The determination of variations in pH is not satisfactory. IGFBP1 is at least better than DAO with, additionally, advantages of rapidity and simplicity.

Premature rupture of membranes (PROM) is sometimes difficult to diagnose. This report proposes the use of alpha-feto-protein (AFP) values in vaginal secretions for diagnostic tests. Our investigation took place in two separate phases. The first phase validated the AFP test using an immuno-enzymatic assay method and determined a threshold value from a sample of 167 female patients (Group 1: 133 patients with an extremely low probability of PROM, and Group 2: 54 patients with confirmed PROM). In the second phase the test was applied to a sample of 145 female patients (Group 3) with suspected, but unconfirmed, PROM. Results from alpha-feto-protein (AFP) evaluation were compared with data obtained from clinical, echographic and other tests. The positive/negative threshold adopted was an AFP concentration of 30 micrograms/l. For the two first groups, 1 and 2, sensitivity and specificity was in the 98% to 99% confidence level. For Group 3, sensitivity and specificity results at the 30 micrograms/l threshold value were 94.5% and 95.4% respectively. Quantitative measurement of AFP determined by immuno-enzymatic assay of vaginal secretions with a threshold of 30 micrograms/l is a reliable, simple and rapid diagnostic test. Results obtained are significantly better than the measurement of pH, the determination of prolactin, and more practical than diamino-oxidase (DAO) assays.

Apart from its value in predicting premature labor, vaginal fFN represents a diagnostic test of PRM with good specificity and sensitivity.

The aim of this prospective study was to establish complementary data of uteri exposed to diethylstilbestrol (DES) in utero for transvaginal analysis and vascularity changes during the menstrual cycle. A total of 28 women with DES-exposed uteri were compared with 60 non-exposed women. Transvaginal ultrasound and colour Doppler imaging were performed on days 5 and 22 of the menstrual cycle. Uteri were measured on sagittal and transverse scans. Uterine length, width, thickness and uterine cavity length and width were measured. Uterine volume and uterine cavity area were calculated. DES-exposed uterine volume was equal to 31.84 +/- 3.37 cm3. The cavity area of DES-exposed uterus was equal to 35.85 +/- 3.93 cm2. Cervix length of DES-exposed uterus was significantly smaller than that of non-exposed uterus. The uterine artery pulsatility index (PI) of DES-exposed uterus was significantly higher than that of normal uterus. Blood flow remained stable throughout the menstrual cycle. The PI of DES-exposed uterus remained stable during the menstrual cycle, as in non-exposed uterus, and it decreased during the luteal phase. This lack of modification in vascularity of DES-exposed uterus may explain miscarriages and obstetric complications such as intrauterine growth retardation or pre-eclampsia. The data may have implications for the assessment of reproductive status and the design of future studies on disorders of implantation in DES-exposed uterus.

Transient neutrophil aggregation is reported in a case of infectious mononucleosis. The phenomenon was observed on a blood film patient just before splenic infarction and decreased after splenectomy. The aggregation was so important that differential blood count could not be done. A high serum level of circulating immune complexes was found, and fluorescent spots inside of granulocytes, presumably engulfed immune complexes, could be observed. It is suggested that C activation associated with high immune complexes in infectious mononucleosis is a possible pathogenetic mechanism inducing PMNs aggregation and immune tissue damage.