Predictive value of maternal hormonal serum level of inhibin a in case of threatened abortion

Threatened abortion is the commonest complication in pregnancy, it is defined as vaginal bleeding with or without menstrual like cramps in the first 20 weeks of pregnancy. No history of passage of tissue or rupture of membrane is present and ultrasound demonstrates an intrauterine sac with fetal cardiac activity. The early and accurate prediction of unsuccessful pregnancy in this situation should lead to appropriate treatment without unnecessary delay, but still there is no efhctive marker to predict in advance the outcome of threatened abortion. Inhibin A concentration rises and falls during the menstrual cycle. The lowest level is during the early and late days of the cycle and peaks during midcyles coincident with LH surge and midlureal period [being twofold higher than the first]. its level is higher in pregnant women than in non pregnant, and increases throughout pregnancy until delivery. in the early weeks of gestation, the corpus luteum is the principal source of inhibin but about the eighth week, it is excreted from the fetoplacental unit, immediately after delivery it's level decreases sharply. Th aim of the present research was to study the possible role of inhibin A in predicting pregnancy outcome in women with threatened abortion. This study included fifty pregnant women at 8 and 10 weeks gestational age, they were divided into: Groujy I [studied group] including 30 pregnant women with threatened abortion. Group II [control group] including 20 healthy not complaining pregnant women matched with the studied group. All of them were subjected to the following: Complete history taking, general clinical examination; obstetric examination; routine laboratory investigations; ultrasound examination for detection of fetal viability and fetal parameters; maternal blood samples were collected for determination of the quantitative measurement of inhibin A and follow up of cases till reaching 20 weeks of gestational age. The studied groups were further subdivided according to the outcome of pregnancy into: Group A [threatened abortion and fluting pregnancies] n 15; group B [threatened abortion bui ongoing pregnancies] n 15. The results of the study were analysed statistically, and we found that; there was a significant decrease in the levels of inhibin A in cases of threatened abortion [group I] compared with the control group. Much more significant lower levels of inhibin A were Jbund in cases of threatened abortion and failing pregnancies [group A] compared with the cases of threatened abortion but ongoing pregnancies [group B]. The cutoff value of inhibin A was measured, using the receiving operator curve [Roc curve], it was 268.9 pg/mI with a sensitivity of 82.5% and a specificity of 90.1% at8 weeks, while it was 395.5 pg/mI with a sensitivity of 85.5% undo specificity of 90.5% at 10 weeks. From our study we concluded that, finding an abnormal low level of inhibin A in pregnant fimale with threatened abortion can predict poor pregnancy outcome. The expanding knowledge of the role of inhibins since the development of specific and sensitive assays has opened the field for their potential uses in clinical practice. Examining the role of inhib ins and other biochemical markers in early pregnancy ftzilure will lead to an improved understanding of the mechanism behind it and will aid in selection of patients in whom expectant management is appropriate

Thrombomodulin as a marker of endothelial damage and severity in pre-eclampsia/eclampsia syndrome

Preeciampsia is an idiopathic multisystem disorder specific to human pregnancy characterized by gestational hypertension and proteinuria. It complicates many pregnancies and is the third common cause of maternal mortality. It is also associated with a high perinatal mortality and morbidity. The aim of the present work was to study Thrombomodulin [TM] as a marker of endothelial damage in pre-eclampsia/ eclampsia syndrome Eighty pregnant females in the second half of pregnancy were enrolled in the study divided into control group [I], mild preeclampsia [IIa], severe preeclampsia [IIb], and eclampsia [IIc]. Thrombomodulin was measured by ELISA technique at presentation and 3 days post partum. The results showed that the level of TM is higher in patients with eclampsia and preeclampsia compared to the control group, furthermore, the level decreased with delivery and subsidence of the condition. In conclusion TM can be used as a marker for monitoring preeclampsia/ eclampsia syndrome

CD79a in cases of acute leukemia

Immunoglobulins IgM and IgD on the plasma membrane of B lymphocytes lack a cytoplasmic region of sufficient size to react with other molecules in order to transmit a signal through these cells. It has been demonstrated that a dimeric molecule with a substantial intra-cytoplasmic region named CD79 is physically associated with membrane Igs and helps to initiate intracellular signaling. The two component polypeptide chains of this dimeric molecule have been designated CD79 alpha C [mb-1] and CD79 beta 3 [B29]. The aim of the present work was to study the value of CD79alpha as a diagnostic marker in cases of acute leukemia. Our patients were classified into 2 groups, group I included 20 patients with ALL and group II included 20 patients with AML. Immunophenotyping of the leukemic blasts was carried out using flow cytometry and CD79 alpha was studied. We found that 91.7% of our B-lineage ALL cases were positive for CD79 alpha. Also, CD19 was positive in 100% and CD22 in 75%. All of our T-ALL cases were negative for CD79 alpha and only one case of AML showed positive CD79 alpha expression [5%]. The sensitivity of CD 79 alpha in the diagnosis of B-ALL among all of our ALL patients was 91.7%, the specificity was 100%, the positive predictive value [PPV] was 100% and the negative predictive value [NPV] was 88.9%. The sensitivity of CD79 alpha in the diagnosis of B-lineage ALL among all of our acute leukemia patients was 91.7%, the specificity was 96.4%, the PPV was 91.7% and the NPV was 96.4%