Asian Pacific Journal of Reproduction

Pages 1-7

Authors: Mohamed H Abumaree, Peter R Stone, Fawaz Abomaray, Nail Hassan, Mohamed F El-Muzaini, Larry W Chamley

Objective To quantify trophoblast deportation after developing an in vitro model of trophoblast deportation by culturing placental explants in Net-well inserts which allow passage of cells shed from the explants to the lower chamber from where we can harvest, characterize and quantify the shed trophoblasts. Methods Our original model employed explants from placentae of 12 weeks gestation. Using that model, we estimated about 150 000 trophoblasts would shed daily from a placenta of 12-week gestation. In this study, we determined whether trophoblast shedding is consistent throughout pregnancy. Placental explants from second-trimester and term placentae were cultured in Net-well inserts for 72 hours. Shed cells were characterized by immunocytochemistry and quantified. Published mean placental weights were then used to extrapolate an estimate of the rates of trophoblast shedding in vivo. Results Syncytial nuclear aggregates and mononuclear trophoblasts were shed from the second-trimester and term placentae. We also noted the shedding of cytokeratin-positive anucleate “ghosts” which we presume to be derived from syncytial nuclear aggregates. Relative to the numbers of trophoblasts shed from first trimester placentae, the numbers shed from second trimester placentae declined but the number of trophoblasts shed increased again from third trimester placentae. Conclusion We have shown that the rate of trophoblast shedding is inconsistent throughout gestation confirming the results of others who found variable levels of deported trophoblasts in maternal blood.

Pages 15-18

Authors: AH Abu, PO Amuta, E Buba, TR Inusa

Objective To determine the effects of aqueous extract of Garcinia kola (G. kola) seed on serum sex hormones and epididymal functions of Wistar albino rats. Methods Fifteen male Wistar albino rats were randomly assigned into three groups of five rats per group. The animals in the treatment groups were administered orally aqueous extract of Garcinia kola seed at the doses of 200 and 400 mg/kg body weight once daily for 30 days. Rats in the control group received normal saline (0.9%). The body weights of the rats were determined at the beginning and end of the experiment. Sperm characteristics of each rat were determined. Hormonal assay for FSH, LH and testosterone were done using Enzyme-Linked Immunosorbent Assay (ELISA). Results There were significant (P<0.05) decreases in relative organ weights of extract-treated rats compared to the control. G. kola seed extract decreased sperm motility, sperm concentration and sperm viability as well as affected normal morphology of sperm cells in dose-dependent manner. Furthermore, the extract reduced the serum concentrations of sex hormones of the treated rats relative to the control. Conclusion The findings suggest that aqueous extract of G. kola seed may have antispermatogenic property.

Pages 25-29

Authors: Ibrahim A Abdelazim

Objective To detect the accuracy of the IGFBP-1 in diagnosing premature rupture of fetal membranes. Methods One hundred and fifty pregnant women after 37 weeks gestation were included in this study and divided into two groups according to presence or absence of PROM; 75 patients with PROM were included in group I and 75 patients without PROM were included in group II as controls. The diagnosis of PROM was based on patient's history of sudden gush of water, pooling of amniotic fluid, positive Ferning pattern, positive Nitrazine test, confirmed by visualization of fluid passing from the cervical canal during sterile speculum examination and Trans-abdominal ultrasound to measure the amniotic fluid index. Results In this study, the sensitivity and the specificity of IGFBP-1 (Actim PROM test®) in diagnosing PROM were 89.3% & 82.7%, respectively, as compared with 84% sensitivity & 78.7% specificity for Ferning test, and 86.7% sensitivity & 81.3% specificity for Nitrazine test. The PPV and NPV of IGFBP-1 (Actim PROM test®) were 83.8% & 88.6%, respectively, as compared with 79.7% PPV & 83.1% NPV for Ferning test, and 82.2% PPV & 85.9% NPV for Nitrazine test. The IGFBP-1 (Actim PROM test®) was more accurate (86%) for detection of PROM than Ferning (81.3%) or Nitrazine (84.0%) tests. Conclusion The Actim PROM test®, for detection of IGFBP-1 in the vaginal fluid is a simple bedside test, and can be used as complimentary test to confirm the clinical diagnosis of Premature rupture of fetal membranes.

