Evaluation of serum biomarkers for detection of preeclampsia severity in pregnant women.

OBJECTIVES: To determine serum biomarkers in detection of preeclampsia severity among pregnant women. METHODS: Among 450 pregnant women with various severity of preeclampsia, serum biomarkers ofaspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), hemoglobin (Hb), platelet count (PLT), uric acid, direct bilirubin, total bilirubin, creatinine, and alkaline phosphatase were compared using area under the Receiver operating characteristic (ROC) curve and Area Under the Curve (AUC). RESULTS: The mean age of women was 30.63±6.43 years and with mean gestational age of 34.69±3.97 weeks. The mean level of LDH, ALT, uric acid, and creatinine were significantly higher in the women with severe type of preeclampsia compared to those with mild type. LDH level had ROC and AUC of more than 0.80, with highest sensitivity, and moderatespecificityin comparison to other markers. CONCLUSION: Biomarkers such as ALT, uric acid, and LDH were shown to be prognostic in detection of theseverity of preeclampsia. LDH was demonstrated to significantly be a better prognostic test in detection of preeclampsia severity.

Preterm Birth Prevention: Effects of Vaginal Progesterone Administration on Blood Flow Impedance in Uterine-Fetal Circulation by Doppler Sonography.

OBJECTIVE: The present study aimed to evaluate the effect of vaginal progesterone administration on maternal and fetal circulation to prevent preterm birth. METHODS: The present prospective study was conducted on 35 women with singleton pregnancy at 18-33 weeks of gestation, who presented with at least one episode of preterm labor or asymptomatic short cervix, or past medical history of preterm birth. Doppler flow and Pulsatility Index (PI) assessment of the umbilical artery, fetal middle cerebral artery, uterine arteries, and ductusvenosus were performed before and 72 h after vaginal progesterone administration. RESULTS: Results showed a significant reduction in the PI of the uterine artery following progesterone administration. Nevertheless, no significant changes were observed in the PI of other vessels. No significant difference was found in Doppler flow parameters in any of the examined vessels before or after progesterone treatment in women with Preterm Labor Pain (PLP). Yet, a statistically significant association was observed between short cervix complication in the current pregnancy and medical history of PLP in the previous pregnancy. CONCLUSION: Treatment with vaginal progesterone reduced the PI in the uterine arteries in the second and third trimesters of pregnancy. Thus, this medication may have useful vasodilatory effects on uterine-fetal vessels.

Genetic variation in TGF-beta 1 gene promoter and risk of gestational trophoblastic disease.

OBJECTIVE: To examine the relationship of transforming growth factor beta 1 (TGF-beta 1) gene polymorphisms at promoter positions -509 (C/T) and -800 (G/A) with the risk of gestational trophoblastic disease (GTD) as compared to normal controls STUDY DESIGN: Polymerase chain reaction-restriction fragment length polymorphism was performed on peripheral blood of 102 patients with GTD and 124 normal, healthy, pregnant women as the control group. RESULTS: In this study, TGF-beta 1 gene polymorphisms at positions -509 (C/T) and -800 (G/A) failed to correlate with GTD. CONCLUSION: Our findings suggest that promoter gene polymorphisms of TGF-beta 1 do not play major roles in GTD and may not be risk factors for this disease.