Evaluation of methods using maternal serum alpha-fetoprotein for antenatal screening of pregnancies for open neural tube defects in east Azerbaijan province of Iran

Neural tube defects, resulting from failure of the neural tube to close during the fourth week of embryogenesis, are the most common severely disabling birth defects in most populations. We assayed alpha fetoprotein [AFP] in serum samples of pregnant women during 15 to 20 weeks of gestation using immuno-enzymatic method [Eliza] in east Azerbaijan/Iran. The results obtained from the first 100 samples were used to calculate the median levels of maternal serum AFP in our ethnic population and the resulted Multiple of Median [MOM] were employed in Prisca software to obtain the likelihood ratio for each pregnancy. Among the 300 pregnancies which were screened for Neural Tube Defects [NTDs], 9 were detected as screen positives. The following targeted ultrasonography revealed fetuses affected by open neural defects in two pregnancies, polyhydraminous with no NTDs in two others and bilateral cleft lip in the one. The screening results were confirmed by clinical examination of the aborted fetuses or newborns. The outcome of the last pregnancy showed bilateral cleft lip + cleft palate and congenital pyloric stenosis at birth. The newborns resulted from two other screen positive pregnancies were normal. No information was obtained from the two remaining pregnancies after the ultra-sound scanning. The median weight of pregnant mothers in sample population was 63.34 +/- 10/66, in screen positive patients 61/11 +/- 11.92 and in screen negative patients 63.30 +/- 10.63. The results obtained from antenatal maternal serum screening in the present study compares favorably with the results from reference centers using similar screening strategies. The method employed in this research is reliable and can be readily applied for screening of a large population of pregnant women for open NTDs

Abdominal aortic aneurysm: a 5 years experience in Tabriz Imam Khomeini's hospital

Abdominal aortic aneurysm occurs as a result of chronic degenerative change in arterial wall. Less than 5% mortality rate has been reported for elective infra renal aortic aneurysm surgeries, however, ruptured aortic aneurysms operations have still remained as a main medical problem with a mortality rate of 30% to 70%. In this prospective study we intend to evaluate multifarious signs and factors in prognosis of 31 patients with abdominal aortic aneurism in Imam Hospital during the years 1379-1384. In this analytic-descriptive study, 31 patients with abdominal aortic aneurysm evaluated during the years 1379-1384 in Imam Hospital. These patients divided to 3 groups: 1. Elective patients [10 cases], 2.Unstable ruptured aneurysms [9 cases], 3. Stable ruptured aneurysms [12 cases]. All the patients sustained transperitoneal operation. Early mortality [less than 30 days], post operative morbidity and other prognosis impressive factors were documented. Mean age was 67.1 +/- 8.9 and male to female ratio was 22.9. Early mortality occurred in 77% of unstable ruptured aneurysm group, 25% of stable aneurism group and 10% of elective group. We found no specific relation between sex and mortality. Significant relation found between mortality and systolic blood pressure at the time of admission and presence of renal disease. Mean hospital and ICU stay were 9.1 +/- 5.6 and 4.1 +/- 2 respectively. In alive patients distal embolism and renal failure were the main postoperative complications. Elective surgery increase survival in patients with abdominal aortic aneurysms. However, high rate of rapture decreases the life expectancy. Mortality rate of elective surgeries was 10%. Considering 77% of mortality rate in ruptured and unstable group, it seems evaluation for early detection and in due time operation to be an extremity