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Article
Use of single serum progesterone level measurement as a predictor of the fetal viability during the first trimester
استخدام قياس مستوى هرمون البروجسترون في الدم كمؤشر على سلامة الجنين خلال الأشهر الثلاثة الأولى

Author: Trifa Yousif Muttalib
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 2 Pages: 180-185
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Approximately one in third of pregnant women experience discomfort, pain and or vaginal bleeding during the first trimester of pregnancy. Ultrasound is known to be a useful tool in detecting and diagnosing the viability of the fetus but it is sometimes inconclusive. In cases in which pregnant women experience symptoms of discomfort, serum progesterone may be admitted to the patient for counseling and prediction of the continuity of pregnancy. This study aimed to estimate the relation between single serum progesterone level and the viability of the fetus during the first trimester.Method: A prospective study was carried out in Maternity teaching hospital-Erbil city to estimate the accuracy of single serum progesterone measurement for the prediction of fetal viability at the end of the first trimester. All the cases have been detected by ultrasound device that has been for women who attended the hospital and reported the feeling of discomfort, pain and bleeding early in the first trimester of pregnancy, serum progesterone level of the patients were compared between viable and nonviable fetuses.Results: A total of 97 participants were involved in this study; 57 participants had a viable pregnancy at the end of the first trimester, and 40 participants had un-viable pregnancy that has been terminated either by spontaneous abortion or termination performed for missed abortion. The mean of serum progesterone level in viable pregnancies was (19.358 ngml) when compared with the non-viable pregnancies which were (11.082 ngml). The differences were statistically significant (P <0.001). The cut-off value (13.68ngml) provides the highest sensitivity and specificity.Conclusion: A single serum progesterone measurement was regarded as a reliable test for the prediction of viable and non-viable pregnancy in women who reported to be experiencing pain and bleeding in the early trimester of pregnancy with or with inconclusive ultrasound.


Article
Misoprostol for termination of first trimester missed abortion

Author: Maha Assim AL- Azzawy مها عاصم العزاوي
Journal: Al-Qadisiyah Medical Journal مجلة القادسية الطبية ISSN: 18170153 Year: 2009 Volume: 5 Issue: 7 Pages: 121-141
Publisher: Al-Qadisiyah University جامعة القادسية

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Abstract

Background: misoprostol is prostaglandin E1 analogue that can be given by oral, sublingual, vaginal or rectal route. It is cheap and can be stored at room temperature and because of its utero-tonic action, it become an important drug in obstetric and gynecological practice.Objectives: to evaluate the effectiveness of intravaginal followed by oral misoprostol tablets for medical termination of missed abortion between 8 – 13 weeks.Methods : a prospective study of (60) women with diagnosed missed abortion admitted to AL- Zahraa General hospital – Wassit Governorate Iraq from July 2006 through July 2007 . 800 micrograms (4 tablets) of misoprostol inserted in the posterior fornix of the vagina after moisture with normal saline followed by oral 400 micrograms (2 tablets) 6 hours later. Another 400 micrograms were given orally 6 hours from the last dose for those patients whodid not respond to the previous two doses.Results: (48) patients (80%) had complete expulsion . (21) Patients (35%) after the vaginal dose. (15) Patients (25%) respond after the first oral dose and (12) patients (20%) after the second oral dose. (6) Patients (10%) had incomplete abortion; the remainder (6) patients (10%) failed to respond within 24 hours of starting treatment and require surgical evacuation. The mean time for expulsion was 10 hours. Conclusion: first trimester missed abortion medical termination by misoprostol is effective, save and a practical Methods .

