Anion gap estimation in the diagnosis and prognosis of pregnancy-induced hypertension

To identify the role of the anion gap estimation in the diagnosis and prognosis of pregnancy-induced hypertension. This Cohort study included 224 pregnant women that have attented the antenatal clinic. These comprise 101 women who had developed pregnancy-induced hypertension and 123 healthy pregnant women. Serum electrolytes including sodium, potassium and chloride, blood gases including bicarbonate level, serum albumin and 24 hour-proteins in urine were estimated. Anion gap was then calculated and consequently correlated to the clinical and laboratory data in both groups. Anion gap was significantly decreased in the hypertensive pregnant women than the healthy ones [P < 0.001]. This observation was more severe in the proteinuric hypertensive women than the non-proteinuric women [P< 0.01]. The value of the anion gap was negatively correlated to the severity of the disease. Anion gap depression was significantly increased with the development of placental abruption, intrauterine growth restriction, intrauterine fetal death as well as prematurity [P < 0.05] but this correlation was not observed on the cases of fetal distress. Anion gap estimation could be a reliable test as a diagnostic adjunct in women with pregnancy-induced hypertension as well as a good prognostic test for the development of the complications

study of coagulopathy in hypertensive disorders of pregnancy

This study compared a group of items concerning the activation of the coagulation system and fibrinolytic system in various hypertensive disorders complicating pregnancy, as well as AT III. One hundred and twenty pregnant women were studied contained in 4 equal groups. These were normal controls, PIH, PAH and PAH with super imposed PIH. Each patient had fibrinogen levels, platelet counts, plasminogen levels, Fibrinogen/Fibrin degradation products and Antithrombin III estimated. The results showed that PIH was characterised by significant affection of all 5 parameters. PAH showed only mild drop in platelet counts. When PAH was complicated by PIH all 5 parameters became affected. These results identify a coagulopathy found in PIH only and not in PAH with exception of platelets that are reference in all conditions. Liver involvement in PIH should be tested for to identify its role in this coagulopathy. Reductions of AT III could also have a role in initiating this coagulopathy

Diabetes mellitus with pregnancy Al-Zahraa experience

Eighty pregnant diabetic patients were included in this study. Patients were classified acording to Whites classification and gestational age on admission. Home and hospital management with or without insulin were resorted to, to maintain euglycemia. Maternal and foetal outcome were studied. The effect of parity and time of booking as well as class of diabetes and success of control are presented. Incriminating history was found in 75% of cases. Most obstetric complications occurred in class B diabetes especially in those coming after the 2[nd] trimester. Maternal and perinatal mortality and morbidity were reduced to levels comparable to international standards

Evaluation of the efficacy of ritodrine hydrochloride and magnesium sulphate in suppressing preterm labor

Preterm labor is the comonest cause of perinatal death and neonatal morbidity. It occurs in 5-10% of all births. Attempts to suppress preterm labor by various tocolytic agents have been made in order to prevent these complications. Several drugs were used to achieve tocolysis with various side effects and varying usccess rates. Twenty pregnant patinets with excessive uterine activity at 26 - 37 weeks were studied. Ten of them were given ritodrine hydrochloride [yutopar] and the other ten patients were given magnesium sulphate. Six patients form both groups where the single agent caused serious side effects [ritodrine HCL] or failed to suppress uterine activity [magnessium sulphate], were given both agents simultaneously in modified dosage. Ritodrine HCL suppressed preterm labour in 8 patients [80%] without causing side effects while in the remaining 2 patients [20%] it had to be discontinued due to the intolerable side effects of chest compression, severe chest pain and dyspnea. MgSO[4] succeeded to suppress preterm labour in only 6 patients [60%] and failed in 4 patients [40%].In those 6 failures [2 from the ritodrine group and 4 from the MgSO[4] group] both agents were given simultaneously at a lower dose with successful tocolysis in 83.7% of cases but without complete elimination of the serious cardiovascular side effects of ritodrine. Neither agent caused fetal distress, only mild fetal tachycardia was observed in patients given ritodrine. Pregnancy has continued after suppression of preterm labour for 70.5 days in the ritodrine group, 56.8 days in the MgSO[4] group and 56.9 days in the patients given both together. This study showed that ritodrine HCL is more effective than MgSO[4] in suppressing preterm labour but may cause serious cardiovascular side effects. It is recommended that the two agents should not be used simultaneously and each agent should be used on its own and replaceed by the other agent in cases of failure to suppress preterm labour or development of serious side effects

immunocrit test for the diagnosis of pregnancy

The precipitation reaction although related to the biological activity of gonadotrophins, is not strictly hormone specific. The interfacial ring technique can be used for qualitative and quantitative assay of gonadotrophins and as a pregnancy test, while the immunocrit technique is more suitable as a hormone assay test for extracts of urinary gonadotrophins