Predictive value of hemogram parameters in malignant transformation of the endometrium in patients with different risk factors

Objectives To investigate whether the pretreatment hemogram parameters and their ratios can be used in predicting the endometrial transformation in patients with abnormal uterine bleeding. Material and methods Records of all patients who underwent an endometrial histopathological evaluation between 2011 and 2021 were investigated. Hemogram, neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) were analyzed. Chi square and Mann Whitney U tests were used for analysis. PResults 427 patients were included, of whom 117 were presented with endometrial hyperplasia without atypia (27.4%; mean age, 42±9.7; Group II), 70 with atypia (16.3%; mean age, 53.4±9; Group III), 102 with early endometrial cancer (EC) (23.8%; mean age, 63±7.8; Group IV) and 38 with advanced disease (8.8%; mean age, 63.3±10.5; Group V). Patients without pathology constituted the control group (23.4%; mean age, 42.2±9.5; Group I). Risk factors for atypia and carcinoma were determined as age, postmenopausal state, obesity, diabetes, and increased estrogen exposure (each, p0.05). However, hemoglobin and hematocrit levels were higher in Groups IV and V (13.9 vs 13.1 mg/dL, and 39.1 vs 38.8%, respectively; pConclusions Our findings support the impact of inflammation on malign transformation from normal endometrial mucosa to atypia and carcinoma. NLR and PLR values showed no statistical difference. Instead, thrombocytosis may have a predictive role in EC

İzole Umbilikal Kist ile Prezente olan bir Fetusun Perinatal Sonuçları

Yüksek çözünürlüklü obstetrik ultrasonun yaygın kullanımı ile sadece fetusun değil, aynı zamanda plasenta ve umbilikal kordun geniş çaplı değerlendirilmesi mümkün olmuştur. Umbilikal kord kistleri olan fetusların klinik seyri hakkındaki mevcut verilerin çoğu sınırlıdır, daha çok komplikasyon oranları ile ilgilidir ve vaka raporları ve küçük vaka serileri biçimindedir. Bu vaka sunumunda; üçüncü trimesterde izole umbilikal kord kisti ile prezente olan bir fetusun sonucunu sunmayı amaçladık. Fetüs, fetal distres nedeniyle sezaryen ile doğurtuldu ve operasyondan üç gün sonra perinatal asfiksi nedeniyle exitus oldu. Büyük umbilikal kistlerin hızlı büyüme durumunda kordon damarları üzerinde baskı ile fetal sıkıntıya neden olabileceği unutulmamalıdır. Umbilikal kordun ultrasonografik incelemesinin, muayenenin önemli kısımlarından biri olarak kabul edilmesi hayati önem taşımaktadır

Evaluation of neutrophil-lymphocyte ratio, platelet-lymphocyte ratio and red blood cell distribution width-platelet ratio as early predictor of acute pancreatitis in pregnancy

Objective: Acute pancreatitis (AP) is a state of inflammation. It has been widely known that neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and red blood cell distribution width (RDW) to platelet ratio (RPR) reflect systemic inflammation. The aim of this study is to investigate whether these inflammatory markers could be used as reliable markers in early prediction of AP in pregnancy and if there is a relationship between disease severity and these markers.Methods: The study group consisted of 14 patients, who developed AP in ongoing pregnancy, and the control group consisted of 30 healthy pregnant women. NLR, PLR and RPR were calculated for both the groups.Results: NLR was significantly elevated in the AP group when compared with the controls (p=0.00), but there was no statistically significant difference in terms of PLR and RPR (p>0.05). ROC curve analysis results for NLR showed that there was a significant prediction power of NLR for AP (R-2=0.842; p<0.001). For NLR parameter, if cut-off value is chosen to be 4.1030, then sensitivity is 71.4% and specificity is 100.0%. There was statistically significant and positive correlation between C-reactive protein (CRP) and glucose with NLR (p=0.001, p=0.043). It was seen that Ranson was close to be significant (p=0.051).Conclusion: NLR might be used as an early marker of AP and may have a role in prediction of disease severity

Second Trimester Genetic Amniocentesis: Five- Year Experience of a Maternal- Fetal Medicine Unit

