Spontaneous rupture of unscarred uterus at 27 weeks of gestation

Spontaneous rupture of a gravid uterus is a life-threatening obstetric emergency with high maternal mortality and morbidity, perinatal mortality and loss of future fertility as hysterectomy maybe inevitable in most cases. Most spontaneous uterine ruptures occur during labor in parturients with a scarred uterus. Rupture of unscarred uterus is a rare event involving 1/17,000 - 20,0000 and occur more frequently in older multiparous patients [1 - 3]. Here, we present a case of spontaneous rupture of uterus in a primigravid woman which was successfully repaired

Spontaneous Pneuomothorax in A Pregnant Patient Leading to Fetal Demise

Spontaneous pneumothorax rarely occurs during pregnancy. The most common cause is the rupture of a subpleural apical bulla or bleb, due to the increased respiratory demand of the peripartum period. Respiratory failure is the main risk for the mother; fetal risks include reduction in oxygen supply and preterm labor. Here, we present a case of spontaneous pneumothorax in pregnancy leading to fetal demise

Spontaneous Pneuomothorax in A Pregnant Patient Leading to Fetal Demise

Spontaneous pneumothorax rarely occurs during pregnancy. The most common cause is the rupture of a subpleural apical bulla or bleb, due to the increased respiratory demand of the peripartum period. Respiratory failure is the main risk for the mother; fetal risks include reduction in oxygen supply and preterm labor. Here, we present a case of spontaneous pneumothorax in pregnancy leading to fetal demise

The utility of maternal serum endocan level to predict preterm delivery within seven days in patients with threatened preterm labor

© 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.Objective: The aim of the current study was to determine serum endocan levels in patients with threatened preterm labor and to assign whether endocan levels in patients with true preterm labor who give birth within 7 days differ from those of false preterm labor and uncomplicated pregnancy. Materials and methods: This cross-sectional study was conducted on 58 patients diagnosed with threatened preterm labor and 31 healthy pregnant women matched for gestational age. Patients with threatened preterm labor were divided into two groups; preterm delivery (28) and term delivery (30) groups. Maternal serum endocan levels were measured with the use of an enzyme-linked immunosorbent assay kit. Results: The median serum endocan level (pg/mL) in patients with threatened preterm labor was significantly higher than that of women with uncomplicated pregnancies (725, IQR 619–823 versus 310, IQR 218–423; p .05). Conclusions: The maternal serum endocan level may be a useful marker to define high risk group for preterm delivery in patients with threatened preterm labor and similar cervical length measures

Oxidative stress parameters and inflammatory and immune mediators as markers of the severity of sepsis

Introduction: Sepsis is a complex inflammatory syndrome with diverse etiology and wide spectrum of severity. The aim of this study was to investigate whether inflammatory mediators, in comparison with oxidative parameters, are associated with severity of sepsis. Methodology: Plasma neopterin, adenosine deaminase (ADA), vascular cell adhesion molecule (VCAM), intracellular adhesion molecule (ICAM), interleukin (IL)-1, IL-6, and tumor necrosis factor alpha (TNF-alpha), as inflammatory mediators, and serum nitric oxide (NOx), nitrotyrosine (NT), oxidized LDL (oxLDL) levels, serum paraoxonase 1 (PON1) activity, and erythrocyte glutathione (GSH) levels as oxidative stress parameters of 12 patients with mild sepsis, 25 patients with severe sepsis, and 20 healthy control subjects were evaluated. NOx, GSH levels and PON1 activity were determined by colorimetric methods, whereas neopterin, VCAM, ICAM, IL-1, IL-6, TNF-alpha, NT, and oxLDL levels were measured by enzyme-linked immunosorbent assay (ELISA)

Oxidative stress parameters and inflammatory and immune mediators as markers of the severity of sepsis

