Fetal liver volume and umblical venous volume flow in pregnancies complicated by insulin-dependant diabetes mellitus

to determine fatal liver volume and its relation with umbilical venous volume flow and maternal glycosylated haemoglobin 'HBAlC" in pregnancies complicated by diabetes mellitus type I. A cross sectional matched control study. Eighty pregnant women were included in this study divided into 2 groups. The first group included 40 women with pre-gestational IDDM [18-36 weeks]. The second group consisted of 40 women with normal pregnancy[control group]. Fetal liver volume measurements were obtained using three-dimensional ultrasound. Umbilical venous cross sectional area [mm[2]] and time-averaged velocity [mm/s Doppler] were determined for calculation of volume flow [ml/min] and flow per kilogram fetal weight [ml/min kg]. Umbilical artery pulsatility index was determined. Fetal liver volume was significantly higher in diabetic women than normal controls [mean [SD]:46 [34.0] Vs 38.0 [29.0]]. A positive correlation existed between fetal liver volume and maternal HbAlc Fetal abdominal circumference, estimated fetal weight, feto placental weight ratio and liver volume/ estimated fetal weight ratio were all significantly higher in the diabetic women than the normal group. Umbilical venous volume flow [ml/min] and umbilical artery pulsatility index were not significantly different between the two groups, but umbilical venous volume flow per kilogram fetal weight was lower [P<0.05] in the diabetic group [95.0 [25.0] ml/min/kg] compared with normal group [110.0[28.0] ml/min/kg]. Measurement of fetal liver volume by 3-D utrasound may play a role in identifying fetal maerosomia in diabetic pregnancies. Fetal liver volume increase is positively related to maternal HbAlc levels reflecting degree of maternal glycemic control. Fetal liver volume normalized for estimated fetal weight is significantly higher in the fetuses of diabetic women. In the present study, umbilical venous volume flow and umbilical artery pulsatility index are not different between diabetic and normal pregnancies

Serum cytokine concentrations in patients with ectopic pregnancy

to examine utility of serum cytokine concentration as a marker of ectopic pregnancy "EP" Fifteen women with EP, Fifteen women with miscarriage and Fifteen women with normal intrauterine pregnancy, at comparable stages of gestation. Senim interleukin-6, IL-8 were determined by enzyme linked immunosorbent assay [ELISA]. Serum levels of IL-6 were higher in women with EP than in those with miscarriage and normal pregnancy. Serum levels, of IL-8 were significantly higher in women with EP than in those with miscarriage and normal pregnancy. Serum IL-8 level was>45 pg/mI in all patients of ER Serum levels of IL-8 and IL-6 concentrations are higher in women with EP than in those with miscarriage and normal pregnancy. IL-8>45 pg/ml can be an important diagnostic test in the evaluation of suspected EP. Larger studies are needed to determine theft predictive value

Uterine hemodynamic study after endometrial thermoablation therapy in dysfunctional uterine bleeding [DUB]

to study the hemodynamic changes in uterine artery blood flow using transvaginal color Doppler ultrasonography after endometrial thermoablation therapy in cases of DUB. Prospective randomized study. Al Zahraa University Hospital-Al Azhar University.-Al Haram Hospital for Research and Treatment. Some private hospitals-Egypt. Patients and Fifty premenopausal patients with DUB without obvious structural or premalignant lesions. All patients were in good health and they were submitted to pelvic ultrasonography, pap smear diagnostic hysteroscopy and endometrial biopsy within 6 months of our management. Those patients were randomly divided into 2 groups: first group included 22 patients who received thermal balloon endometrial ablation therapy. Second group: included 25 patients who had medical treatment "a three-months period of medroxy progesterone acetate "10 mg/day". The uterine thermal balloon ablation therapy [Thermachoice] was carried out on cycle days 3-8. Color Doppler measurements were also carried on cycle days 3-8. Flow waveforms were obtained from the main branch of the uterine arteries at the level of the inner cervical os on both sides. Doppler flow parameters were used for subsequent statistical analysis. The measurements took place before the initiation of treatment, on the first post operative day "thermal ablation group only" and 3, 6 months and one year after initiation of the study. Endometrial thermoablation was effective in the treatment of DUB. 20/22 women [90.9%] had amenorrhea, only 2 patients "9.1%" underwent hysterectomy during the follow up period because of problems related to pelvic heaviness recurrent uterine spotting or offensive discharge. The pulsatility index "PI" was significantly higher after endometrial ablation than pretreatment level. The PI was gradually increased throughout the period of follow up [2.8 +/- 0.9 and 2.9 +/- 0.8] at 6 and 12 months post-treatment VS [2.1 +/- 0.5] pretreatment. The hysterectomy rate was significantly higher in the medical therapy group than in thermoablation group "35.7% VS 9.1"-No statistically significant change in uterine artery PI took place after medical therapy. Thermal balloon endometrial ablation therapy induces a gradual rise in uterine artery blood flow impedance which was statistically significant at 6 and 12 months. This rise in impedance may be due to fibrosis in the uterine cavity induced by thermal balloon therapy. The uterine cavity fibrosis is a good marker for therapy success. Thermoablation technique was accepted by the patients with a high efficacy rate "90.9%"

Female genital schistosomiasis: prevalence disease associated morbidity and intensity of infection as detected by soluble egg antigen in urine

This study was done to assess the prevalence and morbidity pattern of S. haematobium infection in women of reproductive age [15 - 45 years] in schistosomiasis endemic area. One hundered and eighty women involved in this study and grouped as follows: group I: women with proven femal genital schistosomiasis [FGS] [n = 80], group II: endemic referents [n = 80] and group III: women living in schistosomiasis-free area [n= 20] serve as controls. Full history, general gynaecological and parasitological examinations were done to every women, a s and wich ELISA was carried to detect soluble egg antigen [SEA] in urine of all cases.Evaluation of the applicability of this assay as a diagnostic and morbidity indicator was done. revealed that significantly more FGS reported a history of spontaneous abortion [P < 0.01], complaints of irregular menstruation [P < 0.001], pelvic pain [P < 0.01] vaginal discharge [P < 0.0001], dysuria [P < 0.01] and haematuria [P < 0.0001] than in the referents. Biopsies were taken from the cervix of 80 women with macroscopical lesions and from them 24 cases, S. haematobium eggs were found by histological sectioning [30%]. In the control group [referents] no eggs were detected in the cervical biopsies of 10 of them [50%]. Infections with C and ida albicans, Trichomonas vaginalis were found in similar frequencies in all groups. Ecographic abnormalities of the urinary tract were present in 24% and 0% of the infected women and referents respectively. These findings were accompanied by an elevated frequency of haematuria [55.6% versus 10%] and proteinuria [70% versus 20%] in the FGS and referent groups. Our study indicates that S. haematobium infection in women may not only cause symptoms in the urinary tract but also frequently in the lower reproductive tract [LRT]. SEA levels in urine of S haematobium infected women significantly correlated with egg counts and with clinical findings [P < 0.001]. In addition lower genital tract pathology as determined by cervical smear and biopsy significantly correlated with the SEA levels in urine