Correlation between doppler middle cerebral artery, umbilical and pregnancy outcome in prelabour premature rupture membranes

To evaluate to role of middle cerebral and umbilical arteries Doppler in prelabour recently ruptured membranes and pregnancy outcome. One hundred twenty patients; their gestational ages were ranging between 28-37 weeks were in rolled in this study. They were divided into: Control group which included 80 patients, and study group which included 40 patients suffering from prelabour rupture membrances; they were further subdivided into two subgroups according to amniotic fluid index into: Subgroup IIa [borderline oligohydramnious] which included 20 patients and subgroup IIb [oligohydramnious] which included 60 patients. All patients were subjected to: Full present history, clinical examination, lab investigations, and ultrasonographic examinations, colour Doppler examinations of foetal middle cerebral artery and umbilical artery and pregnancy outcome. The amniotic fluid index predicted unfavorable outcome in rupture membranes with sensitivity 88%, specificity 72%, +ve predictive value 59.5% -ve predictive value 93%, Kappa=0.33% p<0.001. Pulsitility index of middle cerebral artery predicted unfavorable outcome with values [72%, 56.4%, 42.9%, 77.8%, 0.21% and 0.048 respectively]. Pulsitility index of umbilical artery predicted unfavorable pregnancy outcome with values [80%, 50.9%, 42.6%, 81.6%, 0.23, and 0.019 respectively]. If all the results of middle cerebral artery Doppler, umbilical artery Doppler and amniotic fluid index were taken in consideration the sensitivity reached 40%, specificity 75%, +ve predictive value reached 53% and -ve predictive value 73%. Based on scoring system of pregnancy outcome: There are good agreements between PI[MCA], PI[UM], Amniotic fluid index and pregnancy outcome in prelabour rupture membranes. Studying Doppler middle cerebral artery, umbilical artery and amniotic fluid index together can help in prediction of pregnancy outcome in prelabour premature rupture membranes

Plasma leptin concentration in cord blood: relationship to the degree of preeclampsia and placental weight

The objective of this work was to study the changes in the level of umbilical cord plasma leptin in newborns of women with preeclampsia and whether there is a correlation between the degree of preeclampsia and the level of umbilical cord plasma leptin; in addition, to study if there is any correlation between cord plasma leptin and placental weight. This study compared cord plasma leptin of 42 preeclamptic mothers' newborns [24 mild preeclampsia, 18 severe preeclampsia] and 40 normal control mothers' newborns. Mean value of cord plasma leptin was significantly higher in preeclamptic group, than control group, furthermore, it was significantly higher in severe preeclamptic group than mild preeclamptic group. Female newborns had significantly higher mean value of cord plasma leptin than male gender newborns. Comparing mean value of pulsatility index of umbilical artery in preeclamptic and control groups, it was significantly higher in the former than the later. Also, it was significantly higher in severe preeclampsia compared to mild preeclampsia groups. A significant positive correlation was found between the pulsatility index and cord plasma leptin level in the preeclampsia group, while there was no significant correlation between each of placental weight, maternal weight, birth weight, ponderal index and cord plasma leptin level. In conclusion, cord plasma leptin increased significantly in newborns whose mothers suffer from preeclampsia and this increase is more in newborns of mothers with severe preeclampsia. These changes plus the significant rise in pulsatility index of umbilical artery in preeclamptic women suggested a potential angiogenic regulating role for leptin in preeclampsia and, consequently, a potential therapeutic role for leptin hormone in preeclampsia. Moreover, this study proved that cord plasma leptin is unrelated to placental weight