In vitro fertilization pregnancy may cause fetal thymic volume involution: A case-control study

Background: The effect of modern infertility treatment modalities on fetal thymic volume has not been well known. Objective: 3-dimensional (3D) fetal thymus volumes of 18-24 wk in vitro fertilization (IVF) pregnancies and spontaneous pregnancy cases were compared. Materials and Methods: 135 cases were evaluated in this prospective case-control study. The study was conducted between July 2019 and July 2020 at a university hospital in Trabzon, Turkey. Fetal thymus volume was calculated in the pregnant cases included in the study with the help of the virtual organ computer-assisted analysis system included in the advanced ultrasonography system. The fetal thymus volumes were compared between pregnant women with IVF and spontaneous pregnant women. Results: The fetal thymus size was significantly lower in the IVF pregnancy group than in spontaneous pregnancy cases (p < 0.001). It was found that the fetal complications, such as non-reassuring fetal health status and requirement for neonatal intensive care, were higher in cases who became pregnant after IVF treatment. It was also found that the rate of any pregnancy complication was significantly higher in IVF pregnancy c group (p = 0.02). Conclusion: In light of these results, it may be concluded that small fetal thymus size may be another fetal complication of IVF pregnancies. Key words: Fetus, Fertilization in vitro, Prenatal ultrasonography, Thymus

Tubal Pregnancy Associated with Endometrial Carcinoma after In Vitro Fertilization Attempts

Endometrial carcinoma is rarely seen during reproductive ages and commonly related to infertility, polycystic ovarian syndrome (PCOS), and obesity. Pregnancy associated endometrial carcinoma is even rarer and this is the second case reported in the literature concerning tubal pregnancy associated endometrial carcinoma. We present a case of a 36-year-old woman with a history of PCOS, infertility, and several attempts of ovulation induction and in vitro fertilization, who was diagnosed with tubal pregnancy and a well differentiated endometrial carcinoma. We also review the literature about pregnancy associated endometrial carcinoma in the first trimester

Thrombocyte Alterations in Pregnant Women with Gestational Diabetes Mellitus

Objective: Inflammation and its complications might develop in patients diagnosed with diabetes mellitus. It is shown that number, shape and functions of thrombocytes are important for development and prediction of inflammatory process. We aimed to show the changes of number, morphology and functions of platelets in the patients with gestational diabetes mellitus. study design: In a retrospective study, 928 cases in 24-28th weeks of gestation followed regularly in the same clinic were included. We performed 75g oral glucose tolerance test to all cases. Mean platelet volume, platelet distribution width and plateletcrit values of the cases with and without gestational diabetes mellitus according to American Diabetes Association criteria were compared to evaluate the platelet count, morphology, functions and activity. Results: Platelet count and plateletcrit values of cases were significantly higher in the patients with gestational diabetes mellitus. No significant differences were found between the cases with and without gestational diabetes mellitus in mean platelet volume and platelet distribution width values. Conclusion: There is tendency to inflammation in GDM and platelets are part of inflamatuary process in human metabolism. Our findings show that, platelets are affected in GDM. We believe that further studies in this subject will help understanding of pathophysiology of GDM

Biotin deficiency in hyperemesis gravidarum

The aim of this study was to determine the serum biotin levels in patients with hyperemesis gravidarum (HG). Ninety pregnant women with HG (mild (n = 30), moderate (n = 30) and severe (n = 30)), and 80 pregnant women without HG were included for this study. In both groups, serum biotin levels were measured. There were no statistically significant differences in demographic and clinical characteristics between the HG groups and the control group except for PUQE scores. Serum biotin levels in all hyperemesis gravidarum groups were statistically significantly lower than control group. Negative statistically significant correlation between hyperemesis gravidarum severity and serum biotin levels was noted. This is the first study that shows low serum biotin levels in women with hyperemesis gravidarum.Impact statement What is already known on this subject? Almost 80% of pregnant women have nausea and vomiting. If nausea and vomiting became severe and the symptoms combined with weight loss and ketonuria; the diagnosis should be hyperemesis gravidarum (HG). The etiopathogenetic factors of this unwanted condition have not been exactly known. Biotin is an essential water-soluble vitamin. Biotin catabolism increases in pregnancy. Marginal biotin deficiency occurs in approximately 50% of the gestations despite the “normal” biotin intake on the diet. What do the results of this study add? Current study results elucidated that serum biotin levels were lower in HG cases compared to non HG cases. This study is the first study that reports the association between low serum level of biotin and HG. What are the implications of these findings for clinical practice and/or further research? Further research is needed to show the importance of biotin supplementation in women with hyperemesis gravidarum

Amniotic Fluid Ischemia Modified Albumin as a Novel Prenatal Diagnostic Marker for Down Syndrome: A Prospective Case-Control Study

