Evaluation of some haemostatic markers in normal pregnancies and pregnancies complicated by preeclampsia or eclampsia

To establish the plasma evolution of P-selectin, plateletfactor4 [Pf4], prothrombin fragments 1+2 [F1+2], thrombin antithrombin complex [TAT], von Willebrand factor [vWF] and blood platelet count during normal pregnancy, preeclampsia and eclampsia and to determine which are the most relevant and accurate to perform in clinical practice for estimating the severity of preeclampsia. Twenty patients with mild preeclampsia, twenty patients with severe preeclampsia, ten eclamptic cases and ten normotensive pregnant women were included in the study. All cases and controls were with gestational age ranging between 28 and 38 weeks. All five markers increased and platelet count decreased in the severe preeclampsia and eclampsia groups. A highly significant negative correlation was found between platelet count and both P-selectin and Pf4 in the three studied hypertensive groups. Moving from mild to severe preeclampsia to eclampsia, vWF and Pf4 showed an increasingly abnormal results. Pf4 was the only haemostatic marker elevated in the mild preeclampsia group as compared with the normal pregnant group [P=0.000]. [1] Platelet activation may play an important role in the pathogenesis of preeclampsia; [2] Plasma levels of vWF and Pf4 could reflect the severity of this disease, [3] Pf4 appears to be an interesting marker for detecting early alterations in the haemostatic system in pregnancies complicated by preeclampsia. It seems that measurements of haemostatic markers in patients with preeclampsia may have prognostic value in determining the outcome of pregnancy in this pregnancy disorder. They offer possibilities of early assessment of therapeutic approaches aimed at limiting vascular endothelial damage and platelet activation

Effect of different hormonal treatment modalities on biochemical markers of bone remodling in postmenopausal women

Is to measure some of the biochemical markers of bone formation and bone resorption in postmenopausal women before and after hormone replacement therapy. Thirty postmenopausal women and fifteen healthy pre-menopausal women were included in this work. Postmenopausal women were allocated into two groups. Group I: receiving Estrogen replacement therapy. Group II: receiving Combined hormone replacement therapy. The following serum markers were evaluated before the start and two weeks after the end of the study; total and ionized calcium, inorganic phosphorus, alkaline phosphataseiso enzyme, osteocalcin. Also urinary deoxypyridinoline cross links were assessed. Bone densitometry using quantitative computed tomography was done. In postmenopausal women of this study, there was an increase in both bone formation markers as well as bone resorption markers but in favour of bone resorption with diminished bone mass. There was significant reduction of both serum alkaline phosphatase and osteocalcin in both groups following treatment. This reduction was also noticed in both groups in urinary deoxypyridinoline / creatinine after hormonal therapy. However, bone mineral density showed no obvious changes in both groups after three months of replacement therapy. Changes in biochemical markers of bone turnover preceded changes in bone density observed by densitometry. These effects were similar in both groups receiving two different forms of hormone replacement therapy

Embryosonographic features: can they predict the fate in cases of threatened abortion?

To evaluate the prognostic value of different sonographic milestones of embryonic life in cases of first trimester threatened abortion. Two hundred pregnant females in their first trimester were recruited in the study. One hundred and fifty women with a diagnosis of threatened abortion constituted the study group and fifty matched controls of uncomplicated pregnancy served as a control group. All study patients were subjected to vaginal sonography to evaluate milestones of embryonic life and Doppler ultrasound study of uterine artery waveforms. Serial weekly examination were done till the end of first trimester. Seven hundred and thirty scans are performed to evaluate the following: crown-rump length, gestational age, mean sac diameter, yolk sac, liquor volume, placentation site, embryonic cardiac rate, retro-chorial hematomas and cervical length. Doppler studies of uterine and spiral arteries were also done. Our results have shown significant relations between these findings and the prognosis of cases at risk for abortion. The milestones that adversely affect the prognosis in pregnancies at risk for abortion include fetal bradycardia, retarded growth of the fetus, small sac size, absence of yolk sac and S/D ratio of uterine arteries >4.5