Background: PET is a systemic disorder of vascular endothelial dysfunction and vasospasm that occurs after 20 weeks’ gestational age and can present as late as 4-6 weeks postpartum. It is clinically defined by hypertension and proteinuria, with or without pathologic edema. Maternal obesity is a prominent hazardous risk factor for the pathological development of PET. Aim: To determine the correlation between the raised body mass index and the risk of PET. Methods: Research study performed on 400 recruited cases attending the antenatal care unit of Al-Azhar University Hospital (Assiut) they were recruited at 20 weeks of gestation and follow up was performed at 28 and 36 weeks of gestation. They were categorized into 5 research groups (each n=80) according to the selectivity criteria of their Body Mass Index BMI (kg/m2) at 20 weeks of gestational age. Research group A (n=80): normal BMI (18.50-24.99 kg/m2) research group B (n=80): overweight BMI (25-29.99 kg/m2) Group C (n=80): obese class I BMI (30-34.99 kg/m2) research group D (n=80): obese class II BMI (35-39.99 kg/m2) Research group E (n=80): obese class III BMI (>40 kg/m2). Follow up for PET development was performed to analyze the correlation between BMI and PET development. Developed in 5 cases in the group A (6.25%), 6 cases in the group B (7.5%), 9 cases in the group C (11.2%), 13 cases in the group D (16.2%), 16 cases in the group E (20%). Among these 11 cases developed severe preeclampsia in groups B, C, D, and E. It has been evident in the present study that the incidence of preeclampsia (either mild or severe) in cases of increased BMI (groups B, C, D, and E) was 13.75%. While the incidence of preeclampsia in the general population (group A) is cited to be 6.25%. Relative risk to general population=incidence of preeclampsia in people exposed (13.75%) / incidence in general population (6.25%) =2.2.

The reproductive health of a woman is vital not only for her general health, but also for that of her partner and child. Bacterial infections can affect pregnant women from implantation of the fertilized ovum through the time of delivery and peripartum period. They may also affect the fetus and newborn. Symptomatic pregnant women with confi rmed bacterial vaginosis should be treated. Treatment of pregnant women with asymptomatic bacterial vaginosis is controversial. Guidelines from the Centers for Disease Control and Prevention (CDC) recommend treating asymptomatic high-risk pregnant women with bacterial vaginosis. Antibiotic treatment can eradicate bacterial vaginosis in pregnancy but overall risk of preterm birth (PTB) is not signifi cantly reduced. Present antibiotic therapy (metronidazole and clindamycin), both oral and vaginal, do not reduce the risk of PTB. Probiotics have capability to increase vaginal lactobacilli, restore the vaginal microbiota to normal and hence helps to cure bacterial vaginosis. Therefore, Probiotics should be considered as part of the prevention and as an adjunct to antimicrobial treatment approach for BV.

Objective: To evaluate placental growth factor (PlGF) and soluble fms-like tyrosine kinase-1 (sFlt-1) as early predictors of pre-eclampsia. Methods: Cohort study at Department of Obstetrics and Gynecology, Ain Shams University Hospitals, enrolling eighty pregnant women between 14 and 19 weeks’ gestation, sera were collected, and stored at -80°C. Thirty women developed pre-eclampsia, fifty continued to be normotensive and their second blood samples were collected. Serum sFlt-1 and PlGF were assayed using chemiluminescence. All enrolled subjects were divided into Q1, Q2, Q3 and Q4 according to serum levels of sFlt-1, PlGF and sFlt-1/PlGF. Results: The combined sFlt-1/PlGF ratio (cut-off 40) and PlGF (cut-off 328 pg/mL) had high overall diagnostic performance for early prediction of pre-eclampsia during the second trimester. The Odds ratio for the occurrence of pre-eclampsia was 5.4 in Q4 versus Q3 women and 4.05 higher in Q3 versus Q2 women. Women in Q2 and Q1 had similar risk for developing pre-eclampsia. Conclusion: The combined use of sFlt-1/PlGF ratio with PlGF or sFlt-1, improved the predictive and diagnostic performance of each separate marker.