OBJECTİVE: The objective of this study is to identify the annual variations amniocentesis indications such as change in maternal age, cytogenetic results, and other indications. Another outcome is the investigation of the relationship between indications for amniocentesis and the distribution of chromosomal abnormalities. STUDY DESIGN: This study was designed as a retrospective analysis of amniocentesis results of the 1667 pregnant patients between January 2007 and December 2012 in the Süleymaniye Women’s Health Education and Research Hospital. The karyotype results, indications for intervention and complications during procedure were reported. RESULTS: Total chromosome abnormalities were detected in 101 cases out of 1667 patients which correspond to a 6.1% of the total results. Distribution of the chromosomal abnormality detection rate with respect to the amniocentesis indication was 4.2%; in the abnormal first trimester screening tests group; 5.3% in the abnormal second trimester maternal serum screening group, 18.7% in the fetal malformations in previous pregnancy group, and 7.1%. in the abnormal ultrasound findings group. CONCLUSION: Amniocentesis is the most common invasive procedure for prenatal diagnosis. Although the advanced maternal age is still an important indication, there has been significant development of both new markers and technology making this indication for amniocentesis questionable. Prenatal ultrasonography for the soft markers of chromosomal aneuploidy in association with the maternal serum biochemical screening tests should be evaluated during the decision process for amniocentesis

Evaluation of Neutrophil–Lymphocyte Ratio, Platelet–Lymphocyte Ratio and Red Blood Cell Distribution Width–Platelet Ratio for Diagnosis of Premature Ovarian Insufficiency

Objective: To evaluate whether systemic inflammatory markers (neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and red blood cell distribution width (RDW) to platelet ratio (RPR)) can be used as reliable markers for the diagnosis of premature ovarian insufficiency (POI) and to determine if there is a relationship between these markers and follicle stimulating hormone (FSH), Anti-Müllerian Hormone (AMH) levels. Materials and methods: Written and electronic medical records were reviewed using searches for diagnoses with the terms of 'premature ovarian failure', 'premature ovarian insufficiency'. Patients younger than the age of 40 were diagnosed to have premature ovarian insufficiency based on their menstrual history and sonographic examination and they were compared with healthy females. Complete blood counts, day-3 hormone profiles, AMH levels of all subjects were analyzed. Results: NLR was statistically higher in POI group compared with controls (p < 0.05). NLR had a positive correlation between FSH (r = 0.23, p = 0.045) and a negative association with AMH (r = - 0.27, p = 0.018). The area under ROC curve for NLR in POI was 0.66, with a threshold value 1.5 and sensitivity = 75.7 % and specificity = 46.0 %. Conclusion: NLR can be a marker for the diagnosis of POI. There is a close relationship between NLR and ovarian reserve markers such as FSH and AMH

Preliminary evaluation of foetal liver volume by three-dimensional ultrasound in women with gestational diabetes mellitus

The aim of the study was to assess the standard foetal biometric measurements and foetal liver volume (FLV) in pregnancies complicated by gestational diabetes mellitus (GDM) at the time of GDM screening and to compare the results with foetuses in normal pregnancies. Ninety-seven pregnant women with normal singleton uncomplicated pregnancies between 24 and 28 weeks of gestation were allocated into GDM (+) (n: 33) and GDM (−) (n: 64) groups based on their 75 g oral glucose tolerance test results. Foetal biometric measurements and FLV measurements of the groups were compared. Although there were no significant differences in the standard biometric measurements between the two groups, FLV was significantly higher in the women with GDM (p < .01). The ROC analysis implied that with a cut-off value of FLV of 32.72 cm3 for GDM prediction, the sensitivity was 78.8% and specificity was 56.3%. We suggest that FLV measurements during the second-trimester ultrasound scanning may be a tool for the prediction of GDM in the obstetric population.Impact statement What is already known on this subject? GDM is an important pregnancy disease, because of its possible foetal and maternal complications. Besides the standard biometric measurements, some other foetal body dimensions such as the anterior abdominal wall thickness, skinfold thickness, adipose tissue thickness, Wharton’s jelly thickness, foetal liver length and foetal liver volume (FLV) have been evaluated as ultrasound parameters of glycaemic control. While the evaluation of foetal liver dimensions has a role in identifying foetal growth acceleration, previous studies addressed patients with insulin-dependent diabetes mellitus rather than gestational diabetes mellitus, utilised two-dimensional ultrasound and did not argue the diagnostic value of these findings. What do the results of this study add? In our study, besides the standard biometric measurements, the FLV measurements were evaluated by a three-dimensional ultrasound. Although there were no significant differences in the standard biometric measurements between the GDM (+) and GDM (−) groups, the FLV was significantly higher in women with GDM. The FLV was found to be a potential predictive factor for GDM. The ROC analysis implied that as a cut-off value of FLV of 32.72 cm3 for GDM prediction, the sensitivity was 78.8% and the specificity was 56.3%. What are the implications of these findings for clinical practise and/or further research? Screening for GDM with oral glucose tolerance test within the limited weeks of gestation may not always be feasible. On the other hand, the mid-trimester ultrasound scanning is done almost in all pregnancies. Accordingly, FLV measurement might be an alternative method for the GDM diagnosis