الميزوبرستول هو مثيل البروستوكلاندين- اي 1 ويمكن ان يعطى عن طريق الفم وتحت اللسان و عن طريق المهبل وعن طريق الشرج. يعتبر هذا العقار رخيصا و ممكن خزنه في درجة حرارة الغرفه و بسبب فعاليته في احداث تقلصات رحميه اصبح عقارا مهما في مجال النسائيه و التوليد.الهدف من الدراسة هو لتقييم فعالية الميزوبرستول وذلك بأعطائه عن طريق المهبل يليه اعطائه عن طريق الفم لانهاء الاسقاط المنسي طبيا بين 8 – 13 اسبوع. هذهِ دراسه مستقبليه تضمنت ستون امرأه مشخصه بحالة اسقاط منسي ادخلوا مستشفى الزهراء العام في محافظة واسط / العراق للفتره بين تموز 2006 و تموز 2007 . 800 مايكروكرام ( اربع حبوب) من الميزوبرستول توضع في الجزء الخلفي من المهبل بعد ترطيبها بالنورمال سلاين تليها جرعه عن طريق الفم (400 مايكروكرام) بعد ستة ساعات . وجرعه فمويه اخرى بعد ستة ساعات من الجرعه الاخيره للمرضى الذين لم يستجيبوا للجرعتين الاوليتين.النتائج 48 مريضه (80%) حصل اسقاط كامل. 21 منهن(35%) بعد الجرعه الاولى. 15مريضه (25% ) بعد الجرعه الفمويه الاولى و 12 مريضه (20%) بعد الجرعه الفمويه الثانيه .6مريضات (10%) انتهوا بأسقاط ناقص و 6 مريضات (10%) لم يستجيبوا للعلاج بعد مرور 24 ساعه على بدأ العلاج واحتاجوا الى تداخل جراحي لانهاء الحمل. كان معدل وقت انهاء الاسقاط المنسي هو عشرة ساعات .يستنتج من الدراسة انهاء الحمل الطبي في حالات الاسقاط المنسي في الجزء الاول من الحمل بواسطة الميزوبرستول هي طريقه فعاله و امينه وعمليه.


Article
The association of anticardiolipin antibody IgM with first trimester recurrent abortions
العلاقة بين الجسم المضاد للدهون من نوع آي جي آم والإسقاطات المتكررة خلال أول ثلاثة اشهر من الحمل

Author: Dr. Mohammad Shnain Ali
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2010 Volume: 13 Issue: 2 Pages: 157-161
Publisher: University of Kufa جامعة الكوفة

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Abstract

AbstractBackground: Anticardiolipin antibody has a clearly documented association with recurrent abortions in patients with autoimmune diseases; however, the association of Anticardiolipin antibody with first trimester abortions is not clearly documented in patients with no evident autoimmune diseases.Aim: To estimate the prevalence of Anticardiolipin antibody IgM in patients with first trimester recurrent abortions and to find if there is any association between them.Materials and methods: A total number of 90 women were included, 45 had history of recurrent abortions(more than 2 abortions) and 45 were healthy control women with one or more than one delivery and no history of abortions. Blood samples from the 90 women were taken for investigations including blood group, blood sugar, blood urea, complete blood picture, ESR, general urine examination, TORCH test, VDRL test and Anticardiolipin antibody IgM by ELISA technique in which levels higher than 15 MCL unit are considered to be positive, while levels below 15 MCL unit are considered to be negative.Results: Out of 45 patients, 24.4%(n=11) had history of explained recurrent abortions, 9 of them due to toxoplasmosis and 2 of them were due to cytomegaloviral infection. while 75.6%(n=34) had no explained causes. Significantly raised levels of anticardiolipin antibody IgM was present in 11 out of 45 patients i.e 24.4% of patients while IgM levels were normal in 34 out of 45 patients i.e 75.6%. The total number of explained recurrent abortions was 11 (8 out of 11 had significantly high IgM antibody i.e 72.7% while 3 out of 11 had normal IgM levels i.e 27.3%). The total number of unexplained recurrent abortions was 34 ( 3 out of 34 had significantly high anticardiolipin antibody IgM i.e 8.8% while 31 out of 34 patients had normal levels i.e 91.2%) while the antibody was negative (normal) in the control group. Patients with significantly high levels of anticardiolipin antibody who had history of explained recurrent abortions are eight. Seven of them i.e 87.5% had positive antitoxoplasma antibody IgM and one of them i.e 12.5% had positive anticytomegalovirus antibody IgM. Conclusion: Anticardiolipin antibody IgM is not associated with first trimester recurrent abortions.

