accuracy of placental alpha-microglobuline-1 test in diagnosis of premature rupture of the membranes

Premature rupture of membranes [PROM] is a common obstetric issue during pregnancy which might lead to serious fetal or maternal problems. Therefore, an appropriate diagnosis and management of PROM are of significant importance in patients. The aim of this study was to determine the accuracy of placental alpha microglobuline-1 [PAMG-1] test in PROM diagnosis and compare this diagnostic method with other standard tests in diagnosis of PROM. In this prospective diagnostic accuracy study, patients with symptoms of membrane rupture in 16-39 weeks of gestation were involved. Three tests including Fern, Nitrazine and PAMG-1 were performed at the same time. PROM was confirmed in 86 patients out of 100. The sensitivity and specificity were respectively 81.3% and 100% for Fern test, 93% and 92.8% for Nitrazine test, 98.9% and 92.8% for PAMG-1 test. PAMG-1 test showed higher sensitivity [98.9% with p<0.001] and accuracy [98%] compared with conventional tests. Although PAMG-1 showed a lower positive predictive value [PPV] compared to conventional tests such as Fern test [100%], it was shown to be more accurate. The accuracy of PAMG-1 test was superior to both Fern and Nitrazine test in PROM diagnosis

Comparison of 25-hydroxyvitamin D and calcium levels between polycystic ovarian syndrome and normal women

Given the relationship of vitamin D deficiency with insulin resistance syn-drome as the component of polycystic ovary syndrome [PCOS], the main aim of this study was to compare serum level of 25- hydroxyvitamin D [25[OH]D] between PCOS patients and normal individuals. A cross sectional study was conducted to compare 25[OH]D level between117 normal and 125 untreated PCOS cases at our clinic in Arash Hospital, Tehran, Iran, during 2011-2012. The obtained levels of 25[OH]D were classified as follows: lower than 25 nmol/ml as severe deficiency, between 25-49.9 nmol/ml as deficiency, 50-74.9 nmol/ml as insufficiency, and above 75 nmol/ml asnormal. In addition, endocrine and metabolic variables were evaluated. Among PCOS patients, our findings shows 3[2.4%] normal, 7[5.6%] with insufficiency, 33[26.4%] with deficiency and 82[65.6%] with severe deficiency, whereas in normal participants, 5[4.3%] normal, 4[3.4%] with insufficiency, 28[23.9%] with deficiency and 80[68.4%] with severe deficiency. Comparison of 25[OH]D level between two main groups showed no significant differences [p= 0.65]. Also, the calcium and 25[OH]D levels had no significant differences in pa-tients with overweight [p=0.22] and insulin resistance [p=0.64]. But we also found a relationship between 25[OH]D level and metabolic syndrome [p=0.01]. Furthermore, there was a correlation between 25[OH]D and body mass index [BMI] in control group [p=0.01], while the C-reactive protein [CRP] level was predominantly higher in PCOS group [p<0.001]. Although the difference of 25[OH]D level between PCOS and healthy women is not significant, the high prevalence of 25[OH]D deficiency is a real alarm for public health care system and may influence our results

Unexpected outcome after expectant management of ectopic pregnancy in two persons

Ectopic pregnancy is one of the main problems in women in reproductive age that needs special attention and appropriate strategy should be managed. In some cases expectant management seems good strategy without any medicine or surgery and their possible side effects. But are the outcomes always the same? Which outcomes should we expect? We have reported 2 patients whose ectopic pregnancy had been managed conservatively and they had sustained pain for several months which needed surgery to resolve In the case of ectopic pregnancy, it is important for the clinician to select the patient meticulously and be aware of common and rare consequences of her treatment

Fertility outcome after operative laparoscopy versus no treatment in infertile women with minimal or mild endometriosis

Background: Endometriosis is the presence of endometrial glands and stroma in sites other than the uterine cavity, which is associated with infertility. The objective of this study was to evaluate the effect of laparoscopic surgical treatment on clinical pregnancy in infertile women with minimal or mild endometriosis

Materials and Methods: This clinical trial study was performed in infertile women who were referred to the gynecological clinic between April 2008 and March 2009. After confirmation of minimal or mild endometriosis by diagnostic laparoscopy, patients were randomly assigned into two groups using consecutively numbered, opaque sealed envelops. The first group consisted of women who only underwent diagnostic laparoscopy [no treatment] before randomization. The second group of patients underwent operative laparoscopies. T-test and chi-square test were used when appropriate. A p-value less than 0.05 was considered statistically significant

Results: Analysis with 38 patients in each group showed characteristics such as age, body mass index [BMI], and duration of infertility were statistically similar in both groups. At 9 months follow-up, 9 [24%] women who had operative laparoscopies became pregnant compared with 7 [18%] women in the diagnostic laparoscopy group. The pregnancy rate showed no statistically significant difference between both groups [p=0.49]. No complications were reported in either group

Conclusion: The present study suggested that laparoscopic surgical treatment was not superior to diagnostic laparoscopy in pregnancy occurrence in infertile women with minimal and mild endometriosis. [IRCT Number: IRCT201012311952N2]

Comparison of serum uric acid, iron and total iron binding capacity [TIBC] levels in pre-eclamptic and normal pregnant women

The objective of our study was to compare uric acid, iron and TIBC levels in normal and preeclamptic pregnant women and determine their relations with maternal and fetal complications. A case control study was conducted in 200 normal and preeclamptic pregnant women. At 32-40 weeks of pregnancy [third trimester] a blood test was taken in order to measure the uric acid, iron and TIBC and their relation with maternal and fetal complications. Uric acid level showed significant difference [4.58 +/- 0.73, 4.87 +/- 0.58, p=0.002] between two groups of pre-eclamptic and normal women. The iron and TIBC level had no significant difference in either group. The uric acid level and iron had significant differences between two groups with and without maternal complication, respectively [4.69 +/- 0.66, 5.05 +/- 0.59, p<0.05] [387.42 +/- 82, 405.24 +/- 57, p<0.05]. There was not any difference in three parameters between groups with and without fetal complication. The BMI was significantly higher in preeclamptic group and has positive relation with uric acid level. If we consider 29 as BMI cut-off point; it will be associated with 73% sensitivity and 67% specificity in preeclampsia determination. Using 4.55 as uric acid cut-off point, the sensitivity is 76% and specificity is 49%.Although the higher level of uric acid, higher BMI scale and positive roll-over test are associated with preeclampsia, but they are not very strong predictors as single test