Oligo-Amenorrheic Polycystic Ovary Syndrome Patients Have Higher Risk For Cardiovascular Disease Compared to Hirsute Patients and Healthy Control

OBJECTIVE: To evaluate the clinical, endocrine and cardiovascular disease risk profile differences in polycystic ovary syndrome (PCOS) patients who complain of hirsutism or oligo-amenorrhea. STUDY DESIGN: A total of 129 consecutive women underwent the screening investigation at Dr. Sami Ulus Women’s Health Teaching and Research Hospital between December 2009 and June 2010. There were 48 PCOS patients with hirsutism while 49 PCOS patients with oligo-amenorrhea and 32 healthy women included in the study. Body mass index (BMI), Waist/hip ratio (WHR) serum follicle stimulating hormone (FSH), luteinizing hormone (LH), progesterone, free testosterone, glucose, low density lipoprotein (LDL), total cholesterol, high density lipoprotein (HDL), triglceride (TG), high sensitive C reactive protein (hs-CRP), insulin, insulin sensitivity and carotid intima thickness (CIMT) were compared in PCOS patients who complain of hirsutism or oligo-amenorrhea and control group. RESULTS: Mean ages were similar among groups. There were significant differences among groups in terms of BMI, WHR, total cholesterol, LDL, TG, LH, fasting glucose, hsCRP, CIMT (p<0.05) (table 1). BMI, waist-hip ratio (WHR), total cholesterol, LDL, TG, LH, estrodiol, fasting glucose adjusted mean CIMT values were 0.40±0.01 mm, 0.49±0.012mm, 0.34±0.012mm (p<0.001) in hirsute, oligo-amenorrheic and control groups respectively. CONCLUSION: PCOS patients with oligo-amenorrhea without hirsutism have higher risk for cardiovascular disease (CVD) and abnormal lipid profile than patients with hirsutism without oligo-amenorrhea

Educational Status Number of Previous Contraceptive Failure Do not Effect the Women’s Contraceptive Preference After Surgical Abortion in Turkey

OBJECTIVE: The aim of this study was to investigate the determinants of the contraceptive preference of couples after surgical abortion result of contraceptive failure or no contraception. STUDY DESIGN: Study population consisted of 302 women who admitted to Dr. Sami Ulus Maternity and Women’s Health Teaching and Research Hospital family planning unit and underwent surgical abortion. All pregnancies were in their 5-10 th weeks of gestation. Gravida, parity, number of previous surgical abortions, living children number, last pregnancy status with current contraceptive method were recorded. RESULTS: Mean age, gravida, parity, number of previous surgical abortions and living children were 31.05±6.52 (19-46 years), 4.30±1.83 (1-11), 2.33±1.32 (0-7), 0.96±1.05 (0-5), 2.28±1.29 (0-7) respectively. There were 183 (60,6%) women with previous surgical abortions, mean number of surgical abortions were 1.59±0.6. Among these patients there were 82 (45%) patients using no contraceptive method and 55 (30%) women were using coitus interruptus. Condoms were being used only by 29 (16%) women. Oral contraceptives (OCS) were being used in 11 (6%) women. No association was observed between condom or OCS use and educational status (p=0.786) in these patients. Condom or OCS users a little bit younger but not reached statistical significance (p=0.071). Women with different contraceptive use were similar in terms of gravida, parity, interval from previous pregnancy (p=0.423, p=0.402, 0.467 respectively). No association was obtained between number of previous surgical abortion, current contraceptive use (p=0.386) and educational status (p=0.735). CONCLUSION: Our study suggests that educational status, number previous contraceptive failure or maternal age does not effect the contraceptive preference after surgical abortion

Association of Complete Blood Count Parameters with Gestational Diabetes Mellitus

Objective: The aim of this study is to evaluate the relationship between hematological changes in early pregnancy using complete blood count parameters and gestational diabetes mellitus. Study Design: One hundred pregnant with gestational diabetes mellitus and one hundred healthy pregnant were included in the study. Blood samples for routine complete blood count parameters in first trimester of pregnancy were analyzed. Results: In the gestational diabetes mellitus group white blood cell, platelet count, neutrophil and lymphocyte count, mean platelet volume, red cell distribution width were significantly higher than control group. However, there was no significant difference between groups with regard to neutrophil to lymphocyte ratio and platelet to lymphocyte ratio levels. In binary logistic regression analysis; first trimester mean platelet volume and red cell distribution width values were found to be independently associated with diagnosis of gestational diabetes mellitus. Conclusion: This study demonstrates that hematological parameters in first trimester of pregnancy are closely associated with gestational diabetes mellitus. The parameters that are routinely and automatically calculated in complete blood count; may be used to predict gestational diabetes mellitus

Medroxyprogesterone Acetate Plus Metformin to Prevent Persistent Endometrial Hyperplasia

