Obstructive sleep apnea syndrome is associated with maternal complications in pregnant women

Objectives: This study was performed to evaluate the relationship between obstructive sleep apnea syndrome and pregnancy complications.Material and methods: A total of 500 women (18–45 years) who had delivered (vaginal delivery or caesarean section) between January 2017 and March 2017 in our clinic were included in the study. Patients at high risk for obstructive sleep apnea syndrome were identified using the Stop Bang questionnaire. Based on the results of the questionnaire, pregnancy complications were compared between high-risk pregnant women (Group 1) and low-risk pregnant women (Group 2).Results: Age, body mass index, smoking rate, and the rate of systemic disease (e.g., diabetes and/or hypertension) were higher in Group 1 than in Group 2 (p < 0.05). Rates of preeclampsia, gestational diabetes, preterm labor, premature rupture of the membranes, and cesarean section were significantly higher in Group 1 than in Group 2 (p < 0.05).Conclusions: Obstructive sleep apnea syndrome is associated with a higher rate of maternal complications among pregnant women. Affected patients should be carefully monitored

The nightmare of obstetricians — the placenta accreta spectrum in primiparous pregnant women

Objectives: The incidence of PAS is increasing day by day as a life-threatening condition. The purpose of the present study was to determine the factors affecting PAS formation in primiparous pregnant women and to define possible risk factors for the mother and the baby. Material and methods: Bursa Yüksek İhtisas Training and Research Hospital, department of obstetrics and gynecology, Bursa, Turkey, between June 2016 and December 2020. A total of 58,895 patients were included in the study. After the exclusion criteria, the study was continued with 27 primiparous PAS and 54 non-primiparous PAS patients. The primary purpose is to evaluate PAS risk factors. The secondary aim is to examine maternal and neonatal characteristics. Result:When the parameters that are significant in terms of PAS risk factors were analyzed by Logistic Regression Analysis, it was found that the increase in age also increased the development of PAS 1.552 times (95% CI: 1.236–1.948) and a history of abortion was 7.928. times (95% CI: 1.408–44.654) and 11,007 times (95% CI: 2.059–58.832) with history of myomectomy; postoperative HB values (p < 0.001), an estimated amount of bleeding (p < 0.001), need for transfusion (p = 0.002), and use of drains (< 0.001) were statistically significant different between two groups. When the neonatal results between patients with and without PAS were examined, birth weight (p < 0.001) and gestational week (< 0.001) were statistically significant. Conclusions: PAS does not occur only in multiparous patients who have a history of previous cesarean section. It may also occur in primiparous patients and is a life-threatening condition

Role of platelet indices in prediction of preeclampsia

Objectives: To compare platelet indices in preeclamptic and normotensive pregnants and to investigate the clinical use of these parameters in preeclampsia prediction.Material and methods: This retrospective case- control study included 257 preeclampsia patients and 264 healthy pregnant women as the control group. The groups were compared in terms of platelet count (PC), mean platelet volume (MPV), platelet distribution range (PDW), plateletcrit (Pct), Pct / MPV ratio and PC / MPV ratio.Results: Between the preeclampsia group and the control group; mean platelet count (227.22 ± 78.58 vs 236.69 ± 64.30), plateletcrit (PCT) (0.21 ± 0.06 vs 0.24 ± 0.27), and platelet distribution width (PDW) (17.11 ± 0.80 vs 17.29 ± 0.82) were not significantly different (p> 0.05). However, MPV values were significantly higher in the preclampsia group compared to the control group (9.66 ± 1.62 and 8.92 ± 1.33, respectively) (p < 0.001). In our study, the optimum cut-off value of MPV was 9.15 with 58.7% sensitivity and 61.7% specificity for the prediction of preeclampsia. Pct/MPV ratio (0.02 ± 0.007 vs 0.027 ± 0.029) ( p = 0.01) and PC/MPV ratio ( 24.63 ± 10.90 vs 27.63 ± 10.24) (p = 0.001) were significantly lower in the preeclampsia group than in the control group.Conslusions: In preeclampsia, changes in platelet functions, destruction and production lead to changes in platelet indices. Compared with normal healthy pregnant women, preeclamptic pregnant women have higher MPV values. In preeclampsia prediction, MPV and PC/MPV ratio are promising as a diagnostic parameter

