Preeklamptik hastalarda eritrosit indeksleri

Objective: The purpose of study was to investigate erythrocyte indices in patients with preeclampsia. Materials and Methods: The study population consisted of 102 patients with preeclampsia (49 mild, 53 severe preeclampsia) and 98 control pregnant patients. For the entire study population, red blood cell indices, including baseline mean corpuscular volume (MCV), mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), red cell distribution width (RDW), and red blood cell (RBC) were measured by using an automatic blood counter. Results: In the preeclampsia group, the median RDW was 15% (13.8-16.57), whereas in the control group it was 13.9% (13-15.6) (p<0.01). On the other hand, the mean MCV value was 80.42±7.86 (fL) in preeclampsia group and 83.88±2.31 (fL) in control group (p=0.003). Besides, the mean MCHC value was 33.66±1.71 (g/dL) in preeclampsia group and 33.09±1.48 (g/dL) in control group (p=0.012). However MCH and RBC values were not statistically different between the groups. (p>0.05) Moreover, subgroup analysis revealed that RDW levels were significantly increased in preeclampsia subjects than in mild preeclampsia patients (15.4% (13.9-17.45) vs 14.3% (13.7-15.7), p=0.031), MCV levels were decreased (78.81±7.91 (fL) vs 82.16± 7.43 (fL), p=0.03), RBC values were increased (4.16 (3.79-4.85)x(1012/L) vs 3.82 (3.45- 4.34)x(1012/L), (p=0.006)) in patients with severe preeclampsia when compared to the patients with mild preeclampsia. In the receiver operator characteristic (ROC) analysis of subjects with and without preeclampsia, RDW and MCV showed high predictive values (p<0.01). Besides, in ROC analysis of preeclampsia patients with different severities, RDW and RBC showed the ideal predictive values (p=0.006, p=0.031, respectively). Conclusion: Our study results revealed that among the red blood cell indices, only increased RDW values were associated with both the presence and the severity of preeclampsia.Amaç: Bu çalışmanın amacı preeklampsi tanısı konmuş hastalarda eritrosit indekslerini araştırmaktır. Gereç ve Yöntemler: Bu çalışmaya 102 preeklampsi (49 hafif ve 53 şiddetli preeklampsi olmak üzere) ve 98 kontrol hastası dahil edilmiştir. Tüm çalışma grubunda eritrosit indeksleri olan ortalama korpuskular hacim (MCV), ortalama korpuskular hemoglobin (MCH), ortalama korpuskular hemoglobin konsantrasyonu (MCHC), eritrosit sayımı ve eritrosit dağılım genişliği değerleri otomatik kan sayım cihazı ile ölçüldü.Bulgular: Preeklampsi grubunda, medyan RDW %15 (13,8-16,57), ortalama MCV değeri 80,42±7,86 (fL), ortalama MCHC değeri 33,66±1,71 (g/dL) ve kontrol grubunda medyan RDW %13,9 (13-15,6), ortalama MCV değeri 83,88±2,31 (fL), ortalama MCHC değeri 33,09±1,48 (g/dL) idi (sırasıyla p0,05). Preeklampsi grubunda subgroup analizi yapıldığında, hafif preeklampsi grubuna göre, ciddi preeklampsi grubunda artmış RDW değerleri (% 15,4 (13,9-17,45) vs %14,3 (13,7-15,7), p=0,031), azalmış MCV değerleri (78,81±7,91 (fL) vs 82,16±7,43 (fL), p=0,03), artmış RBC değerleri (4,16 (3,79-4,85)x(1012/L) vs 3,82 (3,45-4,34)x(1012/L), (p=0,006) saptandı. Preeklampsi ve kontrol grubu hastalarının Receiver operatör karakteristik (ROK) analizi sonuçlarına göre eritrosit sayımı ve eritrosit dağılım genişliğinin hastalığı tespit etmede yüksek prediktif değerleri saptandı (p<0,01). Ayrıca ROK analiz sonuçlarına göre, hafif ve ciddi preeklampsili hastalarda RDW ve RBC değerleri hastalığın ciddiyetini belirlemede ideal prediktif değerlere sahip idi (p=0,006, p=0,031). Sonuç: Eritrosit indeksleri arasında artmış RDW değerleri hem preeklampsi tanısı, hem de hastalığın ciddiyeti ile ilişkilidir

