Isolated fetal lymphatic malformation of the thigh: prenatal diagnosis and follow-up

Fetal lymphatic malformation can be found in different parts of the fetal body. It occurs most frequently in the nuchal and axillary region and less frequently in the abdomen or inguinal areas. Lymphatic malformation has been associated with fetal aneuploidy, hydrops fetalis, structural malformations, and intrauterine fetal death. A 31-year-old gravida 3, para 2 woman was admitted to our hospital at 22 weeks of gestation (confirmed by ultrasonographic examination). The fetus was alive, and had a mass derived from the left inguinal region extending to the anterior left leg with fluid-filled cavities about 3–5 cm in size. There was no evidence of intra-abdominal extension of the mass. Amniocentesis was performed. Fetal magnetic resonance imaging revealed a left inguinal cystic mass, which extended to the left thigh. Antenatal follow-up was uneventful. The mother gave birth at term with a cesarean section. Postnatal clinical examination and imaging examination confirmed the diagnosis of lymphatic malformation. Fetal lymphatic malformation carries a high risk of aneuploidy and fetal malformations. Patients diagnosed with lymphatic malformation in antenatal follow-up should be assessed in terms of coexistent anomalies. Fetal karyotyping should be done and the fetus should be monitored for fetal hydrop

Isolated fetal lymphatic malformation of the thigh: prenatal diagnosis and follow-up

Fetal lymphatic malformation can be found in different parts of the fetal body. It occurs most frequently in the nuchal and axillary region and less frequently in the abdomen or inguinal areas. Lymphatic malformation has been associated with fetal aneuploidy, hydrops fetalis, structural malformations, and intrauterine fetal death. A 31-year-old gravida 3, para 2 woman was admitted to our hospital at 22 weeks of gestation (confirmed by ultrasonographic examination). The fetus was alive, and had a mass derived from the left inguinal region extending to the anterior left leg with fluid-filled cavities about 3–5 cm in size. There was no evidence of intra-abdominal extension of the mass. Amniocentesis was performed. Fetal magnetic resonance imaging revealed a left inguinal cystic mass, which extended to the left thigh. Antenatal follow-up was uneventful. The mother gave birth at term with a cesarean section. Postnatal clinical examination and imaging examination confirmed the diagnosis of lymphatic malformation. Fetal lymphatic malformation carries a high risk of aneuploidy and fetal malformations. Patients diagnosed with lymphatic malformation in antenatal follow-up should be assessed in terms of coexistent anomalies. Fetal karyotyping should be done and the fetus should be monitored for fetal hydrop

The role of antioxidant activity in the prevention and treatment of infertility caused by cisplatin in rats

Kurt, Nezahat/0000-0002-1685-5332; AKSOY, Ayse Nur/0000-0002-3793-9797; AKSOY, Mehmet/0000-0003-0867-8660WOS: 000350267200009PubMed: 25632879Background/Aims:To investigate the importance of antioxidant activity in infertility caused by cisplatin in rats. Methods: Rats in cisplatin control (CG), Vitamin E+cisplatin (ECG), Vitamin C + cisplatin (CCG), Hippophae rhamnoides extract (HRE) + cisplatin (HRECG), and thiamine pyrophosphate (TPP) + cisplatin (TPPCG) groups were injected intraperitoneally (ip) with (100 mg/kg) Vitamin E, Vitamin C, HRE, and TPP, respectively. One hour later, ip cisplatin was administered (5 mg/kg), and then antioxidant medications were continued for 10 days. Cisplatin + Vitamin E (CEG-1), cisplatin + Vitamin C (CCG-1), cisplatin + HRE (CHREG-1), and cisplatin + TPP (TPPCG-1) rats received cisplatin (5 mg/kg, ip) and were kept for 10 days. At the end of that period, rats received antioxidant medications for 10 days. (n = 12, for each group). Six rats from each group were sacrificed. Ovaries were removed to measure malondialdehyde, total glutathione, glutathione S-transferase, and glutathione reductase levels. the remaining rats were kept in a suitable laboratory environment. Results: Cisplatin-induced oxidative stress was best prevented by HRE, Vitamin E, Vitamin C, and TPP, in that order. However, infertility caused by cisplatin was only prevented and treated by TPP. Conclusion: Oxidative stress is not a major component in the pathogenesis of cisplatin-associated infertility. (C) 2015 S. Karger AG, Base

C-reactive protein level and obesity as cardiovascular risk factors in polycystic ovary syndrome

