Keywords : Miscarriage
Iraqi Postgraduate Medical Journal,
2015, Volume 14, Issue 1, Pages 7-13
Prompt diagnosis of ectopic pregnancy is a difficult dilemma, and reliable predictors for diagnosis and differentiation of ectopic pregnancy from early pregnancy miscarriage are needed.
To evaluate the diagnostic value of serum progesterone and CA-125 levels in ectopic pregnancy and early intra uterine miscarriage.
Study design: A prospective case control study
Setting: The study was carried out in the department of obstetrics and gynecology of AL-Yarmouk teaching hospital (Baghdad – Iraq) from February 2011 to February 2012
PATIENTS AND METHODS:
This study was carried out on sixty pregnant women in their first trimester. Twenty women diagnosed as unruptured ectopic pregnancy; treated by laparotomy ,twenty women diagnosed as inevitable miscarriage; treated by curettage and twenty women with healthy pregnancy of a comparable gestational age as control group; follow up of this group was done to ascertain uneventful pregnancy with no complications.
We compared the serum levels of progesterone and CA-125 in all groups at the time of presentation and 24h after surgical intervention in first and second groups.
There was a significant decrease in mean post operative progesterone level in women with ectopic pregnancy and miscarriage groups with significant difference (P<0.0001). The study observed that the mean level of progesterone in women with ectopic group (6.76±3.63 ng/ml) was lower than that in miscarriage group (15.17±6.01 ng/ml) and control group (17.58±4.57 ng/ml) with significant difference (P<0.0001). This study also observed that the mean level of CA-125 in women with miscarriage group (117.07±94.30 U/ml) was higher than that in ectopic group (38.11±28.79 U/ml) and control group (30.51±16.10 U/ml) with statistically significant difference (P<0.0001).
There was a significant decrease in mean level of post operative CA-125 in women with ectopic pregnancy and miscarriage groups with significant difference (P<0.0003).
Combined measurement of both serum progesterone and CA-125 can be sensitive predictors in diagnosis and differentiation of ectopic pregnancy from inevitable miscarriage and normal pregnancy.
Evaluation of Some Spontaneous Abortion-Causative Factors for Women in Baghdad Province A Serological and Histological Study
Iraqi Postgraduate Medical Journal,
2012, Volume 11, Issue 3, Pages 297-302
The spontaneous abortion is considered as one of the important clinical problems that may affects pregnant women during the 1st 20-22 weeks of pregnancy causing dangers to the mother and her fetus. The present study was designed to focus on some spontaneous abortion causes and intrauterine fetal death.
Study certain risk factors that may play a role in abortion such as serum level of , progesterone hormone , estradiol hormone , interlukine-6 and perform a histological study on placenta to identify any specific histop-
Seventy (70) Women were selected to represent the samples of spontaneous aborted women. The women were classified into two groups , the first represented aborted women during the first trimester of pregnancy (52) and the second were females in the second trimester of pregnancy (18) , in comparison with result of (20) normally delivered pregnancies. The samples (sera and placenta) were collected during the period from November 2008 to April 2009 in Baghdad.
Significant decrease (p<0.01) in the level of progesterone and estradiol hormone was found in all aborted women at different stages of pregnancy compared with control. There was no significant difference (p>0.05) in level of IL-6 between aborted women and control. There was a correlation (positive) between progesterone with IL-6 in first and second trimester (p<0.05, p<0.01), respectively. And progesterone with estradiol (p<0.05) in second trimester. The histological study shows hydropic degeneration fibroids with hyalinization of fibrinosis changes.
These results suggest an important role of progesterone, estradiol and IL-6 in spontaneous abortion women during first and second trimester. And apparition of the histological changes corresponding to the aborted women.