Is there an association between liver type fatty acid binding protein and severity of preeclampsia?

Objective The aim of this study was to estimate the level of liver fatty acid binding protein (LFABP) in women with preeclampsia. Method A case–control study was conducted in 90 pregnant women who were divided into the following three groups: normal pregnancy (n = 30), mild–moderate preeclampsia (n = 30), and severe preeclampsia (n = 30). Maternal blood samples were obtained during an antenatal clinic visit in normal pregnant women, and at the time of diagnosis in women with preeclampsia. Serum LFABP levels were measured by the quantitative sandwich enzyme immunoassay technique. Results Serum LFABP level was significantly higher in severe and mild–moderate preeclampsia groups than normal pregnancy group (1,709.90 ± 94.82, 1,614.93 ± 118.22, and 1,532.36 ± 140.98 pg/ml, respectively; p\0.001). In multivariate analysis, the severity of preeclampsia was correlated with LFABP level [unadjusted odds ratio (95 % confidence interval), 1.008 (1.003–1.012), p\0.001 and LDH 1.063 (1.029–1.099), p\0.001]. Conclusion Maternal serum LFABP level appears to be correlated with the severity of the preeclampsia and can be used to confirm the diagnosis

Do follicular fluid advanced glycation end products levels affect the ovarian response in unexplained infertility?

Objective: To compare the advanced glycation end products (AGEs) levels in follicular fluid according to the different ovarian responses of women who underwent controlled ovarian stimulation due to unexplained infertility and to examine the relationship between these levels and pregnancy outcomes. Methods: Sixty-three women who underwent fresh IVF/ICSI cycles with GNRH antagonist protocol were divided into 3 groups according to the number of retrieved oocytes as suboptimal (4–9 oocytes), optimal (10–15 oocytes) and high (>15 oocytes) responders. AGEs levels in follicular fluid were measured by ELISA method. Results: AGEs levels were 6.81 ± 2.20 mg/ml, 5.30 ± 2.01 and 6.44 ± 1.43 mg/ml in suboptimal, optimal and high response group, respectively. AGEs level was significantly higher in suboptimal response group than in optimal response group. The cutoff level of 6.19 mg/ml had a sensitivity of 59.3% and a specificity of 66.7% in distinguishing the suboptimal response group from the optimal response group. However, there were no statistically significant difference between AGEs levels and clinical pregnancy and live birth rates. Conclusion: Increased AGEs level in follicular fluid may be associated with decreased ovarian response during controlled ovarian stimulation in unexplained infertility case, however, it does not provide information about pregnancy outcomes

Biochemiczne markery pierwszego trymestru w ciąży bliźniaczej

Objective: Our aim was to investigate the first trimester serum markers and nuchal translucency (NT) measurements in twin pregnancies in our population. Materials and methods: We reviewed the results of all double tests that were performed in our hospital over a three-year period. Out of them, we selected all twins and compared them with a group of three times as many singleton controls. NT measurements and the first trimester serum markers from 49 twin pregnancies were compared to those of 147 pregnant women with normal singleton pregnancy. Results: There were no statistically significant differences in age, gestational age and maternal weight between the two groups (p>0.05). We found similar NT measurements in the two groups. The median MoM of Pregnancy- Associated Plasma Protein A (PAPP-A) and fβ-hCG levels in twins were statistically significantly higher than those in singleton pregnancies. Twelve percent of the twins (12.2 %) were the result of assisted reproduction technologies. IVF versus naturally conceived pregnancies showed similar MoM of PAPP-A (2.2 vs. 1.2, respectively) and fβ-hCG (Mann-Whitney U; p = 0.195 and p = 0.958). Conclusions: Our study revealed that median PAPP-A and fβ-hCG levels for twins were less than twice those of singleton values.Cel pracy: Celem naszego badania było zbadanie surowiczych markerów pierwszego trymestru oraz przezierności karkowej (NT) w ciążach bliźniaczych w naszej populacji. Metoda: Przeanalizowano wyniki wszystkich testów podwójnych wykonanych w naszym szpitalu w ciągu trzech lat. Wyodrębniono grupę ciąż bliźniaczych (n=49) i porównano ją z trzy razy większą grupą kontrolną prawidłowych ciąż pojedynczych (n=147). Wyniki: Nie znaleziono istotnych statystycznie różnic w wieku, wieku ciążowym i masie ciała ciężarnych pomiędzy grupami (p>0,05). Stwierdzono podobne wyniki pomiaru NT w obu badanych grupach. Mediana MoM białka PAPP-A i poziom fβ-hCGw ciążach bliźniaczych był istotnie wyższy niż w ciążach pojedynczych. Dwanaście procent ciąż bliźniaczych było efektem technik wspomaganego rozrodu. Ciąże w wyniku IVF oraz ciąże spontaniczne wykazywały się podobnych wynikiem MoM białka PAPP-A (2,2 vs. 1,2 odpowiednio) i fβ-hCG (Mann-Whitney U; p=0,195 i p=0,958). Wnioski: Średni poziom białka PAPP-A i fβ-hCG dla ciąż bliźniaczych był mniej niż dwa razy większy niż dla pojedynczych ciąż

