The value of plasma SCUBE1 and oxidative stress parameters in the early diagnosis of acute ovarian torsion.

AIM: The purpose of our study was to determine the diagnostic value of plasma SCUBE1, malondialdehyde (MDA), superoxide dismutase (SOD) and total antioxidant status (TAS) investigated on the 4th hour of ovarian torsion, and at the same time to determine the relation between these markers and histopathological damage occurring in the ovary. MATERIALS AND METHODS: Sixteen rats were included, eight in the torsion group and eight in the control group. The right ovaries of the rats in the torsion group were rotated clockwise 720 degrees, after which they were fixed and attached to the abdominal wall. The abdominal walls of the control group rats were opened for 1 min and then closed. Relaparotomy was performed 4 h after surgery in both groups, blood specimens were collected for biochemical analyses, and the right ovaries were surgically extracted. RESULTS: No statistically significant difference was determined in the control and torsion groups' plasma SCUBE1, SOD and TAS values (p = 0.987, p = 0.33, and p = 0.244, respectively). Torsion group plasma MDA values were significantly higher than those of the control group (p = 0.039). At histopathological evaluation, histological score, apoptotic index and Caspase-3 index values of the torsion group were significantly higher compared to the control group. CONCLUSION: Plasma SCUBE1 is not useful in the early diagnosis of ovarian torsion. Similarly, use of the oxidative stress markers SOD and TAS does not appear useful in early diagnosis, although MDA may be considered for that purpose (Tab. 2, Fig. 3, Ref. 23).

The role of cervical ultrasound screening in determining the timing of emergency cerclage.

The present study aimed to determine the outcome of emergency cerclage depending on clinical presentation. Retrospective analysis of non-elective cerclage divided by clinical presentation: (1) bulging membranes with symptoms (n =19); (2) bulging membranes without symptoms (n =13); (3) asymptomatic ultrasound indicated were cerclage (n =23). Data from Group 1 and Group 2 were analysed retrospectively for average prolongation of pregnancy and delivery before 32 weeks. Average prolongation of pregnancy (suture to delivery interval) was significantly shorter in the group with symptoms compared with the group without symptoms (43 vs 89, p <0.01). Delivery before 32 weeks was also significantly higher in the group with symptoms compared with the group without symptoms (79% vs 31%, p <0.05). Emergency and ultrasound indicated cerclage are best performed prior to symptoms. Women at high risk of pre-term birth may benefit from transvaginal ultrasound surveillance.

Social disparity and intrauterine death: from politics to policies.

Correlation between intrauterine demise (IUD) and social disparity, based on maternal post-code of residence, is assessed in this study in order to find out if there is any correlation between IUD and geographical area. A total of 190 IUD cases from September 2002 to August 2004 were collected retrospectively from the IUD register. The maternity computer health record programme (Terranova-Healthware) was used for the assessment of area of residence of the patient and GP, patient demography and pregnancy details. Data were then entered onto a MS Excel spreadsheet and analysed by a public health statistician and a consultant obstetrician using the IMD-Index of Multiple Deprivation and then on to a graph. The results of this study show that there was a strong correlation between the IMD and the distribution of IUDs. Disparities come at a personal, midwifery and obstetric price. Differential access may lead to disparities in quality.

Unified communication to reach vulnerable mothers.

The feasibility of using a mobile text to reach vulnerable patient groups was assessed in this study. A total of 121 pregnant or postnatal women were randomly asked to complete a questionnaire. The questionnaire was given to them in the antenatal clinic, postnatal ward, antenatal ward or in the day assessment unit at St Thomas' Hospital, London. The forms were collected and analysed using an Excel database. The results of this survey show that mobile technology is readily available for 97% of the obstetric population. In mothers from vulnerable groups and in mothers from deprived areas, 61% possessed 3rd generation mobile technology. The majority of mothers surveyed wanted their care supplemented by the use of their mobile phones.