Comparison of Inflammatory Reactions Following Two Different Cesarean Section Techniques: The Modified Misgav-Ladach Versus the Pfannenstiel-Kerr; A Prospective Randomized Trial

Objectives: There is not yet a consensus on the optimal surgical technique for cesarean section. This is the first study comparing two different (Cesarean Section) with respect to the following inflammatory reaction in means of changes in inflammatory marker levels. To evaluate the differences in inflammatory reactions following two different (Cesarean Section) techniques, the modified Misgav-Ladach versus the Pfannenstiel-Kerr technique. Study Desıgn: The study population included 88 pregnant women who met the inclusion criteria. These women were randomized into two groups according to Consolidated Standards of Reporting Trials guidelines: Group 1 (Misgav-Ladach group) and Group 2 (Pfannenstiel Kerr group). To compare the inflammatory reactions following surgery, Interleukin-6 (IL-6) and Tumor Necrosis Factor-α (TNF-α) levels were measured in venous blood samples drawn from the patients just before (0 hour) and 24 hours (24th hour) after the surgery. In 5 women from Group 1 and 2 women from Group 2, the 24th hour blood samples could not be obtained or were lost. Thus, a total of 81 women, 39 women from Group 1 and 42 women from Group 2, comprised the population of study. The differences in inflammatory reactions between the 0 and 24th hours were analyzed by calculating the percent change in IL-6 and TNF-α levels, and these percentages were then compared between the groups. Results: There was a statistically significant difference between Group 1 and Group 2 regarding the serum IL-6 level change between 0 and 24th hour (530±653% and 196±168%, respectively, p=0.022. The difference in TNF-α was also higher in Group 2, but the difference was not statistically significant (229±306% vs. 571±824%, p=0.12). The mean operation time was significantly shorter in Group 1 (9.44 min. vs. 16.86 min, p=0.0001). Conclusions: The results of this study indicate that the modified Misgav-Ladach technique has a weaker inflammatory reaction, which indicates fewer short- and long-term surgical complications

A Novel Atraumatic Tourniquet Technique for Excessive Bleeding during Cesarean Sections

Objective. Controlling excessive bleeding in cesarean sections which may cause a life-threatening event even under well-prepared conditions. We used a novel atraumatic tourniquet technique to temporary arrest blood flow through the uterine and ovarian vessels and compare with other techniques. Toothless vascular clamps were used as clamp. Methods. Tourniquet technique performed postpartum hemorrhage (PPH) cases (19 out of 37) were compared with 18 other cases with PPH. Results. The difference between preoperative and postoperative hemoglobin values was significantly lower in the study group as well as the number of blood products needed during and after surgery. Conclusions. This technique not only prevented massive bleeding from the uterus but also allowed physicians time to consider the necessity of further interventions

Prediction of neonatal respiratory distress syndrome via pulmonary artery Doppler examination

###EgeUn###Objective: We aimed with this study to evaluate the role of pulmonary artery acceleration time to ejection time ratio (PATET) in the prediction of respiratory distress syndrome (RDS) in preterm neonates. Materials and methods: In this prospective cohort study, 105 singleton pregnant women with no congenital abnormalities and pregnancy complications who delivered before 37 weeks of gestational age were included. All the patients underwent ultrasound examination to obtain fetal pulmonary artery Doppler. 15 patients were excluded from the study as they did not give birth within 3 days subsequent to ultrasound examination, or inadequate Doppler measurements. After delivery the neonates were grouped according to diagnosis of RDS as RDS + and RDS-. Results: One hundred five women met the inclusion criteria. Regarding the Doppler findings; only the PATET ratio was significantly different between the groups (0.2965 +/- 0.042 versus 0.386 +/- 0.068 p < .001, Z = -5.206). There was an inverse correlation between the diagnosis of RDS in the neonates and the PATET values, even after adjusted for gestational age estimated fetal weight and fetal gender (r = -0.52 and p = .0017). A cut-off value of 0.327 provided optimal specificity of 77.1%, a sensitivity of 90.9%, a negative predictive value of 95.4%, and a positive predictive value 52.7%. Conclusions: In consideration of these results fetal PATET ratio is a promising noninvasive tool to predict RDS in cases of preterm deliveries

Evaluation of thiol/disulphide homeostasis as a novel predictor testing tool of early pregnancy viability

Objective: To evaluate serum dynamic thiol/disulphide concentrations in patients with suspected missed abortion (MA) and to determine whether this ratio has a predictive role in the viability in these pregnancies

Evaluation of fetal serum thiol/disulphide homeostasis in deliveries complicated by nuchal cord

