Monitoring and Prognosis of Pregnant Women Diagnosed with Placenta Previa

Amaç Plasenta previa tanısı alan gebelerin takipleri ve prognozlarını değerlendirmek. Gereç ve Yöntem Ocak 2013 - ocak 2016 tarihleri arasında plasenta previa tanısı almış ve takiplere gelmiş 36 gebenin demografik verileri, ultrasonografi bulguları, gebelikte tanı haftası ve gebelik sonuçları retrospektif olarak değerlendirildi.Bulgular Plasenta previa olgularında ortalama yaş 33,41±3,89 olarak bulundu. Tanı sırasındaki ortalama gebelik haftası 29,25±4,46 , ortalama doğum haftası 35,32±3,57 , ortalama doğum kilosu 2740,15±842,2 gr idi. Plasenta previa için risk faktörü (yüksek gravida, ileri maternal yaş, geçirilmiş uterin cerrahi vb.) varlığı %88,8 olarak saptandı. Maternal kanama nedeniyle %27,7 (n=10) hastaya değişik miktarlarda kan transfüzyonu yapıldı. Sonuç Antenatal komplikasyonlar, maternal kanama, erken doğum ve erken doğuma bağlı sorunlar plasenta previa olan hastalarda morbidite ve mortalitenin en önemli sebebidir. Tanının önceden bilinmesi operasyonun doğum eylemi başlamadan elektif şartlarda ve tecrübeli bir ekip tarafından donanımlı merkezlerde yapılmasını sağlar; bu durum da komplikasyon gelişme olasılığını azaltır. ( Sakarya Tıp Dergisi 2016, 6(4):196-201 )Aim Evaluation of monitoring and prognosis of pregnant women diagnosed with placenta previa. Material and Method The results of 36 pregnant women diagnosed with placenta previa during pregnancy were evaluated retrospectively in between January 2013 – January 2016.. Results The mean age of the patients with placenta previa was found as 33.41±3.89 . Mean gestational age at the time of the diagnosis was 29.25±4.46 , mean gestational age at delivery was 35.32±3.57 , mean birth weight was 2740.15±842.2 gr . The risk factors for placenta previa (multiparity, advanced age, previous uterine surgery etc.) was found in 88.8% of the patients. 27.7% of the patients recieved variable amount of blood transfusion due to maternal bleeding. Conclusion Antenatal complications, maternal bleeding, premature birth and problems related to prematüre birth are the main causes of morbidity and mortality in cases of plecenta previa. Being aware of plecenta previa results in elective surgery before the onset of delivery with an experienced team at tertiary hospitals. Thus; the incidence of complications decreases. ( Sakarya Med J 2016, 6(4):196-201

Thyroid papillary cancer-related pregnancy: a case report

Differentiated thyroid cancer is the second-most frequent tumor among those tumors diagnosed during pregnancy after breast cancer; it also is the most common endocrine malignancy. Pregnancy-associated cancer was defined as a malignancy detected during pregnancy or within 2 years of delivery, but most of the patients with pregnancy-associated cancer were recognized in the postpartum period. The best time for surgery is unclear. Its management is a challenge for both doctors and patients. Enlargement of the thyroid gland in pregnancy is usually a physiological change related to pregnancy, but even if it is rare, it can be due to thyroid malignancy. We report a case of 31-year-old female diagnosed with thyroid papillary cancer during pregnancy with no symptoms except for a lump on her neck. For this reason, the examination of the thyroid gland and the examination of neck lymph nodes should be routinely performed on all pregnant women.WOS:00041092020000

Comparison of Nerve Fiber Density between Patients with Uterine Leiomyoma with and without Pain: a Prospective Clinical Study

Introduction We aimed to compare the presence and the amount of nerve fibers in endometrial, myometrial and leiomyoma tissues using protein gene product 9.5 (PGP 9.5) and neurofilament (NF) immunohistochemical staining in uterine leiomyoma patients with and without pain complaint. Methods Patients undergoing hysterectomy for uterine leiomyoma were prospectively enrolled in the study. Twenty-five uterine leiomyoma patients without pelvic pain complaint (visual analog scale (VAS) = 5) were assigned to Group 2. Endometrial, myometrial and leiomyoma tissues obtained from hysterectomy specimens were stained immunohistochemically using PGP 9.5 and NF dyes. The presence and density of nerve fibers were compared between the two groups. Results None of the endometrial samples in either groups stained with PGP 9.5 and NF dyes. There was no statistically significant difference in the number of nerve fibers in myometrial and leiomyoma tissues between the two groups with either of the stains (PGP 9.5: p = 0.39 and p = 0.29; NF: p = 0.83 and p = 0.65, respectively). There was agreement between PGP 9.5 and NF immunohistochemical staining for nerve fiber detection in myometrial and leiomyoma tissues (p < 0.05/kappa = 0.622 and p < 0.05/kappa = 0.388, respectively). Conclusion This study demonstrates that the quantity and density of nerve fibers in myometrial and leiomyoma tissue in patients with pain were similar to that in patients without pain.WOS:0004322600000032-s2.0-85060457053PubMed: 2972074

Can first trimester maternal serum follistatin like 3 levels predict developing gestational diabetes mellitus?

