Skuteczność oznaczania parametrów morfologii w diagnostyce ciąży ektopowej jajowodowej

Objective: Ectopic pregnancy (EP) is the major cause of maternal morbidity and is responsible for maternal mortality in the first trimester. In order to reduce undesirable results, it is necessary to find rapid and accurate, non-surgical diagnostic tests for EP. The goal of the study was to investigate the differences in complete blood count parameters between tubal EPs and healthy pregnancies in be used in the diagnosis of ectopic pregnancy. Study design: White blood cell (WBC), neutrophil, monocyte, lymphocyte, platelet (PLT) counts, mean PLT volume (MPV) and PLT distribution width (PDW) levels in the complete blood count samples have been obtained from subjects with diagnosed tubal EP (n=78; study group) and women with healthy intrauterine gestations (n=79; control group). Statistical comparisons between groups were performed using the t test. Results: PDW levels were found to be significantly higher in the control group than EP (pCel: Ciąża ektopowa (EP) jest główną przyczyną śmiertelności matek w pierwszym trymestrze ciąży. Aby zmniejszyć niekorzystne wyniki tej choroby, konieczne jest znalezienie szybkiego i właściwego testu nieoperacyjnego służącego do rozpoznania EP. Celem badania była ocena różnic w wynikach morfologii pomiędzy pacjentkami z ciążą ektopową a zdrowymi ciężarnymi. Materiał i metoda: W próbkach pełnej krwi zbadano następujące parametry: leukocyty (WBC), neutrofile, monocyty, limfocyty, płytki krwi (PLT), średnią objętość płytki krwi (MPV), szerokość rozdziału płytek (PDW) u pacjentek z rozpoznaną ciążą jajowodową (n=78, grupa badana) oraz u zdrowych ciężarnych (n=79, grupa kontrolna). Analiza statystyczna porównująca obie grupy została wykonana przy pomocy testu t. Wyniki: PDW był istotnie wyższy w grupie kontrolnej niż w grupie EP (

İleri yaş gebeliklerde amniyosenteze yaklaşım

Aim: To determine the rates of amniocentesis indications and karyotype results of the five-year data in our center and to evaluate the approach to amniocentesis in pregnancies with advanced age. Material and Method: Between 2008 and 2012, 307 cases of amniocentesis were evaluated retrospectively. Indications were classified as advanced maternal age, increased risk on screening test, advanced maternal age with increased risk on screening test, abnormal ultrasound findings, and others. Cytogenetic findings were classified as normal and abnormal. Maternal age was also classified as older than 35 years old and others. the relation of abnormal karyotype with indications and age was analyzed by chi-square test. Results: Increased risk on screening test (37.8%), advanced maternal age (32.6%), advanced maternal age and the positive screening test (20.8%) were the indications. Cell culture was not successful in 4 cases. Abnormal karyotype was detected in the 26(8.5%) of 303 patients. the frequency of anomalies was not different in terms of the maternal age and the indications. However, in the group with advanced maternal age and increased risk screening test, the detection rate of trisomy 21 was higher. Conclusion: in the course of amniocentesis decision in advanced age pregnancies; the use of ultrasound and biochemical diagnostic methods increases the potential for detection of anomaly. Patients should be illuminated enough about it, and all the facilities of medicine should be used when deciding on the indication.Amaç: Merkezimizdeki beş yıllık amniyosentez verilerinden yola çıkarak endikasyonlara ve yaşa göre anomali dağılımını incelemek. İleri yaş gebeliklerde amniyosenteze yaklaşımı irdelemek. Gereç ve Yöntem: 2008-2012 tarihleri arasında amniyosentez uygulanmış 307 olgu retrospektif değerlendirildi. Endikasyonlar; ileri maternal yaş, tarama testinde risk artışı, ileri maternal yaş ve tarama testinde risk artışı, anormal ultrason bulguları ve diğerleri şeklinde sınıflandı. Sitogenetik bulgular, normal ve anormal olarak sınıflandı. Normal varyasyonlar, normal grubunda değerlendirildi. Anne yaşı ayrıca 35 yaş altı ve 35 yaş ve üstü olarak sınıflandı. Anormal karyotip sonuçları ile endikasyon ve yaş arasındadaki ilişki ki- kare testi ile incelendi. Bulgular: Tarama testinde risk artışı( %37.8), ileri maternal yaş (%32.6), ileri maternal yaş ve tarama testinde risk artışı (%20.8) izlenen endikasyonlardı. Dört olguda kültürde üreme olmadı. Değerlendirmeye alınan 303 olgunun 26 sında (%8.5) anormal karyotip tespit edildi. Otuzbeş yaş altı ve üstünde anomali sıklığı; ve endikasyonlara göre kromozom anomalisi yakalama oranları benzerdi. Ancak, ileri maternal yaş ve tarama testinde risk artışı olan grupta trizomi 21 yakalama oranının daha fazla olduğu görüldü. Sonuç: İleri yaş gebeliklerde amniyosentez kararı verirken; biyokimyasal tanı yöntemleri ve ultrasonografinin kullanılması, anomali yakalama oranını artıracaktır. Hastalar bu konuda yeterli aydınlatılmalı ve karar verirken tıbbın tüm olanakları kullanılmalıdır

The association of HLA-G and immune markers in recurrent miscarriages

WOS: 000377257600028PubMed ID: 26513380Objective: To determine role of human leukocyte antigen (HLA)-G, CD8, CD16, CD56, interferon (IFN)-gamma, and tumor necrosis factor (TNF)-alpha for recurrent miscarriages in feto-maternal interface. Method: Chorion and decidua samples were obtained from 11 women with unwanted pregnancies (healthy pregnancy, HP) and 10 women with missed abortion diagnosis after at least two pregnancy losses (recurrent miscarriage, RM). In addition, endometrial tissues were obtained from 10 non-pregnant women (NonP). The expressions of markers were evaluated using the Western blot analysis. The values obtained between different groups were compared. Results: The highest protein expression of CD56 was found in the HP compared to NonP and RM. Meanwhile, the lowest protein expression of CD16 was observed in the NonP compared to HP and RM. The HLA-G expression exhibited the highest level in HP; however, there was no statistically significant difference between groups. CD8 and IFN gamma expressions were lowest in the NonP group; however, TNF-alpha was highest in the RM group. Conclusions: The CD56 expression of uterine NK cells may be an indicator of a HP. However, not statistically significant, the increased expression of CD16, CD8, and also significantly increased expression of TNF may be associated with the predominant cytotoxic activity in the maternal immune system in patients with RM. Although there was no change in the expression of HLA-G, this finding may mean that the maternal immune system is unresponsive to HLA-G-mediated immunosuppressive signals originating from the fetus in these cases.Scientific Research Projects Commission of Celal Bayar UniversityCelal Bayar University [2013/125]The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. The Scientific Research Projects Commission of Celal Bayar University supported the project for this study, whose reference number is 2013/125