Maternal serum corticotrophin releasing hormone level in preterm Labour

Background: Preterm birth still remains a significant management problem and a large number of markers were investigated

Objective: To assess the increasing of Corticotrophin Releasing Hormone [CRH] level in women diagnosed with preterm labour and are of medical value. Design: - Case control study. Al-Kadhymia Teaching Hospital

Methods: Plasma samples of 80 women diagnosed with preterm labour were used in this study. Samples were divided into three groups, according to week of gestation [24[th] 28[th] 29[th] 32[nd] 33[rd] 37[th]]. CRH values determined by ELISA. Twenty low risk women of control group were recruited near the end of 2[nd] trimester, all of them delivered healthy infants at gestational age greater than 37 weeks

Results: In a study population of one hundred pregnant women, eighty of them were diagnosed as preterm labour and twenty women as a control group, sixty-four out of eighty high risk women delivered preterm birth while the remaining sixteen of the same group delivered term babies. Our study shows that CRH level is elevated in the women with preterm birth, and ranged between [18.30-95.03] pg/ml., serum values of CRH were significantly lower in women with term birth and ranging between [13.5-14.9] pg/ml, the [p<0.001]. The sensitivity of CRH was 80% while specificity was 100%

Conclusion: Maternal serum CRH level was elevated in women who gave preterm birth compared with those giving term delivery

Serum progesterone and CA125 levels as an aid in the prediction of ectopic and intrauterine pregnancy

Prompt diagnosis of ectopic pregnancy is a difficult dilemma, and reliable predictors for diagnosis and differentiation of ectopic pregnancy from early pregnancy miscarriage are needed. To evaluate the diagnostic value of serum progesterone and CA-125 levels in ectopic pregnancy and early intra uterine miscarriage. A prospective case control study. The study was carried out in the department of obstetrics and gynecology of AL-Yarmouk teaching hospital [Baghdad - Iraq] from February 2011 to February 2012. This study was carried out on sixty pregnant women in their first trimester. Twenty women diagnosed as unruptured ectopic pregnancy; treated by laparotomy, twenty women diagnosed as inevitable miscarriage; treated by curettage and twenty women with healthy pregnancy of a comparable gestational age as control group; follow up of this group was done to ascertain uneventful pregnancy with no complications. We compared the serum levels of progesterone and CA-125 in all groups at the time of presentation and 24h after surgical intervention in first and second groups. There was a significant decrease in mean post operative progesterone level in women with ectopic pregnancy and miscarriage groups with significant difference [P<0.0001]. The study observed that the mean level of progesterone in women with ectopic group [6.76 +/- 3.63 ng/ml] was lower than that in miscarriage group [15.17 +/- 6.01 ng/ml] and control group [17.58 +/- 4.57 ng/ml] with significant difference [P<0.0001]. This study also observed that the mean level of CA-125 in women with miscarriage group [117.07 +/- 94.30 U/ml] was higher than that in ectopic group [38.11 +/- 28.79 U/ml] and control group [30.51 +/- 16.10 U/ml] with statistically significant difference [P<0.0001]. There was a significant decrease in mean level of post operative CA-125 in women with ectopic pregnancy and miscarriage groups with significant difference [P<0.0003]. Combined measurement of both serum progesterone and CA-125 can be sensitive predictors in diagnosis and differentiation of ectopic pregnancy from inevitable miscarriage and normal pregnancy

Role of nucleated red blood cells in umbilical cord blood as a marker of neonatal asphyxia with meconium stained amniotic fluid

Neonatal asphyxia is a major cause of neurologic morbidity and mortality. Recent studies suggest increased nucleated red blood cells in neonates with meconium aspiration syndrome, supporting that the pregnancy with meconium stained amniotic fluid is at high risk of fetal hypoxia. To evaluate the role of umbilical cord nucleated red blood cells as a marker of neonatal asphyxia with meconium stained amniotic fluid. This study was conducted at the Department of Obstetrics and Gynecology and Nursery Department in AL-Kadhymia Teaching Hospital from April 2010 through April 2011 as prospective case controlled study. The study included one hundred pregnant women, who were admitted to the delivery ward, they were arranged into two groups. Group one included fifty women with meconium stained amniotic fluid, considered as study group and the other group included fifty women with clear amniotic fluid, considered as control group. This for determination of umbilical cord nucleated red blood cells and comparison between two groups. The percentage of abnormal nucleated red blood cells count [NRBCs] in the study group [30%] was significantly more than the control group [18%] [P value =0.002].The mean nucleated red blood cells count [NRBCs] difference was 3.69 units and it was significantly higher in the study group than the control group [P value =0.0002]. The nucleated red blood cells [NRBCs] count increase in cord blood of neonates with meconium stained amniotic fluid compared to neonates of clear amniotic fluid

Transvaginal sonographic cervical measurements and digital clinical examination in predicting successful labour induction

Induction of labor is safe and effective method of vaginal delivery, however, it carries the risk of cesarean delivery compared with spontaneous labor. Therefore, it is fundamental to assess the cervix condition to predict induction success. To assess the value of transvaginal sonograghical cervical measurements in predicting the outcome of labor induction and compare its performance against digital assessment [Bishop score]. A prospective study in AI-Kadhymia Teaching Hospital, where a group of 90 women with singleton gestation scheduled for induction of labor at more than 37 weeks were studied 48 nullipara and 42 multipara included in the study. Transvaginal sonography measurements of the cervix were performed and Bishop score was determined. All labors were induced by oxytocin infusion and amniotomy. Successful labor induction occurred in 67[75.5%] of women, both transvaginal cervical length and Bishop score were independent predictor of successful labor induction. Transvaginal cervical length can be considered as a diagnostic tool of successful labor induction and it is less subjective than Bishop Score

Maternal serum creatine Kinase and single serum progesterone measurement as predictors of ectopic pregnancy

To evaluate the role of maternal serum creatine kinase and single serum progesterone measurements in the prediction of ectopic pregnancy. The study was conducted at A-Khadhimya Teaching Hospital, department of obstetrics and gynecology during the period from March 2001 through April 2002. The study included 60 women divided into 3 groups: Group A: Twenty patients with ectopic pregnancy confirmed by surgery and histopathology. Group B: Twenty patients with non continuing pregnancy [missed abortion or spontaneous abortion] of comparable gestational age. Group C: Twenty women with normal intrauterine pregnancy of comparable gestational age. The following laboratory measurements for the studied groups were done: serum age. The following laboratory measurements for the studied groups were done: serum creatine kinase, serum progesterone levels and histopathological study to determine the depth of invasion of the trophoblast to the muscular layer of the fallopian tube for group A. The mean serum creatine kinase was significantly higher in group A than in groups B and C [P<0.0001] and the mean serum progesterone level was significantly lower in groups A and B than in group C [P<0.0001]. The mean serum creatine kinase level was significantly higher in ruptured ectopic pregnancy than in the unruptured [P<0.0003], and in isthmic than in ampullary ectopic pregnancy [P<0.007]. In addition, the mean serum progesterone level was significantly higher in ruptured than in the unruptured ectopic pregnancy [P<0.01]. There was a significant positive correlation between serum creatine kinase and progesterone level in group A. There was an increase in the serum creatine kinase levels accompanying muscular damage in ectopic pregnancy probably antedates tubal rupture and could help in discriminating ruptured from unruptured ectopic pregnancy. The combined use of both serum creatine kinase and serum progesterone in patients with suspected ectopic pregnancy has a higher differential accuracy than either analysis alone