Evaluation of the effect of multi-dose Methotrexate therapy on ovarian reserve in ectopic pregnancies: Is polycystic ovarian morphology a protective condition for ovarian reserve?

Objectives: The study aims to evaluate the effects of multi-dose methotrexate (MTX) or subsequent salpingectomy on ovarian reserve and explain the conditions that cause the change in serum anti-Müllerian hormone (AMH) levels. Material and methods: Our department had 58 tubal EP patients treated with a multiple-dose MTX protocol or subsequent salpingectomy between 2017–2020. Serum AMH level was measured in each patient before the medication and 3–6 months after therapy. Patients' details were recorded and analyzed later. Results: The mean AMH value decreased in 32 patients (−17.8%), increased in 26 patients (+31.5%) (p < 0.0001). In the group with an increase, there was a rather high number of patients with a polycystic ovary (PCO) condition compared to the other group (p = 0.0001). AMH values increased in patients with PCO and decreased in patients having no PCO (p < 0.001). Conclusions: Multiple-dose MTX or subsequent salpingectomy treatment in tubal ectopic pregnancy (EP) patients might not refer to significant differences in patients' AMH levels. Remarkably, post-treatment AMH levels were significantly increased in EP patients with PCO and decreased in those without this condition. PCO may be a protective condition for ovarian reserve

The effect of training about environmental toxicant Bisphenol-A exposure in pregnancy on maternal urine Bisphenol-A level

Purpose: Bisphenol A (BPA) is an environmental toxin, clearly capable of initiating epigenetic modifications, leading to the development of numerous human illnesses such as metabolic, reproductive, and behavioural abnormalities. It also causes oxidative stress, which has been shown to be alleviated by selenium supplementation. The purpose of this study was to determine the effect of training of BPA exposure during pregnancy on urine BPA levels. Methods: This research enrolled 30 pregnant women who were in their first trimester and were free of chronic illness. Women were asked questions on their sociodemographic features, anthropometric measures, obstetric characteristics, BPA awareness level, BPA exposure and the Health Practices in Pregnancy Scale as a Pre-test and Post-Test. The initial urine samples were taken from women in their first trimester and stored in BPA-free bags. Then, training was delivered to encourage BPA exposure reduction and maternal health awareness. First-trimester face-to-face instruction and brochure distribution were followed by refresher, reminder, and follow-up trainings during the second and third trimesters. Urine samples from women in their second and third trimesters were obtained again. The levels of BPA in urine were measured using the liquid chromatography-mass spectrometry on 90 samples. Each person's urine concentration differs, thus the creatinine level in all samples was also calculated and compared to the BPA content, and the results were evaluated. Results: Our study shown that BPA exposure may be lowered by training. It has been demonstrated that reducing BPA exposure and increasing knowledge can result in an improvement in health status. Additionally, it has been demonstrated that trainings greatly minimize exposure-causing behaviours. Conclusion: It was discovered that while the duration of a single training does not make a meaningful effect, the continuing of reminder trainings did make a substantial difference in the urine BPA level

Comparison of the Kelly's plication and TOT simultaneously with vaginal hysterectomy, on the incontinence, and sexual functions

ABSTRACT Purpose: To compare the effect of vaginal hysterectomy-anterior/posterior colporrhaphy with Kelly's plication(VH-KP), versus vaginal hysterectomy-anterior/posterior colporrhaphy-transobturator tape(VH-TOT) surgeries on incontinence, quality of life, and sexual functions in patients with pelvic organ prolapse(POP), and concurrent obvious stress urinary incontinence(SUI). Materials and Methods: Between 2013 and 2017, fifty patients treated with VH-KP(n = 25), and VH-TOT(n = 25) due to POP and SUI, were evaluated prospective consecutively. Age, parity, duration of urinary incontinence, and the daily pad use were recorded. Patients were filled “rinary Distress Inventory-6(UDI-6)”, “Incontinence Impact Questionnaire 7(IIQ-7)” and “Index of Female Sexual Function(IFSI)” questionnaire forms at preoperatively, and postoperative 6th month. No usage of pads was accepted as subjective cure rate. Intraoperative, and postoperative complications were noted. Results: There was no statistically significant difference between two groups, for the mean age of the patients, parity, duration of SUI, and the daily pad use, preoperatively (p > 0.05). Decreased UDI-6 scores, IIQ-7 scores and daily pad usage, and increased IFSF scores were found statistical significantly in each group, at the postoperative 6 th month (p < 0.05). However, VH-TOT group had higher improvement rates, on UDI-6 scores (69.5% vs 63.0%, p = 0.04). In addition, it was notable that the the rates of the patients had IFSF scores ≥ 25 was higher in VH-KP group (p = 0.05). Four (16%) patients had recurrent SUI in the VH-KP group (p = 0.039) and vaginal extrusion occurred in 2 (8%) patients in the VH-TOT group (p = 0.153), postoperatively. Conclusions: Although the effects of VH-TOT surgery are superior to conventional methods for incontinence and quality of life; negative effects on sexual functions are notable. In addition, although recurrence rates of TOT are low, complications such as vaginal extrusion are accompanied by drawbacks of mesh usage

Outcomes Of Cases Of Prenatally-Diagnosed Congenital Pulmonary Airway Malformation

Objective To evaluate the outcomes of cases of prenatally-diagnosed congenital pulmonary airway malformation (CPAM). Methods We retrospectively evaluated cases of prenatally-diagnosed CPAM between 2004 and 2018. Ultrasonographic features such as visualization of a fetal lung mass and heterogeneous pulmonary parenchyma were used for CPAM diagnosis. Prenatal and postnatal findings were compared in terms of accuracy regarding the CPAM diagnosis. Results The sample consisted of 27 cases. There were four cases in which the patients opted for the termination of pregnancy due to the severity of the lesion. A total of 23 neonates were delivered, and CPAM was confirmed in 15 cases. The median gestational age at delivery was 37 weeks (28-40 weeks) and the mean birth weight was 2,776 g. There were two neonatal deaths, one due to pneumothorax, and the other due to hypoplastic left heart syndrome (HLHS). A total of five patients with respiratory problems were operated in the postpartum period. There were eight misdiagnosis: bronchopulmonary sequestration (five cases), congenital lobar emphysema (two cases), and congenital diaphragm hernia (one case). Conclusion A precise postnatal diagnosis is very important to organize the proper management of the pregnancies with fetuses with CPAM. The positive predictive value of the prenatal diagnosis of CPAM via ultrasonography is of 70.3%. The differential diagnosis of CPAM may be prolonged to the postpartum period in some cases.WoSScopu