Can antioxidants prevent preeclampsia?

To investigate the role of superoxide dismutase [SOD] in healthy pregnant women and in pregnant women with preeclampsia. The study was carried out on 80 pregnant ladies selected from the outpatient clinic of the Ain Shams University Maternity Hospital. They were classified into two groups: The control group: Consisting of 50 healthy pregnant ladies. The patients groups: Consisting of 30 ladies diagnosed as preeclamptic patients. All patients were subjected to history taking, clinical examination and blood chemistry for evaluation of SOD level using spectrophotometric assay. Compared with values in normotensive pregnant women. Preeclamptic patients had significantly lower SOD level being 1.54 +/- 0.60 vs. 0.63 +/- 0.36 Units/ml respectively. A cut-off point was detected below which preeclampsia supervenes. This level was calculated to be 1.01 U/ml. The decreased activity of the antioxidant enzyme superoxide dismutase may play an important role in the pathogenesis of preeclampsia and hence the possibility of the use of antioxidant drugs in high-risk patients which may be of a prophylactic value. The presence of a cut-off point of SOD level may be of value in the preeclampsia prediction issue in high-risk patients

Modified thermal endometrial balloon ablation in cases of hypermenorrhea: safety and efficacy

Objective: To evaluate the clinical effectiveness and safety of a modified thermal balloon system to ablate the endometrium in cases of hypermenorrhea. Study design: Thirty [30] patients presented with menorrhagia [hypermenorrhea] that had failed to be controlled medically for at least three months. Their ages ranged from 35-55 years, completed their families, with a normal sized uterus or mild symmetrically enlarged less than 12 weeks' gestation size. Patients were free of any uterine or other pelvic pathology. Under general anesthesia, a silicon Foley's catheter balloon was inserted into the endometrial cavity. The balloon was inflated using heated saline up to 90C intermittently every 2 minutes for 8 minutes. Preoperative menstrual pattern [Bleeding Score and Bleeding Index] was compared to the postoperative one at intervals of 1 week, 1 month and 3 months after the procedure

Results: 27 patients out of 30 [90%] had been adequately controlled the menorrhagia. 6 [20%] had amenorrhea, 12 [40%] had hypomenorrhea and 9 [30%] resumed their normal menses, while 3 women [10%] had treatment failure in the form of persistent menorrhagia after the procedure. A second surgical procedure in the form of hysterectomy was done in the 3 patients with persistent menorrhagia. Pathology of uteri removed revealed 2 cases having foci of adenomyosis and 1 case with undetected small intramural myoma 1.5x1.5 cm. There was a statistical significant difference in Hb% levels before the procedure compared to the level at 3 months after the procedure [9.7 vsS 11.1 gm/dl]. As regards patients' satisfaction 27 [90%] patients were satisfied while 3 [10%] were unsatisfied because of the persistent menorrhagia

Conclusion: Thermal balloon endometrial ablation [TBEA] is a safe, simple, effective, easy and minimally invasive procedure. It has several advantages over hysterectomy, e.g. preservation of the uterus, the symbol of femininity to the women, avoidance of surgical incision and the potential to be performed on an out patient basis. Meanwhile, it is a good alternative to hysteroscopic endometrial ablation with a comparable success rates with minimal risks and without limiting factors

Eclampsia in Egypt [1998-2002]: an overview

Objective: To study the trend of eclampsia in a tertiary care maternity hospital over a period of 5 years. Study Design: This is a retrospective study done in Ain Shams University Maternity Hospital. All patients admitted to hospital having eclampsia [antepartum, intrapartum, postpartum] during the period from Jan. 1998 through Dec. 2002 were reviewed as regards: age, parity, gestational age, type of eclampsia, number of fits, mode of delivery, fetal and maternal outcome and duration of hospital stay

Results: Sixty six [66] patients were found during that period [total deliveries were 39, 244]. Forty [40] patients had antepartum eclampsia, while 23 had postpartum eclampsia and 3 had intraparturn eclampsia. Mean maternal age 24.4 years. Mean gestational age 33.4 weeks. Mean number of fits was 2.4. Cesarean section was the mode of delivery in 39 cases [34 cases had antepartum eclampsia, while 5 cases developed post-Cesarean section eclampsia]. On the other hand, 27 cases [41%] ended by vaginal delivery. All cases received magnesium sulphate injection for control of fits. All cases were admitted to the ICU either antepartum or postpartum to get the proper monitored management. No cases of maternal mortality. Fetal and neonatal [perinatal] mortality were encountered in 20 cases [29%]. Mean hospital stay was 7.8 days

Conclusion: Although eclampsia is a prevalent disease in Egypt, the final maternal outcome is relatively satisfactory. ICU admission should be a part of any eclampsia case management. Termination of pregnancy is timed primarily for the sake of the mother. Neonatal outcome depends on the standard of incubation service available. Zero maternal mortality could be a reality when eclampsia management is up to the standard