INTRODUCTION: Abortion is the commonest complication of pregnancy and vaginal bleeding is the commonest complaint of patients within the first trimester of pregnancy. Obtaining assurance about the health of fetus heart and the product of pregnancy lowers the risk of abortion. Unfortunately, there is no reliable way of predicting the outcome of pregnancy in patients with threatened abortion. Levels of CA-125, a glycoprotein of coelomic origin, rise in the first trimester of pregnancy, especially in the presence of vaginal bleeding. This study was conducted to determine the efficacy of maternal serum CA-125 in predicting the outcome of pregnancy.METHODS: The extent, to which CA-125can serve as a predictor of the outcome of pregnancy, has been investigated in this study.CA-125 levels were measured in 100 women who were 8-12 weeks into their pregnancy and presented to the Emergency Services of Alzahra and Shahid Beheshti Hospitals with vaginal bleeding. The presence of fetal heart beat was demonstrated by ultrasonography. These women were followed up until the 20th week of pregnancy for abortion. Findings were analyzed with t-test and Kurscal-Wallis test using SPSS.RESULTS: The mean age of pregnancy and CA-125 level in the population under study was 9.54±1.32 weeks and 48.10±23.24Ulml, respectively. CA-125 levels in the abortion and nonabortion groups measured 73±24 U/ml and 42.4±17.52 U/ml, respectively, showing a statistically significant difference between the two groups. Eta correlation coefficient showed a strong correlation between elevated CA-125 levels and the likelihood of abortion. The CA-125 test had a sensitivity and specificity of 100% and 44.4%, respectively, at a concentration of 35 U/ml.DISCUSSION: Based on the findings of this study, CA-125 levels can be used to predict the outcome of pregnancy in patients with threatened abortion.

OBJECTIVE: Low-grade systemic inflammation is associated with an increased risk of type 2 diabetes. C-Reactive Protein (CRP), an acute phase protein produced by hepatocytes, may be associated with diabetes.This study aimed to compare serum levels of CRP in women with gestational diabetes mellitus (GDM), impaired glucose tolerance test and control subjects.MATERIALS AND METHODS: In this case control study, 30 women with GDM and 28 women with impaired glucose tolerance, (according to Carpenter and Coustan criteria) were compared with 31 normal pregnant women as control group. Groups were matched for gestational age, age and BMI before pregnancy. At 24-28 weeks of gestation, CRP levels were measured in three groups and compared with each other.RESULTS: Our study showed serum CRP level was not significantly different among three groups. The median of serum CRP level in women with GDM, abnormal glucose tolerance test, and normal women was 8.8 (7.5), 6.9 (8.25) and 11.40 (5.8) mg/dL respectively. In GDM patients, there was a significant correlation between CRP and BMI before pregnancy (r=0.467, p=0.033).CONCLUSION: We didn' t find a significant correlation between maternal serum CRP level and gestational diabetes but our study showed a significant correlation between pre-pregnancy BMI and CRP in gestational diabetic women.

To evaluate the maternal serum dehydroepiandrosterone sulfate level as a factor associated with the outcome of labor induction. Venous blood was collected from 45 women at the initiation of labor induction. Pregnancies complicated by maternal corticosteroid use, antepartum chorioamnionitis, or cesarean delivery for indications other than arrest disorders, were excluded from analysis. In 42 women meeting inclusion criteria, induction followed established protocol. Serum dehydroepiandrosterone sulfate levels were measured by radioimmunoassay and correlated with the outcome of each induction attempt. A successful result was defined as progression to active labor. The welch approximate t-test, Mann-Whitney test, Fisher exact test, simple regression, and multiple regression were used for statistical analysis, with p<0.05 considered to be significant. The mean (±standard error) dehydroepiandrosterone sulfate level was higher in women who progressed to active labor (n=25) than in those with unsuccessful attempts (n=17), (48.63±6.53 pg/dl versus 26.86 ± 5.17 mg/dl, respectively; p= 0.03). Compared with women with dehydroepiandrosterone sulfate levels above 60 pg/dl, women with lower levels had an unsuccessful induction odds ratio (OR) of 6.92 (95% confidence interval 1.74, 32.52, p= 0.01). The OR increased as dehydroepiandrosterone sulfate levels decreased. Dehydroepiandrosterone sulfate may be an important factor in successful labor induction.