OBJECTIVE: To determine the effect of metformin on treatment response in simple endometrial hyperplasia without atypia. STUDY DESIGN: In this study, we identified 134 women with simple endometrial hyperplasia without atypia. Seventy two of these women were administered cylic oral medroxyprogesterone acetate 10 mg/day for 3 months, 62 of these women were also receiving metformin 1000 mg/day due to preexisting insulin resistance and and all subjects underwent control endometrial sampling after treatment. All subjects were evaluated in terms of age, gravidity, parity, body mass index (BMI), menstrual cycle, luteal phase endometrial thickness, uterine fibroids, ovarian cysts, serum CA 125 levels, systemic disorders, cigarette smoking. All parameters and metformin were assessed for the effects on treatment success. RESULTS: Out of 72 women who were administered medroxyprogesterone acetate 10 mg/day for 3 months, 15 of them were diagnosed as endometrial hyperplasia in control endometrial sampling while only 5 women had persistent endometrial hyperplasia in group with receiving both medroxyprogesterone acetate 10 mg/day and metformin 1000 mg/day (P<0.05). Age, gravidity, serum CA125, BMI, pretreatment endometrial thickness were comparable between groups (P>0.05). CONCLUSION: Medroxyprogesterone acetate and metformin may be used as an adjunctive therapy for persistent endometrial hyperplasias especially in women with high body mass index

Myometrial elasticity determined by elastosonography to predict preterm labor

Sengul, Ilker/0000-0001-5217-0755WOS: 000341928900003PubMed: 24199673Aim: To determine the utility of elastosonography (ES) combined to cervical length measurement to predict preterm labor. Methods: One hundred twenty-seven women with pregnancies between 21 to 36 weeks of gestation without any risk factor for preterm labor were included in the study. All subjects underwent sonographic evaluation including fetal biometry, cervical length measurement and ES of uterine myometrium. Subcutaneous tissue was the reference point for ES evaluation. Tissue strain ratio values were obtained from all patients. Results: Cervical length was a significant predictor for preterm delivery (AUC = 0.958, p4.7 [24.5 (95 CI, 4.1-146.5, p<0.001)] were the risk factors for preterm delivery. Conclusion: Elastosonographic evaluation of uterine myometrium was found to be significantly correlated with cervical length but cervical length measurement is a better predictor for preterm labor than ES

Predictive Value of Obstetrical Doppler Parameters to Predict Oxidative Stress and Cord Blood PH in Newborn Infants

OBJECTIVE: We sought to determine the clinical value of obstetrical Doppler performed at early stages of active labor in predicting oxidative stress and cord blood pH in neonates. STUDY DESIGN: A total of 54 pregnant women with oligohydramnios who were in active labor were enrolled for the study. Active labor was confirmed for each woman according to uterine contraction frequency, cervical dilatation and effacement. Subjects with amniotic fluid index (AFI) lower than 80 mm were included in the study. Doppler assessment included uterine artery (UtA), umbilical artery (UmA) and middle cerebral artery (MCA) measurements. Umbilical cord lengths were measured after delivery. Cord blood gamma glutamyl transferase (GGT) levels and umbilical arterial blood pH were analyzed. RESULTS: Umbilical artery PI significantly predicted cord blood GGT levels >101 ıu/L (area under curve=0.690, P=0.018). Umbilical artery PI significantly predicted cord blood pH<7.21 (area under curve (AUC) =0.870, P=0.015). None of the MCA Doppler parameters were significantly correlated with cord blood pH or cord blood GGT (P>0.05). Also, MCA Doppler studies could not significantly predict cord blood pH<7.21 OR GGT>101(P>0.05). CONCLUSION: This data led us to conclude that UmA Doppler parameters at early periods of active labor in high-risk population may be predictive for newborn well-being

Clinical Significance of Discordance Between Fetal Biparietal Diameter and Femur Length

OBJECTIVE: To investigate if fetal biometric discordance (FBD) between biparietal diameter (BPD) and femur length (FL) has an association with estimated fetal weight (EFW), fetal birth weight (FBW) and gestational age (GA) at delivery. STUDY DESIGN: Records of 1496 women with singleton pregnancies who attended to our institution for pregnancy follow-up between January 1st 2009 and January 1st 2010 were retrospectively analyzed. Fetuses with FBD lasting until delivery were identified. Degree of discordance (DOD) was defined as the variation between BPD and FL in terms of days. DOD at the time of initial diagnosis of FBD (DOD-ID) and before delivery (DOD-BD), initial GA at diagnosis of discordance (GADD), GA at delivery, EFW and fetal birth weight (FBW) were determined for each fetus. Correlation and linear regression analysis was used to determine associations between study parameters. RESULTS: GADD positively correlated with FBW (r:0.497, p<0.001) and gestational age at delivery (r:0.313, p=0.001), and negatively correlated with preterm delivery(PD) (r: -0.404, p<0.001). DOD before delivery positively correlated with difference between EFW prior to delivery and actual FBW (r:0.491, p<0.001). CONCLUSIONS: Fetal biometric discordance, especially when diagnosed early in pregnancy is associated with increase in preterm and low birth weight deliveries. Also, increase in DOD-BD may result in FBW miscalculations

