Aim: To evaluate the effect of pregnancy on intraobserver and intertechnique agreement for intraocular pressure (IOP) measurements. Material and Methods: Right eyes of 88 healthy women who were likely to become pregnant and of 94 healthy age-matched females were included in the study. Complete ocular examinations were performed on each eye. IOP measurements were obtained by Goldmann, Schiötz and non-contact tonometers (NCT) during 3-week exam periods before (within 6 weeks of conception) and during pregnancy (first, second and third trimesters) for pregnant cases, and in similar time intervals for control subjects. In each exam period, three readings with each of three separate tonometers were obtained, at least 1 day apart. Intraobserver and intertechnique agreements for IOP measurements were assessed. Results: The mean visual acuity, keratometry and refractive error of both control and pregnant subjects did not change significantly during the study (all p values >0.01). In late pregnancy, pregnant cases demonstrated significant decreases in IOP measurements obtained with each of the three tonometers, and in intraobserver agreement with Goldmann and Schiötz tonometers (all p values <0.01). Intertechnique agreement of both Goldmann and Schiötz tonometers with NCT decreased significantly in the third trimester. Both intraobserver and intertechnique agreement in IOP measurements of control subjects were not found to change significantly during the study (all p values >0.01). Conclusion: IOP significantly decreased in the third trimester of pregnancy. Perfect intraobserver agreement in IOP readings of pregnant subjects was obtained with NCT. This may suggest that NCT is a viable option for IOP measurements during the follow-up of pregnant patients at risk for glaucoma.

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Objective  Patients undergoing laparoscopic procedures may experience postoperative pain. We evaluated the effectiveness of intraperitoneal local anaesthetic instillation after laparoscopic gynaecological procedures. Design  Randomized, double‐blinded, placebo‐controlled trial. Methods  Patients were randomly assigned to one of three groups of 20 patients each. Those in group A received ropivacaine, 20 ml 0.75%, and those in group B received bupivacaine, 20 ml 0.5% intraperitoneally. Those in group C (the control group) received 20 ml 0.9% saline. Pain was assessed, using a visual analogue scale (VAS) and a verbal rating scale (VRS), at 30 min, 60 min, 2 h and 4 h after surgery. Total analgesic consumption and the time to first need for analgesia were also noted. Results  VAS and VRS pain scores were significantly lower in the ropivacaine and bupivacaine groups compared with the placebo group. Patients in group A (ropivacaine) experienced less pain than those in group B (bupivacaine) for all measurements. The time to first need for analgesia was significantly later for the ropivacaine and bupivacaine groups compared with the placebo group. The total analgesic consumption was also significantly lower in those groups than in the placebo group. Conclusion  The results indicated that both ropivacaine and bupivacaine were effective at preventing pain and the need for postoperative analgesic when intraperitoneally instilled. However, ropivacaine is the better choice because of its higher efficacy.

Young diabetic women demonstrated a significant depression in visual field threshold sensitivity in the luteal phase of the menstrual cycle. Nasal visual fields are more prone to have menstrual cycle dependent threshold sensitivity depression. This should be taken into consideration in the clinical assessment of women with advanced diabetes who are at risk of glaucomatous optic neuropathy.

Urinary calcium excretion decreases in preeclampsia. To determine the predictability of preeclampsia with hypocalciuria, we investigated the calcium to creatinine ratio and the calcium level of a spot urine sample in 56 primigravid patients aged less than 25 years. Of these 56 cases, 44 remained normotensive and preeclampsia developed in eight cases. There were four cases of gestational hypertension and they are not included in the statistical analysis. The mean age, the mean gestational age at entrance into the study, the mean urine calcium concentration, the mean birthweight, and the mean gestational age at delivery were similar between the normotensive and preeclamptic groups. The mean calcium to creatinine ratio is found to be significantly lower in the preeclamptic group (0.0475 +/- 0.0260) compared with the normotensive group (0.1466 +/- 0.1353; p < 0.0001). A cutoff level of 0.066 for the calcium to creatinine ratio with the use of a receiver operator curve yielded a sensitivity of 75%, a specificity of 86%, and a positive and negative predictive value of 55% and 95%, respectively. The results of this study suggest that a single urine calcium to creatinine ratio might be an effective marker for predicting preeclampsia in a high-risk population.

Fluorescence in situ hybridization analysis using telomere specific probes has been used to detect cryptic translocations in the chromosomal telomeric regions. This study was performed in five clinically normal couples who have had five or more spontaneous abortions and whose karyotypes were found to be normal using conventional cytogenetic techniques. Using the telomere specific probes, in one couple we determined a cryptic translocation between chromosome 3 and 10, and, in another couple, the signal in chromosome 20 was detected in another chromosome, which was probably a D group chromosome. Additionally, in the latter and also in two other couples, we observed a polymorphism. The approach will be helpful for screening cryptic translocations using telomere specific multiple probe sets in couples with recurrent miscarriages. As prenatal diagnosis will be available for these couples for future pregnancies, it will be possible to help these families to have healthy fetuses.

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