Increased serum procalcitonin levels in pregnant patients with asymptomatic bacteriuria

Background: Among the pregnancy urinary tract infections, asymptomatic bacteriuria (ASB) is the most common one. Untreated ASB can progress to pyelonephritis in 30-50% of the patients and can also result in prematurity in 27% of the pregnancy so it needs immediate diagnosis and treatment. In this study, we wanted to evaluate procalcitonin levels, compared to other inflammatory in pregnant women with ASB.Methods: The study was designed between the period of January 2012 and February 2013 at Sakarya University School of Medicine, Department of Gynecology and Obstetrics. The study population included 30 pregnant patients with asymptomatic bacteriuria and 39 healthy pregnant controls.Results: Mean age was 28 (SD, 5.5) of the study population; mean maternal weight was 70 (SD, 8) kilogram. There were no statically significant differences between the groups according to the routine biochemical parameters, but gestational age was significantly lower in the ASB group compared to the controls (20.4 vs 28.6, respectively; p 0.05 ng/ml and 21(70%) patients had negative procalcitonin levels (Chi-squrae, p < 0.001). The sensitivity and specificity of procalcitonin assay for ASB was calculated as 30% and 100%, respectively. The positive predictive value was 100% and the negative predictive value was 65%. The most frequent microorganisms in the urine culture were Escherichia coli (26 patients, 87%), Proteus mirabilis (3 patients, 10%) and Klebsiella (1 patient, 3%) in the ASB group. We experienced four (44%) recurrences among nine positive procalcitonin in ASB patients after completion of treatment of the first ASB diagnosis.Discussion: Procalcitonin levels were significantly higher in ASB group than the control group and serum procalcitonin levels were higher in pregnant women with recurrent ASB. This finding is an important result revealed that high procalcitonin level can predict the further urinary tract infection risk. Finally, serum procalcitonin levels were normal in healthy pregnant women while other inflammatory markers such as WBC, ESR and CRP levels were higher. © 2013 Bilir et al.; licensee BioMed Central Ltd

Prediction of the preeclampsia: a view of biochemical markers

Preeclampsia is a diverse, multiorgan group of related disease processes that occurs in up to 5%-8% of pregnancies after 20 weeks’ gestation and it is one of the leading causes of maternal and fetal morbidity and mortality. Many molecular mechanisms are contributed to the pathogenesis of preeclampsia. Although it is unknown whether the mechanisms act independently or have synergistic effects. This review describes review of primary papers investigating blood based biomarker such as PAP-A, Inhibin A, sFlt1, and PP13 in general and first trimester biochemical markers and combinations of them specifically for preeclampsia

Does applied ultrasound prior to laparoscopy predict the existence of intra-abdominal adhesions?

diagnostic tool, in predicting the presence of intraabdominal adhesions, especially near the trocar entry area, to provide safe surgical access to the abdomen. Materials and methods: Fifty-nine women with a previous history of open abdominal surgery (group A) and a group of 91 women with no previous history of surgery (group B) underwent dynamic ultrasound evaluation of the abdominal fields before laparoscopic operations. The anterior abdominal wall was divided into six quadrants: right upper, right lower, left upper, left lower, suprapubic, and umbilical. Adhesions were evaluated by surgeons during the operation and by radiologists using USG prior to the operation. Visceral organ movements greater than 1 cm was defined as normal visceral slide (positive test), with less than 1 cm of movement defined as abnormal visceral slide (negative test). Sliding test measures movements of omental echogenicity or a stable echogenic focus that corresponds to intestine peritoneal echogenicity that underlies abdominal wall during exaggerated inspiration and expiration. Adhesions observed during surgery were evaluated on a four-point scale, with 0 indicating no adhesions present, 1 indicating the presence of a thin, filmy avascular adhesion, 2 indicating the presence of a dense and vascular adhesion, and 3 indicating adhesions that connect surrounding organs with the overlying peritoneal surfaces. The McNemar test was used to compare the results of USG and laparoscopy for each measure. Results: We found that preoperative USG was successful in identifying adhesions [sensitivity, 96.39% (95% CI 89.8–99.2); specificity, 97.43%] Conclusion: Preoperative ultrasound examination of the abdominal wall may enhance the safety of abdominal entry during laparoscopic operations

Evaluation of the Relationship Between the Level of Vitamin D in Maternal Blood and Breast Milk and Postpartum Depression

