Nitric oxide production is not altered in preeclampsia.

BACKGROUND: Preeclampsia remains a disease of theories as the real aetiology has remained elusive. Altered nitric oxide production has been associated with preeclampsia although conflicting results showing elevation, decrease or no change in nitric oxide levels have emerged from previous studies. OBJECTIVE: The aim of the study was to measure the serum levels of nitrate and nitrite in normal pregnancies and pregnancies complicated by pre-eclampsia. MATERIALS AND METHODS: Venous blood was extracted from 39 normal pregnant women (control) and 34 women with preeclampsia (study group). Serum concentrations of nitrate and nitrite were determined using the HPLC method. Other special investigations including renal function tests were performed. The patients were managed according to protocol and the outcome of the pregnancies evaluated. RESULTS: There was no significant difference in the mean maternal age and gestational age at delivery between the groups. However the mean systolic and diastolic blood pressure of the study group (150.5 mmHg and 98.8 mmHg) were significantly higher than the levels in the control group, (110.86 and 85.5), p<0.0001. There was no significant difference in the mean serum nitrate levels (19.157+/-13.407 vs. 19.189+/-16.805) p=0.993. The fetal and maternal outcomes were comparable. CONCLUSION: Our study has demonstrated that there was no alteration in nitric oxide production in preeclampsia, thus contributing to the existing unresolved role of nitric oxide in the pathogenesis of preeclampsia. Further research is called for.

Differential levels of interleukin 6 in maternal and cord sera and placenta in women with pre-eclampsia.

BACKGROUND: Interleukin 6 (IL-6) is a T helper 2 cytokine with a variety of properties including pro-inflammatory characteristics. It has, therefore, been implicated in the pathophysiology of abnormal pregnancies. OBJECTIVE: To investigate the association between IL-6 and pre-eclampsia by estimating the differential levels of IL-6 in maternal and cord serum and supernatant of homogenized placental tissue. METHODS: 50 primigravidae with pre-eclampsia and 50 matched normotensive primigravidae served as controls. At delivery, maternal and cord blood were collected and the serum extracted. Placental blocks were homogenized and sonicated in RPMI solution and the supernatant collected. The total protein concentration was determined and IL-6 levels assayed with an ELISA technique. RESULTS: Placental IL-6 (170 and 186 pg/mg protein) was threefold that in the maternal (64 and 58 pg/mg protein) and cord serum (63 and 72 pg/mg protein; p < 0.01). There was no significant difference in the mean IL-6 levels in maternal and cord serum or placenta in both pre-eclamptic women and normotensive controls nor in pre-eclamptic patients with babies with intra-uterine growth restriction or in pre-eclamptic patients with babies with an appropriate birth weight and in normotensive controls. CONCLUSION: There are no differences in the maternal and cord sera and placental levels of IL-6 in pre-eclamptic and normotensive women, indicating that IL-6 may not have a role in the pathophysiology of pre-eclampsia.

Influence of alpha-thalassemia trait on the prevalence and severity of anemia in pregnancy among women in Kuwait.

Alpha-thalassemia is very common in the Kuwaiti population, but its influence on anemia of pregnancy has not been previously investigated. We have screened a group of 59 anemic (Hb < 11 g/dl) pregnant women for the alpha-thal-2 (-alpha-3.7 kb) deletion which is the commonest alpha-thal allele in this community, using a polymerase chain reaction method. A control group of 35 nonanemic (Hb > or = 11 g/dl) pregnant women was studied for comparison. All the women were in the second or third trimester of pregnancy. Among the 94 women in both groups, 69 (73.4%) had a normal complement of alpha-globin genes (alphaalpha/alphaalpha), 18 (19.1%) were heterozygotes (-alpha/alphaalpha) and 7 (7.4%) were homozygotes (-alpha/-alpha) giving an allele frequency of 17.0%. Among the anemic group, there were 44 (74.6%) individuals with a normal genotype, 9 (15.3%) heterozygotes and 6 (10.2%) homozygotes. In the nonanemic group, the corresponding prevalence figures were 25 (71.4%), 9 (25.7%) and 1 (2.9%), respectively. The difference between these distributions was statistically significant (chi2 = 37.5, p < 0.0001). However, the mean Hb values were similar in heterozygotes, homozygotes and normal individuals. We, therefore, conclude that while the alpha-thal trait affects the prevalence of anemia among pregnant Kuwaiti women, it does not affect its severity.

Mesonephric adenocarcinoma of cervix: a case report.

Adenocarcinoma arising in the cervix are not common tumors and those arising from mesonephric remnants are extraordinarily rare. A case of mesonephric adenocarcinoma of cervix has been reported in a girl age 1.5 years. This tumor could be diagnosed on the basis of histological examination by criteria laid down by McGee et al. (J Obstet Gynecol 84: 358, 1962) especially on the basis of dilated ducts corresponding to the remnant of mesonephric duct.

Bone marrow status of anaemic pregnant women on supplemental iron and folic acid in a Nigerian community.