الخلاصةالخلفية: للجسم المضاد للدهون علاقة مثبتة مع الاسقاطات المتكررة في حالة وجود الامراض المناعية المكتسبة مع ذلك فان العلاقة غير مثبتة في حالة عدم وجود الامراض المناعية المكتسبة. الغرض: معرفة وجود او عدم وجود علاقة بين الجسم المضاد للدهون من نوع آي جي ام والاسقاطات المتكررة خلال اول ثلاثة اشهر من الحمل.المواد والطرق: تمت دراسة 90 حالة(45 من النساء الحوامل ممن لهم اكثر من حالتين من الاسقاطات اول ثلاثة اشهر من الحمل و 45 من النساء ممن لهم اكثر من ولادة طبيعية وليس لديهم أي حالة اسقاط كمجموعة تتمتع بالصحة). تم جمع عينات الدم والادرار لاجراء التحليلات المرضية التالية: فصيلة الدم,نسبة السكر في الدم, يوريا الدم,صورة الدم الكاملة,نسبة ترسيب الكريات الحمراء,تحليل الادرار العام, اختبار تورج, اختبار السفلس, والجسم المضاد للدهون من نوع آي جي ام بطريقة اليزة وتم اعتبار المستوى الاعلى من 15 وحدة ايجابيا والمستوى الاقل او يساوي 15 سلبيا. النتائج: وجدت نسبة 24.4%(عدد 11) ممن لديهم اسقاطات متكررة مفسرة(9 منهم بسبب داء القطط و 2 منهم بسبب السايتوميجالوفايروس)بينما نسبة 75,6%(عدد 34) ممن ليس لديهم اسباب لتفسير الاسقاطات المتكررة. وجد ان مستويات الجسم المضاد للدهون من نوع آي جي ام بطريقة اليزة عالية احصائيا لدى 11 من مجموع 45 مريضة أي 24.4%(8 مرضى ممن لديهم اسقاطات متكررة أي 72.8% و 3 مرضى فقط ممن لديهم اسقاطات غير مفسرة الاسباب أي 8.8%)الاستنتاج: لا توجد علاقة بين الجسم المضاد للدهون من نوع آي جي ام والاسقاطات المتكررة خلال اول ثلاثة اشهر من الحمل في حالة عدم الاصابة بالامراض المناعية.


Article
Oral Misoprostol Versus Vaginal Surgical Evacuation of First Trimester Incomplete Abortion; A comparative Study

Authors: Falah Abdul Hade Muhi1 --- Haitham F. Hamzha
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2015 Volume: 8 Issue: 1 Pages: 2167-2171
Publisher: Kerbala University جامعة كربلاء

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background: Vaginal surgical evacuation of retained products of conception was the main stay of treatment for a long time for patients with first trimester incomplete abortion. Misoprostol as a thermo stable prostaglandin E1 analogue has been previously tested in the management of incomplete miscarriage in different regimens and setting. Overall results indicate efficacy, effectiveness and acceptability in most of these studies.Objectives: To assess the effectiveness and acceptability of using oral misoprostol for management of first trimester spontaneous incomplete abortion as an alternative to direct vaginal surgical evacuation.Methods: This is a comparative study performed on 84 patients with first trimester incomplete abortion between 6 -12 weeks of gestation requesting medical management .They were divided into two groups; group (1) received misoprostol tablet 200 μg [misotac ,SIGMA] two tablets every 4 h for a maximum of four doses while group (2) underwent surgical vaginal evacuation directly under general anesthesia.Results: In 100% of cases , misoprostol was successful in 79% (p= 0.0006). The overall satisfaction was slightly higher in the surgical group but almost equal percentage of both groups mentioned that they will recommend the method to a friend. No serious side effects or complications were reported in misoprostol group. The incidence of excessive post-abortive bleeding was more in the misoprostol group than the surgical evacuation group (p=0.336). Also endometrial thickness using ultrasonography was significantly thicker in the misoprostol group than group (2) [p=0.0071].Conclusion: Although vaginal surgical evacuation is more effective than misoprostol in solving the problem still medical treatment is effective and acceptable especially when surgical management is not available or risky or patients refuse to do surgical management.


