Induced active labor: color doppler study of fetal hemodynamics

To evaluate fetal hemodynamic changes before and during active labor, either spontaneous or prostaglandin E2 [PGE2] versus prostaglandin E1 [PGE1] induced labor, 120 healthy women at 37-41+ weeks of gestation without signs of maternal medical problem and fetal distress were investigated before and during labor. Group I [60 women] had spontaneous active labor, group II [60 women] were in active labor induced by intra-vaginal PGE2 [1.5-3 mg] and group III [60 women] were in active labor by oral PGE1 [50-100 ug]. Blood flow waveforms indices [systolic/diastolic ratio [S/D ratio], resistant index [RI] and pulsatility index [PI] were assessed by pulsed color Doppler from the umbilical artery [UA] and fetal middle cerebral artery [MCA] before and during labor. The groups were compared for the waveform indices, progress of labor and perinatal outcome including birth weight, umbilical artery pH at delivery, Apgar score and neonatal intensive care unit [NICU] admission. It was found that in group I, the S/D ratio, RI and PI became significantly decreased in the UA and MCA compared with those measured before labor. In group II, there were no significant changes in the waveform indices in the UA and MCA. While, in group III, all the waveform indices in MCA and the S/D ratio in UA were significantly decreased; but the umbilical artery RI and PI were not significantly changed. The incidence of UA pH was significantly more in group II than in group III and I [25%, 10% and 5%, respectively]. No other significant adverse perinatal outcomes were observed in the three groups

Assessment of ovarian stromal blood flow in polycystic ovary

To evaluate stromal echogenicity in women with polycystic ovary syndrome [PCOS] and the effect of ovarian drilling, 62 infertile women were included in this study. All women had PCOS diagnosed on the basis of clinical symptoms, laboratory findings and characteristic ultrasonographic features of PCOS. The patients were divided into two groups: Group I included 48 women who were evaluated in response to clomiphene citrate [CC] therapy and group II included 26 women who did not respond to CC-therapy, up to 150 mg/day for 5 days, and subsequently underwent laparoscopic ovarian drilling. Serum samples were tested using ELISA for the quantitative measurement of FSH, LH and free testosterone before and after CC therapy and drilling. Ovarian volume and stromal index were measured by 3-dimensional ultrasonic machine in both groups and after ovarian drilling. Also, pulsatility index [PI] and peak systolic blood flow velocity [PSV] were assessed by pulsed color Doppler from ovarian stroma. The study concluded that the ovarian stromal index and ovarian volume were significantly higher among women in GII than those in GI, which might explain the failure of response to CC-therapy

Interleukin-6 in maternal and umbilical cord blood as a predictor of chorioamnionitis and neonatal sepsis in patients with preterm premature rupture of membranes

This study included 80 pregnant women with preterm-PROM and their newborns. Maternal serum was obtained at time of admission and delivery for measuring total leucocytic count [TLC], C-reactive protein [CRP] and IL-6. Chorioamnionitis was diagnosed clinically and histologically. Umbilical cord blood at time of delivery was obtained for measurement of IL-6. The clinical outcome of neonates was followed up and documented. IL-6 [maternal and umbilical cord blood] seemed to be a promising predictor for early onset chorioamnionitis and neonatal sepsis

Immediate post-abortion intrauterine contraceptive device insertion

To evaluate immediate post-abortion IUCD insertion, 200 women with spontaneous first trimester abortion were selected. IUCDs were inserted immediately post-abortion in 90 women, within 2-3 weeks after abortion in 30 women and after the first menses in 70 women. Blood loss was estimated during the first post-abortive 24 hours as well as the first and the second menses. All patients were followed for six months post insertion. In this study, it was found that the incidence of leukorrhea was significantly higher among post-abortion IUCD users than among non users. There was a significant reduction in the menstrual blood loss, in the incidence of menorrhagia and inter- mensrual bleeding in immediate post-abortion IUCD users in comparison to interval IUCD users. The incidence of other side effects and complications of IUCD [i.e. pain, infection, expulsion and pregnancy] in immediate post-abortion IUCD users were comparable or even lower than in the interval IUCD users. These data suggested that immediate post-abortion IUCD insertion is a safe and recommendable procedure