Predictive and prognostic significance of placental growth factor in pregnant women at high-risk for development of preeclampsia

Background: The study aimed to assess the predictive and prognostic role of placental growth factor (PlGF) in high-risk antenatal women for development of preeclampsia (PE). Methods: In this observational cohort study, antenatal women with gestation age from 20 to 32 weeks with high risk for development of PE were included. Serum PlGF was estimated by sandwich ELISA technique. A p-value of less than .05 was considered significant. Results: A total of 286 high-risk women were analysed for development of PE and obstetric outcomes. Of these 97/286 (34%) developed PE and 62/286 (21.7%) had abnormal PlGF value ( 100 pg/ml). Among the women with abnormal PIGF, 48 (77.4%) developed PE and out of 224 women with normal PIGF level, 49 (21.9%) developed PE resulting in a significant (p<0.001) odds ratio of 12.2 (95% CI: 6.0-25.9). For prediction of PE, a sensitivity and specificity of more than 75% at a cut-off value of <204.5 pg/ml was observed by ROC curve analysis. For prediction of preterm delivery (<34 weeks), a sensitivity and specificity of 65% was observed at a cut-off value of PlGF 191.7 pg/ml. Obstetric complications like eclampsia, preterm births (<34 weeks), neonate with low 5-minute APGAR score, low birth weight, fetal growth restriction, still-births and neonatal intensive care unit admissions all were significantly higher in abnormal PlGF group compared with normal PlGF group (p<0.05). Conclusions: Serum PlGF levels can provide valuable information for the prediction of PE and preterm births and abnormal PlGF values showed a significant association with adverse obstetrical outcomes

Unsuspected rupture in unscarred uterus at an early gestation: a clinical dilemma

Spontaneous uterine rupture in early second trimester is extremely rare specially in absence of predisposing factors. A pregnant patient presented at 15 weeks’ gestation with lower abdominal pain and vomiting since two days. Ultrasound findings and deranged liver function tests reinforced the diagnosis of chronic liver disease with pregnancy. Clinical course a day later raised suspicion of ruptured uterus and patient was immediately taken for laparotomy. Intra-operatively, hemoperitoneum and 4 cm fundus rent was found. Total hysterectomy was performed and histopathology revealed placenta percreta as the probable cause of spontaneous rupture. The case highlights that a high index of clinical suspicion, an attentive daily clinical examination and immediate surgical management can avert life-threatening catastrophe

Application of phosphonium ionic liquids to separate Ga, Ge and In utilizing solvent extraction: A review

Due to the sudden rise in demand, a shortfall in the supply of critical metals or high technology metals, especially gallium (Ga), germanium (Ge) and indium (In) is experienced throughout the globe. The different primary and secondary resources are being utilized to recover and recycle these metals through the widely accepted technique, solvent extraction (SX). The extraction of metals may be potentially achieved by compounds of negligible volatility, phosphonium ionic liquids (Phos ILs). Ionic liquids (ILs) are potential and useful compounds to separate and recover Ga, Ge and In from synthetic solutions and waste materials due to their tunable nature to achieve higher selectivity, superior physicochemical properties and diverse structural properties. Ion exchange mechanism was mainly found applicable for the extractive separation of such metals through Phos ILs. Based on the efficiency, extraction mechanism and diverse operating conditions of Phos ILs, the present review provides a comprehensive description of separation as well as recovery of Ga, Ge and In from the synthetic solutions as well as waste materials

Process Evaluation of Scandium Production and Its Environmental Impact

With the advancement of technology and a global shift towards clean energy, the need for rare earth metals is increasing. Scandium, a rare earth metal, has been extensively used over the decades in solid oxide fuel cells and aluminum–scandium alloys that have a vast, evolving market in aerospace, automobiles and 3D printing. However, the market struggles to maintain the supply chain due to expensive production processes and the absence of uniform global distribution of primary sources. Therefore, identification of alternative sources and technological advancements for scandium recovery are needed. To this end, an effort has been made to provide a review of the advances in different technologies applied in scandium recovery from diverse sources. Emphasis has been given to the improvements and upgrades to technologies in terms of environmental impact and recovery efficacy. An attempt has been made to discuss and deliver a clear representation of the challenges associated with every source for scandium recovery and the major developments in solving them. The environmental impact of scandium recovery and recycling has also been discussed

Diagnostic and prognostic significance of serum soluble endoglin levels in preeclampsia and eclampsia

Background: Preeclampsia is a multisystem disorder of unknown etiology that affects 4–5% of all pregnancies. The aim of the study was to evaluate the diagnostic accuracy of serum soluble endoglin (sEng) in preeclampsia and eclampsia and also to evaluate its prognostic significance. Materials and Methods: This prospective case–control study carried out over a period of 1 year in the Department of Obstetrics and Gynaecology, King George Medical University, Lucknow. After written informed consent and ethical clearance, total 90 subjects were enrolled. Among them, 30 subjects of eclampsia, 15 of nonsevere preeclampsia, 15 of severe preeclampsia served as cases, and 30 healthy pregnant normotensive women served as controls. Levels were estimated by enzyme-linked immunosorbent assay technique in both cases and controls. Results: Mean level was highest in eclampsia group (14.96 ± 1.96 ng/mL) and lowest in controls (2.08 ± 0.56 ng/mL). At cut-off value of sEng levels of ≥6.26 ng/mL, it was found to be 100% sensitive and 100% specific for the diagnosis of preeclampsia (area under curve =1) at 95% confidence interval. sEng levels were strongly correlated with systolic (r = 0.928) and diastolic blood pressure (r = 0.916), serum lactate dehydrogenase (r = 0.791) and serum uric acid (r = 0.722). All four maternal deaths were reported within eclampsia group, in whom the mean sEng level was significantly higher (17.84 ± 0.22) as compared to other subjects (9.50 ± 5.80). Conclusion: sEng is a novel marker for diagnosis of preeclampsia, and it can also be used as a prognostic marker to predict the severity of preeclampsia

Fetomaternal outcomes in pregnant women with congenital heart disease: a comparative analysis from an apex institute

Objective With advancements in cardiac surgical interventions during infancy and childhood, the incidence of maternal congenital heart disease (CHD) is increasing. This retrospective study compared fetal and cardiac outcomes in women with and without CHD, along with a sub-analysis between cyanotic versus non-cyanotic defects and operated versus non-operated cases. Methods A 10-year data were retrospectively collected from pregnant women with CHD and a 1:1 ratio of pregnant women without any heart disease. Adverse fetal and cardiac outcomes were noted in both groups. Statistical significance was set at P<0.05. Results A total of 86 pregnant women with CHD were studied, with atrial septal defects (29.06%) being the most common. Out of 86 participants, 27 (31.39%) had cyanotic CHD. Around 55% of cases were already operated on for their cardiac defects. Among cardiovascular complications, 5.8% suffered from heart failure, 7.0% had pulmonary arterial hypertension, 8.1% presented in New York Heart Association functional class IV, 9.3% had a need for intensive care unit admission, and one experienced maternal mortality. Adverse fetal outcomes, including operative vaginal delivery, mean duration of hospital stay, fetal growth restriction, preterm birth (<37 weeks), low birth weight (<2,500 g), 5-minute APGAR score <7, and neonatal intensive care unit admissions, were significantly higher in women with CHD than in women without heart disease. Conclusion Women with CHD have a higher risk of adverse fetal and cardiac outcomes. The outcome can be improved with proper pre-conceptional optimization of the cardiac condition, good antenatal care, and multidisciplinary team management