Pages 34-37

Authors: Ibrahim A Abdelazim, Maha M Belal, Hanan H Makhlouf

Objective To detect the relation between serum progesterone and viability of pregnancy during the first trimester. Methods Two hundred and sixty women during the first trimester of their pregnancies were hospitalized due to vaginal bleeding and/or abdominal pain and were included in this study. Women included in this study were: sure of dates, conceived spontaneously with no history of infertility and had a positive serum pregnancy test. Blood samples were taken for women included in this study for serum progesterone assay, they were followed by ultrasound till the end of first trimester for the viability of the pregnancy and the outcome of their pregnancy were recorded. Results By the end of the first trimester, women included in this study were classified into: viable pregnancy group (178 cases, 68.5%) and non-viable pregnancy group (ended by miscarriage) (82 cases, 31.5%). The mean serum progesterone of the studied population was significantly higher in viable pregnancy group (46.5 ± 7.4) ng/mL compared to non-viable pregnancy group (9.9 ± 4.8) ng/mL, (P<0.05). The serum progesterone at cut off level 10 ng/mL was 79.3% sensitive to diagnose non-viable pregnancy and was 93.3% specific to diagnose viable pregnancy, while at cut off level 20 ng/mL it was 95.1% sensitive to diagnose non-viable pregnancy and was 98.9% specific to diagnose viable pregnancy. Conclusion Serum progesterone is a reliable marker for early pregnancy failure and single assay of its serum level can differentiate between viable and non-viable pregnancies.

Pages 42-44

Authors: Filippo Murina, Claudio Benvenuti

Objective Vulvar dermatoses are characterized by dehydration leading to symptoms as itching and burning. Topical corticosteroids and lanolin cream are the standard therapy. A new non-irritant cleanser based on soft natural surfactants (Saugella idraSerum, a product by Rottapharm|Madaus) (SiS) exhibited interesting clinical properties. Purpose of the study was to compare the activity of SiS in vulvar dermatoses versus a common reference cleanser (Aveeno intimo) (Ref). Methods In a controlled randomized clinical study 32 patients with vulvar dermatosis received Mometasone 2 applications weekly and lanolin cream 1 application daily for 7 days followed by 1 application as needed. To one half of the patients SiS and to half of patients Ref were recommended as daily cleanser bid for 1 month. Any onset of symptoms was checked before and after treatment. Results Burning improved after SiS treatment vs Ref in a significantly higher rate (respectively 80% vs 25%, P<0.05). Dryness improvement was superior with SiS (81.1% vs 50.0%, P=0.10) though the Ref group applied a significantly higher number of doses of emollient cream as needed. Conclusion This new-generation intimate cleanser was effective in reducing burning and the concomitant emollient treatment in vulvar dermatoses.

Pages 49-51

Authors: Kailin Yap, Tara Cawley, Phillip Matson

Objective To introduce a system using spiked seminal plasma for the QC of the MAR direct test, and to facilitate the determination of assay variability. Methods A simple quality control (QC) system for use in the direct MAR test was developed using samples prepared by adding serum to antibody-negative centrifuged seminal plasma to obtain optimal binding, and storing 0.4 mL aliquots at −20 °C in straws. The serum was either from vasectomised men (positive control) or an antibody-negative woman (negative control). QC samples were thawed and mixed 1:1 with donor semen and pre-incubated for 1 hr at 37 °C, and tested for sperm antibodies using the direct method of the MarScreen IgG kit (Fertility Technology Resources, USA). Two batches of controls were prepared and one of these was run on each day. Results The negative controls invariably gave binding of less than 5%, whereas the two positive controls had binding (mean ± sd) of 89.5% ± 6.2 % (coefficient of variation [CV] = 7.0%) and (97.2 ± 2.5) (CV = 2.6%). Conclusions In summary, spiked seminal plasma incubated with whole semen can be used as a QC sample in the direct MAR IgG test.

