ASSOCIATION BETWEEN FIRST-TRIMESTER ANEUPLOIDY MARKERS AND BIRTH WEIGHT

Aim: We aimed to investigate whether first trimester ultrasound and biochemical markers of aneuploidy were related to birth weight and to determine the predictive role of these parameters for small for gestational age (SGA) and large for gestational age (LGA) newborns. Material and Method: 1356 women with singleton pregnancy who had undergone first-trimester aneuploidy screening by nuchal translucency (NT)thickness, maternal serum free beta-human chorionic gonadotropin (f beta-hCG), and pregnancy-associated plasma protein-A (PAPP-A) were retrospectively included. Newborns with a birth weight of = 90th percentile as LGA, respectively. Results: Serum PAPP-A level was significantly but weakly (r=0.168: p=0.011) correlated to birth weight whereas maternal serum f beta-hCG levels and NT measurements were not significantly correlated. A single PAPP-A level of <0.795 MoM predicted SGA newborn with a sensitivity of 73.9%, specificity of 63.1%, PPV of 18.5%, NPV of 95.5%, and accuracy of 64.2%. On the other hand, a PAPP-A level of 1.005 MoM was identified as the optimal cut-off point for the prediction of SGA newborn with a sensitivity of 61.0%, specificity of 62.7%, PPV of 26.6%, NPV of 87.9%, and accuracy of 62.4%. Discussion: First-trimester PAPP-A levels may contribute to the prediction of birth weight. However, due to low sensitivity, it is not a clinically relevant screening test for prediction of SGA or LGA newborn

Predictive role of transvaginal ultrasonographic measurement of cervical length at 34 weeks for late pre-term and late-term deliveries in nulliparous women

Objective: To investigate the predictive role of transvaginal ultrasonographic measurement of cervical length (CL) at 34 weeks of gestation in determining late-preterm and late-term deliveries in nulliparous women.Methods: CL was measured by transvaginal ultrasonography at 34 weeks in 318 women (singleton, nulliparous, low-risk and vertex presentation). All women were followed-up till birth and delivered at hospital. Deliveries were classifed according to gestational week as late-preterm (34(0/7) to 36(6/7) weeks), term (37(0/7) to 40(6/7) weeks) and late-term (41(0/7) to 41(6/7) weeks).Results: There was a significant correlation between CL at 34 weeks and gestational week at delivery (r=0.614, p<0.001). Receiver-operating characteristic curve analysis showed that CL measurement below 25.5mm predicted late-preterm delivery with a sensitivity of 80.0%, specificity of 93.9%, positive predictive value (PPV) of 52.6% and negative predictive value (NPV) of 98.2%; while CL above 42.5mm had 70.4% sensitivity, 93.5% specificity, 50.0% PPV and 97.1% NPV in prediction of late-term delivery.Conclusion: Measurement of CL with transvaginal ultrasonography at 34 weeks of gestation can be of beneficial in predicting the risk of late-preterm and late-term deliveries in nulliparous women

Are the cesarean section skin scar characteristics associated with intraabdominal adhesions located at surgical and non-surgical sites

Objective: To investigate whether skin scar characteristics are associated with the presence and severity of abdominal or pelvic adhesions in women who have undergone previous cesarean section

Determinants for poor perinatal outcome in term pregnancies with umbilical cord prolapse

© 2022 Ondokuz Mayis Universitesi. All rights reserved.Umblical cord prolapse is a very rare condition. It is an obstetric emergency that can have unfavourable consequences for the fetus. We aimed to investigate the determinants for poor perinatal outcome following emergency cesarean delivery performed due to umbilical cord prolapse in uncomplicated term pregnancies. Fifty-three term pregnants and their babies born with cesarean section due to umbilical cord prolapse were included in this retrospective study. Newborns who were taken to neonatal intensive care unit were defined as poor perinatal outcome.Eleven of fifty-three newborns needed intensive care. All of them were discharged without any problem after the treatment. The presence of fetal distress detected before or during the umbilical cord prolapse was found to be the only marker associated with poor perinatal outcome. Abnormalities detected in fetal heart rate monitoring before or during umblical cord prolapse increase poor perinatal outcome in uncomplicated term pregnancies

Analysis of factors that influence the outcomes of labor induction with intravenous synthetic oxytocin infusion in term pregnancy with favourable bishop score

