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Abstract: In the complex mechanism of preeclampsia, oxidative stress is an important pathogenic factor, and F2-isoprostane is a marker of oxidative stress and lipid peroxidation. The objective of this study was to identify if the amniotic fluid (AF) levels of F2-isoprostanes were elevated in women who later developed preeclampsia. In this study, we analyzed AF F2-isoprostane concentrations with enzyme immunoassay (EIA), and the EIA results could be validated by quantitative mass spectrometry. The mean AF concentration of F2-isoprostanes was significantly higher in pregnancies with subsequent development of preeclampsia (123.1±57.6pg/ml, n =85) than in controls (73.8±36.6pg/ml, n =85). The AF elevation of F2-isoprostanes was even higher in the preeclampsia with intrauterine growth restriction group (138.3±65.2pg/ml, n =39). The area under the curve of the receiver operating characteristics analysis for AF F2-isoprostanes assay was 0.81, supporting its potential as a biomarker for preeclampsia. These results indicate that oxidative stress existed before the onset of clinical preeclampsia, further suggesting that the elevation of AF F2-isoprostanes may be used as a guide for antioxidant supplementation to reduce the risk and/or severity of preeclampsia. [Copyright &y& Elsevier]

Background: Mirror syndrome is a rare complication of twin-twin transfusion syndrome (TTTS). Its clinical picture includes massive edema, oliguria, and hemodilution in the context of fetal hydrops. The occurrence of mirror syndrome after fetoscopic laser therapy for TTTS has been well documented, but resolution of mirror syndrome before delivery has not been reported in the literature., Case: A 33-year-old woman was referred to our institution at 23(6)/7 weeks' gestation for TTTS, which had been treated with amnioreduction twice: at 21 and 22 gestational weeks, respectively. Mirror syndrome was diagnosed after fetoscopic laser therapy for TTTS at 24 weeks' gestation due to maternal manifestations of pulmonary edema, skin edema, anemia, low blood protein concentration and proteinuria accompanied by donor hydrops. The maternal respiratory symptoms then gradually abated in <2 weeks along with improved fetal condition, resulting in a delivery with favorable outcomes at 36 weeks' gestation., Conclusion: Manifestation of mirror syndrome after fetoscopic laser therapy in twin-twin transfusion due to donor hydrops doesn't necessarily predict a poor perinatal outcome.

Background: Salmonella infection occurs primarily in the gastrointestinal tract but may also be found at extraintestinal locations. An ovarian abscess caused by Salmonella is one of the rare extraintestinal infections, and hematogenous spread by bacteremia to a preexisting ovarian cyst has been suggested as the cause of such infections., Case: A 43-year-old woman presented with diarrhea, fever and an ovarian tumor and was treated initially with antibiotics for Salmonella bacteremia, followed by an exploratory laparotomy due to persistent fever and progressive toxic signs. A pus-containing endometrioma with a thick wall densely adhering to an intestinal segment, with a fistula connecting the 2, was found during surgery. The patient underwent a salpingo-oophorectomy and resection of the intestinal segment, took antibiotics and recovered. Bacterial culture of the abscess showed salmonellosis, and pathology reported a fistula between the ovarian tumor and intestine, suggesting that direct spread through a fistula may be one of the causes of extraintestinal Salmonella infections., Conclusion: Salmonella infection located in the ovary is a rare condition, often caused by bacteremia. To the best of our knowledge, this is the first report of an ovarian Salmonella abscess that occurred through a fistula.