The effect of nifedipine tocolysis on Doppler indices of the uterine and umbilical arteries.

PURPOSE: The aim of this study was to evaluate the effect of oral nifedipine on Doppler indices of the uterine artery (UtA) and umbilical artery (UA) before and 24 hours, 48 hours, and 1 week after tocolytic treatment. METHODS: This was a prospective, self-controlled, cohort study of 65 pregnant women undergoing nifedipine tocolysis. Doppler assessment of the UtA and UA was performed before treatment and 24 hours, 48 hours, and 1 week after the initial 4 doses of 10 mg of oral nifedipine, administered at 20-minute intervals. The maintenance dosage was 20 mg of oral nifedipine administered every 6 hours for 48 hours, for a total dose of 80 mg/day. RESULTS: There was a decrease in the 24-hour values of the UA pulsatility index, resistance index (RI), systolic-diastolic (S:D) ratio, right UtA pulsatility index, RI, S:D ratio, and left UtA RI and S:D ratio with nifedipine therapy in comparison with the values recorded prior to nifedipine therapy. However, these differences were not statistically significant. There were no statistically significant differences between the data recorded prior to nifedipine administration and those obtained at 48 hours and 1 week after treatment. CONCLUSIONS: Oral nifedipine is a safe tocolytic agent with no long-term effect on fetomaternal circulation in pregnant women at risk of preterm delivery.

Comparison of the histopathological diagnoses of preoperative dilatation and curettage and hysterectomy specimens.

AIM: A biopsy is often taken as part of the preoperative workup, regardless of the indication for hysterectomy. Some authors believe that dilatation and curettage is a poor diagnostic procedure for intrauterine pathologies, but dilatation and curettage has been the method of choice for obtaining an endometrial sample. The aim of this study was to investigate the concordance between endometrial histopathological diagnoses from preoperative dilatation and curettage and hysterectomy specimens. The differences between premenopausal and postmenopausal women were also investigated. METHODS: Histopathological results for dilatation and curettage specimens from 645 women (401 premenopausal and 244 postmenopausal) who underwent a hysterectomy between 2003 and 2009 were analyzed retrospectively. RESULTS: High sensitivity (87.8%), specificity (100%), positive (100%) and negative (98.7%) predictive values, and accuracy (98.8%) were observed for all malignant endometrial pathologies obtained at dilatation and curettage. In postmenopausal women, eight malignancies were missed when the preoperative diagnosis from the dilatation and curettage sample indicated inadequate tissue or premalignant lesions. For premenopausal women, we found only two missed malignancies. The accuracy was 99.5% and 96.8% for malignant pathologies diagnosed from curettage material for pre- and postmenopausal women, respectively. CONCLUSIONS: Dilatation and curettage remains the 'gold standard' for diagnosing endometrial pathologies, especially malignancies.

Placental prostate-specific antigen content in preeclampsia.

Preeclampsia is a multisystem disorder that can manifest clinically with hypertension and proteinuria. Previous studies reported the presence of placental PSA in normal pregnancy but no study has been done in preeclampsia. The aim of this study was to investigate PSA content in preeclampsia. Preeclampsia was diagnosed according to the American College of Obstetricians and Gynecologists criteria. Placentas were obtained from 33 preeclamptic and 34 normotensive women. Placenta samples were homogenized and the supernatants were immediately analyzed. The tissue PSA content was measured by Immulite 2000 PSA assay. The data were analyzed with Student's t-test and Pearson correlation test. There was a significant difference in placental PSA content between preeclamptic and normotensive women. Placental content of PSA was higher in the preeclamptic group with intrauterine growth restriction (IUGR) than in the preeclamptic and normotensive pregnant without IUGR groups. No significant difference was found in this respect between preeclamptic and normotensive women without IUGR. In conclusion, we found that placental PSA content is elevated in preeclampsia and negatively correlated with infant birth weight. Further studies will be necessary to define the roles of PSA more precisely and to examine its effects on the pathophysiology of preeclampsia.