Article
Outcome of the First Trimester Threatened Miscarriage: Study of the Predicting Factors

Authors: Abdulrazak H. Alnakash --- Nibras A Omar --- ,Faris Anwer Rasheed
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2015 Volume: 14 Issue: 3 Pages: 320-328
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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ABSTRACT: BACKGROUND:Threatened miscarriage is a distressing condition to both pregnant woman and gynecologist. It is important to predict the outcome of threatened miscarriage through maternal history, biochemical tests, and fetal ultrasound for patient counseling and to avoid delay in management.Study designA prospective multiple logistic regression analysis study.OBJECTIVE:To assess the power of factors which are maternal history (age, vaginal bleeding, parity and hypertension), biochemical tests (β-hCG & serum progesterone level) and fetal ultrasound (crown rump length& fetal heart rate) for predicting the outcome of pregnancy (fetal demise & ongoing pregnancy) complicated by threatened miscarriage between 7-11 wks and to determine the time interval from onset of symptoms to fetal demise development.PATIENTS AND METHODS:The study was carried out on 80 pregnant women at their 7-11 weeks of gestation suffering from vaginal bleeding attending Al-Elwiya Maternity Teaching hospital. They were subjected to ultrasound to confirm fetal viability, assay of serum progesterone and β-hCG levels and pain with bleeding scores. All these were repeated on weekly basis for four weeks follow up to monitor the pregnancy and identify the period to fetal demise (if happened). The data is gathered on questionnaire paper and then subjected to statistical study.RESULTS:The β-hCG (human chorionic gonadotrophin hormone) level was found to be the main predictor for pregnancy outcome (miscarriage/fetal demise & ongoing pregnancy) and highly statistically significant (P value<0.0012), followed by bleeding (p <0.002) and maternal age (p<0.01) respectively, while other variables (serum progesterone, fetal ultrasound, parity) showed no statistically significant effect (P value=0.47, 0.63, 1.146 respectively) on the risk of miscarriage/fetal demise. Serum progesterone level was highly significant in predicting ongoing pregnancy (P value=0.001)CONCLUSION:Measuring of beta hCG levels is found to be a good predictor for the outcome of the first trimester threatened miscarriage whether ends in to fetal demise or continuing pregnancy, while other factors like ultrasound, serum progesterone levels and parity are useful in assessing an ongoing pregnancy but have no power in predicting possibility of fetal demise. Also measuring the interval from the onset of bleeding to fetal demise development can be useful to avoid delaying pregnancy management.


Article
Predictors of poor first trimester outcome in asymptomatic women : the value of embryonic heart rate , mid sac diameter / yolk sac ratio & mid sac diameter / crown rump length

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Background: Ultrasound provides a powerful tool for assessing early pregnancy and detecting pregnancy failure at first trimester and promoting rapid effective management. Several criteria have been established to predict the pregnancy outcome particularly in symptomatic women . Aim: To evaluate asymptomatic women at the first trimester of pregnancy , to assess the efficacy of certain ratios as mid sac diameter (MSD) / yolk sac ratio & crown rump length (CRL)/mid sac diameter (as indicator of early first trimester oligohydramnios) in predicting poor 1st trimester outcome Type of the study: A cross-sectional study.Patients & Methods: A sixty three asymptomatic women were enrolled in this prospective study . Transvaginal sonography was performed for confirmation of pregnancy viability & exclusion of multiple pregnancies 6-8 weeks of gestation & follow up ultrasound repeated at the beginning of second trimester to confirm the continuation of pregnancy and viability of fetus. Several parameters assessed and tested against each others as embryonic heart rate , the size and morphologic criteria of gestational sac , yolk sac and the crown rump length Results: The women were classified into two groups: group A are those with successful outcome at the first trimester and group B are those with poor outcome of the 1st trimester . Decrease embryonic heart rate below 100 beat per minute and low mid sac diameter/ yolk sac size ratio of < 1.9 , were found to be significant predictors of poor outcome however mid sac diameter/crown rump length ratio was not found to have a similar significance Conclusion: In addition to the classical parameters assessed by trans-vaginal ultrasound, other important parameters need to be routinely applied as the embryonic heart rate that predict poor outcome when less than 100 bpm . In addition to the ratio of mid sac diameter to the yolk sac diameter which , if less than 1.9 , may point to abnormal first trimester fate.


