• Colin Warming posted an update 4 months, 1 week ago

    Material & Methods:  Eighty-three women, who attend the department of Obstetrics and Gynecology, Benha University, Egypt, participated in this study (RPL APO866 group: n = 40, and control group: n = 43). Uterine artery Doppler and plasma adrenomedullin (AM) (pg/mL) levels were measured for all women in the mid-luteal phase of a non-pregnant cycle. Results:  Both uterine artery pulsatility index (PI) and AM levels were significantly higher in RPL group compared to controls (2.71 ± 0.259 vs 2.06 ± 0.194 for PI and 287.5 ± 80.4 pg/mL vs 156.1 ± 39.8 pg/mL for AM, P < 0.01). Uterine artery PI had a significant positive correlation with plasma AM levels both in the RPL group (r = 0.645, P < 0.001) and in the control group (r = 0.384, P = 0.011). Number of previous miscarriages in RPL group was significantly correlated with both uterine artery PI (r = 0.838, P = 0.015) and plasma AM levels (r = 0.509, P = 0.001). Conclusions:  Uterine artery PI may be useful in identifying women with unexplained RPL who have impaired uterine circulation. Plasma AM may serve as a biochemical marker for RPL caused by impaired uterine perfusion. "”Aim:  The aim of this study was to determine the relevance of universal screening for gestational diabetes mellitus (GDM) in the patients attending the antenatal clinic of a tertiary institute of North India. Material and Methods:  This was a prospective study conducted on 700 pregnant women attending the antenatal clinic of Lok Nayak Hospital, New Delhi at or before 24 weeks of gestation. All patients underwent screening with a 50-g 1-h glucose challenge test at 24–28 weeks of gestation. The women with an abnormal glucose challenge test subsequently underwent a diagnostic 3-h oral glucose tolerance test. All the patients were followed up till delivery. Results:  Out of 700, thirteen patients were lost to follow up and hence the final outcomes were measured on 687 patients. Out of 687, 613 patients (89.2%) had a normal glucose challenge test value, that is, <140 mg%, and 74 (10.8%) had a glucose challenge test value ≥140 mg%. On the subsequent oral glucose tolerance test, 64 (9.3%) had normal values and only 10 (1.5%) had an abnormal oral glucose tolerance test, that is, GDM. Conclusion:  With such a low prevalence rate it appears to be unjustified to recommend universal screening for GDM. These findings may be considered as a basis for conducting larger, multicentric studies to establish the prevalence rate of GDM before deciding on a policy for screening. "”In order to reduce the risk of visceral injury for patients with upper abdominal adhesions, we devised an alternative to the umbilical approach. Five patients who had undergone a previous upper abdominal laparotomy and were scheduled for gynecologic laparoscopic surgeries at our hospital were evaluated. A micro-trocar was inserted via the posterior vaginal fornix and the periumbilicus was observed using a micro-laparoscope inserted in the micro-trocar.