Comparison of ELISA and three rapid HCG dipsticks in diagnosis of premature rupture of membranes

The importance of accurate diagnosis of premature rupture of membranes [PROM] is quite apparent while trying to diminish false negative or positive results as much as possible. This study compares Enzyme-Linked Immunosrbent Assay [ELISA] and three rapid human chorionic gonadothropin [HCG] dipsticks in diagnosis of premature rupture of membranes. During 2008-2009, 181 pregnant women with single pregnancy from 14 to 41 weeks of gestation who referred to Ayatollah Taleghani Hospital in Tehran, Iran were divided into two groups, 91 patients with PROM and 90 controls with matched gestational weeks. All patients underwent speculum examination for cervicovaginal washing fluid, HCG three rapid tests and ELISA. The HCG concentration of vaginal fluid was significantly different between the two groups. Using receiver operating characteristic [ROC] curve and determining the threshold as 19 mlU/mL for HCG by ELISA method, the sensitivity was 94.5%; specificity, 91%; positive predictive value, 91.5%; negative predicted value, 94.2% and accuracy was 92.2%. In rapid diagnostic test, the most sensitivity was for ACON and the most specificity for DIMA. Comparing the four methods, DIMA strip showed the highest accuracy and the highest value in early diagnosis of ROM. The reliability of three rapid diagnostic tests in diagnosis of ROM in cervicovaginal discharge was acceptable

Existence of inhibin alpha-subunit gene mutation in a population of Iranian women with premature ovarian failure

Premature ovarian failure [POF] is characterized by hypergonadotropic amenorrhea, before the age of 40, for which the Inhibin alpha-submit [INH alpha] gene is proposed as a candidate gene, due to its role in negative feedback control of FSH. In this study we aimed at demonstrating the candidate mutation as a gene variation associated with POF in Iranian population. Using DNA sequencing, DNA samples of 24 women with POF and 24 controls aged below 40 years, were screened for mutations in the Inhibin gene. The 769G[right wards arrow] A mutation in exon 2 of the Inhibin alpha gene was found in four out of 24 idiopathic POF patients. The results obtained in this study have shown that this variation is more frequent in patients with POF than in normal fertile populations of Iran

[Primary amenorrhea: An existing data at Ayat-allah Taleghani hospital [2003-5]]

Primary amenorrhea is one of the most important complaint of women in reproductive age. To determine the causes responsible for primary amenorrhea this study was performed on the basis of clinical, sonography and laboratories investigations. This case series study was performed at Ayat-allah Taleghani teaching hospital during the years of 2003-5. Data were collected from the patients who attended or referred to the clinics of gynecology or endocrinology wards since 10 years ago. 53 cases were evaluated. Mean age of the patients was 26.82 +/- 7.24 years when they were visited at the clinics. The most common cause of primary infertility was mullerian dysgenesis [n=19] according to clinical, sonography and laboratories investigations. Hypogonadotropic hypogonadism and congenital adrenal hyperplasia were seen in 12 and 8 patients, respectively. 5 patients had gonadal dysgenesis. This study suggest that registration of patients with primary amenorrhea in research center, can be beneficial for diagnosis and intervention

Ultrasonographic findings in a group of Iranian patients with primary amenorrhea

This study was performed to report the ultrasonographic finding and final diagnosis of a group of primary amenorrhea patients. Pelvic ultrasonography [US] was employed as the first diagnostic modality to evaluate primary amenorrhea in 53 patients who were admitted to gynecology or endocrinology clinics at Taleghani hospital from 2002 to 2006. US was based upon the presence or absence of the uterus and ovaries and any other abnormal sonographic findings. Karyotype analysis was also performed for all the patients. The uterus was not visualized in 16 [30%] patients: due to mllerian agenesis in 14 and testicular feminization and true hermaphroditism in two other patients. Mllerian anomalies with hematometrocolpos or hematometra were seen in 5 [9%] patients. Thirty-two [60%] patients had a normal or hypoplastic uterus. Pelvic US showed that ovaries were in normal limits in 39 [73%] patients; they were not visible in 9 patients. The report of pelvic US was not conclusive in 3 patients; 2 had an ovarian tumor or cyst. Irrespective of the presence or absence of the uterus, all patients with visible ovaries [except one] had a normal karyotype. US of the pelvis can be the initial diagnostic modality. Based on US findings, we can make decision for further work ups; there is no need to perform all paraclinical investigations for each patient

