Biochemiczne markery pierwszego trymestru w ciąży bliźniaczej

Objective: Our aim was to investigate the first trimester serum markers and nuchal translucency (NT) measurements in twin pregnancies in our population. Materials and methods: We reviewed the results of all double tests that were performed in our hospital over a three-year period. Out of them, we selected all twins and compared them with a group of three times as many singleton controls. NT measurements and the first trimester serum markers from 49 twin pregnancies were compared to those of 147 pregnant women with normal singleton pregnancy. Results: There were no statistically significant differences in age, gestational age and maternal weight between the two groups (p>0.05). We found similar NT measurements in the two groups. The median MoM of Pregnancy- Associated Plasma Protein A (PAPP-A) and fβ-hCG levels in twins were statistically significantly higher than those in singleton pregnancies. Twelve percent of the twins (12.2 %) were the result of assisted reproduction technologies. IVF versus naturally conceived pregnancies showed similar MoM of PAPP-A (2.2 vs. 1.2, respectively) and fβ-hCG (Mann-Whitney U; p = 0.195 and p = 0.958). Conclusions: Our study revealed that median PAPP-A and fβ-hCG levels for twins were less than twice those of singleton values.Cel pracy: Celem naszego badania było zbadanie surowiczych markerów pierwszego trymestru oraz przezierności karkowej (NT) w ciążach bliźniaczych w naszej populacji. Metoda: Przeanalizowano wyniki wszystkich testów podwójnych wykonanych w naszym szpitalu w ciągu trzech lat. Wyodrębniono grupę ciąż bliźniaczych (n=49) i porównano ją z trzy razy większą grupą kontrolną prawidłowych ciąż pojedynczych (n=147). Wyniki: Nie znaleziono istotnych statystycznie różnic w wieku, wieku ciążowym i masie ciała ciężarnych pomiędzy grupami (p>0,05). Stwierdzono podobne wyniki pomiaru NT w obu badanych grupach. Mediana MoM białka PAPP-A i poziom fβ-hCGw ciążach bliźniaczych był istotnie wyższy niż w ciążach pojedynczych. Dwanaście procent ciąż bliźniaczych było efektem technik wspomaganego rozrodu. Ciąże w wyniku IVF oraz ciąże spontaniczne wykazywały się podobnych wynikiem MoM białka PAPP-A (2,2 vs. 1,2 odpowiednio) i fβ-hCG (Mann-Whitney U; p=0,195 i p=0,958). Wnioski: Średni poziom białka PAPP-A i fβ-hCG dla ciąż bliźniaczych był mniej niż dwa razy większy niż dla pojedynczych ciąż

Moguća povezanost gestacijskog dijabetesa s upalom

The aim of this study was to investigate whether gestational diabetes mellitus (GDM) is associated with inflammation by comparing serum levels of human chitinase-3-like protein 1 (YKL-40), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). This case control study included 29 pregnant women with GDM and 29 pregnant women with normal glucose tolerance matched for age (±2 years) and pre-pregnancy body mass index (±2 kg/m2). The YKL-40/CHI3L1 levels were measured, and NLR and PLR investigated. There were no statistically significant differences in maternal age, gestational age, gravidity and parity. Higher YKL-40 levels were recorded in pregnant women with GDM compared to control subjects (203 (65-300) ng/mL vs. 159.2 (14-290) ng/mL, p=0.007). NLR and PLR were significantly higher in GDM compared with control group. In conclusion, GDM is associated with high levels of YKL-40, NLR and PLR, which indicate inflammatory status.Cilj ovoga istraživanja bio je procijeniti je li gestacijski dijabetes melitus (GDM) udružen s upalom i to usporedbom serumskih razina humanog hitinazi-3-sličnog proteina 1 (YKL-40) te omjera neutrofila/limfocita (NLR) i omjera trombocita/limfocita (PLR). U ovo istraživanje parova bilo je uključeno 29 trudnica s GDM i 29 trudnica s normalnom tolerancijom glukoze. Dob (± 2 godine) i indeks tjelesne mase prije trudnoće bili su podjednaki u obje skupine. Mjerene su razine humanog hitinazi-3-sličnog proteina 1 (YKL-40/CHI3L1) te ispitani omjeri NLR i PLR. Nije bilo statistički značajnih razlika u dobi, gestacijskoj dobi i gravidnosti. Zabilježene su više razine YKL-40 u trudnica s GDM u usporedbi s kontrolnim trudnicama (203 (65-300) ng/mL prema 159,2 (14-290) ng/mL, p=0,007). NLR i PLR bili su značajno viši u skupini s GDM nego u kontrolnoj skupini. U zaključku, GDM je udružen s visokim razinama YKL-40, NLR i PLR koji ukazuju na upalno stanje

Age-Stratified Analysis of Tumor Markers and Tumor Characteristics in Adolescents and Young Women with Mature Cystic Teratoma

