Renal angiomyolipoma during pregnancy: Case report and literature review [Gebelikte renal anjiomyolipom: Olgu sunumu ve literatürün gözden geçirilmesi]

Renal angiomyolipoma is a rare tumor that can be either sporadic or found together with tuberous sclerosis or pulmonary lymphangioleiomyomatosis. These tumors are hormone sensitive and therefore tend to grow during pregnancy and their main complication is the risk of rupture. Optimal management is still controversial because there are very few cases reported in the literature. We expect that the case of our patient, who delivered her baby vaginally at 36 weeks of gestation and underwent definitive treatment (nephrectomy) thereafter, to further enhance the knowledge about the management of these rare tumors during pregnancy. © 2015, Turkish Society of Obstetrics and Gynecology. All rights reserved

The evaluation of perinatal outcomes in pregnancies complicated with thrombophilias [Trombofili saptanan gebelerde perinatal sonuçlari{dotless}ni{dotless}n degerlendirilmesi]

Objective: In our study we included pregnant patients diagnosed with thrombophilia in whom thromboprophylaxis was initiated and evaluated their perinatal outcomes (pregnancy loss, preeclampsia, low birth weight, preterm labor, and venous thrombosis). We aimed to compare perinatal outcomes of the study group with those of control group with negative thrombophilia screening results. Material and Methods: Pregnant subjects that applied to Obstetrics and Gynecology Department of Çukurova University Faculty of Medicine Hospital between June 2010 and February 2012 were recruited in the study. Patients with a positive thrombophilia screening for primary and secondary recurrent pregnancy loss were initiated a thromboprophylaxia protocol in the first trimester and their demographic backgrounds and past obstetric histories were also recorded. In addition to this, the type of thrombophilia and number of thrombophilia defects were also noted and the route of birth and perinatal outcomes were evaluated prospectively. The control group included patients who had a history of recurrent unexplained miscarriages, with a negative thrombophilia screening. Differences between both groups were statistically significant at a p value <0.05. Results: Sixty patients diagnosed with thrombophilia were included in the study group, while 50 patients with no etiological cause including thrombophilia composed the control group. When the perinatal outcomes were compared; pregnancy loss, development of preeclampsia/eclampsia (p=0.257), rate of low weight baby according to gestational week (p=0.619), preterm birth rate (p=0.232) and the incidence of venous thrombosis (p=0.246) did not differ significantly. The cesarean section rate in the study group was 55% (33-60) and 18% (9/50) in the study group (p=0.000) and the difference was statistically significant between both groups. Conclusion: Our study discovered similar findings and perinatal outcomes in patients with and without thrombophilia. The only significant difference between both groups was the difference in cesarean rates

Differential effect of neocuproine, a copper(I) chelator, on contractile activity in isolated ovariectomized non-pregnant rat, pregnant rat and pregnant human uterus

PubMedID: 19248249The study was conducted to examine effects of a selective copper(I) chelator, neocuproine on the spontaneous or oxytocin-induced contractions in isolated ovariectomized non-pregnant rat, pregnant rat and pregnant human uterus. Uterus activity was evaluated in tissues obtained from bilaterally ovariectomized non-pregnant rats on the 21st day of the operation (n = 24), pregnant rats on the 19-21st day of gestation (n = 24) and women undergoing caesarean section at 38-42 weeks of pregnancy (n = 15). Neocuproine (100 µM) significantly suppressed the amplitude and frequency of the spontaneous contractions in the ovariectomized non-pregnant rat uterus while this agent facilitated the frequency of the spontaneous or oxytocin-induced contractions in the pregnant rat and human uterus without altering the amplitude of these contractions. At high concentration of 200 µM, neocuproine could enhance the amplitude of the contractions in the pregnant uterus. These effects were blocked by a purinergic receptor antagonist, suramin (100 µM) and did not occur following the administration of neocuproine-copper(I) complex or copper(II) chelator cuprizone. ?,ß-methylene ATP increased the amplitude and frequency of contractions in the pregnant uterus, but not affected the contractions in the ovariectomized non-pregnant rat uterus, and neocuproine potentiated this facilitation effect. However, the suppressive effect of neocuproine on the ovariectomized non-pregnant rat uterus increased in the presence of ?,ß-methylene ATP. ß-adrenoceptor blocker, propranolol or nitric oxide synthase inhibitor, l-nitroarginine did not affect the responses to neocuproine. These findings suggest that neocuproine can affect the uterus contractile activity by modulation purinergic excitatory responses and that copper(I)-sensitive mechanisms may play a role in this effect. © 2008 Elsevier B.V. All rights reserved.TF 2005 BAP15The authors wish to thank Ahmet Kantur and Zeynep Akıllı from the same department for their technical assistance. The authors are indebted to Çukurova University Experimental Research Center (TIPDAM) for the supply of rats. This work was supported by the Çukurova University Research Foundation (TF 2005 BAP15)

