah Kanety · Eyal Sivan ·

    American Journal of Obstetrics and Gynecology 01/2013; 208(1):S92. DOI:10.1016/j.ajog.2012.10.359 · 4.70 Impact Factor

Publication Stats

4k Citations
482.27 Total Impact Points


  • 2015
    • Tel Aviv Sourasky Medical Center
      • Obstetrics Gynecology
      Tell Afif, Tel Aviv, Israel
  • 2005-2015
    • Tel Aviv University
      • Department of Obstetrics and Gynecology
      Tell Afif, Tel Aviv, Israel
  • 2004-2015
    • Sheba Medical Center
      • • Department of Pathology
      • • Institute of Endocrinology
      Gan, Tel Aviv, Israel
  • 2013
    • Duke University
      Durham, North Carolina, United States
  • 2006-2012
    • Wayne State University
      • Department of Obstetrics and Gynecology
      Detroit, Michigan, United States
    • University College Dublin
      Dublin, Leinster, Ireland
    • Universitair Medisch Centrum Groningen
      Groningen, Groningen, Netherlands
  • 2011
    • Seoul National University Hospital
      • Department of Obstetrics and Gynecology
      Sŏul, Seoul, South Korea
  • 2008-2011
    • Eunice Kennedy Shriver National Institute of Child Health and Human Development
      • Division of Intramural Research (DIR)
      Maryland, United States
  • 2010
    • Detroit Medical Center
      Detroit, Michigan, United States
  • 2009
    • Université du Québec
      Quebec City, Quebec, Canada
  • 2007
    • University of Texas Medical Branch at Galveston
      • Department of Obstetrics and Gynecology
      Galveston, Texas, United States