ABSTRACT
To evaluate different predictive tests for pre-eclampsia, either individually or in combination, we prospectively studied 100 primigravid females. Eighty-eight of the subjects continued the follow-up until delivery and 17 developed pre-eclampsia. Venous blood samples were take for determination of plasma fibronectin, and urine samples were taken for determination of microalbuminaria and calcium-creatinine ratio. Isometric handgrip exercise tests were also performed. Evaluation of predictive tests, as well as t and chi-squared statistical tests, were used for analysis of data. Pre-eclampsia developed in 19.3% of the patients studied. Pre-eclamptic and normotensive females showed significant differences in calcium-creatinine ratio and plasma fibronectin levels in both ( 14-24 weeks and 28-32 weeks) gestation periods (P <.0001). Plasma fibronectin had the best sensitivity, positive, and negative values in gestation period 14-24 weeks, whereas isometric handgrip exercise tests had the best specificity. These values improved for all the tests in the 28-32-week gestation period; even so, plasma fibronectin proved best of all. A combination of tests failed to improve the predictive ability of fibronectin alone. We conclude that plasma fibronectin is the best predictive test for pre-eclampsia.
ABSTRACT
Ten breastfeeding women had the contraceptive implants NORPLANT inserted between days 30 and 39 postpartum. The immunoglobulins IgG, IgM and IgA were measured in the serum of the mothers and the infants before insertion and five months later. A control group of breastfeeding mothers who did not use any contraception or used local barrier methods were similarly studied. Although there were changes in the immunoglobulin levels with time in both mothers and infants, there were no group differences; this indicates that the use of NORPLANT does not influence these factors of humoral immunity.
PIP: This study measured major immunoglobulin levels in the serum of 10 breastfeeding mothers and their infants before insertion of the Norplant contraceptive implant (at 30-39 days postpartum) and again 5 months after insertion. 10 women who were also breastfeeding but either used no contraception or used barrier methods (diaphragm or condom) served as controls. Comparison of preinsertion and postinsertion mean serum concentrations revealed a significant rise in IgG and a significant decline in IgM in both groups of mothers. IgA concentrations declined after 6 months postpartum in both the study and control groups, but the difference was statistically significant only for women in the Norplant group. There were no significant differences between the 2 groups in changes occurring after 5 months. Similarly, there were no group differences, either at study admission or after 5 months, in the immunoglobulins of infants of Norplant-using women and controls. Overall, the changes in maternal and infant immunoglobulin levels noted in this study are similar to those expected during parturition and infancy. These results provide no evidence that use of hormonal contraception in the immediate postpartum period can make both mothers and infants more susceptible to infection. It is noted, however, that immunoglobulin levels are only 1 aspect of the immune system.