Aim: To investigate the serum thiol/disulphide homeostasis in deliveries complicated by nuchal cord (NC) and to compare the results with healthy deliveries (without NC). Methods: This prospective controlled study included 48 pregnant women complicated by NC and 48 similar gestational aged healthy pregnant women during labor. Fetal umbilical cord serum samples were collected during labor and the thiol/disulphide homeostasis was measured by using an automated assay method. The patients were followed up until end of the delivery and perinatal outcomes were recorded. Results: Fetal umbilical cord native thiol, total thiol, and disulphide levels as well as disulphide/native thiol and disulphide/total thiol ratios are impaired in labor with the presence of NC. There were no statistically significant differences in terms of maternal and gestational age at delivery and maternal number of gravida and parity, fetal gender, fifth Apgar scores <7, mode of delivery and fetal birth weight between groups. The group of patients with NC had higher emergency C/S numbers indicated for fetal distress and lower first Apgar scores Conclusions: Maternal serum thiol/disulphide homeostasis reflect transient effects of NC during labor regardless of labor type. Vaginal delivery can be safely and successfully performed in pregnancies complicated with NC

Relationship between first trimester aneuploidy screening test serum analytes and placenta accreta

WOS: 000415799600010PubMed ID: 28027672Objective: The aim of this study is to determine whether there is a relationship between first trimester serum pregnancy-associated plasma protein A (PAPP-A) and free beta human chorionic gonadotropin (fhCG) MoM values and placenta accreta in women who had placenta previa.Study design: A total of 88 patients with placenta previa who had first trimester aneuploidy screening test results were enrolled in the study. Nineteen of these patients were also diagnosed with placenta accreta. As probable markers of excessive placental invasion, serum PAPP-A and fhCG MoM values were compared in two groups with and without placenta accreta.Results: Patients with placenta accreta had higher statistically significant serum PAPP-A (1.20 versus 0.865, respectively, p=0.045) and fhCG MoM (1.42 versus 0.93, respectively, p=0.042) values than patients without accreta.Conclusions: Higher first trimester serum PAPP-A and fhCG MoM values seem to be associated with placenta accreta in women with placenta previa. Further studies are needed to use these promising additional tools for early detection of placenta accreta

Differences in Poly(ADP-ribose) Polymerase1-(PARP1-) and Proliferative Cell Nuclear Antigen (PCNA) Immunoreactivity in Patients Who Experienced Successful and Unsuccessful Microdissection Testicular Sperm Extraction Procedures

Purpose: The aim of this study is to evaluate expression of deoxyribonucleic acid (DNA) synthesis and repair markers in testicular tissues of azoospermic men in whom sperm retrieval could and could not be achieved as a result of microdissection testicular sperm extraction (micro-TESE) procedure

Nuchal cord: is it really the silent risk of pregnancy?

Objective: To evaluate the relationship between entanglement of umbilical cord around the fetal neck and adverse perinatal outcomes.Methods: In this prospective cohort study, perinatal outcomes of 218 pregnancies complicated with nuchal cord (NC) (study group) were compared with 190 uncomplicated pregnancies (control group). Main outcome measures were umbilical cord pH values, APGAR scores and cesarean section (C/S) rates. Fetal distress was stated as an abnormal heart rate pattern on electronic fetal heart monitorization.Results: There were no statistically significant differences in maternal demographic and obstetric features, between groups. There were no statistically significant differences regarding C/S rates between groups, even though fetal distress was significantly the leading indication for cesarean delivery, in the study group (p=0.021). The number of entanglement was significantly related with fetal distress (p<0.001). There were no statistically significant differences in umbilical cord gas values, one-minute and five-minute APGAR scores between the groups. Furthermore, there was a significant male dominance in the study group (p=0.014) and also, amniotic fluid indexes (AFI) were significantly higher in this group (p=0.002).Conclusion: This study demonstrated that, entanglement of umbilical cord around the fetal neck or NC is not related with adverse perinatal outcomes such as acidosis and low APGAR scores. So that, a targeted care on NC via ultrasound during labor, is not an essential part of the examination

Association of serum and follicular fluid leptin and ghrelin levels with in vitro fertilization success

Objectives: The aim of this study was to evaluate the relationship between in vitro fertilization (IVF) cycle outcomes, serum and follicular fluid (FF) levels of leptin and ghrelin

Association of serum and follicular fluid leptin and ghrelin levels with in vitro fertilization success

Objectives: The aim of this study was to evaluate the relationship between in vitro fertilization (IVF) cycle outcomes, serum and follicular fluid (FF) levels of leptin and ghrelin