Biochemiczne markery pierwszego trymestru w ciąży bliźniaczej

Objective: Our aim was to investigate the first trimester serum markers and nuchal translucency (NT) measurements in twin pregnancies in our population. Materials and methods: We reviewed the results of all double tests that were performed in our hospital over a three-year period. Out of them, we selected all twins and compared them with a group of three times as many singleton controls. NT measurements and the first trimester serum markers from 49 twin pregnancies were compared to those of 147 pregnant women with normal singleton pregnancy. Results: There were no statistically significant differences in age, gestational age and maternal weight between the two groups (p>0.05). We found similar NT measurements in the two groups. The median MoM of Pregnancy- Associated Plasma Protein A (PAPP-A) and fβ-hCG levels in twins were statistically significantly higher than those in singleton pregnancies. Twelve percent of the twins (12.2 %) were the result of assisted reproduction technologies. IVF versus naturally conceived pregnancies showed similar MoM of PAPP-A (2.2 vs. 1.2, respectively) and fβ-hCG (Mann-Whitney U; p = 0.195 and p = 0.958). Conclusions: Our study revealed that median PAPP-A and fβ-hCG levels for twins were less than twice those of singleton values.Cel pracy: Celem naszego badania było zbadanie surowiczych markerów pierwszego trymestru oraz przezierności karkowej (NT) w ciążach bliźniaczych w naszej populacji. Metoda: Przeanalizowano wyniki wszystkich testów podwójnych wykonanych w naszym szpitalu w ciągu trzech lat. Wyodrębniono grupę ciąż bliźniaczych (n=49) i porównano ją z trzy razy większą grupą kontrolną prawidłowych ciąż pojedynczych (n=147). Wyniki: Nie znaleziono istotnych statystycznie różnic w wieku, wieku ciążowym i masie ciała ciężarnych pomiędzy grupami (p>0,05). Stwierdzono podobne wyniki pomiaru NT w obu badanych grupach. Mediana MoM białka PAPP-A i poziom fβ-hCGw ciążach bliźniaczych był istotnie wyższy niż w ciążach pojedynczych. Dwanaście procent ciąż bliźniaczych było efektem technik wspomaganego rozrodu. Ciąże w wyniku IVF oraz ciąże spontaniczne wykazywały się podobnych wynikiem MoM białka PAPP-A (2,2 vs. 1,2 odpowiednio) i fβ-hCG (Mann-Whitney U; p=0,195 i p=0,958). Wnioski: Średni poziom białka PAPP-A i fβ-hCG dla ciąż bliźniaczych był mniej niż dwa razy większy niż dla pojedynczych ciąż

H. pylori infection and antral nodular gastritis in children

Objectives: The aim of the study was to determine the prevalence of antral nodularity and establish its association with Helicobacter pylori infection in children. Methods: A total of 358 children (mean age: 10.35±3.15 years, M/F:0.95) who had upper gastrointestinal endoscopy were evaluated retrospectively in terms of clinical, endoscopic and histological findings. The association between antral nodularity and H. pylori infection was determined. Results: Antral nodularity was observed in 158 (44.1%) patients. H. pylori was detected in 138 (83.4%) of those patients with antral nodularity. Infected children with H. pylori compared to non-infected group were older (p= 0.0001). The antral nodularity was observed significantly higher in H. pylori-positive patients than in H. pylori-negative cases (p=0.0001). The sensitivity was 52%, specificity 78%, positive predictive value 87% and negative predictive value was 37%. Lymphoid follicle and aggregates formation was observed higher in patients with antral nodularity than patients without (p=0.0001 and p=0.017, respectively). Statistically significant difference was observed between antral nodularity and the grades of H.pylori density (p=0.0001). Conclusions: Children with antral nodularity were more likely to have H. pylori gastritis compared to children without. The parameters associated significantly with antral nodularity were older age, H. pylori infection and H. pylori density

A Successful Pregnancy by Utilization of Gradually Increasing Low Dose Gonadotrophin Stimulation in a Modified Natural Cycle in Vitro Fertilization Procedure: Case Report

The modified natural cycle in vitro fertilization (MNC-IVF) treatment can be a promising method for poor responder patients especially in young patients with poor ovarian reserve. A 34-year-old primary infertile woman presented with a history of poor ovarian response and cycle cancellation following controlled ovarian hyperstimulation during an IVF-ET procedure two months ago. During MNC-IVF treatment with intracytoplasmic sperm injection (ICSI), gradually increasing doses of hMG for three days (totally 675 IU) have been administered accompanied by daily 0,25 mg cetrorelix. Following ovulation triggering, one oocyte was picked up and a good quality (grade 1) embryo was transferred on day 2. A clinical pregnancy was established with ultrasonography on sixth weeks of gestation. Acceptable pregnancy rates per embryo transfer, low medication cost, relatively low risk of complications and higher patient acceptability are the main advantages of MNC-IVF treatment as a feasible treatment option especially for poor responder patients