[Cytogenetic diagnosis of first trimester spontaneous abortion]. / Diagnóstico citogenético en aborto espontáneo del primer trimestre.

BACKGROUND: About 15% of all pregnancies end in abortion. In approximately 60% of all losses are chromosomal abnormalities as a cause of pregnancy loss. OBJECTIVE: To determine the importance of cytogenetic study in patients with spontaneous abortion. MATERIALS AND METHODS: A series of cases of women diagnosed with spontaneous abortion less than 12 weeks and cytogenetic studies. Two groups, one group of women with normal cytogenetics and group 2 patients with abnormal cytogenetic result. 44 patients were excluded by cytogenetic study failed. RESULTS: We included 164 women, 55 and 65 for groups 1 and 2, respectively. In 44 cases the material was not suitable for performing karyotype. Of the 120 cases included, had abnormal karyotypes in 65 cases (54%), of which 34 cases (52.3%) were trisomy, 16 cases (24.6%) to polyploidy and 9 cases (13.8%) a monosomy. In addition, we found six cases (8.7%) with recurrent pregnancy loss. The maternal age limit increased incidence of chromosomal abnormalities occurred in the group of 31 and 35 years with 20 cases (30%). Of trisomies, the 16 were the mostfrequent with 11 cases (32.3%). CONCLUSIONS: The finding of 54% of chromosomal abnormalities in spontaneous abortion products demonstrates the importance of cytogenetic study, regardless of patient age and number of previous pregnancy losses.

Urinary prolactin as a reliable marker for preeclampsia, its severity, and the occurrence of adverse pregnancy outcomes.

CONTEXT: It has been proposed that preeclampsia may result from of an imbalance in angiogenic factors. Although prolactin (PRL) is mainly related to lactation, it is also involved in other biological functions, including angiogenesis. OBJECTIVE: Our objective was to determine the relationship among preeclampsia, serum and urinary PRL (uPRL) levels, and excretion of antiangiogenic PRL fragments in urine. STUDY DESIGN: Using a cross-sectional design, uPRL and serum PRL levels, and the presence of PRL isoforms were determined in 546 pregnant women: 207 healthy pregnant, 124 with gestational hypertension, 48 with mild preeclampsia, and 167 with severe preeclampsia (sPE). RESULTS: uPRL concentrations were significantly (P < 0.001) higher in preeclampsia (11.99 ng/mg creatinine) than in healthy pregnancy (0.20 ng/mg creatinine) and gestational hypertension (0.19 ng/mg creatinine), and were even higher in sPE compared with mild preeclampsia (21.20 vs. 2.77 ng/mg creatinine, respectively; P < 0.001). Antiangiogenic PRL fragments (14-16 kDa) were detected in 21.6% of urine samples from women with sPE but in none from other groups. Patients with hemolysis, elevated liver enzymes, low platelet count syndrome, and/or eclampsia, placental abruption, acute renal failure, and pulmonary edema exhibited highest uPRL concentrations (P < or = 0.028) and frequency of antiangiogenic PRL fragments in urine (P < or = 0.036). High-serum PRL levels were associated with sPE independently of gestational age, proteinuria, and prolactinuria (P = 0.032). CONCLUSIONS: Preeclampsia is characterized by increased uPRL excretion. uPRL concentrations and their isoforms appear to be suitable markers to assess the severity of preeclampsia and occurrence of adverse outcomes. PRL and and/or its isoforms might be involved in the pathophysiology of preeclampsia.