The bone marrow status of 31 consecutive pregnant women who had been on supplemental oral iron and folic acid since early pregnancy at the University of Benin Teaching Hospital was assessed later in pregnancy to test the efficacy of oral iron and folic acid in preventing iron deficiency and/or megaloblastic anaemia in our community. Only those pregnant patients with haemoglobin genotype AA or AS took part in the study. Nobody was excluded except those with CC or SC. 96.77% (30 out of 31 patients) had iron deficiency with no stainable iron in the bone marrow. 35.4% (11 out of 31 patients) had megaloblastic changes in the bone marrow. 32.2% (10 out of 31 patients) had a combined iron deficiency and megaloblastic anaemia while only one out of 31 patients (3.23%) had megaloblastic anaemia without concurrent iron deficiency. 60.4% (20 out of 31 patients) had iron deficiency alone without concomitant megaloblastic changes in marrow. The bone marrow in all the patients were normal in other respects except with regards to iron-deficiency and/or megaloblastic status. The significance of this high incidence of iron-deficiency and/or megaloblastic anaemia in patients already on routine pre-natal drugs is discussed.

The problems of management of gestational trophoblastic neoplasms at the University of Benin Teaching Hospital, Benin City, Nigeria.

Analysis of 31 cases of gestational trophoblastic neoplasms at the University of Benin Teaching Hospital, Benin City, over a 7 1/2 year period (1/1/75 to 6/30/82) was carried out. The incidence of this disease was 1:656 deliveries. Although it was more prevalent in grandmultipara, it occurred in all parities and ages. The main clinical features were secondary amenorrhea, vaginal bleeding, uterine enlargement, and vaginal secondaries. The most common gestational antecedent event of gestational trophoblastic disease was a normal pregnancy. This was believed to have contributed to the high overall mortality of 35.5%. Numerous shortcomings during the management of these cases (inadequate laboratory facilities, shortage of reagents, shortage of drugs) were highlighted.

The heights and weights of secondary school girls in Benin City, Nigeria.

A cross-sectional study of the heights and weights of secondary school girls in Benin City, Nigeria, aged 11-20 years was carried out with a view to providing baseline data for these physical characteristics. The overall mean height and weight of the population studied were 158.0 +/- 7.2 cm and 49.4 +/- 7.9 kg respectively. The heights and weights increased rapidly with age until 14 years, more gradually until age 17 years after which the height remained static while the weight continued to increase gradually. The finding indicates that in our population, significant increase in height should not be expected after age 17 years. Socio-economic factors (income level) did not significantly affect heights and weights in the age group studied. An attempt is made to explain the differences in the growth patterns of our girls compared with their counterparts from the developed countries.

Racial differences in the etiology of abruptio placentae.

Of 13,500 deliveries in a 6-year period, 326 cases of antepartum hemorrhage (2.4%) were encountered. Fifty-six (0.42%) of these patients had abruptio placentae while 130 (0.96%) had placenta previa. An inverse ratio of placenta previa and abruption placentae was observed in this study, which may be due to a racial difference--probably a result of the late onset of preeclampsia among Nigerians. A high perinatal mortality of 643/1000, influenced mainly by the high prematurity rate, was observed; cesarean section resulted in the lowest perinatal mortality (154/1000). There was one maternal death, giving a maternal mortality rate of 18/1000.

Adhesion of the labia minora complicating circumcision in the neonatal period in a Nigerian community.

Twelve cases of adhesion of the labia minora complicating circumcision in the neonatal period of a Nigerian Community are presented. 9 of the cases were under one year in age. 10 of the cases were erroneously diagnosed by general practitioners as cases of imperforate vagina or hymen. The commonest presenting symptom was a poor urinary stream. Treatment was by separation of the adhesion and local application of dienoestrol cream, the success rate of this mode of therapy was 91.7%. The aetiology and treatment of labial adhesions are discussed. If labial adhesions are untreated other complications could arise in later life, hence female circumcision in the neonatal period should be discouraged.

Personality and menstruation.

An attempt was made to relate personality to premenstrual tension (PMT), using two groups of 40 parous and 40 mulliparous women, respectively composed of 20 single and 20 married subjects with an age range of 21 to 30 years. The menstrual instruction group had identical age range and means with the nonmenstrual group. Control for pregnancy, use of contraceptives, and irregularity of periods was by exclusion. The influence of civil status and parity was also examined. Standard measures of personality and anxiety were utilized. It was found that: 1) The menstrual instruction group had higher scores in state anxiety than the nonmenstrual group. 2) State anxiety scores were positively and significantly correlated with trait anxiety scores. 3) The differences in state anxiety between the menstrual and nonmenstrual groups manifested in the form of exaggeration of symptomm reporting. 4) The Maudsley Personality Inventory did not discriminate between our menstrual and nonmenstrual groups. 5) The global scores of the premenstrual sympto checklist did not discriminate between our menstrual and nonmenstrual groups but the sections on breast, urinary, and pelvic symptoms did. 6) Neither marital status nor parity by itself had any significant effect on the performance of our menstrual and nonmenstrual groups.

Heat loss in Nigerian newborn infants in the delivery room.

Fifty-three vigorous infants were randomly assigned to six different groups (A-F). The babies in groups A and F were not dried and were either exposed wet to room air or warmed under the radiant heater. The other groups of infants were quickly dried and exposed to room air (group B), wrapped with one sterile sheet (group C), wrapped with two towels (group D) or placed under the radiant heater (group E). The infants exposed to room air lost twice the amount of heat when compared with those insulated with two towels. The amount of heat loss by evaporation could not be demonstrated. The role of high relative humidity as an important determinant of the degree of heat loss by evaporation is stressed.