Severe pre-eclampsia and maternal thyroid function.

This study was conducted to determine the thyroid function in severe pre-eclamptic patients compared with healthy controls. Twenty-seven women with severe pre-eclampsia and 26 healthy normotensive controls were studied prospectively. Both groups were matched according to three gestational age subgroups; 30-33,34-37 and 38-41 weeks. Serum concentrations of free thyroxine(Fr4), free triiodothyronine (FT3) and thyroid-stimulating hormone (TSH) were measured by immunochemoluminiscence using an automated analyser (Immulite 2000). Pre-eclamptic women obviously showed a statistically significant increase in terms of systolic BP, diastolic BP, levels of urinary albumin and uric acid compared with the healthy controls. There were no significant differences in the levels of FT4, FT3 and TSH between the two study groups in the various gestational age subgroups. We conclude that the thyroid function is not altered in severe pre-clampsia, therefore it does not reflect the severity of pre-eclampsia.

Medical vs. surgical treatment for clomiphene citrate-resistant women with polycystic ovary syndrome.

This study was conducted to evaluate the efficacy of metformin compared with ovarian drilling in the treatment of clomiphene citrate (CC) resistant women with polycystic ovary syndrome. A total of 161 infertile, CC-resistant women with PCOS aged 22-34 years (mean 25.5 +/- 4.4) were evaluated prospectively during the period between January 2000 and December 2001. Patients were allocated into two groups; group 1 includes 64 women who received metformin, 850 mg twice daily throughout the cycle, and group 2 which includes 97 women who underwent laparoscopic ovarian drilling. If spontaneous ovulation or pregnancy was not achieved within 3 months after treatment, CC was added with increments of 50 mg (up to 150 mg/day) for both groups. Clinical and menstrual characteristics in addition to the hormonal profile were evaluated before and after the treatment. There were no significant differences between the two groups in terms of age, body weight, BMI, duration of infertility and serum hormone levels (androgens, gonadotrophins, insulin) before starting the treatment. A significant improvement in the regularity of menstrual cycles (P < 0.05) and a significant reduction in the serum levels of testosterone(P<0.01), androstenedione (P<0.01), DHEAS (P <0.05), LH (P<0.01) and LH:FSH ratio (P<0.05) were noted after the treatment. There were no significant differences between the metformin group compared with the drilling group in the rates of ovulation (79.7% vs. 83.5%) and pregnancy (64.1% vs. 59.8%). It is concluded that CC-resistant patients with polycystic ovary syndrome can be treated effectively either by metformin or by laparoscopic ovarian drilling. Menstrual cycle pattern and the rates of ovulation and pregnancy are improved significantly, due most probably to the significant decrease in the levels of androgens and luteinising hormone.