[ comparison of platelet count and volume in normal and preeclamptic pregnancy]

Background: hypertensive disorders in pregnancy are one of the high risk pregnancies. There are considerable evidences about the role of platelet in preeclampsia in pathophysiology. In this study the mean of volume platelet and count in normal pregnant women and preeclamptic women were compared

Materials and methods: in a case - control study 35 normal pregnant women who matched in age, gestational age, and gravity were compared with 35 preeclamptic women to determine the mean volume platelet and count from 2003 to 2005 on pregnant women who admitted at obstetric ward of Taleghani Hospital and outpatient department were entered the study

Results: totaly 70 pregnant women [35 case of preeclamptic women and 35 control groups] , were evaluated. Mean age in normal pregnant women were 27+/- 5.4 years and in preeclamptic group was 27.2 +/- 5.3 years [range:17-38 years]. The Number of gravity of the patients Were between 1 to 8.the mean of gestational age in both group were 32.7 +/- 5.1 weeks[range:20-41 weeks]. In normal group no one has platelet count less than 150.000/[micro]l and in none of them means platelet volume was more than 10fm. In preeclamptic group in 16[45.7%] cases platelet count was less than 150000/[micro]l and in 9 [25.7%] mean platelet volume of >/= 10fl was obtained. In normal pregnant women mean platelet count was 208300/[micro]l+/- 4600 and mean of mean platelet volume was 8.2+/-0.63fl. In preeclamptic women mean platelet count was 154000/[micro]l+/-84000 [P<0.005] and mean of mean platelet volume was 9.2 +/- 0.84 fl. [P<0.0001]

Conclusion: decrease in count and increase in size of platelets probably precede preeclampsia

[Epidemiologic characteristics of patients with gestational trophoblastic tumors in selected teaching hospitals in Tehran, Iran: 1992-2002]

Background: the aim of this study is to explain the epidemiologic characteristic of the patients with Gestational Trophoblastic Tumors [GTT]. GTT is among the rare human malignancies that can be cured even in the presence of widespread metastasis. Although persistent GTT usually occurred after molar pregnancy, it can occur after term pregnancy, abortion and ectopic pregnancy

Materials and Methods: in a descriptive study based on existing data, we reviewed the records of 85 cases of GTT in Imam Hossein, Taleghani and Mirza Koochak Khan teaching hospitals in Tehran during 1992 to 2002 .The epidemiologic variables taken into consideration include: age, parity score, antecedent pregnancy, mean serum Beta Human Chorionic Gonadotropin [HCG] level before therapeutic interventions, clinical manifestations, probable metastasis and staging

Results: mean age of the patients with GTT was 30.8 with standard deviation[SD] of 10.9 .80% of them were multipara and 80% developed GTT following molar pregnancy .64.3% of cases were in stage 1 [limited to uterus] and the other 35.7% of cases had distance metastasis to lung[16.7%], brain[8.2%], liver[8.2%], kidney[2.4%] and other sites. surprisingly, levels of [beta]HCG were less than 5000mIU/mL in more than half of the patients before therapeutic interventions

Conclusions: in this study most cases of GTT occurred after molar pregnancy, while it could be prevented by following [beta]HCG levels .More over, mean level of serum [beta]HCG was too low even in the presence of metastasis which needs further investigations

Effects of hypertension of pregnant mothers on neonates, Taleghani Hospital- 1999

Recent studies show that presence of hypertension during pregnancy results to neonatal morbidity and mortality. The aim of this study is to investigate and identify the neonatal out comes, which their mothers were afflicted with hypertension during pregnancy. This was a Cohort type of study and in this regard, 160 pregnant women with hypertension were considered from Obs and Gyn Department of Taleghani Hospital, Shahid Beheshti Medical Sciences University. 80 pregnant women without hypertension were considered as control group. Morbidity and mortality were compared in these neonates. Results of this study showed that in group of mothers afflicted with hypertension, morbidity and mortality of neonates were 7.5 times, low apgar scores, 9 times birth of premature neonate, 3.5 times, low birth weight of neonate [fetal growth retardation] 2 times of control group. Since hypertension in pregnant women has many serious side effects for neonates, therefore it is recommended that there should be improved cares during pregnancy and on time of recognition and control of this disease, which can be lead to serious problems, and mortality of neonates