Article
Study of Toxoplasma infection in women recurrent abortion in First trimester of pregnancy by Indirect immunoflurescent antibody test (IFAT)
دراسة عدوى التوكسوبلازما في إجهاض المرأة المتكررة في الأشهر الثلاثة الأولى من الحمل عن طريق غير مباشر اختبار الجسم المضاد immunoflurescent (IFAT

Author: Rana Talib AL-Ani
Journal: Diyala Journal For Pure Science مجلة ديالى للعلوم الصرفة ISSN: 83732222 25189255 Year: 2012 Volume: 8 Issue: 2 Pages: 24-34
Publisher: Diyala University جامعة ديالى

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During a period of six months, 50 blood samples were collected from women theoccupation were Housewife in First trimester of pregnancy who were referred to theMaternity and Child Hospital in Ramadi , in addition to 50 samples from healthy women ascontrol. All women were screened for Toxoplasma antibodies by latex agglutination test tostudy the positive rate of toxoplasmosis in the community and to investigate the effect of therisk factors on the positive rate of the disease.Toxoplasma -IgM antibodies were demonstrated by using IFAT to distinguish between acuteand chronic infections. The overall seroprevalence of toxoplasmosis was 50%. TheToxoplasma antibodies increased with age especially in the age groups (26-30-31-35) years.Most of the positive women showed the highest titers 320 IU/ml especially in age group 26-30, 31-35 years. Were recorded high number for abortion (30) from total number (50) .IFAT test was evaluated for specific IgM when testing 50 sera, 15 cases were with acuteinfection and 25with chronic toxoplasmosis using IFAT .

جمع ٥٠ نموذجا من دم نساء تعرضن للإجھاض خلال فترة ستة أشھر من اللواتي راجعن مستشفى النسائیة و الأطفال في مدینة . الرمادي، أضافھ إلى ٥٠ نموذج جمعت من النساء الأصحاء واعتمدت مجموعة كسیطرة Control فحصت النماذج بطریقة التلازن المباشر Latex agglutination test للكشف عن الأجسام المضادة لمقوسات كوندي Toxoplasma gondii واستخدمت طریقة الاستشعاع المناعي غیر المباشر IFAT لقیاس مستوى الكلوبیولین المناعي IgM . للكشف عن الحالات الحادة Acute المزمنة Chronic وجدت الأجسام المضادة للطفیلي في ٣٠ عینة وتركزت أعلى إلاصابات عند الفئة العمریة (26-30-31-35) وأظھرت غالبیة النساء أعلى معیاریة 32:1 320 وحدة دولیة /مل وخصوصا في الفئات العمریة (26-30-31-35) سنة حیث سجل أعلى عدد للإجھاض من العدد الكلى 50


Article
Association between Vitamin D Deficiency and Bacterial Vaginosis among First Trimester Pregnant Women in Erbil Maternity Hospital
العلاقة بين نقص فيتامين د و التهاب المهبل البكتري بين النساء الحوامل في الاشهر الثلاثة الاولى في مستشفى اربيل للولادة

