effect of orally administered iron-saturated lactoferrin on systemic iron homeostasis in pregnant women suffering from iron deficiency and iron deficiency anaemia

Background: Anemia is a common medical disorder affecting a lot of women in pregnancy in the developing countries. Anemia is the second indirect obstetric cause of death after cardiac causes

Aims: To compare the safety, tolerability, efficacy and hematological response of lactoferrin in treatment of iron deficiency anemia during pregnancy versus ferrous sulfate capsules

Methodology: Hematological Response to lactoferrin versus ferrous sulfate in Treatment of Anemia with Pregnancy". Study site: Ain Shams University hospital. Study design: A double blind clinical trial. Study population: The study was included Two-hundred pregnant females with iron deficiency anemia attending the outpatient clinics of Ain shams university maternity hospital for routine antenatal care. For each pregnant woman, age, parity and gestational history were taken before treatment. All pregnant women took their allocated treatment regularly for eight weeks after diagnosis of iron deficiency anemia with hemoglobin level and serum ferritin level and followed up after four and eight weeks. Also, epigastric pain, diarrhea, constipation, nausea, vomiting or gastric distress reported to assess tolerability of the drugs

Results: The study included 200 pregnant women in a double blind study: Group I [lactoferrin]: 100 cases were received 100mg of bovine lactoferrin [Pravotin sachets, Hygint, Egypt] twice a day. Group II [ferrous sulfate]: 100 cases were received 150 mg of dried ferrous sulphate + folic acid [vitamin B9] 0.50mg [Ferrofol, E.I.P.I.C.O, Egypt] three capsules per day

Conclusion: lactoferrin is more tolerable than ferrous sulphate. It has lesser GIT side effects and seems to icrease both hemoglobin and serum ferritin more than iron salts

Recommendations: Lactoferrin is recommended for patients with iron deficiency anemia

Does emergency cerclage prolong pregnancy and affect neonatal outcome?

Cervical cerclage has been used as an emergency or 'rescue' suture in women presenting with dilated cervices in the mid-trimester attempting to prolong pregnancy and improving fetal Outcome. This study was conducted to assess efficacy of cervical cerclage in pregnancy prolongation and improving fetal/neonatal outcome in patients with cervical changes and/or herniation of the fetal membranes. During the period from January 2000 to December 2007, twenty seven women between 18 and 24 weeks pregnancy presented with cervical dilation and fulfilled the inclusion criteria underwent emergency cerclage. Two patients, however, were lost during follow-up and therefore the case group included 25 patients while the control group included 19 patients, who refused the procedure and were managed conservatively with bed rest alone. The 2 groups were compared with regard to duration of pregnancy prolongation, gestational age at delivery, and neonatal birth weight. In the cerclage group, the mean prolongation of pregnancy was 69.28 days, the mean gestational age at delivery was 30.71 weeks, and the mean birth weight was 1843gm. These measures were significantly different from those of the control group [39 days, 26.43 weeks, and 1064gm, respectively]. Twenty of the 25 pregnancies in the cerclage group ended in live births, while 10 of the 19 pregnancies in the control group ended in live births [P>0.05]. Emergency cervical cerciage in the presence of bulging fetal membranes can be carried out safely. It resulted in prolongation of pregnancy, increased gestational age at delivery and improved neonatal outcome

Ovarina mass assessment with transvaginal ultrasound, color doppler and the histopathological findings

To compare transvaginal sonography and color Doppler imaging accuracy in diagnosing benign ovarian masses from malignant masses by the histopathological finding. The study was performed as a prospective study at Ain Shams University, departments of Obstetrics and Gynecology and Radiodiagnosis over the period from November-2002 to September-2004. A total of 80 cases with ovarian masses on which transvaginal sonography was performed before surgical exploration were included in the study. An ovarian mass was first studied using transvaginal sonography, then color Doppler evaluation of the solid portions of the tumor were done. A mass was graded malignant if flow was shown within the solid areas or papillary projection and benign if there was no flow and the actual histological type was detected after surgical exploration. The overall agreement between the test result and the actual outcome was calculated by K-statistics. Color Doppler evaluation was more accurate in the diagnosis of ovarian malignancies in comparison with transvaginal sonography [K = 0.836 and 0.62, respectively] because of significant higher specificity [0.95 versus 0.84; P <.05] and higher Positive predicative value [PPV] [0.81 for color Doppler versus 0.56 for transvaginal sonography] with same negative predictive value [NPV] [0.984 for color Doppler versus 0.982 for transvaginal sonography]