Predictors of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy

Objectives: Our objective was to evaluate in our clinic the perinatal outcomes of patients diagnosed with ICP based on pre-treatment maternal serum bile acid levels, attempt to identify the risk group and review the literature in light of this information.  Material and methods: In total, 370 patients diagnosed with ICP were included in the study, divided into two groups based on the fasting total serum bile acid level before UDCA (Group 1: 10 ≥ 40 μmol/L, and Group 2: ≥ 40 μmol/L). The groups were examined for clinical characteristics and pregnancy outcomes.  Results: It was found that preterm delivery and neonatal intensive care need increased at a serum bile acid cut-off value of 34 μmol/L. Regardless of serum bile acid, significantly higher rates of meconium-stained amniotic fluid and foetal distress were observed in patients whose diagnoses were made before 34 weeks of gestation.  Conclusions: Foetal complications over 40 μmol/L of serum bile acid were significantly increased. However, slightly lower levels cut-off values (34 μmol/L) were obtained in terms of preterm birth and neonatal intensive care need. The incidence of meconium-stained amniotic fluid and foetal distress was higher in patients whose diagnosis were made before 34 weeks of gestation.

Gebelerde asemptomatik bakteriüri sıklı?ının araştırılması

The aims of this study were to establish and compare asymptomatic bacteriuria (ASB) in pregnant and non-pregnant women, to determine the agents of ASB in both groups and to investigate antibiotic sensitivity to agents of ASB. 323 pregnant and 75 non-pregnant women who were admitted to Erbaa State Hospital, Department of Obstetric and Gynecology Unit were included to the study. ASB was diagnosed in 22 pregnant (6.8%) and 4 (5.3%) non-pregnant women. It was not statistically significant. All pregnant women with ASB were treated according to antibiotic sensitivity of bacteria. To decrease acute pyelonephritis in pregnant women and to avoid maternal and fetal risks ascociated with ASB (premature delivery, premature rupture of membrane, delivery of low-birth weight fetus), all pregnant women should be investigated about ASB and all pregnant women with ASB should be treated with appropriate antibiotics. © 2012 Düzce Medical Journal

Predictors of adverse perinatal outcomes in intrahepatic cholestasis of pregnancy

WOS: 000466963400008PubMed: 31059115Objectives: Our objective was to evaluate in our clinic the perinatal outcomes of patients diagnosed with ICP based on pre-treatment maternal serum bile acid levels, attempt to identify the risk group and review the literature in light of this information. Material and methods: In total, 370 patients diagnosed with ICP were included in the study, divided into two groups based on the fasting total serum bile acid level before UDCA (Group 1: 10 >= 40 mu mol/L, and Group 2: >= 40 mu mol/L). The groups were examined for clinical characteristics and pregnancy outcomes. Results: It was found that preterm delivery and neonatal intensive care need increased at a serum bile acid cut-off value of 34 mu mol/L. Regardless of serum bile acid, significantly higher rates of meconium-stained amniotic fluid and foetal distress were observed in patients whose diagnoses were made before 34 weeks of gestation. Conclusions: Foetal complications over 40 mu mol/L of serum bile acid were significantly increased. However, slightly lower levels cut-off values (34 mu mol/L) were obtained in terms of preterm birth and neonatal intensive care need. The incidence of meconium-stained amniotic fluid and foetal distress was higher in patients whose diagnosis were made before 34 weeks of gestation

The investigation of frequency of asymptomatic bacteriuria in pregnants

Bu çalışmada gebelerde ve gebe olmayan kadınlarda asemptomatik bakteriüri (ASB) sıklığının araştırılması ve karşılaştırılması, her iki grupta ASB etkenlerinin tesbit edilmesi ve ASB etkenlerinin antibiyotik duyarlılıklarının belirlenmesi amaçlanmıştır. Bu amaçla Erbaa Devlet Hastanesi Kadın Hastalıkları ve Doğum polikliniğine başvuran 323 gebe ve 75 gebe olmayan kadın çalışma kapsamına alınmıştır. Gebelerin 22’sinde (%6,8) gebe olmayanların ise 4’ünde (%5,3) ASB saptanmıştır. Aralarında istatistiki bir fark yoktur. ASB saptanan gebeler bakterilerin antibiyotik duyarlıklıklarına göre tedavi edilmiştir. Akut pyelonefrit sıklığını azaltmak ve ASB ile ilişkili maternal ve fetal komplikasyonları (erken doğum, erken membran rüptürü, düşük doğum ağırlıklı bebek doğurma) önlemek için, gebelerde ASB araştırması yapılmalı ve ASB saptanan olgular uygun antibiyotiklerle tedavi edilmelidir.The aims of this study were to establish and compare asymptomatic bacteriuria (ASB) in pregnant and non-pregnant women, to determine the agents of ASB in both groups and to investigate antibiotic sensitivity to agents of ASB. 323 pregnant and 75 non-pregnant women who were admitted to Erbaa State Hospital, Department of Obstetric and Gynecology Unit were included to the study. ASB was diagnosed in 22 pregnant (6.8%) and 4 (5.3%) non-pregnant women. It was not statistically significant. All pregnant women with ASB were treated according to antibiotic sensitivity of bacteria. To decrease acute pyelonephritis in pregnant women and to avoid maternal and fetal risks ascociated with ASB (premature delivery, premature rupture of membrane, delivery of low-birth weight fetus), all pregnant women should be investigated about ASB and all pregnant women with ASB should be treated with appropriate antibiotics

