Maternal plasma fetuin-A levels in fetal growth restriction: A case-control study

Background: Higher Fetuin-A (FA) concentrations were found to be associated with obesity and there is an interest to the relation between maternal FA and pregnancy outcomes. Objective: In this study, our aim was to evaluate the association of maternal plasma levels of FA with fetal growth restriction (FGR). Materials and Methods: 41 pregnant women with FGR and 40 controls were recruited in this case-control study between July and November 2015. At the diagnosis of FGR, venous blood samples (10 cc) were obtained for FA analysis. Results: Maternal plasma FA levels were significantly higher in fetal growth-restricted pregnant women compared with controls (19.3 ± 3.0 ng/ml vs 25.9 ± 6.8 ng/ml, p = 0.001). Area under receiver operating characteristic curve analysis of FA in FGR was 0.815 (95% confidence interval (CI): 0.718-0.912, p < 0.001). The maternal FA levels with values more than 22.5 ng/ml had a sensitivity of about 73.17% (95% CI: 56.79- 85.25) and a specificity of about 82.5% (95% CI: 66.64-92.11) with positive and negative predictive values of about 81.08% (95% CI: 64.29-91.45) and 75% (95% CI: 59.35-86.30), respectively. Therefore, the diagnostic accuracy was obtained about 77.78%. Conclusion: The results of this study show higher maternal plasma levels of FA in FGR. Further studies are needed in order to demonstrate the long-term effects of FA in pregnancies complicated with FGR and early prediction of FGR

Diagnostic value of CA 19-9 in pregnancies complicated by spinal neural tube defects: a preliminary study

Objectives: Various physiological and pathological conditions can induce significant variations in plasma concentrations of tumor markers, such as CA 19-9, which is present in the serum and amniotic fluid of pregnant women. Herein, we aimed to determine the clinical importance of maternal serum CA 19-9 levels in the diagnosis of neural tube defects (NTDs). Material and methods: A total of 100 women were included in this controlled cross-sectional study. Thirty-three patients whose pregnancies were complicated by isolated meningocele or meningomyelocele constituted the study group, whereas 33 normal, healthy pregnant women constituted the control group, and 34 age- and body mass index (BMI)-matched non-pregnant women were chosen for the validation group. Results: The mean maternal serum CA 19-9 levels were 17.2 ± 17.0 IU/mL, 7.1 ± 5.9 IU/mL, and 4.7 ± 3.6 IU/mL in the study, control, and validation groups, respectively (p < 0.001). ROC analyses showed that elevated CA 19-9 values may predict NTDs (p < 0.001). The cut-off value for CA 19-9 was found to be 9.6 IU/mL at 70% (51%–84%, 95% CI) sensitivity and 84% (74%–92%, 95% CI) specificity. Conclusions: CA 19-9 may be a promising noninvasive marker for NTDs. Further studies are needed to reveal the clinical applicability and diagnostic potential of maternal serum CA 19-9 levels in the identification of NTDs

Fetoscopic Laser Coagulation in Twin-Twin Transfusion Syndrome: Case Series

Twin-to-twin transfusion syndrome is a fatal complication and twins with monochorionic/diamniotic placentas are affected due to placental vascular anastomoses, producing volume transfer of blood from one twin to the other. The donor twin becomes hypovolemic with oligohydramnios and the recipient becomes hypervolemic with polyhydramnios. Twin-to-twin transfusion syndrome is associated with increased perinatal morbidity and mortality and expresses longstanding health hazards. Serial amnioreduction and fetoscopic laser photocoagulation of the vascular anastomoses are the main therapeutic approaches for twin-to-twin transfusion syndrome. Higher survival rates after fetoscopic laser ablation of the anastomotic vessels in comparison to serial amnioreduction have been reported in multicenter randomized clinical trials. We report the fetoscopic laser coagulation of three twin-to-twin transfusion syndrome cases at Ankara Dr. Zekai Tahir Burak Health Practice Research Center, Perinatology Clinics

The association of serum androgens and insulin resistance with fat distribution in polycystic ovary syndrome

