Background Immunological factors play a unique role in the setting of preeclampsia; there is a rising debate about the performance of interleukin 17 (IL-17) as inflammatory mediator in its pathogenesis. The purpose of this paper was to evaluate the significance of IL-17 in the diagnosis and prognosis of preeclampsia and estimate a cutoff value for better prediction. Methods A prospective case control study, 40 patient were enrolled in the study, two groups were designed: a normotensive (control) group (n=20) and preeclampsia group (n=20). Both groups were compared regarding serum IL-17 level to clarify its significance, then ROC curve analysis was done to establish the best cutoff level to predict preeclampsia, with further assessment of its relation to blood pressure to determine its prognostic value. Results We noted a statistically significant difference in serum IL-17 (pg/mL) level between the preeclampsia and control group ( P <0.05). The best cutoff value of serum IL-17 in preeclampsia was (8.2 pg/mL) with a sensitivity of 100%, specificity 80% and accuracy 89%. There was also significant variation in its concentrations before and after control of blood pressure and a significant positive correlation with systolic blood pressure level ( r =0.9). Conclusion IL-17 is a significant inflammatory biomarker in preeclampsia with useful prognostic power to predict severity of disease.

BackgroundGroup B streptococcus (GBS) is one of the main causes of neonatal sepsis.PurposeEvaluation of the diagnostic performance of direct latex agglutination test (DLA), post-enrichment latex agglutination (LA) test, and direct culture on chromogenic media in rapid identification of GBS carrier in pregnant women in comparison with the conventional post-enrichment CDC-recommended culture method and further to estimate GBS carriage prevalence and its antimicrobial susceptibility.MethodsTwo hundred pregnant women at gestational age (35–37 weeks) were enrolled. Three low vaginal swabs were obtained from each participant. One swab was directly inoculated into Strep B Select (SBS) agar. The second swab was inoculated in enrichment Lim broth for immunological antigen detection by post-enrichment latex agglutination (5 h and 24 h) and subculture for bacteriological detection. The third swab was used for immunological detection of GBS antigen by direct latex agglutination. The isolated GBS was subjected to antimicrobial susceptibility testing.ResultsAmong 200 pregnant women, 47 (23.5%) were GBS carriers. Considering post-enrichment subculture on SBS medium as a gold standard, the sensitivities for post-enrichment 5 h and 24 h LA were 66% and 95.7%, respectively. However, direct cultivation of the vaginal swabs on SBS medium and DLA recorded 83% and 4.3%, respectively, for sensitivity. All GBS isolates (100%) were sensitive to penicillin G, ampicillin, ceftriaxone, and vancomycin. In contrast, 21.3% and 12.8% of isolated GBS were resistant to erythromycin and clindamycin, respectively.ConclusionGroup B streptococcal antigen detection by latex agglutination after 5 h enrichment is a reliable, easy, and relatively rapid method for screening of GBS carriage in pregnant woman not in labor. Latex agglutination after 18–24 h enrichment can be used alternative to standard subculture method for screening GBS carriage.

Objective To design an ultrasound scoring model for the prediction of the intrapartum morbidly adherent placenta (MAP) and maternal morbidity. Patients and Methods 114 females with singleton pregnancies ≥ 28 weeks of gestation referred for suspicion of MAP were included. All patients underwent examination by two-dimensional ultrasound with the color Doppler setting. Five signs were evaluated: the retroplacental echolucent space, placental lacunae, the hyperechoic uterine-bladder interface, retroplacental myometrium thickness, and subplacental, uterine serosa-bladder wall, intraplacental and bladder wall vascularity. We designed a score ranging from 0 – 8.5 points, including the five signs according to their odds ratios and evaluated its prediction for MAP and maternal morbidity. Results Using multivariate logistic regression, all ultrasound signs were significant dependent predictors for both MAP and maternal morbidity (myometrium thickness < 1 mm followed by lacunae ≥ 4 and lost retroplacental echolucent space). The only independent predictors for MAP were myometrium thickness < 1 mm and lacunae ≥ 4, while myometrium thickness < 1 mm and lost retroplacental echolucent space were predictive for maternal morbidity. The score showed a perfect agreement with MAP and a good one for maternal morbidity. Conclusion Application of the score we designed can improve the ultrasound diagnosis of MAP and the maternal outcome.

No abstract

Background: Preterm birth is a multifactorial problem with a confounding management. Latent interval (Time to delivery) always shows wide variation and presence of a valid, reliable and applicable predictor is a controversial issue. Objectives: to evaluate the role of fetal adrenal biometry (corrected-total gland volume c-TGV and fetal zone enlargement FZE), cervical length and IL17 serum level (maternal inflammatory biomarker) in prediction of preterm that could help in proper management and decreased morbidities. Patient and Methods: Observational comparative study for 100 case (28 to 36 weeks gestation) showing clinical signs of threatened preterm labor. Corrected fetal adrenal gland volume, fetal zone enlargement, cervical length and IL17 serum level were measured then all candidates were followed up till delivery to classify the results into two groups according to the (latent interval). Diagnostic performance for all variables was done to detect the best cutoff value that can predict impending preterm delivery within 7 days using univariate analysis and receiver operating characteristic (ROC) curve. Results: The studied predictors were showing best cutoff, sensitivity%, specificity% and accuracy% as follow: c-TGV (≥400 mm 3 /kg, 80, 75, 85), FZE (≥ 50%, 90, 80, 92), cervical length (≤16 mm, 70, 67, 65), IL17 serum level (8 pg/ml, 80, 95, 83) respectively. Conclusion Utility of corrected fetal adrenal gland volume, fetal zone enlargement in addition to the IL17 (inflammatory marker) as a non-invasive predictors for impending preterm birth can guide a proper decision.