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Article
Serum Erythropoietin Concentration In Normal And Preeclamptic Pregnancies

Authors: Athba A. kadhim عذبه عبد كاظم --- Lilyan W. Sersam لليان وديع سرسم
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 2 Pages: 43-49
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Preeclampsia is a multisystem disease and a threat to the well-being of both the mother and her newborn; it contributes significantly to the causes of maternal and perinatal morbidity and mortality. An increase in maternal plasma of erythropoietin in women with preeclampsia may be of placental origion and a reflection of an underlying placental hypoxic condition. Aims: To compare serum erythropoietin concentrations among patients with and without preeclampsia and to investigate the association between serum erythropoietin levels and preeclampsia.Methods: This case-control study involved one hundred pregnant women in their third trimester of singleton pregnancy with gestational age (28-40wk). Fifty patients were with preeclampsia (study group) and fifty patients were with normal healthy pregnancies (control group). For both groups maternal blood samples were collected for Erythropoietin concentration measured by ELISA method. Statistical analysis was performed to compare maternal serum erythropoietin levels in preeclamptic women and normal heathy pregnant women, and to evaluate the association between serum erythropoietin and preeclampsia. Results: Mean erythropoietin level for the preeclamptic group was (41.66±26.76) ranging from 10.716-159.121(mIU/ml) with a median of 36.101 mIU/ml, while for the control group, the mean value was (28.71±14.38) ranging from 6.482-65.228 (mIU/ml) with a median of 26.741 mIU/ml. Erythropoietin levels were significantly (P=0.003) higher among preeclamptic patients compared with controls.Conclusion: Women with preeclampsia have significantly higher levels of serum erythropoietin compared to normal healthy pregnancy.


Article
CA-125, plasma fibrinogen and C-reactive protein in correlation with severity of preeclampsia.

Authors: WasanW.Ibrahem وسن وجدي ابراهيم --- Raya Kh. Al-Assaly ريا خالد السالي --- Nada Saeed Al-Haddad ندى سعيد الحداد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2017 Volume: 59 Issue: 1 Pages: 31-35
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Preeclampsia is most common medical disordersduring pregnancy, and the rate of hypertension ranges from 5 – 8 % f or all types of pregnancy. There was a significant difference between cancer antigen -125, plasma fibrinogen and C- reactive protein to the severity of preeclampsia.Objective: To determine the level ofserum CA-125 level, C-reactive protein and plasma fibrinogen in preeclampsia and their association with the severity of disease and progression of mild preeclampsia to severe type.Patients and method: A prospective case-control studywhich was carried out in the department of gynecology and obstetric at Baghdad teaching hospital from 1st ofJanuary 2015 to 1st of July 2015.One hundred forty pregnant women were included; they were selected and divided into three groups:Group A: Thirty five (35) pregnant women with mild preeclampsia.Group B: Thirty five(35) pregnant women with severe preeclampsia.Both group A and B are selected according to the clinical signs, symptoms and investigations and admitted to obstetrics ward for evaluation.Group C: seventy (70) pregnant women with uncomplicated singleton pregnancies as control group .Blood samples were taken for measurement of serum cancer antigen -125, C- reactive protein and plasma fibrinogen for all groupsResults: The mean level of Cancer antigen- 125in control , mild and severe preeclampsia groups was ( 14.4±4.11) , (33.60± 4.52) and ( 37.35± 4.85) respectively which was a significant difference between control ,mild groups ( p value < 0.0001) and between control and severe preeclampsia groups ( p value < 0.0001), the mean level of C-reactive protein in mild and severe preeclampsia was( 15.62± 2.6)and ( 29.3± 7.02) which was significant higher in comparison to control group which was ( 8.17 ± 1.56 ) the P value was < 0.0001 . theplasma fibrinogen levels in mild and sever preeclampsia was (470.37±51.1) and (563.14±48.28) which were markedly higher than that of control group (342. 97±56.6) in third trimester pregnant women.Conclusion:Serum Cancer antigen -125, Serum C - reactive protein and Serum plasma fibrinogen were significantly higher in preeclampsia groups in comparison to the control group and these increments was directly correlated with the severity of preeclampsia .Key Words:preeclampsia, plasma fibrinogen, CA 125, C – reactive protein.