Yucel, Aykan/0000-0002-5888-692XWOS: 000238005400014PubMed: 16337726Objective: The aim of the study was to compare the body fat distribution of women with polycystic ovary syndrome (PCOS) with age and body mass index matched healthy controls and to investigate if androgens and insulin resistance associated with fat distribution. Study design: Thirty-three PCOS and 21 age and body mass index (BMI) matched healthy control women were evaluated in terms of body fat distribution with dual X-ray absorpsiometry (DEXA). Blood samples were obtained for follicle stimulating hormone (FSH), luteinizing hormone (LH), estradiol, prolactin, thyroid stimulating hormone (TSH), dehydroepiandrosterone-sulfate (DHEA-S), free testosterone, sex hormone binding globulin (SHBG), insulin and glucose levels. A 75 g 2 h glucose tolerance test was performed for each woman. Insulin resistance was estimated by fasting insulin level, fasting glucose/insulin ratio and 75 g 2 h glucose tolerance test. The Student's t-test and Mann-Whitney U-test were used to compare the groups. Pearson and Spearman rank correlation coefficients were calculated for normally and normormally distributed variables, respectively. Partial correlation coefficients were calculated using age and BMI as covariates. Results: Fat mass in trunk and arms were significantly higher in patients with PCOS (p < 0.043 and 0.036, respectively). The ratio of fat mass in trunk to fat mass in legs were significantly higher in patients with PCOS (p < 0.011). Free testosterone was found to be positively correlated with fat mass in arms (r = 0.401, p < 0.05). There was still significant correlation between free testosterone and fat mass in arms (r = 0.5964, p < 0.05) after controlling for age and BMI. Conclusion: Free testosterone level is positively correlated with the fat mass in arms in women with PCOS. (C) 2005 Elsevier Ireland Ltd. All rights reserved

Contrast&#8722;induced monoplegia following coronary angioplasty with iopromide

Seizures, alterations in mental and cerebral functions, and ophthalmoplegia are known side effects of contrast agents. Here we report a case of self-limiting monoplegia in a patient after the administration of intracoronary iopromide after coronary angiography which emphasises that, although benign, contrast-induced monoplegia is a neurological disease which requires careful evaluation and accurate management.Seizures, alterations in mental and cerebral functions, and ophthalmoplegia are known side effects of contrast agents. Here we report a case of self-limiting monoplegia in a patient after the administration of intracoronary iopromide after coronary angiography which emphasises that, although benign, contrast-induced monoplegia is a neurological disease which requires careful evaluation and accurate management

Plasma adrenomedullin levels in patients with polycystic ovary syndrome

Yucel, Aykan/0000-0002-5888-692XWOS: 000241165400022PubMed: 16963041Objective: To evaluate adrenomedullin levels in patients. with polycystic ovary syndrome (PCOS). Design: Prospective study. Setting: Department of obstetrics and gynecology in a university hospital. Patient(s): Thirty-eight women with PCOS and 29 healthy control subjects were enrolled in the study. Intervention(s): Plasma. adrenomedullin, serum androstenedione, free T, T, DHEAS, SHBG, thyrotropin, PRL, FSH, LH, and E-2 were measured in each subject. Insulin resistance was estimated by fasting insulin level, fasting glucose:insulin ratio and 75-g glucose tolerance test for 2 hours. Main Outcome Measure(s): Plasma adrenomedullin levels and, correlations among adrenomullin and gonadotropins , female sex steroids, androgens, and insulin resistance. Result(s): There was no significant difference concerning plasma adrenomullin concentrations between the groups. In patients with PCOS, fasting glucose, fasting insulin, body mass index, and free T were inversely 179 y correlated with glue correlated with the plasma adrenomedullin. Plasma adrenomedullin was significantly correlated with glucose: insulin ratio. After controlling for, body mass index, there were no significant correlations between the above-mentioned parameters. Conclusion(s): Adrenomedullin may play a role in regulating the insulin metabolism in patients with PCOS

Maternal and perinatal effects of vaginal delivery after caesarean section

We aimed to determine the risk factors of vaginal delivery after caesarean section (VDAC) that may be effective on maternal and neonatal outcomes and compare the pregnancy outcomes of VDAC with the results of the previous caesarean delivery. 36 women, who had VDAC in Dr. Zekai Tahir Burak Women's Health Education and Research Hospital between 2009-2014 years, were included in this study. Mean age of patients was 32.53± 3.595, mean birth week of previous caesarean was 38.21 ± 1.84 and mean birth week of present vaginal delivery was 36,10 ± 3,99. Birth weeks of previous caesarean and present vaginal deliveries were significantly different. Neonatal birth weight was not significantly different between these groups. Gravida and parity of the patient, and the number of previous vaginal deliveries, have been identified as factors that reduce adverse pregnancy outcomes by lineer regression analysis. Increased number of previous vaginal deliveries, gravida and parity reduce the adverse pregnancy outcomes in women having VDAC. [Med-Science 2016; 5(4.000): 957-60

Prenatal diagnosis of the persistent right umbilical vein, incidence and clinical significance

