Gestational diabetes mellitus screening and outcomes

Objective: To verify the usefulness of the World Health Organization criteria for the diagnosis of gestational diabetes mellitus in pregnant women and its effectiveness in the prevention of maternal and neonatal adverse results in women younger than 35 years without apparent risk factors for gestational diabetes mellitus. Material and Methods: This is a retrospective study based on population involving 1360 pregnant women who delivered and who were followed-up in a university hospital in Istanbul. All women underwent the 75-g oral glucose tolerance test screening, usually in between the 24 th- 28 th weeks of pregnancy. In all cases, the identification of gestational diabetes mellitus was determined in accordance with the World Health Organization criteria. Results: Approximately 28% of the pregnant women aged younger than 35 years with no risk factors for gestational diabetes mellitus were diagnosed with the oral glucose tolerance test in this study. In the gestational diabetes mellitus group, the primary cesarean section rate was importantly higher than that in the non-gestational diabetes mellitus group. Preterm delivery was also associated with gestational diabetes mellitus. The diagnosis of gestational diabetes mellitus was strongly associated with admittance to the neonatal intensive care unit. Neonatal respiratory problems didn’t showed any significant deviation between the groups. There was a moderate association between gestational dia - betes mellitus and metabolic complications. Conclusion: Pregnant women with no obvious risk factors were diagnosed with gestational diabetes mellitus using the World Health Organiza - tion criteria. The treatment of these women potentially reduced their risk of adverse maternal and neonatal hyperglycemia-related events, such as cesarean section, polyhydramnios, preterm delivery, admission to neonatal intensive care unit, large for gestational age, and higher neonata

Predictive risk factors in the treatment of gestational diabetes mellitus

WOS: 000215780200004PubMed ID: 26508897OBJECTIVE: This study aims to investigate predictive risk factors in the treatment of gestational diabetes mellitus (GDM). PATIENTS AND METHODS: A total of 256 pregnant tvomen who underwent 75 g oral glucose tolerance test (OGTT) during 24-28 weeks of pregnancy were included according to the World Health Organization criteria. Demographic characteristics of the patients, including age, parity, family' history of diabetes, body weight before pregnancy, and body weight at the diagnosis of GDM, were recorded. Fasting insulin and hemoglobin Ale (HbAlc) values at the time of diagnosis were evaluated. The patients were divided into two groups: those requiring insulin treatment (insulin group, n =89) and those receiving diet therapy (diet group, 71=167) during pregnancy according to the American Diabetes Association recommend ations. RESULTS: A total of 34.760 of the pregnant women with (TDM required insulin treatment. The mean age of these patients was significantly higher compared to the diet group (34.9 +/- 0.6 years vs. 31.9 0.6 years; PS 0.004). Body mass index before pregnancy was also significantly-higher in the insulin group than that in die diet group (32 0.9 kg/m(2) vs. 29 0.7 kg/m(2); P =0.004). Fasting blood glucose (FBG) during OGTT was 105.6 2.1 mg/d L and 96.7 1.1 mg/dL in the insulin group and diet group, respectively (P < 0.001). There was no significant difference in fasting plasma glucose during OGTT between the groups (P =0.069), while plasma glucose at two Flours was 161.1 +/- 6.8 mg/d L in the insulin group and 145.1 +/- 3.7 nig/dL in the diet group (P =0.027). At the dine of diagnosis, HbAlc values were significantly higher iii the insulin group compared to the diet group (5.3 0.1 vs. 4.9 0.1; P=0.001). There was no significant difference iii FBG and homeostasis model assessment -insulin resistance values between the groups (P=0.908, P=0.073). CONCLUSION: Our study results suggest that age, family history' of diabetes, body weight befivre pregnancy, FUG-, and HbAlc values are predictors for the necessity o f insulin treatment