Article
Preeclampsia and Consanguinity

Authors: Wisam Akram --- Fatin Al Defer
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 3 Pages: 1-10
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Type of the study: case controlAim: to evaluate the severity of imminent preeclampsia in consanguinity versus non consanguinity groupsDesign and patients methods: a highly selective criteria have been chosen for the women to be participated in this study. The study group (N=30) were not only cousins rather their parents were also cousins and most came from the rural area. While the control Group (N=30) were women in whm no consanguinity neither with couple nor their parents were selected. All women were primigravida 20- 30 years in age. They were all taken from labor ward after 37 weeks of gestation, and for each at admission systolic, diastolic blood pressure, serum uric acid, blood urea, blood platelets count and serum fibrinogen and SGPT with SGOT were initially taken at admission. Since all thepatients were in severe and imminent preeclampsia they were all pre prepared with MgSO4 as anti convulsant and during preparation serial reading were also taken for all the above parameters at 3 and 6 hours later to measure the area under curve profile AUC. Mean blood pressure was taken instead of systolic and diastolic and calculated by the well documented formula Results: The ODD ratio for the primary determinant of preeclampsia severity namely blood pressure and proteinurea were higher in the consanguinity group versus control; 6.58 for systolic; 6.73 for diastolic and 4.07 for protein/creatinine ration in urine, respectively. Serum uric acid and blood urea was also higher for their ODD ratio in the consanguinity group; 5.2 and 5.21 respectively.More importantly the markers of imminent preeclampsia were also significantly higher in the consanguinity group with odd ratio 2.22 and 2.61 for SGOT and SGPT respectively. Best subset regression was calculated for the best combination which correlates with mean blood pressure and serum SGPT with Blood urea combinations were having the lowest coefficient of Mallow (Cp); 32.23. From that independent variable a prediction table has been constructed to sort out all the patients with imminent preeclampsia who are most affected and near complications probably and expressed as column of intervals of bloodurea with corresponding 1,2.5, 5, 10, 90, 95,97.5 and 99 centile of serum SGPT. The area under 10th centile was shaded with green while above 90th centile with red and in between shaded with yellow color. It is probable that patients who’s reading in the red zone or upper yellow zone are at more risk for more serious complications of preeclampsia like adrenal hemorrhage and renal complications and better to expedite their delivery. Conclusion: this study hasshown that preeclampsia among consanguinity group was much more severethan those in non consanguinity couples. Yet by no mean that respect reflects the true picture in society. A table has been constructed and we over stress here that under no circumstances this table can be used for evaluating, modifying or changing the routine protocol of preeclampsia management.


Article
Measuring of Plasma Melatonin Level in Patients with Preeclampsia
قياس مستوى الميلاتونين في مصل دم مرضى ما قبل تسمم الحمل او مرضى مقدمة الارتعاج

Authors: Maad M. Shalal د. معد مهدي شلال --- Ishraq M. Kadhim د. اشراق محمد كاظم --- Nada S. Abbas د. ندى سعيد عباس --- Ghaidaa Abdulsattar د. غيداء عبد الستار
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2017 Volume: 59 Issue: 3 Pages: 234-238
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: disturbed physiological rhythm of blood pressure in preeclampsia is a common finding. The role of oxidative stress in pathogenesis of preeclampsia is well accepted. Melatonin is a powerful free radical scavenger so it's rapidly consumed by enhanced reactive oxygen species in preeclampsia causing non-dipping in blood pressure.Objective: To evaluate the change in plasma melatonin levels in patients with preeclampsia and its relationship with blood pressure.Patients and methods: In this prospective case control study a total of 40 primigravidae pregnant women were recruited during the period of 11 months between August 2015 and August 2016 in Baghdad teaching hospital, medical city, Iraq, divided into two groups:First groups: (cases group) were 20 primigravidae pregnant women with PE.Second group: (control group) were 20 normal healthy primigravidae.Blood Pressure measurement, melatonin blood samples were taken, plasma melatonin levels measurement was done by ELISA immunoassay. Urine was collected over 24 hours for protein in urine measurement.Results : Plasma Melatonin level in control , day and night was (22.72 ± 2.6 pg/mL ) , (75.26 ± 2.99 pg/mL ) compared to Plasma Melatonin level in dipper PE day and night (20.5±2.4 pg/mL ) , (75.26 ± 1.8 pg/mL) which was statistically not significant( P value 0.055 ) , (P value 1.0) respectively .Plasma Melatonin level for non-dipper ( 22.45 ± 2.48 pg/mL) were similar to dipper (20.5±2.4 pg/mL) which is not significant (P value 0.1) , while Night time Plasma Melatonin of non-dipper (36.76 ± 1.27 ) were reduced when compared to control (75.26 ± 2.99 pg/mL) and to dipper group (75.26 ± 1.8 pg/mL ) which was highly significant (p <0.0001 , p <0.0001) respectively .Conclusion: Night time Plasma Melatonin level reduced in Primigravid Women with preeclampsia that did not show nocturnal dipping in blood pressure.Keywords: Melatonin hormone, melatonin during pregnancy, melatonin levels in preeclampsia, preeclampsia

