A Rare Complication: Blue Urine Developed After Laparoscopic Chromopertubation

Methylene blue is a dye that is widely used in medicine. The underlyin reason this widespread use is that it is easily accessible, inexpensive and safe. Although rarely seen, some complications may develop during use of methylene blue. It is important that clinicians should be aware of these unwanted conditions, recognize these complications at an earlier stage, and take suitable measures

Wpływ rodności na kształt fali przepływu Dopplera w pierwszym trymestrze pojedynczej ciąży niskiego ryzyka

Objectives: The aim of the study was to evaluate the effect of parity on uteroplacental blood flow during the first trimester in low-risk singleton pregnancies. Materials and methods: Uterine artery Doppler examinations were performed in 190 singleton pregnancies between 11-14 gestational weeks. Twenty-five pregnancies were excluded from the study due to history of preeclampsia, diabetes mellitus or inherited thrombophilia. A total of 165 low-risk singleton pregnancies were included in the study. Mean uterine artery pulsatility index (PI) was recorded and compared between nulliparous and multiparous women. The relation between maternal age, gestational week, maternal weight, parity, biochemical markers and abnormal uterine artery Doppler flows was evaluated. T-test and logistic regression analyses were used for the statistical analysis. Results: A total of 165 singleton pregnancies without any risk factors for uteroplacental insufficiency were included in the study. Of them, 58 (36.7%) were nulliparous and 107 (63.3%) were parous. Correlation analysis revealed that the uterine artery pulsatility indices during the first trimester were not affected by maternal age and parity. Conclusions: Mean uterine artery pulsatility indices are not different in nulliparous and multiparous low risk pregnancies at 11-14 weeks of gestation.Cel: Celem badania była ocena wpływu rodności na przepływ maciczno-łożyskowy w pierwszym trymestrze pojedynczej ciąży niskiego ryzyka. Materiał i metoda: Przepływ w tętnicy macicznej zbadano w 190 pojedynczych ciążach w 11-14 tygodniu. Z analizy wyłączono 25 ciąż z powodu dodatniego wywiadu w kierunku stanu przedrzucawkowego, cukrzycy lub wrodzonej trombofilii. Ostatecznie do badania włączono 165 pojedynczych ciąż niskiego ryzyka. Zmierzono średni indeks pulsacji w tętnicy macicznej (PI), który porównano pomiędzy nieródkami i wieloródkami. Oceniono również związek pomiędzy wiekiem matki, wiekiem ciążowym, masą matki, liczbą porodów, markerami biochemicznymi a nieprawidłowym przepływem w tętnicach macicznych. T-test i regresji logistycznej zostały wykorzystane do analizy statystycznej. Wyniki: Do badania włączono 165 pojedynczych ciąż bez czynników ryzyka niewydolności maciczno-łożyskowej. Z tej grupy, 58 (36,7%) kobiet było nieródkami a 107 (63,3%) wieloródkami. Analiza statystyczna wykazała brak związku pomiędzy indeksem pulsacji w pierwszym trymestrze ciąży a wiekiem matki i rodnością. Wnioski: Średni indeks pulsacji w tętnicy macicznej nie różni się pomiędzy nieródkami a wieloródkami w ciąży niskiego ryzyka w 11-14 tygodniu

The effect of maternal vitamin D levels on placental shear wave elastography findings in the first trimester

The aim of this study was to investigate the effect of maternal serum Vitamin D levels on the elasticity of placenta. Seventy-four spontaneously conceived singleton pregnancies in their first trimester were enrolled into this study. Fifty-one of them had Vitamin D deficiency ( .05). Placental elasticity was not found to be different in the pregnancies with Vitamin D deficiency during the first trimester.IMPACT STATEMENT What is already known on this subject? The pSWE technique provides opportunity to determine the elasticity of any interested tissue. Placental elasticity has been found to be changed in inflammatory and fibrotic conditions such as in preeclampsia, intrauterine growth restriction or diabetes. On the other hand, Vitamin D deficiency is linked with several comorbidities such as autoimmune disorders, cancer and cardiovascular disorders. Vitamin D also plays a role in placental angiogenesis in the first trimester. Maternal Vitamin D levels are shown to be related with adverse pregnancy outcomes. What do the results of this study add? To the best of our knowledge, this study is the first assessing the association between Vitamin D levels and placental elasticity. Placental elasticity was not found to be changed by Vitamin D deficiency. What are the implications of these findings for clinical practice and/or further research? Our pilot study revealed that Vitamin D deficiency does not have any impact on placental elasticity in the first trimester. However, longitudinal studies concerning placental elasticity in subsequent trimesters are needed to support our findings

Abnormal Elevated CA 19-9 in the Dermoid Cyst: A Sign of the Ovarian Torsion?

Dermoid cyst is the most common germ cell tumor of the ovary containing various tissue elements. Ovarian torsion is a common complication of which ultrasonographic diagnosis is confusing. We report here a 14-year-old adolescent with painless torsion of the ovary including dermoid cyst and with abnormal elevated CA 19-9 serum levels. Elevated CA 19-9 level may be related to ovarian torsion and may predict the extent of tissue necrosis

Role of VPAC1 and VPAC2 receptors in the etiology of pregnancy rhinitis: an experimental study in rats