Background: Serum tumor markers are widely used for the preoperative evaluation of an adnexal mass. Elevations of cancer antigen (CA) 125 and CA 19-9 have been reported in patients with mature cystic teratoma (MCT). The aim of the study is to investigate the relation of serum tumor markers with tumor characteristics in young women with MCT. Methods: We conducted a retrospective review of 157 patients under the age of 35 who underwent laparoscopic surgery for ovarian MCT. Patients were divided into two age groups: Group I (n = 80): adolescents/young adults (aged 13-25 years) and Group II (n = 77): women aged 26-35 years. Data were analyzed for serum tumor markers, tumor size, and bilaterality. Results: The rates of elevated CA 125 and CA 19-9 were 10.7% and 31.5%, respectively, for Group I, and 13.9% and 26.5%, respectively, for Group II. The bilaterality rate was higher in Group II compared to Group I (19.5% vs. 8.8%, respectively, p = 0.04). Serum CA 125 and CA 19-9 elevations were not related to tumor size in Group I. In Group II, elevated levels of CA 125 were also unrelated to tumor size. However, significant elevation in CA 19-9 levels was observed when tumor size was larger than 4 cm in this age group (p = 0.004). Elevated CA 125 and CA 19-9 levels were not significantly associated with the presence of bilateral MCT in either group. Conclusion: The results of our study indicate that elevations of CA 19-9 are associated with larger tumor size in women aged 26-35 years, but not in adolescents/young adults. However, elevated serum CA 125 levels are not related to tumor size in either age group. Copyright (C) 2017, the Chinese Medical Association. Published by Elsevier Taiwan LLC.Wo

Sexual function and quality of life in a sample of postmenopausal women admitted in a menopause clinic in Turkey | [Türkiye’deki bir menopoz kliniğine başvuran bir grup postmenopozal kadinda cinsel işlev ve yaşam kalitesi]

Introduction: Sexual issues in postmenopausal women have garnered limited interest despite their high prevalence. Menopause is a natural part of ageing in women and has been reported to have a negative impact on the quality of life. In the present study, we examined the association between sexual functions and quality of life parameters in postmenopausal women. Materials and Method: In total, 67 postmenopausal women who sequentially presented to climacteric clinics were enrolled in this study. All participants were administered a structured sociodemographic data form, a 7-item relationship assessment scale, female sexual function index and the 36-item short-form health survey-SF-36-. Results: Mean age, mean age at the beginning of menopause and mean menopause duration were 52.6±6.14, 46.46±5.58 and 6.23±4.94 years, respectively. 36-item short-form health survey-SF-36-social function score was positively correlated with sexual desire, arousal, degree of lubrication, ability to achieve orgasm, intercourse satisfaction, female sexual function index pain domain score, and total female sexual function index score. Moreover, 36-item short-form health survey-SF-36-physical function score was positively correlated with arousal, pain and total female sexual function index score. 36-item short-form health survey-SF-36-physical role difficulties score was positively correlated with the ability to achieve orgasm and female sexual function index pain scores. female sexual function index score correlated with SF-36 social function, physical function and physical role difficulties subscale scores. 36-item short-form health survey-SF-36-social function score predicted arousal, ability to achieve orgasm, intercourse satisfaction, pain and total female sexual function index scores after controlling for age and menopause duration. Conclusion: In the evaluation of sexual functioning in postmenopausal women, problems related to relationship with partner and quality of life, especially physical functions, should be take into account carefully

Sixth-Month Perinatal Outcomes of Anemic Pregnancies

OBJECTIVE: In this study, we retrospectively compare the outcomes of anemia in 3rd trimester pregnant women who applied to our clinic, in terms of maternal factors and its fetal effects, in 0 and 6th months. STUDY DESIGN: 139 cases admitted to our clinic during December 2010 - May 2012 due to pregnancy in their 3rd trimester and were diagnosed with anemia and whose records were available were included in the study. The pregnant women were divided into two groups according to their hemoglobin (Hb) levels; hemoglobin levels below 11 g/dL formed the anemia group (AG Hb<11 g/dL) and those above were the non-anemia group (NAG Hb ›11 g/dL). Maternal age, occupation, number of live births, Hb and hematocrit (Hct) levels, mode of delivery, labor time, and head circumference, weight and height of infants at birth and 6th month were compared. RESULTS: Anemia was determined in 69 pregnant women (49.6%). No significant difference among the groups in terms of age and parity was detected. Anemia was found to be higher in housewife mothers (p=0.0001). No difference in terms of birth weight and height was detected among the babies of mothers of the two groups, but the head circumference of the babies from anemic mothers were determined to be significantly lower (p= 0.0001). In terms of the 6th month outcomes; weight, height and head circumference of babies from anemic mothers were found to be significantly lower (p=0.0001). Risk analysis has determined a negative correlation between anemia and fetal development at 6th month. CONCLUSION: There is a negative correlation between anemia and preterm delivery week, fetal development and small head circumference at birth. Therefore maternal candidates with high rates of anemia such as housewives should be closely monitored during pregnancy and in the postpartum period for fetal development

Does the anti-Müllerian hormone truly reflect ovarian response in women with endometrioma?

