Lipopolysaccharide- and lipoteichoic acid-mediated pro-inflammatory cytokine production and modulation of tlr2, tlr4 and myd88 expression in human endometrial cells

Toll-like receptor [TLR]-mediated inflammatory processes are supposed to be involved in pathophysiology of spontaneous abortion and preterm labor. Here, we investigated functional responses of human endometrial stromal cells [ESCs] and whole endometrial cells [WECs] to lipopolysaccharide [LPS] and lipoteichoic acid [LTA] Endometrial tissues were obtained from 15 cycling women who underwent laparoscopic tubal ligation. Modulation of TLR2, TLR4 and MyD88 expression and production of pro-inflammatory cytokines by WECs and ESCs in response to LPS and LTA were assessed. WECs and ESCs expressed significant levels of TLR4 and MyD88 transcripts but, unlike WECs, ESCs failed to express TLR2 gene. Regardless of positive results of Western blotting, ESCs did not express TLR4 at their surface as judged by flow cytometry. Immunofluorescent staining revealed intracellular localization of TLR4 with predominant perinuclear pattern. LPS stimulation marginally increased TLR4 gene expression in both cell types, whereas such treatment significantly upregulated MyD88 gene expression after 8 hr [p<0.05]. At the protein level, however, LPS activation significantly increased TLR4 expression by ESCs [p<0.05]. LTA stimulation of WECs was accompanied with non-significant increase of TLR2 and MyD88 transcripts. LPS and LTA stimulation of WECs caused significant production of IL-6 and IL-8 in a dose-dependent manner [p<0.05]. Similarly, ESCs produced significant amounts of IL-6, IL-8 and also TNF-alpha in response to LPS activation [p<0.05]. Our results provided further evidence of initiation of inflammatory processes following endometrial TLR activation by bacterial components which could potentially be harmful to developing fetus

Seroprevalence of varicella-zoster virus among pregnant women in two teaching hospitals, Tehran, Iran

Varicella zoster virus [VZV] can cause life-threatening disease in pregnant women. The aim of this study was to identify the VZV immune status in pregnant women and also determine the validity of self-reported history for chickenpox. Serologic testing for VZV was performed for 400 pregnant women attending prenatal care at clinics located in two teaching and referral hospitals in Tehran, Iran. The Enzyme Immunoassay method was used to assess IgG antibodies against VZV. A total of 400 pregnant women, aged 16-43 years [median: 27 years, mean: 27.6 +/- 5.9 years], were examined in which 361 [90.3%] were found to be seropositive. Sensitivity, specificity and positive and negative predictive values of patients' self reported history were 51.8%, 71.7%, 94.4% and 13.8% respectively. Serologic screening for VZV in pregnant women seems crucial. We suggest considering the pregnant women as the target group for future immunization programs in Iran

[ comparison of effectiveness between skin patch of nitroglycerin and nifedipin on controlling preterm labor]

Preterm labor is defined by bearing before 37 weeks of gestation. Premature newborn is associated with a high morbidity. Past studies demonstrated TNG has a positive effect on preterm labor, but no studies have been done comparing TNG and nifedipin in this field. The objective of the present study was to compare the effect and complications of Patch of TNG and nifedipin [Ca channel blocker] for treatment of preterm labor. A randomized clinical trial study was performed on 120 pregnant women with preterm labor pregnancy in Shahid Akbar Abadi Hospital in Tehran. Sixty women [TNG group] were compared with 60 women [nifedipin group] for drugs' safety and efficacy [delay of delivery for more than 48 hours]. Contractions and blood pressure were controlled in both the groups. In 41 [68.3%] patients of group 1, delay of delivery occurred for more than 48 hours, and in second group, it happened in 52[86.7%] patients. There was a statistically significant difference [p=0.016]. In 37 [61.7%] patients of group 1, delay of delivery occurred for more than 72 hours, and in second group, it happened in 47[78.3%] patients. There was a statistically significant difference [p=0.046]. TNG patch is an effective and suitable drug, associated with fewer complications in comparison with nifedipin in the treatment of preterm labor

[Evaluation of the value of urinary calcium to creatinine ratio for predicting pre-eclampsia]

Pre-eclampsia is one of the most serious complications in pregnancy and is one of the major causes of maternal death during pregnancy. Therefore, its prediction has special importance and many studies have been performed on different materials, which may be useful for its prediction. The purpose of the present study was to evaluate the urine calcium to creatinine ratio for prediction of pre-eclampsia. A prospective cohort study was performed on 150 pregnant women who were 15-35 years old. A single urine sample was obtained at 20-24 weeks of gestation for measurement of urinary calcium and calcium to creatinine ratio. The women were followed till delivery and this ratio was compared between the women with and without pre-eclampsia. Statistical analysis was performed with t-test, Roc Curve and SPSS version 16. p value < 0.05 was considered as statistically significant. Mean urinary calcium of pre-eclamptic women was significantly lower than normotensive women [179 +/- 35 mg/dl vs 272 +/- 59 mg/dl, p<0.001].Mean calcium to creatinine ratio was significantly lower in pre-eclamptic women [0.07 +/- 0.007 vs 0.16 +/- 0.006, p<0.001].The optimal cut off point for calcium to creatinine ratio was calculated 0.071 with a sensitivity of 77% and specificity of 78%. Urinary calcium and calcium to creatinine ratio are lower in pre-eclamptic women and may be used as a screening test for the prediction of pre-eclampsia

[Evaluation of the risk factors of ectopic pregnancy and a comparison between two age groups: more and less than 20 years old]