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Background: Bacterial vaginosis (BV) is a polymicrobial clinical syndrome characterized by changes in vaginal flora, with replacement of normally abundant Lactobacillus species by high concentrations of anaerobic bacteria among reproductive age women. Studies have different aspects on the effect of vitamin D on BV.Objective: To find out the prevalence of BV, vitamin D deficiency in early pregnancy and to examine association between BV and vitamin D deficiency.Patients and Methods: A cross-sectional study was carried out during July 2017 till October 2018 among 100 pregnant women at first trimester pregnancy, aged 18-35 years old at Erbil Maternity Hospital. Results: At enrollment the prevalence of BV was (53%), about (73%) of our clients suffering from homogenous white greyish vaginal discharge, (57%) were with elevated vaginal PH and fishy odor, clue cells was found among (53%) of them. Vitamin D deficiency, defined as 25 (OH) D concentration below 20 ng/ml, was found in (67%) of women. Insufficiency of the vitamin D 25(OH) D concentration between 20-30ng/ml was present in (29%) of the women. Sufficient level of 25 (OH) over (30 ng/ml) was found in (4%). The incidence of Vitamin D pattern among women with BV were (49.3%), (62.1%) and (50%) respectively for each vitamin D deficiency, Insufficiency and sufficient vitamin D. No significant association was found between Vitamin D deficiency and BV.Conclusion: High occurrence of BV and vitamin D deficiency were found. Vitamin D was not associated significantly with increased BV incidence. We suggested that pregnant women should check and manage their level of vitamin D and BV additionally they must not depend only on vitamin D for curing BV

خلفية الدراسة: التهاب المهبل البكتري هي متلازمة سريرية متعددة الميكروبات تتميز بالتغيرات في فلورا المايكروبات المهبلية ، بحيث تستبدل فلورا المايكروبات الطبيعية species Lactobacillus ببكتيريا اللاهوائية بين النساء في سن الإنجاب. هنالك الدراسات و استنتاجات مختلفة حول تأثير فيتامين د على التهاب المهبل البكتري.اهداف الدراسة: لمعرفة مدى انتشار التهاب المهبل البكتري ونقص فيتامين (د) في الحمل المبكر وايجاد العلاقة بين نقص فيتامين (د) التهاب المهبل البكتري.المرضى والطرائق: أجريت دراسة مقطعية خلال الفترة من يوليو 2017 حتى أكتوبر 2018 بين 100 حوامل في الأشهر الثلاثة الأولى من الحمل في مستشفى أربيل للولادة, حيث تتراوح اعمارهن ما بين 18-35 سنة.النتائج: تشير نتائج البحث ان نسبة التهاب المهبل البكتري كان (%53) ، حوالي (73٪) من الحوامل ا يعانون من إفرازات مهبلية رقيقة ,رمادية أو بيضاء مع وجود رائحة "سمكية" كريهة بالمهبل (57%) مما ادى الى ارتفاع PH المهبل بمعدل (57٪) .و تم العثور على الخلاياclue بين (53 ٪) منهم, بالنسبة لمستويات فيتامين د حيث وجد ان نقص فيتامين د الذي تم تحديده بتركيز 25 (OH) D أقل من 20 نانوغرام / مل في (67 ٪) من الحوامل. وكان عدم كفاية تركيز فيتامين د الذي تم تحديده بتركيز (OH) D25 بين 20-30 نانوغرام / مل موجود في (29٪) منهم و تم العثور على مستوى كاف من فيتامين د الذي تم تحديده بتركيز 25 (OH) أكثر من (30 نانوغرام / مل) في (4 ٪ ) من الحوامل . و ايضا تشير البحث بان مسيويات فيتامين د بين النسوان الاتي يعانون من التهاب المهبل البكتري (%49.3)، (%62.1) و (50٪) على التوالي لكل من نقص فيتامين د ، عدم الكفاية فيتامين د ومستوى كاف من فيتامين د. ايضا استنتج الباحثون بعدم وجود علاقة معنوية بين نقص فيتامين د و التهاب المهبل البكتري.الاستنتاجات : تم العثور على نسبة عالية من التهاب المهبل البكتري ونقص فيتامين (د). لم يكن فيتامين د مرتبطا بشكل كبير بزيادة حدوث التهاب المهبل البكتري. اقترحنا على النساء الحوامل التحقق من مستوى فيتامين د و ، بالإضافة إلى ذلك يجب ألا يعتمدن فقط على فيتامين (د) التهاب المهبل البكتري.


