Decorin levels in early- and late-onset preeclampsia

Objectives: Preeclampsia (PE) is a pregnancy complication caused by typically limited proliferation, apoptosis, migration,and invasion of extra-trophoblast cells. Decorin (DCN) is a decidua-derived transforming growth factor (TGF)-bindingproteoglycan which exerts multiple physiological functions such as collagen fibrillogenesis, myogenesis, angiostasis, andrestraining placental invasiveness by adversely regulate proliferation, migration, and invasiveness of human extravilloustrophoblast cells. Preeclampsia is mainly classified as early- and late-onset PE according to the timing of the disease onset.In the present study, we aimed to investigate the DCN levels in early-onset PE (EOPE, < 34 weeks) and late-onset severe PE(LOPE, ≥ 34 weeks) and uncomplicated pregnancies.Material and methods: In this case-control study, serum samples were obtained from 21 pregnant women with EOPEand 29 pregnant women with LOPE, as well as from 38 healthy controls (n = 12 early-onset controls and n = 26 late-onsetcontrols) with uncomplicated pregnancies.Results: The mean DCN level was statistically significantly higher in the early-onset PE controls than late-onset PE controls(p = 0.040). Although the mean DCN level was higher in the early-onset PE controls than EOPE and LOPE groups, it did notreach statistical significance (p = 0.119 and p = 0.117, respectively).Conclusions: Although DCN has been thought to play a role in the pathophysiology of PE, our study results show that DCNis not a useful predictive marker of EOPE and LOPE. Further large-scale studies are needed to draw a definitive conclusion

Assessment of the relationship of basal serum anti-mullerian hormone levels with oocyte quality and pregnancy outcomes in patients undergoing ICSI

Background: Anti-Mullerian hormone (AMH) is constantly secreted during menstrual cycles and may offer several advantages over traditional biomarkers of ovarian reserve. Objective: To assess the relationship of anti-Mullerian hormone (AMH) values, which are used to evaluate ovary reserves, with oocyte and embryo quality and with ART outcomes in patients undergoing intra-cytoplasmic sperm injection (ICSI). Materials and Methods: This cross sectional study was performed using 50 women undergoing ICSI in IVF center of Zeynep Kamil Women's and Children's Hospital, İstanbul, Turkey. All patients received the long protocol. Follicle-stimulating hormone, luteinizing hormone, estradiol, and AMH levels were measured and antral follicle counts were obtained on the 3rd day of menstruation. A cut-off value based on the number of oocytes was determined for AMH, and women were evaluated after being divided into two groups as bad responders and good responders, according to their AMH levels. Results: Twelve (27.3%) women were in bad responders group and 32 (72.7%) women were in good responders group. AMH measurements were statistically significantly different between the two groups (p<0.01). Based on this significance, the researchers used ROC analysis to estimate a cut-off point for AMH. The researchers detected the good responders with an AMH level 1.90 or above, with 87.50% sensitivity, 66.67% specificity, 87.50% positive prediction, and 66.67% negative prediction (AUC=0.777, p<0.01). Conclusion: Basal AMH levels can be used as an indicator to determine the ovarian response in women undergoing ICSI. AMH can be used to predict the number of mature oocytes that can be collected during treatment and the number of oocytes that can be fertilized. However, AMH is not a valuable tool to evaluate oocyte quality, the development of high-quality embryos, or pregnancy conception

A Prediction Model for Severe COVID-19 Infection and Intensive Care Unit Admission in Pregnant Women

Objective: This study developed a prediction model that can predict the intensive care admission of coronavirus disease-2019 (COVID-19) pregnant and postpartum women. Materials and Methods: The study was retrospective and single-center and was conducted with pregnant and postpartum patients 18 years of age and older who had been diagnosed with COVID-19 and were admitted to the obstetrics clinic between April 2020 and December 2021. The clinical and radiological featuresand laboratory values of the patients were recorded to develop a prediction model. Two different multivariate logistic regression models and the Naive Bayes classification algorithm were used for estimation. The results of the developed prediction models were summarized with the nomogram, and the prediction successes were evaluated with the receiver operating characteristic (ROC) curve. Results: The study included 436 pregnant and postpartum patients. Twelve of 51 patients admitted to the intensive care unit died. The specificities of the three different classification models that we developed to determine the risk factors for intensive care admission were found to be over 95% and their sensitivities were 70.6%, 86.3%, and 87%, respectively. Additionally, the area under the ROC values were found to be 0.94, 0.941 and 0.978 for the models, respectively. High procalcitonin level, fever, dyspnea, and moderate-to-severe radiological involvement were determined as risk factors for admission to intensive care in pregnant and postpartum women patients. Conclusion: It is thought that the risk models we have developed will be easy to implement and will help identify pregnant women who are at risk of severe COVID-19 disease in the early period and to take measures

Reliability and validity of Turkish version of pregnancy physical activity questionnaire (PPAQ) in patients with gestational diabetes mellitus

Gestational diabetes mellitus (GDM) is a common complication during pregnancy. Evaluation of the quantitative physical activity in diabetic pregnant women is critical. The aim of this study was to test the reliability and validity of the Pregnancy Physical Activity Questionnaire (PPAQ) in Turkish patients with GDM. A total of 120 pregnant women between the ages of 18 and 44 years with GDM were included. The reliability of the questionnaire was measured by internal consistency and analysis of 2-week test-retest reliability. Of the patients, 74 completed the test-retest procedure. Concurrent validity was examined by comparing the PPAQ with the Short Form of the International Physical Activity Questionnaire (IPAQ) in 36 patients. Test-retest intraclass correlation coefficient scores varied between 0.72 and 0.95. The Spearman rank correlation analysis showed that the PPAQ total activity values were statistically significantly correlated with the total values of IPAQ-Short Form (r = 0.410 and p = .030). In conclusion, the Turkish version of the PPAQ is a valid and reliable tool for the measurement of the physical activity level of pregnant women with GDM.Impact statement What is already known on this subject? The pregnancy physical activity questionnaire (PPAQ) developed in 2004 by Chasan-Taber et al.; is a simple and short questionnaire measuring the frequency, duration, and intensity of physical activity in pregnant women. To date, this questionnaire has been translated into many languages and has been used in a number of studies. What do the results of this study add? The aim of this study was to test the reliability and validity of the PPAQ in Turkish pregnant women with GDM. On the basis of our study results, we suggest that the Turkish version of the PPAQ is a valid and reliable tool for the measurement of the physical activity level of pregnant women with GDM. What are the implications of these findings for clinical practice and/or further research? Evaluation of the quantitative physical activity in diabetic pregnant women may contribute to gain a better understanding of the role of physical activity during treatment and may be useful to compare the results of different studies carried out in different places more effectively