The thiol/disulfide balance in ketone positive and ketone negative pregnant women with nausea and vomiting — a prospective study in a tertiary center

Objectives: We aimed to investigate the thiol/disulfide balance in ketone positive (hyperemesis gravidarum) and ketonenegative pregnant women with nausea and vomiting.Material and methods: A total of 60 patients under the 14th week of pregnancy were included in this study, and they weredivided into two groups. Group 1 included 30 pregnant women with ketone positive, group 2 included 30 ketone negativepregnant women with nausea, and vomiting.Results: The native thiol, disulfide, and total thiol concentrations were measured using an automated method and comparedamong the two groups. There were also three indexes that are derived from disulfide, native and total thiol (Index1 = 100 × disulfide/native thiol); (Index 2 = 100 × disulfide/total thiol); (Index 3 = 100 × native thiol/total thiol). Whencompared with Group 1 and Group 2, total thiol was high, native thiol was low but not statistically significant. Disulphide(p = 0.046), index 1 (p = 0.036) and index 3 (p = 0.034) were statistically significant.Conclusions: Patients with ketone positive are shifting to OS direction due to lack of nutrients and electrolytes. This studyemphasizes the therapeutic potential of antioxidant supplementation, which is becoming an increasingly used approachin treating the symptoms of women with ketone positive

Ghrelin does not change in hyperemesis gravidarum

Objectives: Ghrelin levels can play an important role in maintaining the energy balance of pregnant women. Therefore,we investigated the relationship between HG and Ghrelin.Material and methods: 50 female patients admitted to the VAN Yüzüncü Yıl University, Gynecology and Obstetrics Departmentwere evaluated. The patients were divided into two groups: Group 1 included 25 pregnant women with HG, Group 2included 25 healthy pregnant women.Results: The two groups showed similarities in terms of age, gravidity, B-HCG and gestational age. There was no statisticallysignificant difference between the two groups in terms of the Ghrelin levels (p = 0.867).Conclusions: This study shows that there is no difference between Ghrelin levels and HG during pregnancy. IncreasedGhrelin in previous studies was attributed to low oral intake. Another study reported lower Ghrelin levels are not the resultof, but are rather the cause of, reduced oral intake during. The balancing of these two conditions does not lead to a changein the level of Ghrelin

A Fatal and Extremely Rare Obstetric Complication: Neglected Shoulder Presentation at Term Pregnancy

Stillbirth is still an important problem for parents and healthcare providers worldwide. Nowadays, the neglected shoulder presentation is usually observed in developing countries and is associated with increased risk of fetomaternal morbidity and mortality. In recent years, there were limited reports about obstetric management of this serious complication in the literature. In this case report, we aimed at describing the neglected shoulder presentation at term pregnancy that caused fetal death and discussing management options for this rare obstetric complication during labor