Circulating s-Endoglin concentrations in non-obese patients with gestational diabetes mellitus

The aim of this study was to compare maternal concentrations of soluble Endodlin (s-Endoglin) in women with gestational diabetes (GDM) and women with normal glucose tolerance (NGT) in pregnancy. Also, the association of insulin resistance markers and s-Endoglin was investigated. Forty patients complicated by GDM and forty gestational age-matched healthy pregnant women with NGT were included in the present study. s-Endoglin level was higher in patients with GDM compared with the control group (p .01). Besides a positive correlation was found between s-Endoglin and fasting glucose (r = 0.206, p = .057), insulin (r = 0.302, p = .005), HbA1c (r = 0.376, p < .01), HOMA-IR values (r = 0.283, p = .008) in pregnant women included in the study. s-Endoglin, as an anti-angiogenic marker seemed to have a role in pathogenesis and significantly associated with insulin resistance markers in non-obese GDM, thus may play important roles in the regulation of glucose hemostasis.Impact Statement What is already known on this subject? In women with GDM, hyperglycaemia induced glycosylation products might cause oxidative stress that may be subsequently involved in the release of inflammatory mediators, inducing angiogenesis What the results of this study add? s-Endoglin has an anti-angiogenic effect and is a useful marker of endothelial injury, activation of inflammation, senescence and oxidative stress, we speculate that it may be involved in the pathogenesis of GDM. What the implications are of these findings for clinical practice and/or further research? s-Endoglin seemed to have a role in the regulation of glucose hemostasis. Further exploration of novel factors like s-endoglin in the pathogenesis of GDM, is essential and valuable to develop new therapeutic strategies for this complex disease and its complications

Prognosis of Pregnancies with Different Degrees of Glucose Intolerance

OBJECTIVE: The purpose of the present study was to evaluate the effect of different degrees of glucose intolerance on maternal and perinatal outcomes. STUDY DESIGN: Retrospective data of 500 singleton pregnancies screened for gestational diabetes mellitus were reviewed. Maternal and perinatal outcomes for four different groups were compared. First group consisted of patients with normal 50-g test, second group was formed by patients with abnormal 50-g test but a normal 100-g test. Third group included patients with one abnormal value after 100-g test. Patients in the fourth group were diagnosed to have gestational diabetes mellitus with two or more abnormal values after 100-g test. RESULTS: Macrosomia, neonatal intensive care unit admission and preterm premature rupture of membranes were the highest in the group with one elevated value after glucose tolerance test. Preterm labor was the highest in the gestational diabetes group. The difference in the rate of preeclampsia, polyhydramnios, neonatal hypoglycemia and hypocalcemia was not statistically significant (p>0.05). CONCLUSION: Although women with one elevated value after glucose tolerance test are not diagnosed with gestational diabetes mellitus, they are still at risk for adverse maternal and perinatal outcomes. They seem to be prone to develop obstetric complications related to glucose intolerance and should be followed up carefully during the antepartum and intrapartum period

The Association Between Platelet Indices and Clinical Parameters in Recurrent Pregnancy Loss

OBJECTIVE: Etiology of recurrent pregnancy loss (RPL) is variable. Hypercoagulability is one of the treatable conditions causing RPL. Platelet (PLT) count, mean PLT volume (MPV), PLT distribution width (PDW) and plateletcrit (PCT) are platelet indices and may be markers for increased platelet aggregability. In the present study, we aimed to determine and compare PLT count, MPV, PDW and PCT between patients with RPL and healthy controls. STUDY DESIGN: A total number of 39 patients with RPL and 40 healthy controls were enrolled in the research. PLT count, MPV, PDW and PCT values were compared between the patients and the controls. RESULTS: There were no statisti¬cally significant differences in number of PLTs, MPV, PCT and PDW values between women with RPL and healthy women (p> 0.05). CONCLUSION: Thrombocyte indices have still an unsatisfactory value in RPL and it seems that they are not appropriate for routine clinical practice regarding RPL

