Systemic lupus erythematosus and pregnancy

We present a retrospective study of 42 consecutive cases of systemic lupus erythematosus (SLE) and pregnancy followed and delivered during the period 2002-2007 in our department. The mean patient age was 28.6 years and the nulliparity rate was 45.2%. Disease flare up occurred in 9.5% of patients. Lupus anticoagulants, anticardiolipin IgG and IgM antibodies were positive in 33%, 16.6% and 19% of patients, respectively. Mean gestational age at delivery was 36.9 +/- 4.2 and mean birth weight was 2,750 +/- 844 g. Stillbirth, fetal growth restriction, pre-eclampsia and pre-term delivery rates were 7.1%, 14.3%, 2.4% and 23.1%, respectively. Cases with uterine artery Doppler abnormalities had significantly poorer obstetric outcomes. Antiphospholipid antibodies, renal involvement and lupus activation did not have any significant influence on poor obstetric outcome. Multidisciplinary approach to the care of pregnant women with SLE is mandatory for good maternal and fetal outcomes. Uterine artery Doppler seems to be a good prognostic factor for adverse obstetric outcomes

Characteristics and outcome of 102 fetuses with fetal cerebral ventriculomegaly: Experience of a university hospital in Turkey

The aim of this study was to evaluate the incidence of associated structural anomalies and the outcome of fetuses with ventriculomegaly. We retrospectively collected 102 cases of antenatally diagnosed ventriculomegaly examined between 2000 and 2008. Ventricular width measurements were 10-12 mm, 12.1-14.9 mm and >= 15 mm in 24.5%, 20.6% and 54.9% of the cases, respectively. Associated structural malformations were detected in 77.4% of the fetuses. Mortality rate of fetuses with associated malformations and isolated ventriculomegaly was 86.1% and 55.7%, respectively (p = 15 mm) cases (p 12 months of age, without morbidity. Our results suggest that the prognosis of fetuses with ventriculomegaly mainly depends on the aetiology and on the presence of associated abnormalities. Fetuses with mild isolated ventriculomegaly have a favourable outcome

False-negative scintigraphy with Tc-99m sestamibi in stage IV neuroblastoma

WOS: 000079440800011PubMed ID: 10466525Tc-99m sestamibi, originally developed for myocardial studies, has been used as a tumor-seeking agent. Recently, the agent also was reported to be a functional tracer to predict multidrug resistance-related p-glycoprotein expression in tumor tissue. The current report presents the authors' experience with sestamibi tumor scintigraphy in a neuroblastoma. Although I-131 MIBG tumor imaging and Tc-99m MDP bone scanning accurately demonstrated the extent of the disease, Tc-99m sestamibi showed no accumulation in primary and metastatic foci. Lack of sestamibi uptake was initially thought to be suggestive of failure to respond to chemotherapy because of p-glycoprotein expression. However, the patient responded well to chemotherapy and complete remission was achieved. The failure of Tc-99m sestamibi to detect a neuroblastoma and the lack of sestamibi accumulation in the tumor may not always be related to chemotherapy resistance

The relationship between placental elasticity and prenatal serum screening markers and Doppler indices

It has been shown that placental elasticity values were higher in pregnant women with preeclampsia and intrauterine growth restriction. The studies have been reported that prenatal serum screening markers and uterine artery Doppler parameters could be useful in the prediction of preeclampsia and intrauterine growth restriction. In this study, we aimed to investigate the relationship between placental elasticity values and these serum markers and Doppler indices in the first and second-trimester. 108 cases between 11-14 gestational weeks were enrolled for this study. Placental elasticity measurements were performed after the first-trimester combined test and Doppler assessment. The same procedures were repeated with the second-trimester triple test for 71 pregnant women who were followed-up. Correlation analysis of demographic characteristics, biochemical parameters and Doppler findings with placental elasticity values were performed. In the first-trimester, we found a statistically significant and positive correlation between placental elasticity values and bilateral uterine artery notching (r =0.193, p =0.045) and mean arterial pressure (r =0.398, p <0.001). Likewise, positive correlation was found between placental elasticity values and bilateral uterine artery notching (r =0.303, p =0.023) and mean arterial pressure (r =0.274, p =0.041) in the second-trimester. Our study showed that placental elasticity values were positively correlated with mean arterial pressure and bilateral uterine artery notching in the first and second-trimesters. In light of these findings, the utility of placental elasticity measurement in early gestation to predict pathologies due to insufficient placentation has to be proven with comprehensive studies. © 2020, Yuzuncu Yil Universitesi Tip Fakultesi. All rights reserved

The surgical outcomes of abdominal radical trachelectomy: does transrectal ultrasonography determine the cervical incision site during surgery?

Purpose: To evaluate the surgical outcomes of abdominal radical trachelectomy(ART) and the efficacy of transrectal ultrasonography in determining the upper end of cervical incision during this operation. Materials and Methods: ART was performed in five patients with early-stage cervical cancer in the present clinic. In the first three patients, uterine corpus was transacted blindly at a level of approximately five mm below the internal os. In the last two patients, the authors performed transrectal ultrasonography before vaginal incision to evaluate the distance between upper margin of tumoral mass and internal os of cervical canal. Results: Mean follow-up was 21 months. During this period, menstrual abnormality occurred in three patients. The two patients in which transrectal ultrasonographies were taken intraoperatively had 9- and 12-mm postoperative cervical canal length and both of them were asymptomatic postoperatively. Conclusions: ART is usually associated with menstrual abnormality at late postoperative period and transrectal ultrasonograph during this procedure may decrease postoperative morbidity

Iodine status of pregnant women in a metropolitan city which proved to be an iodine-sufficient area. Is mandatory salt iodisation enough for pregnant women?

PubMed ID: 26489983The objective of this study was to assess the iodine status of pregnant women in a metropolitan city which was stated as iodine sufficient area after salt iodination program. This multicenter, cross-sectional study was carried out on 3543 pregnant women. Age, gestational weeks, smoking, consumption of iodized salt, dietary salt restriction, history of stillbirth, abortus and congenital malformations were questioned. Spot urine samples were analyzed for urine iodine concentration (UIC). The outcomes were: (a) median UIC in three trimesters of pregnancy and (b) frequency of ID among pregnant women. The median UIC was 73 ?g/L. The median UIC was 77 ?g/L (1-324), 73 ?g/L (1-600) and 70 ?g/L (1-1650) in three trimesters of pregnancy, respectively (p: 0.14). UIC <50 ?g/L was observed in 36.6% (n: 1295) and UIC<150 ?g/L was observed in 90.7% (n: 3214) of pregnant women. Only 1% (n: 34) of the pregnant women had UIC levels higher than 500 ?g/L. This study showed that more than 90% of the pregnant women in this iodine-sufficient city are facing some degree of iodine deficiency during their pregnancy. A salt iodization program might be satisfactory for the non-pregnant population, but it seems to be insufficient for the pregnant population. © 2015 Taylor & Francis

Significance of serum c-erbB-2 oncoprotein, insulin-like growth factor-1 and vascular endothelial growth factor levels in ovarian cancer

OBJECTIVES: Our aim was to determine the predictive values of serum levels of several growth factors in ovarian cancer, including soluble c-erbB-2 oncoprotein, insulin-like growth factor-1 (IGF-1) and vascular endothelial growth factor (VEGF)