The thiol/disulfide balance in ketone positive and ketone negative pregnant women with nausea and vomiting — a prospective study in a tertiary center

Objectives: We aimed to investigate the thiol/disulfide balance in ketone positive (hyperemesis gravidarum) and ketonenegative pregnant women with nausea and vomiting.Material and methods: A total of 60 patients under the 14th week of pregnancy were included in this study, and they weredivided into two groups. Group 1 included 30 pregnant women with ketone positive, group 2 included 30 ketone negativepregnant women with nausea, and vomiting.Results: The native thiol, disulfide, and total thiol concentrations were measured using an automated method and comparedamong the two groups. There were also three indexes that are derived from disulfide, native and total thiol (Index1 = 100 × disulfide/native thiol); (Index 2 = 100 × disulfide/total thiol); (Index 3 = 100 × native thiol/total thiol). Whencompared with Group 1 and Group 2, total thiol was high, native thiol was low but not statistically significant. Disulphide(p = 0.046), index 1 (p = 0.036) and index 3 (p = 0.034) were statistically significant.Conclusions: Patients with ketone positive are shifting to OS direction due to lack of nutrients and electrolytes. This studyemphasizes the therapeutic potential of antioxidant supplementation, which is becoming an increasingly used approachin treating the symptoms of women with ketone positive

Ghrelin does not change in hyperemesis gravidarum

Objectives: Ghrelin levels can play an important role in maintaining the energy balance of pregnant women. Therefore,we investigated the relationship between HG and Ghrelin.Material and methods: 50 female patients admitted to the VAN Yüzüncü Yıl University, Gynecology and Obstetrics Departmentwere evaluated. The patients were divided into two groups: Group 1 included 25 pregnant women with HG, Group 2included 25 healthy pregnant women.Results: The two groups showed similarities in terms of age, gravidity, B-HCG and gestational age. There was no statisticallysignificant difference between the two groups in terms of the Ghrelin levels (p = 0.867).Conclusions: This study shows that there is no difference between Ghrelin levels and HG during pregnancy. IncreasedGhrelin in previous studies was attributed to low oral intake. Another study reported lower Ghrelin levels are not the resultof, but are rather the cause of, reduced oral intake during. The balancing of these two conditions does not lead to a changein the level of Ghrelin

Analysis of the process leading to termination of pregnancy in the third trimester

Objective: To evaluate fetal anomalies and processes leading to termination of pregnancy in the third trimester. Methods: The study includes all cases who underwent termination of pregnancy after 28 weeks of gestation due to fetal anomalies between 2017 and 2022. Results: Forty four of third trimester terminations were carried out in our clinic due to fetal anomalies incompatible with life or associated with severe sequelae. Structural anomalies including 35 (79.5%) cases were the most common reason of terminations followed by chromosomal or genetic abnormalities in 8 (18.2%) cases and intrauterine cytomegalovirus infection in 1 (2.3%) case. The processes leading to the third trimester termination were evaluated by dividing 44 patients into 5 groups. (1) Delayed diagnosis due to inadequate prenatal care (25 patients, 56.8%); (2) patients diagnosed with late-onset findings (5 patients, 11.4%); (3) patients with abnormal findings in prenatal care or history but delayed diagnosis (5 patients, 11.4%); (4) patients with abnormal findings requiring further evaluation (4 patients, 9.0%); (5) patients with a definitive diagnosis but latency in the decision of family for termination of pregnancy (5 patients, 11.4%). Conclusion: Termination of pregnancy in the third trimester has an important role in countries where unfollowed pregnancies are common and access to health services is poor due to low socio-economic status

Increased oxidative stress is associated with thiol/disulphide homeostasis in clomiphene citrate resistant polycystic ovary syndrome

The purpose of this study was to evaluate the relation CC resistant PCOS and the thiol/disulphide homeostasis, used as a marker of OS, by measuring that exchange using a novel technique. Sixty women patients admitted to the infertility clinic were evaluated. The patients were divided into two groups. Group 1 comprised 30 infertile PCOS patients with CC resistance; Group 2 was the control group comprising 30 infertile PCOS patients with CC sensitivity. Serum total thiol (p = .024), native thiol (p = .0052), disulphide (p = .003), index 1 (p = .001), index 2 (p = .001) and index 3 (p = .001), HOMA-IR (p < .001) and free testosterone (p < .001) were statistically significant. The independent variables BMI and age effects were adjusted according to the logistic regression method with groups. Significant differences were observed between the two groups in the levels of native thiol (p* = .0042), total thiol (p* = .024), disulphide (p* = .0003), index 1 (p* = .0001) index 2 (p*= .0001), index 3 (p* = .0001), HOMA-IR (p* = .0044), insulin (p*= .032) and free testosterone (p* = .0001) values. The thiol/disulphide homeostasis viewed in favour of OS. Like a reflection of OS in the follicular endocrine microenvironment may be linked with increased thiol/disulphide homeostasis, free testosterone, insulin and HOMA-IR levels.Impact statement What is already known about this subject? In previous studies, thiol/disulphide homeostasis was compared between PCOS and control groups. In this study, serum thiol/disulphide homeostasis was measured in infertile PCOS patients resistant to CC for the first time. What do the results of this study add? Disulphide concentrations were significantly higher in patients with CC resistant patients thanthe control group. This shows us that more OS occurs in the CC-resistant group. What are the implications of these findings for clinical practice and further research? Thiol/disulphide homeostasis will be a guide for PCOS management in patients with CC-resistant PCOS