IL-6 level as a predictor for diagnosis of pre-eclampsia in the third trimester of pregnancy

Pre-eclampsia is a disease of pregnancy that is associated with increased incidence of maternal and fetal morbidity and mortality. The diagnosis of pre-eclampsia is dependent mainly on the presence of hypertension associated with proteinuria. This work studies serum lL-6 concentration and its association with both the early diagnosis and the prognosis of pre-eclampsia. The population of this study included 90 pregnant women in the third trimester of their pregnancy who were admitted for the Department of Obstetrics and Gynaecology of El-Sahel Teaching Hospital from August 2007 to May 2008. The study population was further subdivided into two groups, pre-eclampsia group [60 patients-67%] and control group [30 patients-33%]. There were no differences in age, gravidity, parity or gestational age between the two groups. The two groups showed significant differences in blood pressure [both systolic and diastolic] with p<0.0001 ; renal function tests [creatinine [p<0.000l], urea concentration [p<0.0001] and uric acid concentration [p<0.0001]]; liver function tests [SGOT [p<0.03], SGPT [p<0.04] and bilibrubin [p<0.001]], blood picture [WBCs [p<0.03], platelets [p<0.01] and hemoglobin [p<0.02]]; IL-6 concentraion [p<0.0001]. IL-6 at a cutoff value of 3.12 pg/mL showed a 100% sensitivity and specificity for pre-eclampsia. IL-6 failed to show a significant correlation with systolic blood pressure in pre-eclampsia group cases [p<0.059] while it showed a significant correlation with the diastolic blood pressure [p<0.015]. The IL-6 serum concentration correlation was significant for platelet levels [p value=0.021] and for white cell count [p value=0.002]. IL-6 serum concentration is a highly sensitive and highly specific markers for the diagnosis of pre-eclampsia and as indicators for the severity of the condition

Value of a single serum CA-125 in the prediction of miscarriage in women presenting with first trimester abortion

CA-125 levels are raised during all processes involving decidual activity [early pregnancy, immediately after birth and bleeding episodes during pregnancy]. In this study we investigated the usefulness of determining maternal single serum levels of CA-125 in maternal serum as a predictor of the fate of the bleeding episode in women presenting with first trimester abortion. The study is a prospective controlled study. Inclusion criteria including vaginal spotting, transvaginal ultrasound evidence of living intrauterine embryo or fetus, monovular pregnancy, normal ovaries seen by ultrasound and gestational age between 6-12 weeks. Exclusion criteria are multiple pregnancy, ovarian masses and pelvic endometriosis. Our study included 95 pregnant patients in their first trimester of pregnancy [40 patients [42.2%] in the abortion group who actually terminated their conceptions, 30 patients [31.5%] in the recovery group who successfully overcame the bleeding episode and continued their pregnancy, and 25 patients [26.3%] as a control group, who have no bleeding]. Our results showed that the abortion group tends to have a significantly lower duration of conception than the other two groups. As regards CA-125 levels, the p value was 0.00 for recovery vs. abortion groups [highly significant], 0.0006 [highly significant] for recovery vs. control groups, and 0.00 for abortion vs. control groups [highly significant]. The test yielded a sensitivity of 93.33% and a specificity of 95.38%. Such results lead to the conclusion that determination of CA-125 level in maternal serum during a bleeding episode in the first trimester of pregnancy has a significant predictive ability as regards the outcome of pregnancy