Perinatal outcome of pregnancies complicated by immune thrombocytopenia

Immune thrombocytopenia [ITP] is an autoimmune disorder that leads to premature destruction of antibody-coated platelets. This study evaluated perinatal outcome and medications used for pregnancies complicated by ITP. Medical records of 132 pregnancies belonged to 125 parturients with ITP who delivered between March 2001 and January 2011 were reviewed. Cases were included if diagnosed before pregnancy or if their platelet counts [PCs] were less than 80,000/microL during pregnancy without any other cause. Maternal and fetal outcomes were compared. Fifty six mothers [42.1%] had PC<50,000, 18 women [13.5%] developed preeclampsia and 15 [11.3%] were diabetics. Corticosteroid was used for120 cases [90.9%] and intravenous immunoglobulin for 14 women [10.5%]. PCs of 114 neonates were available in the charts and 84 [83.2%] had PC>150,000/microL. Three neonates [2.3%] had PC<50 000, 31 neonates [23.3%] had preterm births and 32 [24.1%] needed NICU admissions. Fifty seven cases of ITP [43.2%] were diagnosed before pregnancy and 75 [56.8%] were diagnosed during pregnancy. There were 2 intrauterine fetal deaths and higher NICU admissions, 20 [34.48%] versus 12 [16%] in the first group [p=0.01]. Perinatal outcome of pregnancies with ITP is generally good. However neonates born from parturients with chronic ITP needed more NICU admissions

Maternal risk factors and neonatal outcome of the admitted patients for preterm spontaneous uterine contractions

Preterm birth [PTB] is one of the most important unsolved problems in reproductive medicine. This study aims to evaluate several maternal risk factors and outcome of pregnancies who were admitted for preterm spontaneous uterine contractions [PSUC]. From September 2007 to February 2009, 327 cases who were admitted for PSUC were retrospectively studied. They were classified according to their fetal numbers and presence of true versus threatened preterm labor [PTL]. There were 297 [90.82%] singleton, 27 [8.25%] twin and 3 [0.91%] triplet pregnancies. Only 12 women [3.6%] fulfilled the ACOG criteria for PTL who delivered in a few hours and 315 cases [96.3%] were classified as threatened PTL and most of them were discharged undelivered from the hospital. 103 cases were missed and 224 mothers and their 247 neonates remained. 121 women from this cohort had PTB and delivered before 259 days [54%]. Pregnancy outcomes including; the time interval between admission for PSUC and delivery, the mean gestational ages at birth, birth weights, number and duration of NICU admissions were evaluated in each group. Regular uterine contractions even in the absence of cervical changes should be considered as a potential risk factor for PTB. The most frequently associated maternal risk factors were history of abortion, infertility and previous PTB, and the most frequently associated complications were preterm rupture of membranes, vaginal bleeding and febrile diseases

Cutaneous application of menthol 10% solution on temporal area in acute treatment of common migraine

Migraine as the most popular vascular headache was always been the topic of discussion in the medical literatures. Regarding the theories underlying pathophysiology of migraine, various methods for treatment of this disorder have been proposed. Menthol is the most important active agent in peppermint and various mechanisms of action for it have been proposed till now, many of them focused on it's analgesic effect through TRPMs, a group of the transient receptor protein TRP. In previous interventional studies also, a solution of peppermint extract in ethanol significantly reduced the clinical tension type headache intensity. Regarding numerous therapeutic effects of menthol, we performed this study to evaluate the effect of cutaneous application of menthol on reducing headache intensity in migraine acute attacks. Twenty five female patients enrolled in this interventional uncontrolled study. They all used the 10% menthol solution the way they were informed. During the consumption, they filled out some questionnaires containing information about intensity of headache and associated symptoms. Within 33 well recorded attacks of migraine, 50% relief of pain occurred after 1.85 hours and sustained pain-free efficacy was achieved after 6.76 hours. Seventy one percent of migraine patients who had nausea/vomiting and 43% of those who were suffering from photophobia and photophobia associated with headache became symptom-free after 2 hours. This study demonstrates that cutaneous consumption of 10% menthol in ethanol solution is well tolerated by the patients and relives the pain and associated symptoms. However, further controlled studies are needed to confirm these observations