Lung growth factors in the amniotic fluid of normal pregnancies and with congenital diaphragmatic hernia

Respiratory failure secondary to pulmonary hypoplasia is the main cause of death in congenital diaphragmatic hernia (CDH). Lung growth is regulated by growth factors (GFs), whose imbalances are reported in pathological conditions. We measured amniotic fluid levels of GFs, regulating lung development, in pregnancies with CDH and compared them with normal gestations

Meconium-stained amniotic fluid: a risk factor for postpartum hemorrhage

Background/aim Clinical data with respect to the impact of meconium on the risk of maternal hemorrhage are scarce. Therefore, in this study, we aimed to determine whether meconium-stained amniotic fluid (MSAF) represents a risk factor for postpartum hemorrhage (PPH) after vaginal delivery in a large unselected population. Patients and methods A retrospective cohort study evaluated 78,542 consecutive women who had a vaginal delivery between 24th and 44th weeks of gestation. The women who had undergone cesarean section were excluded to avoid possible bias. Postpartum blood loss was measured with graduated blood sack. Postpartum blood loss between 1,000 and 2,000 mL and >2,000 mL were classified as moderate and severe PPH, respectively. Results A total of 74,144 patients were available for analysis. According to the color of amniotic fluid (AF), two groups of patients were identified: MSAF (n=10,997) and clear AF (n=63,147). The rates of severe and massive PPH were found to be significantly higher in the MSAF group than that of clear AF group (OR=1.3, 95% CI: 1.2\u20131.5, p<0.001 and OR=2.5, 95% CI: 1.5\u20134.2, p<0.001). Operative vaginal delivery rate was found to be higher in the MSAF group than that of clear AF group, but the difference was only borderline significant (OR=1.5, 95% CI: 1.0\u20132.2, p=0.05). There were no significant differences between the MSAF and the clear AF groups with respect to episiotomies, second- or third-degree perineal tears, vaginal\u2013perineal thrombus, cervical lacerations, vaginal births after cesarean section, twin deliveries, and placental retention rates. Conclusion To the best of our knowledge, this is the first clinical study that has investigated the role of MSAF as a risk factor for PPH after vaginal delivery in an unselected population. Our results suggest that MSAF is significantly associated with higher risk of moderate and severe PPH than clear AF

Risk factors for developing endometrial cancer after benign endometrial sampling

As already demonstrated by several clinical studies, dilation and curettage and the other blind procedures have a low diagnostic accuracy for evaluating women with uterine disorders. By contrast, there is a large body of evidence showing that hysteroscopy is highly sensitive and specific in diagnosing endouterine diseases. Therefore, currently, hysteroscopy should be considered \u2018gold standard\u2019 in uterine cavity evaluation, and blind procedures should be abandoned. In fact, as suggested by many reports, the risk of missing premalignant or malignant endometrial lesions with these procedures is not negligible