Helicobacteria pylori seorpositiveness in hyperemesis gravidarum

Amaç: Bu çalışma da Helicobacteria pylori ile hiperemezis gravidarum arasındaki ilişkinin ortaya konması amaçlandı. Gereç ve Yöntem: Çalışmamıza 82 hiperemezis gravidarum tanısı almış gebe ile 98 gebe kontrol grubu olarak alındı. ELİSA tekniği ile 180 hastanın Helicobacteria pylori IgG, H. pylori Cytotoxin associated gene A (Cag A) pozitifliğine bakıldı. Bulgular: Hiperemezis gravidarum ve kontrol grubunda Helicobacteria pylori seropozitifliği açısından istatistiksel olarak anlamlı fark bulunamadı. Literatürde bu konuda kısıtlı sayıda çalışmaların çelişkili sonuçlar vermesi gebelikte Helicobacteria pylori taraması yapmak Türkiye koşullarında hem pratik değil hem de oldukça masraflı görünmektedir. Sonuç: Helicobacteria pylori ye karşı oluşmuş spesifik antikorların yüksek oranda pozitif olması nedeniyle,risk faktörü taşıyan kadınlara (önceki gebeliklerinde şiddetli hiperemezis gravidarum öyküsü veya gastrointestinal yakınmaları olanlar)bir sonraki gebeliklerinden önce Helicobacteria pyloritaramasının yapılması ve pozitif çıkanlara tedavinin verilmesi, hem gebelikteki şikayetlerinin azalmasında hemde risk faktörü taşıyan grubun aile fertlerininde taranarak, tedavisi, Helicobacteria pylori eleminasyonu açısından önerilebilir.Objective: In our study, we tried to present the relation of Helicobacteria pylori and hyperemesis gravidarum. Material and Method: 82 pregnancies complicated with hyperemesis gravidarum and 98 pregnancies controls were studied. In both groups Helicobacteria pylori IgG and Helicobacteria pylori Cytotoxin-associated gene A (Cag A) were studied by ELISA. Results: As a result we did not find any statistical significancy of seropositivity between hiperemezis gravidarum and control groups. In Turkey it seems to the non practical and expensive to scan or eradicate Helicobacteria pylori. Conclusion: In high risk population (previous hyperemesis gravid arum or evident gastrointestinal symptoms), on the other hand, Helicobacteria pylori specific antibody scanning and appropriate therapy before pregnancy and follow up the family may be feasible

The effects of polycystic ovary syndrome on gestational diabetes mellitus

WOS: 000374873900012PubMed ID: 26479686The aim of this study was to explore the inter-relationship between polycystic ovary syndrome and gestational diabetes mellitus, and demonstrate maternal and fetal outcomes. This was a case-control study in 1360 pregnant women who received a diagnosis of gestational diabetes mellitus between 24 and 28 weeks of gestational age. Among all diagnosed with gestational diabetes mellitus, 150 pregnant women had received a polycystic ovary syndrome, and 160 women who did not have polycystic ovary syndrome were designated as controls. The incidence of pregnancy-induced hypertension was 26.3% and 12% in the case and control groups, respectively. Preeclampsia was seen at an incidence of 12% and 6% in case and in control groups, respectively. The difference in neonatal hypoglycemia between the two groups was statistically significant, with an incidence of 17% and 5% in the case and in control groups, respectively. This study demonstrated that the presence of polycystic ovary syndrome along with gestational diabetes mellitus increases the risk of pregnancy induced hypertension by 2.4 fold, preeclampsia by 2 fold and neonatal hypoglycemia by 3.2 fold, compared to gestational diabetes mellitus alone

Bir olgu sunumu: Olağandışı over lokalizasyonu ve müller kanalı anomalili hastada başarılı gebelik

