Maternal placi protein levels in early- and late-onset preeclampsia

Objectives: The objective of this study was to determine the maternal PLAC1 protein levels in early and late onset preec­lampsia. Material and methods: A total of 135 pregnant women were included in the study, of which 55 were at < 34 weeks of gesta­tion and 80 were at ≥ 34 weeks of gestation, between June and November 2014 were recruited in this case control study. Results: Analysis of maternal serum PLAC1 levels did not reveal any significant differences between early onset PE and controls (p = 0.422). However, late onset PE patients exhibited significantly elevated levels of PLAC1, in comparison with healthy controls (p = 0.026). The difference in PLAC1 levels between early onset PE and late onset PE was also significant (p = 0.001). Area under ROC curve of PLAC1 for early and late onset PE was 0.563 and 0.646 with p values of 0.422 and 0.026 respectively. Area under ROC curve of PLAC1 in PE was 0.613 with p value = 0.024. The cutoff value for PLAC1 was 6.19 ng/mL with sensitivity: 56% (95% CI 44.1–67.3) and specificity: 63 %; (95% CI 49.9–75.1) and diagnostic odds ratio: 2.2 (95% CI 1.1–4.4) (p value = 0.037). The cutoff value for PLAC1 was 7.2 ng/mL with sensitivity: 43% (95% CI 31.5–54.6) and specificity: 78% (95% CI 65.5–87.5) and diagnostic odds ratio: 2.69 (95% CI 1.25–5.79) (p value = 0.016) Conclusion: In conclusion, the results of the current study showed that PLAC1 protein levels were significantly elevated in pregnant women with late onset PE in comparison with healthy control group

MYOMECTOMY DURING CESAREAN SECTION AND ADHESION FORMATION AS A LONG-TERM POSTOPERATIVE COMPLICATION

Objectives: We aimed to evaluate the incidence and features of postoperative adhesion related complications occurring following myolysis or myomectomy performed during cesarean section (C/S). Methods: This cross-sectional study consists of four groups of patients who underwent C/S: group I; myolysis is performed by electric cauterization for small superficial fibroids less than 2 cm. (n: 21), group II; myomectomy is performed for pedunculated fibroids (n: 18), group III; myomectomy is performed for intramural/subserous fibroids less than 5 cm. (n: 23), group IV; control group (n: 19) who did not go through myomectomy. Repeat C/S is performed to study subjects within 1-5 years. All cases are evaluated in terms of mild to moderate adhesions between omentum and uterus, mild to moderate adnexial area adhesions, mild to moderate incision area adhesions and surgical difficulty due to severe adhesions. Results: The incidence of adhesions of omentum and uterus (p= 0.278), mild to moderate adnexial area adhesions (p= 0.831), mild to moderate incision area adhesions (p= 0.804) were similar between the intervention groups (group I, II, and III) and the controls (group IV). Conclusion: Cesarean myomectomy is a safe procedure and can be performed without significant postoperative adhesion formation.Cel pracy: Celem naszego badania była ocena częstości występowania i charakter zrostów pooperacyjnych po zabiegu miolizy lub miomektomii w trakcie cięcia cesarskiego. Metoda: Do badania włączono cztery grupy pacjentek, które miały wykonane cięcie cesarskie (C/S) oraz miolizę powierzchniowego, mniejszego niż 2cm mięśniaka metodą elektrokauteryzacji – grupa I (n:21), usunięcie mięśniaka uszypułowanego – grupa II (n:18), miomektomię mięśniaka wewnątrzściennego/podsurowicówkowego, mniejszego niż 5 cm – grupa III (n:23), nie miały wykonanej miomektomii – grupa IV kontrolna (n:19). Ponowne cięcie cesarskie wykonano u badanych pacjentek w ciągu 1-5 lat. Wszystkie pacjentki oceniono pod kątem małych do średnich zrostów pomiędzy siecią większą i macicą, małych do średnich zrostów w okolicy przydatków, małych do średnich zrostów w okolicy nacięcia powłok i trudności operowania z powodu ciężkich zrostów. Wyniki: Częstość występowania zrostów pomiędzy otrzewną i macicą (p=0,278), małych do średnich zrostów w okolicy przydatków (p=0,831), małych do średnich zrostów w okolicy nacięcia powłok (p=0,804) była podobna pomiędzy badanymi grupami (I,II i III) a grupą kontrolną (IV). Wnioski: Miomektomia podczas cięcia cesarskiego jest bezpieczną procedurą i może być przeprowadzana bez istotnych, pooperacyjnych zrostów

