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Article
High Expression of P53 protein in Recurrent Pregnancy Loss Could Play a Role in the Pathology!!

Authors: Thanaa Rasheed ثناء رشيد --- Asmaa’ B. Al-Obaidi اسماء العبيدي --- Nidhal Abdul-Mohaymen نضال عبد المهيمن
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2011 Volume: 53 Issue: 2 Pages: 194-197
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Recent data provide evidence that p53 plays a critical role in mediating pregnancy by regulating steroid hormone activation
Objective: localization of semi quantitation tof por protein at the materno-fetal interface, in patients with recurrent pregnancy loss.
Methods: Immunohistochemistry analysis of p53 protein using paraffin embedded sections of curate samples obtained from 40 women, who where divided into three groups: 24 women with RPL, 10 women with abortion for the first time, and 6 women with induced abortion.
Results: The mean value of the expression of p53 protein in the RPL group was (65.8±2.16), which is significantly higher than that of the second group (48.0±2.81), and the third group (50.0±4.66), (p=0.000).
Conclusion: High expression of p53 protein in women with RPL may have a role in accelerating placental apoptosis leading to failure of pregnancy.


Article
Treatment of hyperhomocysteinemia and pregnancy outcome in patients with recurrent miscarriage

Author: Esraa H. Humadi
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2016 Volume: 15 Issue: 2 Pages: 9-13
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background; Developmental dysplasia of the hip (DDH) means femoral head subluxation or dislocation and/or acetabular dysplasia. Management of neglected (DDH) in children after the walking age is challenging to the Back ground: During pregnancy hyperhomocysteinemia, can cause damage to the vascular system that support the placental function , and this damage might lead to miscarriage and other adverse pregnancy outcome. Objective: To investigate whether lowering homocysteine level in women with recurrent pregnancy loss and hyperhomocysteinemia can improve pregnancy outcome Patients and Method; this study ,initially include 80 women with history of three or more consecutive miscarriage between 8-20 weeks gestation Those with homocystein level >12μmol/l were include in this study (65women) ,they received folic acid 5mg per oral daily ,vitamin B6 40 mg per oral daily , vitamin B12 1000 μg per oral daily for two 2-3 months . After normalization of homocysteine 55 women completed the treatment course and same treatment was continued during pregnancy, 48 women get pregnancy and involved in this study .All participants were followed during pregnancy for any complications that might develop. Result: out of 80 women 48 women participated in this study, their age ranged from 18-42 years.Pregnancy outcome (alive birth) was significantly improved after normalization of homocysteine level and P value is 0.001. Despite that high incidence of complications still developed the most significantly frequent complications include : 16 patients delivered small for gestational age , 14 pregnancies complicated by pregnancy induced hypertension and preeclampsia, ,8 pregnancies ended with preterm labor ,placental abruption complicated around 6 pregnancies and no congenital abnormality neither still birth were reported in this study. Conclusion: Lowering homocysteine level would significantly improve pregnancy outcome (alive birth ) in women with recurrent pregnancy loss.


Article
Deficiency of Protein C and Protein S in Recurrent Pregnancy Loss

Authors: Hussein Naji Alshammary --- Hadi M.A. Almosawi --- Farah Salih Hadi
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 2 Pages: 348-356
Publisher: Babylon University جامعة بابل

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Abstract

Recurrent pregnancy loss (RPL) is a common disorder that affects around 3-5% of pregnant women. It has different causes and in about 50% it is of unknown etiology. Normal pregnancy is associated with increased procoagulants, decreased fibrinolysis and decreased anticoagulants to maintain placental hemostasis during pregnancy. However, hypercoagulability or thrombophilia might be a risk factor with these changes especially in women with deficiency of any of natural anticoagulant factors. Protein C and protein S are natural anticoagulants and their deficiency was found to be associated with placental thrombosis, hypo perfusion, fetal death and fetal loss.The aim of the study is to identify protein C and protein S deficiency in women with recurrent pregnancy loss. 90 women were involved in the study, 45 of them have three or more miscarriages in the first and second trimester considered as patient group, 45 healthy women at time of full term delivery with at least one alive child as control group. Full history was taken from patients and controls. Blood investigations were done for protein C and protein S levels by using ELISA (enzyme linked immune sorbent assay).Platelets count was performed by auto analyzer (Ruby). The results showed a significant relation of low protein S with recurrent miscarriage (P =0.002) OR=2.250 (95%C.I. 1.764-2.870), while the relation of low protein C with recurrent miscarriage was not significant (P>0.05).There was a significant association of low protein S andlow protein C with the abortion occurred in the second trimester (P<0.05). Positive family history for thrombosis was significantly associated with recurrent abortion (p<0.05). Platelets count has non-significant association with recurrent miscarriage.There is a significant association of protein S deficiency with recurrent miscarriage especially in the miscarriages occurring in the second trimester.Thepositive family history of thrombosis is considereda risk factorfor recurrentmiscarriage.Protein C deficiency had no statistical significant.