How Do Serum Zonulin Levels Change in Gestational Diabetes Mellitus, Pregnancy Cholestasis, and the Coexistence of Both Diseases?

We investigated the question of how serum zonulin levels change in intrahepatic cholestasis of pregnancy (ICP) and gestational diabetes mellitus (GDM) and, in the case of the coexistence of ICP and GDM, evaluated the eventual increase in zonulin plasmatic levels. Participants were enrolled for the study between 25 February 2021 and 20 August 2021. The prospective case-control study included: group 1 of 95 pregnant women diagnosed with ICP; group 2 of 110 pregnant women diagnosed with GDM; group 3 of 16 women diagnosed with both GDM and ICP; group 4 of 136 healthy pregnant women as the control group. The groups were compared in terms of age, body mass index (BMI), gravidity, parity, gestational week of delivery, plasma zonulin levels, delivery type, birth weight, first- and fifth-minute APGAR scores, newborn intensive care unit (NICU) admission, and meconium staining of amniotic fluid parameters. The results suggested that the plasma zonulin levels of ICP (group 1), GDM (group 2), and GDM with ICP (group 3) patients were higher than those of the healthy pregnant women of group 4 (p < 0.001). Among the patient groups, the highest median plasma zonulin levels were found in group 3 (110.33 ng/mL). Zonulin levels were also associated with the severity of ICP and adverse pregnancy outcomes. High serum zonulin levels were related to GDM, ICP, and adverse perinatal outcomes. The coexistence of GDM and ICP led to higher serum zonulin concentrations

Unraveling the Puzzle: Oocyte Maturation Abnormalities (OMAS)

Oocyte maturation abnormalities (OMAS) are a poorly understood area of reproductive medicine. Much remains to be understood about how OMAS occur. However, current knowledge has provided some insight into the mechanistic and genetic origins of this syndrome. In this study, current classifications of OMAS syndromes are discussed and areas of inadequacy are highlighted. We explain why empty follicle syndrome, dysmorphic oocytes, some types of premature ovarian insufficiency and resistant ovary syndrome can cause OMAS. We discuss live births in different types of OMAS and when subjects can be offered treatment with autologous oocytes. As such, we present this review of the mechanism and understanding of OMAS to better lead the clinician in understanding this difficult-to-treat diagnosis

A Comparative Multicentric Study on Serosal and Endometrial Myomectomy During Cesarean Section: Surgical Outcomes

Tinelli, Andrea/0000-0001-8426-8490; GULER, OGUZ/0000-0001-7756-4267; erol, onur/0000-0002-7411-1200WOS: 000514513400001PubMed: 32064967Objective: This multi-center study aims to determine the efficiency and safety of endometrial myomectomy (EM) for the removal of uterine fibroids during cesarean section (CS). Methods: Retrospective review of 360 women diagnosed for fibroids during pregnancy. They all delivered by CS between 2014 and 2019. The study groups included 118 women who only underwent EM, 120 women who only had subserosal myomectomy by traditional technique and 122 women with fibroids who decided to avoid cesarean myomectomy, as control group. They were analyzed and compared the surgical outcomes. Results: The EM, subserosal myomectomy and control groups were statistically (p > 0.05) similar for to age, body mass index (BMI), gravidity, parity, gestational age at delivery, indications for CS, number of excised fibroids, size of the largest myoma. Postoperative hemoglobin values and ? (?) hemoglobin concentrations were lower in SM group (10.39gr/dl vs 9.98 gr/dl vs 10.19 - 1.44 gr/dl vs 1.90 gr/dl vs 1.35; p = 0.047, p = 0.021; respectively) Hybrid fibroids were significantly more frequent in the EM group than subserosal myomectomy and control groups (respectively, 33.1% vs 23.3% vs 27.0%, p = 0.002). Surgery time was significantly longer in the subserosal myomectomy group than EM and control groups (respectively, 46.53 min vs 37.88 min vs 33.86 min, p = 0.001). Myomectomy took significantly longer time in the subserosal myomectomy than EM group (13.75 min vs 8.17 min, p = 0.001). Conclusions: Endometrial myomectomy is a feasible choice for treatment of fibroids during CS, and, basing on our results could be an alternative to traditional cesarean subserosal myomectomy