Early second trimester retinol-binding protein-4 values in cases with or without gestational diabetes mellitus risk factors: A cross-sectional study

Aim: Retinol-binding protein-4 (RBP-4) has been correlated with different degrees of insulin resistance includinggestational diabetes mellitus (GDM). Presence of risk factors for GDM is an indication for early screening.We studied RBP-4 values in the early second trimester of pregnancy in pregnant subjects with or without GDMrisk factors and compared the results by routine GDM screening methodology.Methods: Seventy-nine patients with at least one GDM risk factor and 46 patients without any GDM riskfactors were enrolled in the cross-sectional study as risk and control groups, respectively. In the early secondtrimester, RBP-4 values were measured, in addition to fasting plasma glucose and 50-g glucose challenge testin all subjects.Results: The RBP-4 values in 16–18th weeks of pregnancy were not significantly different between risk andcontrol groups (95.3 ± 20.1 vs 103.1 ± 24.4 µg/mL, respectively; P = 0.055) although fasting plasma glucoselevels and 50-g glucose challenge test results were higher in the risk group than the control group (75.3 vs69.3 mg/dL and 112.4 vs 97.5 mg/dL, respectively; P < 0.05).Conclusion: Presence of GDM risk factors does not have an impact on early second trimester RBP-4 values inpregnant subjects

Interobserver reproducibility of intracranial anatomy assessment during second trimester sonographic scan

To evaluate the reproducibility of mid-trimester intracranial anatomy assessment. Women undergoing mid-trimester scan (between 18th to 25th gestational weeks) for fetal anatomy assessment were included in the study. Measurements of lateral ventricle (LV), cisterna magna (CM) and transverse cerebellar diameter (TCD) were obtained for reproducibility analyses. Inter-observer reproducibility analysis was made with correlation coefficients. A total of 162 women were included in the analysis while one woman was excluded from the study due to diagnosis of vermian agenesis. Correlation coefficient (CC) of cisterna magna measurements have shown weak to moderate interclass correlation (r=0.28, P=0.001). Measurements of lateral ventricle have shown moderate to strong interclass correlation (r=0.73, P<0.0001). Transverse cerebellar diameter measurements have shown the best interclass correlation (r=0.88, respectively P<0.0001). Mean difference between different observers were-0.4 mm (95% CI:-3.0 to 2.1 mm), 0.7mm (95% CI:-1.0 to 2.5 mm) and 0.53 mm (95% CI:-2.5 to 3.6 mm) for measurements of cerebellum, lateral ventricle and cisterna magna, respectively. When grouped according to BMI (Over 30 kg/m2 and lower than 25 kg/m2) and presentation (cephalic and breech), there were no differences between groups regarding the prevalence of an absolute difference gre ater than 1 mm between paired measurements by different observers. Measurements of TCD, LV and CM during mid-trimester scan have good interobserver reliability with the exception of CM measurements. Methods used for measuring these structures have shown good consistency between different BMI categories and different fetal presentations during ultrasound scans

The value of placental protein 13, beta-human chorionic gonadotropin and progesterone in the prediction of miscarriages in threatened miscarriage patients

The aim of this paper was to investigate the levels of maternal serum placental protein13 (PP13), beta human chorionic gonadotropin (beta-hCG) and progesterone in the prediction of miscarriages in threatened miscarriages. A total of 110 patients with a gestational age < 14 weeks were included in the study. A total of 42 patients were allocated as the study group (threatened miscarriage) and 68 patients were allocated as controls. A total of six miscarriages were observed in the study group. beta-hCG levels were significantly lower in the group with threatened miscarriage when compared with controls (p = 0.018). There was no statistically significant difference in regard to progesterone and PP13 levels occurred between two groups (p = 0.653 and p = 0.062, respectively). Following receiver operating characteristic (ROC) analysis, the beta-hCG parameter was found useful in differentiating miscarriages from the threatened miscarriage group (p = 0.031). PP13 and progesterone parameters in predicting miscarriages were not found as statistically significant (p = 0.084 and p = 0.914, respectively). This study suggests that beta-hCG measurements could be useful in predicting spontaneous miscarriage in women presenting with threatened miscarriage. Even though PP13 seems unfeasible to be used as a predictive marker for miscarriage, factors affecting PP13 levels should be considered along with the need for comprehensive studies including larger patient populations