Single measurement of total serum cholesterol, HDL-C, LDL-C and triglycerides in the second trimester as a predictor of pre-eclampsia in high risk pregnant women

To evaluate the utility of measuring different serum lipids in the second trimester of pregnancy for predicting pre-eclampsia in high risk patients. The study comprised 90 pregnant females with high risk of developing pre-eclampsia. Serum measurements of total cholesterol, HDL-C, LDL-C and triglycerides were taken between 18-24 weeks of gestation. Patients were followed up and divided into 2 groups accordingly. Group I [healthy patients], Group II [patients who develop pre-eclampsia]. Serum triglycerides showed a sensitivity of 100%, a specificity of 100%, a PPV of 100% and a NPV of 100% with a total accuracy of 100%. Total serum cholesterol showed a sensitivity of 88.1%, a specificity of 70.83%, a PPV of 72.55% and a NPV of 87.18% with a total accuracy of 78.89%. HLD-C showed a sensitivity of 74.19%, a specificity of 52.54%, a PPV of 45.1% and a NPV of 79.49% with a total accuracy of 60%. Moreover, LDL-C showed a sensitivity of 100%, a specificity of 44.32%, a PPV of 3.92% and a NPV of 100% with a total accuracy of 45.56% and finally TC/HDL ratio showed a sensitivity of 96.43%, a specificity of 61.29%, a PPV of 52.94% and a NPV of 97.44% with a total accuracy of 72.22%. According to the results of the study, the most accurate predictor for the prediction of pre-eclampsia, was the serum triglycerides level, while Total serum cholesterol and TC/HDL ratio came next in accuracy

Intrauterine contraceptive device position: a possible cause for intrauterine contraceptive device associated menorrhagia

Intrauterine contraceptive device [IUCD] is used by more than 100 million women around the world. Menorrhagia is the most common complication for many women using this method. To evaluate the relation between the position of intrauterine contraceptive device [IUCD] within the uterus and abnormal uterine bleeding in the form of menorrhagia. A cross sectional study. Out-patient gynecology clinics at Kasr El-Aini Hospital, Cairo University and National Research Centre. Fifty women with IUCD in place and menorrhagia [study group] were enrolled in the study and compared with thirty women with IUCD and normal menstrual flow [control group]. The distances between the top of the vertical arm of IUCD and the fundus [IUCD-F], the myometrium [IUCD-M], and the junction between the endometrium and uterine cavity [IUCD-E] were measured by the use of trans-vaginal ultrasound [TV U/S] scan. Also, the distance between the lower end of the vertical arm of IUCD and the internal Os as measured [IUCD-I]. 3D ultrasound transparent mode was used in frontal plane. All the measurements were longer among the study group compared to the control one, where the IUCD-F distance was 24.66 +/- 9.76 and 17.98 +/- 4.04mm respectively [p<0.001]. Also, the IUCD-M distance was 10.42 +/- 9.73 and 5.38 +/- 1.89mm respectively [p=0.006]. The IUCD-E distance was 6.76 +/- 8.40 and 1.83 +/- 1.47mm respectively [p=0.002]. Also, the IUCD-I distance was longer among the control group than the study group, 14.23 +/- 4.56 and 6.20 +/- 9.09mm respectively [p=0.0001]. There is a possible relationship between the IUCD position inside the uterine cavity and the IUD associated menorrhagia in IUCD users. Less incidence of menorrhagia due to IUCD use is seen in women with higher device in position. We recommend the simultaneous use of TV U/S scan with IUCD application, and for follow up, to ascertain its proper position in the uterus