Ultrasonografik endometriyal kalınlık ölçümü atipisiz endometriyal hiperplazi tedavi cevabında öngörücüdür

Objective: We sought to determine the predictors of treatment response in simple endometrial hyperplasia without atypia. Material and Methods: We prospectively treated 67 women with simple endometrial hyperplasia without atypia who were administered cyclic oral medroxyprogesterone acetate 10 mg/day for 12 days of luteal phase for 3 months and underwent control endometrial sampling after treatment. All subjects were evaluated in terms of age, gravidity, parity, body mass index (BMI), menstrual cycle, endometrial thickness, uterine fibroids, ovarian cysts, serum CA 125 levels, systemic disorders and cigarette smoking. All parameters were used to predict treatment success. Results: Persistent hyperplasia was observed in 11 subjects. Endometrial thickness was significantly correlated with treatment failure (r=0.293, p=0.015). In ROC analysis, endometrial thickness was found to be predictive for persistent hyperplasia (area under curve: 0.724, P=0.019). Optimal cut off value was calculated to be 16.5 mm with 64% sensitivity, 72% specificity and 91% negative predictive value. The number of persistent hyperplasia in women with and without endometrial thickness greater than 16.5 mm was significantly different (7/23 vs. 4/45, p=0.029). Odds ratio of endometrial thickness higher than 16.5 mm for treatment failure was 4.4 (95% CI, 1.2-17.4, p=0.03). Conclusion: Results of this study suggest treatment modification according to the baseline endometrial thickness in patients with simple endometrial hyperplasia without atypia. © 2013 by the Turkish-German Gynecological Education and Research Foundation

Obstetrik Doppler parametlerinin yenidoğanda oksidatif stres ve Kord pHsını öngörmedeki değeri

AMAÇ: Aktif doğum eyleminin erken döneminde obsterik Dopplerin oksidatif stres ve yenidoğan kord kanı pH sını öngörmedeki değerini tanımlamayı amaçladık. GEREÇ VE YÖNTEM: Çalışmaya aktif doğum eyleminde oligohidramniozu olan 54 hasta dahil edildi. Aktif doğum eylemi her hasta için uterin kontraksiyon, servikal dilatasyon ve efasman ile doğrulandı. Amniotik sıvı indeksi (AFİ) 80 mm altında olan hastalar dahil edildi. Doppler değerlendirmesi umbilikal arter, uterin arter ve orta serebral arter parametrelerini içermekteydi. Umbilikal kord uzunluğu doğumdan sonra ölçüldü. Kord kanı gama glutamil transferaz (GGT) düzeyi ve umbilikal arter PH düzeyi ölçüldü. BULGULAR: Umbilikal arter PI değeri, kord kanı GGT 101ıu/L düzeyini anlamlı olarak öngörmekteydi (AUC0,690, p0,018). Umbilikal arter PI değeri, kord kanı pH7,21 değerini anlamlı olarak öngörmekteydi (AUC0,870, p0,015). MCA doppler parametrelerinden hiçbiri ne kord kanı ne de pH değeri ile anlamlı korele idi (p0,05). Ayrıca MCA Doppler çalımaları kord kanı pH7,21 veya GGT101 değerini öngörmüyordu (p0,05). SONUÇ: Bu veriler aktif doğum eyleminin erken dönemindeki yüksek riskli hastalarda umbilikal arter Doppler parametrelerinin yenidoğan iyilik halini değerlendirmede öngörücü olabileceğini göstermektedir.OBJECTIVE: We sought to determine the clinical value of obstetrical Doppler performed at early stages of active labor in predicting oxidative stress and cord blood pH in neonates. STUDY DESIGN: A total of 54 pregnant women with oligohydramnios who were in active labor were en- rolled for the study. Active labor was confirmed for each woman according to uterine contraction fre- quency, cervical dilatation and effacement. Subjects with amniotic fluid index (AFI) lower than 80 mm were included in the study. Doppler assessment included uterine artery (UtA), umbilical artery (UmA) and middle cerebral artery (MCA) measurements. Umbilical cord lengths were measured after delivery. Cord blood gamma glutamyl transferase (GGT) levels and umbilical arterial blood pH were analyzed. RESULTS: Umbilical artery PI significantly predicted cord blood GGT levels >101 ıu/L (area under curve0.690, P0.018). Umbilical artery PI significantly predicted cord blood pH0.05). Also, MCA Doppler studies could not significantly predict cord blood pH101(P>0.05). CONCLUSION: This data led us to conclude that UmA Doppler parameters at early periods of active labor in high-risk population may be predictive for newborn well-being