[Vaccination against cervical cancer and diseases caused by Human Papillomavirus].

Developing the vaccine against human papillomavirus (HPV) types 6, 11, 16 and 18 which cause a variety of lesions, in particular cervical cancer, is regarded as a scientific breakthrough and received the FDA and CDC approval. Cervical cancer is the leading cause of death from cancer in women in developing countries. About 490,000 women develop cervical cancer yearly and 230,000 women die yearly of this disease. The vaccine includes a virus-like-particle (VLP) without the genetic core, which could have caused a malignant transformation. The present review describes how HPV causes cancer and how the vaccine has been developed. The large scale studies that have examined the vaccine depicted that it is well received, leads to a high antibody level, and prevents a chronic HPV infection and the diseases that are associated with it. However, several new questions arose, such as: at what age to administer the vaccine and whether it is possible to vaccinate those who had already been infected; for how long the immunity acquired by the vaccine lasts and is it effective in those whose immune system is depressed. Although best results will be achieved if the vaccine is administered to girls prior to sexual intercourse, vaccination at a later age may also be valuable. Previous exposure to the vaccine is not a contraindication to administration of the quadrivalent vaccine and it is not necessary to examine if it has occurred. Cervical cancer screening policy should continue for a few more years.

Does maternal height affect triplets' birth weight?

BACKGROUND: In cases of triplet gestation where patients are reluctant to undergo multifetal pregnancy reduction, it would be helpful to identify predictive factors regarding poor or better outcomes. One such possible factor may be maternal height, which is possibly predictive of gestational age and neonatal birth weight. MATERIAL/METHODS: To examine such a possible association, we have retrospectively evaluated 102 triplet gestations. Maternal height and BMI were compared and correlated to neonatal weight, week of delivery, NICU hospitalization duration, and other parameters of pregnancy outcome. RESULTS: Mothers taller than 165 cm gave birth to significantly heavier neonates than shorter parturients delivered of triplets. Individual and mean total triplet neonatal weights were positively correlated to maternal height. There was no significant correlation between preconceptional maternal BMI and triplet neonatal weight and week of delivery, NICU hospitalization or any other parameter. CONCLUSIONS: The taller patient (>165 cm) may be at a significantly lower risk of very low birth weight neonates and very premature delivery as compared to the shorter patient (< 165 cm). Therefore, the factor of maternal height may be taken into consideration in multiple gestation pregnancy consultations. Smaller mothers should never receive more than two embryos in IVF programs to reduce the risk of triplets almost completely.

Hyperemesis gravidarum is associated with oxidative stress.

Hyperemesis gravidarum (HEG), associated with pregnancy, is a severe form of nausea and vomiting causing decrease in nutrient antioxidants. Hence, we hypothesize that oxidation injury may be involved in the pathogenesis of HEG. Plasma levels of the ubiquitous antioxidant, reduced glutathione (GSH) may serve as a sensitive measure for systemic oxidative stress. Women with pregnancies complicated by HEG (study group) were compared with pregnant women without HEG (pregnant control group) and with healthy nonpregnant women (nonpregnant control group). Plasma GSH levels were determined in the study group at the time of admission to hospital, and when the vomiting had ceased, it was compared with those of the two control groups. Plasma GSH levels were significantly higher in the pregnant control group than in nonpregnant controls (6.13 +/- 2.9 microM vs. 1.01 +/- 0.3 microM p <0.01). In contrast, values in the HEG women at the time of admission were significantly lower than the pregnant controls (3.12 +/- 1.6 microM, p <0.01). At the second sampling, when the women had ceased vomiting, plasma GSH values were higher than at the acute stage of the illness and were no longer significantly different from the pregnant control group (4.43 +/- 1.6 microM). Low values of plasma GSH in HEG patients suggest that oxidative stress is associated with this condition.