Meckel Gruber Syndrome- A Case Report And Review of Literature

Meckel-Gruber syndrome (MGS) is a lethal autosomal recessive disorder. MGS is thought to be caused by ciliary dysfunction. The worldwide incidence of MGS varies from 1 in 13 250 to 1 in 140.000 live births. MGS is characterized by three main symptoms: central nervous system (CNS) malformations, tetramelic postaxial polydactyly and cystic renal dysplasia with associated fibrocystic changes of the liver, pancreas and epididymis. Here a case of MG syndrome, diagnosed in early weeks of gestation was reported

Antepartum Risk Factors for Peripartum Hysterectomy in Women with Placenta Previa

OBJECTIVE: The aim of the present study was to identify the antepartum risk factors for peripartum hysterectomy in women with placenta previa. STUDY DESIGN: The medical records of 57 women, who underwent cesarean because of placenta previa during the period January 2006-January 2013, were reviewed retrospectively. Antepartum characteristics of women who did and did not undergo peripartum hysterectomy were compared. RESULTS: Among the 57 cases with placenta previa, peripartum hysterectomy was required in 6 (10.5%) women. A statistically increased risk emerged for a history of repeated cesarean delivery (p=0.045), placental adhesive disorders (p<0.001), and an estimated blood loss ≥2000 ml (p<0.001). CONCLUSION: The present study confirmed placenta previa is a condition for a substantial risk of peripartum emergent hysterectomy. An increasing number that of previous cesareans, placental adhesive disorders and blood loss ≥2000 ml were found to be associated with the risk. Antepartum evaluation of adhesive disorders with imaging studies may play a crucial role in predicting hysterectomy in these cases

The Maternal Body Fluids and Amniotic Fluid in Near Term Pregnancies

OBJECTIVE: This study aimed to investigate the relationship between amniotic fluid volume and mainly volume of maternal body fluid compartments and secondly maternal obesity in near term pregnancies. STUDY DESIGN: A case control study was conducted involving 211 women with near term singleton pregnancies who attended Adnan Menderes University Faculty of Medicine between 2007 and 2009. Patients in Group 1(n=119), included near term pregnancies with normal amniotic fluid index (AFI) and Group 2 included near term pregnancies complicated with idiopathic oligohydramnios (n=92). Oligohydramnios was diagnosed when AFI was measured <8 cm. For determining maternal body fluid status we used valid formulas (defined in methods). Maternal body mass index (BMI), weight gain during pregnancy and volume of maternal body fluid compartments including total body water, intracellular fluid volume, extracellular fluid volume, interstitial fluid volume, plasma volume and plasma osmolality were compared between two groups. RESULTS: There was no significant difference between the groups in terms of maternal BMI, weight in partum, weight gain during pregnancy, volume of maternal body fluid compartments, plasma osmolality (p>0.05). Besides, there was no significant correlation with these parameters and AFI (p>0.05). CONCLUSION: Our data favor that maternal BMI, volume of maternal body fluid compartments and plasma osmolality do not have any effect on amniotic fluid volume in near term pregnancies

Trap Sequence: Case Report

TRAP (Twin Reversed Arterial Perfusion) sequence is a rare syndrome seen in monochorionic twin pregnancies. It occurs in 1% of monochorionic twin pregnancies. It is characterized with a recipient fetus exhibiting lethal anomalies including acardia and a pump fetus supplying blood by vascular anastomosis in the placenta. Pump twin is structurally normal but heart failure may develop with cardiomegaly, pericardial and pleural effusion, ascites and polyhydramnios also seen during pregnancy. This anomaly has high mortality for pump twin and is always lethal for recipient. Here, a TRAP sequence case diagnosed at 14 weeks of gestation in antenatal period and followed up spontaneously until labor, with the demand of the family is presented