Article
Prediction of Pregnancy Outcome Using HCG, CA125 and Progesterone in Cases of Habitual Abortions
والبروجستيرون في حالات الإجهاض المعتاد CA125, HCG باستخدام التنبؤ بنتيجة الحمل

Authors: Ali Hassan Mohammed علي حسن محمد --- Sawsan Talib Salman سوسن طالب سلمان --- Huda Khaleel Ibrahim هدى خليل ابراهيم
Journal: Diyala Journal of Medicine مجلة ديالى الطبية ISSN: 97642219 Year: 2013 Volume: 5 Issue: 2 Pages: 63-68
Publisher: Diyala University جامعة ديالى

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Abstract

Background: - Although CA125 is a valuable tumor marker of ovarian carcinoma but it may be have a value to assess the risk of miscarriage at the early stages of pregnancy for woman with history of recurrent pregnancy loss either alone or in combination with other biochemical marker.Objective: To predict pregnancy outcome by studying the level of serum β HCG, progesterone and CA125 at different gestational age in the first trimester for predicting pregnancy loss.Patient and Methods: This study was conducted in Al-Batool Teaching Hospital (in the center of Diyala governorate by studying the patient records as a prospective trail in period from Jan. 2010 to Jan. 2011. The study carried out on 90 pregnant women with a history of recurrent pregnancy loss in there first trimester of pregnancy divided in 3 groups (30 women with no history of abortion as control group, 30 women with history of recurrent pregnancy loss, 30 women who failed to complete their pregnancy in the first trimester during the study. Serial maternal B-HCG, progesterone and CA125 were determined. Results: Serum B-HCG showed a sensitivity of 97%, a specificity of 53%, a PPV(positive predictive value) of 56% and a NPV(negative predictive value) of 97%. Serum progesterone showed a sensitivity of 27%, a specificity of 79%, a PPV of 38% and a NPV of 69%, while serum CA125 showed a sensitivity of 8%, a specificity of 60%, a PPV of 10% and a NPV of 70%. Conclusion: the value of CA125 in recurrent abortions is still unclear and cannot be recommended on routine basis. On the other hand, β-HCG is 97% sensitive with a 53% NPV as a single serum measurement for the prediction of pregnancy outcome.

الخلفية: - على الرغم من أن CA125 هو علامة قيمه لكشف سرطان المبيض ولكن قد يكون لها قيمة لتقييم مخاطر الإجهاض في المراحل الأولى من الحمل في امرأة مع تاريخ فقدان الحمل المتكرر إما وحدها أو بالاشتراك مع علامة حيوية كيميائية اخرى الهدف: توقع نتيجة الحمل من خلال دراسة مستوى مصل البروجسترون، HCG و CA125 في مراحل الحمل المختلفة في الأشهر الثلاثة الأولى لتنبؤ فقدان الحمل . العينات وطرق العمل: أجريت هذه الدراسة في مستشفى البتول التعليمي (في وسط محافظة ديالى) من خلال دراسة سجلات المرضى كدراسة مستقبليه في الفترة من يناير 2010 - يناير 2011 الدراسة التي أجريت على 90 امرأة حامل لديها تاريخ فقدان الحمل المتكرر في الأشهر الثلاثة الأولى من الحمل حيث قسمت الحوامل الى 3 مجموعات (30من النساء اللواتي ليس لهن اجهاض سابق استخدمت كمجموعة ضابطة، 30 امرأة مع تاريخ فقدان الحمل المتكرر ، 30 امرأة فشلت في إكمال الحمل في الأشهر الثلاثة بشكل متسلسل. B-HCG والبروجسترون وCA125 وتم قياس الأولى خلال فترة الدراسة.النتائج: اظهرت النتائج بان حساسية B-HCG 97% والخصوصية 53% PPV (القيمة التنبؤية الايجابية) 56% وNPV (القيمة التنبؤية السلبية ) 97%.وايضا اظهرت النتائج بان حاسية البروجستون 27% والخصوصية 79% وPPV 38% MPV 69%.بينما حساسية CA125 8% والخصوصية 60% و PPV 10% وMPV 70% .الاستنتاج :ان قيمة CA125 في حالات الاجهاض المتكررة لا تزال غير واضحة ولا نستطيع اعتمادها كاساس روتيني.من الناحية الاخرى حساسية B-HCG 97% و MPV 53% يمكن استخدامهم كقياس مستقل للتنبؤ بنتيجة الحمل.

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