Maternal Aspects of Preeclampsia

Preeclampsia is almost exclusively a disorder of human pregnancy, the pathogenesis of which remains unknown. Preeclampsia affects 3 to 8% of all pregnancies and still remains a leading cause of maternal morbidity and mortality. Because of the defective uteroplacental unit associated with preeclampsia; adverse fetal, neonatal events usually observed in these cases. the adverse effects of preeclampsia on the maternal hematologic, cardiovascular and pulmonary, neurologic, renal, and gastrointestinal system are also important. the aim of this review is to underline the maternal adverse effects of preeclampsia.Preeklampsia yalnızca insan gebeliğinde görülen bir hastalıktır, patogenezi bilinmemektedir. Tüm gebeliklerin % 3 ile 8’ini etkilemektedir ve hala maternal morbidite ve mortalitenin en sık nedenidir. Preklampside bozulmuş uteroplasental üniteye bağlı olarak, bu olgularda fetal ve neonatal kötü sonuçlar görülebilmektedir. Fetal ve neonatal kötü sonuçların yanında, annede de hematolojik, kardiyovasküler, pulmoner, nörolojik, renal ve gastrointestinal sistemde anlamlı ölçüde kötü sonuçlar görülebilmektedir. Bu derlemede preeklampsiye bağlı oluşan kötü maternal sonuçların değerlendirilmesi amaçlanmıştır

RUPTURED CORNUAL HETEROTOPIC PREGNANCY AFTER IN VITRO FERTILIZATION AND EMBRYO TRANSFER: A CASE REPORT

Heterotopic pregnancy, characterized by the condition of coexisting intrauterine and extrauterine pregnancy, until recently, was considered to be a rare event occurring once in every 30000 cases. Herein, we report a case of ruptured cornual pregnancy, coexisting intrauterine pregnancy, diagnosed during 11th week of in vitro fertilization (IVF) pregnancy who was on hemorrhagic shock and successfully managed by cornual repairment and salpingectomy.Heterotropik gebelik, 30 000 vakada bir görülen, ekstrauterin gebeliğin intrauterine gebeliğe eşlik ettiği nadir görülen bir durumdur. Olgumuzda, rupture kornual gebeliğe, intrauterine gebelik eşlik etmektedir. Heterotropik gebelik tanısı, 11.gebelik haftasında ve hemorojik şok tablosunda iken konulmuştur. Tedavisi salfenjektomi ve kornual onarımla başarı ile yapılmıştır

Comparison of serum maternal adiponectin concentrations in women with isolated intrauterine growth retardation and intrauterine growth retardation concomitant with pre-eclampsia

Objective: the aim of this study was to compare serum maternal adiponectin concentrations in pregnant women with isolated intrauterine growth retardation (IUGR) and in pregnant women with IUGR concomitant with pre-eclampsia (IUGRcwPE). Material and Methods: Thirty patients with isolated IUGR (group 1), 20 patients with IUGRcwPE (group 2), and 30 healthy controls (group 3) between age 18-40 were included into the study. Venous blood samples of those patients were obtained in the starving state. Adiponectin con- centrations were measured by enzyme-linked immunosorbent assay in serum obtained after centrifugation. To find the differences between the groups, student t-test and one-way ANOVA statistical methods were used. Results: There were no differences between the groups in terms of age, body mass index, gestational age, and parity (p>0.05). the values of amniotic fluid index (p<0.001) and weight gained during pregnancy (p=0.017) were significantly different when compared among the three groups. the mean concentrations of adiponectin were 94.041 pg/mL in the IUGR group, 55.717 pg/mL in the IUGRcwPE group, and 51.831 pg/mL in the control group. Both of the differences between the IUGR and IUGRcwPE groups (p value; <0.05) and IUGR and control groups were statis- tically significant (p value; <0.001). However, there were no significant differences between the IUGRcwPE group and control group (p>0.05). Conclusion: We found that IUGR increased maternal serum adiponectin concentrations; however, this rise does not occur in pregnant women with IUGRcwPE

Complete hydatidiform mole presenting as placenta previa in a twin pregnancy with a coexisting normal foetus: Case report

We present a case of a patient with a complete hydatidiform mole co-existing with a normal foetus (CMCF) who had a caesarean section in week 32 of gestation, resulting in a live female infant weighing 1590 grams. The mother, with a normal bleeding pattern, did not require any surgical intervention. She was discharged from hospital on the third post-operative day. Premature termination is recommended in this type of pregnancy because of the risks associated with molar pregnancies. However, with the close follow-up of these pregnancies, good maternal and perinatal results may be obtained. (We present a case of a patient with a complete hydatidiform mole co-existing with a normal foetus (CMCF) who had a caesarean section in week 32 of gestation, resulting in a live female infant weighing 1590 grams. The mother, with a normal bleeding pattern, did not require any surgical intervention. She was discharged from hospital on the third post-operative day. Premature termination is recommended in this type of pregnancy because of the risks associated with molar pregnancies. However, with the close follow-up of these pregnancies, good maternal and perinatal results may be obtained.

Maternal Serum Nitric Oxide Levels in Adolescent Pregnancies

OBLECTIVE: We aimed to evaluate maternal serum nitric oxide (MSNO) levels in adolescent pregnancies. STUDY DESIGN: A total of forty five pregnancies were included to the study, of these eight were adolescent pregnancies (age range, 18-19 years old). Factors analyzed between adolescent pregnancies and reproductive age pregnancies (age range 20-35 years old) were; age, gravidity, parity, gestational weeks, umbilical and middle cerebral artery Doppler velocimetry values, birth weigts, APGAR 5. minute scores and MSNO levels. Statistical analyses were carried out by using the statistical packages for SPSS 15.0 for Windows (SPSS Inc., Chicago, IL, USA) with Chi-square (χ2) test and Student’s t test. The receiver operator characteristic (ROC) curve analysis was used to establish the cutoff values for MSNO levels. RESULTS: Demographic and clinical characteristics showed no statistically significant difference among the groups (p>0.05). MSNO levels were statistically significantly lower in adolescent age pregnancies.                                               CONCLUSION: According to current study, MSNO levels were statistically significantly different from reproductive age pregnancies. MSNO levels may be a discriminative marker in adolescent age pregnancies but further studies with larger participants are needed to get more definite results

Evaluation of the Diagnostic Accuracy of Serum D-Dimer Levels in Pregnant Women with Adnexal Torsion

We aimed to evaluate the diagnostic accuracy of serum D-dimer levels in pregnant women with adnexal torsion (AT). The pregnant women with ovarian cysts who suffered from pelvic pain were divided into two groups; the first group consisted of the cases with surgically proven as AT (n = 17) and the second group consisted of the cases whose pain were resolved in the course of follow-up period without required surgery (n = 34). The clinical characteristics and serum D-dimer levels were compared between the groups. Patients with AT had a higher rate of elevated serum white blood cell (WBC) count (57% vs. 16%, p = 0.04) and serum D-dimer levels (77% vs. 21%, p < 0.01) on admission in the study group than in the control group. Elevated D-dimer and cyst diameter larger than 5 cm yielded highest sensitivity (82% for each); whereas the presence of nausea and vomiting and elevated CRP had the highest specificity (85% and 88%, respectively). This is the first study that evaluates the serum D-dimer levels in humans in the diagnosis of AT, and our findings supported the use of D-dimer for the early diagnosis of AT in pregnant women