Fetal assessment using umbilical artery doppler indices and nonstress testing in high risk pregnancy

Doppler velocimetry of the umbilical artery and nonstress testing [NST] were done for 60 patients with high risk pregnancies. These included severe pre-eclampsia [N= 18], severe hypertension [N=11], diabetes [N=10], postdate [N=7], suspected IUGR [N=14]. Both tests were done on the same day on weekly basis or more frequently whenever necessary to evaluate fetal condition, predict any adverse outcome, and to avoid unexpected fetal demise. Neonatal outcome was determined by 1 and 5 minute Apgar score, admission to neonatal intensive care unit [NICU], and perinatal morbidity and mortality. Adverse fetal outcome was encountered in 80% and 88% of fetuses with abnormal doppler and abnormal NST respectively. On the other hand adverse outcome was found in 30% and 40% of fetuses with normal Doppler and NST respectively. When both tests were abnormal. 95% of fetuses showed adverse outcome. Sensitivity, specificity, positive predictive value, and negative predictive value were nearly the same for both tests with no superiority of one test over the other. It is concluded that Doppler velocimetry of the umbilical artery and NST are useful in predicting fetal outcome. The two tests are complementary to one another with the doppler measuring umbilical blood flow and NST measuring CNS function

Role of interleukin 6 level in post splenectomized thalassemic patients in Zagazig University Hospitals

Interleukin-6 [IL-6] plays an important role in megakaryocytopoiesis and platelet production.Thrombocytosis and inappropriate blood clotting occur postsplenectomy, this rebound phenomenon is more common following splenectomy for myeloproliferative disorders. So this study was done to assess levels of interleukin 6 in these patients. Levels of interleukin 6 were studied in 34 nonsplenectomized thalassemic patients [thal/nonsplen], 23 post-splenectomized thaIassemic patients [thal. I postsplen.], 13 splenectomized non thalassemic [non thal. /postsplenectomized] and 18 normal control by enzyme linked immunosorbent assay method. Serum IL-6 concentration in thaI. I postsplenectomized was significantly increased when compared with thal/nonsplenectomized and control volunteers [3.55 +/- 2. 47 pglml vs 2.38 +/- 2.31 pg/ml, P = 0.036 and 3.55 +/- 2.47 pg /ml vs 2.66 + 0.45 pg/ml, P = 0.028 respectively]. There was a trend towards increasing of cytokine levels in thal. / postsplen with higher platelet count although no correlation was observed. This study addresses the possible role of IL-6 in the pathogenesis of reactive thrombocytosis in thal/postsplenectomy