Estrogen Receptor Alpha [ESR1] gene polymorphisms in pre-eclamptic Saudi patients

Pre-eclampsia causes maternal mortality worldwide. Estrogen receptor alpha [ESR1] gene polymorphisms were responsible for cardiovascular diseases. This case control study was conducted to investigate whether 2 polymorphic genes of ESR1 are associated with pre-eclampsia among Saudi women in Madina city, Saudi Arabia. Blood samples from 97 pre-eclamptic and 94 healthy pregnant women were analyzed using restriction fragment length polymorphism-polymerase chain reaction method. All the subjects were recruited randomly from outpatient clinics of Madina Maternity Children Hospital [MMCH], Madina, Saudi Arabia, between Dec. 2012 and Jan. 2014. There was no association between pre-eclampsia and PvuII and XbaI ESR1 gene polymorphisms individually. TT/AA and TT/AG genotype combination existed significantly in pre-eclamptic patients compared to control. The frequency of PvuII and XbaI combined TT/AA genotypes between pre-eclamptic women was 36.1% vs 9.6%, however, frequency of PvuII and XbaI combined TT/AG genotypes between preeclamptic women was 3.1% vs 17%, compared to control. The homozygous T-A haplotype carriers showed high pre-eclampsia risk, independent of pregnancy, BMI and smoking status [adjusted odds ratio [OR]: 3.26, 95% confidence interval [CI]:1.71-9.21]. The heterozygous T-A haplotype carriers did not differ from that of non-carriers [adjusted OR: 1.12, 95% CI: 0.47-2.75]. No association was observed between pre-eclampsia and T-G, C-G and C-A haplotype of PvuII and XbaIESR1 gene polymorphisms. T-A haplotype of homozygous associated with pre eclampsia not heterozygous carriers of ESR 1 PvuII and XbaI gene polymorphisms elicited high risk of pre-eclampsia. GG genotype of XbaI polymorphism decreased pre-eclampsia risk. Further studies using larger sample size are recommended to investigate the ESR 1 gene polymorphisms associated with pre-eclampsia

Women health in Saudi Arabia: a review of non-communicable diseases and their risk factors

This is a review of the changing pattern of chronic diseases among women in the Kingdom of Saudi Arabia [KSA]. Data from national surveys conducted in KSA, whose results were published between 1996 and 2011 were used. The results showed that over a period of ten years the prevalence of obesity increased in Saudi women from 23.6% to 44.0% and in men from 14.2% to 26.2%; self-reported physical inactivity worsened in both women [from 84.7% to 98.1%] and men [from 43.3% to 93.9%]; prevalence of smoking in women increased [from 0.9% to 7.6%], while it declined in men [from 21.0% to 18.7%]. The prevalence of metabolic syndrome was significantly greater in women than men [42.0% versus 37.2%; p < 0.01]. In conclusion, Saudi women are potentially at a greater risk than a decade ago to develop cardiovascular diseases and diabetes mellitus, with a notable increase in obesity compared to men

Cardiovascular disease markers in women with polycystic ovary syndrome with emphasis on asymmetric dimethylarginine and homocysteine

Polycystic ovary syndrome [PCOS] is a disorder characterized by hyperandrogenism, ovulatory dysfunction, and polycystic ovaries. Little is known about cardiovascular risk factors in patients with PCOS. We investigated plasma markers of cardiovascular disease in Saudi women with PCOS, with an emphasis on asymmetric dimethylarginine [ADMA] and total homocysteine [tHcy]. Fifty Saudi women with PCOS diagnosed by the Rotterdam criteria [mean age [SD] 30.2 [3.0] years] and 40 controls without PCOS [mean age 29.3 [2.5] years] had measyrements taken of clinical, metabolic, and hormonal parameters, including plasma ADMA, tHcy, lipoprotein [a] [[Lp[a]], and serum high sensitivity C-reactive protein [hs-CRP], nitric oxid, and fibrinogen. Insulin resistance was calculated by the homeostasis model assessment [HOMA-IR]. Women with PCOS had significantly higher fasting insulin, HOMA-IR, and luteinizing hormone [LH] levels than healthy controls [P<.001]. Lipid profile, free androgen index [FAI], ADMA, tHcy, hsCRP, and Lp[a] were significantly higher in women with PCOS compared with healthy controls [P<.001]. The women with PCOS had significantly lower nitric oxide and high-density lipoprotein cholesterol [HDL-C] levels compared with healthy controls [P<.001]. Our study revealed that Saudi women with PCOS had a significantly different levels of plasma markers of cardiovascular disease compared with normal controls. Therefore, clinicians who manage women with PCOS should follow up on these markers to reduce the risk of cardiovascular disease

Results of delivery in umbilical cord prolapse

To review the peripartum clinical course of patients whose pregnancies were complicated by umbilical cord prolapse and to evaluate its impact on neonatal outcome. All cases of cord prolapse managed in King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia between 1990-2000 were identified. There were 111 patients identified among 55,789 deliveries. Each maternal and fetal chart was reviewed for parity, age, gestational age, fetal presentation, status of membranes, time from diagnosis to delivery, mode of delivery, baby weight, Apgar scores and cord blood hydrogen ion concentration [PH]. The data collected was analyzed using Gold Stat Software Package, and statistical significance was established by using analysis of variance and Chi-square. The incidence of cord prolapse was found to be one in 503 cases [1.99 per thousand deliveries] in our study. Seventy-two [64.9%] of the fetuses were in vertex presentation and 39 [35.1%] were non-vertex, including breech and transverse presentations. Ninety one point nine% were singletons and 8% were twins. At the time of diagnosis in 15 [13.5%] membranes were artificially ruptured and in 96 [86.5%], they were spontaneously ruptured. The cervix was fully dilated in 10% and minimally dilated in 100 [90%]. Regarding mode of delivery, 7 [6.5%] were vaginal deliveries and 104 [93.5%] were cesarean sections. The interval from diagnosis to delivery ranged from 10 minutes to >20 minutes. Six [5.4%] of the babies were delivered in 10 minutes, 49 [44.1%] in 20 minutes and 56 [50.5%] in more than 20 minutes. Apgar score was less than 7 in 44 [39.6%] of the babies at one minute and in 5 [4.5%] of the babies at 5 minutes. Cord PH was less than 7 in 2 [1.8%] cases and more than 7 in 109 [98.2%]. Forty-one [36.9%] of the babies were admitted in neonatal intensive care unit. There was no perinatal mortality in our study group. In our review, we found that cord prolapse is not associated with higher rates of perinatal mortality or morbidity and our study supports clinical management of cord prolapse by cesarean section. The interval from diagnosis to delivery may not be the only determinant of neonatal outcome

Prediction of low birth weight infants from ultrasound measurement of placental diameter and placental thickness.

The aim of the study was to help to predict low birth weight infants by measuring placental diameter and thickness. Subjects and A prospective study was conducted of 70 consecutive singleton pregnancies to evaluate placental diameter and thickness by ultrasonographic measurement at 36 weeks gestation. The individual data were fitted to a logistic regression analysis. A "warning limit" of a placental diameter of 18 cm and placental thickness of 2 cm at 36 weeks gestation were calculated to predict low birth weight infants. Ultrasonographic placental diameter and thickness measurements appears to be of prognostic value in identifying the subsequent occurrence of fetal growth retardation