Heme iron polypeptide (proferrin®-ES) versus iron saccharate complex (ferrosac) for treatment of iron deficiency anemia during pregnancy

Objectives: Anemia is one of the world's leading causes of considerable perinatal morbidity and mortality. This study designed to compare the efficacy and safety of Heme iron polypeptide (Proferrin®-ES) versus iron saccharate complex (Ferrosac) in treatment of iron deficiency anemia during pregnancy. Methods: Two hundred and sixty (260) pregnant women with hemoglobin level below 10 gm/dl due to iron deficiency anemia were included in this study and randomized to receive either; intravenous Iron Saccharate (IV group) or oral Proferrin®-ES (PO group) for correction of iron deficiency anemia during pregnancy. Treatment efficacy checked by comparing pre-treatment values of hemoglobin, serum ferritin, mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH) and reticulocytes count by the 3-months` post-treatment values. Results: The 3-months` post-treatment hemoglobin level increased compared to the pre-treatment level without any significant difference between the two studied groups (from 8.5 ± 3.5 to 11.3 ± 1.3 gm/dl in PO group and from 8.7 ± 2.5 to 11.7 ± 0.9 gm/dl in IV group). In addition; the 3-months` post-treatment ferritin level, increased compared to the pre-treatment level without any significant difference between the two studied groups (from 19.4 ± 4.9 to 118.8 ± 7.1 ug/l in PO group and from 15.3 ± 5.6 to 122.3 ± 6.4 ug/l in IV group). 1.6% (2/124) of the studied women developed gastrointestinal intolerance and upset with oral Proferrin®-ES (insignificant difference and excluded from the study) and no other side effects recorded with oral Proferrin®-ES. Conclusion: HIP (Proferrin®-ES) is an effective, safe, well tolerable oral iron preparation as well as intravenous iron saccharate complex for treatment of iron deficiency during pregnancy; it increases the hemoglobin and replaces the depleted iron store.

Relation between Uterine Natural Killer Cells and Unexplained Recurrent Miscarriage.

Objective: To evaluate the relation between uK (uterine Killer) cells and unexplained repeated miscarriage (RM). Patients and Methods: Eighty (80) women with unexplained repeated miscarriage and missed miscarriage of current pregnancy were studied. Fetal viability and gestational age of current pregnancy were confirmed by ultrasound, followed by suction evacuation to collect abortus specimens and uterine wall curettage to collect decidua specimens. Abortus specimens were collected for long-term monolayer cell culture and subsequent chromosome analysis using conventional G-banding technique. Decidua specimens were subjected to IHC (Immunohistochemical) staining using monoclonal antibodies specific to CD56+ and CD16+ expressed by uK cells. Results: CD56+ CD16+ uK cells was found in 85% (68/80) of studied decidua specimens of women with unexplained repeated miscarriage, 88.5% (54/61) had normal abortus karyotyping and 73.7% (14/19) had abnormal abortus karyotyping. 73.75% (59/80) of studied women with past history of early miscarriage had CD56+ CD16+ uK cells in their decidua specimens and 66.25% (53/80) of studied women with past history of late miscarriage had CD56+ CD16+ uK cells in their decidua specimens, the association between early and late miscarriage and CD56+ CD16+ uK cells in deciduas specimen was significant. Conclusion: CD56+ CD16+ uK cells were predominant in decidua specimens of studied women with repeated miscarriage. Significant association was found between presence of CD56+ CD16+ uK cells in studied decidua specimens and unexplained repeated miscarriage.

Insulin-like Growth Factor Binding Protein-1/ alpha-fetoprotein versus Placental alpha microglobulin-1 for diagnosis of premature fetal membranes rupture.

Objectives: To compare insulin-like growth factor binding protein-1/alpha-fetoprotein (IGFBP-1/AFP) to placental alpha microglobulin-1 (PAMG-1) for diagnosis of premature fetal membranes rupture (PROM). Methods: 220 pregnant women ≥ 37 and < 39 weeks` gestation studied and classified into two groups; study group (PROM) and control group (no PROM). Examination of the studied women followed by abdominal ultrasound (TAS) and sterile vaginal speculum examination to visualize amniotic fluid leaking and for collection of samples for fern, nitrazine, AmniSure® and AmnioQuick® Duo+ tests on admission. Results: The sensitivity and specificity of AmnioQuick® Duo+ test to detect PROM was 93.6% and 86.4%; respectively compared to 95.5% and 89.1%; respectively for AmniSure® test, 72.7% and 80.9%; respectively for fern test and 76.4% and 83.6%; respectively for nitrazine test. PPV, NPV and accuracy of AmnioQuick® Duo+ test to detect PROM were 87.3%, 93.1% and 90%; respectively compared to 89.7, 95.1% and 92.3%; respectively for AmniSure® test, 79.2%, 74.8% and 76.8%; respectively for fern test and 82.4%, 77.97% and 80%; respectively for nitrazine test. AmnioQuick® Duo+ and AmniSure® tests had higher sensitivity, specificity, predictive values and accuracy to detect PROM compared to conventional diagnostic tests. Conclusion: AmnioQuick® Duo+ test for detection of IGFBP-1/AFP was rapid, accurate bedside test better than the individual conventional diagnostic tests and has same accuracy and performance like AmniSure® test.