In this article we aimed to describe the clinical findings in a patient with subhepatic right ovary and müllerian duct anomalies who was successfully treated with in vitro fertilization (IVF) due to male factor infertility. Ovarian maldescent is a rare condition, and ovary localization can be seen up to the subhepatic region. This unusual ovarian localization suggests ovarian maldescent can be anywhere between the liver and pelvic brim When required, transabdominal ultrasound-guided oocyte retrieval and IVF can be performed successfully.Sağ over lokalizasyonu subhepatik alanda izlenen ve Müller kanal anomalileri bulunan bu olguda male faktör sebebiyle ıvf uygulanmıştır. İnmemiş over lokalizasyonu nadir görülmekle birlikte , görüldüğünde sıklıkla pelvis giriminde olmaktadır. Bu olguda literaütrde ilk defa bu kadar yüksek seviyede yani subhepatik bölgede yerleşmiş bir over lokalizasyonu belirtilmiştir. Male faktör sebebiyle IVF uygulanan hastaya abdominal oosit toplama işlemi yapılmış, inmemiş over olgularında overin pelvik giriminden subhepatik alana kadar herhangi bir alanda olabileceği fikri savunulmuştur

Vajinal Cuff'da izlenen nadir bir behçet ülseri olgusu

Behçet Syndrome (BS) is a rare chronic, inflammatory, recurrent and multisystemic disease that is characterised by vasculitis throughout the body. BS is an autoimmune disease that affects the neurological and gastrointestinal systems that is characterized by reoccurring oral and genital aphthosis, arthritis, eye and cutaneous lesions. In BS, genital lesions have been reported at rates of 60-90% in different series. Lesions are observed most commonly on the vulva labium majora, followed by the vagina and uterine cervix in descending order. However, no previous study has reported a lesion on the vaginal cuff of a patient who has undergone total hysterectomy. In this study, for the first time, we defined a rare vaginal cuff ulcer in a patient previously diagnosed with BS. This case study will be the first in literature and contribute to it by revealing the appearance of a genital ulcer on the vaginal cuff caused by BS. Moreover, we think that it should be considered in the differential diagnosis of vaginal lesions.Behçet sendromu (BS) nadir görülen, vaskülit ile karakterize kronik, inflamatuar, tekrarlayan, multisistemik bir hastalıktır. BS, tekrarlayan oral ve genital aftlar, artrit, göz lezyonları, kutanöz lezyonlar, gastrointestinal sistem ve merkezi sinir sistemi tutulumuyla karakterize otoimmün bir hastalıktır. Behçet sendromunda genital tutulum farklı serilerde %60-90 olarak rapor edilmiştir. Genital bölgede en sık tutulum vulvada labium majuslarda görülmektedir. Daha sonra azalan sıklıkta vajen ve servikste rapor edilmiştir. Fakat şu ana kadar histerektomize bir hastada vajinal cuffta herhangi bir tutulum bildirilmemiştir. Biz bu makalede daha önceden BS olduğu bilinen hastada ilk defa görülen nadir bir vajinal cuff ülseri tanımladık. Bu olgu BS’ye bağlı genital ülserin vaginal cuff da görülmesi bakımından literatürde ilk olup bu anlamda literatüre katkı sağlayacağını ve vajinal lezyonların ayırıcı tanısında göz önüne alınması gerektiğini düşünüyoruz

A rare gestational trophoblastic neoplasia form; placental site trophoblastic Tumor and literature review

Placental site trophoblastic tumor (PSTT) is one of the gestational trophoblastic neoplasias (GTN) arising from intermediate gestational trophoblasts. It is a rarely seen type of GTN’s, and 300 cases have been reported in the literature so far (1). Is also covers 1-2%of trophoblastic tumors (2). Having a low incidence limits the understanding of its etiology and clinical pathology. Typically seen in women of reproductive age and term pregnancy may occur months or years later. It may occur after any pregnancy as well. PTTY is not easy to diagnose in the early stages because patients often present with irregular vaginal bleeding or amenorrhea. ß-HCG levels are generally lower than those patients moderately high and choriocarcinoma (3). Infiltration of the proliferative growth myometrial muscle in the intermediate trophoblast is required for diagnosis. İntrauterine aspiration is inadequate and uterine curettage is required for diagnosis. While GTNs are responsive to chemotherapy, PSTTs are relatively chemoresistance due to the weak biological behavior (3). PSTT grows slowly, spreads into the uterus, and makes metastatis passing to lymph nodes. Hysterectomy is the most effective treatment to the non-metastatic disease (3). For metastatic patients and with high mitotic indexed large tumor adjuvant chemotherapy is recommended. We aim to provide a PSTT which is a rare form of GTNs’case accompanying the literature in the case report

