Applicability of fetal renal artery Doppler values in determining pregnancy outcome and type of delivery in idiopathic oligohydramnios and polyhydramnios pregnancies

Aims: To investigate the relationship between fetal renal artery Doppler results and pregnancy outcomes in patients with idiopathic abnormal amniotic fluid indices. Material and method: A total of 110 patients without signs of fetal distress were included in the study: 31 idiopathic oligohydramnios and 29 idiopathic polyhydramnios pregnancies (study group) and 50 normal pregnancies (controls). Doppler investigation of the umbilical artery (UA), middle cerebral artery (MCA), fetal descendant thoracic aorta (DTA) and fetal renal artery (RA) was performed in all patients. Fetal RA resistive index (RI) and pulsatile index (PI) values were measured. Values pertaining to type of birth, newborn weight and APGAR scores were compared. Results: Average patient age, gravidity and week of pregnancy were 25±4, 1.6, and 37.4±1, respectively. There were no statistically significant differences between the groups as far as UA S/D, MCA S/D, DTA S/D, DTA RI, DTA PI, and RA S/D measurements were concerned. However, in the oligohydramnios group RA RI and RA PI values were significantly higher than the other two groups. Birth weight in the polyhydramnios group and cesarean section rate due to fetal distress in the oligohydramnios group were significantly higher. Conclusions: In the oligohydramnios group, without affecting fetal distress parameters, Doppler USG evaluation identified an increase in the RA resistance. Also in that group, cesarean rate due to fetal distress during labor was significantly higher than in the remaining two groups. Due to the predictive potential of values of fetal renal artery Doppler of fetal outcome further large sample-sized studies on the subject ought to be carried out

Prolonged breast-feeding is an independent risk factor for postmenopausal osteoporosis.

Objectives: This study investigated the effects of parity and age at first pregnancy and breast-feeding, as well as duration of BF for total and per child on postmenopausal osteoporosis

Fetal supraventricular tachycardia: Case report and review of the literature

Fetal tachyarrhythmias may occur in 0.4-0.6% of pregnancies. Supraventricular tachycardia (SVT) is the most frequently reported fetal tachyarrhythmia. Fetal SVT is a rhythm disturbance characterized by 1:1 atrioventricular conduction at a rate between 220 and 300 beats per minute. Digoxin is the most common first-line antiarrhythmic agent for fetal SVT, but there is no consensus on the most effective second-line therapeutic agent. Herein, we report a case of SVT at her 23rd week of gestation in whom digoxin and sotalol combination therapy failed. Management guidelines in the literature were also reviewed

Postpartum Diagnosed Wilsons Disease

Wilsons disease is an autosomal recessive genetic disorder in which defective biliary excretion of copper leads to its accumulation, especially in liver, brain and cornea. Clinical manifestations can vary widely. Untreated Wilsons disease may lead to subfertility and pregnancy complications such as; recurrent miscarriages, induced hypertension, preeclampsia, placental abruption and intrauterine growth restriction. Here we present a case with Wilsons disease (WD) diagnosed postpartum, underwent urgent cesarean section with a presumptive diagnosis of HELLP (Hemolysis, Elevated Liver Enzymes, Low Platelet Count) syndrome. Acute intravascular hemolytic anemia and thrombocytopenia in WD can be interpreted as a feature of HELLP syndrome besides acute liver failure. It should be considered in the diferrantial diagnosis. [Med-Science 2016; 5(1.000): 290-5

Targeted fetal cell-free DNA screening for aneuploidies in 4,594 pregnancies: Single center study

Background Next-generation sequencing (NGS) and discovery of fetal cell-free DNA (cfDNA) in the maternal circulation render possible prenatal screening for trisomy 21 (Down syndrome), trisomy 18, trisomy 13, and sex chromosome aneuploidies. The approach is called "fetal cfDNA screening" and in contrast to noninvasive conventional serum screening, it provides the identification of 98%-99% of fetuses with Down syndrome. Methods Retrospective analysis of targeted noninvasive prenatal testing (NIPT) (Clarigo Test) pregnancies with moderate risk, which we have reported between 2016 and 2018 years is presented. Two separate laboratory workflows and NGS platforms are used for the same targeted NIPT analysis. Results In total, 4,594 pregnant women were investigated. Initial 3,594 cases are studied by MiSeq platform, the last 1,000 cases by NextSeq. Failure rate for MiSeq platform is 10.9% and for NextSeq is 8.7%. Automatically reported cases constitute 75% of the MiSeq group and 87% of the NextSeq group. Conclusions Targeted NIPT results suggest that MiSeq platform could be used for NIPT which would be an essential option particularly for laboratories with low sample flow. And, the NextSeq platform has easier wet lab process and also increased success rate in automatic reporting which is suitable for centers with high number of NIPT cases