Laparoscopic Removal of An Ectopic Intrauterine Device From The Anterior Abdominal Wall

The intrauterine devices (IUDs) have been used widely by women of childbearing years. In this report, we presented a case of a 25-year-old gravida 4, parity 3 woman with an abdominal wall penetration by an IUD. She had an IUD (TCu-380A) inserted immediately after dilatation & curettage. The IUD was removed laparoscopically

Recurrent Placental Abruption with Methylenetetrahydrofolate Reductase C667t Heterozygosity: A Case Report

Placental abruption although uncommon, can result in high rate of maternal and fetal morbidity and mortality. Several studies suggest abnormal placental vasculature, thrombosis and reduced placental perfusion in pathophysiology. Genetic variations may predispose to these problems. Case: A thirty year old 28 weeks pregnant women underwent cesarean section with the diagnosis of placental abruption, intrauterine dead fetus and previous cesarean section in our clinic. It was learned that she had a cesarean section due to placental abruption 1 year ago. In the postoperative period trombophilia markers, methylenetetrahydrofolate reductase , Factor V leiden and Prothrombin gene polymorphism, homocystein, folate and vitamin B12 levels and genetic karyotyping were evaluated. The only pathology was the metylenetetrahydrofolate reductase gene heterozygosity for the C to T substitution at nucleotide 677. Risk of recurrence is high in patients with a history of placental abruption. Antenatal care and delivery after fetal lung maturation is advised since the perinatal mortality is high with placental abruption

Evaluation of pain after uterine artery embolization

Objective: In this study our aim was to determine the severity of post procedure pain associated with uterine artery embolization (UAE). Study Design: Twenty-one women with symptomatic uterine fibroid were recruited for the study. The procedure was performed in the angiography unit under conscious sedation. All patients received prophylactic intravenous antibiotics and analgesic, ibuprofen 600 mg. At the completion of the procedure, all patients were given ibuprofen 600 mg orally every six hours. The patients were discharged with oral ibuprofen (600 mg 4 times daily). The main outcome measure was severity of pain. The instrument for evaluation of pain was visual analog scale. The measurements were taken at every hour. Results: Twenty-one procedures were performed. The mean age was 43.04±4.21 years (range 34-52) and median parity was 4 (0-6). The mean post procedure pain scores after 1, 2 and 3 hours were 3.33±2.00, 4.57±1.74, 4.95±1.71 respectively. After the completion of embolization, it was found that pain appeared to peak in the initial 3-4 post-embolization hours, reached a plateau and then declined by 9 hours. Conclusion: There is an increased need for post procedural pain control for UAE patients, especially in the first 6 hours after the procedure.Objective: In this study our aim was to determine the severity of post procedure pain associated with uterine artery embolization (UAE). Study Design: Twenty-one women with symptomatic uterine fibroid were recruited for the study. The procedure was performed in the angiography unit under conscious sedation. All patients received prophylactic intravenous antibiotics and analgesic, ibuprofen 600 mg. At the completion of the procedure, all patients were given ibuprofen 600 mg orally every six hours. The patients were discharged with oral ibuprofen (600 mg 4 times daily). The main outcome measure was severity of pain. The instrument for evaluation of pain was visual analog scale. The measurements were taken at every hour. Results: Twenty-one procedures were performed. The mean age was 43.04±4.21 years (range 34-52) and median parity was 4 (0-6). The mean post procedure pain scores after 1, 2 and 3 hours were 3.33±2.00, 4.57±1.74, 4.95±1.71 respectively. After the completion of embolization, it was found that pain appeared to peak in the initial 3-4 post-embolization hours, reached a plateau and then declined by 9 hours. Conclusion: There is an increased need for post procedural pain control for UAE patients, especially in the first 6 hours after the procedure

Retrospective Analysis of Culture Results of Cases with Acute Vulvovaginitis: University Experience

OBJECTIVE: To analyse the results of the vaginal cultures and find out the prevalence of pathogens in patients with acute vulvovaginitis, retrospectively. STUDY DESIGN: Vaginal cultures results of patients with the diagnosis of acute vulvovaginitis were analyzed retrospectively between June 2005 and January 2006. RESULTS: Totally 241 patients were included in the study within 6 months time period. Mean age of patients was 30,63±6,87 changing between 19 and 57 years. While there was no pathogen detected in 18,3% (44/241) of vaginal cultures, various pathogens growed in 81,7% (197/241) of cultures. Normal vaginal flora was detected in 70,6% (139/197) of cultures with growth. The second most common pathogen was Candida subspecies with a rate of 14,2% (28/197). Other pathogens were Candida albicans, E.coli, Gardnerella vajinalis, Klebsiella pneumonia, Candida subspecies and Klebsiella, Candida albicans and Klebsiella, Candida albicans and Gardnerella vajinalis with a rate of %7,1 (14/197), %4,1 (8/197), %2 (4/197), %0,5 (1/197), %0,5 (1/197), %0,5 (1/197) and %0,5 (1/197) respectively. CONCLUSION: The most frequent pathogen detected in culture of patients with acute vulvovaginitis was candida subspecies in our clinic

