Accuracy of ultrasonic age determination and weight prediction in the fetus with preterm premature rupture of membranes

Ultrasonic gestational age determination and fetal weight prediction were performed in 20 patients with preterm premature rupture of the membranes [PPROM], and 10 normal gravides with intact membranes, between the 28th and less than 37 weeks of gestation, to assess of the effect of PPROM on the accuracy of ultrasonic age estimation and fetal weight prediction.All gravides had known menstrual age, and delivered within 24 hours of ultrasonic examination, and the actual birth weight was determined. Using single parameter for gestational age assessment [bipartietal diameters, abdominal circumference or femur length], the bipartietal diameters was the least reliable, as there was significant difference in the mean error between the control and studied groups [p<0.05]. Multiple parameters formulas for gestational age estimation [HC, FL;HC, FL, AC; and HC, FL, BPD, AC], did not appear to add further accuracy to single parameters methods. Using three questions for prediction of fetal weight [BPD, AC, MAD, BPD, FL; and HC, AC, FL], we have found no significant difference in the mean error percent between the control and studied groups. Neither amniotic fluid volume, duration of membrane presence or absence of labor pains affected the accuracy of ultrasonic estimation of gestational age or prediction of fetal weight. It is concluded that PPROM appears to have no deleterious effect on the accuracy of ultrasonic estimation of gestational age and prediction of fetal weight, except when the BPD is used as a single parameter for age estimation

Combined bioelectric and ultrasonographic evaluation of the fetus in pregnancy induced hypertension and diabetic pregnancies

To determine the individual and combined abilities of scored non- stress test [NST] and amniotic fluid volume [AFV] assessment in predicting fetal risk in- utero, and to provide an effective screening protocol for intra-uterine fetal compromise, one hundred near term patients [50 patients with severe pregnancy - induced hypertension, and 50 gravidas with known controlled diabetes mellitus] with a singleton pregnancy, formed the subject of the study. Scored NST, and qualitative AFV assessement were weekly performed for each patient till delivery. The obstetric outcome for each pregnancy was determined [perinatal mortality, intrapartum fetal distress, 5- minutes Apgar score <7, or small for gestational age infant], and the predictive abilities of the results of the last performed tests before delivery were estimated, individually and in combination. The predictive ability of scored NST was : sensitivity 75%, specificity 93.2%, PPV 60% and NPV 96.5%; the predictive ability of AFV assessment was sensitivity 58.3% specificity 92% PPV 50%, and NPV 94.2% while the predictive ability of combined NST+ AFV was: sensitivity 80%, specificity 96% PPV 73%, and NPV 97%. The predictive ability of combined NST and AFV assessment was higher than that of either of the testes alone, in both studied groups. The NST was superior to AFV assessment, specially in diabetic gravidas

Plasma beta-endorphin level in cases of premenstrual syndrome

The concentrations of plasma B-endorphin and serum prolactin, progesterone, estradiol and cortisol in 14 women complaining of premenstrual tension syndrome [P.M.S] and 14 normal women were measured at 25th day of the cycle followed by endometrial biopsy using Novak curette. There was significant elevation in prolactin and significant reduction in B-endorphin levels in cases of P.M.S. when P.M. S patients were classified according to prolactin level, hyper-prolactinaemic patients [serum prolactin > 20 ng/ml] had significantly higher level of B-endorphin compared to norm oprolactinaemic patients P < 0.01, while according to endometrial pattern, patients with luteal phase defect showed significant elevation of prolactin and B-endorphin compared to cases with normal secretory activity pattern. Nevertheless at all circumstances B-endorphin levels in P.M.S patients were significantly lower than normal. It is included from this study that, B-endorphin depletion can be considered, as a marker of P.M.S. and it may have an etiological effect on it

Whole blood viscosity in preeclampsia

The whole blood viscosity was estimated in twenty patients with mild preeclampsia, 20 patients with severe pre-eclampsia and 20 women with normal pregnancy in the 3rd trimester of pregnancy using the viscometer of Denning and Watson. The whole blood viscosity was significantly high in pre-eclampsia compared to normal with positive correlation with diastolic blood pressure. Also hematocrit value was significantly high in pre-eclampsia but without correlation with whole blood viscosity. Fibrinogen was significantly high in severe pre-eclampsia but not in mild cases. Whole blood viscosity was significantly high in cases with unfavourable pregnancy outcome [P < 0.01]. It is concluded from the study that whole blood viscosity has a role in assessing the severity of pre-eclampsia and at the same time it has a predictive value as regards fetal outcome

ultrastructure of human endometrium in cases of IUD complicated by abnormal uterine bleeding

Electron microscopic examination of endometria of 7 normal women and 14 women wearing Cu T380 IUD [7 of them were complaining of menorrhagia] was done. It was found that when bleeding was complicating the device use marked epithelial and vascular degenerative changes were evident, but when no bleeding was present, these changes were minimal in 5 cases and absent completely in 2 cases. Microthrombi and platelets blugs were present in cases with menorrhagia only. It is concluded from this study that the epithelial and vascular changes accompanying IUD use may have a role as a cause of abnormal bleeding

role of toxoplasma in repeated pregnancy wastage an experimental study in mice

Transplacental transmission of T. gondii was studied using peroxidase Antiperoxidase [PAP] and Hx and E., histologic examination of uteri and placentas of 90 experimentally infected female mice in 3 successive pregnancies. Their sera were also examined for specific IgM by double sandwitch IgM enzyme linked immunosorbent assay [DS-ELISA]. It was found that placental infection can occur in mice with parasitaemia [during primary infection] and in those which were not parasitaemic but their uteri showed setting of T. gondii in their muscular wall. This study suggests that similar situation can be found in human and may be responsible for habitual abortion and congenital infections of fetuses