الخلاصةخلفية : اختلال تناغم فسلجة ضغط الدم في حالات ما قبل تسمم الحمل حالة شائعة. دور الاجهاد التأكسدي في تكوين مرض ما قبل تسمم الحمل تعتبر نظرية مقبولة جدا.يعتبر الميلاتونين كاسح قوي للشوارد الحرة ولذلك سرعان ما يستهلك من قبل المشتقات التفاعلية للأوكسجين المحفزة في حالات ما قبل تسمم الحمل مسببة عدم انخفاض ضغط الدمالهدف من الدراسة : دراسة التغير في مستويات الميلاتونين في مصل دم مرضى ما قبل تسمم الحمل وعلاقته بضغط الدم.المرضى والاساليب: في دراسة عنصر تحكم مقارنة مستقبلية خلال فترة 11 شهر تم اختيار 40 امرأه ذوات حمل اولي في اعمار تتراوح من 20 الى 30 سنة ومدة حمل من 32 اسبوع وما بعد.من بين ال 40 امرأه كان هناك 20 امرأه في حالة تسمم ما قبل الحمل و 20 امرأه كن حالات حمل طبيعي كعنصر تحكم. تم قياس معدل ضغط الدم ومستوى الميلاتونين في مصل الدم لجميع النساء الحوامل في اوقات منتصف النهار ومنتصف الليل وكذلك قياس مؤشر كتلة الجسم وقياس بروتين الادرار من خلال تجميع الادرار لمدة 24 ساعة لجميع النساء الحوامل.النتائج: وجد ان جميع نساء الحمل الطبيعي تمتلك مستوى ميلاتونين طبيعي للقياس الليلي والنهاري مع تناغم فسلجي طبيعي لضغط الدم من خلال القياسين الليلي والصباحي. اما نساء حالات تسمم ما قبل الحمل فوجد انهم على مجموعتين , المجموعة الاولى وتمثل نسبة 35% من حالات تسمم ما قبل الحمل وتمتلك هذه المجموعة مستوى ميلاتونين طبيعي للقياس الصباحي والليلي مقارنة مع نساء الحمل الطبيعي ومعدل انخفاض ضغط دم طبيعي ايضا مقارنة مع نساء الحمل الطبيعي لذلك سميت بمجموعة الانخفاض, اما المجموعة الثانية من نساء تسمم ما قبل الحمل وتمثل نسبة 65% فوجد ان قياس مستوى الميلاتونين للقرأه الصباحية طبيعي مقارنة مع نساء الحمل الطبيعي وقياس الميلاتونين للقراة الليلية ذو مستوى منخفض مقارنة مع نساء الحمل الطبيعي وبفرق معتمد احصائيا (قيمة بي<0,0001). الاستنتاج: نساء حالات تسمم ما قبل الحمل ذوات عدم انخفاض معدل ضغط الدم الليلي تمتلك مستوى ميلاتونين ليلي منخفض.عدم وجود علاقة بين شدة حالة تسمم ما قبل الحمل ومستوى الميلاتونين المنخفض.كلمات البحث : هورمون الميلاتونين, الميلاتونين خلال الحمل, مستوى الميلاتونين في حالات تسمم ما قبل الحمل .


Article
The correlation between serum levels of soluble platelet -selectin in preeclampsia with & without intrauterine growth retardation versus normal pregnancy