Introduction: Pregnancy rhinitis is a common sex hormone-related otorhinolaryngological disorder. There are some epidemiological and physiological studies on pregnancy rhinitis, but histopathological and biomolecular changes have not been studied thoroughly. Objectives: The receptors VPAC1 and VPAC2 are known for their roles in allergic rhinitis. On the other hand, activation of subclinical allergy has been suggested in the pathophysiology of pregnancy rhinitis. Therefore, we aimed to compare the physiological and gestational pattern of VPAC1 and VPAC2 expression in rat nasal mucosa. Methods: Twenty adult Wister albino female rats were enrolled into the study. Two groups constituted as 10 control (group A) and 10 pregnant (group B) rats. They were fed ad libitum and sheltered at room temperature (22°±2 °C). The rats were sacrificed at the 20th day of gestation by intraperitoneal injection of 400 mg/kg Na-pentobarbitone. Then, 10 − 15 mL of blood was taken, and samples were reserved for the detection of serum estradiol and progesterone levels by ELISA test. The nasal septum was resected and divided in half for immunohistochemical analyses and real time polymerase chain reaction testing of VPAC1 and VPAC2. Results: VPAC1 and VPAC2 were found to be in all layers of septal specimens, but the immunostaining of surface epithelium was more distinct in specimens of both groups. We demonstrated higher overall staining intensity in the pregnant group. PCR revealed significant increase in expression of VPAC1 (p = 0.023) and VPAC2 (p = 0.021) in pregnant group when compared with control group. In addition, we demonstrated upregulatory effect of estradiol and progesterone on the vasoactive intestinal peptide receptor expression. Conclusions: Gestational up-regulation of nasal VPAC1 and VPAC2 was shown both by PCR and immunohistochemical analysis. These findings support the hypothesis that PR is caused by the activation of subclinical allergy that is present before pregnancy

Prenatal Diagnosis and Fetomaternal Outcomes of Two Cases with Placental Chorioangioma

Placental chorioangiomas greater than 4 cm in diameter are rare placental tumors. They have adverse fetomaternal outcomes. We present our experience with two cases having a giant angioma and review the relevant literature

Use of the modified myocardial performance index for evaluating fetal cardiac functions in pregestational diabetic pregnancy babies

The aim of this study is assessment of importance of use of the modified myocardial performance index (Mod-MPI) for the evaluation of foetal cardiac function in foetuses of women with pregestational diabetes mellitus (PDM). In this study, data of 30 pregnant patients aged 18–45 years diagnosed with PDM and 30 pregnant women aged 18–45 years with normal pregnancy and their babies were evaluated. Foetal echocardiographic and doppler measurements, foetal biometric measurements, umbilical artery and ductus venosus pulsatility indexes were measured in both PDM and control groups. The Mod-MPI was significantly higher in foetuses of PDM women. Many influences especially cardiac and postpartum complications are observed in infants of PDM women. The Mod-MPI is a simple and useful method for assessing foetal ventricular function. Our study has shown that PDM is associated with foetal ventricular dysfunction.Impact statement What is already known on this subject? Although MPI is frequently used in routine clinical assessment of neonates, it is not used adequately in foetuses. Many influences especially cardiac and postpartum complications are observed in infants of PDM women. However, there are few studies focussed specifically on the assessment of foetal cardiac function in PDM. What do the results of this study add? MPI, which shows both diastolic and systolic functions is independent of ventricular anatomy and foetal heart rate, was found significantly higher in diabetic mother foetuses, can be said to be a valuable parameter in evaluating foetal cardiac functions globally. What are the implications of these findings for clinical practice and/or further research? Our study has shown that foetuses PDM are associated with foetal ventricular dysfunction. For this MPI measurement can be routinely performed at foetal cardiac measurements in foetuses of PDM mothers

The impact of invasive prenatal testing on anxiety and sleep quality in pregnant women with a screen-positive result for aneuploidy

Purpose Prenatal anxiety has negative effects on pregnancy and neonate. Both screening tests and invasive diagnostic tests are associated with elevated anxiety level. But a normal fetal karyotype result could improve the anxiety level in high-risk patients. We hypothesized that patients who prefer follow-up without karyotyping may experience increased anxiety and sleep impairment until delivery. Our aim was to determine the effect of invasive diagnostic test decision on anxiety and sleep quality in women with a positive screening result. Methods 132 women were included for the study and three groups were described. The invasive group consisted of women who underwent invasive procedure after a screen-positive test result, the follow-up group consisted of women who preferred non-invasive follow-up after a screen-positive result and the control group consisted of women with screen-negative test results. Participants were evaluated with the State-Trait Anxiety Inventory (STAI) and the Pittsburgh Sleep Quality Index (PSQI) after genetic counseling. They were asked for completing the same questionnaires in the third trimester to establish the course of anxiety and sleep quality throughout pregnancy. Results STAI scores were significantly higher in both screen-positive groups than in the control group in the first evaluation (p < 0.001). STAI scores decreased in the invasive group and controls while PSQI scores did not significantly change during the course of the pregnancy. However, the anxiety level and sleep quality were worsened over time in the follow-up group. Conclusion Screen-positive women who preferred to follow up had higher anxiety level and worse sleep quality in the later stages of pregnancy. We concluded that invasive prenatal diagnostic tests could improve anxiety and sleep quality in pregnant women with a screen-positive result for aneuploidy

Maternal serum perlecan levels in women with preeclampsia

Objective: Perlecan is an extracellular matrix proteoglycan suggested to maintain endothelial functions. We aimed to measure maternal serum perlecan levels in different preeclampsia phenotypes. Methods: This study included 50 women with preeclampsia and 30 healthy pregnant women. Results: Serum perlecan levels were significantly higher (p = 0.016) in preeclamptic women with severe features(n = 23) than preeclampsia patients(n = 27). There were no statistically significant differences in serum perlecan levels between the early-onset preeclampsia(n = 25), late-onset preeclampsia(n = 25), and healthy pregnancies. Conclusion: Our findings suggest that preeclamptic women with severe features have higher serum perlecan levels than women with preeclampsia