Microsatellite instability in young women with endometrioid type endometrial cancer

This study was designed to determine the frequency of Microsatellite Instability [MSI] in young Iranian patients with endometrial carcinoma and to evaluate its association with histopathologic and clinical features of disease. Microsatellite status was analyzed in 23 patients with endometrioid type endometrial cancer who were less than 55 years. Clinicopathologic characteristics such as age, International Federation of Gynecology and Obstetric [FIGO] grading and staging of tumor, family history of Hereditary Non-polyposis Colorectal Cancer [HNPCC], oral conception [OC] consumption, number of pregnancies, fertility, menstrual cycles and underlying disease were considered. Chi-square and Fisher exact tests were used to find the significant relationships. MSI analysis showed 8 patients [34.8%] were MSS [Microsatellite Stable], 15 patients [62.5%] were MSI positive. Among cases with MSI phenotype, 4 cases [17.45] had low instability [MSI-L] and 11 cases [47.8%] had high instability [MSI-H]. Three cases with MSI-H had family history of HNPCC related cancers. Five cases [21.7%] had infertility in which 4 of them [80%] had MSI phenotype. There was no statistically significant relationship between MSI phenotype and tumor grade and stage. Few studies reported high frequency of MSI among young patients. Some studies mentioned similar results in endometrioid type of tumor. This study showed even higher frequency [65%] when MSI analyzed in young endometrioid type endometrial patients. Most cases with infertility had MSI-H phenotype. It may suggest that beside women with family history of HNPCC, EC screening using MSI would be beneficial in infertile women too

Evaluation of the correlation between fetal well being tests with APGAR score and pH of umbilical artery in high risk pregnant women

Acidosis-hypoxic phenomenon is a valid indicator to determine fetal distress and is defined by mearuring the blood pH of umbilical cord. None of the present screening tests for evaluation of pregnant mothers have acceptable clinical accuracy to assess fetal acidosis. We decided to evaluate the relationshop between fetal well being tests Non-Stress Test [NST], Oxytocin Challenge Test [OCT] and Biophysical Profile [BPP] with APGAR score and the blood pH of umbilical cord. In this case-control study, we enrolled 50 high-risk pregnant women [BPP test positive, OCT positive or non reactive NST] as cases and 50 pregnant women without fetal risk factors as control group. The umbilical cord blood sample was taken immediately after delivery. Some variables such as maternal age, gestational age, parity, NST, OCT, BPP, blood pH of umbilical cord, neonatal weight, sex and APGAR score were evaluated and the data was analyzed by SPSS software. Discrimination between NST with acidosis [P<0.01] was significant in the case and control groups, but in case of OCT with acidosis it was not significant. NST and OCT had low sensitivity [58.3 and 46.5 respectively]. Besides, the relationship between BPP and blood pH of umbilical cord was significant in the case and control groups [P<0.02]. APGAR score of the cases were lower than the control group [P<0.0001]. In evaluation of fetal acidosis, the BPP test is the best screening test comparing to NST and OCT

[Relationship between cervical dilatation and fetal descent in the first 2 hours of active labor with method of delivery in term nulliparous women]

Diagnosing parturients in risk of cesarean section early in the beginning of active phase of labor, is very important. This may let take necessary action to accelernate labor [delivery] and prevent maternal mortality and morbidity due to late cesarean section. During a period of 8 months from July 2004 to March 2005, 216 primiparous women, with term pregnancy and cephalic single fetus, referred to Imam Reza hospital in [during] active phase of labor, were studied. Changes of cervical dilatation and descent of the conceptus were observed. Parturients were devided to two groups, vaginal delivery and cesurean section. Protraction or arrest disorders were the indications of cesarean deliveries. Findings were analysed through using T-Test, unilateral variance and Chi square test. The more change in cervical dilatation in the first 2 hours of active phase of labor, the less possibility of cesarean delivery [p< 0.001]. Also the more rate of the conceptus descent in the first 2 hours of active phase of labor, the less rate of cesarean section [p< 0.001]. There was no significant statistical relationship between condition of membranes at the onset of active labor and method of delivery, however there was a significant relationship between oxytocin augmentation and method of delivery [p< 0.001]. In primiparous women with term pregnancy, vaginal delivery would be fairly predictable by observing changes of cervical dilatation and conceptus descent during the first 2 hours of active phase of labor