Article
The Association of Serum Copper with Ceruloplasmin and Zinc with Folic Acid Levels in Recurrent Pregnancy Loss in Iraqi Women

Authors: Olaa Riad Kadim --- Shatha M. J. Al‑Khateeb --- Esraa H. Humadi
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2019 Volume: 18 Issue: 1 Pages: 43-46
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background and Objectives: Recurrent pregnancy loss(RPL) is the most common adverse pregnancy outcome. Micronutrients include mineralsand vitamins are essential for normal function, growth, and development. Minerals have important effects on the health of the mother and the fetus. Micronutrient deficiency during pregnancy can lead to obstetric complications and even fetal death. Materials and Methods: A total of 90 pregnant women included in this study were between 7 and 20 weeks of gestation, their age was 18–40 years, and they were divided into three main groups. Patients: Group 1, pregnant women diagnosed with missed miscarriage no = 30; Controls: Group 2, ongoing pregnancy no = 30; and Group 3, nonpregnant women no = 30. Serum copper (Cu) and zinc (Zn) were determined using flame atomic absorption spectrometry.While the serum ceruloplasmin (CP) was measured by immunoturbidimetric assay and folic acid (FA) by enzyme‑linked immune sorbent assay. Results: Serum Cu and CP were significantly higher in the women with RPL compared with healthy groups. Moreover, the levels of Zn were significantly lower in in women with RPL compared with healthy control groups, and the result of serum FA was showed that there no significant variation in patients with RPL compared with control groups. Conclusions: The study showed that the alteration in the trace elements could participate with the RPL.


Article
THE POSSIBLE PROTECTIVE ROLE OF BCL-2 IN RECURRENT ABORTION
الدور المحتمل لبروتين (BCL-2) في الحماية من الإجهاض المتكرر

Author: Haider Sabah Kadhim حيدر صباح كاظم
Journal: IRAQI JOURNAL OF MEDICAL SCIENCES المجلة العراقية للعلوم الطبية ISSN: P16816579,E22244719 Year: 2010 Volume: 8 Issue: 3 Pages: 49-54
Publisher: Al-Nahrain University جامعة النهرين

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Abstract

Background: Recurrent abortion is a worldwide problem, with undefined causes. Apoptosis could play a major role in the process.Objective: Detect the expression of Bcl-2 protein at the materno-fetal interface in patients with recurrent pregnancy loss (RPL).Methods: Immunohistochemistry analysis of Bcl-2 protein using paraffin embedded sections of curate samples obtained from 40 women divided into three groups: 24 women with recurrent abortion, 10 women with abortion for the first time, and 6 women with induced abortion.Results: The mean value of the expression of Bcl-2 protein was (57.9± 1.4), which is significantly higher than that of the second group (39± 1.9), and the third group (47.5± 2.4).Conclusion: High expression of Bcl-2 protein in women with recurrent abortion may have a protective role in preventing placental apoptosis that leads to failure of pregnancy. Keywords: Bcl-2, recurrent pregnancy loss (RPL).

خلفية الدراسة: الإجهاض المتكرر عند النساء الحوامل يعتبر معضلة طبية في كل إنحاء العالم. هدف الدراسة: التحديد الموضعي وتقييم بروتين (BCL-2) في حالات فقدان الحمل المتكرر.المرضى وطريقة الدراسة: استخدمت تقنية التصبيغ الكيميائي النسيجي المناعي لبروتين Bcl-2 في عينات الجرف الرحمي والتي تم الحصول عليها من 40 امرأة تم تقسيمهن إلى ثلاث مجاميع:المجموعة A وتشمل 24 امرأة حصل لها فقدان حمل متكرر،المجموعة B وتشمل 10 نساء حصل لهن إجهاض تلقائي للمرة الأولى، والمجموعة C وتشمل ستة نساء أجري لهن عملية إنهاء حمل علاجي.النتائج: أظهرت النتائج إن مستويات التعبير الموضعي بروتين (BCL-2) في حالات فقدان الحمل المتكرر ذات زيادة ملحوظة مقارنة مع المجموعتين الثانية والثالثة.الاستنتاج: إن ارتفاع نسبة التعبير الموضعي لبروتين (BCL-2) قد يلعب دور مهم في الحماية من موت الخلايا المبرمج في الرحم مما يؤدي إلى فشل الحمل.مفتاح الكلمات: بروتين BCL-2, الإجهاض المتكرر


Article
Single‑Nucleotide Polymorphism of Interleukin‑27 Gene: A Risk Factor of Recurrent Pregnancy Loss in Iraqi Women