Introduction: Sepsis is a complex inflammatory syndrome with diverse etiology and wide spectrum of severity. The aim of this study was to investigate whether inflammatory mediators, in comparison with oxidative parameters, are associated with severity of sepsis. Methodology: Plasma neopterin, adenosine deaminase (ADA), vascular cell adhesion molecule (VCAM), intracellular adhesion molecule (ICAM), interleukin (IL)-1, IL-6, and tumor necrosis factor alpha (TNF-alpha), as inflammatory mediators, and serum nitric oxide (NOx), nitrotyrosine (NT), oxidized LDL (oxLDL) levels, serum paraoxonase 1 (PON1) activity, and erythrocyte glutathione (GSH) levels as oxidative stress parameters of 12 patients with mild sepsis, 25 patients with severe sepsis, and 20 healthy control subjects were evaluated. NOx, GSH levels and PON1 activity were determined by colorimetric methods, whereas neopterin, VCAM, ICAM, IL-1, IL-6, TNF-alpha, NT, and oxLDL levels were measured by enzyme-linked immunosorbent assay (ELISA)

Emergency cerclage in twins during mid gestation may have favorable outcomes: Results of a retrospective cohort

Purpose. - Cervical cerclage treatment for cervical changes at mid trimester is a very controversial topic in twins. The aim of the study was to present our maternal and fetal outcomes of mid-trimester cervical cerclage in twin pregnancies. Basic procedures. - This study was performed using data extracted from the medical files of the twin pregnancies whom performed emergency cervical cerclage between January 2012 and March 2018 at Trakya University, Facuty of Medicine, Department of Perinatology. Main findings. - Mean (min.-max.) gestational age at delivery was [27.3 (21-34) weeks]. The median time between cervical cerclage and delivery was 6.4 weeks, while the maximum prolongation of the pregnancy was 11 weeks. The median prolongation period of pregnancy was 4.1 weeks in patients with bulging membranes, but 10 weeks in patients with cervical effacement and cervical shortening. Eight infants died at the neonatal period. Two patients (20%) developed late abortions at 21 and 22 weeks of gestation, and 2 women (20%) delivered extremely premature neonates at the 24th weeks. Overall neonatal mortality rate was 40% (8/20 neonates). Twelve out of twenty were born alive (60%). Principal conclusions. - Despite the lack of randomized controlled trials, it seems reasonable to offer emergency cervical cerclage to twin pregnancies with cervical shortening (<15 mm). For the twin pregnancies with advanced cervical dilatation and protruding membranes, emergency cervical cerclage should be an option only for carefully selected patients after informing about the complications and low success rate. (C) 2018 Elsevier Masson SAS. All rights reserved

Evaluation of maternal serum hypoxia inducible factor-1α, progranulin and syndecan-1 levels in pregnancies with early- and late-onset preeclampsia

© 2017 Informa UK Limited, trading as Taylor & Francis Group.Objective: To determine the serum levels of HIF-1 α, progranulin, and syndecan-1 in preeclampsia (PE) and normal pregnancy, and to compare whether these markers demonstrate any difference between early-onset PE (EO-PE) and late-onset PE (LO-PE). Methods: This cross-sectional study was conducted on 27 women with EO-PE, 27 women with LO-PE, and 26 healthy normotensive pregnant controls matched for gestational age. Maternal levels of serum HIF-1 α, progranulin, and syndecan-1 were measured with the use of an enzyme-linked immunosorbent assay kit. Results: Statistical analysis revealed significant differences between the control and the PE groups in progranulin (p <.001) and syndecan-1 (p <.001) levels. There were no significant differences in the serum HIF-1 α levels between these groups (p=.069). When PE patients were evaluated by considering subgroups; statistical analysis revealed significant inter-group differences in all biomarkers. Serum progranulin levels were significantly higher in LO-PE compared with the other two groups (EO-PE versus LO-PE and LO-PE versus controls p =.000). Control group presented significantly higher syndecan-1 levels, than EO and LO-PE (p <.001). HIF-1 α levels positively correlated with progranulin levels (r =.439, p=.000). Conclusions: Serum progranulin may have potential to be used as a biomarker for the differentiation of EO-PE and LO-PE. The co-operative action between HIF-1 α and progranulin might play a key role in the pathogenesis of LO-PE. The predominant feature of LO-PE seems to be an inflammatory process, whereas in EO-PE placentation problem seems to be the main pathology