A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy

Mucinous cystadenoma (MC) of the ovary is an unilateral, multilocular cystic benign epithelial tumor. Supposed to be hormone responsive, MC reaches huge sizes during pregnancy. Aortocaval compression is common during pregnancy, especially when the pregnant woman is in the supine position. However, the compression recovers with a change in position. The authors report the first case of a huge mucinous cystadenoma of the ovary complicating pregnancy and causing virilization, premature labor, and persistent supine hypotensive syndrom

Extended High Frequency Audiometry in Polycystic Ovary Syndrome

Objective. Polycystic ovarian syndrome (PCOS) is the most common endocrine disorder affecting 5–10% of women in reproductive age. Insulin resistance, dyslipidemia, glucose intolerance, hypertension, and obesity are metabolic disorders accompanying the syndrome. PCOS is a chronic proinflammatory state and the disease is associated with endothelial dysfunction. In diseases with endothelial damage, hearing in high frequencies are mostly effected in early stages. We evaluated extended high frequency hearing loss in PCOS patients. Material Methods. Forty women diagnosed as PCOS and 25 healthy controls were included in this study. Age and BMI of PCOS and control groups were comparable. Each subject was tested with low (250–2000 Hz), high (4000–8000 Hz), and extended high frequency audiometry (8000–20000). Hormonal and biochemical values including LH, LH/FSH, testosterone, fasting glucose, fasting insulin, HOMA-I, and CRP were calculated. Results. PCOS patients showed high levels of LH, LH/FSH, testosterone, fasting insulin, glucose, HOMA-I, and CRP levels. The hearing thresholds of the groups were similar at frequencies of 250, 500, 1000, 2000, and 4000 Hz; statistically significant difference was observed in 8000–14000 Hz in PCOS group compared to control group. Conclusion. PCOS patients have hearing impairment especially in extended high frequencies. Further studies are needed to help elucidate the mechanism behind hearing impairment in association with PCOS

A huge ovarian mucinous cystadenoma causing virilization, preterm labor, and persistent supine hypotensive syndrome during pregnancy

Mucinous cystadenoma (MC) of the ovary is an unilateral, multilocular cystic benign epithelial tumor. Supposed to be hormone responsive, MC reaches huge sizes during pregnancy. Aortocaval compression is common during pregnancy, especially when the pregnant woman is in the supine position. However, the compression recovers with a change in position. The authors report the first case of a huge mucinous cystadenoma of the ovary complicating pregnancy and causing virilization, premature labor, and persistent supine hypotensive syndrom

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

Predictive value of serum and follicular fluid chemerin concentrations during assisted reproductive cycles in women with polycystic ovary syndrome

Aims To evaluate the effect of serum and follicular fluid (ff) Chemerin levels on Assisted Reproductive Technology (ART) outcomes in lean patients with PCOS. Materials and methods The study included 76 infertile reproductive aged women, between 21-35 years who underwent intracytoplasmic sperm injection (ICSI) procedure. Serum and ff Chemerin levels were evaluated. Fertilization and clinical pregnancy rate were compared between the groups. Results Serum (13.32 ng/ml versus 29.82 ng/ml) and ff chemerin (35.90 ng/ml versus 87.60 ng/ml) levels were significantly higher in lean PCOS patients compared to controls (p < .01). Serum (24.5 ng/ml versus 18.4 ng/ml) and ff chemerin (71.7 ng/ml versus 52.8 ng/ml) levels were higher in subjects without clinical pregnancy compared to the subjects with clinical pregnancy (p < .05). A cutoff value of 36.2 ng/ml in the ff chemerin level was found to estimate clinical pregnancy with 83% sensitivity and 52% specificity (Area under the curve 0.66; 95% confidence interval, 0.53-0.79). A cutoff value of 12.7 ng/ml in the serum chemerin level was found to estimate clinical pregnancy with 91% sensitivity and 49% specificity (Area under the curve 0.65; 95% confidence interval, 0.52-0.78). Clinical pregnancy rates were significantly higher in group with lower serum chemerin levels (80.0% versus 30.4%, p < .001). High serum chemerin levels are associated with failure of assisted reproduction [OR:0.1(95% CI, 0.03-0.4, p < .001)]. Conclusions PCOS is associated with higher serum and ff chemerin levels and high serum chemerin level is a risk factor for failed ART cycle

Protective Effect of Ursodeoxycholic Acid in Experimental Endometriosis Induced Rat Model

Background: Considering the presence of an inflammatory process in the pathogenesis of endometriosis, anti-inflammatory agents could be an alternative option. The study aimed to elucidate the curative efficacy of Ursodeoxycholic acid (UDCA) on the experimental rat model of endometriosis. Methods: This experimental research included a total of 60 mature female Wistar albino rats (250 ± 50 g) with no pregnancy. They were grouped as Standard (n: 20), Laparoscopic Pretreatment (n: 10), Laparoscopic Posttreatment (Sham) (n: 10), UDCA-Pretreatment (n: 10) and UDCA-Posttreatment (n: 10). Transforming growth factor β1 (TGF-β1), matrix metallo-proteinases-2 (MMP-2), Tissue inhibitor of metalloproteinase-1 (TIMP-1), Tumor necrosis factor-α (TNF-α) were analyzed. Results: In the UDCA post-treatment group, endometriotic focal volume (43.3 ± 24.04 mm3) was lower than the pre-treatment values (165.7 ± 21.7 mm3) (p = 0.005). There was no significant change UDCA group before and after the treatment in terms of MMP-2, TGF-β1, TIMP-1 and TNF-α levels (p > 0.05). Comparing the posttreatment values of the Sham srugery group and the UDCA group, while the endometriotic focal volume was 251 ± 51 mm3 in the Sham group, it decreased to 43.3 ± 24 mm3 in the UDCA (p < 0.0001). Histological scoring decreased from 2.6 ± 0.51 to 1 ± 0.81 after the treatment (p = 0.001). Conclusions: The pre-treatment laparotomy group exhibited elevated TNF-α levels, indicating an inflammatory response. UDCA treatment reduced endometriotic focal volume and histological scoring, indicating a potential therapeutic benefit

Diagnosis and clinical approach in primary ovarian ectopic pregnancy: A case report and review of the literature

Primary ovarian pregnancy is a rare type of extrauterinepregnancy with an incidence of 0.5-1% of all ectopic pregnancies.The incidence ranges from 1/40000 to 1/7000deliveries. We report a primary ovarian pregnancy in aspontaneus conception cycle in a 40-year-old womanwith no predisposing factor. The patient was admitted tothe emergency clinic with signs and symptoms of acuteabdomen with heamoperitoneum , in a preshock state. Anemergency laparotomy and wedge resection of the ovarywas performed. Histopathologic examination showedchorion villi embedded in the ovarian tissue in multiplesections in different areas of the material. This is a discussionabout this rare phenomenon, its ethiology, differentialand clinical diagnosis and a review of literature.Key words: Ectopic, pregnancy, ovar