Transformed alpha-fetoprotein (t-AFP) levels in women with threatened preterm labor.

BACKGROUND/AIMS: To evaluate maternal serum transformed alpha-fetoprotein (MSt-AFP) levels, a new molecular conformation of AFP was used in cases of threatened preterm labor (TPL). METHODS: Prospective case-control study. Maternal serum levels of classical AFP and transformed AFP (t-AFP) were compared between 2 groups matched by gestational age: 25 women with TPL and 25 healthy pregnant women as controls. RESULTS: There was no significant difference in classical maternal serum AFP (MSAFP) levels between the 2 groups. In contrast, MSt-AFP levels were significantly lower in cases of TPL than in the control group [7.64 (1.78-29.06) vs. 33.38 (13.80-190.50) ng/ml; p = 0.006]. Similarly, the t-AFP:AFP ratio was also decreased in the TPL group [0.04 (0.004-0.12) vs. 0.16 (0.05-0.80); p = 0.008]. There was no significant correlation between MSAFP and MSt-AFP levels. CONCLUSIONS: MSt-AFP levels are decreased in women with TPL.

Maternal and fetal serum transformed alpha-fetoprotein levels in normal pregnancy.

AIM: To evaluate transformed alpha-fetoprotein (t-AFP) (a new molecular conformation of alpha-fetoprotein) levels in maternal serum and fetal serum in normal pregnancy. METHODS: Prospective longitudinal study. Fifty pregnant women were studied in two groups: 25 were evaluated in each trimester of pregnancy and near term (12, 20, 32 and 36 weeks) and the other 25 were evaluated at the time of planned cesarean section at term. In the first group, maternal serum t-AFP was measured and in the second group, maternal and fetal serum t-AFP were analyzed. RESULTS: Maternal serum t-AFP levels (medians) were 14.73 ng/mL in the first trimester, 28.29 ng/mL in the second trimester, 30.45 ng/mL in the early third trimester and 8.06 ng/mL in late pregnancy. t-AFP levels were significantly higher in maternal than in fetal serum (P < 0.001). There were no significant correlations between AFP and t-AFP levels in maternal versus fetal serum. CONCLUSIONS: t-AFP increases during pregnancy until the early third trimester and then falls before delivery. t-AFP levels are higher in maternal than in fetal serum which suggests that native AFP is transformed to t-AFP either in the mother or in the placenta.

Effects of antenatal betamethasone on human fetal branch pulmonary artery flow velocity waveforms.

OBJECTIVE: To evaluate the effect of antenatal betamethasone on fetal branch pulmonary artery flow velocity waveforms. METHODS: Betamethasone 12 mg i.m. in 2 injections 24 h apart was given to 25 pregnant women at risk of preterm delivery. Pulsatility (PI) and resistance (RI) indexes were measured at the proximal, middle and distal segments of the fetal pulmonary artery before and repeatedly 1, 2 and 7 days after the first dose. ANOVA for repeated measures and the general linear model were used to statistically analyze the results. RESULTS: Blood flow resistance decreased after betamethasone treatment at both the middle (p = 0.001 and p = 0.02 for RI and PI, respectively) and the proximal (p = 0.03 for RI) segments returning to basal values after 7 days. CONCLUSIONS: Antenatal betamethasone decreases fetal branch pulmonary artery vascular resistance.

Metabolic syndrome in normal and complicated pregnancies.

OBJECTIVE: To evaluate the prevalence of metabolic syndrome and its components in normal and complicated pregnancies. SETTING: university hospital, tertiary referral centre. SUBJECTS: 90 pregnant women in four groups: 20 women with preeclampsia, 20 women with gestational hypertension, 30 women with late-onset gestational diabetes and 20 healthy pregnant women as a control group. INTERVENTION: peripheral insulin resistance was measured by using the insulin tolerance test. Glucose, triglycerides, high-density lipoprotein cholesterol, blood pressure and body mass index were analysed. Comparisons were done by Chi-squared test, one-way analysis of variance and the Bonferroni's test. Prevalence of the metabolic syndrome was calculated by adapting both the WHO and the NCEP definitions of the metabolic syndrome to pregnancy. RESULTS: There were no cases of metabolic syndrome in the control group according to any of the adapted definitions. The prevalence of this syndrome was 3.3% and 10% in the late-onset gestational diabetes group, 35% and 20% in the gestational hypertension group and 30% and 30% in the preeclampsia group for the WHO and the NCEP definitions, respectively. CONCLUSIONS: Metabolic syndrome is present in about one-third of women with pregnancy-induced hypertension but only in 10% of women with late-onset gestational diabetes.

Maternal serum transformed alpha-fetoprotein levels in women with intrauterine growth retardation.

OBJECTIVE: To evaluate maternal serum transformed alpha-fetoprotein (t-AFP) levels in women with intrauterine growth retardation (IUGR). METHODS: 60 pregnant women in two groups were studied: 30 with IUGR and 30 healthy pregnant women as a control group. t-AFP concentrations were determined by ELISA assay. RESULTS: Maternal serum t-AFP levels were higher in women with IUGR than in the control group: 15.39 (10.81-24.01) ng/ml vs. 8.66 (6.22-13.45) ng/ml (p = 0.003). t-AFP levels were even higher in those with fetal hemodynamic redistribution 21.08 (16.02-40.85) ng/ml than in those without 12.15 (10.48-17.45) ng/ml (p = 0.03). CONCLUSIONS: Maternal serum t-AFP is increased in women with IUGR and this elevation is marked in those with fetal hemodynamic redistribution.

Teratoma quístico maduro de ovario con tumor carcinoide estrumal. Presentación de un caso / Mature cystic teratoma with strumal carcinoid tumor of the ovary. Report of a case

El carcinoide estrumal es un raro tumor de células germinalesovárico constituido por folículos tiroideos entremezcladoscon un tumor carcinoide. Presentamos el caso deuna mujer de 27 años, asintomática, con hidronefrosis ymasa retrouterina en la ecografía abdominal, que resultócorresponder a un teratoma quístico maduro en el que sedescubrió un carcinoide estrumal. El componente estrumalmostró inmunotinción positiva para tiroglobulina. El tumorcarcinoide de patrón trabecular mostró inmunorreactividadpara cromogranina A y fosfatasa ácida prostática. Revisamoslas características histopatológicas e inmunohistoquímicasde este infrecuente tumor

Background:Strumal carcinoid is a rare ovarian germ celltumor composed of thyroid follicles admixed with carcinoidtumor. Patients and methods: A case of a 27 year-old womanwith hydronephrosis and retrouterine mass revealed by ultrasonographyis reported. An strumal carcinoid was found incidentallywithin a mature cystic teratoma. Results: Immunohistochemicaltechniques revealed the presence of thyroglobulinwithin the strumal tissue. The trabecular carcinoidcomponent was immunoreactive for chromogranin A andprostatic acid phosphatase. Histopathology and immunohistochemicalfeatures of this uncommon tumor are reviewed