Objective: This study aimed to evaluate the relationship between postpartum depression (PPD) and vitamin D levels in maternal blood and breast milk. Material and Methods: The study included women who presented to a polyclinic between December 2017 and_x000D_ August 2018, 4-6 weeks after having given live birth, who were aged between 18 and 40 years and married, gave birth after a planned single_x000D_ pregnancy, were feeding their baby with only breast milk and stated that they were taking vitamin D supplementation at the dose recommended by the Ministry of Health. The depression status of the women who agreed to participate in the study by signing the volunteer informed_x000D_ consent form was evaluated using the Edinburgh Postpartum Depression Scale (EPDS). Two groups were formed as Group 1: EPDS score_x000D_ <13 (n=44) (without PPD) and Group 2: EPDS score ≥13 (n=31) (with PPD). The vitamin D levels in breast milk and maternal blood in both_x000D_ groups were compared. Results: 75 female patients included in the study had a mean age of 29.80±4.54 years. The mean vitamin D levels in_x000D_ breast milk and maternal blood were found to be 13.26±5.39 ng/mL and 17.14±6.79 ng/mL, respectively. In terms of depression status, no_x000D_ statistically significant difference was found between the groups regarding the serum vitamin D levels and the mean level of vitamin D in breast_x000D_ milk (p=0.463, p=0.847). Conclusion: No significant correlation was determined between the vitamin D levels in maternal blood and breast_x000D_ milk and PPD, while vitamin D was found to be low both in maternal blood and breast milk

Evaluation of the presence of SARS-COV-2 in the vaginal fluid of reproductive-aged women

Objectives: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is mainly transmitted through respiration and direct contact. The status of the infection in the female genital system is still unknown. The study aimed to evaluate whether SARS-CoV-2 is present in the vaginal fluid of women with COVID-19 infection in reproductive period.Material and methods: Women who were between the ages of 18–50 years and clinically confirmed to have COVID-19 infection at our hospital between 20 April–31 May 2020 were included in the study. Women who were in their menstrual cycle during the study and who had a known cervical intraepithelial lesion and/or cancer, sexually transmitted disease and history and/or symptoms of vaginitis were excluded from the study. In patients in whom no pathology was detected during the examination, a sample was taken from the vaginal fluid for PCR by using Dacron tip swab. Analysis was performed with Genesig Real-Time PCR COVID-19 kit (Primer Design, England).Results: Eighteen women who were in reproductive period and diagnosed with severe COVID-19 pneumonia were included in the study. The mean age of the patients was 38.16 ± 8.54. None of the patients were in their menopause period. The clinical symptoms of these women were similar to those of confirmed severe COVID-19 cases. SARS-CoV-2 was found to be negative in the samples taken from the vaginal fluid in all patients.Conclusions: SARS-CoV-2 virus was not detected in the vaginal fluid of the patients who tested positive for COVID-19 in reproductive period

Relationships Among Some Biochemical Parameters, Trace Elements and Lipid Peroxidation Levels in Women With Gestational Diabetes Mellitus

Aim:The aim of the present study was to determine levels of copper (Cu), zinc (Zn), iron (Fe), malondialdehyde and some biochemical parameters in women with gestational diabetes mellitus (GDM) compared with healthy pregnant women, and to evaluate the relationships among these parameters.Materials and Methods:The patients consisted of 56 pregnant with GDM. The control group consisted of 60 healthy pregnant women. Plasma malondialdehyde, blood glucose, insulin, glycosylated hemoglobin (HbA1c), total cholesterol, triacylglycerol and LDL-cholesterol were measured by biochemical methods. The concentrations of serum Fe, Cu and Zn were determined by flame atomic absorption spectrophotometer.Results:The levels of blood glucose, insulin, HOMA-IR, glycosylated hemoglobin (HbA1c), total cholesterol, triacylglycerol and LDL-cholesterol, levels of plasma malondialdehyde, levels of serum Fe and Cu in women with GDM group were found higher than those in healthy pregnant women. However, levels of serum Zn were significantly lower in GDM pregnants than those in the healthy pregnant women. There were significant negative correlations between LDL-cholesterol and Cu levels of GDM subjects. Additionally, there were significant negative correlation between LDL-cholesterol and plasma malondialdehyde levels. However, there were significant positive correlations between serum Fe and plasma malondialdehyde levels.Conclusion:Our findings emphasize the significant deficiencies of Zn levels and the significant elevation of malondialdehyde, hyperglycemia and hyperlipidemia in women with GDM. Therefore, supplementation with Zn element involved in the antioxidative system may increase antioxidative enzyme activities, and consequently, an improvement in fetal and maternal complications may be expected

Increased serum asymmetric dimethylarginine levels in hyperemesis gravidarum

The results of this study showed the role of endothelial dysfunction in the pathogenesis of hyperemesis gravidarum

Fertility Preservation

Gonad cells (oocyte or spermatozoon) and tissues (ovary, testicle) are protected from gonadotoxic exposure to ensure the continuity of fertility due to medical interventions such as chemotherapy, radiotherapy, surgery, and the other non-oncological reasons. Depending on the progress of the cancer treatment, an increasing rate of patient survival has led to an increased importance of the fertility preservation concept. The currently used methods for fertility preservation are cryopreservation of the embryo, cryopreservation of the sperm and oocytes, ovarian transposition before radiotherapy, ovarian tissue freezing, GnRH analogue use, testicular tissue cryopreservation, and isolated spermatogonial stem cell transplantation, xenotransplantation, and some other methods of ongoing sperm maturation. Fertility patients and physicians are increasingly aware of the importance of protecting patients, increasing the knowledge and awareness of the society about the subject, and that this is an increasing contemporary problem