Adolescent pregnancies: complications, birth outcomes and the possible solutions

Objectives: In this study we aim to evaluate antenatal, perinatal and postnatal outcomes and complications of adolescent pregnancies, as well as to discuss the social and psychological consequences of these pregnancies. Material and methods: We compare a total of 243 pregnant women at age 14–18 years to a vast control group at age 19–36 who all delivered at Bursa Yüksek Ihtisas Training and Research Hospital between years 2005–2014. Results: Antenatal care (folic acid supplementation, pre-conception counseling) was significantly higher in adolescent pregnancy group. Unplanned pregnancy rate was significantly higher in in study group (p < 0.001). Preterm delivery (before 37th week) ratio was statistically higher in pregnancy complications. Conclusions: Adolescent pregnancy is a social entity which should be regulated and prevented by legal measures. Planned pregnancies should be promoted and the public should be educated and informed about the Hazards of adolescent pregnancies. Press institutions, public broadcasting services support the efforts to decrease adolescent pregnancies

Increased serum neuregulin 4 levels in women with polycystic ovary syndrome: A case-control study

Neuregulin 4 (NRG4) is an adipokine that is synthesized in many tissues and has been shown to be associated with the development of obesity and metabolic disorders in animals and humans. The aim of this study is to investigate the relationship between serum NRG4 levels and various metabolic parameters in women with PCOS. This cross-sectional study included 40 women with PCOS and 40 age- and BMI-matched controls without PCOS. NRG4, fasting blood glucose (FBG), insulin, hs-CRP, LDL-C, HDL-C, SHBG, DHEA-SO4 and total-testosterone levels were measured in all the participants. HOMA-IR was used to calculate the insulin resistance. Serum NRG4 levels were higher in women with PCOS than in healthy women (24.89 ± 9.32 [ng/mL] vs. 18.98 ± 6.40 [ng/mL], p = 0.002). FBG, LDL-C, HDL-C, LH, SHBG, FAI, DHEA-SO4, insulin, hs-CRP, HOMA-IR and total-testosterone levels were significantly higher in women with PCOS than controls. Circulating NRG4 levels were positively correlated with HOMA-IR, insulin and hs-CRP for both groups. There was a positive correlation between NRG4 and FBG in the PCOS group. HOMA-IR and hs-CRP were associated with NRG4. The high concentration of circulating NRG4 in PCOS may be associated with insulin resistance and low-grade chronic inflammation

Hysteroscopic assessment of postmenopausal endometrial thickening

Introduction: Endometrial thickness is measured by transvaginal sonography and thickening indicates an increased risk of malignancy or other pathology (hyperplasia or polyp) in the postmenopausal period. The main screening methods for the uterine cavity are dilatation and curettage, and hysteroscopy. We sought to correlate hysteroscopic and pathological findings in asymptomatic postmenopausal women with sonographically thickened endometrium (> 5 mm) in this study. Material and methods : This retrospective cross-sectional study involved case records of 197 women who have thickened (> 5 mm) endometrium in the postmenopausal period. All these women underwent hysteroscopy with diagnostic dilatation and curettage between January 2012 and January 2013 at the Bursa Zübeyde Hanım Maternity Hospital. Sensitivity, specificity, positive, negative predictive values and p value of hysteroscopy were calculated. Dilatation and curettage was set as the gold standard. Results : For the evaluation of postmenopausal thickened endometrium, hysteroscopy revealed sensitivity, specificity, positive predictive value and negative predictive value as 76.4%, 76.9%, 73.1%, 79.8%, respectively. Conclusions : Hysteroscopy is a fast and accurate technique in evaluation of the intrauterine space occupying lesions (polyp, fibroid) but only moderate for endometrial hyperplasia. Hysteroscopic view combined with direct biopsy could be a gold standard for endometrial assessment

Similar Pregnancy Rates Between Different Endometrial Echo Patterns in ART

OBJECTIVE: To determine whether endometrial echo pattern effects outcome in ART cycles STUDY DESIGN : Prospective evaluation of 63 ART cycles results with the same protocole RESULTS : The data from a total 63 patients were analyzed. The mean age of patients was 31.3 ± 5.1. The mean number of oocytes retrieved was 8.9 ± 3.9 and the mean number of embryos transferred was 3.4 ± 0.5. The overall clinical pregnancy rate was 33.3 % ( 21/63 ). In the sonographic evaluation of these 63 patients 37(58.7%) had homogeneous hyperechogenic ( HH ) pattern, 26 (33.3%) had non- HH pattern on the third day of embryo transfer. CONCLUSION: As the morphological assessment of endometrium by sonography has a high inter observer variability and the influence of sonographic patterns of endometrium on pregnancy rates remains unclear, we conclude that evaluating endometrial patterns by sonography alone is not an optimal diagnostic procedure for determining the success of IVF outcome