Pages 58-62

Authors: James A Osaikhuwuomwan, Abieyuwa P Osemwenkha

Abstract Objective To investigate the attitudes and perceptions of youths regarding adolescent pregnancy, in order to appraise their understanding of sexuality, contraception and why adolescents failed to use contraceptives. Methods This is a descriptive survey of a group of 163 students in their junior clinical postings in the Department of Obstetrics and Gynaecology, University of Benin. The participants completed an anonymous self-administered questionnaire which elicited information on perceptions, attitude, beliefs and their knowledge about adolescent pregnancy, prevention and utilization of contraception. Results Overall, majority of the participants held a negative attitude about adolescent pregnancy with over 85% regarding it as wrong and considered it to be associated with medical, socio-economic and educational problems. Peer pressure to have sex (71.8%%) had the highest rating on participants perceptions pertaining to the causes of adolescent pregnancy, other items rated were ignorance on basics of sexuality and pregnancy (60.1%) and being forced or coerced/refusal by boys/men to use condoms (52.1%). Condom was reported as the most common method youths/adolescents used in attempting to prevent pregnancy (38.1%), albeit, majority (69.3%) reported poor uptake of contraception by adolescents. Common reasons cited why adolescent/youths do not use contraceptives were: feeling embarrassed or ashamed to use or purchase condom/contraceptives (68.7%) and male partner dislikes for condoms (50.3%). An overwhelming majority (87.1%) of respondents thought that private access to condoms would increase uptake. Conclusions Although youths have a negative attitude towards adolescent pregnancy, their perception and understanding of sexuality and contraception is poor. Useful strategies for empowering youth and changing perception/behavior should include peer education and access to simple non-judgmental information on family life. Adoption of strategies tailored to our socio-cultural background to make condoms accessible privately may improve uptake and consequently reduce the menace of adolescent pregnancy. Citing articles (0) Open Access Open Access Article Postpartum anxiety disordersOriginal Research Article

Pages 69-75

Authors: Prashant Tiwari, Anish Chandy, Kuldip Kumar, Rahul Mishra, Dheeraj Ahirwar

Hyperprolactinaemia has been an expected and derelict side effect of neuroleptic medication for decades. Neuroleptic drugs differ in efficacy and side effects such as movement disorders and prolactin elevation because of varying mechanisms of action. A neuroleptic drugs which categorizes the drugs according to efficacy risk of movement disorders and risk of prolactin elevation. Statistics on the safety and acceptability of neuroleptic agents such as risperidone, olanzapine, quetiapine, ziprasidone and clozapine, are stationary increase because these agents are relatively new compared with conventional neuroleptic. Nearly all side effects of neuroleptic agents are dose related and therefore should use the lowest effectual dose for the entity. In evaluating the risk of neuroleptic medication, we should determine the occurrence of its common side effects and uneasiness connected with these side effects. Throughout the course of action patients should be monitor regularly for the surfacing of side effects.

Pages 80-81

Authors: Emily Zuvela, Melanie Walls, Phillip Matson

Objective To describe the effect of combined oral contraceptives (COC) on serum AMH level in 2 women. Methods The COC was initially stopped after over 12 years use then restarted, with the serum being analysed by 6–8 laboratories in an EQA scheme using the same assay (Beckman Coulter Gen II). Results In both women, the AMH rose significantly after cessation of the pill, and then dropped after resumption. Conclusions In summary, AMH was affected by the combined oral contraceptive pill and further studies on the effect of oral contraceptives are warranted.