Purpose: The purpose of this study is to determine whether the first trimester maternal serum levels of follistatin like 3 (FSTL3) are altered in patients who develop gestational diabetes mellitus (GDM).Methods: This is a prospective nested case-control study that included 170 singleton pregnant women recruited in their first trimester. All women were followed up until the delivery and 144 of them completed the study. The maternal serum levels of FSTL3 were measured at 11-14 weeks of gestation. The GDM-affected women (n=19) were compared with the GDM-free control women (n=125) for potential serum biomarkers including the FSTL3 levels.Results: There were no significant differences in maternal age, maternal pre-pregnancy body mass index, and neonatal birth weight between the GDM group and the GDM-free control group. Women with GDM had significantly greater weight gain during pregnancy than the women without GDM. Serum concentration of glycosylated hemoglobin was significantly higher in women with GDM. There were no significant differences in serum FSTL3 levels (p=0.578) between the GDM group and the GDM-free control group.Conclusions: Our results suggest that the first trimester maternal serum FSTL3 levels are not altered in women who develop GDM and thus do not support the use of serum FSTL3 levels for early prediction of GDM.WOS:0004027138000152-s2.0-84989227715PubMed: 2762397

First Trimester Renin and Aldosterone Levels of Pregnant Women With Prognosis of Preeclampsia and/or Related Adverse Pregnancy Outcomes

Objective: To evaluate the first-trimester renin and aldosterone levels in pregnancies complicated by prognosis of preeclampsia and/or related adverse pregnancy outcomes.Methods: We measured serum levels of renin and aldosterone in pregnant women for first trimester screening test. Total of 180 pregnant women were included in the study and 144 of them completed the study. All pregnant women were followed during pregnancy for preeclampsia and related complications. Renin and aldosterone levels in preeclampsia and/or poor obstetric prognosis group were compared with normal pregnancy outcome group.Results: Preeclampsia developed in 13 pregnant women and one or more poor obstetric outcome developed in 36 women. Renin and aldosterone levels were not significantly different in preeclamptic women or those with poor obstetric outcome compared with the controls.Conclusion: We think that maternal first trimester renin and aldosterone levels do not have a role in the pathogenesis and prediction of preeclampsi

Sclerosing Mesenteritis Mimicking Ovarian Tumor: A Very Rare Case

Sclerosing mesenteritis is a rare, benign and chronic inflammatory disease with fibrosis that affects the mesentery and on rare occasions mesocolon, peripancreatic region, omentum, retroperitoneum, pelvis. Since the sclerosing mesenteritis has no special clinical manifestations and typical signs, the patients are very easy to be misdiagnosed. We report a case of sclerosing mesenteritis in 38 year-old patient which is misdiagnosed as ovarian tumor both clinically and radiologically. Definitive diagnosis was made with omental biopsy taken via laparatomy. There was only omental involvement without mesenteric and/or intestinal involvement. This is the first case in the literature with primary omental involvement. The striking point of the case was omental replacement towards pelvis mimicking adnexal mass. Even it is a very rare condition sclerosing mesenteritis should be kept in mind in the differential diagnosis of a pelvic mass

INVESTIGATION OF THE SUPERIORITY OF TDxFML AND LAMELLAR BODY COUNTS IN THE EVALUATION OF FETAL LUNG MATURATION

Objective: To evaluate the superiority of the most performed tests; lamellar body counts and TDxFLM test compared to each other to estimate the maturation of fetal lungs and also to evaluate the reasons for the unclear cut-off values of lamellar body counts. Material and Method: Amnion fluids that were taken into 2 separate tubes from 56 patients within a year were evaluated with both of the tests. Newborns were evaluated and monitored for respiratory distress syndrome of newborns by a neonatologist who was blinded to the results of the amnion fluids. Clinical findings such as grunting, tachypnea, retractions and cyanosis beginning within 6-8 hours after birth, oxygen need over 24 hours, arterial blood gas analyses with partial oxygen pressure under 50 mmHg and presence of chest x-ray findings that are compatible with the situation were accepted as the respiratory distress of newborns. Results: Respiratory distress was not seen in 44 of the 56 newborns while it was seen in 12 (21.4%) of them. In 30 patients whose lamellar body counts were > 55000/mm(3) without centrifuge, RDS was not seen. In the patients whose lamellar body counts were 41, all cases can be detected. Conclusion: Count of lamellar bodies is adiagnostic tool which is fast, practical, easily accessible and cost-effective; also there is no doubt on the benefits of the tool. It seems that the different cut-off values have reasonable causes. Thus, we suggest that every clinic should have its own cut-off values. In the presence of interim results, additional evaluation with TDxFLM was found to increase the sensitivity and specificity.WOS:00040990730000