Objective: To investigate the role of C-reactive protein(CRP) level elevation and obesity for the increased cardiovasculardisease risk in polycystic ovary syndrome(PCOS).Methods: A hundred and nine patients with PCOS and 30age matched healthy volunteers with regular menstrualcycle are involved in the study. PCOS group is furthersubdivided into three subgroups according to the bodymass index (BMI). Subgroups included 54 with BMI<25,22 with BMI 25-30, and 33 with BMI>30. Blood samplesfor glucose, insulin, uric acid, and CRP were collected inthe morning after overnight fasting (12 hours). Homeostasismodel assessment-insulin resistance (HOMA-IR)was calculated. Results: Fasting blood glucose, insulin,and HOMA-IR was significantly higher in PCOS group(p=0.02, p=0.01 and p=0.02). CRP level was higher insubgroup with BMI>30. High CRP level in PCOS wasfound to be independent from BMI (p<0.001). HOMA-IRand insulin level was higher in the subgroup with BMI>30.When compared with the control group high insulin levelwas the only to be statistically significant in obese PCOSpatients (p=0.005). HOMA-IR was higher in PCOS subgroupwith BMI>30 when compared with controls and thePCOS subgroup with BMI<25 (p<0.001, p= 0.003).Conclusion: Obesity, hyperinsulinemia, and high CRPlevels are seemed to be related and potentiating eachother in PCOS. Struggling with obesity is one of the mostimportant issues for preventive medicine.Key words: PCOS, CRP, obesity, cardiovascular ris

Contribution of spiral artery blood flow changes assessed by transvaginal color Doppler sonography for predicting endometrial pathologies

ive: To investigate the diagnostic value of blood flow measurements in spiral artery by transvaginal color Doppler sonography (CDS) in predicting endometrial pathologies.Methods: Ninety-seven patients presenting with abnormal uterine bleeding and requiring endometrial assessment were included in this prospective observational study. Endometrial thickness, structure and echogenicity were recorded. Pulsatility index (PI) and resistive index (RI) of the spiral artery were measured by transvaginal CDS. Endometrial sampling was performed for all subjects. Sonographic and hystopathologic findings were compared.Results: The histopathological diagnoses were as follows; 39 cases (40.2%) endometrial polyp, 9 cases (9.3%) endometrial hyperplasia, 10 cases (10.3) submucous myoma, 7 cases (7.2%) endometrium cancer, and 32 cases (33%) nonspecific findings. The spiral artery PI in endometrium cancer group was highly significantly lower than other groups (p<0.01). The spiral artery RI was also significantly lower in the patients with malignant histology (p<0.05). Conclusion: Endometrial pathologies are associated significantly with endometrial spiral artery Doppler changes.Key words: Spiral artery, Doppler ultrasonography, endometriu

A new marker for the prediction of mean platelet volume, placenta previa and placental invasion anomalies

Amaç: Bu çalışmanın amacı bazı tam kan say›m› parametreleri ile plasenta previa ve plasenta yapışma anomalileri arasındaki ilişkiyi değerlendirmektir. Yöntem: Bu çalışmada Eylül 2015 – Aral›k 2016 tarihleri arasında Mustafa Kemal Üniversitesi Kadın Hastalıkları ve Doğum Kliniği’ne başvuran 70 plasenta previa ve 70 kontrol olgusu retrospektif olarak tarandı. Hastaların sosyodemografik özellikleri, önceki sezaryen sayıları kaydedildi. Sezaryen öncesi tüm olguların preoperatif lenfosit sayısı, nötrofil sayısı, trombosit sayısı, ortalama trombosit hacmi (MPV), nötrofil/lenfosit oranı, trombosit/lenfosit oran›, hemoglobin ve hematokrit değerleri kaydedildi. Bu parametrelerin plasenta previa ve plasenta yapışma anomalilerini öngörüp öngöremeyeceği analiz edildi. Bulgular: Her iki grupta olguların sosyodemografik (yaş, gravida, parite, yaşayan, geçirilmiş sezaryen sayısı) verileri açısından fark yoktu. Doğumdaki gestasyonel yaş ve doğum ağrıları plasenta previa grubunda anlamlı düflük bulundu. Postoperatif hemoglobin ve hematokrit değerleri previa grubunda anlamlı düflük idi. Tam kan parametrelerine bakıldığında previa grubunda MPV anlamlı düflük bulundu (p=0.042). Previa grubundaki sezaryen histerektomi uygulanan 27 olgunun 24 tanesinde histopatolojik olarak plasenta invazyon anomalisi konfirme edildi. ınvazyon anomalisi olan grup ile kontrol grubu karşılandığında MPV yine anlamlı düşük bulundu (p=0.047). Sonuç: Sonografik görüntülere ek olarak basit kan sayımı parametreleri plasenta previa ve özellikle de plasenta invazyon anomalilerini konfirme etmek için kullanılabilir. Bu parametreler içinde MPV en güçlü prediktör gibi görünmektedir.Objective: The aim of this study is to evaluate the relationship between some parameters of complete blood count and placenta previa and placental invasion anomalies. Methods: In this study, 70 cases with placenta previa and 70 control cases who admitted to the Department of Obstetrics and Gynecology of Mustafa Kemal University between September 2015 and December 2016 were reviewed retrospectively. The sociodemographic data and the numbers of previous cesarean section of the patients were recorded. Before the cesarean section, the counts of preoperative lymphocyte, neutrophil and platelet, mean platelet volume (MPV), neutrophil/lymphocyte rate, platelet/lymphocyte rate, and hemoglobin and hematocrit values were recorded. It was analyzed whether these parameters were able to predict placenta previa and placental invasion anomalies or not. Results: There was no difference between two groups in terms of sociodemographic (age, gravida, parity, living fetus and the number of previous cesarean section) data. The week of gestation during delivery and birth weight were significantly low in placenta previa group. Postoperative hemoglobin and hematocrit values were also significantly low in previa group. Considering the complete blood parameters, MPV was significantly low in previa group (p=0.042). Placental invasion anomaly was confirmed histopathologically in 24 of 27 cases in previa group who underwent cesarean hysterectomy. When the group with invasion anomaly was compared to the control group, MPV was also significantly low (p=0.047). Conclusion: In addition to the ultrasound images, simple blood count parameters can be used to confirm placenta previa and placental invasion anomalies in particular. Among these parameters, MPV seems to be the most potent predictor