Aims: There is no study in the literature about ischemia-modified albumin (IMA) and hepatocyte growth factor (HGF) levels in amniotic fluid for Down syndrome cases. The aim of this study was to investigate the changes of IMA and HGF in Down syndrome cases at 16-20 weeks of gestation compared to normal fetuses.Methods: For this prospective case-control study, following reaching the number of 20 women (study group) who had the prenatal diagnosis of Down syndrome, maternal and gestational age-matched pregnant women with normal constitutional karyotype were selected for the control group (n = 74) from the stored amniotic fluid samples. Results: Mean women and gestational ages were comparable between the two groups. Amniotic fluid IMA (1.32 ± 0.13 vs. 1.11 ± 0.11 ABSU, respectively, p < 0.001) and HGF (2743.53 ± 1389.28 vs. 2160.12 ± 654.63 pg/mL, respectively, p = 0.008). Levels were significantly higher in pregnant women having Down syndrome fetuses compared with women having normal fetuses. The amniotic fluid IMA levels for the diagnosis of Down syndrome, and the sensitivity and specificity were calculated as 95.0% and 71.6% for the limit value 1.171 cm3, respectively. Conclusion: In cases with suspected Down syndrome, the diagnosis of Down Syndrome may be made in approximately 1 hour with high sensitivity and specificity by measuring the IMA level in the amniotic fluid sample taken for fetal karyotyping

Is resveratrol a potential substitute for leuprolide acetate in experimental endometriosis?

WOS: 000348826200001PubMed: 25462211Objective: Resveratrol, a phytoalexin polyphenol, has anti-angiogenic, antioxidant, anti-inflammatory properties. We aimed to compare the anti-inflammatory and anti-angiogenic effects of resveratrol and leuprolide acetate (LA) in an experimental endometriosis model. Study design: A prospective experimental study was conducted in a University Surgical Research Center. Thirty-three non-pregnant female Sprague-Dawley rats, in which experimental model of endometriosis were surgically induced were randomly divided into four groups. Group 1 was administered 30 mg/kg resveratrol i.m. for 14 days, group 2 was given 1 mg/kg s.c. single dose LA, group 3 was administered both resveratrol and LA, and group 4 had no medication. After two weeks medication rats were sacrificed and size, histopathology and immunreactivity to matrix metalloproteinase (mmp)2, mmp9, vascular endothelial growth factor (VEGF) of the endometriotic implants were evaluated. Plasma and peritoneal fluid levels of interleukin (IL)-6, IL-8, and tumor necrosis factor-alpha (TNF-alpha) were analyzed. Results: the endometriotic implant volumes, histopathological grade and immunreactivity to mmp2, mmp9 and VEGF were significantly reduced (p < 0.001), and plasma and peritoneal fluid levels of IL-6, IL-8 and TNF-alpha were significantly decreased in group 1 and group 2 in comparison to group 3 and group 4 (p < 0.001). Conclusion: Resveratrol alone is a potential agent for the treatment of endometriosis and may be an alternative to LA. in contrast, the combination of LA and resveratrol decreased the anti-inflammatory and anti-angiogenic effects of each agent. Since resveratrol is widely used as an alternative therapy for a variety of conditions, it can undermine the effectiveness of LA. Therefore, caution should be exercised when used in combination with other agents. (C) 2014 Elsevier Ireland Ltd. All rights reserved.Recep Tayyip Erdogan University, Scientific Research Project UnitRecep Tayyip Erdogan University [2012.106.02.3]This study was funded by Recep Tayyip Erdogan University, Scientific Research Project Unit (Project number: 2012.106.02.3)

Tekrarlayan Gebelik Kayıplarında Scube-1 Düzeyinin Ve Karotis İntima Media Kalınlığının Değerlendirilmesi