To evaluate the maternal serum dehydroepiandrosterone (DHEA) sulfate levels as a factor influencing labor ‘efficiency’ at term and unsuccessful labor induction. This is a prospective study. In this study the mean (± standard error) maternal serum DHEA sulfate levels of 90 singleton pregnant women in 3 groups with spontaneous labor, need for augmentation and need for induction were compared.Pregnancies complicated by diabetes mellitus, hypertension, fetal growth restriction, tobacco consumption, corticosteriod use or chorioamintis were excluded. Bishop score of all cases was less than 5. Serum DHEA sulfate levels were measured by radioimmunoassay. Dehydroepiandrosteone sulfate levels and other obstetric variables were correlated retrospectively with the clinically determined requirements of oxytocin augmentation of labor, and the outcome of each induction attempt. The t-test, Variance analysis Kruskal –Wallis test, Mann-Whitney test, chi-square (X2) distribution, linear correlation and regression were used for statistical analysis. P<0.05 was considered statistically significant. This study showed that the mean (± standard error) maternal serum DHEA sulfate level was not significantly higher in women who progressed spontaneously through labor (n=30) than in those who required augmentation (n=30) (60.78±4.22 versus 70.38±5.84). No significant difference was found between the mean DHEA sulfate levels of spontaneous labor group (n=30) and cases who had prolonged latent phase (n=21) (66.78±4.22 versus 67.02±7.13) or prolonged active phase disorders (n=9) (60.78±4.22 µg/dl versus 78.22±10.23 µg/dl p=0.25)This study showed that the mean maternal serum DEHA sulfate level was significantly higher in women with spontaneous labor (n=30) than in those who needed induction (n=30) (60.78±4.22 µg/dl versus 39.49±4.56 µg/dl, respectively; p=0.001).In the group who needed induction, the mean DHEA sulfate level waa significantly higher in women who progressed to active labor (n=18) than in whom attempts were unsuccessful (n=12). (48.83±6.48 µg/dl versus 26.96±5.10, respectively p=0.035). in the group who were induced, the main cause of C/S was failure of labor progression (77.8%).The mean DHEA level was significantly higher in women with spontaneous labor (n=28) than in those requiring cesarean delivery (n=7) (61.01±4.22 µg/dl versus 24.67±7.06, respectively; p=0.001). The maternal serum DHEA sulfate level did not correlate significantly with cervical Bishop score on admission (r=0.02, p=0.78). DHEA sulfate may be an important factor iin successful labor induction, and in efficient labor

Background: Preeclampsia is associated with maternal and neonatal complications. It has been indicated that increased uric acid might have a predictive role on preeclampsia. Objective: We aimed to investigate the relationship between the level of uric acid with maternal and neonatal complications in women with preeclampsia. Materials and Methods: In this cross-sectional study, 160 singleton preeclamptic women at more than 28 wk gestational age were included. Hemoglobin, hematocrit, platelet count, liver and uric acid tests, and maternal and neonatal complications were assessed. The severity of preeclampsia, placental abruption, preterm labor, thrombocytopenia, elevated alanine aminotransferase and aspartate aminotransferase (ALT and AST), HELLP syndrome, eclampsia and required hospitalization in the ICU was considered as the maternal complication. Fetal complications were: small for gestational age (SGA), intrauterine fetal death, hospitalization in the neonatal intensive care unit, and Apgar score <7 at five minutes. Results: Of our participants, 38 women had severe preeclampsia (23. 8%). The mean level of uric acid in women with severe preeclampsia was significantly higher than non-severe preeclampsia (p=0. 031), also in those with an abnormal liver test (p=0. 009). The mean level of uric acid in women with preterm delivery was significantly higher than women with term delivery (p=0. 0001). Also, the level of uric acid had no effect on neonatal hospitalization in neonate invasive care unit. Based on logistic regression, the incidence of severe preeclampsia not affected by decreased or increased serum levels of uric acid. Conclusion: With higher level of uric acid in server preeclampsia we can expected more complications such as hepatic dysfunction and preterm delivery. Thus serum uric acid measurement can be helpful marker for severe preeclampsia.