Maternal and neonatal outcomes in women with preeclampsia.

OBJECTIVE: Preeclampsia is a pregnancy-specific hypertensive syndrome associated with significant morbidity and mortality in mother and neonate. We compared neonatal and maternal complications in preeclamptic women with healthy pregnant women. MATERIALS AND METHODS: All 125 consecutive women with preeclampsia at Bandarabbas Shariati Hospital were assessed between July 2005 and July 2006. Parity, type of delivery, common causes of cesarean section, gestational age, birth weight, and neonatal complications and mortality were included as study variables and compared with the control group. RESULTS: Cesarean section rates were significantly higher in the group with preeclampsia than in the control group (p < 0.05). The mean parity was higher in the normotensive group than in the preeclamptic patients (2.3 +/- 0.65 vs. 3.6 +/- 0.74; p < 0.05). In the preeclamptic women undergoing vaginal delivery, 31% of them underwent induction of labor. The most common indication for induction of labor was severity of preeclampsia (77.8%). Birth weight was statistically significantly lower in women with preeclampsia (p < 0.0001). Among the patients, 5.6% of them were admitted with intrauterine fetal demise, while 111 neonates survived for the remaining patients. The most common causes of neonatal mortality were congenital abnormalities and respiratory distress syndrome. CONCLUSION: Gestational age, parity, cesarean section rate, the rate of induced labor, and low birth weight neonates were more frequent in preeclamptic women than in healthy pregnant women.

Outcomes in patients with primary breast cancer and a subsequent diagnosis of endometrial cancer : comparison of cohorts treated with and without tamoxifen.

BACKGROUND: The study compared tumor characteristics and survival in women with breast cancer who subsequently developed endometrial cancer with or without a history of tamoxifen use. METHODS: The British Columbia Cancer Agency registry identified 163 women diagnosed with breast cancer between 1989-1999 who received a subsequent diagnosis of endometrial cancer. Of these, 55% (n = 90) had a history of tamoxifen use. Outcomes analyzed were breast cancer-specific survival (BCSS), endometrial cancer-specific survival (ECSS), and overall survival (OS). RESULTS: Median follow-up was 9.4 years. Distributions of age, menopausal status, body mass index, and comorbidities were similar in the tamoxifen-treated and nontamoxifen cohorts. Proportions of aggressive endometrial cancer subtypes including papillary serous, clear cell, and mixed mullerian tumors were higher in the tamoxifen cohort (28% vs14%, P = .03). Distributions of endometrial cancer grade and stage were similar in the 2 groups (P > .05). Hysterectomy and/or oophorectomy were the primary treatments for endometrial cancer in 99% of patients, with comparable pelvic control rates in the tamoxifen and nontamoxifen groups. At 10 years, patients in the tamoxifen group experienced lower BCSS compared with the nontamoxifen group (89% vs 97%, P = .02). No significant differences in ECSS and OS were observed between the 2 groups (ECSS 82% and 82%, P = .85; and OS 69% v. 66%, P = .85). CONCLUSIONS: In patients with breast cancer who developed a subsequent endometrial cancer, tamoxifen-treated patients had higher proportions of aggressive endometrial cancer subtypes, but almost all cases were amenable to surgery, thus resulting in similar endometrial cancer control and survival when compared with nontamoxifen treated patients.