Authors: EsraaH. AL-Maini اسراء حمدي --- Sarah I. Ali ساره اسماعيل
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2017 Volume: 59 Issue: 1 Pages: 36-41
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: preeclampsia is characterized by endothelial dysfunction with vasoconstriction due to cell adhesion molecules or mediators released by defective placentation. Soluble platelet selectin, one of the cell adhesion molecules, is elevated in many inflammatory conditions including preeclampsia.Objective: To investigate if soluble platelet-selectin levels can be used as a marker for adverse outcomes in pregnancy complicated with sever preeclampsiaPatients and methods:This study involved 115 pregnant women in their third trimester of pregnancy; divided into Group A: involves 25 pregnant women with preeclampsia complicated by intrauterine growth restriction.Group B: involves 35 pregnant women with preeclampsia without intrauterine growth restriction.Control group: involve 55 pregnant women with normal blood pressure and normal fetal growth .The data were conducted from patients by special questionnaire, this involve name, age, parity, examination included vital signs, abdominal, obstetrical examination and investigations including :Liver function test, Renal function test, Complete blood picture and maternal serum levels of soluble platelet selectin was measured by enzyme-linked immunosorbent assay ,albumin in urine and serial obstetrical ultrasound scan to confirm the diagnosis of intrauterine growth retardation and Doppler study to determine fetuses at risk .Results: this study revealed a significantly higher concentration of soluble platelet selectin levels in serumofpreeclamptic women with and without intrauterine growth retardation versus normotensive and normal fetal growth. The maternal serum levels of sP-selectin in preeclampsia without intrauterine growth restriction were significantly higher than preeclampsia complicated by intrauterine growth restriction .Sensitivity was 91.7% and specificity 100% at cut off value 6.975 ng/ml of maternal soluble platelet _selectin for prediction of adverse pregnancy outcome .Conclusion: soluble platelet -selectin levels have a positive significant correlation with the severity of preeclampsia, so it can beconsidered as a marker for its severity and can be used as a predictor for adverse outcomes as itsnegatively correlated with these complicationsKeywords:soluble platelet-selectin ,preeclampsia with & without intrauterine growth retardation versus normotensive pregnancy .


Article
Early-Pregnancy Changes in Maternal Lipid Profile in Women with Recurrent Preeclampsia and Women with Normal Pregnancy
تغييرات الحمل المبكر في دهون الأم الشخصيه عند النساء مع مقدمات الارتعاج المتكررة والنساء ذوات الحمل الطبيعي

Author: Sumaya T. Saihood د. سمية طاهر
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: PISSN: 00419419 / EISSN: 24108057 Year: 2017 Volume: 59 Issue: 2 Pages: 128-131
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: “According to the current knowledge, changes in lipid profile in pregnancy is a major contributor in the pathogenesis of preeclampsia. The present study was designed to compare the changes in lipid profile in normal pregnancy and in patients with history of recurrent pre-eclampsia (PE).”Objective: Assessment the relationship between lipid profiles changes in women with history of recurrent preeclampsia in comparison to normal pregnancy in early pregnancy.Patients and Methods: Measurement of lipid profile changes in women with history of recurrent preeclampsia (more than two preeclampsia in previous pregnancies) at 12 to 16 weeks of pregnancy and compared to normal pregnancy as a control group who does not have history of preeclampsia also early in pregnancyResults: The patients with history of recurrent Preeclampsia had significantly higher mean total cholesterol level compared to controls (216.1 ± 25.5 mg/dl) and (195.6 ± 23.2 mg/dl), respectively, (P<0.05).The mean HDL cholesterol (HDL-C) level was significantly lower in PE group (49.3 ± 9.2 mg/dl) than controls (52.2 ± 8.4 mg/dl), (P<0.05). The mean level of LDL cholesterol was (122.3 ± 28.7) mg/dl in PE group and it was significantly higher than the (108.6 ± 26.8 mg/dl) of controls, (P<0.05). Similarly, the mean VLDL cholesterol was also higher in women with history of recurrent preeclampsia than control group, (44.8 ± 12.6) vs. (34.8 ± 7.3) mg/dl, respectively, (P<0.05). The Triglycerides (TG) was also elevated in women with history of recurrent preeclampsia where the mean TG level was (224.2 ± 63.1 mg/dl) compared to (174.6 ± 36.3mg/dl) in controls, (P<0.05).Conclusion: “This study showed that the women who have history of recurrent preeclampsia had disturbed lipid profile (increased levels of total TC, TG, VLDL-C and LDL-C concentration) in addition to decrease the high density lipoprotein cholesterol (HDL-C) level in subsequent pregnancy compared to normal pregnancy.”

الخلفية: وفقا للدراسات الحالية فان التغييرات في شخصية الدهون لدى الحوامل هو العامل الرئيسي في احداث مقدمات الارتعاج. صممت الدراسةلمقارنة التغيرات في شخصية الدهون في النساء ذوات الحمل الطبيعي وتلك ذوات تاريخ مرضي بمقدمات الارتعاج المتكررة.الهدف: لتقيم العلاقة بين تغيرات الدهون الشخصية في الحمل المبكر عند النساء مع مقدمات الارتعاج المتكررة.المريض والطريقة: قياس الدهون الشخصية عند النساء الحوامل مع تاريخ مرضي بمقدمات الارتعاج المتكررة بين الأسبوع 12 و 16 من الحملومقارنتها مع النساء ذوات الحمل الطبيعي.النتائج: وجد ان النساء مع تاريخ مرضي بمقدمات الارتعاج المتكررة ان تغيرات الدهون الشخصية تكون اكثر وبنسب اعلى من النساء ذوات الحملالطبيعي بما فيها ارتفاع نسبة الكولسترول الى حوالي ) 216 ± 25.5 ( وارتفاع الدهون الثلاثية ) 224.2 ± 63.1 ( وارتفاع البروتين الدهني منخفضالكثافة ) 122 ± 28.7 ( وارتفاع البروتين الدهني منخفض الكثافة جدا) 44.8 ± 12.6 ( وانخفاض البروتين الدهني عالي الكثافة ) 49.3 ± 9.2 .)الاستنتاج: النساء مع تاريخ مرضي بمقدمات الارتعاج المتكررة لها ارتفاع بنسبة الدهون الشخصية مبكرا في الحمل اكثر من النساء ذوات الحملالطبيعي.