The effects of the epidural analgesia on the progress of the labor and labor outcome at different degrees of cervical dilatation [Primipar olgularda degişik servikal açikliklarda uygulanan epidural analjezinin travay süresi ve dogum eylemi üzerine etkileri]

Recently, different results have been reported that epidural analgesia prolongs labor, increases instrumental vaginal delivery and operative delivery. The purpose of the present study was to determine the effects of the epidural analgesia on the progress of labor and labor outcome at different degrees of cervical dilatation. After approval by the ethical committee, a total of 136 patients scheduled for vaginal delivery were divided into 2 groups. Each group divided into 3 subgroups according to the degree of cervical dilatation. In these subgroups; the degree of cervical dilatation was &lt; 4 cm in group Ia and IIa, 4-5 cm in group Ib and IIb and &gt;5 cm in group Ic and IIc. Epidural catheters were placed for analgesia in group I. Group II was not given any analgesic therapy during labor. Group I parturient received an epidural injection of 12.5 mg (0.125 %) bupivacaine + 50 µg fentanyl. Then they received 0.125 % bupivacaine with 2.5 µg ml-1 fentanyl via patient controlled analgesia (PCA). Patient controlled epidural analgesia (PCEA) background infusion was launched at a rate of 10 mL hour-1. Patients receiving PCEA were allowed to administer themselves a bolus dose of 5 mLevery 30 min as needed. Demographic data, number of pregnancy, degree of cervical dilatation, latent and active phases of the-labor (in the first and in the second stage), and duration of total stage of the labor was recorded. Additionally, systolic- diastolic blood pressure (SBP-DBP), fetal (FHR) and maternal (HR) heart rates and peripheral oxygen saturation (SpO2) were also assessed. However, duration of the first and total stage of the labor was found significantly shorter in epidural subgroups duration of latent phase of the labor was similar between two groups. (p &lt; 0.05). Although duration of the second stage of the labor was found shorter in all epidural subgroups, it was statistically not significant. It was found that the incidence of instrumental vaginal delivery and frequency of Caesarean section was not significant between two groups. In conclusion; epidural analgesia applied at different cervical dilatations, shortened the duration of the first stage and total duration of the labor, but it did not change the duration of the second stage of the labor. Epidural analgesia did not cause an increase in the incidence of instrumental vaginal delivery and the frequency of Caesarean section

Fraser syndrome

PubMedID: 7649327In a consanguineous marriage, a woman at 32 weeks' pregnancy presented with intrauterine growth retardation and bilateral renal agenesis. Fraser syndrome (cryptophthalmus syndactyly syndrome) was diagnosed based on cryptophthalmos, atresia of meatus acusticus externus in auricula, syndactyly, hypoplastic larynx, hypoplastic left lung, agenesis of urinary system and aberrant pancreas in duodenum. The syndrome is inherited as a recessive trait and the risk of recurrence is 25%. © 1995

Factors that influence morbidity and mortality in severe preeclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count syndrome

