Optimal Dose of Pituitrin in Laparoscopic Uterine Myomectomy: A Double-Blinded, Randomized Controlled Trial.

STUDY OBJECTIVE: To determine the optimal effective dose of pituitrin in laparoscopic myomectomy for uterine leiomyoma. DESIGN: Double-blinded, randomized controlled trial. SETTING: Tertiary women's hospital in China. PATIENTS: Total of 118 patients who underwent laparoscopic myomectomy. INTERVENTIONS: Patients randomly received 0, 2, 4, or 6 units of pituitrin injected into the myometrium surrounding the myoma. MEASUREMENTS AND MAIN RESULTS: Rate of satisfactory surgical condition, hemodynamic changes, total surgical time, and blood loss were recorded. The rates of satisfactory surgical conditions were 6.7%, 72.4%, 89.7%, and 93.3% in groups 0U, 2U, 4U, and 6U, respectively; they were higher in groups 2U, 4U, and 6U than those in group 0U, but there were no significant differences among the groups 2U, 4U, and 6U. The blood loss was higher in group 0U than that in groups 2U, 4U, and 6U (p < .01). Pituitrin was associated with a transient decrease in blood pressures and an increase in heart rate in a dose-dependent fashion, with more pronounced changes in groups 4U and 6U, and these groups also required a higher amount of vasoactive drug to correct hemodynamic changes (p < .05). CONCLUSION: Two units of pituitrin could provide a satisfactory surgical field with minimal hemodynamic changes for laparoscopic uterine myomectomy.

[Relationship between serum and placental interleukin-18 levels and preeclampsia].

OBJECTIVE: To investigate the relationship of interleukin (IL)-18 concentrations in serum and placenta and preeclampsia. METHODS: Twenty-seven patients with preeclampsia and 28 women with normal pregnancy were recruited. Blood and placenta samples were taken and serum and placental IL-18 concentrations were determined by enzyme-linked immunosorbent assay (ELISA). The levels of IL-18 in serum and placenta were compared. RESULT: (1) The median of serum IL-18 in patients with preeclampsia was 704 ng/L, which was significantly higher than that of control group (470 ng/L, P<0.05). (2) The median of placental IL-18 in patients with preeclampsia was 105 ng/L, which was also significantly higher than that of control group (31.5 ng/L, P<0.005). CONCLUSION: Increased serum and placental levels of IL-18 were presented in preeclampsia as compared to normal pregnancy, which might offer insight into the pathogenesis of the disease.

Serum and placental interleukin-18 are elevated in preeclampsia.

OBJECTIVES: Interleukin-18 (IL-18) is a proinflammatory cytokine with pleiotrophic qualities and its roles in pregnancy, labor onset and pregnant complications have been proposed. However, the alterations of serum and placental IL-18 have been less investigated. The objective of the current investigation was to detect IL-18 concentrations in serum and placentas from patients with preeclampsia and women with normal pregnancy. METHODS: 27 patients with preeclampsia and 28 women with normal pregnancy were recruited. Blood and placental samples were taken and IL-18 concentrations in serum and placental homogenate were analyzed by enzyme-linked immunosorbent assay (ELISA). The levels of IL-18 in serum and placenta were compared between preeclampsia and control. RESULTS: Both serum and placental levels of IL-18 were significantly increased in preeclampsia as compared with control (P=0.014 and 0.003, respectively). Serum and placental levels of IL-18 were not significantly different in preeclamptic women who received dexomethasone and those who did not (P=0.223 and 0.330, respectively). Serum and placental IL-18 levels were not significantly different between preeclamptic women who delivered before 36 complete gestational weeks and those who delivered after 36 complete weeks (P=0.616 and 0.869, respectively). There were no significant differences in serum and placental IL-18 between women with mild preeclampsia and those with severe preeclampsia (P=0.056 and 0.357, respectively). CONCLUSIONS: Increased serum and placental levels of IL-18 were observed in preeclampsia. Those associations may offer insight into the pathogenesis of the disease.