Cervical length versus vaginal PH in the second trimester as preterm birth predictor

To evaluate diagnostic value of vaginal pH and cervical length measurement in the second trimester of pregnancy as a preterm labor [PTL] predictor. During a prospective cohort study 438 uncomplicated singleton pregnant women between 18 and 24 weeks of gestation were assessed regarding vaginal PH and cervical length. Vaginal pH was measured using Ph-indicator strips and cervical length was determined using transvaginal ultrasound. The cut-off values for vaginal PH and cervical length were defined as 5 and <30 mm respectively. Vaginal pH of 5 and above was found in 162/438 women [37%] while cervical length <30 mm was found in 38/438 [8.7%]. The incidence of PTL < 37 weeks was 87/438 [19.9%] while the incidence of early [PTL <34 weeks] was 51/438 [11.6%]. Predictive value of higher vaginal PH was significantly more [31%] than vaginal PH<5 [13%] in predicting PTL. As a result, alkaline vaginal PH significantly increases the odds of preterm labor [OR=3.06]. Shortened cervical length is better predictor of PTL than higher vaginal PH with positive predictive value of 71% and negative predictive value of 85%. Cervical length less than 30 mm nearly 14-fold increases odds of preterm birth [OR=13.9]. Compared to alkaline vaginal PH, shortened cervical length has better value to predict PTL overall. However, regarding early or late PTL, vaginal PH is more accurate to predict late PTL, while cervical length measurement is more appropriate to predict early PTL [<34 weeks]

[ effect of letrozole on symptomatic uterine leiomyomas]

Uterine leiomyomas are the most common benign tumors of the uterine, and several medical treatments have been suggested for these myomas. This study was conducted with the aim of determining the effect of letrozole on symptomatic uterine leiomyomas in patients referring to Naghavi Clinic in Kashan city. This study is a before and after clinical trial, in which 30 premenopausal women with large symptomatic uterine leiomyoma equal to 3cm received 2.5mg letrozole daily for 90 days continuously. Then, the effect of letrozol on uterine and myoma size, hemoglobin, FSH, LH, and estradiol levels and also accompanied symptoms such as amount and duration of menstrual bleeding and dysmenorrhea were evaluated. Data were analyzed by statistical tests such as paired t-test and test. Levels of p<0.05 were considered as significant. In this study, letrozole had significant effect on decrease in uterine volume [p=0.001] and myoma volume [p<0.001]. Also, the means of amount [p<0.001] and duration [p=0.007] of menstrual bleeding decreased and hemoglobin increased by 8% [p<0.001], but have no effect on FSH, LH and, estradiol levels. The results of this study showed that letrozole leads to decrease in leiomyoma and uterine size, amount and duration of menstruation, and increase in hemoglobin level. Therefore, this drug can be used for treatment of symptomatic uterine leiomyomas

Plasma total antioxidant capacity and its related factors in Iranian pregnant women

To determine the plasma total antioxidant capacity [TAC] and its related factors in pregnant Iranian women attending maternity clinics. In a cross-sectional study carried out in Naghavi Maternity Clinic, Shaheed Beheshti Specialty and Subspecialty Polyclinic and 10 antenatal centers, affiliated to Kashan University of Medical Sciences, Kashan, Iran, we determined the plasma TAC and its related factors including maternal age, weight, and body mass index [BMI] at the beginning, thirteenth, and twenty-first to twenty-fourth weeks of pregnancy, and gestational age at the twenty-first to twenty-fourth weeks of pregnancy in 137 primigravid pregnant women, 18-30 years old from October 2010 to March 2011. We used multiple linear regression to assess the relationship between TAC and its related factors. Plasma TAC in the twenty-first to twenty-fourth weeks of pregnancy was 0.75 +/- 0.11 mmol/l. The BMI at the beginning was 25.06 +/- 4, 25.72 +/- 4.13 at the thirteenth, and 26.95 +/- 4.19 kg/m[2] at the twenty-first to twenty-fourth weeks of pregnancy. Multiple regression analysis showed that gestational age was inversely associated with the plasma TAC [beta: -0.234, p=0.007]. Regression analysis also suggested a trend toward significant association between maternal age and plasma TAC [beta: 0.150, p=0.080], but there was no association between other variables and plasma TAC. Gestational age was inversely correlated with plasma TAC and maternal age had a trend toward significant association with TAC in 18-30 year-old Iranian pregnant women in their sixth month of pregnancy