Background: Pregnancy leads to major physiological changes, which can cause complications like intrauterine fetal death, hypertensive disorders. Changes in placental leucine aminopeptidase serum levels may indicate placental dysfunction and associated risks for maternal health.

Aim of the study: To evaluate the relationship between maternal serum placental leucine aminopeptidase levels and pregnancy outcomes.

Patients and Methods: A case-control study involving 150 pregnant women was conducted in the Obstetrics and Gynecology department of Al- Khansaa and Al Batool Maternity teaching hospitals from January 1 to June 30, 2025. Participants were divided into three groups: Group 1 (25 cases of intrauterine fetal death), Group 2 (25 cases of hypertensive disorders)  and Group 3 (100 healthy controls). Serum placental leucine aminopeptidase levels were measured to compare between cases and controls, adjusting for gestational age differences.

Results: Maternal serum placental leucine aminopeptidase levels were significantly lower in  case groups compared with the control group (p < 0.001). The intrauterine fetal death group demonstrated the lowest of maternal serum placental leucine aminopeptidase levels. Significant differences were also observed in maternal age, body mass index, gravidity, and parity. Receiver operating characteristic analysis revealed excellent discriminative ability of  maternal serum placental leucine aminopeptidase as a predictor of adverse pregnancy outcomes, with an area under the curve of 0.999 and cut-off points 812.7566.

Conclusion: Lower maternal serum placental leucine aminopeptidase levels were showed in  complicated pregnancies, which may indicate negative pregnancy outcomes.

Background: Varicocele is one of the most common surgically correctable causes of male infertility, affecting approximately 15% of the general male population. It is detected in nearly 35% of men with primary infertility and up to 81% of those with secondary infertility. Several operative techniques are currently available for varicocele repair, including open and laparoscopic approaches.Aim: To compare open bilateral subinguinal varicocelectomy and laparoscopic bilateral varicocelectomy regarding operative time, clinical outcome, seminal fluid analysis, postoperative complications, operation-related pain, hospital stay, and return to normal activity.Patients and Methods: This prospective comparative study was conducted at the Urology Department of Al-Imamain Al-Kadhymain Medical City from January 2015 to August 2016. A total of 63 male patients with bilateral varicocele were enrolled and divided into two groups. Group I included 30 patients who underwent open bilateral subinguinal varicocelectomy, whereas Group II included 33 patients treated with laparoscopic bilateral varicocelectomy. Clinical assessment, semen analysis, operative time, postoperative complications, pain score, hospital stay, and return to normal activity were evaluated and statistically analyzed.Results: The mean age was 28 ± 8 years in the open surgery group and 25 ± 7 years in the laparoscopic group. Operative time was significantly shorter in the laparoscopic group (45 ± 9 minutes) compared with the open group (50 ± 20 minutes) (P < 0.05). Operation-related pain was significantly lower in the open surgery group (2.8 ± 1.2) compared with the laparoscopic group (4.1 ± 1.3) (P < 0.05). Improvement in semen analysis was observed in both groups without statistically significant differences (P > 0.05). Most patients had no postoperative complications. The mean hospital stay was one day in both groups, and no significant difference was found regarding return to normal activity.Conclusion:Both open bilateral subinguinal varicocelectomy and laparoscopic bilateral varicocelectomy are effective and safe techniques for bilateral varicocele treatment. Laparoscopic surgery offers shorter operative time and faster recovery, whereas open surgery is associated with lower postoperative pain.