Homocysteine level as a marker in case of early onset sevre preeclampsia

To determine the association between plasma homocysteine level and early onset severe preeclampsia, and its relevance as a potential marker for predicting preeclampsia. A case control study was conducted on twenty early onset severe preeclamptic pregnant women [group I], and ten normotensive pregnant women as controls [group 11]. The gestational age of both groups ranged between 22 and 26 weeks. Routine laboratory tests, serum creatinine, serum uric acid, platelet count, and plasma homocysteine were measured for both groups. Infirmed consent of the patients was taken. The laboratory findings showed significantly higher mean serum creatinine, serum uric acid, and plasma homocysteine of group [I] compared to the control group [P = 0.00001, P = 0.0000], P = 0.00001 respectively]. However, the mean platelet count of group [I] was significantly lower than that of the control group [P = 0.0000]]. Positive significant correlations were found between plasma homocysteine and systolic blood pressure [r = 0.936, P = 0.001], diastolic blood pressure [r = 0.954, P = 0.001], serum creatinine [r = 0.954, P = 0.001], and serum uric acid [r = 0.963, P = 0.001]. On the other hand, a negative significant correlation was found between homocysteine and platelet count [r = 0.880, P = 0.00]]. Plasma homocysteine concentration is significantly increased in early onset severe preeclampsia and it might contribute in the pathophysiology of the disease. It may be considered as a marker in early onset severe preeclampsia

Diagnostic value of beta-HCG, estradiol, and progesterone in ectopic pregnancy versus normal-intrauterine pregnancy

To evaluate the diagnostic value of rising level of serum beta subunit human chorionic genadotrophin, single measurement of progesterone, and estradiol in early diagnosis of ectopic pregnancy. A case control study was conducted on 40 women with ectopic pregnancy and 40 women with normal intrauterine pregnancy from Shatby University Maternity Hospital. Blood samples for the measurement of beta subunit human chorionic genadotrophin [beta-hCG], estradiol [E2], and progesterone were drawn in all the women upon admission. Extra blood sample was drawn for measurement of beta-hCG 24 hours after admission. The mean serum levels of beta-hCG, progesterone, and estradiol in patients with ectopic pregnancies [969.0 +/- 302.1, 7.9 +/- 2.83, 621.9 +/- 131.4 respectively] were significantly lower than these levels in normal intrauterine pregnancies [3186.8 +/- 649.2, 23.5 +/- 5.3, 1853.6 +/- 508.4 respectively]. The average rate of beta-hCG rising was [8%] for 24 hours in patients with ectopic pregnancy and [31%] in normal intrauterine pregnancies. Single measurement of serum progesterone level has the greatest sensitivity [97%] and specificity [90%] in the diagnosis of early ectopic pregnancy

Evaluation of the role of thrombophilia associated factors in pre-eclampsia

To evaluate the role of thrombophilia associated factors in pre-eclamptic pregnant women. A case control study was conducted on 30 severe pre-eclamptic pregnant women [group A], and 30 normotensive pregnant women [group B] from Shatby University Maternity Hospital. Routine laboratory tests, protein C, protein S, antithrombin III, factor V Leiden and anticardiolipin antibodies [IgM, IgG] were measured for both groups. Informed consent of the patients was taken. There was not any significant difference in the values of factor V Leiden, protein C, protein S, antithrombin III, and anticardiolipin IgG between pre-eclamptic and normotensive pregnant women. However, anticardiolipin IgM was shown to be significantly higher in the pre-eclamptic patients. Severe pre-eclamptic patients were 3.5 times more likely to develop elevated levels of anticardiolipin IgM. Routine screening for inherited thrombophilia disorders is not recommended in pre-eclamptic females

Factor XII deficiency and habitual abortion: the Haegman connection

To evaluate the role of factor XII deficiency in cases of habitual abortions. A case control study was conducted on 50 women with history of three or more consecutive first-trimester abortions [group A] of unexplained nature from outpatient clinic of Shatby Maternity University Hospital, and 25 healthy women with no history of recurrent miscarriage, thrombotic disease or adverse pregnancy outcomes [group B]. Blood sample was taken from each patient to assay the following parameters: protein S [PS], protein C [PC], antithrombin III [ATIII], and coagulation factor XII [FXII]. The subsequent miscarriage rate with abnormal FXII is significantly higher than that with normal FXII. However, there were no statistically significant differences in the subsequent miscarriage rates between normal and abnormal PC, PS and ATIII values. Factor XII deficiency might play a role in recurrent miscarriages

Laparoscopic management of ovarian mature cystic teratomas

To evaluate the safety and efficacy of laparoscopic management of dermoid cysts, to present some guidelines, and to avoid possible complications that may occur from cyst spillage. A retrospective review of twenty-four women, who underwent laparoscopic surgery for dermoid cysts. Cases were recruited during the period from March 2002 to May 2005 at Shatby University Maternity Hospital, using special technique during laparoscopic removal of dermoid cysts. All patients were counseled for the procedure and informed consent was obtained to do laparoscopic management. In 24 women aged 18 to 38 years, thirteen patients [54.2%] had unilateral cysts, while eleven patients [45.8%] had bilateral cysts. The size of the dermoid cysts ranged from one to ten centimeters, mean cyst diameter was, 4.7 +/- 2.9 cm, and all these cysts removed via the use of endobag. The chief complaint was chronic pelvic pain in 11 patients [45.8%], irregular menstrual cycles in 4 cases [16.7%], one case [4.2%] presented with acute abdomen and torsion, while 8 cases [33.3%] were asymptomatic and discovered incidentally during routine ultrasound examination. All patients underwent operative laparoscopic cystectomy of the dermoid cysts. During the cyst extraction, spillage occurred in 4 cases [16.6%], and none developed chemical peritonitis. Operative time for dermoid cyst removal was 103 +/- 30 minutes. There were no intraoperative or postoperative complications, and no conversion to laparatomy. Using strict adherence to guidelines for preoperative clinical assessment and intra-operative management, laparoscopic treatment of dermoid cysts appears to be a safe procedure