Ectopic pregnancy [EP], is one of the most important complications of pregnancy and one of the most important factors of maternal mortality in developing countries. Evaluation of the risk factors might be helpful for patients in order to conduct a better management. The purpose of the present study, was to determine the risk factors of ectopic pregnancy and to compare them between the ago group of more and less than 20 years old. Also, these risk factors were compared between Iranian and Afghans. The study was conducted as a case- control study. In this evaluation 308 cases of EP [case group], were compared with 616 cases of normal pregnancy in Akbarabadi Teaching Hospital. All ectopic pregnancies have been confirmed by surgery and pathology. The evaluated factors were age, BMI, smoking, history of previous EP, history of STD, consanguinity, blood group and Rh, history of infertility and abortion, pelvic surgery, marital age, contraceptive methods, previous cesarean section, socioeconomic status, and nationality. Statistical analyses were performed using SPSS version 16. Chi- square test and logistic regression were used for analysis. Smoking p<0.001, AOR=5.7 [CI 95%= 2.8-11.6]], previous EP p=0.000, AOR= 11.4 [CI 95%= 3-42.4]], previous STD p<0.001, AOR= 3.2 [CI 95%= 2.1-4.9]], previous use of IUD p<0.001, AOR=4.1 [CI 95%= 2.1-8]], history of infertility p=0.01, AOR= 1.8 [CI 95%= 1.1-3]], previous cesarean delivery p=0.03, AOR= 1.5 [CI 95%=1.1-2.3]], consanguinity, p=0.002, AOR=2.2 [CI 95%= 1.3-3.6]], were considered as risk factors for EP. Age, BMI, previous abortion, socioeconomic status, blood group and Rh, did not show significant relationship with EP. Smoking, previous EP, history of STD, IUD, infertility, previous cesarean delivery, and consanguinity were, risk factors for EP

[Evaluation of the diagnostic value of the first and third trimester maternal mean platelet volume [MPV] for prediction of pre-eclampsia]

Preeclampsia is a severe complication of pregnancy, often associated with significant morbidity and mortality for both mother and newborn. The aim of this study is to evaluate if mean platelet volume during first trimester predict preeclampsia or preterm labour development. All pregnant women, in the first trimester, attending to prenatal clinic at Shahid Akbar Abadi Hospital for routine obstetric care during 2010 were enrolled. According to the study, blood sample was taken from women at the first visit in first trimesters and the third and recorded. After delivery, outcome data were obtained. A total of 400 women were included and 35 [8.8%] and 96 [24%] of them developed preeclampsia and preterm labor, respectively. Parameters of platelet during pregnancy were similar between groups. MPV values of pre-eclamptic women were not significantly different with normotensive counterparts. Our study did not provide evidence that MPV changes could predict preeclampsia or preterm labor development.

Risk factors for pre-eclampsia: a study in Tehran, Iran

This study evaluated some risk factors for pre-eclampsia, which is one of the most problematic complications of pregnancy. This was a retrospective case control study conducted on 318 pre-eclamptic women [case group] and 318 women who were normotensive at the time of delivery as the control group. Evaluated factors were: maternal age, gestational age, nuliparity, mother's educational status, maternal body mass index [BMI], maternal hemoglobin and blood Rh, familial history of pre-eclampsia, history of pre-eclampsia in a previous pregnancy, marital relations, urinary infection [UTI] during the present pregnancy, season of delivery, and method of contraception. Risk factors for pre-eclampsia were: UTI [P=0.04]; history of pre-eclampsia during previous pregnancy [P=0.003], and winter season [P=0.001]. Maternal age of more than 20 years, high educational status of mother, parity more than one, and oral contraceptive pills were protective for pre-eclampsia. After adjusting for all possible confounding factors using multiple logistic regression, only preexisting pre-eclampsia [P=0.004] was a risk factor, whereas parity more than three [P=0.007] and anemia [P=0.01] were protective for pre-eclampsia. The rate of cesarean delivery was more common in the pre-eclamptic group [245 cases, 77%] than the control group [85 cases, 26.7%]. The one minute Apgar scored neonates less than 8 was more common in the case group [28.6% vs. 47.4%, P<0.001]. Gestational age at the time of delivery was lower in the case group [36.48 +/- 3.4 weeks vs. 37.12 +/- 3.3 weeks, P<0.001]. Awareness of risk factors of pre-eclampsia can help to monitor patients, ensure earlier diagnosis and predict which patients are more likely to develop pre-eclampsia

[Quality of life in patients with endometriosis in Tehran in 2009]

Endometriosis is a estrogen-depended and chronic gynecological disease. The symptoms of this with an overall negative impact on the psychosocial parameters in the patients, leading to a significant reduction of health-related quality of life. The aim of this study was to evaluate health-related quality of life in patients with endometriosis. This cross-sectional study was performed on women with endometriosis in Several hospitals affiliated Tehran University of Medical Sciences, with non randomized sampling method. Health-related quality of life in patients with endometriosis was investigated with endometriosis health profile [EHP-30] questionnaire in 5 scales including Pain, Emotional well-being, control and powerlessness, Social support and self imaging scales. Data analyzed by descriptive statistics in SPSS [15] software. Mean age of 100 Participants in this study was 39.5 +/- 7.54 years. Quality of life scores in core questionnaire domains was 36.20 to 46.73 and in modular questionnaire domains was 34.85 to50.55.Most aspects affected by disease were psychological and pain in core questionnaire and infertility in modular questionnaire. The least affected by the disease was self image domain. Our study showed that Endometriosis impairs health related quality of life, especially in the domains of psychological and pain. Emphasizing on life Quality of patients using appropriate medication therapy and Psychotherapy is necessary and important