Prediction of Preterm Birth: Maternal Characteristics, Ultrasound Markers, and Biomarkers: An Updated Overview

There is not a single or combined screening method for preterm birth with high sensitivity which will truly identify the women at risk for preterm birth while also with high specificity to prevent unnecessary interventions and high treatment costs. Measurement of cervical length is the most cost-effective method that is used in clinical practice. Bedside tests have also been developed for detecting markers like fetal fibronectin, insulin-like growth factor binding protein-1 (IGFBP-1), interleukin-6, and placental alpha-macroglobulin-1. Taking the maternal history, health condition, and sociodemographical factors into consideration is recommended. Ultrasound markers apart from cervical length measurements as uterocervical angle and placental strain ratio are studied. Investigations on metabolomics, proteomics, and microRNA profiling have brought a new aspect on this subject. Maybe in the future, with clear identification of women at true risk for preterm birth, development of more effective preventive strategies will not be unfeasible

25-Hydroxy vitamin D levels in premenopausal Turkish women with uterine leiomyoma

We aimed to evaluate the relationship between serum 25-hydroxy vitamin D levels and the risk of uterine fibroids in premenopausal women in Turkish population in this prospective observational cross-sectional study. Sixty-eight women with at least one uterine leiomyoma >= 10 mm were compared with 56 healthy controls. Serum 25-(OH) vitamin D-3 levels were measured by electrochemiluminescence immunoassay. The groups were similar in terms of age, BMI, gravidity and parity numbers. The mean level of 25-(OH) D3 were 7.28 +/- 4.94 ng/ml and 78% of patients (n=97) had severe vitamin D deficiency (<10 ng/mL). Vitamin D levels were significantly lower in the study group (6.54 +/- 4.66 ng/ml vs. 8.18 +/- 5.16 ng/ml, respectively; p=.009). Vitamin D levels were not correlated with size, volume, localization and number of leiomyomas. Traditional covered clothing style, low education level and being housewife were risk factors for Vitamin D deficiency. This is the first study that investigates the vitamin D levels in women with leiomyomas in Turkish population. Influence of vitamin D on uterine leiomyoma formation to may lead to new preventive strategies in the future

Echogenic particles in the amniotic fluid of term low-risk pregnant women: does it have a clinical significance?

In this study, we aimed to analyse the clinical features of the third-trimester pregnant women, with echogenic amniotic fluid and to compare their obstetric and neonatal outcomes with pregnant women with normal amniotic fluid echogenicity. This case-control study was conducted in a tertiary antenatal care centre. A total of 560 term (37–42 weeks of gestation) singleton women; 280 with echogenic particles in amniotic fluid and 280 with clear amniotic fluid, who delivered within 24 h after the ultrasound scan were evaluated. The women in the two groups were similar in terms of age, parity, body mass index, foetal birth weight, and gestational age. More patients in the particulate amnion group had lower Apgar scores (<7) in 1st and 5th minutes than controls (p = .006, p = .031 respectively) however the rate of admission to neonatal intensive care was similar. Vernix stained amniotic fluid was more common in the study group (48.8%, p = .031), the rate of meconium-stained amniotic fluid was similar in the study and control groups (9.6–9.2%, p = .881). The primary caesarean section rate was higher in women with particulate amnion (18.4%, p = .037). Echogenic particles in the amniotic fluid in the third trimester could not be attributed to meconium, however, higher rates of primary caesarean section may require further attention.IMPACT STATEMENT What is already known on this subject? Previous studies showed that high-density intra-amniotic particles were possibly related to vernix caseosa, intra-amniotic bleeding, and meconium. The number of study groups in these studies was also limited. What do the results of this study add? Additional to other previous studies, we found an increased rate of intra-amniotic echogenic particles in male foetuses. What are the implications of these findings for clinical practice and/or further research? The presence of echogenic particles on ultrasound was not related to increased risk for the presence of meconium. Significantly more neonates born to mothers with intra-amniotic echogenic particles tended to have lower Apgar scores (<7), however, this significant difference did not affect the need for NICU admission. The presence of echogenic particles in the amniotic fluid of the third-trimester pregnant women could not be attributed to meconium and adverse perinatal outcomes, however, the higher rates of primary caesarean section may require further attention

Risk Factors of Prolonged Hospitalization in Patients with Hyperemesis Gravidarum

Purpose: To evaluate the risk factors of prolonged hospitalization in patients with hyperemesis gravidarum (HEG). Material and Methods: The medical records of 114 patients who were admitted to the Zekai Tahir Burak Womens Health Education and Research Hospital with a diagnosis of HEG in the period January 2013 to June 2014 were analyzed retrospectively. Hospital stay of more than 4 days was considered as prolonged hospitalization. Ninety -three patients with HEG who needed hospitalization less than four days formed the control group and 21 patients with HEG who needed hospitalization equal to or longer than four days formed the study group. The variables regarding age, body mass index, week of pregnancy, number of parity, daily vomiting number, number of days in hospital, need of combined antiemetic use, complete blood count, biochemistry markers, hormone tests, urine analysis were evaluated to assess their relationship with the risk factors for prolonged hospitalization in patients with HEG. Results: Twenty-one of 114 patients diagnosed with HEG had a prolonged hospital stay, with a mean stay of 5.1 days. Age, body mass index, week of pregnancy, need of using combined antiemetics, complete blood count parameters, liver and kidney function tests were not associated with the duration of hospitalization. Daily vomiting, maternal serum TSH levels and blood urea nitrogen levels were 2.4 +/- 1.3 vs 4.2 +/- 1.9; p= 0.01, 1.19 +/- 0.71 vs 0.82 +/- 0.67; p= 0.04, 21.2 +/- 6.4 vs 18.1 +/- 5.3; p= 0.03; respectively, and these differences were found to be statistically significant among groups. The serum maternal TSH < 0.1 and micro;IU/mL and vomiting and #8805; 5 per day were found to be significant indicators for longer hospitalization (OR = 4.05, 95%CI = 1.07-15.3; P <0.05, OR=9.55, 95%CI = 1.81-50.4 P <0.05; respectively). Conclusion: Number of vomiting per day and maternal serum TSH levels could help physicians to estimate the risk of prolonged hospitalization; however further investigations are needed in large population studies. Identifying the high risk patients is important both for prevention of HEG and beginning appropriate antiemetic treatment to avoid complications to reduce the economic costs. [Cukurova Med J 2015; 40(1.000): 113-118

Eyeliner in Bladder: A Case Report

Intravesical foreign objects in bladder are really seen rarely. Most of the time, the reasons of insertions of the foreign body are self-autoerotism to iatrogenic urological procedures, migration from surrounding organs or trauma. It can damage the bladder and may result in several urogenital and bowel complications. Herein, we present a case in a 42-year-old female with an eyeliner pencil self-introduced into the urethra with successfully removal of eyeliner from bladder despite to the anamnesis given involuntarily due to embarrassment, guilt and humiliation. [Cukurova Med J 2015; 40(1.000): 158-161