Gestational diabetes mellitus is as innocent as you think?

Background: We aimed to compare fetal outcomes, fetal hypoxia, acidemia and maternal chracteristics including hemoglobin A1c, doppler indices between gestational diabetes mellitus (GDM) and pregestational diabetes mellitus (DM) among pregnant women treated with insulin.Methods: Data of pregnant patients with diagnosis of pregestational diabetes (type 1 and 2) and GDM who were treated with insulin (GDM A2 in White classification) was retrospectively collected and compared. Patients with active chronic systemic disease, multiple pregnancies, lost to follow up and detected fetal malformations were exluded. Maternal characteristics, umbilical doppler indices and amnion fluid index, gestational age at delivery, delivery characteristics (including vaginal delivery, or cesarean section) and newborn characteristics such as birth weight, Apgar score and umblical cord pH were all recorded.Results: A total of 130 patients (67 patients with GDM and 63 pregestational DM) were recruited to the study. There were no significant difference regarding type of delivery, fetal birth weight, umbilical cord Hb and gestational birth age. No other significant difference in frequency of low Apgar scores and fetal acidosis or metabolic acidosis were reported. HbA1c and blood glucose levels and insulin dosage were significantly statistically higher in pregestational group.Conclusions: The frequency of fetal distress parameters and poor fetal outcome were similar between groups although pregestaional diabetic patients had higher HbA1c rates. Therefore, patients with GDM (A2) should be followed up as closely as pregestational (overt) diabetic patients

Level of anxiety, depression, self-esteem and quality of life among the women with vaginitis

Background: Present aim is to evaluate anxiety, depression, quality of life and self-esteem in patients with vaginitis (not only specific to candidasis) and also to determine factors affecting vaginitis such as demographic, cultural and psychological causes.Methods: Each patient completed a self-administered questionnaire (Rosenberg’ Self-Esteem Scale, Short-Form 36, Quality of Life Scale, Beck Anxiety Inventory, and Beck Depression Inventory, Body Image Scale) and underwent a careful examination of the vulva and vagina. The cross-sectional study was carried out with two groups. The first group consisted of 107 women between the ages 18 and 45 years and had no physical disease but reccurrent vulvovaginitis (≥4 in a year).  The comparison control group consisted of 94 healthy (no vaginitis symptoms in 12 months) age matched volunteer participants.Results: Women with vaginitis had significantly higher anxiety and depression scores. There was no statistically significant difference in body image scale. Regarding type of marriage, arranged type was statistically significantly higher in vaginitis group while flirting type was statistically higher in control group. University school degree and income was statistically significantly lower in vaginitis group. Living residence as rent and vaginal douch was statistically significantly higher in vaginitis group.Conclusions: A better detailed history should be taken into consideration for personal stress sources and treatment support should be provided for patients with vaginitis. Not only gynecologists but also a multidisciplinary team should take part in the treatment and follow up of the patients to cope with recurrency even in non-specific vaginitis

Surgical Removal of an Extrauterine Device Migrating to Appendix

Intrauterine devices (IUDs) remain highly effective reversible family planning methods in developing countries. We aimed to report one of the complications of extrauterine and intrauterine devices. A 44-year-old woman was admitted to our hospital with mislocated intrauterine device and abnormal uterine bleeding. Extrauterine IUD device was proven by ultrasound and X-ray. She had normal blood test count with a negative pregnancy test. There are several cases of complications with intrauterine devices, but this is the first case report about an extrauterine IUD embedded by inflame enlarged appendix presenting with abnormal uterine bleeding. Although intrauterine devices are a common safe method for contraception, there is no risk-free insertion even with advanced ultrasounds. A regular self-examination should be taught to the patients and ultrasonography should be performed in the follow-up of the patients especially for inserted devices during lactation period. Extrauterine IUDs can be successfully removed by laparotomy

Relationship between first trimester vaginal bleeding and the risk of placental abruption

The aim of this study was to analyze influence of first trimester vaginal bleeding on the risk of placental abruption, as well as to assess the relation of first trimester bleeding and perinatal outcome in this patients with placental abruption. The second objective was to assess the connection of first trimester bleeding with low pregnancy-associated plasma protein-A and maternal serum alpha-fetoprotein with placental abruption. This is the first study that evaluated all relations these analytes in placental abruption with first trimester bleeding. Spontaneous, singleton pregnancies with live fetus ≥26 weeks of gestation with placental abruption were divided into two groups based on their prensence of first-trimester bleeding (Group 1) or without (Group 2). Maternal age, parity, smoking habits, body mass index, history of abortion and abruption, levels of pregnancy-associated plasma protein-A and Alpha-fetoprotein were also analyzed and compared. Main outcome measures were, mean gestational age, gender of baby, APGAR scores, birth length and weight and cesarean section rates. A total of 122 patients were included in the study.There were 44 patients accompanied with first trimester bleeding (group 1) and 78 patients without first trimester bleeding (group 2). The neonatal birthweight was significantly lower in first trimester bleeding group. The rate of smoking mother was significantly higher in first trimester bleeding group. Regarding serum maternal biomarkers, pregnancy-associated plasma protein-A≤0.5 and Alpha-fetoprotein ≥2 MOM was significantly higher in first trimester bleeding group.First trimester bleeding should alert clinicians for the signs of later possible complications in addition to low regnancy-associated plasma protein-A(≤0.5 MOM) and higher Alpha-fetoprotein (≥2 MOM) levels. Presence of vaginal bleeding in first trimester are related with poor maternal and fetal outcome at birth in patient with placental abruption. [Med-Science 2018; 7(3.000): 660-3

Is there any relationship between low PAPP-A levels and measures of umbilical vein and placental thickness during first trimester of pregnancy?