Maternal and Fetal Outcomes of Pregnant Women with Hepatic Cirrhosis

Aim. The reproductive hormone levels and systemic physiology of women with hepatic cirrhosis are altered. Existing data have indicated the adverse effects of cirrhosis on both the mother and the fetus. Pregnancy is successful in most of the patients with chronic liver disease. But maternal and fetal complication rates are still high for decompensated hepatic cirrhosis. In this study, we aimed to evaluate the clinical features, etiological factors, medications, morbidity, mortality, and obstetric outcomes of pregnant women with hepatic cirrhosis. Methods. Pregnant women, who were diagnosed with maternal hepatic cirrhosis and followed up in our clinic between 2014 and 2017, were retrospectively evaluated. The pregnant women that had been followed up for hepatic cirrhosis were classified as compensated disease and decompensated disease. Eleven cases were included in this period. Results. The mean age of cases was 33.5±5.5 years. The mean gravida number was 3.2±1.1, and the mean parity number was 1.7±1. Six cases were in the compensated cirrhosis stage, and 5 cases were in the decompensated cirrhosis stage. A pregnancy with decompensated cirrhosis was terminated after the fetal heart sound was negative in the 9th week of pregnancy. Spontaneous abortus occurred in one case (<20 weeks). The mean gestational week of the 9 cases was 33.3±6.2. Two of the 9 cases delivered birth vaginally. Seven cases delivered by cesarean section. The mean first- and fifth-minute APGAR scores were 6.6±1.41 and 8.2±1.56, respectively. The mean birth weight was 2303±981 g. Among 9 cases with live birth, 6 had compensated cirrhosis and 3 had decompensated cirrhosis. In the second trimester, upper gastrointestinal endoscopy was performed to all patients in terms of esophageal varices. Endoscopic band ligation was performed in 3 cases with upper gastrointestinal bleeding. The postpartum mortality did not occur. Discussion. Pregnancy is not recommended for patients with hepatic cirrhosis due to high maternal and fetal morbidity and mortality. The pregnancy course of cases with cirrhosis changes according to the stage of liver injury and severity of disease. Although the delivery method is controversial, delivery by cesarean section is recommended for patients with esophageal varices by the reason of bleeding from varices after pushing during labor. The bleeding risk must be kept in mind as coagulopathy is common in hepatic diseases. The maternal-fetal morbidity and mortality rates have been decreased by the current developments in hepatology, prevention of bleeding from varices with drugs and/or band ligation, improvement in liver transplantation, and increasing experience in this issue

Relationship between erythrocyte catalase and serum adenosine deaminase activities in eclampsia

Kurdoglu, Mertihan/0000-0002-5344-9739; Bugdayci, Guler/0000-0002-4060-3354; Cebi, Aysegul/0000-0003-3804-7966WOS: 000265583100007PubMed: 19172437Objective. To examine the relationship between antioxidant status and T-cell activation in the pathogenesis of eclampsia by measuring the activities of erythrocyte catalase, an enzyme of antioxidant mechanism, and serum adenosine deaminase (ADA), regarded as a marker of T-cell activation. Methods. A total of 60 patients [20 eclamptic (E) pregnant women, 20 healthy pregnant (HP) women and 20 non-pregnant (NP) women] were included in the study. Maternal venous blood samples were obtained from each patient during weeks 28-37 of gestation, and biochemical analyses of catalase activity in erythrocytes and ADA activity in serum were carried out. Results. Erythrocyte catalase activity was significantly lower and serum ADA activity was significantly higher in the E pregnant women when compared with the HP women and NP women (P 0.001). No significant correlation was observed between erythrocyte catalase activity and serum ADA activity. Conclusions. Erythrocyte catalase and serum ADA activities may at least in part contribute to the pathogenesis of eclampsia. However, more studies are needed to verify and clarify the relationship between antioxidant status and T-cell activation in eclampsia

Maternal serum thiol/disulfide homeostasis in pregnancies complicated by fetal hypoxia

We aimed to evaluate maternal serum thiol/disulphide homeostasis in pregnancies complicated by fetal distress (FD). A total of 100 patients beyond the 34th week of pregnancy were included in this study, and they were divided into two groups. The study group included 50 patients who had been diagnosed with FD; the control group was composed of 50 patients who had shown no signs of FD and who had undergone an elective (previous) caesarean section (CS). The native thiol, total thiol and native thiol/total thiol (%) concentrations were lower in Group 1 patients than Group 2 patients (p < .001). The disulphide, disulphide/native thiol (%) and disulphide/total thiol (%) concentrations were higher in Group 1 patients than Group 2 patients (p < .001). This study suggests that maternal thiol/disulphide homeostasis is impaired in pregnancies complicated by FD.IMPACT STATEMENT What is already known about this subject? Oxidative stress (OS) has previously been investigated in FD. This study reports for the first time a new novel and automatic measurement method. What do the results of this study add? This study shows that the thiol balance shifts in the direction of disulphide in the cases of FD. What are the implications of these findings for clinical practice and further research? Thiol balance can be used for the timely diagnosis of FD