Maternal Serum Concentrations of Corin, Endoglin, PP13, and sFlt-1 and their Changes with Advancement of Pregnancy and Correlation with Doppler of Uterine Arteries.

BACKGROUND: Pre-eclampsia (PE) affects 2% to 5% of all pregnancies and is a major cause of maternal and perinatal morbidity and mortality worldwide. Since PE has complex pathogenesis and treatment is still not found, effective methods for prediction and prevention of PE are still actively searched. AIM: The aim of this study was to find the mean maternal serum concentration of four proteins in Bulgarian pregnant women and to investigate the correlation with uterine artery pulsatility index in the first and second trimester of pregnancy. MATERIALS AND METHODS: In this prospective case-control study, maternal serum concentrations of corin, sEndoglin, PP13, and sFlt-1 were measured, pulsatility index of uterine artery (PI-UA) was assessed in 40 women with Doppler, twice during pregnancy - at the 11th - 13th weeks of gestation and the 20th gestational week. They were randomized in two groups: an experimental group: with increased PIUA at gestational week 13 and a control group: with normal PI-UA. All pregnancies were followed up until the day of delivery and outcomes were recorded. RESULTS: There was no significant difference in the APGAR score and birth weight of the newborns between groups. We found no significant difference in the mean concentration of sEnd, sFlt-1 and PP13 between 11-13 weeks of gestation and 20 week of gestation in the control and experimental groups. Statistically significant difference was found only in the mean concentrations of corin between weeks 11-13 and week 20 in both control (t=3.27; p=0.004) and experimental group (t=3.22; p=0.005). Corin levels and the mean PI of uterine arteries tended to decrease with progression of pregnancy in both groups. CONCLUSIONS: Further prospective studies of larger populations are required to develop a panel of multiple predictors for PE.

Vulvovaginal Candidiasis in Pregnant Women and its Importance for Candida Colonization of Newborns.

UNLABELLED: Vulvovaginal candidiasis is the second most common cause of vaginitis worldwide (after bacterial candidiasis). Maternal vulvovaginal candidiasis is a major risk factor for Candida colonization and infection of the infant where prognosis depends on different predisposing factors. The aim of this study was to determine the incidence and the etiological structure of vulvovaginal candidiasis in pregnant women and its impact on Candida colonization of newborns. MATERIALS AND METHODS: Samples of vaginal secretions from 80 healthy pregnant women who were clinically suspicious for Candida vaginitis were collected within 48 hours before delivery. Samples for probable Candida colonization from the oral mucosa and feces were collected from their newborns within 47-72 hours after birth. Samples were plated on Sabouraud agar, followed by species identification by API Candida yeast assay. RESULTS: Twenty-three (28.75 ± 5.06%) of the evaluated pregnant women were positive for Candida spp. Positive samples for Candida colonization were found in 18 (22.22 ± 4.62%) of the examined 81 newborns (one pair of twins) from mothers who were clinically suspicious for vaginal candidiasis. Isolates of the newborns were 100% identical to those of the mothers' vaginal secretion. Candida albicans was the predominant species identified in the pregnant women (91.67 ± 0.06%) and in the neonates (83.33±8.78%).

A case of TRAP sequence with immense acardiac twin.

Twin-reversed arterial perfusion sequence is a rare complication of monochorionic twin pregnancy in which an anomalous acardiac fetus is hemodynamically dependent on its structurally normal "pump" twin. Early diagnosis is essential for improving perinatal prognosis for the normal twin. In this case report we present a case of TRAP sequence with immense acardiac twin with favorable outcome, emphasizing the importance of ultrasound imaging, follow-up and timing of delivery in this complicated pregnancy.

Bilateral simultaneous isthmic ectopic pregnancy after clomiphene induction.

A rare case of a 32-year-old patient with simultaneous bilateral isthmic tubal pregnancy. A 32-year-old woman with a 3-year history of primary infertility was admitted with light vaginal bleeding and mild abdominal pain. She was 41 days after her last menstruation and 23 day after intrauterine insemination with her husband's sperm. Clomiphene citrate (CC) was used for the induction of ovulation. In cases of ectopic pregnancy with ovulation induced by CC, doctors must be aware of the possibility of bilaterality.