ABSTRACT
Objective: Ectopic pregnancy [EP] is an implantation of fertilized ovum outside the intrauterine cavity. Many cases of EP are not associated with a clinical signs at early stages that makes its diagnosis is difficult. The confirmation of EP needs several investigations as ultrasonography and repeated measurements of serum beta-hCG levels every 48 hours that make it very expensive and take a long time so, rupture may be occurred that leads to increased maternal morbidity and mortality rates. Thus, the aim of this study was to investigate the alterations of some hematological and biochemical parameters associated with normal and ectopic pregnancy in addition to evaluate their efficacy in early diagnosis of tubal ectopic pregnancy [TEP] among women living in Jazan area, Kingdom of Saudi Arabia
Subjects and methods: this retrospective study was carried out on 200 women with their ages ranged from 25-37 years old at the Obstetric and Gynecology Department of King Fahd Central Hospital and Sabiya General Hospital during the period between March 2010 and March 2014. The subjects were divided into three groups. Group [1] consists of 69 cases ruptured EP; Group [2] consists of 61 cases non-ruptured by visual examination during surgery and subsequently histopathological examination, where as group [3] consists of 70 women representing the control group having a normal intrauterine pregnancy. Hematological and biochemical measurements were done on all groups
Results: the hematological findings revealed a significant increase in mean platelet volume [MPV], total leukocytic count [WBC] and erythrocyte sedimentation rate [ESR] among TEP patients especially in ruptured cases in comparison with those of normal pregnancy control. A significant decrease in hemoglobin [Hb] and packed cell volume [PCV] in TEP cases either ruptured or non-ruptured and a non-significant changes in total erythrocytic count [RBC]. The biochemical findings revealed a significant increase in serum creatine kinase [ CK] but a significant decrease in serum beta-hCG in both ruptured and non-ruptured TEP
Conclusion: it could be concluded that the WBCs, MPV count and ESR were significantly increased in TEP especially in ruptured cases. The MPV can differentiate between TEP and normal pregnancy but has less clinical significance to differentiate between ruptured and non-ruptured cases. On the other hand, the level of beta-hCG is an important indicator of TEP. Moreover, serum CK cannot be used as a tool for diagnosis of TEP but may differentiate between ruptured and non-ruptured cases
ABSTRACT
Escherichia coli [E. coli] isolates from women with bacteriuria of pregnancy establish significant bacteriuria without causing symptoms of urinary tract infection [UTI]. In this study Escherichia coli isolates from patients with bacteriuria of pregnancy were compared phenotypically with uropathogenic E. coli [UPEC] from patients with community-acquired cystitis for the presence of established virulence determinants. The asymptomatic bacteriuria [ABU] strains from pregnant women were less likely to express type 1 fimbriae [26, 66%], P-fimbriae [20%] and ?-haemolysin [6.6%] than the other group [66.66% , 40% , and 13.3% respectively]. PCR analysis of the gene producing type 1 fimbria showed that the gene is present in 93.33% among both groups. However, determination of the phase switch orientation by analysis of positive PCR isolates showed that 3 of 14 ABU isolates of pregnant women [21.4%] was detectable in the on orientation compared to [64.2%] in community acquired cystitis patients. These data indicate that type 1 fimbriae are not necessary to maintain the majority of E. coli bacteriuria in pregnant women since there appears to be selection against their expression in this particular group in contrast to the considered role of this adhesion in community-acquired symptomatic infections