Article
Platelets Count, Indices And Fibrinogen Level In Patients With Preeclampsia Compared To Normal Pregnant Women
عدد الصفيحات الدموية , عوامل الصفيحات الدموية,ومستوىالفايبرينوجين في النساء ذوات ضغط الدم المرتفع أثناء الحمل(ما قبل الارجاج)مقارنة بذوات الحمل الطبيعي

Authors: Sawsan Talib Salman سوسن طالب سلمان --- Asil Hashim Ali أسيل هاشم علي --- Inaam Faisal انعام فيصل
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2017 Volume: 16 Issue: 1 Pages: 58-62
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Preeclampsia (PE) is a pregnancy specific syndrome that affects 6–8% of pregnancies worldwide. The specific pathogenesis of preeclampsia remains incompletely elucidated. Many tests have attempted to establish the diagnosis of preeclampsia as early as possible, often even before the patients develop arterial hypertension.Objective: This study aims to identify whether the platelet indices and fibrinogen level are significantly affected by preeclampsia compared to normal pregnancy Patients and methods :This retrospective case-control study was done in AL- Batool Teaching Hospital-Department of Obstetrics and Gynecology, from the 1st of September 2014 to 30th of September 2015 , 75 woman who fulfill the inclusion criteria were included in the study , they were divided into two groups 25 pregnant woman with preeclampsia & 50 normal pregnant woman as control group(were all normotensive pregnant woman with single intrauterine gestation and the obstetric history is uneventful ) . Results: Systolic, diastolic & MAP were highly different between the control & the patient groups. Regarding fibrinogen level it was lower in the patients with preeclampsia. Platelet count was also reduced in preeclamptic patients. While all platelet indices were higher in the patient group compared to the control group.Conclusion: Platelet indices and fibrinogen level can be used in predicting preeclampsia.

خلفية الموضوع: إن ارتفاع ضغط الدم الشرياني أثناء الحمل (ما قبل الارجاج) هي إحدى الحالات التي تصيب ما بين 6_8% من النساء الحوامل في العالم 0 إن السبب الرئيسي للمرض غير معرف تماما0هناك عده فحوصات مختبريه أجريت في محاوله لتشخيص المرض مبكرا قدر الامكان0حتى قبل إن يرتفع ضغط الدم عند المريضه0أهداف الدراسة:الغرض من الدراسة هو لمعرفه هل إن عوامل الصفيحات الدموية ومستوى الفايبرينوجين يتأثران بشكل واضح بارتفاع ضغط الدم(ما قبل الارجاج)مقارنه بالحمل الطبيعيطريقه الدراسة: دراسة رجعيه أجريت في قسم النسائية والتوليد في مستشفى البتول التعليمي-ديالى-العراق0للفتره من الأول من ايلول2014 إلى الثلاثون من أيلول 2015. تضمنت الدراسة 75 مريضه لها نفس الصفات الديموغرافيه وقد تم تقسيم المريضات إلى مجموعتين:الاولى50 أمراه حامل مصابه بارتفاع ضغط الدم أثناء الحمل والمجموعة الثانيه25 مريضه لا تعاني من المرض إن مده الحمل قدر اعتمادا على الفحص بالأمواج فوق الصوتية(السونار)خلال الأسابيع الأولى للحمل0النتائج:لوحظ إن مستوى الفايبرينوجين كان اقل لدى المريضات اللواتي يعانين من ارتفاع الضغط أثناء الحمل وكذلك عدد الصفيحات الدمويه0بينما عوامل الصفيحات الدموية كانت أعلى لدى المريضات اللواتي لديهن ارتفاع ضغط الدم أثناء الحمل0الاستنتاج:مستوىالفايبرينوجين وعوامل الصفيحات الدموية لها قيمه تنبؤيه في حالات ارتفاع الضغط أثناء الحمل0

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