9 research outputs found
Maternal Deaths and Their Causes in Ankara,Turkey, 1982-2001
This study was carried out to determine the incidence and causes of
maternal deaths about a 20-year period at the Zekai Tahir Burak Women's
Health Education and Research Hospital (ZTBWHERH), Ankara, Turkey. All
maternal deaths from January 1982 to July 2001 were reviewed and
classified retrospectively. Using a computer-generated list, 348
patients admitted to the Labour Department of ZTBWHERH during 1982-2001
were selected as controls. Medical records were reviewed for
demographic data, history of antenatal care, route of delivery,
referral history, and perinatal mortality. Cases and controls were
compared, and standard tests were used for calculating odds ratio (OR)
and 95% confidence interval (CI) for the association of demographic and
delivery characteristics. During this period, there were 174 maternal
deaths and 430,559 livebirths, giving a maternal mortality ratio of
40.4/100,000 livebirths. The mortality rate declined from 85.1/100,000
in 1982 to 11.6/100,000 in 2001. One hundred thirty (74.7%) deaths were
due to direct obstetric causes and 24 (13.7%) were abortion- related,
while 20 (11.4%) were due to indirect obstetric causes. The most common
cause of direct obstetric deaths was pre-eclampsia/eclampsia, followed
by obstetric haemorrhage and embolism. Abortion-related sepsis and
haemorrhage, anesthesia-related deaths, obstetric sepsis, acute fatty
liver of pregnancy, and ectopic pregnancy accounted for other causes of
deaths. Cardiovascular disease was the leading indirect cause of death.
Referral, lack of antenatal care, and foetal death at admittance were
associated with 8-, 3-, and 6-fold increased risk of maternal mortality
respectively (OR 8.89, 95% CI 5.7- 13.8; OR 3.74, 95% CI 2.5-5.5; OR
6.38, 95% CI 3.1-13.1). Although maternal mortality ratios have
declined at the hospital, especially in the past five years, the rate
is still high, and further improvements are needed. The problem of
maternal mortality remains multifactorial. Short-term objectives should
be focused on improving both medical and administrative practices.
Improving the status of women will necessarily remain a long-term
objective
Copy number variation and regions of homozygosity analysis in patients with MÜLLERIAN aplasia
Fatal Disseminated Tuberculous Peritonitis following Spontaneous Abortion: A Case Report
We describe a rare case of fatal disseminated tuberculous peritonitis in a young woman with rapid progressive clinical course following spontaneous abortion of 20-week gestation. Clinical and laboratory findings were initially unremarkable. She underwent diagnostic laparoscopy which revealed numerous tiny implants on the peritoneum and viscera. Histopathology showed chronic caseating granulomas, and the tissue culture grew Mycobacterium tuberculosis. At fifth day of the antituberculous treatment multiorgan failure occurred in terms of pulmonary, hepatic, and renal insufficiency. She developed refractory metabolic acidosis with coagulopathy and pancytopenia, and she died of acute respiratory distress syndrome and septic shock on her twelfth day of hospitalization
A Retrospective Analysis of Pregnancy Outcomes after Kidney Transplantation in a Single Center
Partial recovery of the visual field scotoma upon early retinal photocoagulation and the medical therapy in a preeclamptic patient
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Copy number variation and regions of homozygosity analysis in patients with MÜLLERIAN aplasia
Background: Little is known about the genetic contribution to Müllerian aplasia, better known to patients as Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome. Mutations in two genes (WNT4 and HNF1B) account for a small number of patients, but heterozygous copy number variants (CNVs) have been described. However, the significance of these CNVs in the pathogenesis of MRKH is unknown, but suggests possible autosomal dominant inheritance. We are not aware of CNV studies in consanguineous patients, which could pinpoint genes important in autosomal recessive MRKH. We therefore utilized SNP/CGH microarrays to identify CNVs and define regions of homozygosity (ROH) in Anatolian Turkish MRKH patients. Result(s) Five different CNVs were detected in 4/19 patients (21%), one of which is a previously reported 16p11.2 deletion containing 32 genes, while four involved smaller regions each containing only one gene. Fourteen of 19 (74%) of patients had parents that were third degree relatives or closer. There were 42 regions of homozygosity shared by at least two MRKH patients which was spread throughout most chromosomes. Of interest, eight candidate genes suggested by human or animal studies (RBM8A, CMTM7, CCR4, TRIM71, CNOT10, TP63, EMX2, and CFTR) reside within these ROH. Conclusion(s) CNVs were found in about 20% of Turkish MRKH patients, and as in other studies, proof of causation is lacking. The 16p11.2 deletion seen in mixed populations is also identified in Turkish MRKH patients. Turkish MRKH patients have a higher likelihood of being consanguineous than the general Anatolian Turkish population. Although identified single gene mutations and heterozygous CNVs suggest autosomal dominant inheritance for MRKH in much of the western world, regions of homozygosity, which could contain shared mutant alleles, make it more likely that autosomal recessively inherited causes will be manifested in Turkish women with MRKH