Premature progesterone elevation does not affect pregnancy outcome in high-responder patients undergoing short-interval coasting in IVF cycles

WOS: 000399157000040PubMed ID: 26634938Background: We aimed to present the relationship between premature progesterone elevation (PPE) and clinical outcomes in high-responder patients who had a coasting period of 4000 pg/ml and/or > 20 follicles each >= 10 mm in diameter and at least 20% 3 15 mm) and who were coasted for = 1.3 ng/ml on the day of human chorionic gonadotropin (hCG) administration, designated in this study as PPE, does not appear to be related to adverse effects in terms of clinical outcomes in high-responder patients undergoing coasting < 4 days due to their high risk of developing OHSS treated with a long-acting GnRH-a protocol in IVF-embryo transfer cycles

Investigation 18-24 weeks of gestation fetal humeral lenght nomogram

Amaç: On sekiz-Yirmi dört gebelik haftaları arasında fetal humerus uzunluğu nomogramını araştırmak. Gereç ve Yöntemler: Bu çalışmaya 18-24 gebelik haftaları arasında bulunan 349 normal gebe dahil edildi ve çalışma retrospektif olarak yürütüldü. Transabdominal ultrasonografi ile fetusa ait fetal biyometrik ölçümler elde edildi.Bu fetusların humerus kemik uzunluğunun gebelik haftalarına göre dağılımı çıkarıldı ve persantil değerleri hesaplandı. Humerus uzunluğunun gebelik haftası ve diğer biyometrik parametrelerle olan korelasyon katsayıları arasındaki ilişki ve anlamlılık düzeyi araştırıldı. Bulgular: Gebeliğin 18-24. haftaları arasındaki humerus uzunluğunun medyan değerleri sırasıyla 25,28,31,33,35,37,39 mm olarak saptandı. Humerus uzunluğu (HL) ile gebelik haftası (GH) arasındaki ilişki (r2=0,908; P<0,001) Biparyetal çap (BPD) arasında (r2=0,89; P<0,001), femur uzunluğu (FL) arasında (r2=0,947; P<0,001), baş çevresi (HC) arasında (r2=0,930; P<0,001), karın çevresi (AC) arasında (r2=0,911; p<0,001) idi ve HL ile tüm diğer parametreler arasında istatiksel olarak anlamlı korelasyon saptandı. Sonuç: Toplumumuzdan elde ettiğimiz 18.-24. gebelik haftalarındaki humerus uzunluğu nomogramının ile dünyada kullanılan diğer humerus nomogramları ile uyumlu olduğu görüldü.Objective: To obtain the nomogram of the fetal humerus length (HL) at 18-24 weeks of gestation. Material and Methods: This retrospective study involved 349 pregnant women between 18-24 weeks gestation. Fetal biometric measurements were obtained by transabdominal ultrasound. The distributions of HL and percentile values were established according to 18-24 gestational weeks (GW). Correlation co efficients and associated P values for the relationships between the HL, GW and other biometri- cal parameters were defined. Results: Median values of humerus length between 18-24 weeks were 25,28,31,33,35,37, and 39 mm respectively. Statistically significant correlation was found between the HL and GW (r2=0.908; P&lt;0.001), biparietal diameter (r2=0.89; P&lt;0.001), femur length (r2=0.947; P&lt;0.001), head circumference (r2=0.930; P&lt;0.001), and abdominal circumference (r2=0.911; p&lt;0.001). Conclusion: The HL nomogram obtained at 18-24 gestational weeks from our patient population show conformity with the other humerus length nomograms used worldwide

Ozone (O3)-oxygen mixture therapy inhibits endometrial implant growth

WOS: 000372180000258