Diagnosis of Congenital Cytomegalovirus Antigenemia by Immunohistochemical Detection of Immediate Early Antigen

Cytomegalovirus (CMV) can be a cause of fetal morbidity and mortality among approximately 1% of pregnancies. With an aim to detect CMV antigenemia among 51 pregnant women with/without clinically diagnosed abnormalities and intrauterine growth retardation (IUGR) maternal and fetal samples either prenatal (n:22) or postpartum (n: 29) were obtained between 17-42weeks of gestation to analyze anti-CMV IgG, IgM antibodies and cytoplasmic or nuclear CMV antigens. Cytoplasmic and nuclear CMV antigenemia was detected among 19.6% and 11.8% of maternal samples. These values were 29.4% and 17.6% for fetal samples. Among both maternal and fetal samples, there was a 100% correlation when IgG and IgM were negative. The correlation for IgG and IgM positivity was not present among maternal samples since cytoplasmic (37.5%) and nuclear (25%) antigens could not be demonstrated in spite of immunity. Cytoplasmic and nuclear CMV antigens were detected within fetal samples fromsubjects presenting maternal immunoglobulin positivity, clinical abnormality and clinically normal findings (50, 32, 16.7% and 50, 16, 5.6%) respectively. In conclusion, immunocytochemical detection of CMV antigenemia improves CMV infection diagnosis which may be associated with clinical abnormalities/IUGR

Prediction of Preterm Birth: Maternal Characteristics, Ultrasound Markers, and Biomarkers: An Updated Overview

There is not a single or combined screening method for preterm birth with high sensitivity which will truly identify the women at risk for preterm birth while also with high specificity to prevent unnecessary interventions and high treatment costs. Measurement of cervical length is the most cost-effective method that is used in clinical practice. Bedside tests have also been developed for detecting markers like fetal fibronectin, insulin-like growth factor binding protein-1 (IGFBP-1), interleukin-6, and placental alpha-macroglobulin-1. Taking the maternal history, health condition, and sociodemographical factors into consideration is recommended. Ultrasound markers apart from cervical length measurements as uterocervical angle and placental strain ratio are studied. Investigations on metabolomics, proteomics, and microRNA profiling have brought a new aspect on this subject. Maybe in the future, with clear identification of women at true risk for preterm birth, development of more effective preventive strategies will not be unfeasible

First trimester screening of serum advanced glycation end products levels of pregnant women who have risk factors for gestational diabetes and their obstetric outcomes: a preliminary case-control study

Advanced glycation end-products (AGE) are complex compounds formed by nonenzymatic glycosylation of proteins, nucleic acids, and lipids with glucose in the blood. We aimed to investigate whether there was a difference in first-trimester serum AGE levels of pregnant women with and without risk factors for gestational diabetes mellitus (GDM) and their obstetric outcomes. There were 44 women in study group who have risk factors for GDM and 44 as controls. Demographic features, serum AGE levels, adverse perinatal and neonatal outcomes were compared between groups. Five patients (11.4%) in the study group and one patient (2.3%) in the control group were diagnosed as GDM (p = .2). The serum AGE values were not statistically different between the study and control groups. There were no statistical differences between groups in terms of adverse perinatal and neonatal outcomes. However, in the group with adverse perinatal outcome (n = 25), AGE values were higher than the control group. The results of our preliminary study suggested that high-risk women for GDM did not have increased serum levels of AGE in the first trimester. Nevertheless, a high first-trimester serum AGE level was found to be associated with adverse perinatal outcomes. IMPACT STATEMENT What is already known on this subject? Advanced glycation end products (AGE) are markers that are associated with diabetes and its complications. For pregnant women, a high third trimester serum AGEs levels were found in women who had gestational diabetes. What do the results of this study add? The results of our study revealed that first trimester screening of serum AGE levels of women who had risk factors for gestational diabetes was not discriminate. Nevertheless, a high first trimester serum AGE levels was associated with adverse perinatal outcome. What are the implications of these findings for clinical practice and/or further research? Whether reducing exogenous sources of AGE (western-style diet, smoking) before pregnancy will be associated with better pregnancy outcomes should be investigated in future studies

Fasting and post-prandial plasma glucose screening for gestational diabetes mellitus

Background: Gestational diabetes mellitus (GDM) is defined as impaired glucose tolerance with onset during the second or third trimester of pregnancy