In this study, our aim was to determine which factor is more correlated with the number of oocytes retrieved in patients with endometrioma compared with controls undergoing in vitro fertilisation–intracytoplasmic sperm injection (IVF–ICSI) cycles: antral follicle count (AFC) or anti-Müllerian hormone (AMH). A total of 60 women with endometrioma and a control population of 60 women without endometrioma in the same period were randomly selected underwent the injection IVF–ICSI treatment. No significant differences were found between the groups in terms of age (28.78 ± 3.49 vs. 29.52 ± 2.47, p = .187), body mass index (23.62 ± 2.05 vs. 23.91 ± 2.11, p = .449), duration of infertility [(3 (2–4) vs. 3 (2–3), p = .139)], AMH level (1.52 ± 0.51 vs. 1.32 ± 0.92, p = .133), duration of stimulation [(9 (9–10) vs. 10 (9–10), p = .135)], total gonadotropin dose [(2750 (2262.5–3337.5) vs. 2770 (2680–3562.5), p = .125)], endometrial thickness [(10 (10–11) vs. 10 (9–11), p = .463)], fertilisation rates (67.20 ± 18.04 vs. 62.28 ± 17.13, p = .123), grade I embryo (43.3% vs. 30%, p = .185), clinical pregnancy rates (40% vs. 26.7%, p = .123), and the perinatal outcomes between the groups. The AFC was higher in the controls than in those with endometrioma (9.20 ± 1.80 vs. 6.32 ± 2.04, p < .001). The number of oocytes retrieved was also higher in the controls than in those with endometrioma [(7 (6–8) vs. 4 (4–5.75), p < .001)]. We found that women with endometrioma had a significantly lower number of oocytes retrieved than the controls despite the same AMH levels in both groups. AFC is a better marker of ovarian response than AMH in women with endometrioma undergoing IVF-ICSI.Impact statement What is already known on this subject? Utilising the ovarian reserve is important in the success of ovarian stimulation and in evaluating the success of assisted reproductive technologies. The anti-Müllerian hormone (AMH) level and the antral follicle count (AFC) are widely used in the prediction of ovarian functional reserve and response. However, no perfect marker exists in the evaluation of ovarian reserve and ovarian response. What do the results of this study add? Our study demonstrated that women with endometrioma have a significantly lower number of oocytes retrieved than the controls, despite the same AMH levels in both groups; which strongly suggests that AFC is a better reflection of ovarian response than AMH in women with endometrioma undergoing an in vitro fertilisation–intracytoplasmic sperm injection (IVF-ICSI). What are the implications of these findings for clinical practice and/or further research? This important issue has been reviewed and discussed for years, however, the conclusions are still controversial. Additional research is needed to understand which ovarian reserve test could better predict ovarian response outcome

Arthrogryposis Multiplex Congenita: Case Report

Arthrogryposis multiplex congenita (AMC), characterized by multiple congenital joint contractures due to decreased fetal movements, is a non-progressive rare syndrome. Prevalence is determined to be 1 in 3000 deliveries. Although it is autosomal recessively inherited, sporadic cases have also been reported. Prenatal diagnosis of AMC is difficult. Here we report a case with a diagnosis of AMC not diagnosed during antenatal follow-up

Gestational diabetes mellitus seems to be associatied with inflammation

The aim of this study was to investigate whether gestational diabetes mellitus (GDM) is associated with inflammation by comparing serum levels of human chitinase-3-like protein 1 (YKL-40), neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR). This case control study included 29 pregnant women with GDM and 29 pregnant women with normal glucose tolerance matched for age (±2 years) and pre-pregnancy body mass index (±2 kg/m2). The YKL-40/CHI3L1 levels were measured, and NLR and PLR investigated. There were no statistically significant differences in maternal age, gestational age, gravidity and parity. Higher YKL-40 levels were recorded in pregnant women with GDM compared to control subjects (203 (65-300) ng/mL vs. 159.2 (14-290) ng/mL, p=0.007). NLR and PLR were significantly higher in GDM compared with control group. In conclusion, GDM is associated with high levels of YKL-40, NLR and PLR, which indicate inflammatory status

Factor XII (Hageman) Levels in Women with Recurrent Pregnancy Loss

Objective. To evaluate factor XII levels in women with recurrent pregnancy loss (RPL) in a tertiary referral hospital. Methods. Women who were referred to our hospital for two consecutive abortions or three abortions in between 2007 and 2013 were included in this retrospective observational study. Women were further grouped according to factor XII levels, as &lt;60% and ≥60%. Results. Mean factor XII level was 109.1 ± 35.7% (range: 9-200). Ninety-three (7.4%) women had factor XII levels &lt; 60%. Mean factor XII level was 44.8 ± 13.1, and levels ranged between 9 and 60 in this group. Only one woman had factor XII level &lt; 10 %. Remaining 1164 (92.6%) women had factor XII levels ≥ 60%. Mean factor XII level was 114.3 ± 31.7, and levels ranged between 60.3 and 200 in this group, while 1015 (72.4%) women had factor XII levels within the normal range (60%-150% [100% = 30 g/mL]). Conclusion. Decreased activity of F-XII was diagnosed in 7.4% of women with RPL. We concluded factor XII deficiency that might be a rare but significant factor for RPL, and should be evaluated in women who are investigated for recurrent pregnancy loss