Chicago, IL -- The American College of Obstetricians and Gynecologists (ACOG) awarded the 2008-09 Donald F. Richardson Memorial Prize Paper Awards to ACOG Junior Fellows Sharai C. Amaya, MD, for her research paper "Dietary Impact on Endometriosis: A Closer Look at the Active Ingredients of Red Wine and Soy," and Anthony N. Imudia, MD, for his research paper "Retrieval of Trophoblast Cells from the Cervical Canal for Prediction of Abnormal Pregnancy." Dr. Amaya is a fourth-year ob-gyn resident at Greenville Hospital in Greenville, SC, and Dr. Imudia is a third-year ob-gyn resident at Wayne State University/Detroit Medical Center. Both physicians presented their papers today at ACOG's 57th Annual Clinical Meeting.

Dietary Impact on Endometriosis: A Closer Look at the Active Ingredients of Red Wine and Soy

Dr. Amaya's paper shows how dietary compounds found in red wine and soy may have a role in the treatment of endometriosis due to their estrogen-like activity. Endometriosis, when tissue similar to that which lines the uterus is found elsewhere in the body, is exacerbated by high amounts of estrogen. Endometriosis can cause mild to severe pain for some women and may also lead to infertility.

The study looked at the effect resveratrol, a red wine component, and geninstein, a soy protein, have on endometrial cells. Soy is a source of phytoestrogens, naturally occurring compounds that act like estrogen in the body, and is thought to provide cardiovascular benefits, enhance bone strength, and alleviate vasomotor symptoms of menopause. Resveratrol in red wine is also thought to have cardiovascular benefits and to account for the "French Paradox," a phenomenon in which the French eat high fat diets and smoke heavily, yet their rates of coronary artery disease are low.

By examining the estrogenic and anti-estrogenic characteristics of each component, researchers showed they both act as anti-estrogens. Resveratrol, in particular, was shown to significantly reduce the growth of endometriosis in mice.

"This is an exciting study, as it shows promise that resveratrol may provide a novel approach for the treatment of endometriosis," Dr. Amaya said. "However, a lot more work needs to be done. Studies need to be performed to investigate resveratrol as a treatment in actual women who have the disease, and dosage questions need to be addressed." Dr. Amaya said studies to investigate the role of resveratrol for the treatment of endometriosis, including possible benefits for pelvic pain and infertility, are planned.

Retrieval of Trophoblast Cells from the Cervical Canal for Prediction of Abnormal Pregnancy

In Dr. Imudia's paper, researchers found that the number of fetal trophoblastic cells in a woman's cervical canal can be identified, quantified, and used to distinguish normal pregnancies from some abnormal pregnancies, such as ectopic pregnancy or blighted ovum, a common type of miscarriage, early in the pregnancy. The findings could lead to a simple, noninvasive screening test for abnormal pregnancy and possibly for prenatal diagnosis of chromosomal abnormalities using fetal cells from the cervical canal.

Using a method similar to a Pap test, cells were collected from 37 women presenting with a normal intrauterine pregnancy, 10 women with symptoms of ectopic pregnancy, and five women with blighted ovum. Seven nonpregnant women who had never given birth before were included as negative controls.

Immunohistochemical staining with a monoclonal antibody recognizing HLA-G, a specific antigen expressed by fetal cells, was used. The average frequency of HLA-G positive cells in the samples from the women presenting with a normal intrauterine pregnancy was approximately 1 in 2,000, four to five times higher than the samples from patients with ectopic pregnancy or blighted ovum. The frequency of HLA-G positive cells in the ectopic pregnancy group and the blighted ovum group were not significantly different.

"We reliably distinguished normal pregnancy from abnormal pregnancy very early, and this is a new scientific discovery," Dr. Imudia said. "The information needs to be validated by a clinical trial, but it would mean that very early in the pregnancy, by doing a simple test like a Pap smear, we'll be able to know which pregnancies would need to be followed more closely or not."

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