Objectives: Evaluation of the signal peptide complement C1r/C1s, Uegf, and Bmp1 (CUB), and epidermal growth factor-like domain-containing protein-1 (SCUBE-1) levels and carotid intima media thickness (CIMT) between the group of patients with and without recurrent pregnancy loss (RPL). Materials and Methods: This prospective and single-center study included 20-40-year-old 30 patients with and 30 patients without a history of RPL. No patients with any anatomical, hereditary, or endocrinological thrombophilic defects were included. A comparison of SCUBE-1 levels and CIMT were made between the patient and control groups. Results: There were no statistically significant differences between patients and control groups in terms of demographic characteristics except for gravidity, parity, and miscarriages. The mean SCUBE-1 level in the RPL group was statistically significantly higher compared to the control group (16.44±5.43 vs.10.17±5.19, respectively, p=0.001). The mean CIMT value in RPL patients was statistically significantly higher than that of the control group (0.60±0.09 vs.0.44±0.07, respectively, p=0.001). Conclusion: High levels of serum SCUBE-1 and CIMT in RPL may suggest that ischemia and endothelial dysfunction may be involved in the etiology of RPL. Future studies may shed light on the diagnosis, treatment, and management of RPL.Amaç: Tekrarlayan gebelik kaybı olan hasta grubu ile tekrarlayan gebelik kaybı öyküsü olmayan hasta grubu arasında serum signal peptid C1r/C1s, Uegf, ve Bmp1 (CUB) epidermal growth factor-like domain-containing protein-1 (SCUBE-1) düzeyinin ve karotis intima media kalınlığının değerlendirilmesi. Materyal ve Metot: Prospektif ve tek merkezli çalışmaya 20-40 yaş arasında 30 tekrarlayan gebelik kaybı öyküsü olan, 30 tekrarlayan gebelik kaybı öyküsü olmayan hasta olgusu alınmıştır. Tekrarlayan gebelik kaybı olanlarda ve kontrol grubunda anatomik, kalıtımsal, endokrin, trombofilik defekti olanlar çalışma kapsamına alınmamıştır. Hasta grubu ile kontrol grubu arasında SCUBE-1 düzeyinde ve ölçülen karotis intima media kalınlığı arasında istatistiksel fark olup olmadığı araştırılmıştır. Bulgular: Demografik özellikler açısından hastalar ve kontrol grupları arasında gravite, parite ve düşükler dışında istatistiksel olarak anlamlı fark bulunmamıştır. TGK kaybı olan hastaların ortalama SCUBE1 düzeyleri (16,44±5,43) kontrol grubunun ortalama SCUBE1 düzeylerinden (10,17±5,19) istatistiksel olarak anlamlı şekilde yüksektir (p=0,001). TGK kaybı olan hastaların ortalama CIMT düzeyleri (0,60±0,09) kontrol grubunun ortalama CIMT düzeylerinden (0,44±0,07) istatistiksel olarak anlamlı şekilde yüksektir (p=0,001). Sonuç: TGK olan grupta yüksek serum SCUBE-1 ve CIMT seviyeleri, iskemi ve endotel disfonksiyonunun TGK etiyolojisinde rol oynayabileceğini düşündürebilir. Gelecekteki çalışmalar TGK'nın tanı, tedavi ve yönetimine ışık tutabilir

Disability and psychiatric symptoms in hyperemesis gravidarum patients

Ustuner, Isik/0000-0002-3791-4071WOS: 000329222100011PubMed: 23807698Nausea and vomiting is an important health problem which adversely affects the daily routine and quality of life in pregnant women. the purpose of this study was to measure the level of change in the quality of life, depression and anxiety in hyperemesis gravidarum (HG) patients in relation to social-demographic data and disease variables. One hundred pregnant women hospitalized with the diagnosis of HG were included in the study. A total of 100 healthy pregnant women were also evaluated as the control group. All the patients in the study completed the socio-demographic data form, the Hospital Anxiety and Depression Scale (HADS-A and D) and Brief Disability Questionnaire (BDQ). the mean HADS-D subscale score was 7.09 +/- 3.91 in HG patients and 5.73 +/- A 3.32 in controls. the depression score in the HG patients were significantly higher than that of the control group (p = 0.009). the mean HADS-A subscale score was 7.73 +/- A 3.86, which was significantly higher in HG patients compared to 6.70 +/- A 3.31 in controls (p = 0.045). the mean BDQ score was 11.2 +/- A 4.40 in HG patients and 8.5 +/- A 3.31 in the control group of pregnant women, thus, significantly higher in the HG group as compared to controls (p < 0.0001). in the HADS-D, 52 patients in the HG group and 40 patients in the control group scored above the threshold value (p = 0.089). in the HADS-A, 28 patients in the HG group and 20 in the control group scored above the threshold value (p = 0.185). in patients with HG, a significant deterioration of physical and social health was encountered. HG disease is independent of any underlying psychiatric condition and adversely affects the quality of life of the sufferer

Management of cesarean scar pregnancy with suction curettage: a report of four cases and review of the literature

Ustuner, Isik/0000-0002-3791-4071WOS: 000336394600007PubMed: 24464347To present the outcomes of four cases of cesarean scar pregnancy treated with suction curettage. Four patients were ultrasonographically diagnosed with cesarean scar pregnancies treated with suction curettage in a tertiary care center. Serum beta-human chorionic gonadotropin levels ranged between 1,681 and 15,573 mU/mL, gestational sac diameter measured from 10 to 24 mm and scar thickness was between 4.7 and 6.8 mm. All patients underwent suction curettage under general anesthesia with transabdominal ultrasonography guidance. No complications were observed during or after operation. Suction curettage is a viable alternative for conservative treatment in selected cases of patients who are diagnosed with CSP early in gestation and who have a myometrial thickness of more than 4.5 mm