Authors: Esraa H. Humadi --- Layla H. Hamad --- Hasan F. Al Azzawie --- Samera H. Hamad
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2018 Volume: 17 Issue: 1 Pages: 47-51
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Studies have been done to investigate the association between a single‑nucleotide polymorphism (SNP) of interleukin‑27 (IL‑27)gene and the recurrent pregnancy loss (RPL). However, different results have been found in different spots of the world. Therefore, more studies are needed to understand the variation in these results. This is the first study that shows the implication of the SNP of IL‑27 gene in RPL. Objective: This study aims to investigate the association between RPL and SNP of gene (−964 A > G) in Iraqi women.Materials and Methods: From September 2013 to September 2014; 100 women, as a control group, and 100 women (with three or moreconsecutive pregnancy loss), as a study group, were recruited to investigate the association between the IL‑27(−964 A > G) SNP and the PRL. The IL‑27(−964 A > G) SNP was determined using polymerase chain reaction‑restriction fragment length polymorphism technique. Genotypeand allele frequencies were compared using Fisher test between the two groups. P < 0.05 is considered to be statistically significant. Results: The age and body mass index were both not significantly different between the two groups. The frequencies of genotypes of this polymorphism in the RPL group were AG (60%), AA (31%), and GG (9%), while these frequencies were AG (21%), AA (68%), and GG (11%) in the control group.The genotype frequencies of the −964 A > G polymorphism was significantly different between the study and the control groups (P = 0.007). The allele frequencies of this polymorphism were A (35%), G (65%) in the RPL group versus A (61%), G (39%) in the control group. The frequencies of A and G alleles in the both groups were not significantly different. Conclusion: IL‑27 (−964 A > G) polymorphism is a risk factor for RPL in a sample of Iraqi women. However, this is different from what has been found in some studies which might implicate other factors in the RPL.


Article
Detection of Mycoplasma hominis and Ureaplasma urealyticum in Blood Samples of Recurrent Pregnancy Loss in Women by Polymerase Chain Reaction
الكشف عن بكتريا Mycoplasma hominisو Ureaplasma urealyticum في نماذج دم نساء لديهم فقدان الحمل المتكرر بواسطة تفاعل البلمرة التسلسلي

Author: Ishraq A. Chiad اشراق احمد جياد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2013 Volume: 55 Issue: 1 Pages: 87-91
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Genital mycoplasma are implicated in pelvic inflammatory disease, puerperal infection, septic abortion, low birth weight, nongonococcal urethritis and prostatitis as well as spontaneous abortion and infertility in women. Objective: We aimed to find a relationship between repeated abortions of unknown etiology and caused of Mycoplasma hominis andor Ureplasma urealyticum.Methods: one hundred sixty cases, (15-49 years old) with history of recurrent abortion, intrauterine fetal death andor neonatal death (after exclusion of other factors as cause abortion), and hundred women with normal pregnancy outcome with the same age were chosen as controls. M. homini and U. urealyticum were detected in blood by PCR.Result: M. homini could be detected in 12160 (7.5%) in women with pregnancy losses, but was not detected in control group. U. urealyticum could be detected in 64160 (40%) in patient group and 4100 (4%) in control group. The rapid detection of M. homini andor U. urealyticum by PCR in pregnancy loss women could be important and necessary. The detection rate of M. homini andor U. urealyticum in young women age (20-29 years) was higher than the others. Significant difference was observed in patients with three or four abortions compare with 2 or one abortion in addition to history of adverse outcome.Conclusion: the role M. homini andor U. urealyticum in the etiology of pregnancy losses was proposed.Key words: Mycoplasma hominis, ureaplasma urealyticum, recurrent pregnancy loss, PCR.