PubMedID: 16830022Objective: To evaluate the prognostic factors affecting morbidity and mortality in severe preeclampsia, eclampsia and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome cases. Methods: We retrospectively evaluated, 2245 cases who delivered in the Department of Obstetrics and Gynecology, Faculty of Medicine, Cukurova University, Turkey between January and December 2002. Ninety-three cases had severe preeclampsia, 26 cases eclampsia, 19 cases HELLP syndrome, and 6 cases with eclampsia and HELLP syndrome were included in this study. The pregnancy induced hypertension cases were evaluated retrospectively for socioeconomic status, obstetrical history, biochemical parameters, and maternal complications. Results: The incidence of preeclampsia was 20.1% (453/2245), the incidence of severe preeclampsia, eclampsia, and HELLP syndrome was 6.4% (144/2245). These ratios are higher than that reported in the English literature. The complication rate was 38% in severe preeclampsia cases. Among the severe preeclampsia cases, 32 had eclampsia (22.1%), and 25 had HELLP syndrome (17.3%). Conclusion: The most important biochemical marker for maternal mortality is bilirubin levels. Maternal mortality was statistically higher in cases with jaundice. Also, there was a statistically significant relation between maternal complications and liver function tests, lactate dehydrogenase levels, and low platelet levels

Prenatal diagnosis of placental teratoma: A case report

PubMedID: 19604620[No abstract available

Incidence of Mycoplasma and group B streptococci in the genitourinary system of pregnant women and their effect on pregnancy [Gebe kadinlarin genitoüriner sistemlerinde Mycoplasma ve B grubu streptokoklarin insidansi ile gebelige etkileri.]

PubMedID: 1528145This study included 59 pregnant women and their mature infants born in term in order to establish the incidence of potential microorganisms that may transmit through the birth canal to infant and the evidence for vertical transmission in pregnancy. Using isolation studies based on selective methods, it was found that U.urealyticum had the highest incidence with 26 (44%) and Diphtheroid was isolated from 19 (32.2%), Staphylococcus from 17 (28.8%), M.hominis from 16 (27.1%), group B Streptococcus from 8 (13.6%) of genital canal specimens, respectively. It was also found that E.coli with a carriage rate of 6 (50%), M.hominis with 4 (25%) and Diphtheroid with 4 (21%) were transmitted through the birth canal to infant and colonized the conjunctiva and face of infant at birth

Angiographic treatment of the arteriovenous malformation occurred after caesarean section [Sezaryen sonrasi geli·şmi·ş arteri·ovenöz malformasyonun anji·ografi·k olarak tedavi·?i]

Introduction: Uterine arteriovenous malformations are classified as acquired or congenital. Caesarean section which is performed more frequently on nowadays, uterine curettage and other uterine surgeries are the most common causes of the acquired arteriovenous malformations. Case: Twenty-two years old woman delivered her second child by caesarean section, due to history of caesarean section, was admitted with complaint of profuse vaginal bleeding 15 days after the surgery. She demonstrated the clinical features of the hypovolemic shock. At first she treated with four units of red blood suspension, two units of fresh frozen plasma and rapid infusion of the fluids. On endometrial curettage only blood and coagulum were obtained. The bleeding could only be controlled by the internal pressure of the 18 F Foley catheter. Doppler analyze of the uterus revealed a vascular malformation signifying a turbulent flow pattern with low pressure and high flow rate. A unilateral uterine artery embolization was performed to her and her menstruel cycles are restarted at the fifth month of the puerperium. Discussion: The clinical presentation of the uterine arteriovenous malformations depends on the localization and the dimensions of the malformation. The uterine arteriovenous malformation should be kept in mind in cases of late occurrence vaginal bleeding unresponsive to the uterotonic medications, especially in a woman with previous history of uterine damage, like curettage or caesarean section

Acute bilateral temporomandibular joint dislocation; An unusual complication of hyperemesis gravidarum: Case report [Hiperemezis gravidaruma bagli alişilmadik bir komplikasyon; Akut bilateral temporomandibuler eklem dislokasyonu]

Hyperemesis gravidarum, is the most severe form of pregnancy induced nausea-vomiting. More than 5% weight loss, electrolyte imbalance, acetonuria and oliguria can be seen in the patients. Up to date, infrequent complications like Wernicke encephalopathy, eyeball subluxation, esophageal ruptures and pneumothorax have been reported. Although the frequency of the temporomandibular joint disorders does not change during pregnancy, in the presented case, a temporomandibular dislocation has been developed due to hyperemesis gravidarum. The disorder, known as displacement of the mandibular condyle outside the glenoid fossa, mainly occurs during movements which force the joint for hyperextension. To the best of our knowledge, regarding to this condition, a first has been described in our case. Copyright © 2013 by Tükiye Klinikleri