Cesarean birth after vaginal delivery : a survey in healthcare proffesionals

Amaç: Çalışmadaki amacımız sağlık çalışanlarının sezaryen sonrası vajinal doğum hakkında bilgi düzeylerini ölçmek.Gereç ve Yöntemler: Tanımlayıcı tipteki bu çalışmada Mustafa Kemal Üniversitesi Tıp Fakültesinde görev yapan 100 sağlık personeline randomize anket formu dağıtılmış ve yanıtlanması istenmiştir. Anket formu Amerikan Obstetri ve Jinekoloji Derneği (ACOG) tarafından yayınlanmış SSVD hakkında hasta bilgilendirme formuna istinaden hazırlanmıştır.Bulgular: Çalışmaya dahil edilen 87 sağlık çalışanından'Sezaryen sonrası vajinal doğum yapılabilir mi?' sorusuna 63 (%72,4) kişi evet yanıtını verirken 24 (%27,6) kişi hayır cevabını verdi. Aynı sorunun cevabına meslek gruplarına göre bakıldığında ise gruplar arasında fark izlenmedi (p=0,3). Sezaryen sonrası vajinal doğuma evet cevabı veren katılımcılara SSVD yapılabilmesi için gerekli önceki doğuma ait kesi şekli ve sezaryen sayısı sorulduğunda 21( %33,3) kişi bilmiyorum, 30 (%47,6) kişi transvers ve 12 (%19) kişi vertikal olması gerektiğini belirtti. Aynı grubun SSVD için gerekli minimum geçirilmiş sezaryen sayısına cevabı değerlendirildiğinde 25 (%39,7) kişi bilmiyorum, 13 (%20,6) kişi 1, 13 (%20,6) kişi 2, 11 (%17,5) kişi 3 ve 1 (%1,6) kişi 4 olarak kaydedildi. 'Sezaryen sonrası normal doğum yapmanın riskleri nelerdir?' sorusuna katılımcıların cevaplarının dağılımları 29(%46) bilmiyorum, 30(%47,6) rüptür ve 4 (%6,3) yok olarak kaydedildi.Sonuç: Sonuç olarak özellikle geçirilmiş sezaryen olan hastalarda SSVD'nin bir seçenek olduğu günümüzde, SSVD'nin mümkün olduğu çoğu sağlık çalışanı tarafından bilinse de, şartları ve riskleri konusunda sağlık çalışanlarının yeterince bilgi sahibi olmadığı görüldü. Bu konuda uygun eğitim ve bilgilendirmenin sağlanması artan sezaryen oranlarının kontrolünde yardımcı olabilirAim: The aim of this study was to ascertain the knowledge for Vaginal Birth after Cesarian Section (VBAC) in people who are working in hospitalMaterial And Methods: This descriptive study was done in Mustafa Kemal University, Medical Faculty Hospital and a total of 100 surveys were randomized distrubuted. The surveys were prepared by using the patient aknowledgement form of American College of Obstetricians and Gynecologists (ACOG). Results: Eighty seven surveys were returned and evaluated. ‘ Is VBAC possible ?’ question was responded by 63 (72.4%) health care providers as ‘yes’ and 24(27.6%) as ‘no’. There were no difference between occupation groups for this question (p=0.3).’What should be the uterine incision scar in previous section to achieve VBAC?’ was asked to persons that said ‘yes’ for former question. Twenty one ( 33.3%) of them responded as ‘I don’t know’ , 30 (47.6%) as ‘transvers’ and 12 (19%) as ‘vertical’.Same group also responded of minimum previous cesarian section number for VBAC 25 (39.7%) as ‘I don’t know’, 13 (20.6%) people as 1, 13 (20.6%) as 2, 11 (17.5%) people as 3 and 1 (1.6%) person as 4. ‘What is the risk of VBAC?’ was asked and responded as ‘I don’t know’ from 29 (%46) people, as ‘uterine rupture’ from 30(%47,6) people and ‘no risk’ from 4 (%6,3) people.Conclusion: In conclusion even though VBAC is considered as an option in most of health care providers they have not sufficient knowledge about conditon and risks of VBAC. Informing of this group may help to decrease cesarian rate in the populatio