المقدمة: ان المايكوبلازما التناسلية معنية بأمراض عنق الرحم، اصابات النفاس، الأسقاط المتعفن، ولادات اطفال قليل الوزن، التهاب الأحليل غير السيلاني، والتهابات البروستات، كذلك حالات الأسقاط العفوي او التلقائي والعقم عند النساء. الهدف: دراسة العلاقة بين حالات الأسقاط المتكرر الغير معروف السبب ووجود مثل هذه البكتريا Mycoplasma homini و Ureaplasma urealyticum.المنهجية: مئة وستون حالة بعمر يتراوح من 15-49 سنة لديهم تاريخ بالأسقاط المتكرر وموت الطفل داخل الرحم او بعد الولادة (في حين تم ترك العوامل الأخرى المسببة للأجهاض)، ومئة حالة حمل طبيعي في نفس العمر اختيروا كمجموعة سيطرة. هذه البكتريا M. homini و U. urealyticum تم الكشف عنها باستخدام نماذج دم نساء من مجموعتي المرضى والسيطرة وبالتالي تحليلها بواسطة تفاعل البلمرة التسلسلي.النتائج: تم الكشف عن M. homini في 12 حالة موجبة من مجموع 160 ونسبة (7.5%) عند النساء التي تعاني من فقدان الحمل في حين لم تسجل اي حالة اصابة عند مجموعة السيطرة. بينما بكتريا U. urealyticum تم الكشف عنها في 64 حالة موجبة من مجموع 160 حالة ونسبة (40%) عند مجموعة المرضى و 4 حالات موجبة من مجموع 100 وبنسبة (4%) لدى مجموعة السيطرة. ان هذا الكشف السريع لبكتريا M. homini و U. urealyticum باستخدام تفاعل البلمرة التسلسلي عند النساء فقدان الحمل كان ضروري ومهم. اما معدل كشف هذه البكتريا M. homini و U. urealyticum وجد عند فئة النساء الشابات بعمر (20-29 سنة) اعلى من المجاميع الأخرى. كما لوحظ وجود أختلاف معنوي مهم للمرضى الذين لديهم تاريخ 4 او 3 اسقاطات سابقة مقارنة بالذين لديهم 2 او واحد مضاف لهم حالات موت الجنين داخل الرحم او حالات ولادة طفل ميت.الأستنتاجات: وجود هذا النوع من البكتريا M. homini و U. urealyticum لها دورها المفترض كمسبب لفقدان الحمل عند النساء.مفتاح الكلمات: بكتريا Mycoplasma homini ، بكتريا Ureaplasma urealyticum ، فقدان الحمل المتكرر، تفاعل البلمرة التسلسلي.


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.


Article
INDUCTION OF ICAM-1 AND ICAM-3 IN WOMEN WITH RECURRENT PREGNANCY LOSS
تحفيز الجزيئه اللاصقه بين الخلايا-1 و الجزيئه اللاصقه بين الخلايا -3 في النسوه المصابين بالاجهاض المتكرر

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Abstract

Recurrent pregnancy loss (RPL) has been found to be associated with increase in the pro-inflammatory cytokines which cause up-regulation of inflammatory mediators including cell adhesion molecules (CAMs) that might act in aggravation of this pathological process.Objective: To find out whether there is a relation between the pathology of RPL and the expression of intracellular adhesion molecule-1 (ICAM-1) and ICAM-3 at the feto-maternal interface in these patients.Methods: Immunohistochemistry technique was performed to detect and determine the expression of ICAM-1 and ICAM-3 using paraffin embedded sections of curate samples obtained from 40 women, who where divided into three groups: 24 women with RPL, 10 women with abortion for the first time, and 6 women with induced abortion.Results: The levels of the expression of both endothelial ICAM-1 and leukocytes ICAM-3 at the feto-maternal interface were found to be significantly up-regulated in the first group as compared with the second and the third groups (p=0.001), with a highly significant positive correlation between these two parameters (r=0.927, p<0.01).Conclusion: ICAM-1 and ICAM-3 might play an important role in the pathology of RPL by increase adherence and recruitment of inflammatory cells at the feto-maternal interface ending with a pregnancy failure

خلفية الدراسة: تتميز حالات فقدان الحمل المتكررة بارتفاع نسبة المدورات المناعية الالتهابية والتي بدورها تعمل على تحفيز العديد من الجزيئات الالتهابيية مثل جزيئات التلاصق الخلوية التي قد يكون لها دور مهم في مرضية فقدان الحمل المتكرر.هدف الدراسة: ايجاد العلاقة بين مرضية فقدان الحمل المتكرر والتعبير الموضعي لجزيئات التلاصق الخلوية ICAM-1 and ICAM-3 .طريقة العمل: استخدمت تقنية التلوين الكميائي النسيجي المناعي لجزيئات التلاصق ICAM-1 و ICAM-3 في عينات الجرف الرحمي والتي تم الحصول عليها من 40 امراة تم تقسيمهن الى ثلاثة مجاميع: 24 امراة حصل لها فقدان حمل متكرر، 10 نساء حصل لهن اجهاض تلقائي للمرة الأولى، و ستة نساء أجري لهن عملية انهاء حمل علاجي.النتائــج: كانت مستويات التعبير الموضعي لجزيئات التلاصق ICAM-1 و ICAM-3 في حالات فقدان الحمل المتكرر ذات زيادة ملحوظة مقارنة مع المجموعتين الثانية والثالثة (p=0.001). فضلاً عن وجود ارتباط معنوي ايجابي كبير بين التعبير الموضعي لهذه الجزيئات (r=0.927, p<0.01).الاستنتاج: قد تؤدي جزيئات التلاصق ICAM-1 و ICAM-3 دورا مهما في مرضية فقدان الحمل المتكرر من خلال زيادة التصاق وجذب الخلايا الالتهابية مؤدية الى فشل الحمل.

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