Purpose: To investigate the factors that influence the success of labor induction with synthetic intravenous oxytocin infusion in term pregnancies with favourable Bishop score. Material and Methods: 150 pregnant women with completed 37 weeks of gestation and Bishop score>6 who had single and cephalic presentation of pregnancy and were decided to underwent labor induction with intravenous oxytocin infusion were included in the study. Labor induction was considered unsuccessful if a vaginal delivery did not occur within 24 hours after the onset of loxytocin infusion or a cesarean section was performed during oxytocin infusion due to foetal distress, cephalopelvic disproportion or failure to progress in labor. Multivariable regression were used to identify odds of induction success. Results: Out of 150 women, induction of labor was unsuccessful in 23 (15.3%). Multivariate analysis demonstrated that nulliparity, shorter gestation period, persistent occiput posterior presentation and greater birth weight were independent risk factors for the induction failure. ROC curve analysis stated that gestation period of 3445-gram-birth weight has a sensitivity of 82.6% and a spesificity of 71.7% for the prediction of failure. Conclusion: Nulliparity, shorter gestation period, persistent occiput posterior presentation and greater birth weight increase the failure risk of labor induction with intravenous synthetic oxytocin infusion. [Cukurova Med J 2015; 40(2.000): 317-325

The role of ultrasonographic measurement of bladder and detrusor wall thickness in diagnosis of urinary incontinence

© 2021, Kuwait Medical Association. All rights reserved.Objective: To evaluate the diagnostic accuracy of bladder wall thickness (BWT) and detrusor wall thickness (DWT) measurements by transvaginal ultrasound in diagnosis and classification of urinary incontinence Design: Fifty-one women with pure stress urinary incontinence (SUI), 53 women with pure detrusor over activity incontinence (DOI), both of which were diagnosed by urodynamic studies, and 50 women without urinary incontinence (as controls) were enrolled in this prospective cross-sectional study. Settings: Using transvaginal probe, BWT was measured in three sites: at the thickest part of the dome of the bladder, the trigone and the anterior wall of the bladder. Measurements are taken first at 250-300 ml bladder volume and repeated after voiding at <50 ml bladder volume. Subjects: An average of the three measurements was considered as the mean BWT and DWT. Intervention: BWT and DWT at both empty and full bladder were significantly thicker in DOI group than in controls. DOI group measurements were also thicker than SUI group, except for DWT measurement in full bladder. Main outcome measure: There were no statistical differences in DWT and BWT measurements between SUI and control groups. Results: By using ROC curve analysis, the best cut off values for predicting the DOI were calculated as 4.35 mm for full BWT; 1.95 mm for full DWT; 5.95 mm for empty BWT and 2.25 mm for empty DWT. Conclusion: Transvaginal ultrasonographic measurement of BWT and DWT in full and empty bladder can be valuable in diagnosis of DOI with low sensitivity and relatively high specificity

Effect of Bilateral Salpingooferectomy due to Hypoestrogenism Combined with Hysterectomy on Cysto-Rectocele Development

Aim: The objective of this study was to investigate the effect of total abdominal hysterectomy (TAH) combined with bilateral salpingooferectomy(BSO) due to hypoestrogenism on cystocele or rectocele development in postoperative period

Analysis of Risk Factors for Post-Hysterectomy Vaginal Vault Prolapse

Purpose: To identify risk factors for vaginal vault prolapse after hysterectomy and also estimate incidence of post-hysterectomy vault prolapse. Material and Methods: This is a retrospective study of women who underwent hysterectomy for benign indications between January 2010 and December 2012. Medical records were reviewed from two groups of women. Case group was women who had undergone surgery for vault prolapse after hysterectomy; control group was women who were not identified with vault prolapse after hysterectomy by the time of the study. Multivariate regression model identified odds of post-hysterectomy vault prolapse. Results: Of 1758 hysterctomies, 56 (3.19%) were cases. Multivariate regression analysis demonstrated that age at hysterectomy and #8805;60 years, presence of asthma, previous pelvic organ prolapse surgery, vaginal route of hysterectomy, genital prolapse as indication of hysterectomy, body mass index and #8805;27 kg/m2 and number of vaginal delivery and #8805;2 are independent risk factors for development of post-hysterectomy vault prolapse. Conclusions: Vault prolapse after hysterectomy is a relatively rare complication. Elderly age, obesity, chronic obstructive lung diseases, prior genital prolapse sugery, vaginal hysterectomy, genital prolapse as indication of hysterectomy and the number of vaginal delivery and #8805;2 increase vault prolapse risk. Identification of these risk factors is important to prevent this complication. [Cukurova Med J 2015; 40(1.000): 63-71

Management of Labor Complicated with Extensive Uterine Prolapse

Management of severe uterine prolapsus during active labor is challenging. Detrimental complications are inevitable unless preventive measures have been taken. Active labor may result with uneventful vaginal delivery, nevertheless impeded cervical dilation, cervical dystocia and obstructive labor are all potential outcomes. Enlarged and edematous cervix accompanying prolapse in such cases may obstruct course of labor and may result with dystocia. In this instance, C-section stands as feasible and safe option for both mother and the fetus. Also, it is more likely to provide normal anatomic texture during C-section with effective prolapse reduction. Moreover, spontaneous resolution of the uterine prolapse is possible following C-section and considering suspension procedures till complete recovery of the pelvic anatomy seems reasonable. In this case report, succesful management of an active labor complicated with extensive uterus prolapse have been described along with current literature findings