Prenatal diagnosis of persistent right umbilical vein (PRUV) is important due to accompanying malformations. Pregnant women diagnosed with PRUV were analysed retrospectively. Intrahepatic PRUV was seen in 12 of 10.743 foetuses and its incidence was found to be 0.11%. The gestational week at the time of diagnosis was between 20 and 35 weeks. Six of the cases had additional abnormal sonographic findings (50%) and six cases (50%) were isolated. Major congenital malformations were seen in four (33.3%) foetuses, 75% of which were congenital heart disease (CHD). Genitourinary system anomaly accompanied in two cases (16.6%). Invasive diagnostic tests were applied to three pregnant women and the results were reported as normal karyotype. In PRUV cases, a detailed sonographic examination should be performed, especially the cardiovascular system. Although PRUV cases do not appear to be associated with chromosomal abnormalities, invasive diagnostic tests should be recommended in the presence of concomitant anomalies.Impact statement What is already known on this subject? The persistent right umbilical vein (PRUV) is a pathological vascular anomaly, in which the left umbilical vein regresses and the right umbilical vein remains open. PRUV can occur in an isolated form that represents its normal variant or be associated with other major or minor anomalies. What do the results of this study add? Additional abnormal sonographic findings were accompanied in 50% of PRUV, major anomaly was detected in 33.3% of them and cardiovascular abnormalities constituted 75% of foetuses with major anomalies. What are the implications of these findings for clinical practice and/or further research? The presence of concomitant anomalies in PRUV cases is not rare and detailed anatomy screening should be done. The most common accompanying abnormality is seen in the cardiovascular system, so foetuses with PRUV should be evaluated by foetal echocardiography

Relationship between neck circumference and overactive bladder in women with metabolic syndrome: a preliminary study

WOS: 000391829500006PubMed: 25854906To investigate relationship between overactive bladder (OAB) and metabolic syndrome (MtS) by using neck circumference (NC). In retrospective view of prospective collected data, 204 women with or without OAB were enrolled into study, between August 2012 and December 2013. All patients were administered OAB validated questionnaires (OAB-V8) and whose score was > 8 were accepted as OAB. Patients were divided into two groups and group 1 consisted of patients with OAB, group 2 consisted of patients without OAB. Demographic data with anthropometric measurements and blood analyses were recorded. Statistical analyses including receiver operating characteristic (ROC) curves were performed; statistically significant p was < 0.05. Mean age was 41.06 +/- 9.78 years. There were 115 (56.4 %) patients in group 1, and 89 (43.6 %) patients in group 2. OAB-V8 scores were significant higher in group 1 than group 2 (p < 0.001). Waist circumference (WC) and NC measurements were statistical significant longer in group 1 than group 2 (p < 0.001). In multivariate logistic regression analyses age, body mass index, MtS, WC, and NC were statistical significant associated with OAB. In ROC curves, area under the curve (AUC) was 0.72 cm(2) for relationship between OAB and WC (p < 0.001), and AUC was 0.73 cm(2) for relationship between OAB and NC (p = 0.004). Cut-off NC and WC values for OAB were determined as 35.25 cm and 98.5 cm, respectively. OAB with metabolic syndrome seems like more common in women than in those without. NC may be a novel indicator for OAB in selected female patients with MtS

Relations between second-trimester aneuploidy screening results and prediction of labour induction success in term pregnancies

We aimed to assess whether the second-trimester maternal serum markers could be used for the prediction of labour induction success. This prospective study enrolled women planned labour induction at term. Women were assigned to one of two groups: vaginal prostaglandin or balloon dilatation. All patients were evaluated for Bishop score, maternal serum oestriol, human chorionic gonadotropin and progesterone at the time of second-aneuploidy screening. The total successful rate for induction of labour was 63.9% in both groups. Maternal serum oestriol multiple of median (MoM) values were significantly lower among the caesarean section group compared to the vaginal delivery group (p < .001). A MoM value of 0.74 for oestriol was associated with a sensitivity of 75.9%, specificity of 41.0%, a positive predictive value of 76.6% and a negative predictive value of 58.0% for a successful induction of labour. Oestriol had a good performance in the prediction of successful induction of labour at term.IMPACT STATEMENT What is already known on this subject? Induction of labour is a common procedure undertaken whenever the benefits of prompt delivery outweigh the risks of expectant management. Previous studies have reported that a decreased progesterone/oestradiol ratio and increased maternal plasma oestriol levels are associated with successful labour. What the results of this study add? The results of this study showed that second-trimester oestriol multiple of median (MoM) value provide a significant contribution to the efforts of the prediction of successful induction of labour in term pregnancy, having a sensitivity of 69.8%, specificity of 92.4%, positive predictive value of 83.3% and negative predictive value of 82.5%. What the implications are of these findings for clinical practice and/or further research? This finding can be used as an additional method for prediction of labour induction as well as multiparity and Bishop score. This adds new valuable data to the literature which could be used for systematic reviews and for implementing guidelines and protocols on labour induction