OBJECTIVE: Low pregnancy-associated plasma protein A (PAPP-A) level is associated with adverse perinatal outcomes. The purpose of this study was to evaluate relationship between umbilical cord diameter (UCD), umbilical vein and artery diameters (UVD, UAD), placental thickness, and PAPP-A level at gestational age of between 11 and 14 weeks

Is there a relationship between high birth weight and umbilical vein diameter?

WOS: 000579909200001PubMed: 33081536Objective the aim of the study was to evaluate the associations between sonographical measurements of the umbilical cord and birth weight in 20-24 weeks of gestations. Methods This cross-sectional study was conducted with the participation of 220 low-risk pregnant women between 20-24 gestational weeks. Biparietal diameter, head and abdominal circumference, and femur length were measured for anthropometric calculations. Umbilical cord including umbilical vein diameters, placental thickness, umbilical artery. Doppler measurements (RI, PI) were recorded. Results in accordance with the results of statistical computations, an inverse relationship was found between umbilical vein diameter and birth weight of a large gestational age (LGA) newborn in 20-24 gestational weeks (p < .05). There was no significant relationship between other parameters and birth weight of LGA newborns. Conclusion There is an inverse relationship between birth weights of newborns with LGA and umbilical vein diamater at 20-24 weeks of pregnancy. the umbilical vein diameter in the second trimester may be a promising measurement on predicting LGA fetus. the researches have not confirmed the physiopathology of this finding yet, but it is paving the path for future studies

A comparison of two different oral contraceptives in patients with severe primary dysmenorrhoea

Pain relief of two different oral contraceptive pills (OCPs) in severe primary dysmenorrhoea (PD) was compared. Sixty-six nulliparous patients with severe PD requiring contraception were evaluated. Group 1 comprised 33 healthy controls. Patients with severe PD were divided into two groups. Patients in Group 2 were administered oestradiol valerate/dienogest and patients in Group 3 were administered ethinylestradiol/drospirenone. Doppler indices of both uterine arteries (left and right) including systolic/diastolicrates (S/D), pulsatility index (PI) and resistance index (RI) were measured, and a visual analogue scale (VAS) was applied to patients before treatment. VAS scores and Doppler indices were repeated after 3 months of OCP treatment and the changes in values were compared. The demographic and clinical characteristics of the patients were similar. The mean value of RI was significantly lower after therapy in Groups 2 and 3 in the right and left uterine arteries (p = .001 and p = .039, respectively)

Evaluation of fetal serum thiol/disulphide homeostasis in deliveries complicated by nuchal cord

Aim: To investigate the serum thiol/disulphide homeostasis in deliveries complicated by nuchal cord (NC) and to compare the results with healthy deliveries (without NC). Methods: This prospective controlled study included 48 pregnant women complicated by NC and 48 similar gestational aged healthy pregnant women during labor. Fetal umbilical cord serum samples were collected during labor and the thiol/disulphide homeostasis was measured by using an automated assay method. The patients were followed up until end of the delivery and perinatal outcomes were recorded. Results: Fetal umbilical cord native thiol, total thiol, and disulphide levels as well as disulphide/native thiol and disulphide/total thiol ratios are impaired in labor with the presence of NC. There were no statistically significant differences in terms of maternal and gestational age at delivery and maternal number of gravida and parity, fetal gender, fifth Apgar scores <7, mode of delivery and fetal birth weight between groups. The group of patients with NC had higher emergency C/S numbers indicated for fetal distress and lower first Apgar scores Conclusions: Maternal serum thiol/disulphide homeostasis reflect transient effects of NC during labor regardless of labor type. Vaginal delivery can be safely and successfully performed in pregnancies complicated with NC

Quality of life in patients with recurrent aphthous stomatitis treated with a mucoadhesive patch containing citrus essential oil

Purpose: To assess 1) patient satisfaction of a mucoadhesive biopatch with citrus essential oil and 2) the change in pain severity and the oral health-related quality of life in patients with recurrent aphthous stomatitis

Evaluation of thiol/disulphide homeostasis as a novel predictor testing tool of early pregnancy viability

Objective: To evaluate serum dynamic thiol/disulphide concentrations in patients with suspected missed abortion (MA) and to determine whether this ratio has a predictive role in the viability in these pregnancies