[Comparison of serum ceruloplasmin in preeclampsia and normal pregnancy]

Preeclampsia is a disorder of pregnancy with increased maternal and fetal morbidity and mortality. Endothelial cell dysfunction is important in the pathogenesis of preeclampsia. An imbalance between free radical induced lipid preoxidation and antioxidant system such as ceruloplasmin has been suggested as a possible pathogenic factor in preeclampsia and disturbing endothelial function. The aim of this study is to compare serum ceruloplasmin level in preeclampsia and normal pregnancy. This is a cross-sectional study that was performed on 39 preeclamptic patients [21 mild and 18 severe preeclampsia as case group] and 30 women with normal pregnancy [control group]. Five cc of blood was obtained from each patient and serum ceroloplasmin level was measured with special kit. Data were analyzed by one-way ANOVA Kruskal-wallis tests and ROC curve. P<0.05 was considered statistically significant. Maternal serum ceroloplasmin level was significantly different between the studied groups [P=0.47]. Increased serum ceroloplasmin level can be used as a predictive factor to diagnose severe preeclampsia

use of protein to creatinin ratio in random urine sample for prediction of proteinuria in preeclampsia

Preeclampsia occurs in approximately 17% of pregnancies, unknown etiology. The gold standard method for assessment of protein excreted in the urine to diagnose preeclampsia is a 24- h urine collection. However, this method is cumbersome and time consuming for the patient and laboratory. The aim of this study is to evaluate the use of protein to creatinin ratio in random urine sample for prediction of proteinuria in preeclampsia. This study is a cross-sectional descriptive study. This study was performed on 150 pregnant women who were hospitalized as preeclampsia in Ghaem Hospital during early 2006. At first, a random urine sample was collected for each patient to determine protein/creatinine ratio. Then, 24-h urine collection was analyzed for the measurement of proteinuria. Statistical analysis was performed with SPSS software and Pearson correlation coefficient for evaluation of the results. A total of 150 patients were entered the study. There was a significant relation between the 24-h urine protein and protein to creatinine ratio [r=0.659, P<0.001]. The use of e protein-to-creatinin ratio in random urine sample is a suitable replacement for the measurement of 24-h urine protein. This method is quick, reliable and cost effectiveness

Comparison of neonatal complications in newborns by cesarean and vaginal delivery

Background and Purpose: Because of the uncontrolled prevalence of cesarean in Iran and its complications for mother and infant with further social and ethical consequences, this study was conducted to compare the neonatal complications in newborns by cesarean and vaginal delivery

Methods and Materials: This cross-sectional, analytical descriptive study was conducted on infants born at the maternity ward of Imamreza Hospital and Ghaem Hospital in Mashad, Iran. The sample size with the confidence interval of 95% and test power of 80% was estimated to be 770 neonates. The obtained data were analyzed in SPSS 11.5 using Student t-test, Mann Whitney U and chi-square test

Results: Vaginal delivery was attempted by 344 women, and 426 women underwent elective cesarean delivery. The two delivery procedures were significantly different [p=0.002]as for the occurrence of RDS, which occurred in 31 cesarean cases [7.3%] and 12 vaginal cases [3.7%]. Also, in 14 cesarean cases [3.4%] and 24 vaginal cases [7%], asphyxia occurred. Transient tachypnea was observed to occur in 14 cesarean cases [3.3%] and 2 vaginal cases [0.6%], and the difference between the two groups was statistically significant [p=0.001]. Hospitalization in NICU was prescribed for 28 cesarean cases [6.6%] and 33 vaginal cases [10.2%], and the difference between the two groups was statistically significant [p=0.001]. Six cesarean cases [1.4%] and 48 vaginal cases [14%] experiences labor disorders, and the difference between the two groups was statistically significant [p<0.001]

Conclusion: Fetal complications like RDS, gestational asphyxia and neonatal tachypnea due to cesarean were significantly higher in infants born by cesarean section than those born by vaginal delivery

[Thyroid dysfunction in perimenopausal women]

There are mild changes in Hypothalamous - pituitary -thyroid axis with aging that may be accompanied with thyroid dysfunctions without clinical manifestation. The aim of this study is evaluation thyroid dysfunction in perimenopausal women. This is a cross-sectional descriptive study that was performed on 100 women at the age of 40-60yr, who had referred to Gynecology and Menopausal clinic of Ghaem hospital, Mashhad University in 2005. At first, a questionnaire including clinical symptoms was completed, then patients were submitted to laboratory tests including T3, T4, T3 RU, TSH, TG [triglyceride], HDL-cholesterol and LDL cholesterol. The information was analyzed by chi2 and fisher exact tests. [P

[ term pregnancy upon complete bed rest in a case with uterine cervical incompetence]

Uterine cervical incompetence is one of the risk factors for preterm labor and it is characterized by painless cervical dilatation and prolapse of membranes into the vagina in the second or third trimester of pregnancy. The aim of this report is to discuss a term pregnancy following complete bed rest in cervical insufficiency. A 24-year old woman with a history of uterine cervical incompetence was admitted to hospital with cervical dilatation and effacement at the 24th week of gestation. She had a successful term pregnancy with bed rest and expectant management at the 39th week of gestation. Expectant management with bed rest in an appropriate position, along with anti-coagulant prophylaxis is an effective and safe method for the management of cervical incompe-tency in advanced stages of pregnancy

relationship between precence of antiphospholipid antibodies in pregnant womens' serum and preeclampsia

Antiphospholipid antibodies may be detected in normal pregnancies and may cause thrombosis, recurrent fetal loss, placental infarction and preeclampsia. In this study the possible differences in antiphospholipid antibody titer between healthy pregnant women and preeclampsic cases was examined. The antiphospholipid antibody titer in 50 healthy pregnant women with 50 preeclampsia cases without the history of thrombosis and autoimmune disease was compared. IgG and IgM anticardiolipin antibody was measured by immunoassay methods. Teclot kits were used for Lupus-like anticoagulant antibodies. Data was analyzed by Chi-square test, p<0/05 was considered significant. There was no association between antiphospholipid antibody titer in healthy and preecalamptic group. In normal pregnant women and preeclamptic cases there was 6% and 8% Lupus like anticoagulant antibody, 12% and 4% IgG anticardiolipin antibody and 26% and 30% IgM anticardiolipin antibodies respectively. Despite the evidence of prothrombotic state during preeclampsia, it is unlikely that antiphospholipid antibodies represent a risk factor for preeclamptic women as compared to healthy pregnant women

[Liver rupture in pregnancy, report of a rare case]

Rupture of the liver is a rare and threatening complication during pregnancy. This important accident is more common during preeclampcia and HELLP syndrome. It is also reported in old mu1tiparous.Hemorrhagic shock is usually the most common symptom and sign. Maternal and fetal mortality rate is more than 50%. A 39 year old gravid 9 para woman presented to the emergency room with abdominal pain and signs of hemorrhagic shock and, fetal distress. Urgent laparatomy was planned, the uterus was intact and gross hemorrhage was present in the pelvic and abdominal cavity. The fetus was delivered by cesarean section and the exploration proved 8 cm rupture in the right lobe of liver which was repaired. Both mother and fetus were saved from the effects of this dangerous complication. Liver rupture should be considered when there occur pain in the upper part of the abdomen and signs of hemorrhagic shock, even in the case of an uncomplicated pregnancy