Preeclampsia is characterized by increased uPRL excretion. uPRL concentrations and their isoforms appear to be suitable markers to assess the severity of preeclampsia and occurrence of adverse outcomes. PRL and and/or its isoforms might be involved in the pathophysiology of preeclampsia.

Preeclampsia is a multisystemic pregnancy-specific disease characterized by endothelial dysfunction.1 This condition develops in 5% to 8% of all pregnant women and remains a major cause of maternal and perinatal morbidity and mortality worldwide. 2,3 Although the cause of this pregnancy-specific syndrome is unclear, accumulating evidence suggests that preeclampsia results from an imbalance between placental proangiogenic and antiangiogenic factors that result in maternal vascular endothelium damage. 4,5 Higher circulating concentrations of soluble vascular endothelial growth factor receptor-1 (also referred as soluble fms-like tyrosine kinase-1 [sFlt-1]) and soluble endoglin (sEng), and lower concentrations of placental growth factor (PlGF), are present at the time of diagnosis of preeclampsia and have been associated with an elevated risk to develop this condition for several weeks before the onset of the clinical manifestations.5-8 On the other hand, prolactin (PRL), which is physiologically elevated during normal pregnancy, has many effects beyond reproduction and lactation, including an eminent role in angiogenesis and antiangiogenesis. 9-11The major circulating PRL isoform is a 23-kDa single-chain polypeptide (monomeric PRL), which comprises up to 90% of total PRL.12 This full-length PRL stimulates angiogenesis. In contrast, 16-and 14-kDa PRL fragments that result from proteolytic cleavage of monomeric PRL have antiangiogenic effects. 9,13 We and others have shown that urinary PRL excretion and its antiangiogenic PRL fragments are elevated in preeclamptic women, increasing with the severity of the disease and the occurrence of adverse outcomes.11,14 Furthermore, the antiangiogenic PRL fragments are also increased in serum, amniotic fluid, and placenta of preeclamptic women.14,15 These data suggest that PRL might contribute to the pathogenesis of preeclampsia and that perturbation of this angiogenesis pathway may have an important impact on the development of clinical manifestations and complications.Despite the establishment of criteria and guidelines for diagnosis of preeclampsia, its severity, and management, these criteria have been unable to predict adverse maternal outcomes.Abstract-Preeclampsia is characterized by an imbalance in angiogenic factors. Urinary prolactin (PRL) levels and its antiangiogenic PRL fragments have been associated with disease severity. In this study, we assessed whether these biomarkers are associated with an increased risk of adverse maternal and perinatal outcomes in preeclamptic women. We studied 501 women with preeclampsia attended at a tertiary care hospital. Serum concentrations of soluble fmslike tyrosine kinase-1 (sFlt-1), placental growth factor (PlGF), and soluble endoglin (sEng), as well as urinary PRL levels, were measured by enzymed-linked immunosorbent assay. Antiangiogenic PRL fragments were determined by immunoblotting. The risk for any adverse maternal outcome and for having a small-for-gestational-age infant was higher among women with sFlt-1/PlGF ratios, sEng...

Objective: To assess the added value of maternal serum levels of IL-6 in women with preterm-prelabor rupture of membranes (PPROM) as a non-invasive test for the prediction of histological chorioamnionitis (HCA). Methods: This was a prospective cohort study of pregnant women between 20 + 0 and 36 + 6 weeks of gestation with a confirmed diagnosis of PPROM. Logistic regression models were created for the prediction of HCA and compared by assessing the improvement in their Naegelkerke R² as a measure of goodness of fit. Predictive performance of all models was assessed by receiver operating characteristics curve (ROC) analysis and compared by the DeLong method. Results: From 47 women with PPROM, 31 (66%) developed HCA. Maternal serum IL-6 ≥19.5 pg/dL was the best cut-off point for the prediction of HCA (OR = 15; 95% CI: 3.6–61; p < 0.01). A model comprising maternal characteristics and IL-6 ≥19.5 pg/dL showed an area under the curve of 0.85 (95% CI: 0.74–0.95), significantly improving the previous models of IL-6 ≥19.5 pg/dL (R²: 23.3 vs. 34.1%; p = 0.01) or maternal characteristics (R²: 8.4 vs. 34.1%; p < 0.01). Conclusions: A model comprising maternal serum levels of IL-6 plus maternal characteristics proves to be a good non-invasive predictor of HCA.

Objetivo: Describir las complicaciones transoperatorias y posoperatorias en pacientes operadas de histerectomía total laparoscópica.

Objective: Describe the intraoperative and postoperative complications in patients undergoing total laparoscopic hysterectomy (TLH). Method: Cases series carried out in the gynecology service of Hospital de Centro Medico Nacional La Raza, Instituto Mexicano del Seguro Social, of all patients undergoing total laparoscopic hysterectomy from December 2015 to December 2018. Uterine weight, body mass index, age, comorbidities, CO 2 use, and complications were documented. Frequencies, proportions, central tendency, and dispersion measures were used. Results: 79 patients are reported. Mean age was 44.2 ± 7.5 years. Surgery time was 104.3 ± 32.7 minutes, and bleeding 102.8 ± 62.3 mL. Six (7.6%) had intraoperative complications: two (2.5%) bladder injury, one (1.3%) bowel injury, one (1.3%) stump hemorrhage, and two(2.6%) were converted to exploratory laparotomy: one for uterine size > 14 cm, and one because malignant ovarian tumor was suspected. Seven patients (8.8%) had postoperative complications: four (5.1%) were re-operated: 3 due to hemorrhage and 1 due to vaginal dome dehiscence; three (3.7%) had vaginal collection. Conclusions: The rate of perioperative complications reported in this series coincides with that reported in other studies. Surgery time and bleeding were slightly minor regardless of program's youth.