BackgroundPreterm labor (PTL) is a challenging gynecological problem that is accountable for high rates of perinatal mortality and morbidity. Low maternal serum cholesterol and progesterone levels are associated with preterm birth. Measurement of cervical length, funneling, and consistency are essential in screening for PTL. ObjectiveThe aim of the study was to show a correlation between maternal serum progesterone and cholesterol levels and cervical transvaginal gray-scale histogram at 20-25 weeks in the prediction of preterm birth in high-risk women. Patients and methodsThe study included 100 patients at high risk for PTL attending Minia Maternity University Hospital. Levels of progesterone and cholesterol were analyzed and a cervical transvaginal histogram to determine cervical glandular/stromal ratio was performed for all patients at 20-25 weeks of gestation. Results PTL occurred in 30 of 100 women. Increased incidence of spontaneous PTL was seen in patients with a short cervix and increased funneling. Serum progesterone was significantly (P = 0.001) lower in women who delivered preterm (80.6 ± 27.5) compared with women who delivered at term (116.1 ± 15.8). Also, serum cholesterol was significantly (P = 0.001) lower in women who delivered preterm (156.6 ± 35.4) than in women who delivered at term (185.6 ± 42.3). Glandular/stromal ratio was significantly lower (Po0.001) in women who delivered preterm (0.31 ± 0.04) than in those who delivered at term (0.98 ± 0.02). Conclusion Glandular/stromal ratio, serum progesterone and cholesterol levels, and transvaginal ultrasound findings can predict PTL in high-risk women. They can also be used for prevention of PTL.

Introduction Premature development of microvascular and macrovascular disease is the most frequent complication of diabetes. It is responsible for diabetic retinopathy, nephropathy, and neuropathy. Moreover, diabetes leads to reduced collateralization in ischemic tissues, which causes a three- to four-fold increase in cardiac mortality in diabetic individuals compared with nondiabetic individuals. The pathophysiological mechanisms responsible for impaired angiogenic activity in diabetes remain unknown. The role of angiogenin in the physiological revascularization process has not been clarified. Purpose This work was carried out to determine the serum angiogenin level in type 2 diabetic patients and to determine its correlation with various microangiopathies, cardiovascular complications, and the duration in type 2 diabetic patients. Patients and methods This work was carried out on 88 individuals, 68 type 2 diabetic patients and 20 apparently healthy controls. All individuals were subjected to the following assessments: medical history taking; clinical examination including measurement of BMI; estimation of levels of fasting blood sugar, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, urea, low-density lipoprotein, and creatinine; determination of the albumin/creatinine ratio and complete lipid profile (total cholesterol, triglyceride, high-density lipoproteins); serum angiogenin estimation by enzyme linked immunosorbent assay; fundus examination; ECG and transthoracic echocardiography; and abdominal ultrasonography. Results Our results indicated a significant decrease in the serum angiogenin level in diabetic patients compared with the control group; an insignificantly low serum angiogenin level in diabetic patients with retinopathy and nephropathy compared with those without retinopathy and nephropathy, respectively; a significant decrease in the serum angiogenin level in patients with coronary artery disease (CAD) compared with diabetic patients without CAD; an insignificant inverse correlation of angiogenin with fasting blood sugar, duration of diabetes mellitus with urea, and creatinine with albumin/creatinine ratio; and an insignificant proportional correlation of angiogenin with ejection fraction in diabetic patients with complications of retinopathy, nephropathy, and CAD in each group separately. Conclusion This work concluded that the serum angiogenin level is lower in type 2 diabetic patients compared with the control group and it decreases with prolonged duration of diabetes, especially in uncontrolled patients and patients with microangiopathic and cardiovascular complications. As angiogenin is one of most powerful angiogenic factors, we recommend further studies to evaluate the diagnostic, prognostic, and therapeutic value of angiogenin in various microangiopathic and cardiovascular complications of type 2 diabetes.