Neutrophil granule products in identification of subclinical chorioamnionitis in patients with premature rupture of membrane

The purpose of this study was to evaluate the sensitivity of neutrophil granule products compared to WBC's and CRP in identification of sub clinical chorioamnionitis in women with preterm premature rupture of membrane [PROM]. Twenty five patients between 26-30 week gestations suffered from preterm PROM were included as a study group. The control group contained 25 apparently healthy pregnant women with matched gestational age. Blood samples were collected through latency period and at delivery for estimation of plasma defensin and lactoferrin and serum C - reactive protein CRP levels in addition to WBC's determination. After delivery the placenta of the study patients were examined histologically for evidence of chorioamnionitis. The fetal birth weight, Apgar score and any neonatal complications were recorded. At admission defensin level was significantly higher in patients with developed chorioamnionitis compared to patients without histological findings and controls [6583.1 vs 722.36 and 714.5 ng/ml respectively, p < 0.05]. WBC's were higher in patients with developed chrioamnionitis [p< 0.05]. lactoferrin and CRP didn't show the same relation. At delivery defensin, WBC's and CRP have demonstrated significantly increased levels in patients with developed chorioamnionitis compared to subjects who didn't develop chorioamionitis. Correlation coefficient of different studied lab tests demonstrated significant positive correlation between defensin, WBC's and CRP. In conclusion maternal plasma defensin level may serve as a good promising predictor for development of chorioamnionitis in patients with preterm PROM

Evaluation of placental aspiration as a new method for placenta delivery

This is a randomized prospective study, of six months duration, to test the efficacy, of placental aspiration, a new method to deliver placenta, in comparison with placental drainage and expectant technique for management of third stage of labor. Total of 148 parturient women were randomized to one of three groups for management of third stage of labor, 50 women in expectant management control group, 48 in placental drainage group, and 50 in placental aspiration group. The clinical profile of the three groups was compared together, the age, gravidity, gestational age, onset of labor, augmentation with syntocinon, fetal weight, and placental weight. The outcome of each method, time of placental separation, amount of blood loss, and hemoglobin level were tested together. The three groups were comparable regarding items of clinical characteristics. Placental drainage had a comparable short time of placental separation as well as placental aspiration method in comparison with expectant management. Placental aspiration method demonstrated the best outcome; a significant decreased amount of blood loss and short time of placental separation. In conclusion, placental aspiration can be considered a useful method for management of third stage of labor. It decreases the duration of third stage of labor and reduces the amount of blood loss

Bacterial vaginosis and risk of early pregnancy loss

The aim this study was to assess the vaginal flora of pregnant women early in pregnancy [<13 wk] and to determine the possible link between bacterial vaginosis [BV] and subsequent spontaneous early pregnancy loss. 201 consecutive healthy pregnant women of less than 13 weeks' gestation were recrutied for this study through the year 2003. They underwent standardized vaginal speculum examination for microbiological flora of the vagina. Bacterial vaginosis was assessed using Amsel's criteria [1993] in addition to cullture study for BV associated organisms. Incidence of BV among pregnant females was 21.4%. BV was associated with late pregnancy loss [Relative Risk=1.8]. Those patients with intermediate flora were strongly associated with subsequent pretem labor. Among BV associated microorganisms, Gardnerella vaginalis was the most common organism. In conclusion, desspite no association was found between BV and early pregnancy loss, there was a striking relation with late abortion and pretern labor which makes proposing diagnosis and treatment of BV during pregnancy worthily

effect of smoking on follicle stimulating hormone and estradiol and bone mineral density among premenopausal women

Ninety women between 39-49 years old who did not had hysterectomy or oopherectomy and according to certain eligible criteria were classified into active smoker group [20], passive smokers [30] and nonsmoker control group [40]. Each woman was interviewed and completed a specially designed questionnaire including socio- demographic data, full obstetric data and information about tobacco exposure for the active and passive group and their spouses. Body mass index [BMI] was estimated for each participant. E2 level and basal follicle stimulating hormone [FSH] measured on days two-four of the menstrual cycle. Also, bone mineral density [BMD] of the forearm was measured by dual-energy X-ray absorptiometry. In conclusion, both active and passive smoking are associated with an elevated FSH concentration in premenopausal women, an effect which is consistent with a shorter duration of menopausal transition period. Moreover, BMD was much lower in both groups in spite of the normal estradiol level