Subarachnoid Hemorrhage of Unknown Origin During Pregnancy: Case Report

Subarachnoid hemorrhage (SAH) is a stroke subtype resulting from leakage of blood. The incidence of SAH during pregnancy varies from 1 to 2 per 10000 pregnancies. The most frequent (%85) cause of SAH is a ruptured cerebral aneurysm. A 39-year-old woman at 33 weeks’ gestation experienced abrupt onset of severe headache, neck stiffness, photophobia, and vomiting and was admitted to the hospital and diagnosed as SAH. On neurological examination, no deficits were apparent. A magnetic resonance imaging showed a subarachnoid hemorrhage. Lumbar puncture was performed and SAH was confirmed. It was decided to proceed with a caesarean section. After cesarean delivery of a healthy infant, the patient immediately underwent cerebral angiography, which was normal. Eight days after the initial cerebral angiography, a second angiography demonstrated a suspicious aneurysm and vasospasm; therefore a third angiography was performed and was found normal. At discharge and at clinical follow-up, our patient was asymptomatic. Patients with significant SAH and negative cerebral angiography findings should be considered for further diagnostic testing including repeat cerebral angiography

Did the SARS-CoV-2 effect pregnancy complications?

Objectives: This study aimed to evaluate the effect of SARS-CoV-2 on pregnancy complications, which increased compared to the same period before the pandemic. Material and methods: This prospective study was conducted at Etlik Zübeyde Hanım Women's Health Practices & Research Center between June 2020 and July 2020. The asymptomatic term PROM and miscarriage pregnant women were screened for SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2) positivity by using IgM and IgG antibody tests. All the positive cases were confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). All the patients answered 12 questions to determine their approach to COVID-19. Result: Four of the 205 (2%) term PROM patients had positive anti-SARS-CoV-2 IgM antibody tests, one of the 205 (0.5%) term PROM patients had a positive anti-SARS-CoV-2 IgG antibody test, and one of the 205 (% 0.5) term PROM patients had positive anti-SARS-CoV-2 IgM and IgG antibody tests. All 230 miscarriage patients had negative IgM/IgG antibody tests. Four of the positive antibody cases had positive RT-PCR tests (2%) and were referred to a pandemic hospital. The patients thought that 93.2% and 95.6% of pregnant women with term PROM and miscarriage, respectively, SARS-CoV-2 would infect themselves, and 89.8% and 92.6%, respectively, would infect their children. The number of patients who would not consider pregnancy if they were not pregnant during this period was significantly higher in the term PROM (48.3%) compared to the miscarriage (27.8%) patients (p < 0.005). Conclusions: No COVID-19 cases were determined in the asymptomatic miscarriage patients. In the asymptomatic term PROM patients, the effects of COVID were not observed

Comparison of serum maternal adiponectin concentrations in women with isolated intrauterine growth retardation and intrauterine growth retardation concomitant with pre-eclampsia

Objective: the aim of this study was to compare serum maternal adiponectin concentrations in pregnant women with isolated intrauterine growth retardation (IUGR) and in pregnant women with IUGR concomitant with pre-eclampsia (IUGRcwPE). Material and Methods: Thirty patients with isolated IUGR (group 1), 20 patients with IUGRcwPE (group 2), and 30 healthy controls (group 3) between age 18-40 were included into the study. Venous blood samples of those patients were obtained in the starving state. Adiponectin con- centrations were measured by enzyme-linked immunosorbent assay in serum obtained after centrifugation. To find the differences between the groups, student t-test and one-way ANOVA statistical methods were used. Results: There were no differences between the groups in terms of age, body mass index, gestational age, and parity (p>0.05). the values of amniotic fluid index (p<0.001) and weight gained during pregnancy (p=0.017) were significantly different when compared among the three groups. the mean concentrations of adiponectin were 94.041 pg/mL in the IUGR group, 55.717 pg/mL in the IUGRcwPE group, and 51.831 pg/mL in the control group. Both of the differences between the IUGR and IUGRcwPE groups (p value; <0.05) and IUGR and control groups were statis- tically significant (p value; <0.001). However, there were no significant differences between the IUGRcwPE group and control group (p>0.05). Conclusion: We found that IUGR increased maternal serum adiponectin concentrations; however, this rise does not occur in pregnant women with IUGRcwPE