Evaluation of serum biomarkers for detection of preeclampsia severity in pregnant women

Objectives: To determine serum biomarkers in detection of preeclampsia severity among pregnant women

Methods: Among 450 pregnant women with various severity of preeclampsia, serum biomarkers ofaspartate aminotransferase [AST], alanine aminotransferase [ALT], lactate dehydrogenase [LDH], hemoglobin [Hb], platelet count [PLT], uric acid, direct bilirubin, total bilirubin, creatinine, and alkaline phosphatase were compared using area under the Receiver operating characteristic [ROC] curve and Area Under the Curve [AUC]

Results: The mean age of women was 30.63 +/- 6.43 years and with mean gestational age of 34.69 +/- 3.97 weeks. The mean level of LDH, ALT, uric acid, and creatinine were significantly higher in the women with severe type of preeclampsia compared to those with mild type. LDH level had ROC and AUC of more than 0.80, with highest sensitivity, and moderatespecificityin comparison to other markers

Conclusion: Biomarkers such as ALT, uric acid, and LDH were shown to be prognostic in detection of theseverity of preeclampsia. LDH was demonstrated to significantly be a better prognostic test in detection of preeclampsia severity

Triage by cervical length sonographic measurements for targeted therapy in threatened preterm labor: a double blind randomized clinical trial

Background: preterm labor and birth are associated with several neonatal complications including respiratory distress syndrome and intraventricular hemorrhage. Differentiating true and false labor pain is a dilemma to obstetricians

Objective: to elucidate the role of cervical length measurement in prediction of birth in pregnant women with threatened preterm labor

Materials and Methods: in this double blind randomized clinical trial, 120 women with gestational age <34 wk who presented painful uterine contractions randomly assigned to undergo measurement of cervical length. Patients were registered in the hospital and a unit number was given. Based on the unit numbers, patients were randomly assigned to two groups using a computerized random digit generator. All participants were managed accordingly [n=65] or to receive tocolysis as planned [n=55]. Tocolysis was prescribed when cervical length was <15 mm while those with cervical length >/=15 mm were managed expectantly. Delivery within 7 days of the presentation was the primary outcome

Results: this RCT showed in case group, 78.9% of patient with cervical length <15 mm were delivered within 7 days and only 21.1% of them maintained their pregnancy. Of those with cervical length >/=15 mm, only 15.2% were delivered within the study period and the rest [84.8%] maintained their pregnancy [p<0.001]

Conclusion: "our results indicate that in women who presented preterm labor symptoms, cervical length measurement will result in decreased unnecessary tocolytic treatment. Women with cervical length >/=15mm should not receive tocolysis, however, withholding corticosteroid therapy in these patients needs further evidence

Serum concentration of calcium, magnesium and zinc in normotensive versus preeclampsia pregnant women: a descriptive study in women of Kerman province of Iran

Preeclampsia is a disorder of pregnancy without any specific reasons that characterized by high blood pressure and large amounts of protein in the urine. This disorder is caused by multiple factors and finding any factor related to this disorder can help on time prevention of this disease. In this study, serum levels of calcium [Ca], magnesium [Mg] and zinc [Zn] were evaluated in preeclampsia women and compared to normotensive ones. This was a case-control study on 40 normotensive pregnancies as controls, 20 mild and 20 severe preeclamptic pregnancies as case groups. The women were studied in their 28-40 weeks of pregnancy. Simple random sampling was done based on inclusion and exclusion criteria and data were collected by blood sampling. The serum Ca levels of 4.96 +/- 0.62, 4.89 +/- 0.34, 5.05 +/- 0.35 mg/dL, Mg levels of 0.83 +/- 0.08, 0.85 +/- 0.11, 0.84 +/- 0.11 mg/dL and Zn levels of 107.55 +/- 22.74, 108.00 +/- 22.40, 107.50 +/- 22.30 mg/dL was detected in normotensive, mild and severe preeclampsia, respectively. Statistical analysis revealed that there were no significant differences between three groups in serum levels of Ca [p=0.6], Mg [p=0.827] and Zn [p=0.997]. The findings of this study showed that the assessment of serum Ca, Mg and Zn levels does not have any clinical values for predicting and/or managing of preeclampsia. However, based on the positive relationship between serum Ca and Mg concentration and the severity of preeclampsia in this study, we recommend assessment of serum levels of these two mineral elements as indices of the severity of preeclampsia

Administration of intravenous infliximab for prevention of peritoneal adhesions formation in rats

Objectives: To investigate the effects of intravenous infliximab in preventing the formation of peritoneal adhesions in an animal model of rat

Methods: This was an experimental study being performed in animal laboratory of Shiraz University of Medical Sciences during 2012. Sixty albino rats were randomly assigned in to three groups by Random Design Method. The first group received single infliximab injection [n=20], the second one received double infliximab injection [n=20] and the third received nothing [n=20], after receiving intra-peritoneal injection of talc for induction of peritoneal adhesions. All the animals were sacrificed after 6 weeks and the peritoneal adhesions were evaluated according to Nair classification

Results: We observed that the mean adhesion grade was lower in those who received double dose of infliximib when compared to single dose and controls. However the difference did not reach a significant value [p=0.178]. The grade of peritoneal adhesion was also comparable between the three study groups [p=0.103]. The mean number of 1st WBC count was also comparable between three study groups [p=0.382]. We observed that 2 nd WBC count was also comparable between two study groups [p=0.317]

Conclusion: Administration of intravenous infliximab after intraabdominal surgicalprocedures would not prevent the formation of peritoneal adhesions in animal model of albino rat

Comparison of abnormal cervical cytology from HIV positive women, female sex workers and general population

Sex workers and HIV seropositive women are at high risk of abnormal cervical cytology. The objective of this study was to compare the cervical cytology among three groups of women: active sex workers, HIV-infected women, and general population in Iran. This was a cross-sectional study performed in Hazrat Zeinab, Lavan clinics and drop in center [DIC] in Shiraz, Iran. This study was performed from October 2009 to October 2011. A total of 266 patients were assigned into three groups: sex-workers [85], HIV positive patients [100], and general population [81]. Pap smear was performed for all participants from the exocervix and endocervix, using a plastic Ayres's spatula and cytobrush. The samples were sent to a pathology center, using a liquid-based media. The risk of cervical infection in sex workers and HIV positive women was greater than the general population [OR=5.47, 95% confidence interval [CI]:2.24, 13.40], [OR=3.71, 95% CI:1.52, 9.09], respectively. The frequency of abnormal cervical cytology in the HIV positive and sex worker groups was higher than the general population [OR=6. 76, 95% CI:2.25, 20.32], [OR=3. 80, 95% CI:1.19, 12.07], respectively. Low-grade squamous intraepithelial lesion [LSIL] and high-grade squamous intraepithelial lesion [HSIL] were associated with CD4 cell count<200I106/L, P=0.021 and P<0.001, respectively. Vaginal infections were seen more often in the sex worker group, and abnormal cervical cytology was greater in the HIV positive group