The role of early determination of β-human chorionic gonadotropin levels in predicting the success of single-dose methotrexate treatment in ectopic pregnancy

Objective: The aim of the study was to determine the importance of β-hCG level on day 4 following methotrexate (MTX) administration, and the difference between β-hCG levels assessed on day 0 and day 4 in predicting treatment success. Material and methods: A total of 68 women with tubal pregnancy, treated with a single dose of MTX, were selected for this retrospective study. Results: The success rate of single-dose MTX treatment in our clinic was 75% (51/68). Among 51 patients in whom MTX treatment was successful, 25 (36.8%) showed a decrease in β-hCG level of > 15% on days 0 and 4, and 44 (64.7%) showed a β-hCG level decrease of > 15% on days 4 and 7. For subjects with β-hCG decrease of > 15% on days 4 and 7, the standard error was 6.5%, and the area under the ROC curve was 81.7%, while the corresponding values for days 0 and 4 were 7.2% and 64%, respectively. Conclusions: A decrease of > 15 % in β-hCG levels between days 0 and 4 does not seem to be a better predictor for success of single-dose MTX treatment for ectopic pregnancy than between days 4 and 7. A statistically significant difference was observed only in β-hCG levels on day 7 in both, successful and unsuccessful single-dose MTX groups

Incidence and Sonographic Detection of Fetal Anomalies in Pregnancies Complicated by Polyhydramnios

OBJECTIVE: The purpose of this study was to evaluate the incidence and sonographic detection of fetal anomaly related with polyhydramnios and to estimate the relationship between fetal anomaly and the severity of polyhydramnios and to compare the idiopathic polyhydramnios with polyhydramnios associated with fetal anomaly. STUDY DESIGN: This was a prospective study of 60 singleton pregnancies with polyhydramnios. Though all singleton pregnancies with polyhydramnios were included, only the patients with idiopathic polyhydramnios or with fetal anomalies were the object of this study. Idiopathic polyhydramnios was defined as polyhydramnios that is not associated with congenital anomalies, fetal chromosomal abnormalities, fetal infections, maternal diabetes, placental tumors or isoimmünization. Polyhydramnios was defined as 25 cm or greater amniotic fluid index. Polyhydramnios was categorized as mild (amniotic fluid index of 25-29,9 cm) and severe (amniotic fluid index of 30 cm or more). The prevalence of fetal anomalies was analyzed according to the severity of polyhydramnios. RESULTS: Polyhydramnios was diagnosed in 60 patients. Of the 60 patients, 33 were considered to have idiopathic polyhydramnios (55 %), and of the remaining, 22 patients (37%) were associated with fetal anomalies. There was statically significant difference between these two groups in respect to amniotic fluid index. In patients with fetal anomaly, amniotic fluid index was significantly higher than in patient with idiopathic polyhydramnios (p=0.001). In 55 patients, mild polyhydramnios was observed in 43 pregnancies (78%) and severe polyhydramnios was noted in 12 pregnancies (22%). The prevalence of congenital anomaly was increased significantly with the severity of polyhydramnios (p=0,001). The number of fetal anomaly was 11 (25%) in mild polyhydramnios group, 11 (91%) in severe polyhydramnios group. CONCLUSION: It is reasonable to distinguish between mild and severe polyhydramnios regarding special attention and antenatal follow-up as fetal anomaly is related to the degree of polyhydramnios. Significant risk of fetal anomalies should be considered in patients with severe polyhydramnios (AFI≥ 30 cm)

Prenatal Diagnosis of Trisomy 8 Mosaicism: A Case Report

In this report we present a case of partial trisomy 8 referred to our clinic initially due to ultrasonographic finding of lateral ventricular dilatation. The detailed ultrasound scan at 26 weeks’ gestation demonstrated agenesis of corpus callosum and bilateral hidronephrosis in fetus. Later amniocentesis and fetal blood sampling were performed. The case of mosaicisim for partial trisomy 8 was detected in cultured amniotic fluid cells. This karyotypic anomaly was subsequently confirmed by fetal blood sampling as well

Severe Hypertriglyceridemia - Induced Pancreatitis During Pregnancy

We reported a case of acute pancreatitis associated with type V hyperlipoproteinemia. A 27-year-old woman was admitted at 25 weeks of gestation with persistent nausea, vomiting, progressive epigastric pain. She had very severe hypertriglyceridemia. Her serum amylase level was elevated. An ultrasound scan of abdomen was normal, with no evidence of cholelithiasis but there was perisplenic fluid accumulation. A diagnosis of acute pancreatitis secondary to hypertriglyceridemia was made. With early conservative treatment the patient’s condition was effectively improved and she was discharged from the hospital 8 days later. After 12 weeks, cesarean section was performed due to previous cesarean section. She was discharged home three days later with her baby

A Rarely Seen Fetal Anomaly: Fraser Syndrome

There are about 200 published case reports of patients with Fraser syndrome and several comprehensive reviews have previously been published. Fraser syndrome has a recurrence risk of 25% among siblings, therefore prenatal diagnosis is an important task for the diagnostician counseling affected families. We aimed to report a case of Fraser Syndrome that was diagnosed prenatally at 19 weeks of gestation with multiple ultrasonographic anomalies and terminated at 21 weeks of gestation, to review prenatal diagnostic criteria and possible etiologic factors of Fraser syndrome

Antenatal Screening for the Frequency of Subclinic Hypothroidism

OBJECTIVE: The objective of this study is to investigate the frequency of subclinical hypothyroidism in pregnant population. STUDY DESIGN: This study was performed in Ondokuz Mayıs University Obstetrics and Gynecology Clinic between January 2006 – September 2006. Six hundred forty nine pregnant women between 17 – 46 ages were included into the study. The pregnant women who have evident or subclinical hypothyroidism in their medical history were excluded from the study. The study was done by searching TSH, fT3, fT4 levels by using Electrochemiluminescence immunoassay (ECLİA) analisators. All pregnant women were evaluated according to age, height, weight, body mass index (BMI). Mann Whitney U and Chi-square test were used for statistical assessment. RESULTS: Subclinical hypothyroidism was detected in 4 % of 649 screened women. When demographic and physical parameters taken into consideration, there were no statistically significant differences between women having hypothyroidism and normal hormone levels. CONCLUSION: Subclinical hypothyroidism which was detected in % 4 of pregnant women in Samsun and places near it

Multidisciplinary Management of Giant Fetal Sacrococcygeal Teratom

Sacrococcygeal Teratoma (SCT) is one of the most frequent tumors of the newborn period. SCT is seen in varying sizes, and there is a relationship between the size and the clinical course. Postoperative prognosis of SCT with a low malign potential is good in the newborn period. Prenatal follow-up and postnatal management are rather important. We described our patient who was diagnosed in the early weeks and followed up till week 37, and then was given birth by caesarean section. The hemodynamic findings were stabilized during the newborn period. the patient was successfully operated by pediatric surgeons to restore her health